WorldWideScience

Sample records for partially supported practical

  1. 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.

  2. 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

  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-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.

  5. 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.

  6. 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

  7. 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.

  8. 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

  9. 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

  10. 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 ...

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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

  18. 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.

  19. 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.

  20. 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.

  1. 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.…

  2. [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.

  3. 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.

  4. 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…

  5. 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…

  6. 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.

  7. 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

  8. 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

  9. 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.

  10. 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.

  11. 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...

  12. 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 ...

  13. [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.

  14. 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.

  15. 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.

  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. 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.

  18. 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

  19. 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.

  20. 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.

  1. 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....

  2. 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…

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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

  8. 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

  9. 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.

  10. 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.

  11. 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...

  12. 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.

  13. 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.

  14. 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:

  15. 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.

  16. 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…

  17. 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,…

  18. [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.

  19. 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.

  20. 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.

  1. 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.

  2. 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…

  3. 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.

  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. 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.

  6. 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.

  7. 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.

  8. 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.)

  9. [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.

  10. 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.

  11. 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

  12. 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.

  13. 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.

  14. 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…

  15. 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.

  16. 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.

  17. 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.

  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. 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.

  20. 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.

  1. 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.

  2. 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.

  3. The theory and measurement of partial discharge transients

    DEFF Research Database (Denmark)

    Pedersen, Aage; Crichton, George C; McAllister, Iain Wilson

    1991-01-01

    A theoretical approach to partial discharge transients is presented. This approach is based on the relationship between the charge induced on the measurement electrode by those created in the interelectrode volume during partial discharge activity. The primary sources for these induced charges ar...... electrode systems of practical interest is illustrated. A discussion of the salient features and practical aspects of the theory is included...

  4. 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.

  5. 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.

  6. 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

  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. [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

  9. 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...

  10. 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.

  11. 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...

  12. 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....

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. Parsing partial molar volumes of small molecules: a molecular dynamics study.

    Science.gov (United States)

    Patel, Nisha; Dubins, David N; Pomès, Régis; Chalikian, Tigran V

    2011-04-28

    We used molecular dynamics (MD) simulations in conjunction with the Kirkwood-Buff theory to compute the partial molar volumes for a number of small solutes of various chemical natures. We repeated our computations using modified pair potentials, first, in the absence of the Coulombic term and, second, in the absence of the Coulombic and the attractive Lennard-Jones terms. Comparison of our results with experimental data and the volumetric results of Monte Carlo simulation with hard sphere potentials and scaled particle theory-based computations led us to conclude that, for small solutes, the partial molar volume computed with the Lennard-Jones potential in the absence of the Coulombic term nearly coincides with the cavity volume. On the other hand, MD simulations carried out with the pair interaction potentials containing only the repulsive Lennard-Jones term produce unrealistically large partial molar volumes of solutes that are close to their excluded volumes. Our simulation results are in good agreement with the reported schemes for parsing partial molar volume data on small solutes. In particular, our determined interaction volumes() and the thickness of the thermal volume for individual compounds are in good agreement with empirical estimates. This work is the first computational study that supports and lends credence to the practical algorithms of parsing partial molar volume data that are currently in use for molecular interpretations of volumetric data.

  3. 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.

  4. Clarifying the Effects of Human Resource Diversity Management Practices on Organizational Citizenship Behavior: The Mediating Role of Diversity Receptiveness

    Directory of Open Access Journals (Sweden)

    Ahmad Nizan Mat Noor

    2014-06-01

    Full Text Available The aim of this study is to scrutinize the impact of employees’ perceptions of their organization’s human resource diversity management (HRDM practices on their organizational citizenship behavior (OCB level. The influence of diversity receptiveness as a mediator in the proposed relationship is also examined. Survey data were gathered from operational employees attached to large hotel in Malaysia. 430 usable questionnaires were used in statistical analyses. The results indicated that the hypothesized linkage between HRDM practices and diversity receptiveness as well as between HRDM practices and OCB were partially supported. The mediating role of diversity receptiveness in the relationship was also partially supported. Implications and limitations of the findings are specified. Finally, directions for future research are suggested.

  5. 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. .

  6. 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.

  7. 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.

  8. 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 ...

  9. 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

  10. 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

  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. 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.

  13. 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

  14. Image Reconstruction For Bioluminescence Tomography From Partial Measurement

    OpenAIRE

    Jiang, M.; Zhou, T.; Cheng, J. T.; Cong, W. X.; Wang, Ge

    2007-01-01

    The bioluminescence tomography is a novel molecular imaging technology for small animal studies. Known reconstruction methods require the completely measured data on the external surface, although only partially measured data is available in practice. In this work, we formulate a mathematical model for BLT from partial data and generalize our previous results on the solution uniqueness to the partial data case. Then we extend two of our reconstruction methods for BLT to this case. The first m...

  15. [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...

  16. 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

  17. [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.

  18. 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.

  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. 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

  1. 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

  2. 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.

  3. 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)

  4. 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

  5. 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.

  6. Flexible Thermoplastic Denture Base Materials for Aesthetical Removable Partial Denture Framework

    OpenAIRE

    Singh, Kunwarjeet; Aeran, Himanshu; Kumar, Narender; Gupta, Nidhi

    2013-01-01

    Conventional fixed partial dentures, implant supported Fixed Partial Dentures (FDPs) and removable partial dentures are the most common treatment modalities for the aesthetic and functional rehabilitation of partially edentulous patients. Although implants and FDP have certain advantages over removable partial dentures, in some cases, removable partial dentures may be the only choice which is available. Removable cast partial dentures are used as definitive removable prostheses when indicated...

  7. 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…

  8. Partial Safety Factors for Rubble Mound Breakwaters

    DEFF Research Database (Denmark)

    Sørensen, John Dalsgaard; Burcharth, H. F.; Christiani, E.

    1995-01-01

    On the basis of the failure modes formulated in the various subtasks calibration of partial safety factors are described in this paper. The partial safety factors can be used to design breakwaters under quite different design conditions, namely probabilities of failure from 0.01 to 0.4, design...... lifetimes from 20 to 100 years and different qualities of wave data. A code of practice where safety is taken into account using partial safety factors is called a level I code. The partial safety factors are calibrated using First Order Reliability Methods (FORM, see Madsen et al. [1]) where...... in section 3. First Order Reliability Methods are described in section 4, and in section 5 it is shown how partial safety factors can be introduced and calibrated. The format of a code for design and analysis of rubble mound breakwaters is discussed in section 6. The mathematical formulation of the limit...

  9. Memoization in Type-Directed Partial Evaluation

    DEFF Research Database (Denmark)

    Balat, Vincent; Danvy, Olivier

    2002-01-01

    We use a code generator—type-directed partial evaluation— to verify conversions between isomorphic types, or more precisely to verify that a composite function is the identity function at some complicated type. A typed functional language such as ML provides a natural support to express the funct......We use a code generator—type-directed partial evaluation— to verify conversions between isomorphic types, or more precisely to verify that a composite function is the identity function at some complicated type. A typed functional language such as ML provides a natural support to express...... originate in the handling of sums, which uses delimited continuations. We successfully eliminate these redundancies by extending type-directed partial evaluation with memoization capabilities. The result only works for pure functional programs, but it provides an unexpected use of code generation...... and it yields orders-of-magnitude improvements both in time and in space for type isomorphisms. Basic Research in Computer Science (www. brics. dk), funded by the Danish National Research Foundation....

  10. 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.

  11. 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...

  12. 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

  13. 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.

  14. 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.

  15. Clinical evaluation of failures in removable partial dentures.

    Science.gov (United States)

    Jorge, Janaina H; Quishida, Cristiane C C; Vergani, Carlos E; Machado, Ana L; Pavarina, Ana C; Giampaolo, Eunice T

    2012-01-01

    The aim of this clinical study was to evaluate the effects of removable partial dentures on the support tissues and changes occurring in lower tooth-supported and bilateral distal-extension dentures, 5 years after placement. The study involved analysis of a total of 53 patients who received prosthetic treatment for removable partial dentures. The patients were divided into two groups. In group 1, the patients had a completely edentulous maxilla and an edentulous area with natural teeth remaining in both the anterior and posterior regions. In group 2, the patients had a completely edentulous maxilla and partially edentulous mandible with preserved anterior teeth. Tooth mobility, prevalence of caries, fracture of the abutment teeth, fracture and/or deformation of the removable partial denture components and stability of the denture base were evaluated. The use of a removable partial denture increased tooth mobility, reduced the prevalence of caries, and did not cause loss or fracture of the abutments or damage to their components, when compared with the baseline. It was concluded that there was no difference between the groups as evaluated in terms of tooth mobility, prevalence of caries, loss and fracture of the abutments or damage to the components of the removable partial denture.

  16. 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.

  17. CIRCUIT IMPLEMENTATION OF VHDL-DESCRIPTIONS OF SYSTEMS OF PARTIAL BOOLEAN FUNCTIONS

    Directory of Open Access Journals (Sweden)

    P. N. Bibilo

    2016-01-01

    Full Text Available Method for description of incompletely specified (partial Boolean functions in VHDL is proposed. Examples of synthesized VHDL models of partial Boolean functions are presented; and the results of experiments on circuit implementation of VHDL descriptions of systems of partial functions. The realizability of original partial functions in logical circuits was verified by formal verification. The results of the experiments show that the preliminary minimization in DNF class and in the class of BDD representations for pseudo-random systems of completely specified functions does not improve practically (and in the case of BDD sometimes worsens the results of the subsequent synthesis in the basis of FPGA unlike the significant efficiency of these procedures for the synthesis of benchmark circuits taken from the practice of the design.

  18. 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

  19. 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.

  20. 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.

  1. Factors related to coping strategies during Japanese physical therapy students' clinical practice.

    Science.gov (United States)

    Higuchi, Daisuke; Echigo, Ayumi

    2017-08-01

    [Purpose] This study aimed to identify social skills and support that are related to the coping strategies Janpanese physical therapy students use during their clinical practice. [Subjects and Methods] Third-year students who were finished with their clinical practice participated. Self-administered questionnaires were used, including the daily life skill scale, social support scale, and tri-axial coping scale. Spearman's partial correlation coefficients were calculated between social skills, support of daily living, and coping strategies used during the clinical practice, while controlling for gender. [Results] A total of 56 completed questionnaires (median of age: 21 years; 27 males). Social skills during personal situations-knowledge summarization, self-esteem, and positive thinking-were significantly, positively correlated with planning and affirmative interpreting strategies to approach stressors regarding clinical practice, and negatively related to giving up strategies to avoid stressors. Intimacy, leadership, and empathy (social skills during interpersonal situations) were significantly, positively correlated with the following responses to approach stressors: catharsis, information gathering, and affirmative interpreting. Moreover, emotional/companionship social support was significantly, positively correlated with all avoidant coping strategies. [Conclusion] Japanese physical therapy students who had low personal and interpersonal social skills and excess emotional/companionship support in daily life tend to select avoidance, not approach, coping strategies during clinical practice.

  2. 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.

  3. Mediating role of psychological well-being in the relationship between organizational support and nurses' outcomes: A cross-sectional study.

    Science.gov (United States)

    Pahlevan Sharif, Saeed; Ahadzadeh, Ashraf Sadat; Sharif Nia, Hamid

    2018-04-01

    To examine the relationship between organizational support for nursing practice and nurse-assessed quality of care and nurses' job satisfaction in hospital settings and to investigate the mediating role of psychological well-being in the aforementioned relationships. There has been growing concern about quality of care in healthcare organizations. The past research has documented the effect of nurse practice environment on nurses' quality of care and job satisfaction. However, little is known about the underlying mechanism behind these associations. A cross-sectional survey was undertaken. Data were collected from two large public hospitals in Iran between February - March 2017. A sample of 345 nurses participated in the study. Data were analysed using descriptive statistics and partial least squared-structural equation modelling. The results showed that nurses' perception of organizational support was related to their quality of care, job satisfaction and psychological well-being. Also, there was a positive relationship between nurses' psychological well-being and their quality of care and job satisfaction. Moreover, psychological well-being partially mediated the relationship between organizational support with nurse-assessed quality of care and nurses' job satisfaction. The findings suggest that organizational support for nursing practice and psychological well-being are two factors that contribute to caring behaviour of nurses and their job satisfaction. Also, positively perceived organizational support generates favourable psychological well-being which in turn enhances nurses' quality of care and job satisfaction. The findings highlight the importance of establishing a supportive nurse practice environment and paying attention to the nurses' psychological well-being in healthcare sectors. © 2017 John Wiley & Sons Ltd.

  4. 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...

  5. 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.

  6. A partial grid for a nuclear reactor fuel assembly

    International Nuclear Information System (INIS)

    Demario, E.E.

    1985-01-01

    The invention relates to a nuclear-reactor fuel assembly including fuel-rod supporting transverse grids. The fuel assembly includes at least one additional transverse grid which is disposed between two fuel-rod supporting grids and consists of at least one partial grid structure extending across only a portion of the fuel assembly and having fuel rods and control-rod guide thimbles of only said portion extending therethrough. The partial grid structure includes means for providing lateral support of the fuel rods and/or means for laterally deflecting coolant flow, and it is formed of inter-leaved inner straps and border straps, the interleaved inner straps preferably being of substantially smaller height than the border straps to reduce the amount of material capable of parasitically absorbing neutrons. The additional transverse grid may comprise several partial grid structures associated with different groups of fuel rods of the fuel assembly

  7. 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…

  8. 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…

  9. 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.

  10. 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.

  11. 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

  12. 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

  13. 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

  14. 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

  15. 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.

  16. A fast exact sequential algorithm for the partial digest problem.

    Science.gov (United States)

    Abbas, Mostafa M; Bahig, Hazem M

    2016-12-22

    Restriction site analysis involves determining the locations of restriction sites after the process of digestion by reconstructing their positions based on the lengths of the cut DNA. Using different reaction times with a single enzyme to cut DNA is a technique known as a partial digestion. Determining the exact locations of restriction sites following a partial digestion is challenging due to the computational time required even with the best known practical algorithm. In this paper, we introduce an efficient algorithm to find the exact solution for the partial digest problem. The algorithm is able to find all possible solutions for the input and works by traversing the solution tree with a breadth-first search in two stages and deleting all repeated subproblems. Two types of simulated data, random and Zhang, are used to measure the efficiency of the algorithm. We also apply the algorithm to real data for the Luciferase gene and the E. coli K12 genome. Our algorithm is a fast tool to find the exact solution for the partial digest problem. The percentage of improvement is more than 75% over the best known practical algorithm for the worst case. For large numbers of inputs, our algorithm is able to solve the problem in a suitable time, while the best known practical algorithm is unable.

  17. 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.

  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. 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

  20. 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…

  1. Performance of RC columns with partial length corrosion

    International Nuclear Information System (INIS)

    Wang Xiaohui; Liang Fayun

    2008-01-01

    Experimental and analytical studies on the load capacity of reinforced concrete (RC) columns with partial length corrosion are presented, where only a fraction of the column length was corroded. Twelve simply supported columns were eccentrically loaded. The primary variables were partial length corrosion in tensile or compressive zone and the corrosion level within this length. The failure of the corroded column occurs in the partial length, mainly developed from or located nearby or merged with the longitudinal corrosion cracks. For RC column with large eccentricity, load capacity of the column is mainly influenced by the partial length corrosion in tensile zone; while for RC column with small eccentricity, load capacity of the column greatly decreases due to the partial length corrosion in compressive zone. The destruction of the longitudinally mechanical integrality of the column in the partial length leads to this great reduction of the load capacity of the RC column

  2. Flexible thermoplastic denture base materials for aesthetical removable partial denture framework.

    Science.gov (United States)

    Singh, Kunwarjeet; Aeran, Himanshu; Kumar, Narender; Gupta, Nidhi

    2013-10-01

    Conventional fixed partial dentures, implant supported Fixed Partial Dentures (FDPs) and removable partial dentures are the most common treatment modalities for the aesthetic and functional rehabilitation of partially edentulous patients. Although implants and FDP have certain advantages over removable partial dentures, in some cases, removable partial dentures may be the only choice which is available. Removable cast partial dentures are used as definitive removable prostheses when indicated, but location of clasps may affect aesthetics. So, when patient is concerned about aesthetics, flexible partial dentures which is aesthetically superior to flipper and cast partial dentures, may be considered. But for the success of flexible removable partial denture, proper diagnosis, treatment planning and insertion technique of this prosthesis is very important, which have been thoroughly described in this article.

  3. Case and Administrative Support Tools

    Science.gov (United States)

    Case and Administrative Support Tools (CAST) is the secure portion of the Office of General Counsel (OGC) Dashboard business process automation tool used to help reduce office administrative labor costs while increasing employee effectiveness. CAST supports business functions which rely on and store Privacy Act sensitive data (PII). Specific business processes included in CAST (and respective PII) are: -Civil Rights Cast Tracking (name, partial medical history, summary of case, and case correspondance). -Employment Law Case Tracking (name, summary of case). -Federal Tort Claims Act Incident Tracking (name, summary of incidents). -Ethics Program Support Tools and Tracking (name, partial financial history). -Summer Honors Application Tracking (name, home address, telephone number, employment history). -Workforce Flexibility Initiative Support Tools (name, alternative workplace phone number). -Resource and Personnel Management Support Tools (name, partial employment and financial history).

  4. Variance Function Partially Linear Single-Index Models1.

    Science.gov (United States)

    Lian, Heng; Liang, Hua; Carroll, Raymond J

    2015-01-01

    We consider heteroscedastic regression models where the mean function is a partially linear single index model and the variance function depends upon a generalized partially linear single index model. We do not insist that the variance function depend only upon the mean function, as happens in the classical generalized partially linear single index model. We develop efficient and practical estimation methods for the variance function and for the mean function. Asymptotic theory for the parametric and nonparametric parts of the model is developed. Simulations illustrate the results. An empirical example involving ozone levels is used to further illustrate the results, and is shown to be a case where the variance function does not depend upon the mean function.

  5. 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...

  6. [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.

  7. 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.

  8. 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…

  9. 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

  10. Perceived organizational support-burnout-satisfaction relationship in workers with disabilities: The moderation of family support.

    Science.gov (United States)

    Alcover, Carlos-María; Chambel, Maria José; Fernández, Juan José; Rodríguez, Fernando

    2018-05-02

    Our study tests the perceived organizational support-burnout-satisfaction relationship based on stressor-strain-outcome model of stress (Koeske & Koeske, ) and on the conservation of resources theory (Hobfoll, ) in workers with disabilities employed in ordinary or competitive jobs (open labor market), analyzing the relationship between perceived organizational support, family support, job satisfaction and burnout. We use a sample of 246 workers with physical, motor, sensory and psychological disabilities working in ordinary jobs. To test our proposed model we used a regression-based path analysis using PROCESS software, which is a computational tool for estimating and probing interactions and the conditional indirect effects of moderated mediation models. We find that the positive relationship between organizational support and job satisfaction was partially mediated by the levels of cynicism and the relationship between burnout and job satisfaction was moderated by family support. Employees with low support from family had identical job satisfaction with high burnout or low burnout, but employees with high support from family when they had high burnout had lower job satisfaction than when they had low burnout, indicating that the support outside work could have a negative effect in workers' life. Practical implications and future research are discussed and proposed. © 2018 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

  11. 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.

  12. International Conference on Multiscale Methods and Partial Differential Equations.

    Energy Technology Data Exchange (ETDEWEB)

    Thomas Hou

    2006-12-12

    The International Conference on Multiscale Methods and Partial Differential Equations (ICMMPDE for short) was held at IPAM, UCLA on August 26-27, 2005. The conference brought together researchers, students and practitioners with interest in the theoretical, computational and practical aspects of multiscale problems and related partial differential equations. The conference provided a forum to exchange and stimulate new ideas from different disciplines, and to formulate new challenging multiscale problems that will have impact in applications.

  13. 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...

  14. Quantum communication for satellite-to-ground networks with partially entangled states

    International Nuclear Information System (INIS)

    Chen Na; Quan Dong-Xiao; Pei Chang-Xing; Yang-Hong

    2015-01-01

    To realize practical wide-area quantum communication, a satellite-to-ground network with partially entangled states is developed in this paper. For efficiency and security reasons, the existing method of quantum communication in distributed wireless quantum networks with partially entangled states cannot be applied directly to the proposed quantum network. Based on this point, an efficient and secure quantum communication scheme with partially entangled states is presented. In our scheme, the source node performs teleportation only after an end-to-end entangled state has been established by entanglement swapping with partially entangled states. Thus, the security of quantum communication is guaranteed. The destination node recovers the transmitted quantum bit with the help of an auxiliary quantum bit and specially defined unitary matrices. Detailed calculations and simulation analyses show that the probability of successfully transferring a quantum bit in the presented scheme is high. In addition, the auxiliary quantum bit provides a heralded mechanism for successful communication. Based on the critical components that are presented in this article an efficient, secure, and practical wide-area quantum communication can be achieved. (paper)

  15. 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.

  16. 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

  17. Incorporating online teaching in an introductory pharmaceutical practice course: a study of student perceptions within an Australian University.

    Science.gov (United States)

    Benino, Diana; Girardi, Antonia; Czarniak, Petra

    2011-10-01

    To examine student perceptions regarding online lectures and quizzes undertaken during a pharmaceutical practice course for first year undergraduate students enrolled in the Bachelor of Pharmacy course at an Australian University. The University uses a standard instrument to collect feedback from students regarding unit satisfaction. Data were collected for three different teaching modalities: traditional face-to-face, online and partially online. Descriptive statistics support that, from a student's perspective, partial online delivery is the preferred teaching methodology for an introductory pharmaceutical practice unit. This study has served to highlight that while there are a few points of significant difference between traditional and online teaching and learning, a combination of the two provides a reasonable avenue for teaching exploration. This result has implications for teaching practice generally, and within the pharmacy discipline, specifically.

  18. Standard Practice for Analysis and Interpretation of Light-Water Reactor Surveillance Results, E706(IA)

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2001-01-01

    1.1 This practice covers the methodology, summarized in Annex A1, to be used in the analysis and interpretation of neutron exposure data obtained from LWR pressure vessel surveillance programs; and, based on the results of that analysis, establishes a formalism to be used to evaluate present and future condition of the pressure vessel and its support structures (1-70). 1.2 This practice relies on, and ties together, the application of several supporting ASTM standard practices, guides, and methods (see Master Matrix E 706) (1, 5, 13, 48, 49). In order to make this practice at least partially self-contained, a moderate amount of discussion is provided in areas relating to ASTM and other documents. Support subject areas that are discussed include reactor physics calculations, dosimeter selection and analysis, and exposure units. Note 1—(Figure 1 is deleted in the latest update. The user is refered to Master Matrix E 706 for the latest figure of the standards interconnectivity). 1.3 This practice is restri...

  19. 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.

  20. Spreading paths in partially observed social networks

    Science.gov (United States)

    Onnela, Jukka-Pekka; Christakis, Nicholas A.

    2012-03-01

    Understanding how and how far information, behaviors, or pathogens spread in social networks is an important problem, having implications for both predicting the size of epidemics, as well as for planning effective interventions. There are, however, two main challenges for inferring spreading paths in real-world networks. One is the practical difficulty of observing a dynamic process on a network, and the other is the typical constraint of only partially observing a network. Using static, structurally realistic social networks as platforms for simulations, we juxtapose three distinct paths: (1) the stochastic path taken by a simulated spreading process from source to target; (2) the topologically shortest path in the fully observed network, and hence the single most likely stochastic path, between the two nodes; and (3) the topologically shortest path in a partially observed network. In a sampled network, how closely does the partially observed shortest path (3) emulate the unobserved spreading path (1)? Although partial observation inflates the length of the shortest path, the stochastic nature of the spreading process also frequently derails the dynamic path from the shortest path. We find that the partially observed shortest path does not necessarily give an inflated estimate of the length of the process path; in fact, partial observation may, counterintuitively, make the path seem shorter than it actually is.

  1. Spreading paths in partially observed social networks.

    Science.gov (United States)

    Onnela, Jukka-Pekka; Christakis, Nicholas A

    2012-03-01

    Understanding how and how far information, behaviors, or pathogens spread in social networks is an important problem, having implications for both predicting the size of epidemics, as well as for planning effective interventions. There are, however, two main challenges for inferring spreading paths in real-world networks. One is the practical difficulty of observing a dynamic process on a network, and the other is the typical constraint of only partially observing a network. Using static, structurally realistic social networks as platforms for simulations, we juxtapose three distinct paths: (1) the stochastic path taken by a simulated spreading process from source to target; (2) the topologically shortest path in the fully observed network, and hence the single most likely stochastic path, between the two nodes; and (3) the topologically shortest path in a partially observed network. In a sampled network, how closely does the partially observed shortest path (3) emulate the unobserved spreading path (1)? Although partial observation inflates the length of the shortest path, the stochastic nature of the spreading process also frequently derails the dynamic path from the shortest path. We find that the partially observed shortest path does not necessarily give an inflated estimate of the length of the process path; in fact, partial observation may, counterintuitively, make the path seem shorter than it actually is.

  2. 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)

  3. 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

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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.

  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. Memorization in Type-Directed Partial Evaluation

    DEFF Research Database (Denmark)

    Balat, Vincent; Danvy, Olivier

    2002-01-01

    We use a code generator—type-directed partial evaluation— to verify conversions between isomorphic types, or more precisely to verify that a composite function is the identity function at some complicated type. A typed functional language such as ML provides a natural support to express the funct...

  12. On 0-Complete Partial Metric Spaces and Quantitative Fixed Point Techniques in Denotational Semantics

    Directory of Open Access Journals (Sweden)

    N. Shahzad

    2013-01-01

    Full Text Available In 1994, Matthews introduced the notion of partial metric space with the aim of providing a quantitative mathematical model suitable for program verification. Concretely, Matthews proved a partial metric version of the celebrated Banach fixed point theorem which has become an appropriate quantitative fixed point technique to capture the meaning of recursive denotational specifications in programming languages. In this paper we show that a few assumptions in statement of Matthews fixed point theorem can be relaxed in order to provide a quantitative fixed point technique useful to analyze the meaning of the aforementioned recursive denotational specifications in programming languages. In particular, we prove a new fixed point theorem for self-mappings between partial metric spaces in which the completeness has been replaced by 0-completeness and the contractive condition has been weakened in such a way that the new one best fits the requirements of practical problems in denotational semantics. Moreover, we provide examples that show that the hypothesis in the statement of our new result cannot be weakened. Finally, we show the potential applicability of the developed theory by means of analyzing a few concrete recursive denotational specifications, some of them admitting a unique meaning and others supporting multiple ones.

  13. Incorporating online teaching in an introductory pharmaceutical practice course: a study of student perceptions within an Australian University

    Directory of Open Access Journals (Sweden)

    Benino D

    2011-12-01

    Full Text Available Objectives: To examine student perceptions regarding online lectures and quizzes undertaken during a pharmaceutical practice course for first year undergraduate students enrolled in the Bachelor of Pharmacy course at an Australian University.Methods: The University uses a standard instrument to collect feedback from students regarding unit satisfaction. Data were collected for three different teaching modalities: traditional face-to-face, online and partially online. Results: Descriptive statistics support that, from a student's perspective, partial online delivery is the preferred teaching methodology for an introductory pharmaceutical practice unit. Conclusion: This study has served to highlight that while there are a few points of significant difference between traditional and online teaching and learning, a combination of the two provides a reasonable avenue for teaching exploration. This result has implications for teaching practice generally, and within the pharmacy discipline, specifically.

  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. A partial snake for the AGS

    International Nuclear Information System (INIS)

    Ratner, L.G.

    1990-01-01

    Based on snake experiments at the Indian University Cyclotron Facility and computer simulations at Brookhaven National Laboratory, as well as the conclusions of a BNL mini-workshop, we feel that a partial Siberian snake is a practical device for the AGS. It is anticipated that such a device could reduce the polarized beam tune-up time from 2--3 weeks to 2--3 days

  16. 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

  17. 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

  18. 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.

  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. 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.

  1. 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…

  2. The marketing of partial hospitalization.

    Science.gov (United States)

    Millsap, P; Brown, E; Kiser, L; Pruitt, D

    1987-09-01

    Health-care professionals are currently operating in the context of a rapidly changing health-care delivery system, including the move away from inpatient services to outpatient services in order to control costs. Those who practice in partial-hospital settings are in a position to offer effective, cost-efficient services; however, there continue to be obstacles which hinder appropriate utilization of the modality. The development and use of a well-designed marketing plan is one strategy for removing these obstacles. This paper presents a brief overview of the marketing process, ideas for developing a marketing plan, and several examples of specific marketing strategies as well as ways to monitor their effectiveness. Partial-hospital providers must take an active role in answering the calls for alternative sources of psychiatric care. A comprehensive, education-oriented marketing approach will increase the public's awareness of such alternatives and enable programs to survive in a competitive environment.

  3. 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...

  4. 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.

  5. 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

  6. Acoustic position finding of partial discharges in transformers. Combination of partial discharge measurement technology with 3D visualization; Akustische Ortung von Teilentladungen in Transformatoren. TE-Messtechnik und 3-D-Visualisierung kombiniert

    Energy Technology Data Exchange (ETDEWEB)

    Kraetge, Alexander; Hoek, Stefan [Omicron Electronics GmbH, Klaus (Austria)

    2013-11-01

    A new measuring system facilitates the detection of partial discharges in transformers by means of the fully synchronous combination of measurement technology for electrical partial discharges with intuitive 3D visualization of the test object. The contribution under consideration describes the application of this system with examples from the measurement practice.

  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. 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...

  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. 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.

  11. Magnetic properties of partially oxidized Fe films

    Science.gov (United States)

    Garcia, Miguel Angel; Lopez-Dominguez, Victor; Hernando, Antonio

    Hybrid magnetic nanostructures exhibit appealing properties due to interface and proximity effects. A simple and interesting system of hybrid magnetic nanomaterials are partially oxidized ferromagnetic films. We have fabricated Fe films by thermal evaporation and performed a partial oxidation to magnetite (Fe3O4) by annealing in air at different times and temperatures. The magnetic properties of the films evolve from those of pure metallic iron to pure magnetite, showing intermediate states where the proximity effects control the magnetic behavior. At some stages, the magnetization curves obtained by SQUID and MOKE magnetometry exhibit important differences due to the dissimilar contribution of both phases to the magneto-optical response of the system This work has been supported by the Ministerio Español de Economia y Competitividad (MINECO) MAT2013-48009-C4-1. V.L.D and M.A.G. acknowledges financial support from BBVA foundation.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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…

  17. How GPs implement clinical guidelines in everyday clinical practice--a qualitative interview study.

    Science.gov (United States)

    Le, Jette V; Hansen, Helle P; Riisgaard, Helle; Lykkegaard, Jesper; Nexøe, Jørgen; Bro, Flemming; Søndergaard, Jens

    2015-12-01

    Clinical guidelines are considered to be essential for improving quality and safety of health care. However, interventions to promote implementation of guidelines have demonstrated only partial effectiveness and the reasons for this apparent failure are not yet fully understood. To investigate how GPs implement clinical guidelines in everyday clinical practice and how implementation approaches differ between practices. Individual semi-structured open-ended interviews with seven GPs who were purposefully sampled with regard to gender, age and practice form. Interviews were recorded, transcribed verbatim and then analysed using systematic text condensation. Analysis of the interviews revealed three different approaches to the implementation of guidelines in clinical practice. In some practices the GPs prioritized time and resources on collective implementation activities and organized their everyday practice to support these activities. In other practices GPs discussed guidelines collectively but left the application up to the individual GP whilst others again saw no need for discussion or collective activities depending entirely on the individual GP's decision on whether and how to manage implementation. Approaches to implementation of clinical guidelines vary substantially between practices. Supporting activities should take this into account. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  18. Partial Thickness Rotator Cuff Tears: Current Concepts

    Science.gov (United States)

    Matthewson, Graeme; Beach, Cara J.; Nelson, Atiba A.; Woodmass, Jarret M.; Ono, Yohei; Boorman, Richard S.; Lo, Ian K. Y.; Thornton, Gail M.

    2015-01-01

    Partial thickness rotator cuff tears are a common cause of pain in the adult shoulder. Despite their high prevalence, the diagnosis and treatment of partial thickness rotator cuff tears remains controversial. While recent studies have helped to elucidate the anatomy and natural history of disease progression, the optimal treatment, both nonoperative and operative, is unclear. Although the advent of arthroscopy has improved the accuracy of the diagnosis of partial thickness rotator cuff tears, the number of surgical techniques used to repair these tears has also increased. While multiple repair techniques have been described, there is currently no significant clinical evidence supporting more complex surgical techniques over standard rotator cuff repair. Further research is required to determine the clinical indications for surgical and nonsurgical management, when formal rotator cuff repair is specifically indicated and when biologic adjunctive therapy may be utilized. PMID:26171251

  19. Partial Thickness Rotator Cuff Tears: Current Concepts

    Directory of Open Access Journals (Sweden)

    Graeme Matthewson

    2015-01-01

    Full Text Available Partial thickness rotator cuff tears are a common cause of pain in the adult shoulder. Despite their high prevalence, the diagnosis and treatment of partial thickness rotator cuff tears remains controversial. While recent studies have helped to elucidate the anatomy and natural history of disease progression, the optimal treatment, both nonoperative and operative, is unclear. Although the advent of arthroscopy has improved the accuracy of the diagnosis of partial thickness rotator cuff tears, the number of surgical techniques used to repair these tears has also increased. While multiple repair techniques have been described, there is currently no significant clinical evidence supporting more complex surgical techniques over standard rotator cuff repair. Further research is required to determine the clinical indications for surgical and nonsurgical management, when formal rotator cuff repair is specifically indicated and when biologic adjunctive therapy may be utilized.

  20. 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)

  1. 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

  2. Computing the partial volume of pressure vessels

    Energy Technology Data Exchange (ETDEWEB)

    Wiencke, Bent [Nestle USA, Corporate Engineering, 800 N. Brand Blvd, Glendale, CA 91203 (United States)

    2010-06-15

    The computation of the partial and total volume of pressure vessels with various type of head profiles requires detailed knowledge of the head profile geometry. Depending on the type of head profile the derivation of the equations can become very complex and the calculation process cumbersome. Certain head profiles require numerical methods to obtain the partial volume, which for most application is beyond the scope of practicability. This paper suggests a unique method that simplifies the calculation procedure for the various types of head profiles by using one common set of equations without the need for numerical or complex computation methods. For ease of use, all equations presented in this paper are summarized in a single table format for horizontal and vertical vessels. (author)

  3. 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.

  4. 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

  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. Partial volume and aliasing artefacts in helical cone-beam CT

    International Nuclear Information System (INIS)

    Zou Yu; Sidky, Emil Y; Pan, Xiaochuan

    2004-01-01

    A generalization of the quasi-exact algorithms of Kudo et al (2000 IEEE Trans. Med. Imaging 19 902-21) is developed that allows for data acquisition in a 'practical' frame for clinical diagnostic helical, cone-beam computed tomography (CT). The algorithm is investigated using data that model nonlinear partial volume averaging. This investigation leads to an understanding of aliasing artefacts in helical, cone-beam CT image reconstruction. An ad hoc scheme is proposed to mitigate artefacts due to the nonlinear partial volume and aliasing artefacts

  7. Cast Partial Denture versus Acrylic Partial Denture for Replacement of Missing Teeth in Partially Edentulous Patients

    Directory of Open Access Journals (Sweden)

    Pramita Suwal

    2017-03-01

    Full Text Available Aim: To compare the effects of cast partial denture with conventional all acrylic denture in respect to retention, stability, masticatory efficiency, comfort and periodontal health of abutments. Methods: 50 adult partially edentulous patient seeking for replacement of missing teeth having Kennedy class I and II arches with or without modification areas were selected for the study. Group-A was treated with cast partial denture and Group-B with acrylic partial denture. Data collected during follow-up visit of 3 months, 6 months, and 1 year by evaluating retention, stability, masticatory efficiency, comfort, periodontal health of abutment. Results: Chi-square test was applied to find out differences between the groups at 95% confidence interval where p = 0.05. One year comparison shows that cast partial denture maintained retention and stability better than acrylic partial denture (p< 0.05. The masticatory efficiency was significantly compromising from 3rd month to 1 year in all acrylic partial denture groups (p< 0.05. The comfort of patient with cast partial denture was maintained better during the observation period (p< 0.05. Periodontal health of abutment was gradually deteriorated in all acrylic denture group (p

  8. 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.

  9. 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.

  10. Mastication and jaw motion of partially edentulous patients are affected by different implant-based prostheses.

    Science.gov (United States)

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

    2014-07-01

    The main goal of prosthetic treatment is to restore masticatory function. However, insufficient evidence supports the recommendation of one specific prosthetic intervention for partially edentulous patients. Function after the use of three different prostheses by the same partially edentulous subject. Mastication was assessed in 12 subjects (mean age 62.6 ± 7.8 years) after they had used removable partial dentures (RPDs), implant-supported partial dentures (IRPDs) and implant-fixed partial dentures (IFPDs). Masticatory ability (MA) was estimated by visual analogue scale questionnaire, while the mandibular chewing motion was evaluated by kinesiographic device, representing an objective measurement of masticatory function. Data were analysed by repeated-measures anova followed by Tukey-Kramer (P < 0.05). MA improved after IRPD and IFPD use (P < 0.05). Opening, closing and total cycle time duration were reduced after both IRPD and IFPD use (P < 0.05), irrespectively the implant prosthesis type. IFPDs and IRPDs restore the masticatory function of partially edentulous patients better than RPDs. © 2014 John Wiley & Sons Ltd.

  11. 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.

  12. 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.

  13. 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

  14. Equation of state of partially-ionized dense plasmas

    International Nuclear Information System (INIS)

    Rogers, F.J.

    1989-01-01

    This paper describes methods for calculating the equation of state of partially-ionized dense plasmas. The term dense plasma is used rather than strongly coupled plasma, since it is possible that at plasma conditions such that only a few levels can be observed spectroscopically the plasma coupling parameters are not large. Due mainly to their importance in theoretical astrophysics, the properties of partially ionized plasmas have been of interest for a long while. More recently, this interest has intensified due to the development of methods for producing partially ionized plasmas in the laboratory. This has opened up large programs of experimental investigation and of practical application. In this paper we consider detailed statistical mechanical methods that explicitly treat the distribution over ionic species and their energy level structure. These detailed approaches are generally characterized as being in the ''chemical picture'' when a free energy expression is minimized or in the ''physical picture'' when the starting point is the grand canonical ensemble. 52 refs., 2 tabs

  15. Partial Automated Alignment and Integration System

    Science.gov (United States)

    Kelley, Gary Wayne (Inventor)

    2014-01-01

    The present invention is a Partial Automated Alignment and Integration System (PAAIS) used to automate the alignment and integration of space vehicle components. A PAAIS includes ground support apparatuses, a track assembly with a plurality of energy-emitting components and an energy-receiving component containing a plurality of energy-receiving surfaces. Communication components and processors allow communication and feedback through PAAIS.

  16. 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

  17. 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.

  18. Respiratory Support for Pharmacologically Induced Hypoxia in Neonatal Calves

    Directory of Open Access Journals (Sweden)

    C. G. Donnelly

    2016-01-01

    Full Text Available Practical methods to provide respiratory support to bovine neonates in a field setting are poorly characterised. This study evaluated the response of healthy neonatal calves with pharmacologically induced respiratory suppression to nasal oxygen insufflation and to continuous positive airway pressure (CPAP delivered via an off-the-shelf device. Ten calves were randomised to receive either nasal oxygen insufflation (Group 1, n=5 or CPAP (Group 2, n=5 as a first treatment after induction of respiratory depression by intravenous administration of xylazine, fentanyl, and diazepam. Calves received the alternate treatment after 10 minutes of breathing ambient air. Arterial blood gas samples were obtained prior to sedation, following sedation, following the first and second treatment, and after breathing ambient air before and after the second treatment. Oxygen insufflation significantly increased arterial oxygen partial pressure (PaO2 but was also associated with significant hypercapnia. When used as the first treatment, CPAP was associated with significantly decreased arterial partial pressure of carbon dioxide but did not increase PaO2. These results suggest that the use of CPAP may represent a practical method for correction of hypercapnia associated with inadequate ventilation in a field setting, and further research is required to characterise the use of CPAP with increased inspired oxygen concentrations.

  19. An Introduction to the Partial Credit Model for Developing Nursing Assessments.

    Science.gov (United States)

    Fox, Christine

    1999-01-01

    Demonstrates how the partial credit model, a variation of the Rasch Measurement Model, can be used to develop performance-based assessments for nursing education. Applies the model using the Practical Knowledge Inventory for Nurses. (SK)

  20. Nonlinear analysis of shear deformable beam-columns partially ...

    African Journals Online (AJOL)

    In this paper, a boundary element method is developed for the nonlinear analysis of shear deformable beam-columns of arbitrary doubly symmetric simply or multiply connected constant cross section, partially supported on tensionless Winkler foundation, undergoing moderate large deflections under general boundary ...

  1. Three-dimensional finite element analysis of implant-assisted removable partial dentures.

    Science.gov (United States)

    Eom, Ju-Won; Lim, Young-Jun; Kim, Myung-Joo; Kwon, Ho-Beom

    2017-06-01

    Whether the implant abutment in implant-assisted removable partial dentures (IARPDs) functions as a natural removable partial denture (RPD) tooth abutment is unknown. The purpose of this 3-dimensional finite element study was to analyze the biomechanical behavior of implant crown, bone, RPD, and IARPD. Finite element models of the partial maxilla, teeth, and prostheses were generated on the basis of a patient's computed tomographic data. The teeth, surveyed crowns, and RPDs were created in the model. With the generated components, four 3-dimensional finite element models of the partial maxilla were constructed: tooth-supported RPD (TB), implant-supported RPD (IB), tooth-tissue-supported RPD (TT), and implant-tissue-supported RPD (IT) models. Oblique loading of 300 N was applied on the crowns and denture teeth. The von Mises stress and displacement of the denture abutment tooth and implant system were identified. The highest von Mises stress values of both IARPDs occurred on the implants, while those of both natural tooth RPDs occurred on the frameworks of the RPDs. The highest von Mises stress of model IT was about twice that of model IB, while the value of model TT was similar to that of model TB. The maximum displacement was greater in models TB and TT than in models IB and IT. Among the 4 models, the highest maximum displacement value was observed in the model TT and the lowest value was in the model IB. Finite element analysis revealed that the stress distribution pattern of the IARPDs was different from that of the natural tooth RPDs and the stress distribution of implant-supported RPD was different from that of implant-tissue-supported RPD. When implants are used for RPD abutments, more consideration concerning the RPD design and the number or location of the implant is necessary. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  2. Removable partial denture on osseointegrated implants and natural teeth.

    Science.gov (United States)

    Chang, Li-Ching; Wang, Jen-Chyan; Tasi, Chi-Cheng

    2007-01-01

    Implants have been designed to provide edentulous patients with fixed prostheses or overdentures. Recently, implant-supported fixed partial prostheses and single crowns have become successful treatment alternatives to removable and fixed partial dentures. However, few researchers have examined "removable partial dentures on implants and natural teeth". In this article, we report two patients fitted with "removable partial dentures on implants and natural teeth". The patients were satisfied with their dentures in terms of function and aesthetics. Regular follow-up visits revealed that the periodontal and peri-implant conditions were stable. There was no evidence of excessive intrusion or mobility of the teeth, nor were any visible changes in the bone levels of the natural teeth or implants noted on radiographs. Since the average duration of observation was about 38 months, further follow-up examinations are necessary to determine whether these dentures remain stable long-term.

  3. 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.

  4. 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…

  5. The partial-reinforcement extinction effect and the contingent-sampling hypothesis.

    Science.gov (United States)

    Hochman, Guy; Erev, Ido

    2013-12-01

    The partial-reinforcement extinction effect (PREE) implies that learning under partial reinforcements is more robust than learning under full reinforcements. While the advantages of partial reinforcements have been well-documented in laboratory studies, field research has failed to support this prediction. In the present study, we aimed to clarify this pattern. Experiment 1 showed that partial reinforcements increase the tendency to select the promoted option during extinction; however, this effect is much smaller than the negative effect of partial reinforcements on the tendency to select the promoted option during the training phase. Experiment 2 demonstrated that the overall effect of partial reinforcements varies inversely with the attractiveness of the alternative to the promoted behavior: The overall effect is negative when the alternative is relatively attractive, and positive when the alternative is relatively unattractive. These results can be captured with a contingent-sampling model assuming that people select options that provided the best payoff in similar past experiences. The best fit was obtained under the assumption that similarity is defined by the sequence of the last four outcomes.

  6. Support system, excavation arrangement, and process of supporting an object

    Science.gov (United States)

    Arnold, Bill W.

    2017-08-01

    A support system, an excavation arrangement, and a process of supporting an object are disclosed. The support system includes a weight-bearing device and a camming mechanism positioned below the weight-bearing device. A downward force on the weight-bearing device at least partially secures the camming mechanism to opposing surfaces. The excavation arrangement includes a borehole, a support system positioned within and secured to the borehole, and an object positioned on and supported by the support system. The process includes positioning and securing the support system and positioning the object on the weight-bearing device.

  7. 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.

  8. Gravity Effects Observed In Partially Premixed Flames

    Science.gov (United States)

    Puri, Ishwar K.; Aggarwal, Suresh K.; Lock, Andrew J.; Gauguly, Ranjan; Hegde, Uday

    2003-01-01

    Partially premixed flames (PPFs) contain a rich premixed fuel air mixture in a pocket or stream, and, for complete combustion to occur, they require the transport of oxidizer from an appropriately oxidizer-rich (or fuel-lean) mixture that is present in another pocket or stream. Partial oxidation reactions occur in fuel-rich portions of the mixture and any remaining unburned fuel and/or intermediate species are consumed in the oxidizer-rich portions. Partial premixing, therefore, represents that condition when the equivalence ratio (phi) in one portion of the flowfield is greater than unity, and in another section its value is less than unity. In general, for combustion to occur efficiently, the global equivalence ratio is in the range fuel-lean to stoichiometric. These flames can be established by design by placing a fuel-rich mixture in contact with a fuel-lean mixture, but they also occur otherwise in many practical systems, which include nonpremixed lifted flames, turbulent nonpremixed combustion, spray flames, and unwanted fires. Other practical applications of PPFs are reported elsewhere. Although extensive experimental studies have been conducted on premixed and nonpremixed flames under microgravity, there is a absence of previous experimental work on burner stabilized PPFs in this regard. Previous numerical studies by our group employing a detailed numerical model showed gravity effects to be significant on the PPF structure. We report on the results of microgravity experiments conducted on two-dimensional (established on a Wolfhard-Parker slot burner) and axisymmetric flames (on a coannular burner) that were investigated in a self-contained multipurpose rig. Thermocouple and radiometer data were also used to characterize the thermal transport in the flame.

  9. 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

  10. 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.

  11. Vocational training courses as an intervention on change of work practice among immigrant cleaners.

    Science.gov (United States)

    Jensen, Flemming W; Frydendall, Karen B; Flyvholm, Mari-Ann

    2011-11-01

    The aim of the study was to examine how knowledge and skills from vocational training courses on working techniques modified for immigrant cleaners are applied in practice and to identify factors that influence the implementation. The modifications of the standard course included language support with possibilities for translation and an extension of the duration of the course. The study is a prospective intervention study based on qualitative data. Data were collected as structured interviews and observations were carried out at the workplaces before and after the course. The study population included 31 immigrant cleaners from five different workplaces. Changes were observed in the use of working techniques (i.e., positioning of hands when using the floor mop). In some cases the use of the taught techniques was incorrect, partial, or only used part of the time. Interactions between individual factors (i.e., knowledge, awareness, capability, or work orientation) and environmental factors (i.e., equipment, time, workload, or physical surroundings) influenced the use of the techniques in practice. The course provided the participants with new working techniques through which some were able to reduce work related pain. However, with regard to incorrect and partial use of the working techniques, follow-up and post-training support is recommended. Copyright © 2011 Wiley Periodicals, Inc.

  12. 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

  13. 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…

  14. 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.

  15. Dual Component Removable Partial Denture shows improved ...

    African Journals Online (AJOL)

    Dual Component Removable Partial Denture (DuCo RPD) is composed of a double base; lower and upper. The lower base, where the artificial teeth are attached, acts as a support and is in contact with the alveolar ridges and oral mucosa. Clasps are designed on the upper base, which acts towards the retention and ...

  16. 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

  17. 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

  18. 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.

  19. An Efficient Implementation of Partial Condensing for Nonlinear Model Predictive Control

    DEFF Research Database (Denmark)

    Frison, Gianluca; Kouzoupis, Dimitris; Jørgensen, John Bagterp

    2016-01-01

    -horizon trade-off is investigated from a theoretical point of view (based on algorithms flop count) as well as by benchmarking (in practice, the performance of linear algebra routines for different matrix sizes plays a key role). Partial condensing can also be seen as a technique to replace many operations...... on small matrices with fewer operations on larger matrices, where linear algebra routines perform better. Therefore, in case of small-scale MPC problems, partial condensing can greatly improve performance beyond the flop count reduction....

  20. New applications of partial residual methodology

    International Nuclear Information System (INIS)

    Uslu, V.R.

    1999-12-01

    The formulation of a problem of interest in the framework of a statistical analysis starts with collecting the data, choosing a model, making certain assumptions as described in the basic paradigm by Box (1980). This stage is is called model building. Then the estimation stage is in order by pretending as if the formulation of the problem was true to obtain estimates, to make tests and inferences. In the final stage, called diagnostic checking, checking of whether there are some disagreements between the data and the model fitted is done by using diagnostic measures and diagnostic plots. It is well known that statistical methods perform best under the condition that all assumptions related to the methods are satisfied. However it is true that having the ideal case in practice is very difficult. Diagnostics are therefore becoming important so are diagnostic plots because they provide a immediate assessment. Partial residual plots that are the main interest of the present study are playing the major role among the diagnostic plots in multiple regression analysis. In statistical literature it is admitted that partial residual plots are more useful than ordinary residual plots in detecting outliers, nonconstant variance, and especially discovering curvatures. In this study we consider the partial residual methodology in statistical methods rather than multiple regression. We have shown that for the same purpose as in the multiple regression the use of partial residual plots is possible particularly in autoregressive time series models, transfer function models, linear mixed models and ridge regression. (author)

  1. 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.

  2. New approach to breast cancer CAD using partial least squares and kernel-partial least squares

    Science.gov (United States)

    Land, Walker H., Jr.; Heine, John; Embrechts, Mark; Smith, Tom; Choma, Robert; Wong, Lut

    2005-04-01

    Breast cancer is second only to lung cancer as a tumor-related cause of death in women. Currently, the method of choice for the early detection of breast cancer is mammography. While sensitive to the detection of breast cancer, its positive predictive value (PPV) is low, resulting in biopsies that are only 15-34% likely to reveal malignancy. This paper explores the use of two novel approaches called Partial Least Squares (PLS) and Kernel-PLS (K-PLS) to the diagnosis of breast cancer. The approach is based on optimization for the partial least squares (PLS) algorithm for linear regression and the K-PLS algorithm for non-linear regression. Preliminary results show that both the PLS and K-PLS paradigms achieved comparable results with three separate support vector learning machines (SVLMs), where these SVLMs were known to have been trained to a global minimum. That is, the average performance of the three separate SVLMs were Az = 0.9167927, with an average partial Az (Az90) = 0.5684283. These results compare favorably with the K-PLS paradigm, which obtained an Az = 0.907 and partial Az = 0.6123. The PLS paradigm provided comparable results. Secondly, both the K-PLS and PLS paradigms out performed the ANN in that the Az index improved by about 14% (Az ~ 0.907 compared to the ANN Az of ~ 0.8). The "Press R squared" value for the PLS and K-PLS machine learning algorithms were 0.89 and 0.9, respectively, which is in good agreement with the other MOP values.

  3. General formalism for partial spatial coherence in reflection Mueller matrix polarimetry.

    Science.gov (United States)

    Ossikovski, Razvigor; Hingerl, Kurt

    2016-09-01

    Starting from the first principles, we derive the expressions governing partially coherent Mueller matrix reflection polarimetry on spatially inhomogeneous samples. These are reported both in their general form and in the practically important specific form for two juxtaposed media.

  4. Management of long span partially edentulous maxilla with fixed removable denture prosthesis.

    Science.gov (United States)

    Jeyavalan, Mahilan I; Narasimman, M; Venkatakrishnan, C J; Philip, Jacob M

    2012-07-01

    Restoration of a long span partially edentulous maxilla with tooth supported prosthesis is challenging because of inherent anatomic limitations and unfavourable biomechanics present after the loss of teeth. A tooth supported fixed-removable prosthesis is a treatment option for restoration of such long span partially edentulous maxillary arches. This prosthesis meets the requirements for esthetics, phonetics, comfort, and hygiene, as well as favourable biomechanical stress distribution to the remaining natural tooth abutments. This article presents a procedure for fabrication of a fixed-removable prosthesis that has cement-retained custom cast bar metal substructure and a ball attachment retained removable superstructure prosthesis.

  5. A default Bayesian hypothesis test for correlations and partial correlations

    NARCIS (Netherlands)

    Wetzels, R.; Wagenmakers, E.J.

    2012-01-01

    We propose a default Bayesian hypothesis test for the presence of a correlation or a partial correlation. The test is a direct application of Bayesian techniques for variable selection in regression models. The test is easy to apply and yields practical advantages that the standard frequentist tests

  6. 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.

  7. Catalytic Partial Oxidation of Biomass/Oil Mixture

    Czech Academy of Sciences Publication Activity Database

    Veselý, Václav; Hanika, Jiří; Tukač, V.; Lederer, J.; Kovač, D.

    2013-01-01

    Roč. 7, č. 10 (2013), s. 1940-1945 ISSN 1934-8983 R&D Projects: GA TA ČR TE01020080; GA MPO 2A-2TP1/024 Institutional support: RVO:67985858 Keywords : hydrocarbon oil * biomass * catalytic partial oxidation Subject RIV: CI - Industrial Chemistry, Chemical Engineering http://www.davidpublishing.com/journals_info.asp?jId=1718#

  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; 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.

  9. 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.

  10. Removable partial dentures: The clinical need for innovation.

    Science.gov (United States)

    Campbell, Stephen D; Cooper, Lyndon; Craddock, Helen; Hyde, T Paul; Nattress, Brian; Pavitt, Sue H; Seymour, David W

    2017-09-01

    The number of partially dentate adults is increasing, and many patients will require replacement of missing teeth. Although current treatment options also include fixed partial dentures and implants, removable partial dentures (RPDs) can have advantages and are widely used in clinical practice. However, a significant need exists to advance materials and fabrication technologies because of the unwanted health consequences associated with current RPDs. The purpose of this review was to assess the current state of and future need for prosthetics such as RPDs for patients with partial edentulism, highlight areas of weakness, and outline possible solutions to issues that affect patient satisfaction and the use of RPDs. The data on treatment for partial edentulism were reviewed and summarized with a focus on currently available and future RPD designs, materials, means of production, and impact on oral health. Data on patient satisfaction and compliance with RPD treatment were also reviewed to assess patient-centered care. Design, materials, ease of repair, patient education, and follow-up for RPD treatment all had a significant impact on treatment success. Almost 40% of patients no longer use their RPD within 5 years because of factors such as sociodemographics, pain, and esthetics. Research on RPD-based treatment for partial edentulism for both disease-oriented and patient-centered outcomes is lacking. Future trials should evaluate new RPD materials and design technologies and include both long-term follow-up and health-related and patient-reported outcomes. Advances in materials and digital design/production along with patient education promise to further the application of RPDs and improve the quality of life for patients requiring RPDs. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  11. Evaluation of Seismic Behaviors of Partially Deteriorated Reinforced Concrete Circular Columns Retrofitted with CFRP

    Directory of Open Access Journals (Sweden)

    Dongxu Hou

    2014-01-01

    Full Text Available Deficiency of the concrete strength in some regions of reinforced concrete (RC columns in practice may weaken the seismic behaviors of columns. Its effects on RC columns should be well understood. This paper aims to investigate the influences of deteriorated segment on the seismic behaviors of partially deteriorated RC columns and attempts to recover the seismic behaviors of partially deteriorated columns with Carbon Fiber Reinforced Polymer (CFRP composites. A finite element analysis was carried out to simulate the seismic behaviors of CFRP-confined partially deteriorated RC columns. The numerical results were verified by the laboratory tests of six specimens. Based on the finite element results, the failure location of partially deteriorated columns in an earthquake was predicted, and the effectiveness of CFRP retrofitted on partially deteriorated columns was evaluated.

  12. 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.

  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. 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

  15. 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.

  16. 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

  17. 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.

  18. 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.

  19. Spreading paths in partially observed social networks

    OpenAIRE

    Onnela, Jukka-Pekka; Christakis, Nicholas A.

    2012-01-01

    Understanding how and how far information, behaviors, or pathogens spread in social networks is an important problem, having implications for both predicting the size of epidemics, as well as for planning effective interventions. There are, however, two main challenges for inferring spreading paths in real-world networks. One is the practical difficulty of observing a dynamic process on a network, and the other is the typical constraint of only partially observing a network. Using a static, s...

  20. Some Considerations on the Partial Credit Model

    OpenAIRE

    H.H.F.M. Verstralen; N.D. Verhelst

    2008-01-01

    The Partial Credit Model (PCM) is sometimes interpreted as a model for stepwise solution of polytomously scored items, where the item parameters are interpreted as di culties of the steps. It is argued that this interpretation is not justi ed. A model for stepwise solution is discussed. It is shown that the PCM is suited to model sums of binary responses which are not supposed to be stochastically independent. As a practical result, a statistical test of sto...

  1. 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…

  2. Hydrogen or Soot?: Partial Oxidation of High-boiling Hydrocarbon Wastes

    Czech Academy of Sciences Publication Activity Database

    Lederer, J.; Hanika, Jiří; Nečesaný, F.; Poslední, W.; Tukač, V.; Veselý, Václav

    2015-01-01

    Roč. 29, č. 1 (2015), s. 5-11 ISSN 0352-9568 Institutional support: RVO:67985858 Keywords : partial oxidation * waste * hydrocarbon Subject RIV: CI - Industrial Chemistry, Chemical Engineering Impact factor: 0.675, year: 2015

  3. IAEA Global Support of Decommissioning Implementation with a Focus on Advanced Technologies

    International Nuclear Information System (INIS)

    Michal, Vladimir; )

    2017-01-01

    Recently there are about 140 power reactors in decommissioning phase worldwide excluding 17+ that might be considered as decommissioned. In addition, more than 400 other nuclear facilities, such as research reactors or nuclear fuel cycle facilities, have been shutdown for decommissioning, have been undergoing active decommissioning or have already been fully dismantled. The IAEA provides various kind of support for Member States including publication of safety and technical reports providing guidance, recommendations, experiences, good practices and lessons learned covering the preparatory and implementation decommissioning phases. Many training courses, workshops, seminars etc. were organized to support sharing of good practices among specialists and organizations involved. In line with the non-technical aspects, such as decommissioning planning, costing, managerial approaches etc., there are also presented and discussed technical solutions often with a focus on the advanced technologies to be considered. Several completed and ongoing IAEA initiatives partially or fully address the advanced approaches and techniques to support safe and effective implementation of decommissioning projects. The presentation will provide an overview of relevant activities organized so far and perspectives of the IAEA on advanced technologies for decommissioning. (author)

  4. Zinc phosphate as a definitive cement for implant-supported crowns and fixed dentures

    Directory of Open Access Journals (Sweden)

    Flanagan D

    2017-11-01

    Full Text Available Dennis Flanagan Private Practice, Willimantic, CT, USA Abstract: Implant-supported dental prostheses can be retained by a screw or cement. Implant-supported fixed partial dentures have a passive fit. A passive fit means there is an internal gap between the abutment surface and the intaglio of the retainer to insure that there is no lateral pressure on the supporting implants or friction upon seating of the prosthesis. This gap is filled with cement for retention of the prosthesis. Any lateral pressure may cause marginal bone loss or periimplantitis. Also, there is usually a microscopic gap at the margin of a crown retainer that exposes the cement to oral fluids. The solubility of zinc phosphate (ZOP cement is a definite liability due to the risk for cement dissolution. In fixed prostheses, the dissolution of the cement of one or more retainers would cause a transfer of the occlusal load to the retained unit(s. The resulting rotation and lifting of the cement-retained implants from occlusal and parafunctional loads could cause loss of osseointegration of the abutment-retained implant(s. ZOP cement may not be indicated for implant-supported fixed partial dentures or splints. Cement dissolution in single unit probably only involves re-cementation, if the patient does not swallow or aspirate the crown. Keywords: passive fit, retention, film thickness, fixed, marginal gap 

  5. 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.

  6. 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.

  7. Management of long span partially edentulous maxilla with fixed removable denture prosthesis

    Directory of Open Access Journals (Sweden)

    Mahilan I Jeyavalan

    2012-01-01

    Full Text Available Restoration of a long span partially edentulous maxilla with tooth supported prosthesis is challenging because of inherent anatomic limitations and unfavourable biomechanics present after the loss of teeth. A tooth supported fixed-removable prosthesis is a treatment option for restoration of such long span partially edentulous maxillary arches. This prosthesis meets the requirements for esthetics, phonetics, comfort, and hygiene, as well as favourable biomechanical stress distribution to the remaining natural tooth abutments. This article presents a procedure for fabrication of a fixed-removable prosthesis that has cement-retained custom cast bar metal substructure and a ball attachment retained removable superstructure prosthesis.

  8. 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

  9. Effects of oxygen partial pressure on Li-air battery performance

    Science.gov (United States)

    Kwon, Hyuk Jae; Lee, Heung Chan; Ko, Jeongsik; Jung, In Sun; Lee, Hyun Chul; Lee, Hyunpyo; Kim, Mokwon; Lee, Dong Joon; Kim, Hyunjin; Kim, Tae Young; Im, Dongmin

    2017-10-01

    For application in electric vehicles (EVs), the Li-air battery system needs an air intake system to supply dry oxygen at controlled concentration and feeding rate as the cathode active material. To facilitate the design of such air intake systems, we have investigated the effects of oxygen partial pressure (≤1 atm) on the performance of the Li-air cell, which has not been systematically examined. The amounts of consumed O2 and evolved CO2 from the Li-air cell are measured with a custom in situ differential electrochemical gas chromatography-mass spectrometry (DEGC-MS). The amounts of consumed O2 suggest that the oxygen partial pressure does not affect the reaction mechanism during discharge, and the two-electron reaction occurs under all test conditions. On the other hand, the charging behavior varies by the oxygen partial pressure. The highest O2 evolution ratio is attained under 70% O2, along with the lowest CO2 evolution. The cell cycle life also peaks at 70% O2 condition. Overall, an oxygen partial pressure of about 0.5-0.7 atm maximizes the Li-air cell capacity and stability at 1 atm condition. The findings here indicate that the appropriate oxygen partial pressure can be a key factor when developing practical Li-air battery systems.

  10. 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.

  11. Oxford Partial Knee Replacement as a Gateway to Outpatient Arthroplasty “Lessons Learned along the Journey”

    Directory of Open Access Journals (Sweden)

    Michael E Berend

    2016-09-01

    Full Text Available The Oxford Partial Knee Replacement was approved for implantation in the US in 2004 after the surgeon completed an educational training requirement.  Since then my knee practiced has expanded to over 50% partial knee.  This experience coupled with refinement of surgical techniques, anesthesia protocols, and patient selection has facilitated the transformation to same day discharge for partial knee cases and has quickly transitioned to total hip, total knee, and selected revision surgeries.  Patient selection has also expanded for outpatient joints and is now based on medical screening criteria and insurance access.  Over a two-year period we have performed over 1,000 outpatient arthroplasty procedures with no readmissions for pain control.   Overall readmission rate for all reasons was 2%.  Patient satisfaction scores were 98% Great-Good for 2014-15.  The combination of a partial knee replacement practice and an outpatient joint program brings the best VALUE to the patients, surgeons, and the arthroplasty system and represents the future of arthroplasty care.

  12. 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

  13. Acquisition with partial and continuous reinforcement in pigeon autoshaping.

    Science.gov (United States)

    Gottlieb, Daniel A

    2004-08-01

    Contemporary time accumulation models make the unique prediction that acquisition of a conditioned response will be equally rapid with partial and continuous reinforcement, if the time between conditioned stimuli is held constant. To investigate this, acquisition of conditioned responding was examined in pigeon autoshaping under conditions of 100% and 25% reinforcement, holding intertrial interval constant. Contrary to what was predicted, evidence for slowed acquisition in partially reinforced animals was observed with several response measures. However, asymptotic performance was superior with 25% reinforcement. A switching of reinforcement contingencies after initial acquisition did not immediately affect responding. After further sessions, partial reinforcement augmented responding, whereas continuous reinforcement did not, irrespective of an animal's reinforcement history. Subsequent training with a novel stimulus maintained the response patterns. These acquisition results generally support associative, rather than time accumulation, accounts of conditioning.

  14. 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

  15. 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.

  16. 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.

  17. 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.

  18. Reliability Analysis and Calibration of Partial Safety Factors for Redundant Structures

    DEFF Research Database (Denmark)

    Sørensen, John Dalsgaard

    1998-01-01

    Redundancy is important to include in the design and analysis of structural systems. In most codes of practice redundancy is not directly taken into account. In the paper various definitions of a deterministic and reliability based redundancy measure are reviewed. It is described how reundancy can...... be included in the safety system and how partial safety factors can be calibrated. An example is presented illustrating how redundancy is taken into account in the safety system in e.g. the Danish codes. The example shows how partial safety factors can be calibrated to comply with the safety level...

  19. Evaluation of deterioration of insulators in high-voltage motors by partial discharge

    International Nuclear Information System (INIS)

    Mikami, Masao

    2003-01-01

    For the purpose of early detection of deterioration of insulators in high-voltage motors which are widely utilized in nuclear power stations, a new type on-line partial discharge monitor developed at INSS was applied to test the deterioration of about 150 sets of high-voltage motors running in nuclear power stations practically. From the results, it is shown that (1) tendency of the deterioration can be obtained by this method in general, (2) the magnitude of the on-line partial discharge hardly correlates with that of off-line measurement, but depends on temperature and other environmental conditions, and (3) by observing phase characteristics of partial discharge, it is possible to make a diagnosis of phase-to-phase tracking in end-winding coils of a stator. (author)

  20. 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?...

  1. 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

  2. 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.

  3. Nigerian agriculture workers’ outcomes from perceived organisational support and protestant work ethics: Job satisfaction as a mediator

    Directory of Open Access Journals (Sweden)

    Olugbenga J. Ladebo

    2011-10-01

    Research purpose: The present study hypothesised that job satisfaction mediated the relationships between the predictors (perceived organisational support and protestant work ethics and outcomes (organisational citizenship behaviours and organisational commitment. Motivation for the study: There is paucity of literature on the mediating influence of job satisfaction on predictors-outcomes linkages amongst agriculture workers in Nigeria. Available studies either examined the main effect of perceived organisational support on citizenship behaviours or the mediating influence of satisfaction on citizenship behaviours and not the proposed model. Research design, approach and method: The present study was survey-correlational in design. Data were obtained from 223 heterogeneous samples from different organisations (such as ministry of agriculture, parastatals, banks, private agro-allied companies, and insurance companies. Main findings: Results showed that job satisfaction fully mediated the relationship between perceived organisational support and citizenship behaviours and partially mediated the relationship between perceived organisational support and organisational commitment. Further, employee satisfaction partially mediated the relationships between protestant work ethics and citizenship behaviours and organisational commitment. Practical/managerial implications: This study indicated that both protestant work ethics and perceived organisational support are important in motivating employees to engage in cooperative behaviours and exhibit greater commitment through job satisfaction. Contribution/value-add: The present study showed that job satisfaction is a mediator linking both perceived organisational support and protestant work ethics to organisational commitment and citizenship behaviours.

  4. 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.

  5. 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

  6. 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

  7. 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.

  8. 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.

  9. 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.

  10. Supporting students' scientific explanations: A case study investigating the synergy focusing on a teacher's practices when providing instruction and using mobile devices

    Science.gov (United States)

    Delen, Ibrahim

    Engage students in constructing scientific practices is a critical component of science instruction. Therefore a number of researchers have developed software programs to help students and teachers in this hard task. The Zydeco group, designed a mobile application called Zydeco, which enables students to collect data inside and outside the classroom, and then use the data to create scientific explanations by using claim-evidence-reasoning framework. Previous technologies designed to support scientific explanations focused on how these programs improve students' scientific explanations, but these programs ignored how scientific explanation technologies can support teacher practices. Thus, to increase our knowledge how different scaffolds can work together, this study aimed to portray the synergy between a teacher's instructional practices (part 1) and using supports within a mobile devices (part 2) to support students in constructing explanations. Synergy can be thought of as generic and content-specific scaffolds working together to enable students to accomplish challenging tasks, such as creating explanations that they would not normally be able to do without the scaffolds working together. Providing instruction (part 1) focused on understanding how the teacher scaffolds students' initial understanding of the claim-evidence-reasoning (CER) framework. The second component of examining synergy (part 2: using mobile devices) investigated how this teacher used mobile devices to provide feedback when students created explanations. The synergy between providing instruction and using mobile devices was investigated by analyzing a middle school teacher's practices in two different units (plants and water quality). Next, this study focused on describing how the level of synergy influenced the quality of students' scientific explanations. Finally, I investigated the role of focused teaching intervention sessions to inform teacher in relation to students' performance. In

  11. 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…

  12. 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.

  13. 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

  14. Partial Edentulism and its Correlation to Age, Gender, Socio-economic Status and Incidence of Various Kennedy’s Classes– A Literature Review

    OpenAIRE

    Jeyapalan, Vidhya; Krishnan, Chitra Shankar

    2015-01-01

    Partial edentulism, one or more teeth missing is an indication of healthy behaviour of dental practices in the society and attitude towards dental and oral care. The pattern of partial edentulism has been evaluated in many selected populations in different countries by different methods. Most of the studies have evaluated partial edentulism by surveying of Removable Partial Dentures (RPDs), patients visiting clinics, clinical records and population in particular locality.

  15. 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

  16. Esthetic double-structure fixed partial dentures.

    Science.gov (United States)

    Ravasini, G; Ugolini, G; Ravasini, F

    1996-04-01

    A new technical procedure for fixed partial dentures and single inlays allows the use of a metal supporting structure with independent ceramic coverage. The advantages of the technique are the bonding of metal to beveled dentinal margins with conventional cement and the acid-etched resin composite cementation of the ceramic, which permits more conservative preparation of the teeth. The complexity of the structure, the laboratory costs, and the doubling of the cementation procedures are the main disadvantages of the technique.

  17. 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.

  18. Use of information and communication technologies to support effective work practice innovation in the health sector: a multi-site study

    Directory of Open Access Journals (Sweden)

    Georgiou Andrew

    2009-11-01

    Full Text Available Abstract Background Widespread adoption of information and communication technologies (ICT is a key strategy to meet the challenges facing health systems internationally of increasing demands, rising costs, limited resources and workforce shortages. Despite the rapid increase in ICT investment, uptake and acceptance has been slow and the benefits fewer than expected. Absent from the research literature has been a multi-site investigation of how ICT can support and drive innovative work practice. This Australian-based project will assess the factors that allow health service organisations to harness ICT, and the extent to which such systems drive the creation of new sustainable models of service delivery which increase capacity and provide rapid, safe, effective, affordable and sustainable health care. Design A multi-method approach will measure current ICT impact on workforce practices and develop and test new models of ICT use which support innovations in work practice. The research will focus on three large-scale commercial ICT systems being adopted in Australia and other countries: computerised ordering systems, ambulatory electronic medical record systems, and emergency medicine information systems. We will measure and analyse each system's role in supporting five key attributes of work practice innovation: changes in professionals' roles and responsibilities; integration of best practice into routine care; safe care practices; team-based care delivery; and active involvement of consumers in care. Discussion A socio-technical approach to the use of ICT will be adopted to examine and interpret the workforce and organisational complexities of the health sector. The project will also focus on ICT as a potentially disruptive innovation that challenges the way in which health care is delivered and consequently leads some health professionals to view it as a threat to traditional roles and responsibilities and a risk to existing models of care

  19. Use of information and communication technologies to support effective work practice innovation in the health sector: a multi-site study.

    Science.gov (United States)

    Westbrook, Johanna I; Braithwaite, Jeffrey; Gibson, Kathryn; Paoloni, Richard; Callen, Joanne; Georgiou, Andrew; Creswick, Nerida; Robertson, Louise

    2009-11-08

    Widespread adoption of information and communication technologies (ICT) is a key strategy to meet the challenges facing health systems internationally of increasing demands, rising costs, limited resources and workforce shortages. Despite the rapid increase in ICT investment, uptake and acceptance has been slow and the benefits fewer than expected. Absent from the research literature has been a multi-site investigation of how ICT can support and drive innovative work practice. This Australian-based project will assess the factors that allow health service organisations to harness ICT, and the extent to which such systems drive the creation of new sustainable models of service delivery which increase capacity and provide rapid, safe, effective, affordable and sustainable health care. A multi-method approach will measure current ICT impact on workforce practices and develop and test new models of ICT use which support innovations in work practice. The research will focus on three large-scale commercial ICT systems being adopted in Australia and other countries: computerised ordering systems, ambulatory electronic medical record systems, and emergency medicine information systems. We will measure and analyse each system's role in supporting five key attributes of work practice innovation: changes in professionals' roles and responsibilities; integration of best practice into routine care; safe care practices; team-based care delivery; and active involvement of consumers in care. A socio-technical approach to the use of ICT will be adopted to examine and interpret the workforce and organisational complexities of the health sector. The project will also focus on ICT as a potentially disruptive innovation that challenges the way in which health care is delivered and consequently leads some health professionals to view it as a threat to traditional roles and responsibilities and a risk to existing models of care delivery. Such views have stifled debate as well as wider

  20. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  2. 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.

  3. Some Considerations on the Partial Credit Model

    Directory of Open Access Journals (Sweden)

    H.H.F.M. Verstralen

    2008-01-01

    Full Text Available The Partial Credit Model (PCM is sometimes interpreted as a model for stepwise solution of polytomously scored items, where the item parameters are interpreted as di culties of the steps. It is argued that this interpretation is not justi ed. A model for stepwise solution is discussed. It is shown that the PCM is suited to model sums of binary responses which are not supposed to be stochastically independent. As a practical result, a statistical test of stochastic independence in the Rasch model is derived

  4. Maxillary implant-retained partial overdenture with Dolder bar attachment: a clinical report.

    Science.gov (United States)

    Kim, Hyeongil; Buhite, Robert J; Monaco, Edward A

    2015-03-01

    This article describes a technique for maintaining a maxillary Kennedy III partial removable dental prosthesis design in a patient who had non-restorable failing abutments by replacing the abutments with dental implants. Two implants were placed immediately after extraction of the abutment teeth in the anterior maxilla. After the implants were fully integrated, a Dolder bar attachment was fitted onto the implants. A new maxillary partial removable dental prosthesis was fabricated using the implants and the remaining natural teeth as abutments to restore function and esthetics. With the aid of dental implants, this Kennedy III maxillary removable dental prosthesis design could provide additional retention and support by promoting cross-arch stability and tissue, implant and tooth support. The patient's satisfaction was significantly increased.

  5. Partial Oxidation of High-Boiling Hydrocarbon Mixtures in the Pilot Unit

    Czech Academy of Sciences Publication Activity Database

    Hanika, Jiří; Lederer, J.; Nečesaný, F.; Poslední, W.; Tukač, V.; Veselý, Václav

    2014-01-01

    Roč. 68, č. 12 (2014), s. 1701-1706 ISSN 0366-6352 Institutional support: RVO:67985858 Keywords : partial oxidation * high-boiling hydrocarbons * pilot plant Subject RIV: CI - Industrial Chemistry , Chemical Engineering Impact factor: 1.468, year: 2014

  6. 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

  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. Report on ISS Oxygen Production, Resupply, and Partial Pressure Management

    Science.gov (United States)

    Schaezler, Ryan; Ghariani, Ahmed; Leonard, Daniel; Lehman, Daniel

    2011-01-01

    The majority of oxygen used on International Space Station (ISS) is for metabolic support and denitrogenation procedures prior to Extra-Vehicular Activities. Oxygen is supplied by various visiting vehicles such as the Progress and Shuttle in addition to oxygen production capability on both the United States On-Orbit Segment (USOS) and Russian Segment (RS). To maintain a habitable atmosphere the oxygen partial pressure is controlled between upper and lower bounds. The full range of the allowable oxygen partial pressure along with the increased ISS cabin volume is utilized as a buffer allowing days to pass between oxygen production or direct addition of oxygen to the atmosphere from reserves. This paper summarizes amount of oxygen supplied and produced from all of the sources and describes past experience of managing oxygen partial pressure along with the range of management options available to the ISS.

  9. 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.

  10. Experts' understanding of partial derivatives using the Partial Derivative Machine

    OpenAIRE

    Roundy, David; Dorko, Allison; Dray, Tevian; Manogue, Corinne A.; Weber, Eric

    2014-01-01

    Partial derivatives are used in a variety of different ways within physics. Most notably, thermodynamics uses partial derivatives in ways that students often find confusing. As part of a collaboration with mathematics faculty, we are at the beginning of a study of the teaching of partial derivatives, a goal of better aligning the teaching of multivariable calculus with the needs of students in STEM disciplines. As a part of this project, we have performed a pilot study of expert understanding...

  11. Crowdfunding Through a Partial Organizational Lens

    DEFF Research Database (Denmark)

    Roed Nielsen, Kristian

    -professional investors to support their preferred project(s). However, while the phenomenon continues to grow rapidly our academic knowledge of this emergent organizational form has lagged behind. The literature to date remains largely ‘phenomenon-driven’ where definitions and descriptions are typically delimited...... types, where complete and partial organisations do not emerge as separate entities each filling their own presupposed role, but do so co-dependently which consequently allow for a fluid, but also entangled organizational structure. The paper finally argues that crowdfunding literature merits greater...

  12. 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.

  13. 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.

  14. 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.

  15. Practice Facilitator Strategies for Addressing Electronic Health Record Data Challenges for Quality Improvement: EvidenceNOW.

    Science.gov (United States)

    Hemler, Jennifer R; Hall, Jennifer D; Cholan, Raja A; Crabtree, Benjamin F; Damschroder, Laura J; Solberg, Leif I; Ono, Sarah S; Cohen, Deborah J

    2018-01-01

    Practice facilitators ("facilitators") can play an important role in supporting primary care practices in performing quality improvement (QI), but they need complete and accurate clinical performance data from practices' electronic health records (EHR) to help them set improvement priorities, guide clinical change, and monitor progress. Here, we describe the strategies facilitators use to help practices perform QI when complete or accurate performance data are not available. Seven regional cooperatives enrolled approximately 1500 small-to-medium-sized primary care practices and 136 facilitators in EvidenceNOW, the Agency for Healthcare Research and Quality's initiative to improve cardiovascular preventive services. The national evaluation team analyzed qualitative data from online diaries, site visit field notes, and interviews to discover how facilitators worked with practices on EHR data challenges to obtain and use data for QI. We found facilitators faced practice-level EHR data challenges, such as a lack of clinical performance data, partial or incomplete clinical performance data, and inaccurate clinical performance data. We found that facilitators responded to these challenges, respectively, by using other data sources or tools to fill in for missing data, approximating performance reports and generating patient lists, and teaching practices how to document care and confirm performance measures. In addition, facilitators helped practices communicate with EHR vendors or health systems in requesting data they needed. Overall, facilitators tailored strategies to fit the individual practice and helped build data skills and trust. Facilitators can use a range of strategies to help practices perform data-driven QI when performance data are inaccurate, incomplete, or missing. Support is necessary to help practices, particularly those with EHR data challenges, build their capacity for conducting data-driven QI that is required of them for participating in practice

  16. 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.

  17. The breathing of webs under repeated partial edge loading

    Czech Academy of Sciences Publication Activity Database

    Škaloud, Miroslav; Zörnerová, Marie; Urushadze, Shota

    2012-01-01

    Roč. 40, č. 1 (2012), s. 463-468 E-ISSN 1877-7058. [Steel structures and bridges. Podbanske, 26.09.2012-28.09.2012] R&D Projects: GA ČR GA103/08/1340 Institutional support: RVO:68378297 Keywords : slender webs * breathing * fatigue limit state * design * repeated partial edge loading Subject RIV: JM - Building Engineering

  18. Supporting Beginning Teacher Planning and Enactment of Investigation-based Science Discussions: The Design and Use of Tools within Practice-based Teacher Education

    Science.gov (United States)

    Kademian, Sylvie M.

    Current reform efforts prioritize science instruction that provides opportunities for students to engage in productive talk about scientific phenomena. Given the challenges teachers face enacting instruction that integrates science practices and science content, beginning teachers need support to develop the knowledge and teaching practices required to teach reform-oriented science lessons. Practice-based teacher education shows potential for supporting beginning teachers while they are learning to teach in this way. However, little is known about how beginning elementary teachers draw upon the types of support and tools associated with practice-based teacher education to learn to successfully enact this type of instruction. This dissertation addresses this gap by investigating how a practice-based science methods course using a suite of teacher educator-provided tools can support beginning teachers' planning and enactment of investigation-based science lessons. Using qualitative case study methodologies, this study drew on video-records, lesson plans, class assignments, and surveys from one cohort of 22 pre-service teachers (called interns in this study) enrolled in a year-long elementary education master of the arts and teaching certification program. Six focal interns were also interviewed at multiple time-points during the methods course. Similarities existed across the types of tools and teaching practices interns used most frequently to plan and enact investigation-based discussions. For the focal interns, use of four synergistic teaching practices throughout the lesson enactments (including consideration of students' initial ideas; use of open-ended questions to elicit, extend, and challenge ideas; connecting across students' ideas and the disciplinary core ideas; and use of a representation to organize and highlight students' ideas) appeared to lead to increased opportunities for students to share their ideas and engage in data analysis, argumentation and

  19. 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

  20. When Family-Supportive Supervision Matters: Relations between Multiple Sources of Support and Work-Family Balance

    Science.gov (United States)

    Greenhaus, Jeffrey H.; Ziegert, Jonathan C.; Allen, Tammy D.

    2012-01-01

    This study examines the mechanisms by which family-supportive supervision is related to employee work-family balance. Based on a sample of 170 business professionals, we found that the positive relation between family-supportive supervision and balance was fully mediated by work interference with family (WIF) and partially mediated by family…

  1. 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.

  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. 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.

  4. Needs, practices and social support: subjective dimensions of social determinants of health - DOI: 10.3395/reciis.v2i2.124en

    Directory of Open Access Journals (Sweden)

    Deise Lisboa Riquinho

    2009-03-01

    Full Text Available The individual’s role in view of the social and health inequalities does not occur passively; there are strategies, many times ignored by the social services, which cause the search for care. It is believed that the social groups set forth support relationships by configuring social networks which define therapeutic practices and cooperate in confrontation of daily situations. Thus the purpose of this research is to know and understand the needs in health, the therapeutic practices and the social support in the community of Rincão dos Maia, Canguçu, RS, having social inequalities as background. For that a quantitative-qualitative methodology was used by means of forms, semi-structured interview, participant observation and field journal. By considering that the health needs are heterogeneous, the practices performed to meet them correspond to different strategies such as deployment of resources by means of social support of adopted therapeutic practices. The approach of these dynamics will lead to the understanding of health needs, incorporating local realities aiming to contribute to the formulation of decentralized public policies accounting for the citizens’ demands.

  5. Minimal Blocking Sets in PG(2, 8) and Maximal Partial Spreads in PG(3, 8)

    DEFF Research Database (Denmark)

    Barat, Janos

    2004-01-01

    We prove that PG(2, 8) does not contain minimal blocking sets of size 14. Using this result we prove that 58 is the largest size for a maximal partial spread of PG(3, 8). This supports the conjecture that q2-q+ 2 is the largest size for a maximal partial spread of PG(3, q), q>7....

  6. 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…

  7. Experiences of General Practitioners and Practice Support Staff Using a Health and Lifestyle Screening App in Primary Health Care: Implementation Case Study.

    Science.gov (United States)

    Webb, Marianne Julie; Wadley, Greg; Sanci, Lena Amanda

    2018-04-24

    Technology-based screening of young people for mental health disorders and health compromising behaviors in general practice increases the disclosure of sensitive health issues and improves patient-centered care. However, few studies investigate how general practitioners (GPs) and practice support staff (receptionists and practice managers) integrate screening technology into their routine work, including the problems that arise and how the staff surmount them. The aim of this study was to investigate the implementation of a health and lifestyle screening app, Check Up GP, for young people aged 14 to 25 years attending an Australian general practice. We conducted an in-depth implementation case study of Check Up GP in one general practice clinic, with methodology informed by action research. Semistructured interviews and focus groups were conducted with GPs and support staff at the end of the implementation period. Data were thematically analyzed and mapped to normalization process theory constructs. We also analyzed the number of times we supported staff, the location where young people completed Check Up GP, and whether they felt they had sufficient privacy and received a text messaging (short message service, SMS) link at the time of taking their appointment. A total of 4 GPs and 10 support staff at the clinic participated in the study, with all except 3 receptionists participating in the final interviews and focus groups. During the 2-month implementation period, the technology and administration of Check Up GP was iterated through 4 major quality improvement cycles in response to the needs of the staff. This resulted in a reduction in the average time taken to complete Check Up GP from 14 min to 10 min, improved SMS text messaging for young people, and a more consistent description of the app by receptionists to young people. In the first weeks of implementation, researchers needed to regularly support staff with the app's administration; however, this support

  8. 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

  9. Laparoscopic Partial Hepatectomy: Animal Experiments

    Directory of Open Access Journals (Sweden)

    Haruhiro Inoue

    1995-01-01

    Full Text Available As a first step in firmly establishing laparoscopic hepatectomy, we introduce a porcine model of laparoscopic partial hepatectomy. This procedure has been successfully performed under the normal-pressure or low-pressure pneumoperitoneum condition supported by the full-thickness abdominal wall lifting technique. An ultrasonic dissector combined with electrocautery, newly developed by Olympus Optical Corporation (Japan was effectively utilized in facilitating safe and smooth incisions into the liver parenchyma. Although indications for this procedure seem to be limited only to peripheral lesions and not to central lesions, clinical application of this method may be useful for some patients in the near future.

  10. 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.

  11. 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

  12. 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…

  13. 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

  14. 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.

  15. 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.

  16. 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.

  17. Witnessing Interparental Violence, Parenting Practices, and Children´s Long-Term Psychological Distress

    Directory of Open Access Journals (Sweden)

    Manuel Gámez-Guadix

    2011-07-01

    Full Text Available The first objective of this study was to examine the relationship between witnessing interparental violence and children´s long-term psychological distress, and the extent to which this relation is mediated by deteriorating parenting practices (i.e., harsh discipline, affection/support, interparental and intraparental consistency. The second objective was to analyze the possible gender differences in the relationships specified. The sample comprised 680 Spanish university students (62.4% females selected by random, stratified, and proportional sampling (by faculty and sex. Participants retrospectively reported the physical and psychological violence perpetrated by one of his or her parents against the other, the parenting practices when they were preadolescents, and the psychological distress during the past two weeks. Results revealed that harsh discipline and the level of affection and affection/support partially mediated the association between children´s witnessing interparental violence and their long-term psychological distress. These relationships were not significantly different as a function of participants´ sex. Lastly, we discuss the implications of these findings for the planning and development of intervention programs.

  18. The influence of partial oxidation mechanisms on tar destruction in TwoStage biomass gasification

    DEFF Research Database (Denmark)

    Ahrenfeldt, Jesper; Egsgaard, Helge; Stelte, Wolfgang

    2013-01-01

    adsorption and determined by stable isotope dilution analysis. The results have shown that partial oxidation reduces and converts primary tars into low molecular weight, polycyclic aromatic hydrocarbons (PAHs), primarily naphthalene. At temperatures above 950°C practically all phenol is converted...

  19. 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

  20. Professional courtesy--current practices and attitudes.

    Science.gov (United States)

    Levy, M A; Arnold, R M; Fine, M J; Kapoor, W N

    1993-11-25

    Physicians have long provided care free of charge or at a reduced rate as a professional courtesy to other physicians and their families. We conducted a stratified national mail survey to assess the extent to which this practice has changed in recent years. Using the American Medical Association's 1991 master list of physicians, we selected a random sample of 4800 practicing physicians from 12 direct-care specialties. These physicians were asked about their current policy and opinions regarding professional courtesy. Of the 2224 respondents, 2127 (96 percent) offered professional courtesy, defined as providing free or discounted health care to physicians and their families. Psychiatrists were less likely to offer professional courtesy than physicians in any of the other specialties (80 percent vs. 91 to 99 percent, P courtesy included billing only the insurance company (75 percent), providing care at no charge (49 percent), and giving a partial discount (23 percent). Twenty-three percent of the respondents reported that they had changed their policy regarding professional courtesy since starting to practice. Among those who had changed their policy, the most common changes were to increase the practice of billing only the insurance company (67 percent) and to provide care at no charge less often (58 percent). The majority of physicians responding to the survey thought that professional courtesy solidified bonds between physicians (79 percent) and was sound business practice (62 percent); 12 percent believed that it was too expensive to offer free or discounted care as a professional courtesy, and 14 percent thought that the practice had negative effects on the physician-patient interaction. Our survey of physicians involved in direct patient care indicates that, with the exception of psychiatrists, almost all American physicians offer free or discounted care as a professional courtesy and support the practice.

  1. Compatriot partiality and cosmopolitan justice: Can we justify compatriot partiality within the cosmopolitan framework?

    Directory of Open Access Journals (Sweden)

    Rachelle Bascara

    2016-10-01

    Full Text Available This paper shows an alternative way in which compatriot partiality could be justified within the framework of global distributive justice. Philosophers who argue that compatriot partiality is similar to racial partiality capture something correct about compatriot partiality. However, the analogy should not lead us to comprehensively reject compatriot partiality. We can justify compatriot partiality on the same grounds that liberation movements and affirmative action have been justified. Hence, given cosmopolitan demands of justice, special consideration for the economic well-being of your nation as a whole is justified if and only if the country it identifies is an oppressed developing nation in an unjust global order.This justification is incomplete. We also need to say why Person A, qua national of Country A, is justified in helping her compatriots in Country A over similarly or slightly more oppressed non-compatriots in Country B. I argue that Person A’s partiality towards her compatriots admits further vindication because it is part of an oppressed group’s project of self-emancipation, which is preferable to paternalistic emancipation.Finally, I identify three benefits in my justification for compatriot partiality. First, I do not offer a blanket justification for all forms of compatriot partiality. Partiality between members of oppressed groups is only a temporary effective measure designed to level an unlevel playing field. Second, because history attests that sovereign republics could arise as a collective response to colonial oppression, justifying compatriot partiality on the grounds that I have identified is conducive to the development of sovereignty and even democracy in poor countries, thereby avoiding problems of infringement that many humanitarian poverty alleviation efforts encounter. Finally, my justification for compatriot partiality complies with the implicit cosmopolitan commitment to the realizability of global justice

  2. 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

  3. Effective stress principle for partially saturated media

    International Nuclear Information System (INIS)

    McTigue, D.F.; Wilson, R.K.; Nunziato, J.W.

    1984-04-01

    In support of the Nevada Nuclear Waste Storage Investigation (NNWSI) Project, we have undertaken a fundamental study of water migration in partially saturated media. One aspect of that study, on which we report here, has been to use the continuum theory of mixtures to extend the classical notion of effective stress to partially saturated media. Our analysis recovers previously proposed phenomenological representations for the effective stress in terms of the capillary pressure. The theory is illustrated by specializing to the case of linear poroelasticity, for which we calculate the deformation due to the fluid pressure in a static capillary fringe. We then examine the transient consolidation associated with liquid flow induced by an applied surface load. Settlement accompanies this flow as the liquid is redistributed by a nonlinear diffusion process. For material properties characteristic of tuff from the Nevada Test Site, these effects are found to be vanishingly small. 14 references, 7 figures, 1 table

  4. Extended abstract: Partial row projection methods

    Energy Technology Data Exchange (ETDEWEB)

    Bramley, R.; Lee, Y. [Indiana Univ., Bloomington, IN (United States)

    1996-12-31

    Accelerated row projection (RP) algorithms for solving linear systems Ax = b are a class of iterative methods which in theory converge for any nonsingular matrix. RP methods are by definition ones that require finding the orthogonal projection of vectors onto the null space of block rows of the matrix. The Kaczmarz form, considered here because it has a better spectrum for iterative methods, has an iteration matrix that is the product of such projectors. Because straightforward Kaczmarz method converges slowly for practical problems, typically an outer CG acceleration is applied. Definiteness, symmetry, or localization of the eigenvalues, of the coefficient matrix is not required. In spite of this robustness, work has generally been limited to structured systems such as block tridiagonal matrices because unlike many iterative solvers, RP methods cannot be implemented by simply supplying a matrix-vector multiplication routine. Finding the orthogonal projection of vectors onto the null space of block rows of the matrix in practice requires accessing the actual entries in the matrix. This report introduces a new partial RP algorithm which retains advantages of the RP methods.

  5. Impact of partial-volume correction in oncological PET studies. A systematic review and meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Cysouw, Matthijs C.F.; Kramer, Gerbrand M.; Hoekstra, Otto S. [VU University Medical Centre, Department of Radiology and Nuclear Medicine, Amsterdam (Netherlands); Schoonmade, Linda J. [VU University Medical Centre, Department of Medical Library, Amsterdam (Netherlands); Boellaard, Ronald [VU University Medical Centre, Department of Radiology and Nuclear Medicine, Amsterdam (Netherlands); University Medical Centre Groningen, Department of Nuclear Medicine and Molecular Imaging, Groningen (Netherlands); Vet, Henrica C.W. de [VU University Medical Centre, Department of Epidemiology and Biostatistics, Amsterdam (Netherlands)

    2017-11-15

    Positron-emission tomography can be useful in oncology for diagnosis, (re)staging, determining prognosis, and response assessment. However, partial-volume effects hamper accurate quantification of lesions <2-3 x the PET system's spatial resolution, and the clinical impact of this is not evident. This systematic review provides an up-to-date overview of studies investigating the impact of partial-volume correction (PVC) in oncological PET studies. We searched in PubMed and Embase databases according to the PRISMA statement, including studies from inception till May 9, 2016. Two reviewers independently screened all abstracts and eligible full-text articles and performed quality assessment according to QUADAS-2 and QUIPS criteria. For a set of similar diagnostic studies, we statistically pooled the results using bivariate meta-regression. Thirty-one studies were eligible for inclusion. Overall, study quality was good. For diagnosis and nodal staging, PVC yielded a strong trend of increased sensitivity at expense of specificity. Meta-analysis of six studies investigating diagnosis of pulmonary nodules (679 lesions) showed no significant change in diagnostic accuracy after PVC (p = 0.222). Prognostication was not improved for non-small cell lung cancer and esophageal cancer, whereas it did improve for head and neck cancer. Response assessment was not improved by PVC for (locally advanced) breast cancer or rectal cancer, and it worsened in metastatic colorectal cancer. The accumulated evidence to date does not support routine application of PVC in standard clinical PET practice. Consensus on the preferred PVC methodology in oncological PET should be reached. Partial-volume-corrected data should be used as adjuncts to, but not yet replacement for, uncorrected data. (orig.)

  6. School-related social support and subjective well-being in school among adolescents: The role of self-system factors.

    Science.gov (United States)

    Tian, Lili; Zhao, Jie; Huebner, E Scott

    2015-12-01

    This 6-week longitudinal study aimed to examine a moderated mediation model that may explain the link between school-related social support (i.e., teacher support and classmate support) and optimal subjective well-being in school among adolescents (n = 1316). Analyses confirmed the hypothesized model that scholastic competence partially mediated the relations between school-related social support and subjective well-being in school, and social acceptance moderated the mediation process in the school-related social support--> subjective well-being in school path and in the scholastic competence--> subjective well-being in school path. The findings suggested that both social contextual factors (e.g., school-related social support) and self-system factors (e.g., scholastic competence and social acceptance) are crucial for adolescents' optimal subjective well-being in school. Limitations and practical applications of the study were discussed. Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  7. 75 FR 25844 - Class Deviation From FAR 52.219-7, Notice of Partial Small Business Set-Aside

    Science.gov (United States)

    2010-05-10

    ... Small Business Set-Aside AGENCY: Defense Logistics Agency, DoD. ACTION: Notice. SUMMARY: This is to...) regarding partial small business set-asides for Defense Logistics Agency (DLA), Defense Energy Support..., DESC is requesting a class deviation from FAR Clause 52.219-7, Notice of Partial Small Business Set...

  8. 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.

  9. 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

  10. 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...

  11. Prospective study on laser-assisted laparascopic partial nephrectomy

    Science.gov (United States)

    Sroka, Ronald; Hennig, Georg; Zilinberg, Katja; Khoder, Wael Y.

    2012-02-01

    rinsing. Conclusion: This prospective in-vivo feasibility study shows that laser assisted partial nephrectomy seems to be a safe and promising medical technique which could be provided either during open surgery as well as laparascopically. This application showed good haemostasis and minimal parenchymal damage. Further investigations and development are needed for on-line detection of the remain coagulation margin. An optimised treatment equipment will support the applicability of laser assisted laparoscopic partial nephrectomy.

  12. 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.

  13. 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.

  14. [Correlation between the inspired fraction of oxygen, maternal partial oxygen pressure, and fetal partial oxygen pressure during cesarean section of normal pregnancies].

    Science.gov (United States)

    Castro, Carlos Henrique Viana de; Cruvinel, Marcos Guilherme Cunha; Carneiro, Fabiano Soares; Silva, Yerkes Pereira; Cabral, Antônio Carlos Vieira; Bessa, Roberto Cardoso

    2009-01-01

    Despite changes in pulmonary function, maternal oxygenation is maintained during obstetric regional blocks. But in those situations, the administration of supplementary oxygen to parturients is a common practice. Good fetal oxygenation is the main justification; however, this has not been proven. The objective of this randomized, prospective study was to test the hypothesis of whether maternal hyperoxia is correlated with an increase in fetal gasometric parameters in elective cesarean sections. Arterial blood gases of 20 parturients undergoing spinal block with different inspired fractions of oxygen were evaluated and correlated with fetal arterial blood gases. An increase in maternal inspired fraction of oxygen did not show any correlation with an increase of fetal partial oxygen pressure. Induction of maternal hyperoxia by the administration of supplementary oxygen did not increase fetal partial oxygen pressure. Fetal gasometric parameters did not change even when maternal parameters changed, induced by hyperoxia, during cesarean section under spinal block.

  15. 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

  16. 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.

  17. Who Supports the Successful Implementation and Sustainability of Evidence-Based Practices? Defining and Understanding the Roles of Intermediary and Purveyor Organizations.

    Science.gov (United States)

    Franks, Robert P; Bory, Christopher T

    2015-01-01

    Research on implementation science has increased significantly over the past decade. In particular, psychologists have looked closely at the value and importance of bridging the gap between science and practice. As evidence-based practices (EBPs) become more prevalent, concrete mechanisms are needed to bring these scientifically supported treatments and interventions to community-based settings. Intermediary and purveyor organizations (IPOs) have emerged in recent years that specialize in bringing research to practice. Using a framework developed by Franks (), this descriptive study surveyed respondents that self-identified as IPOs and focused on identifying shared definitions, functions, and activities. Results indicated that seven descriptive roles previously identified were supported by this survey and many common shared activities, goals, and functions across these organizations were observed. Further, these organizations appear to be influenced by the growing field of implementation science. Limitations and implications of this study are discussed. © 2015 Wiley Periodicals, Inc.

  18. Development of shared decision-making resources to help inform difficult healthcare decisions: An example focused on dysvascular partial foot and transtibial amputations.

    Science.gov (United States)

    Quigley, Matthew; Dillon, Michael P; Fatone, Stefania

    2018-02-01

    Shared decision making is a consultative process designed to encourage patient participation in decision making by providing accurate information about the treatment options and supporting deliberation with the clinicians about treatment options. The process can be supported by resources such as decision aids and discussion guides designed to inform and facilitate often difficult conversations. As this process increases in use, there is opportunity to raise awareness of shared decision making and the international standards used to guide the development of quality resources for use in areas of prosthetic/orthotic care. To describe the process used to develop shared decision-making resources, using an illustrative example focused on decisions about the level of dysvascular partial foot amputation or transtibial amputation. Development process: The International Patient Decision Aid Standards were used to guide the development of the decision aid and discussion guide focused on decisions about the level of dysvascular partial foot amputation or transtibial amputation. Examples from these shared decision-making resources help illuminate the stages of development including scoping and design, research synthesis, iterative development of a prototype, and preliminary testing with patients and clinicians not involved in the development process. Lessons learnt through the process, such as using the International Patient Decision Aid Standards checklist and development guidelines, may help inform others wanting to develop similar shared decision-making resources given the applicability of shared decision making to many areas of prosthetic-/orthotic-related practice. Clinical relevance Shared decision making is a process designed to guide conversations that help patients make an informed decision about their healthcare. Raising awareness of shared decision making and the international standards for development of high-quality decision aids and discussion guides is important

  19. 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

  20. 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)

  1. 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.

  2. Lower bounds for the circuit size of partially homogeneous polynomials

    Czech Academy of Sciences Publication Activity Database

    Le, Hong-Van

    2017-01-01

    Roč. 225, č. 4 (2017), s. 639-657 ISSN 1072-3374 Institutional support: RVO:67985840 Keywords : partially homogeneous polynomials * polynomials Subject RIV: BA - General Mathematics OBOR OECD: Computer sciences, information science, bioinformathics (hardware development to be 2.2, social aspect to be 5.8) https://link.springer.com/article/10.1007/s10958-017-3483-4

  3. 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 pulmonary disease patients to identify and achieve personal health related goals through action plans. Of 21% of invited practices that responded, 19 were allocated to health mentoring; however, general practice nurses were unable to train as health mentors in 14 (74%), principally due to lack of financial compensation and/or workload pressure. For five general practice nurses trained as health mentors, their roles had previously included some chronic disease management, but training enhanced their understanding and skills of self-management approaches and increased the focus on patient partnership, prioritising patients' choices and achievability. Difficulties that led to early withdrawal of health mentors were competing demands, insufficient time availability, phone calls having lower priority than face-to-face interactions and changing employment. Skills gained were rated as valuable, applicable to all clinical practice and transferable to other health care settings. Although these results suggest that training can enhance general practice nurses' skills to deliver self-management support in chronic disease, there are significant system barriers that need to be addressed through funding models and organisational change.

  4. Compatible Spatial Discretizations for Partial Differential Equations

    Energy Technology Data Exchange (ETDEWEB)

    Arnold, Douglas, N, ed.

    2004-11-25

    From May 11--15, 2004, the Institute for Mathematics and its Applications held a hot topics workshop on Compatible Spatial Discretizations for Partial Differential Equations. The numerical solution of partial differential equations (PDE) is a fundamental task in science and engineering. The goal of the workshop was to bring together a spectrum of scientists at the forefront of the research in the numerical solution of PDEs to discuss compatible spatial discretizations. We define compatible spatial discretizations as those that inherit or mimic fundamental properties of the PDE such as topology, conservation, symmetries, and positivity structures and maximum principles. A wide variety of discretization methods applied across a wide range of scientific and engineering applications have been designed to or found to inherit or mimic intrinsic spatial structure and reproduce fundamental properties of the solution of the continuous PDE model at the finite dimensional level. A profusion of such methods and concepts relevant to understanding them have been developed and explored: mixed finite element methods, mimetic finite differences, support operator methods, control volume methods, discrete differential forms, Whitney forms, conservative differencing, discrete Hodge operators, discrete Helmholtz decomposition, finite integration techniques, staggered grid and dual grid methods, etc. This workshop seeks to foster communication among the diverse groups of researchers designing, applying, and studying such methods as well as researchers involved in practical solution of large scale problems that may benefit from advancements in such discretizations; to help elucidate the relations between the different methods and concepts; and to generally advance our understanding in the area of compatible spatial discretization methods for PDE. Particular points of emphasis included: + Identification of intrinsic properties of PDE models that are critical for the fidelity of numerical

  5. Building chronic disease management capacity in General Practice: The South Australian GP Plus Practice Nurse Initiative.

    Science.gov (United States)

    Fuller, Jeffrey; Koehne, Kristy; Verrall, Claire C; Szabo, Natalie; Bollen, Chris; Parker, Sharon

    2015-01-01

    This paper draws on the implementation experience of the South Australian GP Plus Practice Nurse Initiative in order to establish what is needed to support the development of the chronic disease management role of practice nurses. The Initiative was delivered between 2007 and 2010 to recruit, train and place 157 nurses across 147 General Practices in Adelaide. The purpose was to improve chronic disease management in General Practice, by equipping nurses to work as practice nurses who would coordinate care and establish chronic disease management systems. Secondary analysis of qualitative data contained in the Initiative evaluation report, specifically drawing on quarterly project records and four focus groups conducted with practice nurses, practice nurse coordinators and practice nurse mentors. As evidenced by the need to increase the amount of support provided during the implementation of the Initiative, nurses new to General Practice faced challenges in their new role. Nurses described a big learning curve as they dealt with role transition to a new work environment and learning a range of new skills while developing chronic disease management systems. Informants valued the skills development and support offered by the Initiative, however the ongoing difficulties in implementing the role suggested that change is also needed at the level of the Practice. While just over a half of the placement positions were retained, practice nurses expressed concern with having to negotiate the conditions of their employment. In order to advance the role of practice nurses as managers of chronic disease support is needed at two levels. At one level support is needed to assist practice nurses to build their own skills. At the level of the Practice, and in the wider health workforce system, support is also needed to ensure that Practices are organisationally ready to include the practice nurse within the practice team.

  6. Interventions for replacing missing teeth: partially absent dentition.

    Science.gov (United States)

    Abt, Elliot; Carr, Alan B; Worthington, Helen V

    2012-02-15

    another. With fixed dental prostheses (FDPs), there was no evidence that high gold alloys are better or worse than other alloys, nor that gold alloys or frameworks are better or worse than titanium. There is insufficient evidence to determine whether zirconia is better or worse that other FDP materials, that ceramic abutments are better or worse than titanium, or that one cement was better or worse than another in retaining FDPs. There is insufficient evidence to determine the relative effectiveness of FDPs and RDPs in patients with shortened dental arch or to determine the relative advantages of implant supported FDPs versus tooth/implant supported FDPs. Based on trials meeting the inclusion criteria for this review, there is insufficient evidence to recommend a particular method of tooth replacement for partially edentulous patients.

  7. 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.

  8. Influence of Partial Neutralization on Catalytic Activity of Ion Exchange Resin

    Czech Academy of Sciences Publication Activity Database

    Holub, Ladislav; Jeřábek, Karel

    2005-01-01

    Roč. 231, 1-2 (2005), s. 21-26 ISSN 1381-1169 R&D Projects: GA ČR(CZ) GA104/02/1104 Institutional research plan: CEZ:AV0Z40720504 Keywords : catalysis * partial neutralization * polymer supports Subject RIV: CI - Industrial Chemistry, Chemical Engineering Impact factor: 2.348, year: 2005

  9. Partial Edentulism and its Correlation to Age, Gender, Socio-economic Status and Incidence of Various Kennedy's Classes- A Literature Review.

    Science.gov (United States)

    Jeyapalan, Vidhya; Krishnan, Chitra Shankar

    2015-06-01

    Partial edentulism, one or more teeth missing is an indication of healthy behaviour of dental practices in the society and attitude towards dental and oral care. The pattern of partial edentulism has been evaluated in many selected populations in different countries by different methods. Most of the studies have evaluated partial edentulism by surveying of Removable Partial Dentures (RPDs), patients visiting clinics, clinical records and population in particular locality. The objective of the study is to review the prevalence of partial edentulousness and its correlation to age,gender, arch predominance, socio economic factors and incidence of various Kennedy's Classes. Key observations drawn from the review are as below. There is no gender correlation for partial edentulism.Prevalence of partial edentulism is more common in mandibular arch than maxillary arch.Younger adults have more Class III and IV RPDs. Elders have more distal extension RPDs Class I and II.

  10. 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.

  11. Tutorial on Online Partial Evaluation

    Directory of Open Access Journals (Sweden)

    William R. Cook

    2011-09-01

    Full Text Available This paper is a short tutorial introduction to online partial evaluation. We show how to write a simple online partial evaluator for a simple, pure, first-order, functional programming language. In particular, we show that the partial evaluator can be derived as a variation on a compositionally defined interpreter. We demonstrate the use of the resulting partial evaluator for program optimization in the context of model-driven development.

  12. Finite element methods a practical guide

    CERN Document Server

    Whiteley, Jonathan

    2017-01-01

    This book presents practical applications of the finite element method to general differential equations. The underlying strategy of deriving the finite element solution is introduced using linear ordinary differential equations, thus allowing the basic concepts of the finite element solution to be introduced without being obscured by the additional mathematical detail required when applying this technique to partial differential equations. The author generalizes the presented approach to partial differential equations which include nonlinearities. The book also includes variations of the finite element method such as different classes of meshes and basic functions. Practical application of the theory is emphasised, with development of all concepts leading ultimately to a description of their computational implementation illustrated using Matlab functions. The target audience primarily comprises applied researchers and practitioners in engineering, but the book may also be beneficial for graduate students.

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

    Directory of Open Access Journals (Sweden)

    Dana Ruggiero

    2015-05-01

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

  14. Multicentre prospective evaluation of implant-assisted mandibular bilateral distal extension removable partial dentures: patient satisfaction.

    Science.gov (United States)

    Wismeijer, Daniel; Tawse-Smith, Andrew; Payne, Alan G T

    2013-01-01

    To compare the levels of patient satisfaction with either conventional mandibular bilateral distal extension partial dentures or those assisted by bilateral distal implants. Forty-eight participants who were dissatisfied with their existing conventional mandibular distal extension dentures opposing complete maxillary dentures were selected for a multicentre prospective study in New Zealand, Colombia and the Netherlands. A control group of 12 participants in New Zealand received conventional mandibular partial dentures. Three test groups involving 36 participants in New Zealand (12), Colombia (12) and the Netherlands (12) received bilateral distal implants in the second molar regions. After conventional loading, the test group participants initially had healing caps placed on the distal implants providing support only, followed after approximately 6 months by ball abutments (retentive anchors) for support and retention. Patient outcomes were determined with questionnaires completed at specific stages of the study for up to 3 years. Visual analogue scale, Likert and oral health impact questionnaires before and after treatment indicated improved results. There were significantly improved parameters of overall satisfaction, stability, chewing and appearance after 3 years (P removable partial dentures are a preferable treatment option for patients with complaints about their conventional distal extension partial dentures. © 2011 John Wiley & Sons A/S.

  15. ICT in Portuguese Reference Schools for the Education of Blind and Partially Sighted Students

    Science.gov (United States)

    Ramos, Sara Isabel Moca; de Andrade, António Manuel Valente

    2016-01-01

    Technology has become an essential component in our society and considering its impact in the educational system, Information and Communication Technologies (ICT) cannot be dissociated from the educational process and, in particular, from pedagogical practices adopted for students who are blind or partially sighted. This study focuses on…

  16. A case of partial melanism in Lacerta agilis (Linnaeus, 1758) from the Czech Republic

    Czech Academy of Sciences Publication Activity Database

    Smolinský, Radovan

    2016-01-01

    Roč. 29, 1-2 (2016), s. 110-112 ISSN 1013-4425 Institutional support: RVO:68081766 Keywords : Lacerta agilis * partial melanism * Czech Republic Subject RIV: EG - Zoology Impact factor: 1.194, year: 2016

  17. 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.

  18. Monogamy relations of quantum entanglement for partially coherently superposed states

    Science.gov (United States)

    Shi, Xian

    2017-12-01

    Not Available Project partially supported by the National Key Research and Development Program of China (Grant No. 2016YFB1000902), the National Natural Science Foundation of China (Grant Nos. 61232015, 61472412, and 61621003), the Beijing Science and Technology Project (2016), Tsinghua-Tencent-AMSS-Joint Project (2016), and the Key Laboratory of Mathematics Mechanization Project: Quantum Computing and Quantum Information Processing.

  19. 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.)

  20. Exact Partial Information Decompositions for Gaussian Systems Based on Dependency Constraints

    Directory of Open Access Journals (Sweden)

    Jim W. Kay

    2018-03-01

    Full Text Available The Partial Information Decomposition, introduced by Williams P. L. et al. (2010, provides a theoretical framework to characterize and quantify the structure of multivariate information sharing. A new method ( I dep has recently been proposed by James R. G. et al. (2017 for computing a two-predictor partial information decomposition over discrete spaces. A lattice of maximum entropy probability models is constructed based on marginal dependency constraints, and the unique information that a particular predictor has about the target is defined as the minimum increase in joint predictor-target mutual information when that particular predictor-target marginal dependency is constrained. Here, we apply the I dep approach to Gaussian systems, for which the marginally constrained maximum entropy models are Gaussian graphical models. Closed form solutions for the I dep PID are derived for both univariate and multivariate Gaussian systems. Numerical and graphical illustrations are provided, together with practical and theoretical comparisons of the I dep PID with the minimum mutual information partial information decomposition ( I mmi , which was discussed by Barrett A. B. (2015. The results obtained using I dep appear to be more intuitive than those given with other methods, such as I mmi , in which the redundant and unique information components are constrained to depend only on the predictor-target marginal distributions. In particular, it is proved that the I mmi method generally produces larger estimates of redundancy and synergy than does the I dep method. In discussion of the practical examples, the PIDs are complemented by the use of tests of deviance for the comparison of Gaussian graphical models.

  1. Operational research within a Global Fund supported tuberculosis project in India: why, how and its contribution towards change in policy and practice

    Science.gov (United States)

    Sagili, Karuna D; Satyanarayana, Srinath; Chadha, Sarabjit S; Wilson, Nevin C; Kumar, Ajay M V; Oeltmann, John E; Chadha, Vineet K; Nagaraja, Sharath Burugina; Ghosh, Smita; Q Lo, Terrence; Volkmann, Tyson; Willis, Matthew; Shringarpure, Kalpita; Reddy, Ravichandra Chinnappa; Kumar, Prahlad; Nair, Sreenivas A; Rao, Raghuram; Yassin, Mohammed; Mwangala, Perry; Zachariah, Rony; Tonsing, Jamhoih; Harries, Anthony D; Khaparde, Sunil

    2018-01-01

    ABSTRACT Background: The Global Fund encourages operational research (OR) in all its grants; however very few reports describe this aspect. In India, Project Axshya was supported by a Global Fund grant to improve the reach and visibility of the government Tuberculosis (TB) services among marginalised and vulnerable communities. OR was incorporated to build research capacity of professionals working with the national TB programme and to generate evidence to inform policies and practices. Objectives: To describe how Project Axshya facilitated building OR capacity within the country, helped in addressing several TB control priority research questions, documented project activities and their outcomes, and influenced policy and practice. Methods: From September 2010 to September 2016, three key OR-related activities were implemented. First, practical output-oriented modular training courses were conducted (n = 3) to build research capacity of personnel involved in the TB programme, co-facilitated by The Union, in collaboration with the national TB programme, WHO country office and CDC, Atlanta. Second, two large-scale Knowledge, Attitude and Practice (KAP) surveys were conducted at baseline and mid-project to assess the changes pertaining to TB knowledge, attitudes and practices among the general population, TB patients and health care providers over the project period. Third, studies were conducted to describe the project’s core activities and outcomes. Results: In the training courses, 44 participant teams were supported to develop research protocols on topics of national priority, resulting in 28 peer-reviewed scientific publications. The KAP surveys and description of project activities resulted in 14 peer-reviewed publications. Of the published papers at least 12 have influenced change in policy or practice. Conclusions: OR within a Global Fund supported TB project has resulted in building OR capacity, facilitating research in areas of national priority and

  2. 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.

  3. Developing a software for removable partial denture design: Part II: Introduction of RPD graph software

    Directory of Open Access Journals (Sweden)

    Nejatidanesh F

    2007-06-01

    Full Text Available Background and Aim: Designing removable partial dentures is one of the most important phases of prosthetic treatments. Computer can be used to facilitate and increase accuracy of removable partial denture design. The aim of this study was to develop a software for removable partial denture design.Materials and Methods: A questionnaire (discussed in part I and major textbooks, were used to determine the design rules.  The software (RPD Graph was developed using Visual C++ and Maryam program. The RPD Graph can determine the classification of partial edentulous arch. With defining the missing teeth and providing data about prognosis and conditions of abutment teeth, the removable partial design will be developed by RPD Graph. This software is a knowledge-based system which has specific characteristics. It can be used as an educational tool for teaching RPD design and as a clinical tool for supporting clinician's decision. In addition it can be developed to more complete softwares.

  4. Partially Observed Mixtures of IRT Models: An Extension of the Generalized Partial-Credit Model

    Science.gov (United States)

    Von Davier, Matthias; Yamamoto, Kentaro

    2004-01-01

    The generalized partial-credit model (GPCM) is used frequently in educational testing and in large-scale assessments for analyzing polytomous data. Special cases of the generalized partial-credit model are the partial-credit model--or Rasch model for ordinal data--and the two parameter logistic (2PL) model. This article extends the GPCM to the…

  5. Partial lesions of the intratemporal segment of the facial nerve: graft versus partial reconstruction.

    Science.gov (United States)

    Bento, Ricardo F; Salomone, Raquel; Brito, Rubens; Tsuji, Robinson K; Hausen, Mariana

    2008-09-01

    In cases of partial lesions of the intratemporal segment of the facial nerve, should the surgeon perform an intraoperative partial reconstruction, or partially remove the injured segment and place a graft? We present results from partial lesion reconstruction on the intratemporal segment of the facial nerve. A retrospective study on 42 patients who presented partial lesions on the intratemporal segment of the facial nerve was performed between 1988 and 2005. The patients were divided into 3 groups based on the procedure used: interposition of the partial graft on the injured area of the nerve (group 1; 12 patients); keeping the preserved part and performing tubulization (group 2; 8 patients); and dividing the parts of the injured nerve (proximal and distal) and placing a total graft of the sural nerve (group 3; 22 patients). Fracture of the temporal bone was the most frequent cause of the lesion in all groups, followed by iatrogenic causes (p lesion of the facial nerve is still questionable. Among these 42 patients, the best results were those from the total graft of the facial nerve.

  6. Adolescent Worlds and Literacy Practices on the United States-Mexico Border

    Science.gov (United States)

    de la Piedra, Maria Teresa

    2010-01-01

    This article presents partial results of an ethnographic study about literacy practices among adolescents living near the United States-Mexico border. The students became involved in literacy practices with their friends and family at home. These practices were related to the adolescents' interests in popular culture such as reading magazines or…

  7. The relationship of religious involvement indicators and social support to current and past suicidality among depressed older adults.

    Science.gov (United States)

    Rushing, Nicole C; Corsentino, Elizabeth; Hames, Jennifer L; Sachs-Ericsson, Natalie; Steffens, David C

    2013-01-01

    Elderly people, particularly those with major depression, are at the highest risk for suicide than any other age group. Religious involvement is associated with a range of health outcomes including lower odds of death by suicide. However, not much is known about the effects of religious involvement on suicidal ideation in the elderly or which aspects of religiosity are beneficial. This study examined the relative influence of various conceptualizations of religious involvement, above and beyond the protective effects of social support, on current and past suicidality among depressed older adults. Participants were 248 depressed patients, 59 years and older, enrolled in the Neurocognitive Outcomes of Depression in the Elderly study. A psychiatrist assessed current suicidal ideation using the suicidal thoughts item from the Montgomery-Asberg Depression Rating Scale. Past history of suicide attempts, four religious involvement indicators, social support indicators, and control variables were assessed via self-report. Church attendance, above and beyond importance of religion, private religious practices, and social support, was associated with less suicidal ideation; perceived social support partially mediated this relationship. Current religious practices were not predictive of retrospective reports of past suicide attempts. Church attendance, rather than other religious involvement indicators, has the strongest relationship to current suicidal ideation. Clinicians should consider public religious activity patterns and perceived social support when assessing for other known risk and protective factors for suicide and in developing treatment plans.

  8. Partial twisting for scalar mesons

    International Nuclear Information System (INIS)

    Agadjanov, Dimitri; Meißner, Ulf-G.; Rusetsky, Akaki

    2014-01-01

    The possibility of imposing partially twisted boundary conditions is investigated for the scalar sector of lattice QCD. According to the commonly shared belief, the presence of quark-antiquark annihilation diagrams in the intermediate state generally hinders the use of the partial twisting. Using effective field theory techniques in a finite volume, and studying the scalar sector of QCD with total isospin I=1, we however demonstrate that partial twisting can still be performed, despite the fact that annihilation diagrams are present. The reason for this are delicate cancellations, which emerge due to the graded symmetry in partially quenched QCD with valence, sea and ghost quarks. The modified Lüscher equation in case of partial twisting is given

  9. 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.

  10. 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.

  11. Hopf bifurcation in a partial dependent predator-prey system with delay

    International Nuclear Information System (INIS)

    Zhao Huitao; Lin Yiping

    2009-01-01

    In this paper, a partial dependent predator-prey model with time delay is studied by using the theory of functional differential equation and Hassard's method, the condition on which positive equilibrium exists and Hopf bifurcation occurs are given. Finally, numerical simulations are performed to support the analytical results, and the chaotic behaviors are observed.

  12. Perceptions of Breast Cancer Survivors on the Supporting Practices of Their Supervisors in the Return-to-Work Process: A Qualitative Descriptive Study.

    Science.gov (United States)

    Caron, Maryse; Durand, Marie-José; Tremblay, Dominique

    2018-03-01

    Purpose Supervisors are known to be key actors in ensuring the success of absent employees in their return-to-work process. However, to date, little is known about the perceptions of breast cancer survivors on the practices put in place by their supervisors to support them during this process. The objective of this study was to describe the perceptions of breast cancer survivors on the practices put in place by their supervisors to support them during their return-to-work process. Method A qualitative descriptive study was conducted. Semi-structured interviews were carried out with breast cancer survivors (n = 10) who had returned to work after treatment and were still at work more than 18 months later. Each interview was audio recorded and then transcribed verbatim for qualitative thematic content analysis using a semi-open codification framework. Results Participants identified three main practices put in place by their supervisors to support them and which they perceived as particularly helpful during the return-to-work process: (1) maintaining communication during their period of absence; (2) working with them to structure their return-to-work process before their actual return; and (3) allowing them flexibility in their schedule for a certain period, particularly at the beginning of the return-to-work process. Breast cancer survivors also identified an omission in the practice of employers: lack of follow-up over time. Conclusion Knowledge about the practices perceived as helpful by breast cancer survivors during their return-to-work process lays the groundwork for the eventual development of services to help breast cancer survivors in their return to work.

  13. Peer support and peer-led family support for persons living with schizophrenia.

    Science.gov (United States)

    Duckworth, Kenneth; Halpern, Lisa

    2014-05-01

    Peer support and peer-led family psychoeducation represent two distinct and complementary recovery-oriented models to support individuals who live with schizophrenia and their families, respectively. The goals of these models focus on improving knowledge, coping, self-care, social support, and self-management strategies. These models represent important capacity-building strategies for people who live with the illness and the people who love them. This brief article is intended to provide the practicing clinician, person living with schizophrenia, and policy maker with a working knowledge of the current state of the literature in these two related fields. Practitioners should consider these resources and integrate them into their care. A person living with schizophrenia could use this review to advocate for appropriate resources and to identify career opportunities. Policy makers could benefit from an understanding of the literature to mitigate financial and cultural barriers to adopting these practices. The last 5 years have seen a dramatic expansion of the application of randomized controlled trials (RCTs) to give evidence to match the experience of people in these programs. The field has seen Wellness Recovery Action Plan (WRAP) named as evidence-based practice by the National Registry of Evidence-Based Practices. A RCT was also conducted for another peer-developed and led program called Building Recovery of Individual Dreams & Goals through Education & Support. Family to Family, the largest peer-led family psychoeducation course, was also found to have significant impact after the study and also 6 months later in RCT. Family to Family has also been named as an evidence-based practice. The field of people who are living well with schizophrenia working as resources and supports to others living with the illness is an idea that is growing momentum. This momentum has been matched by the RCT evidence. Peer support as a professional role has an emerging literature

  14. Partial order infinitary term rewriting

    DEFF Research Database (Denmark)

    Bahr, Patrick

    2014-01-01

    We study an alternative model of infinitary term rewriting. Instead of a metric on terms, a partial order on partial terms is employed to formalise convergence of reductions. We consider both a weak and a strong notion of convergence and show that the metric model of convergence coincides with th...... to the metric setting -- orthogonal systems are both infinitarily confluent and infinitarily normalising in the partial order setting. The unique infinitary normal forms that the partial order model admits are Böhm trees....

  15. 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

  16. Breastfeeding Practices and Barriers to Implementing the Ten Steps to Successful Breastfeeding in Mississippi Hospitals.

    Science.gov (United States)

    Alakaam, Amir; Lemacks, Jennifer; Yadrick, Kathleen; Connell, Carol; Choi, Hwanseok Winston; Newman, Ray G

    2018-05-01

    Mississippi has the lowest rates of breastfeeding in the United States at 6 and 12 months. There is growing evidence that the rates and duration of infant breastfeeding improve after hospitals implement the Ten Steps to Successful Breastfeeding; moreover, the Ten Steps approach is considered the standard model for evaluation of breastfeeding practices in birthplaces. Research aim: This study aimed to examine the implementation level of the Ten Steps and identify barriers to implementing the Ten Steps in Mississippi hospitals. A cross-sectional self-report survey was used to answer the research aim. Nurse managers of the birthing and maternity units of all 43 Mississippi hospitals that provided birthing and maternity care were recruited. A response rate of 72% ( N = 31) was obtained. Implementation of the Ten Steps in these hospitals was categorized as low, partial, moderate, or high. The researcher classified implementation in 29% of hospitals as moderate and in 71% as partial. The hospital level of implementation was significantly positively associated with the hospital delivery rate along with the hospital cesarean section rate per year. The main barriers for the implementation process of the Ten Steps reported were resistance to new policies, limited financial and human resources, and lack of support from national and state governments. Breastfeeding practices in Mississippi hospitals need to be improved. New policies need to be established in Mississippi to encourage hospitals to adopt the Ten Steps policies and practice in the maternity and birthing units.

  17. The Tectonic Practice

    DEFF Research Database (Denmark)

    Schmidt, Anne Marie Due

    has the consequence that it is difficult to create architecture where the technical concerns are an inherent part of the architectural expression. The aim of the thesis is to discuss the role of digital tools in overcoming the distance between the professional specializations and thereby support...... a tectonic practice. The project develops a framework to understand the role of digital tools in the tectonic practice from and discusses how and in which areas the tectonic practice could become supported by digital tools....

  18. Beginning partial differential equations

    CERN Document Server

    O'Neil, Peter V

    2011-01-01

    A rigorous, yet accessible, introduction to partial differential equations-updated in a valuable new edition Beginning Partial Differential Equations, Second Edition provides a comprehensive introduction to partial differential equations (PDEs) with a special focus on the significance of characteristics, solutions by Fourier series, integrals and transforms, properties and physical interpretations of solutions, and a transition to the modern function space approach to PDEs. With its breadth of coverage, this new edition continues to present a broad introduction to the field, while also addres

  19. Do fibrin sealants impact negative outcomes after robot-assisted partial nephrectomy?

    Science.gov (United States)

    Cohen, Jason; Jayram, Gautam; Mullins, Jeffrey K; Ball, Mark W; Allaf, Mohamad E

    2013-10-01

    Contemporary rates of postoperative hemorrhage after partial nephrectomy (PN) are low. Commercially available hemostatic agents are commonly used during this surgery to reduce this risk despite a paucity of data supporting the practice. We assessed the impact of fibrin sealant hemostatic agents, a costly addition to surgeries, during robot-assisted partial nephrectomy (RAPN). Between 2007 and 2011, 114 consecutive patients underwent RAPN by a single surgeon (MEA). Evicel fibrin sealant was used in the first 74 patients during renorraphy. The last 40 patients had renorraphy performed without the use of any hemostatic agents. Clinicopathologic, operative, and complication data were compared between groups. Multivariate and univariate logistic regression analysis was performed to test the association between the use of fibrin sealants and operative outcomes. Patient demographic data and clinical tumor characteristics were similar between groups. The use of fibrin sealant did not increase operative time (166.3 vs 176.1 minutes, P=0.28), warm ischemia time (WIT) (14.4 vs 16.1 minutes, P=0.18), or length of hospital stay (2.6 vs 2.4 days, P=0.35). The omission of these agents did not increase estimated blood loss (116.6 vs 176.1 mL, P=0.8) or postoperative blood transfusion (0% vs 2.5%, P=0.17). Univariate analysis demonstrated no association between use of fibrin sealants and increased complications (P>0.05). Multivariable logistic regression showed no statistically significant predictive value of omission of hemostatic agents for perioperative outcomes (P>0.05). Perioperative hemorrhage and other major complications after contemporary RAPN are rare in experienced hands. In our study, the use of fibrin sealants during RAPN does not decrease the rate of complications, blood loss, or hospital stay. Furthermore, no impact is seen on operative time, WIT, or other negative outcomes. Omitting these agents during RAPN could be a safe, effective, cost-saving measure.

  20. 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…

  1. 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.

  2. 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

    2009-07-01

    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 with the self-determination theory model of internalization, which posits that (a) conditional negative regard predicts feelings of resentment toward parents, which then predict dysregulation of negative emotions and academic disengagement; (b) conditional positive regard predicts feelings of internal compulsion, which then predict suppressive regulation of negative emotions and grade-focused academic engagement; and (c) autonomy support predicts sense of choice, which then predicts integrated regulation of negative emotions and interest-focused academic engagement. These findings suggest that even parents' use of conditional positive regard as a socialization practice has adverse emotional and academic consequences, relative to autonomy support.

  3. Complexity of universality and related problems for partially ordered NFAs

    Czech Academy of Sciences Publication Activity Database

    Krötzsch, M.; Masopust, Tomáš; Thomazo, M.

    2017-01-01

    Roč. 255, č. 1 (2017), s. 177-192 ISSN 0890-5401 Institutional support: RVO:67985840 Keywords : nondeterministic automata * partial order * universal ity Subject RIV: BA - General Mathematics OBOR OECD: Computer sciences, information science, bioinformathics (hardware development to be 2.2, social aspect to be 5.8) Impact factor: 1.050, year: 2016 http://www.sciencedirect.com/science/article/pii/S0890540117300998?via%3Dihub

  4. Hyperbolic partial differential equations

    CERN Document Server

    Witten, Matthew

    1986-01-01

    Hyperbolic Partial Differential Equations III is a refereed journal issue that explores the applications, theory, and/or applied methods related to hyperbolic partial differential equations, or problems arising out of hyperbolic partial differential equations, in any area of research. This journal issue is interested in all types of articles in terms of review, mini-monograph, standard study, or short communication. Some studies presented in this journal include discretization of ideal fluid dynamics in the Eulerian representation; a Riemann problem in gas dynamics with bifurcation; periodic M

  5. Calculation of the Full Scattering Amplitude without Partial Wave Decomposition II

    Science.gov (United States)

    Shertzer, J.; Temkin, A.

    2003-01-01

    As is well known, the full scattering amplitude can be expressed as an integral involving the complete scattering wave function. We have shown that the integral can be simplified and used in a practical way. Initial application to electron-hydrogen scattering without exchange was highly successful. The Schrodinger equation (SE) can be reduced to a 2d partial differential equation (pde), and was solved using the finite element method. We have now included exchange by solving the resultant SE, in the static exchange approximation. The resultant equation can be reduced to a pair of coupled pde's, to which the finite element method can still be applied. The resultant scattering amplitudes, both singlet and triplet, as a function of angle can be calculated for various energies. The results are in excellent agreement with converged partial wave results.

  6. 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.

  7. 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.

  8. Partial differential equations

    CERN Document Server

    Evans, Lawrence C

    2010-01-01

    This text gives a comprehensive survey of modern techniques in the theoretical study of partial differential equations (PDEs) with particular emphasis on nonlinear equations. The exposition is divided into three parts: representation formulas for solutions; theory for linear partial differential equations; and theory for nonlinear partial differential equations. Included are complete treatments of the method of characteristics; energy methods within Sobolev spaces; regularity for second-order elliptic, parabolic, and hyperbolic equations; maximum principles; the multidimensional calculus of variations; viscosity solutions of Hamilton-Jacobi equations; shock waves and entropy criteria for conservation laws; and, much more.The author summarizes the relevant mathematics required to understand current research in PDEs, especially nonlinear PDEs. While he has reworked and simplified much of the classical theory (particularly the method of characteristics), he primarily emphasizes the modern interplay between funct...

  9. 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.

  10. Partial Cooperative Equilibria: Existence and Characterization

    Directory of Open Access Journals (Sweden)

    Amandine Ghintran

    2010-09-01

    Full Text Available We study the solution concepts of partial cooperative Cournot-Nash equilibria and partial cooperative Stackelberg equilibria. The partial cooperative Cournot-Nash equilibrium is axiomatically characterized by using notions of rationality, consistency and converse consistency with regard to reduced games. We also establish sufficient conditions for which partial cooperative Cournot-Nash equilibria and partial cooperative Stackelberg equilibria exist in supermodular games. Finally, we provide an application to strategic network formation where such solution concepts may be useful.

  11. Successful removable partial dentures.

    Science.gov (United States)

    Lynch, Christopher D

    2012-03-01

    Removable partial dentures (RPDs) remain a mainstay of prosthodontic care for partially dentate patients. Appropriately designed, they can restore masticatory efficiency, improve aesthetics and speech, and help secure overall oral health. However, challenges remain in providing such treatments, including maintaining adequate plaque control, achieving adequate retention, and facilitating patient tolerance. The aim of this paper is to review the successful provision of RPDs. Removable partial dentures are a successful form of treatment for replacing missing teeth, and can be successfully provided with appropriate design and fabrication concepts in mind.

  12. A simple method for identifying parameter correlations in partially observed linear dynamic models.

    Science.gov (United States)

    Li, Pu; Vu, Quoc Dong

    2015-12-14

    Parameter estimation represents one of the most significant challenges in systems biology. This is because biological models commonly contain a large number of parameters among which there may be functional interrelationships, thus leading to the problem of non-identifiability. Although identifiability analysis has been extensively studied by analytical as well as numerical approaches, systematic methods for remedying practically non-identifiable models have rarely been investigated. We propose a simple method for identifying pairwise correlations and higher order interrelationships of parameters in partially observed linear dynamic models. This is made by derivation of the output sensitivity matrix and analysis of the linear dependencies of its columns. Consequently, analytical relations between the identifiability of the model parameters and the initial conditions as well as the input functions can be achieved. In the case of structural non-identifiability, identifiable combinations can be obtained by solving the resulting homogenous linear equations. In the case of practical non-identifiability, experiment conditions (i.e. initial condition and constant control signals) can be provided which are necessary for remedying the non-identifiability and unique parameter estimation. It is noted that the approach does not consider noisy data. In this way, the practical non-identifiability issue, which is popular for linear biological models, can be remedied. Several linear compartment models including an insulin receptor dynamics model are taken to illustrate the application of the proposed approach. Both structural and practical identifiability of partially observed linear dynamic models can be clarified by the proposed method. The result of this method provides important information for experimental design to remedy the practical non-identifiability if applicable. The derivation of the method is straightforward and thus the algorithm can be easily implemented into a

  13. A Partial Equilibrium Theory for Drops and Capillary Liquids

    International Nuclear Information System (INIS)

    Searcy, Alan W.; Beruto, Dario T.; Barberis, Fabrizio

    2006-01-01

    The two-century old theory of Young and Laplace retains a powerful influence on surface and interface studies because it quantitatively predicts the height of rise of capillary liquids from the contact angles of drops. But the classical theory does not acknowledge that equilibrium requires separate minimization of partial free energies of one-component liquids bonded to immiscible solids. We generalize a theorem of Gibbs and Curie to obtain a partial equilibrium (PE) theory that does so and that also predicts the height of capillary rise from contact angles of drops. Published observations and our own measurements of contact angles of water bonded to glass and Teflon surfaces support the conclusion of PE theory that contact angles of meniscuses and of drops are different dependent variables. PE theory provides thermodynamic and kinetic guidance to nanoscale processes that the classical theory obscures, as illustrated by examples in our concluding section

  14. 32 CFR 751.13 - Partial payments.

    Science.gov (United States)

    2010-07-01

    ... voucher and all other information related to the partial payment shall be placed in the claim file. Action... 32 National Defense 5 2010-07-01 2010-07-01 false Partial payments. 751.13 Section 751.13 National... Claims Against the United States § 751.13 Partial payments. (a) Partial payments when hardship exists...

  15. Social Practices

    DEFF Research Database (Denmark)

    Schmidt, Kirsten

    2013-01-01

    The present understanding of LCM as a product management system supported by a number of tools and methods does not pay attention to the importance of social practices that the employees develop in relation to the systematic approach. A new conceptual model of LCM including the social practices i...... company serves as case for the empirical analyses of the formalized structures and their interaction with the social practices developed by the employees over time.......The present understanding of LCM as a product management system supported by a number of tools and methods does not pay attention to the importance of social practices that the employees develop in relation to the systematic approach. A new conceptual model of LCM including the social practices...... is presented and discussed from theoretical and empirical perspectives. Theoretically, the analyses cover the formalized structures related to the division of labor and the coordination of the tasks on the one hand, and the social practices as meanings, values and priorities on the other hand. A larger Danish...

  16. Eating disorders in general practice.

    Science.gov (United States)

    King, M B

    1986-01-01

    A total of 748 patients who attended four south London group practices were screened using the eating attitudes test; 1% of women had bulimia nervosa and a further 3% a partial syndrome eating disorder. Eating and weight control behaviour and psychiatric indicators for an eating disorder were analysed. Patients with bulimia nervosa and partial syndromes were remarkably similar. They were mainly women, from the middle to upper classes, in the normal weight range but having had considerable weight fluctuation in the past, more likely to have had a history of menstrual irregularity, often psychologically troubled, and tended to have more family psychopathology. PMID:3099893

  17. Lectures on the practical solution of differential equations

    International Nuclear Information System (INIS)

    Dresner, L.

    1979-11-01

    This report comprises lectures on the practical solution of ordinary and partial differential equations given in the In-Hours Continuing Education Program for Scientific and Technical Personnel at Oak Ridge National Laboratory

  18. 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.

  19. Reversibility of partial denaturation of DNA

    International Nuclear Information System (INIS)

    Acuna, M.I.; Mingot, F.; Davila, C.A.

    1976-01-01

    The recovery of hypochromicity in a partially denatured DNA sample when salt concentration is suddenly increased at a intermediate stage of the thermal transition is studied. The results of CsCl gradient analysis, PEG/DEX partition analysis, behaviour in a new thermal transition hydrodynamic properties and transforming ability, support the view that the process is an intramolecular double chain denaturation. The degree of denaturation irreversibility is dependent on single chain molecular weight of DNA (discontinuities denisty) and upon the helicity value at which salt concentration jump is performed. Both dependences are formally interpreted according to Elton's model for base distribution in DNA. Kinetically the process behaves as being an hydrodynamically limited rewinding. (author)

  20. 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…

  1. 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

  2. Uncovering the factors that can support and impede post-disaster EIA practice in developing countries: The case of Aceh Province, Indonesia

    Energy Technology Data Exchange (ETDEWEB)

    Gore, Tom; Fischer, Thomas B., E-mail: fischer@liverpool.ac.uk

    2014-01-15

    The close relationship between environmental degradation and the occurrence and severity of disaster events has in recent years raised the profile of environmental assessment (EA) in the disaster management field. EA has been identified as a potentially supportive tool in the global effort to reduce disaster risk. As a component of this, attention has been brought specifically to the importance of the application of EA in the aftermath of disaster events in order to help prevent recurrence and promote sustainability. At the same time, however, it has also been recognised that post-disaster environments may be unfavourable to such practices. Looking at the practice of environmental impact assessment (EIA), this paper reports on a study which sought to identify more specifically the factors which can both support and hinder such practice following disaster events in a developing country context. Analysing the situation in Aceh Province, Indonesia, after the impact of two tsunamigenic earthquakes in late 2004 and early 2005, it is concluded that if EIA is to have a central role in the post-disaster period, pre-disaster preparation could be a key. -- Highlights: • Close relationship between environmental degradation and occurrence/severity of disaster events has raised profile of EA. • EA as a potentially supportive tool in the global effort to reduce disaster risk • Application of EA in the aftermath of disaster events to help prevent recurrence and promote sustainability • The paper looks at factors which can both support and hinder EA following disaster events in a developing country context. • We analyse the situation in Aceh Province, Indonesia, after the impact of two tsunamigenic earthquakes in 2004 and 2005.

  3. 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

  4. Fixed Points of Multivalued Contractive Mappings in Partial Metric Spaces

    Directory of Open Access Journals (Sweden)

    Abdul Rahim Khan

    2014-01-01

    Full Text Available The aim of this paper is to present fixed point results of multivalued mappings in the framework of partial metric spaces. Some examples are presented to support the results proved herein. Our results generalize and extend various results in the existing literature. As an application of our main result, the existence and uniqueness of bounded solution of functional equations arising in dynamic programming are established.

  5. Partial Actions and Power Sets

    Directory of Open Access Journals (Sweden)

    Jesús Ávila

    2013-01-01

    Full Text Available We consider a partial action (X,α with enveloping action (T,β. In this work we extend α to a partial action on the ring (P(X,Δ,∩ and find its enveloping action (E,β. Finally, we introduce the concept of partial action of finite type to investigate the relationship between (E,β and (P(T,β.

  6. An isotonic partial credit model for ordering subjects on the basis of their sum scores

    NARCIS (Netherlands)

    Ligtvoet, R.

    2012-01-01

    In practice, the sum of the item scores is often used as a basis for comparing subjects. For items that have more than two ordered score categories, only the partial credit model (PCM) and special cases of this model imply that the subjects are stochastically ordered on the common latent variable.

  7. 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.

  8. 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.

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

    Science.gov (United States)

    Garrett, Bernard; Klein, Gerri

    2008-08-01

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

  10. How primary health care staff working in rural and remote areas access skill development and expertise to support health promotion practice.

    Science.gov (United States)

    McFarlane, Kathryn A; Judd, Jenni; Wapau, Hylda; Nichols, Nina; Watt, Kerrianne; Devine, Sue

    2018-05-01

    Health promotion is a key component of comprehensive primary health care. Health promotion approaches complement healthcare management by enabling individuals to increase control over their health. Many primary healthcare staff have a role to play in health promotion practice, but their ability to integrate health promotion into practice is influenced by their previous training and experience. For primary healthcare staff working in rural and remote locations, access to professional development can be limited by what is locally available and prohibitive in terms of cost for travel and accommodation. This study provides insight into how staff at a large north Queensland Aboriginal community controlled health service access skill development and health promotion expertise to support their work. A qualitative exploratory study was conducted. Small group and individual semi-structured interviews were conducted with staff at Apunipima Cape York Health Council (n=9). A purposive sampling method was used to recruit participants from a number of primary healthcare teams that were more likely to be involved in health promotion work. Both on-the-ground staff and managers were interviewed. All participants were asked how they access skill development and expertise in health promotion practice and what approaches they prefer for ongoing health promotion support. The interviews were transcribed verbatim and analysed thematically. All participants valued access to skill development, advice and support that would assist their health promotion practice. Skill development and expertise in health promotion was accessed from a variety of sources: conferences, workshops, mentoring or shared learning from internal and external colleagues, and access to online information and resources. With limited funds and limited access to professional development locally, participants fostered external and internal organisational relationships to seek in-kind advice and support. Irrespective of

  11. Restrictions on the use of e-cigarettes in public and private places-current practice and support among adults in Great Britain.

    Science.gov (United States)

    Brose, Leonie S; McNeill, Ann; Arnott, Deborah; Cheeseman, Hazel

    2017-08-01

    Debates around policies regulating e-cigarette use make it important to obtain an overview of current practice, people's attitudes and correlates of policy support. Aims were to assess (i) current practices for e-cigarette use in homes and workplaces; (ii) characteristics associated with allowing e-cigarette use in the home; and (iii) level of, and characteristics associated with, support for extending smoke-free legislation to include e-cigarettes. Online survey in 2016, n = 11 389 adults in Great Britain. Descriptives for all measures; multivariable logistic regressions assessed correlates of allowing e-cigarette use and support for extension of legislation. Most (79%) reporting on workplace policies reported some level of restrictions on e-cigarette use. Small majorities would not allow e-cigarette use in their home (58%) and supported an extension of smoke-free legislation (52%; 21% opposed). Allowing use was less likely and supporting an extension more likely among men, respondents from a higher socio-economic status, ex-smokers, never-smokers, non-users of e-cigarettes and respondents with increased perceived harm of e-cigarettes or nicotine (all P e-cigarette use. Over half of adults would not allow use of e-cigarettes in their home and support prohibiting the use of e-cigarettes in smoke-free places. Adjusting for socio-demographics, more restrictive attitudes are more common among never-smokers, never-users and those with increased perception of relative harms of e-cigarettes or nicotine as cause of smoking-related illness. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  12. Calculation of the Full Scattering Amplitude without Partial Wave Decomposition II: Inclusion of Exchange

    Science.gov (United States)

    Shertzer, Janine; Temkin, A.

    2003-01-01

    As is well known, the full scattering amplitude can be expressed as an integral involving the complete scattering wave function. We have shown that the integral can be simplified and used in a practical way. Initial application to electron-hydrogen scattering without exchange was highly successful. The Schrodinger equation (SE), which can be reduced to a 2d partial differential equation (pde), was solved using the finite element method. We have now included exchange by solving the resultant SE, in the static exchange approximation, which is reducible to a pair of coupled pde's. The resultant scattering amplitudes, both singlet and triplet, calculated as a function of energy are in excellent agreement with converged partial wave results.

  13. Policing in nonhuman primates: partial interventions serve a prosocial conflict management function in rhesus macaques.

    Science.gov (United States)

    Beisner, Brianne A; McCowan, Brenda

    2013-01-01

    Studies of prosocial policing in nonhuman societies traditionally focus on impartial interventions because of an underlying assumption that partial support implies a direct benefit to the intervener, thereby negating the potential for being prosocial in maintaining social stability for the benefit of the group. However, certain types of partial interventions have significant potential to be prosocial in controlling conflict, e.g. support of non-kin subordinates. Here, we propose a policing support hypothesis that some types of agonistic support serve a prosocial policing function that maintains group stability. Using seven large captive groups of rhesus macaques, we investigated the relationship between intervention type and group-level costs and benefits (rates of trauma, severe aggression, social relocation) and individual level costs and benefits (preferential sex-dyad targeting, dominance ambiguity reduction, access to mates, and return aggression). Our results show that impartial interventions and support of subordinate non-kin represent prosocial policing as both (1) were negatively associated with group-level rates of trauma and severe aggression, respectively, (2) showed no potential to confer individual dominance benefits, (3) when performed outside the mating season, they did not increase chances of mating with the beneficiary, and (4) were low-cost for the highest-ranking interveners. We recommend expanding the definition of 'policing' in nonhumans to include these 'policing support interventions'.

  14. 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.

  15. Ethics and health promotion practice: exploring attitudes and practices in Western Australian health organisations.

    Science.gov (United States)

    Reilly, T; Crawford, G; Lobo, R; Leavy, J; Jancey, J

    2016-04-01

    Issue addressed Evidence-informed practice underpinned by ethics is fundamental to developing the science of health promotion. Knowledge and application of ethical principles are competencies required for health promotion practice. However, these competencies are often inconsistently understood and applied. This research explored attitudes, practices, enablers and barriers related to ethics in practice in Western Australian health organisations. Methods Semistructured, in-depth interviews were conducted with 10 health promotion practitioners, purposefully selected to provide a cross-section of government and non-government organisations. Interviews were recorded, transcribed and then themed. Results The majority of participants reported consideration of ethics in their practice; however, only half reported seeking Human Research Ethics Committee (HREC) approval for projects in the past 12 months. Enablers identified as supporting ethics in practice and disseminating findings included: support preparing ethics applications; resources and training about ethical practice; ability to access HRECs for ethics approval; and a supportive organisational culture. Barriers included: limited time; insufficient resourcing and capacity; ethics approval not seen as part of core business; and concerns about academic writing. Conclusion The majority of participants were aware of the importance of ethics in practice and the dissemination of findings. However, participants reported barriers to engaging in formal ethics processes and to publishing findings. So what? Alignment of evidence-informed and ethics-based practice is critical. Resources and information about ethics may be required to support practice and encourage dissemination of findings, including in the peer-reviewed literature. Investigating the role of community-based ethics boards may be valuable to bridging the ethics-evidence gap.

  16. oral health knowledge, hygiene practices and treatment seeking

    African Journals Online (AJOL)

    2011-10-10

    Oct 10, 2011 ... and the oral health practices among 12 year-old children. Design: Descriptive ... the absence or presence of dental caries (5-7). The patient's ... secondary school teenagers had partial knowledge ... and diet counselling.

  17. Development of a simultaneous partial nitrification and anaerobic ammonia oxidation process in a single reactor.

    Science.gov (United States)

    Cho, Sunja; Fujii, Naoki; Lee, Taeho; Okabe, Satoshi

    2011-01-01

    Up-flow oxygen-controlled biofilm reactors equipped with a non-woven fabric support were used as a single reactor system for autotrophic nitrogen removal based on a combined partial nitrification and anaerobic ammonium oxidation (anammox) reaction. The up-flow biofilm reactors were initiated as either a partial nitrifying reactor or an anammox reactor, respectively, and simultaneous partial nitrification and anammox was established by careful control of the aeration rate. The combined partial nitrification and anammox reaction was successfully developed in both biofilm reactors without additional biomass inoculation. The reactor initiated as the anammox reactor gave a slightly higher and more stable mean nitrogen removal rate of 0.35 (±0.19) kg-N m(-3) d(-1) than the reactor initiated as the partial nitrifying reactor (0.23 (±0.16) kg-N m(-3) d(-1)). FISH analysis revealed that the biofilm in the reactor started as the anammox reactor were composed of anammox bacteria located in inner anoxic layers that were surrounded by surface aerobic AOB layers, whereas AOB and anammox bacteria were mixed without a distinguishable niche in the biofilm in the reactor started as the partial nitrifying reactor. However, it was difficult to efficiently maintain the stable partial nitrification owing to inefficient aeration in the reactor, which is a key to development of the combined partial nitrification and anammox reaction in a single biofilm reactor. Copyright © 2010 Elsevier Ltd. All rights reserved.

  18. 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.

  19. 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.

  20. Practicing uneven age management: does it pay? Some economic considerations

    Science.gov (United States)

    Gary W. Miller

    1991-01-01

    Unevenage silvicultural practices can be used to regenerate and manage many eastern hardwood stands. Single-tree cutting methods are feasible in stands where a desirable shade tolerant commercial species can be regenerated following periodic harvests. A variety of partial harvest practices, including single-tree selection and diameterlimit cutting have been used for 30...

  1. Support vector machines applications

    CERN Document Server

    Guo, Guodong

    2014-01-01

    Support vector machines (SVM) have both a solid mathematical background and good performance in practical applications. This book focuses on the recent advances and applications of the SVM in different areas, such as image processing, medical practice, computer vision, pattern recognition, machine learning, applied statistics, business intelligence, and artificial intelligence. The aim of this book is to create a comprehensive source on support vector machine applications, especially some recent advances.

  2. Supporting aboriginal knowledge and practice in health care: lessons from a qualitative evaluation of the strong women, strong babies, strong culture program.

    Science.gov (United States)

    Lowell, Anne; Kildea, Sue; Liddle, Marlene; Cox, Barbara; Paterson, Barbara

    2015-02-05

    The Strong Women, Strong Babies, Strong Culture Program (the Program) evolved from a recognition of the value of Aboriginal knowledge and practice in promoting maternal and child health (MCH) in remote communities of the Northern Territory (NT) of Australia. Commencing in 1993 it continues to operate today. In 2008, the NT Department of Health commissioned an evaluation to identify enabling factors and barriers to successful implementation of the Program, and to identify potential pathways for future development. In this paper we focus on the evaluation findings related specifically to the role of Aborignal cultural knowledge and practice within the Program. A qualitative evaluation utilised purposive sampling to maximise diversity in program history and Aboriginal culture. Semi-structured, in-depth interviews with 76 participants were recorded in their preferred language with a registered Interpreter when required. Thematic analysis of data was verified or modified through further discussions with participants and members of the evaluation team. Although the importance of Aboriginal knowledge and practice as a fundamental component of the Program is widely acknowledged, there has been considerable variation across time and location in the extent to which these cultural dimensions have been included in practice. Factors contributing to this variation are complex and relate to a number of broad themes including: location of control over Program activities; recognition and respect for Aboriginal knowledge and practice as a legitimate component of health care; working in partnership; communication within and beyond the Program; access to transport and working space; and governance and organisational support. We suggest that inclusion of Aboriginal knowledge and practice as a fundamental component of the Program is key to its survival over more than twenty years despite serious challenges. Respect for the legitimacy of Aboriginal knowledge and practice within health

  3. 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.

  4. 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.

  5. Hacking on decoy-state quantum key distribution system with partial phase randomization

    Science.gov (United States)

    Sun, Shi-Hai; Jiang, Mu-Sheng; Ma, Xiang-Chun; Li, Chun-Yan; Liang, Lin-Mei

    2014-04-01

    Quantum key distribution (QKD) provides means for unconditional secure key transmission between two distant parties. However, in practical implementations, it suffers from quantum hacking due to device imperfections. Here we propose a hybrid measurement attack, with only linear optics, homodyne detection, and single photon detection, to the widely used vacuum + weak decoy state QKD system when the phase of source is partially randomized. Our analysis shows that, in some parameter regimes, the proposed attack would result in an entanglement breaking channel but still be able to trick the legitimate users to believe they have transmitted secure keys. That is, the eavesdropper is able to steal all the key information without discovered by the users. Thus, our proposal reveals that partial phase randomization is not sufficient to guarantee the security of phase-encoding QKD systems with weak coherent states.

  6. Hacking on decoy-state quantum key distribution system with partial phase randomization.

    Science.gov (United States)

    Sun, Shi-Hai; Jiang, Mu-Sheng; Ma, Xiang-Chun; Li, Chun-Yan; Liang, Lin-Mei

    2014-04-23

    Quantum key distribution (QKD) provides means for unconditional secure key transmission between two distant parties. However, in practical implementations, it suffers from quantum hacking due to device imperfections. Here we propose a hybrid measurement attack, with only linear optics, homodyne detection, and single photon detection, to the widely used vacuum + weak decoy state QKD system when the phase of source is partially randomized. Our analysis shows that, in some parameter regimes, the proposed attack would result in an entanglement breaking channel but still be able to trick the legitimate users to believe they have transmitted secure keys. That is, the eavesdropper is able to steal all the key information without discovered by the users. Thus, our proposal reveals that partial phase randomization is not sufficient to guarantee the security of phase-encoding QKD systems with weak coherent states.

  7. Tooth loss in well-maintained patients with chronic periodontitis during long-term supportive therapy in Brazil.

    Science.gov (United States)

    Chambrone, Luiz A; Chambrone, Leandro

    2006-10-01

    The objective of this retrospective study was to assess the reasons for tooth loss in a sample of patients who underwent periodontal therapy and supportive periodontal therapy (SPT) in a Brazilian private periodontal practice. A sample of 120 subjects who had been treated and maintained for 10 years or longer was selected from patients attending a periodontal practice. All patients followed a similar treatment: basic procedures, re-evaluation and periodontal surgery where indicated. Reasons for tooth loss were categorized as periodontal, caries, endodontal, root fractures and extraction of retained or partially erupted third molars. Of the 2927 teeth present at the completion of active periodontal treatment, 53 (1.8%) were lost due to periodontal disease, 16 (0.5%) for root fracture, six (0.2%) to caries, five (0.2%) for endodontic reasons and 31 (1.0%) were lost to extraction of retained or partially erupted third molars. Logistic regression analysis was performed to investigate the association between five independent variables with tooth loss due to periodontitis. Only age (> 60 years) and smoking were statistically significant (p < 0.05). The findings of this survey were consistent with previous studies. Older subjects and smokers were more susceptible to periodontal tooth loss. In addition, patients with generalized chronic periodontitis were treated and maintained for long-term periods with low rates of tooth loss.

  8. 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.

  9. 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…

  10. Towards Optical Partial Discharge Detection with Micro Silicon Photomultipliers

    Directory of Open Access Journals (Sweden)

    Ming Ren

    2017-11-01

    Full Text Available Optical detection is reliable in intrinsically characterizing partial discharges (PDs. Because of the great volume and high-level power supply of the optical devices that can satisfy the requirements in photosensitivity, optical PD detection can merely be used in laboratory studies. To promote the practical application of the optical approach in an actual power apparatus, a silicon photomultiplier (SiPM-based PD sensor is introduced in this paper, and its basic properties, which include the sensitivity, pulse resolution, correlation with PD severity, and electromagnetic (EM interference immunity, are experimentally evaluated. The stochastic phase-resolved PD pattern (PRPD for three typical insulation defects are obtained by SiPM PD detector and are compared with those obtained using a high-frequency current transformer (HFCT and a vacuum photomultiplier tube (PMT. Because of its good performances in the above aspects and its additional advantages, such as the small size, low power supply, and low cost, SiPM offers great potential in practical optical PD monitoring.

  11. Algorithms over partially ordered sets

    DEFF Research Database (Denmark)

    Baer, Robert M.; Østerby, Ole

    1969-01-01

    in partially ordered sets, answer the combinatorial question of how many maximal chains might exist in a partially ordered set withn elements, and we give an algorithm for enumerating all maximal chains. We give (in § 3) algorithms which decide whether a partially ordered set is a (lower or upper) semi......-lattice, and whether a lattice has distributive, modular, and Boolean properties. Finally (in § 4) we give Algol realizations of the various algorithms....

  12. 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.

  13. 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.

  14. Restoration of unfavorably positioned implants for a partially endentulous patient by using an overdenture retained with a milled bar and attachments: a clinical report.

    Science.gov (United States)

    Asvanund, Chanavut; Morgano, Steven M

    2004-01-01

    The restorative dentist may encounter patients with previously placed misaligned implants that are well integrated. Often, these patients have deficient alveolar ridge contour further complicating treatment options. This clinical report describes a treatment approach for a partially edentulous patient with unfavorably positioned implants that incorporated: (1) an implant-supported milled bar with a removable, metal-acrylic resin, partial overdenture, (2) implant-supported single crowns, and (3) crowns retained by natural teeth.

  15. Partial Deconvolution with Inaccurate Blur Kernel.

    Science.gov (United States)

    Ren, Dongwei; Zuo, Wangmeng; Zhang, David; Xu, Jun; Zhang, Lei

    2017-10-17

    Most non-blind deconvolution methods are developed under the error-free kernel assumption, and are not robust to inaccurate blur kernel. Unfortunately, despite the great progress in blind deconvolution, estimation error remains inevitable during blur kernel estimation. Consequently, severe artifacts such as ringing effects and distortions are likely to be introduced in the non-blind deconvolution stage. In this paper, we tackle this issue by suggesting: (i) a partial map in the Fourier domain for modeling kernel estimation error, and (ii) a partial deconvolution model for robust deblurring with inaccurate blur kernel. The partial map is constructed by detecting the reliable Fourier entries of estimated blur kernel. And partial deconvolution is applied to wavelet-based and learning-based models to suppress the adverse effect of kernel estimation error. Furthermore, an E-M algorithm is developed for estimating the partial map and recovering the latent sharp image alternatively. Experimental results show that our partial deconvolution model is effective in relieving artifacts caused by inaccurate blur kernel, and can achieve favorable deblurring quality on synthetic and real blurry images.Most non-blind deconvolution methods are developed under the error-free kernel assumption, and are not robust to inaccurate blur kernel. Unfortunately, despite the great progress in blind deconvolution, estimation error remains inevitable during blur kernel estimation. Consequently, severe artifacts such as ringing effects and distortions are likely to be introduced in the non-blind deconvolution stage. In this paper, we tackle this issue by suggesting: (i) a partial map in the Fourier domain for modeling kernel estimation error, and (ii) a partial deconvolution model for robust deblurring with inaccurate blur kernel. The partial map is constructed by detecting the reliable Fourier entries of estimated blur kernel. And partial deconvolution is applied to wavelet-based and learning

  16. Neutral Atom Diffusion in a Partially Ionized Prominence Plasma

    Science.gov (United States)

    Gilbert, Holly

    2010-01-01

    The support of solar prominences is normally described in terms of a magnetic force on the prominence plasma that balances the solar gravitational force. Because the prominence plasma is only partially ionized. it is necessary to consider in addition the support of the neutral component of the prominence plasma. This support is accomplished through a frictional interaction between the neutral and ionized components of the plasma, and its efficacy depends strongly on the degree of ionization of the plasma. More specifically, the frictional force is proportional to the relative flow of neutral and ion species, and for a sufficiently weakly ionized plasma, this flow must be relatively large to produce a frictional force that balances gravity. A large relative flow, of course, implies significant draining of neutral particles from the prominence. We evaluate the importance of this draining effect for a hydrogen-helium plasma, and consider the observational evidence for cross-field diffusion of neutral prominence material,

  17. Behavior and Three-Dimensional Finite Element Modeling of Circular Concrete Columns Partially Wrapped with FRP Strips

    Directory of Open Access Journals (Sweden)

    Junjie Zeng

    2018-03-01

    Full Text Available Fiber-reinforced polymer (FRP jacketing/wrapping has become an attractive strengthening technique for concrete columns. Wrapping an existing concrete column with continuous FRP jackets with the fiber in the jacket being oriented in the hoop direction is referred to as FRP full wrapping strengthening technique. In practice, however, strengthening concrete columns with vertically discontinuous FRP strips is also favored and this technique is referred to as FRP partial wrapping strengthening technique. Existing research has demonstrated that FRP partial wrapping strengthening technique is a promising and economical alternative to the FRP full wrapping strengthening technique. Although extensive experimental investigations have hitherto been conducted on partially FRP-confined concrete columns, the confinement mechanics of confined concrete in partially FRP-confined circular columns remains unclear. In this paper, an experimental program consisting of fifteen column specimens was conducted and the test results were presented. A reliable three-dimensional (3D finite element (FE approach for modeling of partially FRP-confined circular columns was established. In the proposed FE approach, an accurate plastic-damage model for concrete under multiaxial compression is employed. The accuracy of the proposed FE approach was verified by comparisons between the numerical results and the test results. Numerical results from the verified FE approach were then presented to gain an improved understanding of the behavior of confined concrete in partially FRP-confined concrete columns.

  18. Partial oxidation of methane to syngas on Rh/Al{sub 2}O{sub 3} and Rh/Ce-ZrO{sub 2} catalysts

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Raquel L.; Bitencourt, Isabela G.; Passos, Fabio B., E-mail: fbpassos@vm.uff.br [Universidade Federal Fluminense (UFF), Niteroi, RJ (Brazil). Dept. de Engenharia Quimica e Petroleo

    2013-01-15

    The partial oxidation of methane with {gamma}-Al{sub 2}O{sub 3}-, CeO{sub 2}-, ZrO{sub 2}- and Ce-ZrO{sub 2}-supported rhodium catalysts was investigated. DRIFTS (diffuse reflectance infrared spectroscopy) measurements of adsorbed CO showed the formation of different rhodium species on different supports, which influenced the dispersion of the metal. The effects of the metal dispersion, oxygen storage capacity on the activity of these catalysts for the partial oxidation of methane are discussed. (author)

  19. Occlusion and Temporomandibular Function among Subjects with Mandibular Distal Extension Removable Partial Dentures

    Science.gov (United States)

    Creugers, N. H. J.; Witter, D. J.; Van 't Spijker, A.; Gerritsen, A. E.; Kreulen, C. M.

    2010-01-01

    Objective. To quantify effects on occlusion and temporomandibular function of mandibular distal extension removable partial dentures in shortened dental arches. Methods. Subjects wearing mandibular extension removable partial dentures (n = 25) were compared with subjects with shortened dental arches without extension (n = 74) and with subjects who had worn a mandibular extension removable partial denture in the past (n = 19). Subjects with complete dentitions (n = 72) were controls. Data were collected at baseline and at 3-, 6-, and 9-year observations. Results. Occlusal activity in terms of reported awareness of bruxism and occlusal tooth wear of lower anterior teeth did not differ significantly between the groups. In contrast, occlusal tooth wear of premolars in shortened dental arches with or without extension dentures was significantly higher than in the controls. Differences amongst groups with respect to signs and symptoms related to temporomandibular disorders were not found. Occlusal support of the dentures did not influence anterior spatial relationship. Occlusal contacts of the denture teeth decreased from 70% for second premolars via 50% for first molars, to 30% for second molars. Conclusions. Mandibular distal extension removable partial dentures in moderate shortened dental arches had no effects on occlusion and temporomandibular function. PMID:20671961

  20. 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.

  1. 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

  2. Hospital-based education support for students with chronic health conditions.

    Science.gov (United States)

    Hopkins, Liza J

    2016-04-01

    Objective To examine the evidence for best practice in educational support to hospitalised students and describe the existing supports available across each Australian state and territory. Methods A descriptive approach to the diversity of current practice and a review of the published evidence for best practice. Results We have constructed a model of best-practice in education support to hospitalised students. We found that education support services in each state met some of the criteria for best practice, but no one state service met all of the criteria. Conclusions All Australian states and territories make provision for hospitalised students to continue with their education, however the services in some states are closer to the best-practice model than others. What is known about the topic? It is well known that children and young people living with health conditions are at higher risk of educational underachievement and premature disengagement from school than their healthy peers. Although each state and territory across Australia offers some form of educational support to students during periods of hospitalisation, this support differs widely in each jurisdiction in fundamentals such as which students are eligible for support, where the support is delivered, how it is delivered and who coordinates the support. Published evidence in the literature suggests that the elements of good practice in education support have been well identified but, in practice, lack of policy direction can hinder the implementation of coordinated support. What does this paper add? This paper draws together the different models in place to support students in hospital in each state and territory and identifies the common issues that are faced by hospital education support services, as well as identifying areas where practice differs across settings. It also identifies the elements of good practice from the literature and links the elements of theory and practice to present a model of

  3. 76 FR 45547 - Notice of Intent To Grant Partially Exclusive License Between the National Energy Technology...

    Science.gov (United States)

    2011-07-29

    ... the invention. DOE intends to grant the license, upon a final determination in accordance with 35 U.S... its intent to grant a partially exclusive license to practice the inventions described and claimed in... in Newton, MA. The inventions are owned by United States of America, as represented by DOE. DATES...

  4. Process evaluation of a practice nurse-led smoking cessation trial in Australian general practice: views of general practitioners and practice nurses.

    Science.gov (United States)

    Halcomb, Elizabeth J; Furler, John S; Hermiz, Oshana S; Blackberry, Irene D; Smith, Julie P; Richmond, Robyn L; Zwar, Nicholas A

    2015-08-01

    Support in primary care can assist smokers to quit successfully, but there are barriers to general practitioners (GPs) providing this support routinely. Practice nurses (PNs) may be able to effectively take on this role. The aim of this study was to perform a process evaluation of a PN-led smoking cessation intervention being tested in a randomized controlled trial in Australian general practice. Process evaluation was conducted by means of semi-structured telephone interviews with GPs and PNs allocated in the intervention arm (Quit with PN) of the Quit in General Practice trial. Interviews focussed on nurse training, content and implementation of the intervention. Twenty-two PNs and 15 GPs participated in the interviews. The Quit with PN intervention was viewed positively. Most PNs were satisfied with the training and the materials provided. Some challenges in managing patient data and follow-up were identified. The Quit with PN intervention was acceptable to participating PNs and GPs. Issues to be addressed in the planning and wider implementation of future trials of nurse-led intervention in general practice include providing ongoing mentoring support, integration into practice management systems and strategies to promote greater collaboration in GPs and PN teams in general practice. The ongoing feasibility of the intervention was impacted by the funding model supporting PN employment and the competing demands on the PNs time. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. Algebraic partial Boolean algebras

    International Nuclear Information System (INIS)

    Smith, Derek

    2003-01-01

    Partial Boolean algebras, first studied by Kochen and Specker in the 1960s, provide the structure for Bell-Kochen-Specker theorems which deny the existence of non-contextual hidden variable theories. In this paper, we study partial Boolean algebras which are 'algebraic' in the sense that their elements have coordinates in an algebraic number field. Several of these algebras have been discussed recently in a debate on the validity of Bell-Kochen-Specker theorems in the context of finite precision measurements. The main result of this paper is that every algebraic finitely-generated partial Boolean algebra B(T) is finite when the underlying space H is three-dimensional, answering a question of Kochen and showing that Conway and Kochen's infinite algebraic partial Boolean algebra has minimum dimension. This result contrasts the existence of an infinite (non-algebraic) B(T) generated by eight elements in an abstract orthomodular lattice of height 3. We then initiate a study of higher-dimensional algebraic partial Boolean algebras. First, we describe a restriction on the determinants of the elements of B(T) that are generated by a given set T. We then show that when the generating set T consists of the rays spanning the minimal vectors in a real irreducible root lattice, B(T) is infinite just if that root lattice has an A 5 sublattice. Finally, we characterize the rays of B(T) when T consists of the rays spanning the minimal vectors of the root lattice E 8

  6. Motor Axonal Regeneration After Partial and Complete Spinal Cord Transection

    Science.gov (United States)

    Lu, Paul; Blesch, Armin; Graham, Lori; Wang, Yaozhi; Samara, Ramsey; Banos, Karla; Haringer, Verena; Havton, Leif; Weishaupt, Nina; Bennett, David; Fouad, Karim; Tuszynski, Mark H.

    2012-01-01

    We subjected rats to either partial mid-cervical or complete upper thoracic spinal cord transections and examined whether combinatorial treatments support motor axonal regeneration into and beyond the lesion. Subjects received cAMP injections into brainstem reticular motor neurons to stimulate their endogenous growth state, bone marrow stromal cell grafts in lesion sites to provide permissive matrices for axonal growth, and brain-derived neurotrophic factor (BDNF) gradients beyond the lesion to stimulate distal growth of motor axons. Findings were compared to several control groups. Combinatorial treatment generated motor axon regeneration beyond both C5 hemisection and complete transection sites. Yet despite formation of synapses with neurons below the lesion, motor outcomes worsened after partial cervical lesions and spasticity worsened after complete transection. These findings highlight the complexity of spinal cord repair, and the need for additional control and shaping of axonal regeneration. PMID:22699902

  7. The Nation's Combat Logistics Support Agency

    Science.gov (United States)

    Services Doing Business With DLA Customer Support Business Operations Small Business Federal Contracting CENTCOM & SOCOM DLA Europe & Africa DLA Pacific History News Careers A graphic shows rows of cross -shaped gravestones in a cemetery with the words Heritage, History, Heroes over a partial American Flag

  8. Kaizen practice in healthcare: a qualitative analysis of hospital employees' suggestions for improvement

    Science.gov (United States)

    Mazzocato, Pamela; Stenfors-Hayes, Terese; von Thiele Schwarz, Ulrica; Hasson, Henna

    2016-01-01

    Objectives Kaizen, or continuous improvement, lies at the core of lean. Kaizen is implemented through practices that enable employees to propose ideas for improvement and solve problems. The aim of this study is to describe the types of issues and improvement suggestions that hospital employees feel empowered to address through kaizen practices in order to understand when and how kaizen is used in healthcare. Methods We analysed 186 structured kaizen documents containing improvement suggestions that were produced by 165 employees at a Swedish hospital. Directed content analysis was used to categorise the suggestions into following categories: type of situation (proactive or reactive) triggering an action; type of process addressed (technical/administrative, support and clinical); complexity level (simple or complex); and type of outcomes aimed for (operational or sociotechnical). Compliance to the kaizen template was calculated. Results 72% of the improvement suggestions were reactions to a perceived problem. Support, technical and administrative, and primary clinical processes were involved in 47%, 38% and 16% of the suggestions, respectively. The majority of the kaizen documents addressed simple situations and focused on operational outcomes. The degree of compliance to the kaizen template was high for several items concerning the identification of problems and the proposed solutions, and low for items related to the test and implementation of solutions. Conclusions There is a need to combine kaizen practices with improvement and innovation practices that help staff and managers to address complex issues, such as the improvement of clinical care processes. The limited focus on sociotechnical aspects and the partial compliance to kaizen templates may indicate a limited understanding of the entire kaizen process and of how it relates to the overall organisational goals. This in turn can hamper the sustainability of kaizen practices and results. PMID:27473953

  9. Optimization of partially shaded PV array using a modified P&O MPPT algorithm

    Directory of Open Access Journals (Sweden)

    Abdelaziz YOUCEF

    2016-07-01

    Full Text Available A photovoltaic (PV array generated power is directly affected by temperature, solar irradiation, shading, and array configuration. In practice, PV arrays could be partially shaded by could, buildings, trees and other utilities. In this case, multiple maximums appear in the P-V curve, a global maximum and one or several local maximums. The “perturb and observe“ (P&O maximum power point tracking (MPPT algorithm cannot differentiate between a global and a local maximum and it is therefore ineffective when partial shading occurs. First, this paper presents an original mathematical model of the P-V curve of a partially shaded PV array, that was used to perform a simulation study in order to show the P&O algorithm inability to track the global MPP of a PV array solar system under partial shading for low shading irradiation levels, then an adaptation sub algorithm is proposed to be added to the P&O algorithm in order to give it the ability to track the global MPP. This sub algorithm moves the operating point imposed by the partial shading configuration to a point in the vicinity of the global MPP in order to be easily tracked by the P&O algorithm. In the simulation, a PV array with a hundred modules has been considered by using a light, a medium then a severe shading configuration. The results obtained indicate that the proposed modified P&O algorithm is able to track the global MPP for the considered shading configurations and for any shading irradiation level.

  10. An Isotonic Partial Credit Model for Ordering Subjects on the Basis of Their Sum Scores

    Science.gov (United States)

    Ligtvoet, Rudy

    2012-01-01

    In practice, the sum of the item scores is often used as a basis for comparing subjects. For items that have more than two ordered score categories, only the partial credit model (PCM) and special cases of this model imply that the subjects are stochastically ordered on the common latent variable. However, the PCM is very restrictive with respect…

  11. 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...

  12. THE EFFECT OF PARTIAL DEFOLIATION ON MONOTERPENE LEVELS OF GEWURZTRAMINER WINE (Vitis vinifera L.

    Directory of Open Access Journals (Sweden)

    Marko Karoglan

    2008-07-01

    Full Text Available It is well known that different viticultural practices have an important influence on the quality of grapes, must and wine. Aiming to examine impact of partial defoliation we were measured composition of the aromatic components in the wine of Gewurztraminer, winegrowing hills of Zagreb, subregion Prigorje-Bilogora. Partial defoliation, i.e. removing of 4 (D1 and 8 (D2 basal leaves, conducted manually at veraison and grapevines without defoliation (ND-non defoliated were used as control. Samples for analyses were taken after filtration, stabilization and bottling of wine. It was shown that the wine made from completely sun exposed grapes (D2, were the richest in the content of free volatile terpenes (FVT and potentially volatile terpenes (PVT respectively.

  13. [Conventional retaining of removable partial dentures

    NARCIS (Netherlands)

    Keltjens, H.M.A.M.; Witter, D.J.; Creugers, N.H.J.

    2009-01-01

    Mechanical and biological criteria have to be met in retaining the metal frame of a removable partial denture. Additionally, a removable partial denture is part of the occlusal interface by the clasps and the denture teeth. With respect to mechanical aspects, all rigid parts of the removable partial

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    Ruggiero, Dana; Mong, Christopher J.

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    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. 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.

  18. 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…

  19. Telescopic Partial Dentures-Concealed Technology.

    Science.gov (United States)

    Bhagat, Tushar Vitthalrao; Walke, Ashwini Nareshchandra

    2015-09-01

    The ideal goal of good dentist is to restore the missing part of oral structure, phonetics, his look and the most important is restored the normal health of the patient, which is hampered due to less or insufficient intake of food. Removable partial denture (RPD) treatment option is considered as a notion, which precludes the inevitability of "floating plastic" in edentulous mouth, that many times fail to fulfill the above essential of the patients. In modern dentistry, though the dental implants or fixed partial denture is the better options, but they have certain limitations. However, overdentures and particularly telescopic denture is the overlooked technology in dentistry that would be a boon for such needy patients. Telescopic denture is especially indicated in the distal edentulous area with minimum two teeth bilaterally present with a good amount of periodontal support. This treatment modality is sort of preventive prosthodontics remedy, which in a conservative manner preserve the remaining teeth and helps in conservation of alveolar bone ultimately. There are two tenets related to this option, one is constant conservation edentulous ridge around the retained tooth and the most important is the endless existence of periodontal sensory action that directs and monitor gnathodynamic task. In this option the primary coping or inner coping are cemented on the prepared tooth, and a similar removable outer or inner telescopic crown placed tightly by using a mechanism of tenso-friction, this is firmly attached to a removable RPD in place without moving or rocking of the prosthesis, which is the common compliant of almost all patients of RPD. Copings are also protecting the abutment from tooth decay and also offers stabilization and maintaining of the outer crown. The outer crown engages the inner coping and gives as an anchor for the remainder of the dentition. This work is the review of telescopic prosthesis which is well supported by the case discussion, and

  20. 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