WorldWideScience

Sample records for providing role models

  1. Family child care home providers as role models for children: Cause for concern?

    Directory of Open Access Journals (Sweden)

    Alison Tovar

    2017-03-01

    Full Text Available Health behaviors associated with chronic disease, particularly healthy eating and regular physical activity, are important role modeling opportunities for individuals working in child care programs. Prior studies have not explored these risk factors in family child care home (FCCH providers which care for vulnerable and at-risk populations. To address this gap, we describe the socio-demographic and health risk behavior profiles in a sample of providers (n = 166 FCCH taken from baseline data of an ongoing cluster-randomized controlled intervention (2011–2016 in North Carolina. Data were collected during on-site visits where providers completed self-administered questionnaires (socio-demographics, physical activity, fruit and vegetable consumption, number of hours of sleep per night and perceived stress and had their height and weight measured. A risk score (range: 0–6; 0 no risk to 6 high risk was calculated based on how many of the following were present: not having health insurance, being overweight/obese, not meeting physical activity, fruit and vegetable, and sleep recommendations, and having high stress. Mean and frequency distributions of participant and FCCH characteristics were calculated. Close to one third (29.3% of providers reported not having health insurance. Almost all providers (89.8% were overweight or obese with approximately half not meeting guidelines for physical activity, fruit and vegetable consumption, and sleep. Over half reported a “high” stress score. The mean risk score was 3.39 (±1.2, with close to half of the providers having a risk score of 4, 5 or 6 (45.7%. These results stress the need to promote the health of these important care providers.

  2. The Development of Mouse APECED Models Provides New Insight into the Role of AIRE in Immune Regulation

    Directory of Open Access Journals (Sweden)

    Lara E. Pereira

    2005-01-01

    Full Text Available Autoimmune polyendocrinopathy candidiasis ectodermal dystrophy is a rare recessive autoimmune disorder caused by a defect in a single gene called AIRE (autoimmune regulator. Characteristics of this disease include a variable combination of autoimmune endocrine tissue destruction, mucocutaneous candidiasis and ectodermal dystrophies. The development of Aire-knockout mice has provided an invaluable model for the study of this disease. The aim of this review is to briefly highlight the strides made in APECED research using these transgenic murine models, with a focus on known roles of Aire in autoimmunity. The findings thus far are compelling and prompt additional areas of study which are discussed.

  3. The Development of Mouse APECED Models Provides New Insight into the Role of AIRE in Immune Regulation

    OpenAIRE

    Pereira, Lara E.; Bostik, Pavel; Ansari, Aftab A.

    2005-01-01

    Autoimmune polyendocrinopathy candidiasis ectodermal dystrophy is a rare recessive autoimmune disorder caused by a defect in a single gene called AIRE (autoimmune regulator). Characteristics of this disease include a variable combination of autoimmune endocrine tissue destruction, mucocutaneous candidiasis and ectodermal dystrophies. The development of Aire-knockout mice has provided an invaluable model for the st...

  4. Models and role models

    NARCIS (Netherlands)

    ten Cate, J.M.

    2015-01-01

    Developing experimental models to understand dental caries has been the theme in our research group. Our first, the pH-cycling model, was developed to investigate the chemical reactions in enamel or dentine, which lead to dental caries. It aimed to leverage our understanding of the fluoride mode of

  5. Provider role attitudes, marital satisfaction, role overload, and housework: a dyadic approach.

    Science.gov (United States)

    Helms, Heather M; Walls, Jill K; Crouter, Ann C; McHale, Susan M

    2010-10-01

    Treating the marital dyad as the unit of analysis, this study examined the within-couple patterning of 272 dual-earner spouses' provider role attitudes and their longitudinal associations with marital satisfaction, role overload, and the division of housework. Based on the congruence of husbands' and wives' provider role attitudes, couples were classified into one of four types: (a) main-secondary, (b) coprovider, (c) ambivalent coprovider, and (d) mismatched couples. Nearly half of all spouses differed in their attitudes about breadwinning. A series of mixed model ANCOVAs revealed significant between- and within-couple differences in human capital characteristics, spouses' perceptions of marital satisfaction and role overload, and the division of housework across 3 years of measurement. Coprovider couples reported higher levels of marital satisfaction and a more equitable division of housework than the other couple groups. Wives in the ambivalent coprovider couples' group reported higher levels of role overload than their husbands to a greater extent than was found in the other couple groups. As the first study to adopt a dyadic approach that considers the meanings that both spouses in dual-earner couples ascribe to paid employment, these findings advance understanding of how dual-earner spouses' provider role attitudes serve as contexts for marital quality, behavior, and role-related stress.

  6. The role of decentralized systems in providing universal electricity access in Sub-Saharan Africa – A model-based approach

    NARCIS (Netherlands)

    Dagnachew, Anteneh G.; Lucas, Paul L.|info:eu-repo/dai/nl/272607444; Hof, Andries F.|info:eu-repo/dai/nl/240412397; Gernaat, David E.H.J.|info:eu-repo/dai/nl/372664636; de Boer, Harmen Sytze; van Vuuren, Detlef P.|info:eu-repo/dai/nl/11522016X

    2017-01-01

    Poverty and lack of access to electricity are highly correlated. In Sub-Saharan Africa, one of the poorest regions in the world, two in every three people have no access to electricity. This paper describes a purpose designed model to explore and project the development in the Sub-Saharan African

  7. The role of non-governmental organizations in providing curative ...

    African Journals Online (AJOL)

    Abstract. Background: Conflict in North Darfur state, Western Sudan started in 2003, and the delivering of curative health services was becoming a greater challenge for the country's limited resources. NGOs have played an important role in providing curative health services. Objectives: To examine the role that ...

  8. Development of Model for Providing Feasible Scholarship

    Directory of Open Access Journals (Sweden)

    Harry Dhika

    2016-05-01

    Full Text Available The current work focuses on the development of a model to determine a feasible scholarship recipient on the basis of the naiv¨e Bayes’ method using very simple and limited attributes. Those attributes are the applicants academic year, represented by their semester, academic performance, represented by their GPa, socioeconomic ability, which represented the economic capability to attend a higher education institution, and their level of social involvement. To establish and evaluate the model performance, empirical data are collected, and the data of 100 students are divided into 80 student data for the model training and the remaining of 20 student data are for the model testing. The results suggest that the model is capable to provide recommendations for the potential scholarship recipient at the level of accuracy of 95%.

  9. Entrepreneurship and Role Models

    NARCIS (Netherlands)

    N. Bosma (Niels); S.J.A. Hessels (Jolanda); V. Schutjens (Veronique); M. van Praag (Mirjam); I. Verheul (Ingrid)

    2011-01-01

    textabstractIn the media role models are increasingly being acknowledged as an influential factor in explaining the reasons for the choice of occupation and career. Various conceptual studies have proposed links between role models and entrepreneurial intentions. However, empirical research aimed at

  10. Multiple-role dilemmas for military mental health care providers.

    Science.gov (United States)

    Johnson, W Brad; Bacho, Roderick; Heim, Mark; Ralph, John

    2006-04-01

    Military psychologists and psychiatrists frequently face ethical quandaries involving boundary crossings, or extratherapy contact, and multiple relationships. A multiple relationship is defined as necessarily engaging psychotherapy patients in nonclinical roles, such as coworker, superior officer, neighbor, or friend. In contrast to their civilian counterparts, military mental health professionals must often engage patients in many different contexts and roles. In this article, we consider the distinctive features of mental health practice in the military and offer military providers several practice guidelines for avoiding harm to patients in military settings. This article is also designed to enhance sensitivity to multiple-role risks among nonpsychiatric providers.

  11. Levels of Interaction Provided by Online Distance Education Models

    Science.gov (United States)

    Alhih, Mohammed; Ossiannilsson, Ebba; Berigel, Muhammet

    2017-01-01

    Interaction plays a significant role to foster usability and quality in online education. It is one of the quality standard to reveal the evidence of practice in online distance education models. This research study aims to evaluate levels of interaction in the practices of distance education centres. It is aimed to provide online distance…

  12. Providers' roles in enhancing patients' adherence to pain self management.

    Science.gov (United States)

    Dorflinger, Lindsey; Kerns, Robert D; Auerbach, Stephen M

    2013-03-01

    Practice guidelines and empirical research related to pain management encourage clinicians to take active roles in providing education about self management and promoting adoption of a self-management approach. The purpose of the study was to review the relevant literature, summarize aspects of the patient-provider interaction that influence patient engagement in self management for chronic pain, and outline practice recommendations in this area. Review of the literature on aspects of the patient-provider interaction that promote engagement in pain self-management was used. Findings are synthesized into recommendations for providers. Patients benefit from a biopsychosocial and patient-centered approach. Patients are more likely to fully disclose when providers respond empathically, which can improve conceptualization and treatment. Patient education and motivation play important roles in engaging patients in self management. Self management is influenced in part by the patient-provider communication process. Suggestions for communication strategies to facilitate patient engagement in self-management techniques, including empathic discussion of barriers and motivation enhancement, are provided.

  13. Cost Calculation Model for Logistics Service Providers

    Directory of Open Access Journals (Sweden)

    Zoltán Bokor

    2012-11-01

    Full Text Available The exact calculation of logistics costs has become a real challenge in logistics and supply chain management. It is essential to gain reliable and accurate costing information to attain efficient resource allocation within the logistics service provider companies. Traditional costing approaches, however, may not be sufficient to reach this aim in case of complex and heterogeneous logistics service structures. So this paper intends to explore the ways of improving the cost calculation regimes of logistics service providers and show how to adopt the multi-level full cost allocation technique in logistics practice. After determining the methodological framework, a sample cost calculation scheme is developed and tested by using estimated input data. Based on the theoretical findings and the experiences of the pilot project it can be concluded that the improved costing model contributes to making logistics costing more accurate and transparent. Moreover, the relations between costs and performances also become more visible, which enhances the effectiveness of logistics planning and controlling significantly

  14. Human trafficking: the role of the health care provider.

    Science.gov (United States)

    Dovydaitis, Tiffany

    2010-01-01

    Human trafficking is a major public health problem, both domestically and internationally. Health care providers are often the only professionals to interact with trafficking victims who are still in captivity. The expert assessment and interview skills of providers contribute to their readiness to identify victims of trafficking. The purpose of this article is to provide clinicians with knowledge on trafficking and give specific tools that they may use to assist victims in the clinical setting. Definitions, statistics, and common health care problems of trafficking victims are reviewed. The role of the health care provider is outlined through a case study and clinical practice tools are provided. Suggestions for future research are also briefly addressed. (c) 2010 American College of Nurse-Midwives. Published by Elsevier Inc. All rights reserved.

  15. Guide to Working with Model Providers.

    Science.gov (United States)

    Walter, Katie; Hassel, Bryan C.

    Often a central feature of a school's improvement efforts is the adoption of a Comprehensive School Reform (CSR) model, an externally developed research-based design for school improvement. Adopting a model is only the first step in CSR. Another important step is forging partnerships with developers of CSR models. This guide aims to help schools…

  16. Parents’ role in adolescent depression care: primary care provider perspectives

    Science.gov (United States)

    Radovic, Ana; Reynolds, Kerry; McCauley, Heather L.; Sucato, Gina S.; Stein, Bradley D.; Miller, Elizabeth

    2015-01-01

    Objective To understand how primary care providers (PCPs) perceive barriers to adolescent depression care to inform strategies to increase treatment engagement. Study design We conducted semi-structured interviews with 15 PCPs recruited from community pediatric offices with access to integrated behavioral health services (i.e., low system-level barriers to care) who participated in a larger study on treating adolescent depression. Interviews addressed PCP perceptions of barriers to adolescents’ uptake of care for depression. Interviews were audio-recorded, transcribed, and coded for key themes. Results Although PCPs mentioned several adolescent barriers to care, they thought parents played a critical role in assisting adolescents in accessing mental health services. Important aspects of the parental role in accessing treatment included transportation, financial support, and social support. PCP’s perceived that parental unwillingness to accept the depression diagnosis, family dysfunction and trauma were common barriers. PCPs contrasted this with examples of good family support they believed would enable adolescents to attend follow-up appointments and have a “life coach” at home to help monitor for side effects and watch for increased suicidality when starting antidepressants. Conclusions In this PCP population, which had enhanced access to mental health specialists, PCPs primarily reported attitudinal barriers to adolescent depression treatment, focusing mainly on perceived parent barriers. The results of these qualitative interviews provide a framework for understanding PCP perceptions of parental barriers to care, identifying that addressing complex parental barriers to care may be important for future interventions. PMID:26143382

  17. Parents' Role in Adolescent Depression Care: Primary Care Provider Perspectives.

    Science.gov (United States)

    Radovic, Ana; Reynolds, Kerry; McCauley, Heather L; Sucato, Gina S; Stein, Bradley D; Miller, Elizabeth

    2015-10-01

    To understand how primary care providers (PCPs) perceive barriers to adolescent depression care to inform strategies to increase treatment engagement. We conducted semistructured interviews with 15 PCPs recruited from community pediatric offices with access to integrated behavioral health services (ie, low system-level barriers to care) who participated in a larger study on treating adolescent depression. Interviews addressed PCP perceptions of barriers to adolescents' uptake of care for depression. Interviews were audiorecorded, transcribed, and coded for key themes. Although PCPs mentioned several adolescent barriers to care, they thought parents played a critical role in assisting adolescents in accessing mental health services. Important aspects of the parental role in accessing treatment included transportation, financial support, and social support. PCPs perceived that parental unwillingness to accept the depression diagnosis, family dysfunction, and trauma were common barriers. PCPs contrasted this with examples of good family support they believed would enable adolescents to attend follow-up appointments and have a "life coach" at home to help monitor for side effects and watch for increased suicidality when starting antidepressants. In this PCP population, which had enhanced access to mental health specialists, PCPs primarily reported attitudinal barriers to adolescent depression treatment, focusing mainly on perceived parent barriers. The results of these qualitative interviews provide a framework for understanding PCP perceptions of parental barriers to care, identifying that addressing complex parental barriers to care may be important for future interventions. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Role of nursing leadership in providing compassionate care.

    Science.gov (United States)

    Quinn, Barry

    2017-12-13

    This article encourages nurses to explore the concept of leadership in the constantly changing field of health and social care. All nurses have an important role in leadership, and they should consider what type of leader they want to be and what leadership skills they might wish to develop. This article examines what leadership might involve, exploring various leadership styles and characteristics and how these could be applied in nurses' practice. A core component of nursing and nursing leadership is the ability to provide compassionate care. This could correspond with the idea of servant leadership, an approach that moves the leader from a position of power to serving the team and supporting individuals to develop their potential. ©2017 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

  19. Role Models on Dope

    DEFF Research Database (Denmark)

    Christiansen, Ask Vest; Gleaves, John

    2014-01-01

    Compared to football-players cyclists are virtuous role models. Yes, Lance Armstrong, Michael Rasmussen and other riders have doped, and because of this they have received the predicate as the most immoral athletes in the sporting world. But if morality is not only a question of whether a person...... has enhanced his or hers performances by the use of various drugs (and lied about it), but also is about human beings’ relations and interactions, then cycling isn’t as depraved as we like to tell each other. Football is much worse....

  20. Midwives' Role in Providing Nutrition Advice during Pregnancy: Meeting the Challenges? A Qualitative Study

    OpenAIRE

    Arrish, Jamila; Yeatman, Heather; Williamson, Moira

    2017-01-01

    This study explored the Australian midwives' role in the provision of nutrition advice. Little is known about their perceptions of this role, the influence of the model of care, and the barriers and facilitators that may influence them providing quality nutrition advice to pregnant women. Semistructured telephone interviews were undertaken with a subsample (n = 16) of the members of the Australian College of Midwives who participated in an online survey about midwives' nutrition knowledge, at...

  1. Governance, Government, and the Search for New Provider Models

    Directory of Open Access Journals (Sweden)

    Richard B. Saltman

    2016-01-01

    Full Text Available A central problem in designing effective models of provider governance in health systems has been to ensure an appropriate balance between the concerns of public sector and/or government decision-makers, on the one hand, and of non-governmental health services actors in civil society and private life, on the other. In tax-funded European health systems up to the 1980s, the state and other public sector decision-makers played a dominant role over health service provision, typically operating hospitals through national or regional governments on a command-and-control basis. In a number of countries, however, this state role has started to change, with governments first stepping out of direct service provision and now de facto pushed to focus more on steering provider organizations rather than on direct public management. In this new approach to provider governance, the state has pulled back into a regulatory role that introduces market-like incentives and management structures, which then apply to both public and private sector providers alike. This article examines some of the main operational complexities in implementing this new governance reality/strategy, specifically from a service provision (as opposed to mostly a financing or even regulatory perspective. After briefly reviewing some of the key theoretical dilemmas, the paper presents two case studies where this new approach was put into practice: primary care in Sweden and hospitals in Spain. The article concludes that good governance today needs to reflect practical operational realities if it is to have the desired effect on health sector reform outcome.

  2. Outsourcing customer support : The role of provider customer focus

    NARCIS (Netherlands)

    Wuyts, S.H.K.; Rindfleisch, A.; Citrin, A.

    An increasing number of firms are outsourcing customer support to external service providers. This creates a triadic setting in which an outsourcing provider serves end customers on behalf of its clients. While outsourcing presents an opportunity to serve customers, service providers differ in their

  3. Human Trafficking: The Role of the Health Care Provider

    OpenAIRE

    Dovydaitis, Tiffany

    2010-01-01

    Human trafficking is a major public health problem, both domestically and internationally. Health care providers are often the only professionals to interact with trafficking victims who are still in captivity. The expert assessment and interview skills of providers contribute to their readiness to identify victims of trafficking. The purpose of this article is to provide clinicians with knowledge on trafficking and give specific tools that they may use to assist victims in the clinical setti...

  4. Role model and prototype matching

    DEFF Research Database (Denmark)

    Lykkegaard, Eva; Ulriksen, Lars

    2016-01-01

    Previous research has found that young people’s prototypes of science students and scientists affect their inclination to choose tertiary STEM programs (Science, Technology, Engineering and Mathematics). Consequently, many recruitment initiatives include role models to challenge these prototypes......’ meetings with the role models affected their thoughts concerning STEM students and attending university. The regular self-to-prototype matching process was shown in real-life role-models meetings to be extended to a more complex three-way matching process between students’ self-perceptions, prototype...... images and situation-specific conceptions of role models. Furthermore, the study underlined the positive effect of prolonged role-model contact, the importance of using several role models and that traditional school subjects catered more resistant prototype images than unfamiliar ones did...

  5. Providing Supplemental Counseling Experiences: Alternatives to Role-Playing.

    Science.gov (United States)

    Hazler, Richard J.; Singer, Mark J.

    This paper offers a rationale and introduction to three innovative techniques which provide initial counseling experiences to trainees in the helping professions. The development of a cooperative program with the drama department to train and utilize drama students as coached clients is described as the first technique. The second technique is…

  6. A reappraisal of private employers' role in providing health insurance.

    Science.gov (United States)

    Carrasquillo, O; Himmelstein, D U; Woolhandler, S; Bor, D H

    1999-01-14

    In 1996, according to official figures, 61 percent of Americans received health insurance through employers. However, this estimate includes persons who relied primarily on government insurance such as Medicare, workers whose employers arranged their insurance but contributed nothing toward the premiums, and government employees whose private coverage was paid for by taxpayers. To estimate the number of persons whose principal health insurance was paid for in whole or in part by employers in the private sector and the number receiving government-funded insurance, we analyzed data from the March 1997 Current Population Survey. Approximately 130,000 persons representative of the noninstitutionalized U.S. population were sampled. We considered people to be covered principally by health insurance paid for by private-sector employers if they had no public insurance coverage and were covered by insurance from a non-governmental employer who paid all or part of their premiums. Those who were covered by Medicaid, Medicare, insurance resulting from former or current military service, or the Indian Health Service were considered to be receiving government insurance. In 1996, 43.1 percent of the population (90 percent confidence interval, 42.7 to 43.5 percent) depended principally on health insurance paid for by private-sector employers, 34.2 percent (90 percent confidence interval, 33.8 to 34.6 percent) had publicly funded insurance, 7.1 percent (90 percent confidence interval, 6.8 to 7.6 percent) purchased their own coverage, and 15.6 percent (90 percent confidence interval, 15.3 to 15.9 percent) were uninsured. In only six states was more than half the population covered principally by health insurance paid for by private-sector employers. Current definitions of health insurance overemphasize the role of private employers and underestimate the extent to which government pays for health insurance.

  7. Human trafficking: Role of oral health care providers.

    Science.gov (United States)

    Nuzzolese, E

    2014-11-30

    Trafficking in human beings is a modern form of slavery and is a well-known phenomenon throughout the European Union and beyond. After drug dealing and the weapons industry, human trafficking is the second largest criminal activity in the world today and it is a growing crime. The aim of governmental and non-governmental agencies, which are either directly or indirectly involved in combating trafficking in human beings, is the identification and referral of victims of trafficking and also to encourage self-referrals. Identification is the most important step to provide protection and assistance to victims of trafficking. Victims often have a variety of physical and mental health needs, including psychological trauma, injuries from violence, head and neck trauma, sexually transmitted infections and other gynaecological problems, dental/oral problems and have poor nutrition. The author's experience in the field of community dentistry in presented within. Volunteer dental services are offered to non-European Union patients held in a centre for asylum seekers in Bari (Italy). Dental professionals can, in fact, contribute to the identification, assistance and protection of trafficked persons, as well as offering forensic services to assist the police investigation in order to identify crimes and find the criminal organizations behind them. As for domestic violence and child abuse cases, there are ethical concerns involved in the identification and protection of the trafficked persons, as well as the need for interdisciplinary work and awareness. Adequate training in behavioural science and intercultural learning is paramount in order to avoid misunderstandings and increase sensitivity.

  8. Determining provider choice for the treatment of mental disorder: the role of health and mental health status.

    OpenAIRE

    Frank, R G; Kamlet, M S

    1989-01-01

    This article specifies and estimates a model of provider choice for mental health services. Three types of providers are identified: specialty mental health providers, general medical providers, and informal providers. Specific attention is paid to the role of health and mental health status in determining provider choice. The model is estimated using a multinomial logit approach applied to a sample of 2,800 respondents to the Baltimore Epidemiological Catchment Area Survey. The results are l...

  9. Comprehensive Care For Joint Replacement Model - Provider Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — Comprehensive Care for Joint Replacement Model - provider data. This data set includes provider data for two quality measures tracked during an episode of care:...

  10. The motivational theory of role modeling : How role models influence role aspirants' goals

    NARCIS (Netherlands)

    Morgenroth, Thekla; Ryan, Michelle K.; Peters, Kim

    2015-01-01

    Role models are often suggested as a way of motivating individuals to set and achieve ambitious goals, especially for members of stigmatized groups in achievement settings. Yet, the literature on role models tends not to draw on the motivational literature to explain how role models may help role

  11. Customer-Provider Strategic Alignment: A Maturity Model

    Science.gov (United States)

    Luftman, Jerry; Brown, Carol V.; Balaji, S.

    This chapter presents a new model for assessing the maturity of a ­customer-provider relationship from a collaborative service delivery perspective: the Customer-Provider Strategic Alignment Maturity (CPSAM) Model. This model builds on recent research for effectively managing the customer-provider relationship in IT service outsourcing contexts and a validated model for assessing alignment across internal IT service units and their business customers within the same organization. After reviewing relevant literature by service science and information systems researchers, the six overarching components of the maturity model are presented: value measurements, governance, partnership, communications, human resources and skills, and scope and architecture. A key assumption of the model is that all of the components need be addressed to assess and improve customer-provider alignment. Examples of specific metrics for measuring the maturity level of each component over the five levels of maturity are also presented.

  12. The Role of Safety Culture in Influencing Provider Perceptions of Patient Safety.

    Science.gov (United States)

    Bishop, Andrea C; Boyle, Todd A

    2016-12-01

    To determine how provider perceptions of safety culture influence their involvement in patient safety practices. Health-care providers were surveyed in 2 tertiary hospitals located in Atlantic Canada, composed of 4 units in total. The partial least squares (PLS) approach to structural equation modeling was used to analyze the data. Latent variables provider PLS model encompassed the hypothesized relationships between provider characteristics, safety culture, perceptions of patient safety practices, and actual performance of patient safety practices, using the Health Belief Model (HBM) as a guide. Data analysis was conducted using SmartPLS. A total of 113 health-care providers completed a survey out of an eligible 318, representing a response rate of 35.5%. The final PLS model showed acceptable internal consistency with all four latent variables having a composite reliability score above the recommended 0.70 cutoff value (safety culture = 0.86, threat = 0.76, expectations = 0.83, PS practices = 0.75). Discriminant validity was established, and all path coefficients were found to be significant at the α = 0.05 level using nonparametric bootstrapping. The survey results show that safety culture accounted for 34% of the variance in perceptions of threat and 42% of the variance in expectations. This research supports the role that safety culture plays in the promotion and maintenance of patient safety activities for health-care providers. As such, it is recommended that the introduction of new patient safety strategies follow a thorough exploration of an organization's safety culture.

  13. PROVIDER CHOICE FOR OUTPATIENT HEALTH CARE SERVICES IN INDONESIA: THE ROLE OF HEALTH INSURANCE

    Directory of Open Access Journals (Sweden)

    Budi Hidayat

    2012-11-01

    Full Text Available Background: Indonesian's health care system is characterized by underutilized of the health-care infrastructure. One of the ways to improve the demand for formal health care is through health insurance. Responding to this potentially effective policy leads the Government of Indonesia to expand health insurance coverage by enacting the National Social Security Act in 2004. In this particular issue, understanding provider choice is therefore a key to address the broader policy question as to how the current low uptake of health care services could be turned in to an optimal utilization. Objective:To estimate a model of provider choice for outpatient care in Indonesia with specific attention being paid to the role of health insurance. Methods: A total of 16485 individuals were obtained from the second wave of the Indonesian Family Life survey. A multinomial logit regression model was applied to a estimate provider choice for outpatient care in three provider alternative (public, private and self-treatment. A policy simulation is reported as to how expanding insurance benefits could change the patterns of provider choice for outpatient health care services. Results: Individuals who are covered by civil servant insurance (Askes are more likely to use public providers, while the beneficiaries of private employees insurance (Jamsostek are more likely to use private ones compared with the uninsured population. The results also reveal that less healthy, unmarried, wealthier and better educated individuals are more likely to choose private providers than public providers. Conclusions: Any efforts to improve access to health care through health insurance will fail if policy-makers do not accommodate peoples' preferences for choosing health care providers. The likely changes in demand from public providers to private ones need to be considered in the current social health insurance reform process, especially in devising premium policies and benefit packages

  14. An Observational Study of Provider Perspectives on Alternative Payment Models.

    Science.gov (United States)

    Harris, Drew; Puskarz, Katherine

    2017-10-01

    Over the past decade, reimbursement in the US health care system has undergone rapid transformation. The Affordable Care Act and the Medicare Access and CHIP Reauthorization Act are some of the many changes challenging traditional modes of practice and raising concerns about practitioners' ability to adapt. Recently, physician satisfaction was proposed as an addition to the Triple Aim in acknowledgment of how the physician's attitude can affect outcomes. To understand how physicians perceive alternative payment models (APMs) and how those perceptions may vary by their organizational role, non-leader physicians (N = 31), physician leaders (N = 67), and health system leaders (N = 49) were surveyed using a mixed-methods approach. Respondents to the electronic survey, who were identified from a Jefferson College of Population Health program participant database, rated their organizations' responses to APMs and provided commentary. Analysis of the Likert scale quantitative data indicates a significant difference in ratings between the 3 groups, particularly between health system leaders and non-leader physicians. The aggregated Attitudes Toward APMs Scale indicates that health system leaders were statistically significantly more likely to rate themselves and their organizations as better prepared for APMs compared to non-leader physicians and physician leaders. Qualitative analysis of comments indicates that non-leader physicians are more negative of APMs, often expressing frustration at added administrative burdens, barriers to implementation, and inconsistent or unclear measurement requirements. These findings indicate that the negative feelings non-leader physicians and physician leaders, in particular, expressed could contribute to physician burnout and decreased professional satisfaction, and impede the effective implementation of APMs.

  15. Bring Your Own Device - Providing Reliable Model of Data Access

    Directory of Open Access Journals (Sweden)

    Stąpór Paweł

    2016-10-01

    Full Text Available The article presents a model of Bring Your Own Device (BYOD as a model network, which provides the user reliable access to network resources. BYOD is a model dynamically developing, which can be applied in many areas. Research network has been launched in order to carry out the test, in which as a service of BYOD model Work Folders service was used. This service allows the user to synchronize files between the device and the server. An access to the network is completed through the wireless communication by the 802.11n standard. Obtained results are shown and analyzed in this article.

  16. Training and the Change Agent Role Model

    Science.gov (United States)

    Leach, Wesley B.; Owens, Vyrle W.

    1973-01-01

    The authors discuss the qualities possessed by a model change agent and roles played by him as resident technical participant: analyst, advisor, advocate, systems linker, innovator, and trainer. Besides presenting the teaching plan for change agents, the authors call upon their Peace Corps experiences to provide specific examples of what is…

  17. Constructions of Provider Role Identity among African American Men: An Exploratory Study.

    Science.gov (United States)

    Diemer, Matthew A.

    2002-01-01

    A study was designed to gain an understanding of the role of provider in the identity of African American males. Interviews were conducted with seven African American males at a western university. Participants equated being a man with the provider role and education was seen as the best way to ensure opportunities. Exploratory findings provide…

  18. Conceptual Models of the Individual Public Service Provider

    DEFF Research Database (Denmark)

    Andersen, Lotte Bøgh; Bhatti, Yosef; Petersen, Ole Helby

    Individual public service providers’ motivation can be conceptualized as either extrinsic, autonomous or prosocial, and the question is how we can best theoretically understand this complexity without losing too much coherence and parsimony. Drawing on Allison’s approach (1969), three perspectives...... are used to gain insight on the motivation of public service providers; namely principal-agent theory, self-determination theory and public service motivation theory. We situate the theoretical discussions in the context of public service providers being transferred to private organizations...... theoretical – to develop a coherent model of individual public service providers – but the empirical illustration also contributes to our understanding of motivation in the context of public sector outsourcing....

  19. Modelling catchment areas for secondary care providers: a case study.

    Science.gov (United States)

    Jones, Simon; Wardlaw, Jessica; Crouch, Susan; Carolan, Michelle

    2011-09-01

    Hospitals need to understand patient flows in an increasingly competitive health economy. New initiatives like Patient Choice and the Darzi Review further increase this demand. Essential to understanding patient flows are demographic and geographic profiles of health care service providers, known as 'catchment areas' and 'catchment populations'. This information helps Primary Care Trusts (PCTs) to review how their populations are accessing services, measure inequalities and commission services; likewise it assists Secondary Care Providers (SCPs) to measure and assess potential gains in market share, redesign services, evaluate admission thresholds and plan financial budgets. Unlike PCTs, SCPs do not operate within fixed geographic boundaries. Traditionally, SCPs have used administrative boundaries or arbitrary drive times to model catchment areas. Neither approach satisfactorily represents current patient flows. Furthermore, these techniques are time-consuming and can be challenging for healthcare managers to exploit. This paper presents three different approaches to define catchment areas, each more detailed than the previous method. The first approach 'First Past the Post' defines catchment areas by allocating a dominant SCP to each Census Output Area (OA). The SCP with the highest proportion of activity within each OA is considered the dominant SCP. The second approach 'Proportional Flow' allocates activity proportionally to each OA. This approach allows for cross-boundary flows to be captured in a catchment area. The third and final approach uses a gravity model to define a catchment area, which incorporates drive or travel time into the analysis. Comparing approaches helps healthcare providers to understand whether using more traditional and simplistic approaches to define catchment areas and populations achieves the same or similar results as complex mathematical modelling. This paper has demonstrated, using a case study of Manchester, that when estimating

  20. Role Modeling for FNP Students.

    Science.gov (United States)

    Sherman, Jane Ehlinger

    1980-01-01

    A model is described in which student nurses' preceptors are the joint-appointee nurse practitioners, with physicians providing consultation and serving as team participants. Key points that are examined are program development at the University of Illinois, how the program actually operated, and some of the problems encountered. (CT)

  1. The Role of Childcare Providers in the Prevention of Childhood Overweight

    Science.gov (United States)

    Sellers, Kathleen; Russo, Theresa J.; Baker, Ida; Dennison, Barbara A.

    2005-01-01

    Childhood overweight has received increased national attention as a social and health problem. Childcare providers play an increasingly prominent role in the lives of young children and are therefore important in initiating change. This qualitative study determined the role of childcare professionals in the prevention of childhood overweight.…

  2. The Changing Role of Community Networks in Providing Citizen Access to the Internet.

    Science.gov (United States)

    Keenan, Thomas P.; Trotter, David Mitchell

    1999-01-01

    Examines the changing role of community network associations or freenets in providing Internet access by examining the case of the Calgary Community Network Association (CCNA) in Alberta, Canada. Discusses the withdrawal of states from the telecommunications field, priorities of the Canadian government, and the role of the private sector.…

  3. A logical model provides insights into T cell receptor signaling.

    Directory of Open Access Journals (Sweden)

    Julio Saez-Rodriguez

    2007-08-01

    Full Text Available Cellular decisions are determined by complex molecular interaction networks. Large-scale signaling networks are currently being reconstructed, but the kinetic parameters and quantitative data that would allow for dynamic modeling are still scarce. Therefore, computational studies based upon the structure of these networks are of great interest. Here, a methodology relying on a logical formalism is applied to the functional analysis of the complex signaling network governing the activation of T cells via the T cell receptor, the CD4/CD8 co-receptors, and the accessory signaling receptor CD28. Our large-scale Boolean model, which comprises 94 nodes and 123 interactions and is based upon well-established qualitative knowledge from primary T cells, reveals important structural features (e.g., feedback loops and network-wide dependencies and recapitulates the global behavior of this network for an array of published data on T cell activation in wild-type and knock-out conditions. More importantly, the model predicted unexpected signaling events after antibody-mediated perturbation of CD28 and after genetic knockout of the kinase Fyn that were subsequently experimentally validated. Finally, we show that the logical model reveals key elements and potential failure modes in network functioning and provides candidates for missing links. In summary, our large-scale logical model for T cell activation proved to be a promising in silico tool, and it inspires immunologists to ask new questions. We think that it holds valuable potential in foreseeing the effects of drugs and network modifications.

  4. Can quantum probability provide a new direction for cognitive modeling?

    Science.gov (United States)

    Pothos, Emmanuel M; Busemeyer, Jerome R

    2013-06-01

    Classical (Bayesian) probability (CP) theory has led to an influential research tradition for modeling cognitive processes. Cognitive scientists have been trained to work with CP principles for so long that it is hard even to imagine alternative ways to formalize probabilities. However, in physics, quantum probability (QP) theory has been the dominant probabilistic approach for nearly 100 years. Could QP theory provide us with any advantages in cognitive modeling as well? Note first that both CP and QP theory share the fundamental assumption that it is possible to model cognition on the basis of formal, probabilistic principles. But why consider a QP approach? The answers are that (1) there are many well-established empirical findings (e.g., from the influential Tversky, Kahneman research tradition) that are hard to reconcile with CP principles; and (2) these same findings have natural and straightforward explanations with quantum principles. In QP theory, probabilistic assessment is often strongly context- and order-dependent, individual states can be superposition states (that are impossible to associate with specific values), and composite systems can be entangled (they cannot be decomposed into their subsystems). All these characteristics appear perplexing from a classical perspective. However, our thesis is that they provide a more accurate and powerful account of certain cognitive processes. We first introduce QP theory and illustrate its application with psychological examples. We then review empirical findings that motivate the use of quantum theory in cognitive theory, but also discuss ways in which QP and CP theories converge. Finally, we consider the implications of a QP theory approach to cognition for human rationality.

  5. Drosophila provides rapid modeling of renal development, function, and disease

    Science.gov (United States)

    Romero, Michael F.

    2010-01-01

    The evolution of specialized excretory cells is a cornerstone of the metazoan radiation, and the basic tasks performed by Drosophila and human renal systems are similar. The development of the Drosophila renal (Malpighian) tubule is a classic example of branched tubular morphogenesis, allowing study of mesenchymal-to-epithelial transitions, stem cell-mediated regeneration, and the evolution of a glomerular kidney. Tubule function employs conserved transport proteins, such as the Na+, K+-ATPase and V-ATPase, aquaporins, inward rectifier K+ channels, and organic solute transporters, regulated by cAMP, cGMP, nitric oxide, and calcium. In addition to generation and selective reabsorption of primary urine, the tubule plays roles in metabolism and excretion of xenobiotics, and in innate immunity. The gene expression resource FlyAtlas.org shows that the tubule is an ideal tissue for the modeling of renal diseases, such as nephrolithiasis and Bartter syndrome, or for inborn errors of metabolism. Studies are assisted by uniquely powerful genetic and transgenic resources, the widespread availability of mutant stocks, and low-cost, rapid deployment of new transgenics to allow manipulation of renal function in an organotypic context. PMID:20926630

  6. Proposition of a multicriteria model to select logistics services providers

    Directory of Open Access Journals (Sweden)

    Miriam Catarina Soares Aharonovitz

    2014-06-01

    Full Text Available This study aims to propose a multicriteria model to select logistics service providers by the development of a decision tree. The methodology consists of a survey, which resulted in a sample of 181 responses. The sample was analyzed using statistic methods, descriptive statistics among them, multivariate analysis, variance analysis, and parametric tests to compare means. Based on these results, it was possible to obtain the decision tree and information to support the multicriteria analysis. The AHP (Analytic Hierarchy Process was applied to determine the data influence and thus ensure better consistency in the analysis. The decision tree categorizes the criteria according to the decision levels (strategic, tactical and operational. Furthermore, it allows to generically evaluate the importance of each criterion in the supplier selection process from the point of view of logistics services contractors.

  7. Exploring the role of farm animals in providing care at care farms

    NARCIS (Netherlands)

    Hassink, Jan; Bruin, de Simone R.; Berget, Bente; Elings, Marjolein

    2017-01-01

    We explore the role of farm animals in providing care to different types of participants at care farms (e.g., youngsters with behavioural problems, people with severe mental problems and people with dementia). Care farms provide alternative and promising settings where people can interact with

  8. Family Members Providing Home-Based Palliative Care to Older Adults: The Enactment of Multiple Roles

    Science.gov (United States)

    Clemmer, Sarah J.; Ward-Griffin, Catherine; Forbes, Dorothy

    2008-01-01

    Canadians are experiencing increased life expectancy and chronic illness requiring end-of-life care. There is limited research on the multiple roles for family members providing home-based palliative care. Based on a larger ethnographic study of client-family-provider relationships in home-based palliative care, this qualitative secondary analysis…

  9. Role of accrediting bodies in providing education leadership in medical education

    Directory of Open Access Journals (Sweden)

    Sam Leinster

    2014-01-01

    Role of accreditation authorities: If accreditation authorities are to provide leadership in medical education they must undertake regular review of their standards. This should be informed by all stakeholders and include experts in medical education. The format of the standards must provide clear direction to medical schools. Accreditation should take place regularly and should result in the production of a publicly accessible report.

  10. Macro-linkages between health and outdoor recreation: the role of parks and recreation providers

    Science.gov (United States)

    Randall S. Rosenberger; Terry R. Bergerson; Jeffrey D. Kline

    2009-01-01

    Physical inactivity, overweight, and obesity are growing national concerns owing to their associations with chronic diseases and overall well-being. Parks and recreation providers play a pivotal role in addressing these public health issues by providing the public with infrastructure that enables outdoor physical activity. Our analysis of county-level data for Oregon...

  11. The ambiguous role of healthcare providers: a new perspective in Human Resources Management.

    Science.gov (United States)

    Panari, Chiara; Levati, W; Bonini, A; Tonelli, M; Alfieri, E; Artioli, Giovanna

    2016-05-26

    A strategic Human Resources Management approach, that overcomes anadministrative Personnel Management, is becoming crucial for hospital organizations. In this sense, the aimof this work was to examine the figure of healthcare provider using the concept of role, as expected behaviourin term of integration in the organizational culture. The instrument used to analyse the healthcareprovider figure was "role mapping". Particularly, semistructured interviews were conducted and involved to36 health professionals of four units in order to examine the behaviour expectations system towards thehealthcare providers. The analysis revealed that the expectations of different professionals relatedto the healthcare provider were dissimilar. Physicians' expectations referred to technical preparation and efficiency,while nurses and nurse coordinators required collaboration in equip work and emotional support forpatients. In all Operating Units, directors were perceived as missing persons with vague expectations of efficiency.Differences concerned also the four Units. For example, in intensive care Unit, the role of healthcareprovider was clearer and this figure was perceived as essential for patients' care and for the equip teamwork.On the contrary, in Recovery Unit the healthcare provider was underestimated, the role was ambiguous andnot integrated in the equip even if there was a clear division of tasks between nurses and healthcare providers. The "role mapping" instrument allows to identify healthcare provider profile and find possible roleambiguity and conflicts in order to plan adequate human resources management interventions.

  12. Midwives' perception of their role in providing antenatal asthma management in Australia--a qualitative study.

    Science.gov (United States)

    McLaughlin, Karen; Kable, Ashley; Ebert, Lyn; Murphy, Vanessa

    2016-04-01

    International guidelines recommend a collaborative approach to the care of pregnant women with asthma. Midwives, as the primary health care provider for childbearing women should be viewed as collaborative partners in the provision of antenatal asthma management. However, the role of the midwife in providing antenatal asthma management has not been widely reported. Australian midwives' perceived role in antenatal asthma management was studied using a qualitative descriptive method. Semi-structured in-depth interviews were conducted with 13 midwives working in a regional tertiary hospital. Morse and Field's four-stage process was used to analyse the data. the perceived role of the midwife in antenatal asthma management varied among participants. Some midwives stated their role was to refer women on to other health professionals. Other midwives stated that they should provide education to the women regarding their asthma management during their pregnancy. participants were uncertain about their role and lacked confidence in antenatal asthma management. The midwifery context in which they worked and the resources available to them at this health care facility appeared to influence the perception of their role. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Solitary mammals provide an animal model for autism spectrum disorders.

    Science.gov (United States)

    Reser, Jared Edward

    2014-02-01

    Species of solitary mammals are known to exhibit specialized, neurological adaptations that prepare them to focus working memory on food procurement and survival rather than on social interaction. Solitary and nonmonogamous mammals, which do not form strong social bonds, have been documented to exhibit behaviors and biomarkers that are similar to endophenotypes in autism. Both individuals on the autism spectrum and certain solitary mammals have been reported to be low on measures of affiliative need, bodily expressiveness, bonding and attachment, direct and shared gazing, emotional engagement, conspecific recognition, partner preference, separation distress, and social approach behavior. Solitary mammals also exhibit certain biomarkers that are characteristic of autism, including diminished oxytocin and vasopressin signaling, dysregulation of the endogenous opioid system, increased Hypothalamic-pituitary-adrenal axis (HPA) activity to social encounters, and reduced HPA activity to separation and isolation. The extent of these similarities suggests that solitary mammals may offer a useful model of autism spectrum disorders and an opportunity for investigating genetic and epigenetic etiological factors. If the brain in autism can be shown to exhibit distinct homologous or homoplastic similarities to the brains of solitary animals, it will reveal that they may be central to the phenotype and should be targeted for further investigation. Research of the neurological, cellular, and molecular basis of these specializations in other mammals may provide insight for behavioral analysis, communication intervention, and psychopharmacology for autism.

  14. The Role of the Medical Provider in the Evaluation of Sexually Abused Children and Adolescents

    Science.gov (United States)

    Newton, Alice Whittier; Vandeven, Andrea Marie

    2010-01-01

    It was only 30 years ago that the medical community began to develop an increased awareness of child sexual abuse, and the role of the medical provider in the evaluation of sexually abused children has evolved significantly. As clinicians worldwide develop a greater understanding of the impact of the sexual abuse evaluation on the child, the roles…

  15. Greek Academic Librarians' Perceptions of the Impact of Google on Their Role as Information Providers

    Science.gov (United States)

    Garoufallou, Emmanouel; Balatsoukas, Panos; Siatri, Rania; Zafeiriou, Georgia; Asderi, S.; Ekizoglou; P.

    2008-01-01

    The increased popularity of Google search engine in the daily routine in one's workplace and in the academic information seeking process is undeniable. "Googling" challenges the traditional skills of librarians as information providers and the role of library and information service provision in the digital era. This paper reports on the…

  16. Do Lumped-Parameter Models Provide the Correct Geometrical Damping?

    DEFF Research Database (Denmark)

    Andersen, Lars

    2007-01-01

    This paper concerns the formulation of lumped-parameter models for rigid footings on homogenous or stratified soil with focus on the horizontal sliding and rocking. Such models only contain a few degrees of freedom, which makes them ideal for inclusion in aero-elastic codes for wind turbines and ......-parameter models with respect to the prediction of the maximum response during excitation and the geometrical damping related to free vibrations of a footing....

  17. Utilization of nondentist providers and attitudes toward new provider models: findings from the National Dental Practice-Based Research Network.

    Science.gov (United States)

    Blue, Christine M; Funkhouser, D Ellen; Riggs, Sheila; Rindal, D Brad; Worley, Donald; Pihlstrom, Daniel J; Benjamin, Paul; Gilbert, Gregg H

    2013-01-01

    The purpose of this study was to quantify, within the National Dental Practice-Based Research Network, current utilization of dental hygienists and assistants with expanded functions and quantify network dentists' attitudes toward a new nondentist provider model - the dental therapist. National Dental Practice-Based Research Network practitioner-investigators participated in a single, cross-sectional administration of a questionnaire. Current nondentist providers are not being utilized by network practitioner-investigators to the fullest extent allowed by law. Minnesota practitioners, practitioners in large group practices, and those with prior experience with expanded-function nondentist providers delegate at a higher rate and had more-positive perceptions of the new dental therapist model. Expanding scopes of practice for dental hygienists and assistants has not translated to the maximal delegation allowed by law among network practices. This finding may provide insight into dentists' acceptance of newer nondentist provider models. © 2013 American Association of Public Health Dentistry.

  18. A financing model for Spanish retail electricity providers

    National Research Council Canada - National Science Library

    Isabel Vela Cantalapiedra; José Luís Calvo González

    2018-01-01

    ...; and the definition and structure of the future-flow securitization process. Due to the lack of liquidity and the difficulty of obtaining funds in the financial sector, new electricity providers have to search for alternative financing...

  19. Improving Providers' Role Definitions to Decrease Overcrowding and Improve In-Hospital Cardiac Arrest Response.

    Science.gov (United States)

    Leary, Marion; Schweickert, William; Neefe, Stacie; Tsypenyuk, Boris; Falk, Scott Austin; Holena, Daniel N

    2016-07-01

    How nontechnical factors such as inadequate role definition and overcrowding affect outcomes of in-hospital cardiac arrest (IHCA) is unknown. Using a bundled intervention, we sought to improve providers' role definitions and decrease overcrowding during IHCA events. To determine if a bundled intervention consisting of a nurse/physician leadership dyad, visual cues for provider roles, and a "role check" would lead to reductions in crowding and improve perceptions of communication and team leadership. Baseline data on the number and type of IHCA providers were collected. Providers were asked to complete a postevent survey rating communication and leadership. A bundled intervention was then introduced. Data were then obtained for the subsequent IHCA events. Twenty ICHA events were captured before and 34 after the intervention. The number of physicians present at pulse checks 2 (median [interquartile range]: 6 [5-8] before vs 5 [3-6] after, P = .02) and 3 (7 [5-9] vs 4 [4-5], P = .004) decreased significantly after the intervention. The overall number of providers at the third pulse check (18 [14-22] before vs 14 [12-16] after, P = .04) also decreased after the intervention. On a 10-point Likert scale, ratings of communication (8 [7-8]) and physician leadership (8 [7-9]) did not differ significantly from before to after the intervention. Both the physician leads (90%) and patients' primary nurses (97%) were able to identify clear nurse leaders. A bundled intervention targeted at improving IHCA response led to a decrease in overcrowding at ICHA events without substantial changes in the perceptions of communication or physician leadership. ©2016 American Association of Critical-Care Nurses.

  20. Community psychiatric nurses and the care co-ordinator role: squeezed to provide 'limited nursing'.

    Science.gov (United States)

    Simpson, Alan

    2005-12-01

    This paper reports a study illuminating the factors that either facilitate or constrain the ability of community psychiatric nurses, in their role as care co-ordinators, to meet service users' and carers' needs. The Care Programme Approach is the key policy underpinning community-focused mental health services in England, but has been unevenly implemented and is associated with increased inpatient bed use. The care co-ordinator role is central to the Care Programme Approach and is most often held by community psychiatric nurses, but there has been little research into how this role is performed or how it affects the work of community psychiatric nurses and their ability to meet the needs of service users. A multiple case study of seven sectorised community mental health teams was employed over 2 years using predominantly qualitative methods including participant observation, semi-structured interviews and document review. The data were collected in one National Health Service trust in south England between 1999 and 2001. Additional duties and responsibilities specifically associated with the care co-ordinator role and multidisciplinary working, combined with heavy workloads, produced 'limited nursing', whereby community psychiatric nurses were unable to provide evidence-based psychosocial interventions that are recognized to reduce relapse amongst people with severe mental illness. The role of the Care Programme Approach care co-ordinator was not designed to support the provision of psychosocial interventions. Consequently, community psychiatric nurses in the co-ordinator role are faced with competing demands and are unable to provide the range of structured, evidence-based interventions required. This may partially account for the increased inpatient bed use associated with the Care Programme Approach.

  1. Preferred provider organizations: today's models and tomorrow's prospects.

    Science.gov (United States)

    de Lissovoy, G; Rice, T; Ermann, D; Gabel, J

    1986-01-01

    Preferred provider organizations (PPOs) have recently attracted much attention as an alternative to both traditional fee-for-service medicine and health maintenance organizations. To examine their development and structure, we conducted a telephone survey with executives of more than 130 operational PPOs. We describe typical examples of the three most common types of PPOs-those sponsored by providers, insurers, and entrepreneurs-and identify problems each faces in the increasingly competitive health care environment. We then cite approaches that innovative PPOs are using to deal expressly with these problems.

  2. Using models to provide a virtual test of forest treatments

    Science.gov (United States)

    Janet Sullivan; Kevin Hyde

    2007-01-01

    BEMRP's participation in the Bitterroot National Forest's proposed Trapper Bunkhouse Land Stewardship Project (Trapper-Bunkhouse Project) consists of two parts. One is the field study mentioned elsewhere in this ECO-Report that is looking into the effects of thinning and burning on various resources. The other part involves modeling to determine where...

  3. Do Lumped-Parameter Models Provide the Correct Geometrical Damping?

    DEFF Research Database (Denmark)

    Andersen, Lars

    response during excitation and the geometrical damping related to free vibrations of a hexagonal footing. The optimal order of a lumped-parameter model is determined for each degree of freedom, i.e. horizontal and vertical translation as well as torsion and rocking. In particular, the necessity of coupling...

  4. Exploring the Role of Farm Animals in Providing Care at Care Farms

    Science.gov (United States)

    Hassink, Jan; De Bruin, Simone R.; Berget, Bente; Elings, Marjolein

    2017-01-01

    Simple Summary This paper provides insight into the role of farm animals in farm-based programs and their importance to different types of participants. Farm animals provide real work, close relationships, challenging tasks and opportunities for reflection. They also contribute to a welcoming atmosphere for various types of participants. Abstract We explore the role of farm animals in providing care to different types of participants at care farms (e.g., youngsters with behavioural problems, people with severe mental problems and people with dementia). Care farms provide alternative and promising settings where people can interact with animals compared to a therapeutic healthcare setting. We performed a literature review, conducted focus group meetings and carried out secondary data-analysis of qualitative studies involving care farmers and different types of participants. We found that farm animals are important to many participants and have a large number of potential benefits. They can (i) provide meaningful day occupation; (ii) generate valued relationships; (iii) help people master tasks; (iv) provide opportunities for reciprocity; (v) can distract people from them problems; (vi) provide relaxation; (vii) facilitate customized care; (viii) facilitate relationships with other people; (ix) stimulate healthy behavior; (x) contribute to a welcoming environment; (xi) make it possible to experience basic elements of life; and (xii) provide opportunities for reflection and feedback. This shows the multi-facetted importance of interacting with animals on care farms. In this study the types of activities with animals and their value to different types of participants varied. Farm animals are an important element of the care farm environment that can address the care needs of different types of participants. PMID:28574435

  5. A Model for the Growth of Network Service Providers

    Science.gov (United States)

    2011-12-01

    Chiam 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Naval Postgraduate School Monterey, CA 93943-5000 8. PERFORMING ORGANIZATION REPORT NUMBER...explores the implications for the evolution of the internet. Zhang, Nabipay, Odlyzko and Guerin (2010) present an economic model for studying competition...Performance tradeoffs between heuristic and optimization-based approaches (Master’s thesis). Naval Postgraduate School, Monterey, CA . Dorogovtsev

  6. Centralised gaming models: providing optimal gambling behaviour controls

    OpenAIRE

    Griffiths, M.; Wood, RTA

    2009-01-01

    The expansion in the gaming industry and its widening attraction points to the need for ever more verifiable means of controlling problem gambling. Various strategies have been built into casino venue operations to address this, but recently, following a new focus on social responsibility, a group of experts considered the possibilities of a centralised gaming model as a more effective control mechanism for dealing with gambling behaviours.

  7. Role modelling in medical education: the importance of teaching skills.

    Science.gov (United States)

    Burgess, Annette; Oates, Kim; Goulston, Kerry

    2016-04-01

    By observation of role models, and participation in activities, students develop their attitudes, values and professional competencies. Literature suggests that clinical skills and knowledge, personality, and teaching skills are three main areas that students consider central to the identification of positive role models. The aim of this study was to explore junior medical students' opinions of the ideal attributes of a good role model in clinical tutors. The study was conducted with one cohort (n = 301) of students who had completed year 1 of the medical programme in 2013. All students were asked to complete a questionnaire regarding the ideal attributes of a good role model in a clinical tutor. The questionnaire consisted of seven closed items and one open-ended question. The response rate to the questionnaire was 265/301 (88%). Although students found all three key areas important in a good role model, students emphasised the importance of excellence in teaching skills. Specifically, students see good role models as being able to provide a constructive learning environment, a good understanding of the curriculum and an ability to cater to the learning needs of all students. Students see good role models as being able to provide a constructive learning environment While acknowledging the importance of a patient-centred approach, as well as clinical knowledge and skills, our findings reinforce the importance of the actual teaching abilities of role models within medical education. © 2015 John Wiley & Sons Ltd.

  8. Experimental studies on power transformer model winding provided with MOVs

    Directory of Open Access Journals (Sweden)

    G.H. Kusumadevi

    2017-05-01

    Full Text Available Surge voltage distribution across a HV transformer winding due to appearance of very fast rise time (rise time of order 1 μs transient voltages is highly non-uniform along the length of the winding for initial time instant of occurrence of surge. In order to achieve nearly uniform initial time instant voltage distribution along the length of the HV winding, investigations have been carried out on transformer model winding. By connecting similar type of metal oxide varistors across sections of HV transformer model winding, it is possible to improve initial time instant surge voltage distribution across length of the HV transformer winding. Transformer windings with α values 5.3, 9.5 and 19 have been analyzed. The experimental studies have been carried out using high speed oscilloscope of good accuracy. The initial time instant voltage distribution across sections of winding with MOV remains nearly uniform along length of the winding. Also results of fault diagnostics carried out with and without connection of MOVs across sections of winding are reported.

  9. The Role of Healthcare Providers in the Roll-Out of PrEP

    Science.gov (United States)

    Krakower, Douglas S.; Mayer, Kenneth H.

    2015-01-01

    Purpose of Review To review the most recent studies assessing the preparedness of healthcare practitioners to provide anti-HIV pre-exposure prophylaxis (PrEP) and to suggest areas for future implementation research. Recent Findings As PrEP is a bio-behavioral intervention, healthcare providers are likely to play a critical role in implementing PrEP in care settings. Studies suggest that many specialized providers are aware of PrEP and support its provision as a public health intervention, though knowledge and acceptance are less among generalists. Therefore, utilization of PrEP by clinicians has been limited to a few early adopters. Concerns about the efficacy and long-term safety of PrEP, and perceived barriers to prescribing PrEP, could limit prescribing behaviors and intentions. Resistance to performing routine HIV risk assessments by clinicians is an additional barrier to implementing PrEP, though innovative tools to help clinicians routinely perform risk assessments are being developed. Summary Interventions are needed to engage a broader array of healthcare providers in PrEP provision. Utilizing a framework based on diffusion of innovation theory, this review proposes strategies that can be implemented and evaluated to increase PrEP prescribing by healthcare providers. If resources are invested in training clinicians to provide PrEP, then these stakeholders could enhance the use of PrEP as part of a prevention package by primary providers. PMID:26417953

  10. Providing Bibliographic Services From Machine-Readable Data Bases--The Library's Role

    Directory of Open Access Journals (Sweden)

    Richard De Gennaro

    1973-12-01

    Full Text Available Libraries will play a key role in providing access to data bases, but not by subscribing to tape services and establishing local processing centers as is commonly assumed. High costs and the nature of the demand will make this approach unfeasible. It is more likely that the library's reference staff will develop the capability of serving as a broker between the local campus user and the various regional or specialized retail distribution centers which exist or will be established.

  11. Sugar enrichment provides evidence for a role of nitrogen fixation in coral bleaching

    KAUST Repository

    Pogoreutz, Claudia

    2017-04-21

    The disruption of the coral-algae symbiosis (coral bleaching) due to rising sea surface temperatures has become an unprecedented global threat to coral reefs. Despite decades of research, our ability to manage mass bleaching events remains hampered by an incomplete mechanistic understanding of the processes involved. In this study, we induced a coral bleaching phenotype in the absence of heat and light stress by adding sugars. The sugar addition resulted in coral symbiotic breakdown accompanied by a fourfold increase of coral-associated microbial nitrogen fixation. Concomitantly, increased N:P ratios by the coral host and algal symbionts suggest excess availability of nitrogen and a disruption of the nitrogen limitation within the coral holobiont. As nitrogen fixation is similarly stimulated in ocean warming scenarios, here we propose a refined coral bleaching model integrating the cascading effects of stimulated microbial nitrogen fixation. This model highlights the putative role of nitrogen-fixing microbes in coral holobiont functioning and breakdown.

  12. Using Models to Provide Predicted Ranges for Building-Human Interfaces: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Long, N.; Scheib, J.; Pless, S.; Schott, M.

    2013-09-01

    Most building energy consumption dashboards provide only a snapshot of building performance; whereas some provide more detailed historic data with which to compare current usage. This paper will discuss the Building Agent(tm) platform, which has been developed and deployed in a campus setting at the National Renewable Energy Laboratory as part of an effort to maintain the aggressive energyperformance achieved in newly constructed office buildings and laboratories. The Building Agent(tm) provides aggregated and coherent access to building data, including electric energy, thermal energy, temperatures, humidity, and lighting levels, and occupant feedback, which are displayed in various manners for visitors, building occupants, facility managers, and researchers. This paper focuseson the development of visualizations for facility managers, or an energy performance assurance role, where metered data are used to generate models that provide live predicted ranges of building performance by end use. These predicted ranges provide simple, visual context for displayed performance data without requiring users to also assess historical information or trends. Several energymodelling techniques were explored including static lookup-based performance targets, reduced-order models derived from historical data using main effect variables such as solar radiance for lighting performance, and integrated energy models using a whole-building energy simulation program.

  13. Providing travel health care--the nurses' role: an international comparison.

    Science.gov (United States)

    Bauer, Irmgard; Hall, Sheila; Sato, Nahoko

    2013-01-01

    In many countries, the responsibility for travel health lies with medical practitioners who delegate certain tasks to nursing staff. Elsewhere, nurses have taken a leading role and work independently in private or hospital-based clinics, occupational health departments and general practices. The purpose of this study was to examine the roles and challenges faced by nurses providing travel health care in Australia, Japan and the UK, and to compare educational and professional needs. Nurses involved in travel health care were invited to complete an online questionnaire with multiple choice, open-ended, and Likert Scale questions. SurveyMonkey's statistical facilities analysed quantitative data; thematic content analysis was applied to qualitative responses. Differences and similarities between the three countries were conveyed by 474 participants focusing on current positions, work arrangements, and educational and practical concerns. Clinical practice issues, including vaccination and medication regulations, were highlighted with the differences between countries explained by the respective history of travel health care development and the involvement within their nursing profession. The call for more educational opportunities, including more support from employers, and a refinement of the role as travel health nurse appears to be international. Nurses require support networks within the field, and the development of a specialist "travel health nurse" would give a stronger voice to their concerns and needs for specific education and training in travel health care. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. From "retailers" to health care providers: Transforming the role of community pharmacists in chronic disease management.

    Science.gov (United States)

    Mossialos, Elias; Courtin, Emilie; Naci, Huseyin; Benrimoj, Shalom; Bouvy, Marcel; Farris, Karen; Noyce, Peter; Sketris, Ingrid

    2015-05-01

    Community pharmacists are the third largest healthcare professional group in the world after physicians and nurses. Despite their considerable training, community pharmacists are the only health professionals who are not primarily rewarded for delivering health care and hence are under-utilized as public health professionals. An emerging consensus among academics, professional organizations, and policymakers is that community pharmacists, who work outside of hospital settings, should adopt an expanded role in order to contribute to the safe, effective, and efficient use of drugs-particularly when caring for people with multiple chronic conditions. Community pharmacists could help to improve health by reducing drug-related adverse events and promoting better medication adherence, which in turn may help in reducing unnecessary provider visits, hospitalizations, and readmissions while strengthening integrated primary care delivery across the health system. This paper reviews recent strategies to expand the role of community pharmacists in Australia, Canada, England, the Netherlands, Scotland, and the United States. The developments achieved or under way in these countries carry lessons for policymakers world-wide, where progress thus far in expanding the role of community pharmacists has been more limited. Future policies should focus on effectively integrating community pharmacists into primary care; developing a shared vision for different levels of pharmacist services; and devising new incentive mechanisms for improving quality and outcomes. Copyright © 2015. Published by Elsevier Ireland Ltd.

  15. The role of kaizen in creating radical performance results in a logistics service provider

    Directory of Open Access Journals (Sweden)

    Erez Agmoni

    2016-09-01

    Full Text Available Background: This study investigates the role of an incremental change in organizational process in creating radical performance results in a service provider company. The role of Kaizen is established prominently in manufacturing, but is nascent in service applications. This study examines the impact of introducing Kaizen as an ODI tool-how it is applied, how it works, and whether participants believe it helps service groups form more effective working relationships that result in significant performance improvements. Methods: Exploring the evolving role of Kaizen in service contexts, this study explores a variety of facets of human communication in the context of continuous improvement and teamwork inter-organizationally. The paper consists of an archival study and an action research case study. A pre-intervention study consisting of observations, interviews, and submission of questionnaires to employees of a manufacturing and air-sea freight firm was conducted. A Kaizen intervention occurred subsequently, and a post-intervention study was then conducted. Results: Radical improvements in both companies such as 30% financial growth, 81% productivity improvement and more are demonstrated in this paper. Conclusions: Findings offer unique insights into the effects of Kaizen in creating radical performance improvements in a service company and its customer. Both qualitative and quantitative results of business, satisfaction, and productivity suggest time invested in introducing Kaizen into a service organization helps the companies improve relationships and improve the bottom line dramatically.

  16. Good mentors and role models

    Indian Academy of Sciences (India)

    Lawrence

    , strive for excellence, ... TI'S DAUGHTERS. 260 provided me immense support all through. Any success that is attributed to me is because of his support and encouragement. He has always advised me to stand up for what I believed in and not.

  17. A mixed logit model of health care provider choice: analysis of NSS data for rural India.

    Science.gov (United States)

    Borah, Bijan J

    2006-09-01

    In order to address the persistent problems of access to and delivery of health care in rural India, a better understanding of the individual provider choice decision is required. This paper is an attempt in this direction as it investigates the determinants of outpatient health care provider choice in rural India in the mixed multinomial logit (MMNL) framework. This is the first application of the mixed logit to the modeling of health care utilization. We also use the multiple imputation technique to impute the missing prices of providers that an individual did not visit when she was ill. Using data from National Sample Survey Organization of India, we find the following: price and distance to a health facility play significant roles in health care provider choice decision; when health status is poor, distance plays a less significant role in an adult's provider choice decision; price elasticity of demand for outpatient care varies with income, with low-income groups being more price-sensitive than high-income ones. Furthermore, outpatient care for children is more price-elastic than that for adults, which reflects the socio-economic structure of a typical household in rural India where an adult's health is more important than that of a child for the household's economic sustenance. Copyright 2006 John Wiley & Sons, Ltd.

  18. Challenging obesity: Patient, provider, and expert perspectives on the roles of available and emerging nonsurgical therapies.

    Science.gov (United States)

    Apovian, Caroline M; Garvey, W Timothy; Ryan, Donna H

    2015-07-01

    Adult obesity is recognized as a chronic disease. According to principles of chronic disease management, healthcare professionals should work collaboratively with patients to determine appropriate therapeutic strategies that address overweight and obesity, specifically considering a patient's disease status in addition to their individual needs, preferences, and attitudes regarding treatment. A central role and responsibility of healthcare professionals in this process is to inform and educate patients about their treatment options. Although current recommendations for the management of adult obesity provide general guidance regarding safe and proper implementation of lifestyle, pharmacological, and surgical interventions, healthcare professionals need awareness of specific evidence-based information that supports individualized clinical application of these therapies. More specifically, healthcare professionals should be up-to-date on approaches that promote successful lifestyle management and be knowledgeable about newer weight loss pharmacotherapies, so they can offer patients with obesity a wide range of options to personalize their treatment. Accordingly, this educational activity has been developed to provide participants with the latest information on treatment recommendations and therapeutic advances in lifestyle intervention and pharmacotherapy for adult obesity management. This supplement is based on the content presented at a live CME symposium held in conjunction with ObesityWeek 2014. This supplement provides an expert summary of current treatment recommendations and recent advances in nonsurgical therapies for the management of adult obesity. Patient and provider perspectives on obesity management are highlighted in embedded video clips available via QR codes, and new evidence will be applied using clinically relevant case studies. This supplement provides a topical update of obesity management, including clinical practice examples, for healthcare

  19. Challenging Obesity: Patient, Provider, and Expert Perspectives on the Roles of Available and Emerging Nonsurgical Therapies

    Science.gov (United States)

    Apovian, Caroline M.; Garvey, W. Timothy; Ryan, Donna H.

    2015-01-01

    Objective Adult obesity is recognized as a chronic disease. According to principles of chronic disease management, healthcare professionals should work collaboratively with patients to determine appropriate therapeutic strategies that address overweight and obesity, specifically considering a patient’s disease status in addition to their individual needs, preferences, and attitudes regarding treatment. A central role and responsibility of healthcare professionals in this process is to inform and educate patients about their treatment options. Although current recommendations for the management of adult obesity provide general guidance regarding safe and proper implementation of lifestyle, pharmacological, and surgical interventions, healthcare professionals need awareness of specific evidence-based information that supports individualized clinical application of these therapies. More specifically, healthcare professionals should be up-to-date on approaches that promote successful lifestyle management and be knowledgeable about newer weight loss pharmacotherapies, so they can offer patients with obesity a wide range of options to personalize their treatment. Accordingly, this educational activity has been developed to provide participants with the latest information on treatment recommendations and therapeutic advances in lifestyle intervention and pharmacotherapy for adult obesity management. Design and Methods This supplement is based on the content presented at a live CME symposium held in conjunction with ObesityWeek 2014. Results This supplement provides an expert summary of current treatment recommendations and recent advances in nonsurgical therapies for the management of adult obesity. Patient and provider perspectives on obesity management are highlighted in embedded video clips available via QR codes, and new evidence will be applied using clinically relevant case studies. Conclusions This supplement provides a topical update of obesity management

  20. The Role of Assessment in a Response to Intervention Model

    Science.gov (United States)

    Crawford, Lindy

    2014-01-01

    This article discusses the role of assessment in a response-to-intervention model. Although assessment represents only 1 component in a response-to-intervention model, a well-articulated assessment system is critical in providing teachers with reliable data that are easily interpreted and used to make instructional decisions. Three components of…

  1. Providing Quality Therapeutics in Switzerland: Role of the Stakeholders and Recent Incentives for Further Improvements.

    Science.gov (United States)

    Besson, Marie; Samer, Caroline; Rollason, Victoria; Dayer, Pierre; Desmeules, Jules

    2015-07-01

    Quality therapeutics play an important role in Switzerland's health care and economy. Switzerland holds a key position in the world of research and development, as well as in drug production. Recently, new emphasis has been placed on promoting clinical research and maintaining Switzerland's position as a center of excellence in the field. Recent revisions to the law regarding medical trials in human research allow for better allocation of regulatory resources and simplified procedures for drugs already authorized in Switzerland. The country has its own regulatory agency, the Swiss Agency for Therapeutic Products (Swissmedic), which is a public institution of the Swiss government. Swissmedic is responsible for ensuring safety in medicines, particularly regarding authorizations and market surveillance in the sector of medicinal products and medical devices. Although the centralized authorization procedure of the European Union for medicines does not apply to Switzerland, there are mutual recognition mechanisms between the Swiss medicine regulatory authority and the European Medicines Agency. Swissmedic is also in charge of postmarketing safety and oversees the national pharmacovigilance center, which collaborates closely with the World Health Organization center in Uppsala. In addition, university hospital-based clinical pharmacologists, who are involved in basic science and clinical research, regulatory affairs, ethics committees, and pharmacovigilance, promote quality therapeutics. This article discusses the role of the various stakeholders and the recent efforts made to provide a better allocation of resources aimed at further improving quality therapeutics in Switzerland. Copyright © 2015 Elsevier HS Journals, Inc. All rights reserved.

  2. Nurse, physician, and consumer role responsibility perceived by health care providers.

    Science.gov (United States)

    Hammond, K; Bandak, A; Williams, M

    1999-01-01

    The article describes a study that addressed perceptions of unilateral and egalitarian role functions for nurses, physicians, and consumers in a long-term, 345-bed psychiatric facility in the western United States. Findings indicated that physicians desired to retain authority for health care decisions and that nurses, social workers, and hospital administrators preferred collaborative practice. Support for shared responsibility increased among psychiatric technicians with years of experience. Experience did not alter the attitudes of physicians, occupational therapists, and recreational therapists for physician dominance. With experience, nurses increased their belief in nurse responsibility. Despite evidence for collaborative decision making, results of this study indicate that attitudes of health care providers may prevent this tenet from being actualized.

  3. Exploring the Role of Ad Hoc Grassroots Organizations Providing Humanitarian Aid on Lesvos, Greece.

    Science.gov (United States)

    Kitching, George Tjensvoll; J Haavik, Hanne; Tandstad, Birgit J; Zaman, Muhammad; Darj, Elisabeth

    2016-11-17

    Syrian refugees displaced into Turkey have attempted high-risk sea migrations to reach safer destinations in Europe, most often initially arriving on the Greek island of Lesvos. These refugees were often in need of basic humanitarian assistance that has been provided in part by a new category of ad hoc grassroots organizations (AHGOs). The aim of this study was to understand the internal and external operations of these AHGOs and their role on Lesvos. The experiences of AHGOs were investigated through a qualitative research design utilizing semi-structured interviews with organization leaders and spokespersons. AHGOs identified through media and social media sources as new Lesvos-specific organizations were purposively invited to complete an interview over phone, Skype or email. Data analysis of the transcribed interviews was performed by Systematic Text Condensation. Forty-one organizations were contacted and 13 interviews were conducted. Most organizations were formed in autumn 2015 responding to the greater influx of refugees and migrants at that time and reported an absence of professional humanitarian agencies providing aid on Lesvos. Three categories emerged from the material. Features of organizations; Features of volunteers and; Evolution of AHGOs. The organizations perceived themselves capable of evaluating needs, mobilizing resources, funding and providing quick response. The volunteers came with limited humanitarian experience and from a wide variety of nationalities and professional backgrounds, and the organizations developed while on Lesvos. Knowledge from our findings of AHGOs response to this complex disaster on Lesvos could be utilized in future catastrophes. We conclude that AHGOs may prove effective at providing humanitarian aid in a surge response when international non-governmental organizations are unable to respond quickly. In future complex disasters AHGOs should be recognized as new humanitarian actors and conditions should be made

  4. Sugar enrichment provides evidence for a role of nitrogen fixation in coral bleaching.

    Science.gov (United States)

    Pogoreutz, Claudia; Rädecker, Nils; Cárdenas, Anny; Gärdes, Astrid; Voolstra, Christian R; Wild, Christian

    2017-09-01

    The disruption of the coral-algae symbiosis (coral bleaching) due to rising sea surface temperatures has become an unprecedented global threat to coral reefs. Despite decades of research, our ability to manage mass bleaching events remains hampered by an incomplete mechanistic understanding of the processes involved. In this study, we induced a coral bleaching phenotype in the absence of heat and light stress by adding sugars. The sugar addition resulted in coral symbiotic breakdown accompanied by a fourfold increase of coral-associated microbial nitrogen fixation. Concomitantly, increased N:P ratios by the coral host and algal symbionts suggest excess availability of nitrogen and a disruption of the nitrogen limitation within the coral holobiont. As nitrogen fixation is similarly stimulated in ocean warming scenarios, here we propose a refined coral bleaching model integrating the cascading effects of stimulated microbial nitrogen fixation. This model highlights the putative role of nitrogen-fixing microbes in coral holobiont functioning and breakdown. © 2017 The Authors. Global Change Biology Published by John Wiley & Sons Ltd.

  5. Incorporating a pharmacist into an interprofessional team providing transgender care under a medical home model.

    Science.gov (United States)

    Newsome, Cheyenne; Colip, Leslie; Sharon, Nathaniel; Conklin, Jessica

    2017-02-01

    A pharmacist's role in providing care to transgender and gender-nonconforming (TGNC) patients within a medical home model of care is described. A comprehensive transgender services clinic was established in February 2015 in New Mexico. Clinic services are provided under an "informed consent" model of care, as opposed to the traditional "gatekeeper" approach. The clinic's interprofessional team consists of a clinical pharmacist, a psychiatrist, a nurse practitioner, an endocrinologist, a diabetes educator, a massage therapist, a nurse, a nutritionist, and medical assistants. The clinical pharmacist has served in the following roles: (1) assessing health literacy and tailoring the consent process to the patient's literacy level, (2) initiating in-depth discussion of the medical risks and benefits of cross-sex hormone therapy (HT), as well as HT alternatives, (3) discussing typical timelines for physical outcomes of HT, (4) discussing a patient's expectations and goals for csHT, (5) discussing the different HT formulations and helping to determine which formulation is best suited to meeting patient's goals, (6) helping the team obtain prior authorizations for csHT, and (7) managing risk reduction strategies such as smoking cessation and weight loss. Involvement of a pharmacist in the clinic has improved care access and quality for TGNC patients in the southwestern United States. A pharmacist in an interprofessional team staffing a clinic for TGNC people has assumed multiple responsibilities and helped improve patient care. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  6. Pharmacists providing care in the outpatient setting through telemedicine models: a narrative review.

    Science.gov (United States)

    Littauer, Sydney L; Dixon, Dave L; Mishra, Vimal K; Sisson, Evan M; Salgado, Teresa M

    2017-01-01

    Telemedicine refers to the delivery of clinical services using technology that allows two-way, real time, interactive communication between the patient and the clinician at a distant site. Commonly, telemedicine is used to improve access to general and specialty care for patients in rural areas. This review aims to provide an overview of existing telemedicine models involving the delivery of care by pharmacists via telemedicine (including telemonitoring and video, but excluding follow-up telephone calls) and to highlight the main areas of chronic-disease management where these models have been applied. Studies within the areas of hypertension, diabetes, asthma, anticoagulation and depression were identified, but only two randomized controlled trials with adequate sample size demonstrating the positive impact of telemonitoring combined with pharmacist care in hypertension were identified. The evidence for the impact of pharmacist-based telemedicine models is sparse and weak, with the studies conducted presenting serious threats to internal and external validity. Therefore, no definitive conclusions about the impact of pharmacist-led telemedicine models can be made at this time. In the Unites States, the increasing shortage of primary care providers and specialists represents an opportunity for pharmacists to assume a more prominent role managing patients with chronic disease in the ambulatory care setting. However, lack of reimbursement may pose a barrier to the provision of care by pharmacists using telemedicine.

  7. Pharmacists providing care in the outpatient setting through telemedicine models: a narrative review

    Directory of Open Access Journals (Sweden)

    Littauer SL

    2017-12-01

    Full Text Available Telemedicine refers to the delivery of clinical services using technology that allows two-way, real time, interactive communication between the patient and the clinician at a distant site. Commonly, telemedicine is used to improve access to general and specialty care for patients in rural areas. This review aims to provide an overview of existing telemedicine models involving the delivery of care by pharmacists via telemedicine (including telemonitoring and video, but excluding follow-up telephone calls and to highlight the main areas of chronic-disease management where these models have been applied. Studies within the areas of hypertension, diabetes, asthma, anticoagulation and depression were identified, but only two randomized controlled trials with adequate sample size demonstrating the positive impact of telemonitoring combined with pharmacist care in hypertension were identified. The evidence for the impact of pharmacist-based telemedicine models is sparse and weak, with the studies conducted presenting serious threats to internal and external validity. Therefore, no definitive conclusions about the impact of pharmacist-led telemedicine models can be made at this time. In the Unites States, the increasing shortage of primary care providers and specialists represents an opportunity for pharmacists to assume a more prominent role managing patients with chronic disease in the ambulatory care setting. However, lack of reimbursement may pose a barrier to the provision of care by pharmacists using telemedicine.

  8. Can role models boost entrepreneurial attitudes?

    Science.gov (United States)

    Fellnhofer, Katharina; Puumalainen, Kaisu

    2017-01-01

    This multi-country study used role models to boost perceptions of entrepreneurial feasibility and desirability. The results of a structural equation model based on a sample comprising 426 individuals who were primarily from Austria, Finland and Greece revealed a significant positive influence on perceived entrepreneurial desirability and feasibility. These findings support the argument for embedding entrepreneurial role models in entrepreneurship education courses to promote entrepreneurial activities. This direction is not only relevant for the academic community but also essential for nascent entrepreneurs, policymakers and society at large.

  9. Can role models boost entrepreneurial attitudes?

    Science.gov (United States)

    Fellnhofer, Katharina; Puumalainen, Kaisu

    2017-01-01

    This multi-country study used role models to boost perceptions of entrepreneurial feasibility and desirability. The results of a structural equation model based on a sample comprising 426 individuals who were primarily from Austria, Finland and Greece revealed a significant positive influence on perceived entrepreneurial desirability and feasibility. These findings support the argument for embedding entrepreneurial role models in entrepreneurship education courses to promote entrepreneurial activities. This direction is not only relevant for the academic community but also essential for nascent entrepreneurs, policymakers and society at large. PMID:28458611

  10. What do patients think about the role of optometrists in providing advice about smoking and nutrition?

    Science.gov (United States)

    Downie, Laura E; Douglass, Amanda; Guest, Daryl; Keller, Peter R

    2017-03-01

    Tobacco smoking and nutrition are key lifestyle factors with long-term effects on eye health. However, little is known about patients' perceptions and experiences in these areas in relation to the care received from optometrists. The main aim was to survey patients' perceptions and prior experience regarding the role of optometrists in enquiring and providing advice about tobacco smoking and nutrition. An anonymous, paper-based survey was distributed to a convenience sample of 225 adults attending the University of Melbourne eye care clinic. Respondents provided demographic and other information (age, sex, length of time since last eye examination, country of most recent eye examination, smoking status and intake of nutritional supplements) and indicated their level of agreement (using a five-step Likert scale) with a series of statements relating to the care provided by optometrists in the areas of health, smoking and nutrition. The statements were designed to assess the perceived scope of practice of optometrists and the extent to which patients expect, and feel comfortable, discussing these issues with their optometrist. 220 completed surveys were returned. Most respondents (>80%) agreed that they visit their optometrist to quantify their refractive error and to examine their eye health. About two-thirds of respondents indicated that they expect their optometrist to ask about their general health, with almost half expecting their optometrist to communicate with their general medical practitioner. Approximately one-third of respondents indicated having been routinely questioned about their smoking status, diet and nutritional supplement intake by their optometrist. This was despite about half expecting their optometrist to question them about these factors and almost three out of four respondents indicating that they felt comfortable talking with their optometrist about these lifestyle behaviours. This study provides novel insight into patients' perceptions and

  11. Nurses as role models in health promotion: a concept analysis.

    Science.gov (United States)

    Darch, Joy; Baillie, Lesley; Gillison, Fiona

    2017-09-28

    There are national and international expectations that nurses are healthy role models; however, there is a lack of clarity about what this concept means. This study used concept analysis methodology to provide theoretical clarity for the concept of role models in health promoting behaviour for registered nurses and students. The framework included analysis of literature and qualitative data from six focus groups and one interview. Participants (n=39) included pre-registration students (adult field), nurse lecturers and registered nurses (RNs), working in NHS Trusts across London and South East London. From the findings, being a role model in health promoting behaviour involves being an exemplar, portraying a healthy image (being fit and healthy), and championing health and wellness. Personal attributes of a role model in health promoting behaviour include being caring, non-judgemental, trustworthy, inspiring and motivating, self-caring, knowledgeable and self-confident, innovative, professional and having a deep sense of self.

  12. A feedback system in residency to evaluate CanMEDS roles and provide high-quality feedback : Exploring its application

    NARCIS (Netherlands)

    Renting, Nienke; Gans, Rijk O. B.; Borleffs, Jan C. C.; Van Der Wal, Martha A.; Jaarsma, A. Debbie C.; Cohen-Schotanus, Janke

    Introduction: Residents benefit from regular, high quality feedback on all CanMEDS roles during their training. However, feedback mostly concerns Medical Expert, leaving the other roles behind. A feedback system was developed to guide supervisors in providing feedback on CanMEDS roles. We analyzed

  13. Postgraduate internal medicine residents' roles at patient discharge - do their perceived roles and perceptions by other health care providers correlate?

    Science.gov (United States)

    Card, Sharon Elizabeth; Ward, Heather A; Chipperfield, Dylan; Sheppard, M Suzanne

    2014-01-01

    Knowing one's own role is a key collaboration competency for postgraduate trainees in the Canadian competency framework (CanMEDS®). To explore methods to teach collaborative competency to internal medicine postgraduate trainees, baseline role knowledge of the trainees was explored. The perceptions of roles (self and others) at patient discharge from an acute care internal medicine teaching unit amongst 69 participants, 34 physicians (25 internal medicine postgraduate trainees and 9 faculty physicians) and 35 health care professionals from different professions were assessed using an adapted previously validated survey (Jenkins et al., 2001). Internal medicine postgraduate trainees agreed on 8/13 (62%) discharge roles, but for 5/13 (38%), there was a substantial disagreement. Other professions had similar lack of clarity about the postgraduate internal medicine residents' roles at discharge. The lack of interprofessional and intraprofessional clarity about roles needs to be explored to develop methods to enhance collaborative competence in internal medicine postgraduate trainees.

  14. The Role of Oral Health Care Professionals in Providing Medical Services.

    Science.gov (United States)

    Glick, Michael; Greenberg, Barbara L

    2017-08-01

    Integration of oral health care professionals (OHCPs) into medical care could advance efforts to control increasingly prevalent conditions such as cardiovascular disease, diabetes mellitus, human immunodeficiency virus infection, and hepatitis C infection, each of which is associated with significant morbidity and health care costs. Prevention and early intervention are effective for reducing the incidence and severity of these diseases, while increasing cost of health care may drive the need for nontraditional models of health education and delivery. Studies have suggested that a dental office is a suitable setting for the purpose of screening and referrals for these conditions and may result in medical expenditure savings. Such innovations would challenge the current dental educational model and the education and training of faculty. Implementing this change would require recognizing opportunities and challenges for the profession and the need for new competencies in dental curricula. Challenges and opportunities are described, including reimbursement models and integration of OHCPs into emerging health care delivery models. Ideas for curricular change are presented, including the need for added emphasis on biological sciences and the introduction of new courses to address systems thinking and forces driving preventive behavior. To embrace the evolving health care arena and be a part of the future interprofessional health care delivery dynamic, dental curricula should also include substantive interprofessional education opportunities. Such opportunities would provide the basic skills and training to recognize and appreciate patients' oral health issues in the broader context of their overall health and well-being. This article was written as part of the project "Advancing Dental Education in the 21(st) Century."

  15. The influence of role models in undergraduate nurse education.

    Science.gov (United States)

    Jack, Kirsten; Hamshire, Claire; Chambers, Alison

    2017-03-23

    To explore the concept of role modelling in undergraduate nurse education and its effect on the personal and professional development of student nurses. Effective educative strategies are important for student nurses, who have to cope with learning in both clinical and university settings. Given the contemporary issues facing nurse education and practice in the United Kingdom (UK), it is timely and important to undertake pedagogical research into the concept of role modelling as an effective educative method. A descriptive narrative approach. Unstructured interviews were conducted with 14 current/recently discontinued students from Adult and Mental Health branches of nursing degree programmes in the north-west region of England, United Kingdom (UK). Data were thematically analysed. Students valued exposure to positive role models in clinical and university settings and viewed them as beneficial to their learning. Exposure to negative role models occurred, and this provided students with opportunities to consider the type of nurse they aspired to become. In some cases, students' exposure to perceived poor practice had an adverse effect on their learning and led to negative feelings about nursing work. Clinical staff might be perceived as more relevant role models than those in the university setting although there were still opportunities for academic staff to model professional behaviours. The study found that role modelling is an effective way to support learning and led to student satisfaction across both clinical and university settings. The findings support the use of role models in nurse education, and further research about conscious positive modelling of practice is required. Exploring the use of role models is important when examining ways in which the quality of nurse education might be developed. © 2017 John Wiley & Sons Ltd.

  16. The Other partner: The changing role of good provider for men's union formation in industrialized countries

    Directory of Open Access Journals (Sweden)

    Goldscheider, Frances

    2006-01-01

    Full Text Available EnglishMost studies of union formation behaviors have focused on women and children,with less emphasis on men. Using comparable retrospective survey data, this study looks at the waysCanadian, Italian and Swedish men begin conjugal life (distinguishing between marriage andcohabitation and at how the effects of their good provider status qualifications have changed in thelast 30 years. Results for Canadian men have shown that the simple patterns that have been assumed toshape separate and symmetrical roles for men and women are taking new shapes with the growth incohabitation and changes in women's economic roles. Our study will extend these results to examine twocountries at very different levels of cohabitation prevalence: Italy, where the growth in cohabitationhas just begun, and Sweden, where it has been underway much longer than in Canada. Our results showstrongly parallel changes underway in each country, indicating that it is important to continue tocompare, both between countries and over time, if we are to understand the situations fostering (ornot changing gender roles for men as good providers.FrenchLa plupart des études sur les comportements durant le passage à la vie de coupleont porté sur les femmes et les enfants, avec moins d’emphase sur le comportement des hommes. En se servant de données comparables d’enquêtesrétrospectives, cet article examine les différentes façons dont les Canadiens, lesItaliens et les Suédois commencent leur vie conjugale (en distinguant entre lemarriage et la cohabitation ainsi que les effets causés par les changements destrente dernières années dans leur statut de pourvoyeur. Chez les Canadiens, lesrésultats démontrent que les habitudes de vie qui avaient été prises pour modelerdes rôles masculins et féminins séparés et symétriques sont en train de prendrede nouvelles formes, avec une croissance dans les taux de cohabitation et deschangements dans les rôles économiques des femmes

  17. Psychiatric residency, role models, and leadership.

    Science.gov (United States)

    Sherwood, E; Greenblatt, M; Pasnau, R O

    1986-06-01

    Two hundred fifty ex-fellowship psychiatrists answered a questionnaire on their administrative and other professional experiences during and after residency as part of a study to determine the relationship between psychiatric training experiences and interest in administration. A large majority of subjects had had role models during training. The subjects' interest in administration had grown significantly during residency in the direction of their role models' interest. Postresidency interest in administration was significantly correlated with supervision by a psychiatrist administrator and with the number of hours subjects spent on administrative work.

  18. Ocular hemodynamics and glaucoma: the role of mathematical modeling.

    Science.gov (United States)

    Harris, Alon; Guidoboni, Giovanna; Arciero, Julia C; Amireskandari, Annahita; Tobe, Leslie A; Siesky, Brent A

    2013-01-01

    To discuss the role of mathematical modeling in studying ocular hemodynamics, with a focus on glaucoma. We reviewed recent literature on glaucoma, ocular blood flow, autoregulation, the optic nerve head, and the use of mathematical modeling in ocular circulation. Many studies suggest that alterations in ocular hemodynamics play a significant role in the development, progression, and incidence of glaucoma. Although there is currently a limited number of studies involving mathematical modeling of ocular blood flow, regulation, and diseases (such as glaucoma), preliminary modeling work shows the potential of mathematical models to elucidate the mechanisms that contribute most significantly to glaucoma progression. Mathematical modeling is a useful tool when used synergistically with clinical and laboratory data in the study of ocular blood flow and glaucoma. The development of models to investigate the relationship between ocular hemodynamic alterations and glaucoma progression will provide a unique and useful method for studying the pathophysiology of glaucoma.

  19. Role of primary care providers in dengue prevention and control in the community.

    Science.gov (United States)

    Ang, K T; Rohani, I; Look, C H

    2010-03-01

    Dengue fever is a major public health threat in Malaysia, especially in the highly urbanized states of Selangor and the Federal Territory of Kuala Lumpur. It is believed that many seek treatment at the primary care clinics and are not admitted. This study aims at establishing the fact that primary care practitioners, as the first point of patient contacts, play a crucial role in advising patients suspected of having dengue to take early preventive measures to break the chain of dengue transmission. A total of 236 patients admitted to two government hospitals for suspected dengue fever were interviewed using a structured questionnaire over a one week period in December 2008. It was found that 83.9% of the patients had sought treatment at a Primary Care (PC) facility before admission to the hospital, with 68.7% of them seeking treatment on two or more occasions. The mean time period for seeking treatment at primary care clinic was one and a half (1.4) days of fever, compared to almost five (4.9) days for admission. The majority of patients (96-98%) reported that primary care practitioners had not given them any advice on preventive measures to be taken even though 51.9% of the patients had been told they could be having dengue fever. This study showed the need for primary care providers to be more involved in the control and prevention of dengue in the community, as these patients were seen very early in their illness compared to when they were admitted.

  20. Attitudes towards legalising physician provided euthanasia in Britain: the role of religion over time.

    Science.gov (United States)

    Danyliv, Andriy; O'Neill, Ciaran

    2015-03-01

    Hastening the death of another whether through assisted suicide or euthanasia is the subject of intense debate in the UK and elsewhere. In this paper we use a nationally representative survey of public attitudes - the British Social Attitudes survey - to examine changes in attitudes to the legalisation of physician provided euthanasia (PPE) over almost 30 years (1983-2012) and the role of religious beliefs and religiosity in attitudes over time. Compatible questions about attitudes to euthanasia were available in the six years of 1983, 1984, 1989, 1994, 2005, and 2012. We study the trends in the support for legalisation through these time points and the relationship between attitudes, religious denomination and religiosity, controlling for a series of covariates. In total, 8099 individuals provided answers to the question about PPE in the six years of the study. The support for legalisation rose from around 76.95% in 1983 to 83.86% in 2012. This coincided with an increase in secularisation exhibited in the survey: the percentage of people with no religious affiliation increasing from 31% to 45.4% and those who do not attend a religious institution (e.g. church) increasing from 55.7% to 65.03%. The multivariate analysis demonstrates that religious affiliation and religiosity as measured by religious institution attendance frequency are the main contributors to attitudes towards euthanasia, and that the main increase in support happened among the group with least religious affiliation. Other socio-demographic characteristics do not seem to alter these attitudes systematically across the years. Our study demonstrates an increase in the support of euthanasia legalisation in Britain in the last 30 years coincided with increased secularisation. It does not follow, however, that trends in public support are immutable nor that a change in the law would improve on the current pragmatic approach toward hastening death by a physician adopted in England and Wales in terms of

  1. Men, prostitution and the provider role: understanding the intersections of economic exchange, sex, crime and violence in South Africa.

    Science.gov (United States)

    Jewkes, Rachel; Morrell, Robert; Sikweyiya, Yandisa; Dunkle, Kristin; Penn-Kekana, Loveday

    2012-01-01

    South African policy makers are reviewing legislation of prostitution, concerned that criminalisation hampers HIV prevention. They seek to understand the relationship between transactional sex, prostitution, and the nature of the involved men. 1645 randomly-selected adult South African men participated in a household study, disclosing whether they had sex with a woman in prostitution or had had a provider relationship (or sex), participation in crime and violence and completing psychological measures. These became outcomes in multivariable regression models, where the former were exposure variables. 51% of men had had a provider relationship and expected sex in return, 3% had had sex with a woman in prostitution, 15% men had done both of these and 31% neither. Provider role men, and those who had just had sex with a woman in prostitution, were socially conservative and quite violent. Yet the men who had done both (75% of those having sex with a woman in prostitution) were significantly more misogynist, highly scoring on dimensions of psychopathy, more sexually and physically violent to women, and extensively engaged in crime. They had often bullied at school, suggesting that this instrumental, self-seeking masculinity was manifest in childhood. The men who had not engaged in sex for economic exchange expressed a much less violent, more law abiding and gender equitable masculinity; challenging assumptions about the inevitability of intersections of age, poverty, crime and misogyny. Provider role relationships (or sex) are normative for low income men, but not having sex with a woman in prostitution. Men who do the latter operate extensively outside the law and their violence poses a substantial threat to women. Those drafting legislation and policy on the sex industry in South Africa need to distinguish between these two groups to avoid criminalising the normal, and consider measures to protect women.

  2. The Role of the School Nurse in Providing School Health Services

    Science.gov (United States)

    Journal of School Nursing, 2008

    2008-01-01

    The school nurse has a crucial role in the seamless provision of comprehensive health services to children and youth. Increasing numbers of students enter schools with chronic health conditions that require management during the school day. This policy statement describes for pediatricians the role of the school nurse in serving as a team member…

  3. Growth and division of active droplets provides a model for protocells

    Science.gov (United States)

    Zwicker, David; Seyboldt, Rabea; Weber, Christoph A.; Hyman, Anthony A.; Jülicher, Frank

    2017-04-01

    It has been proposed that during the early steps in the origin of life, small droplets could have formed via the segregation of molecules from complex mixtures by phase separation. These droplets could have provided chemical reaction centres. However, whether these droplets could divide and propagate is unclear. Here we examine the behaviour of droplets in systems that are maintained away from thermodynamic equilibrium by an external supply of energy. In these systems, droplets grow by the addition of droplet material generated by chemical reactions. Surprisingly, we find that chemically driven droplet growth can lead to shape instabilities that trigger the division of droplets into two smaller daughters. Therefore, chemically active droplets can exhibit cycles of growth and division that resemble the proliferation of living cells. Dividing active droplets could serve as a model for prebiotic protocells, where chemical reactions in the droplet play the role of a prebiotic metabolism.

  4. Cartographic modeling: The role and importance

    Directory of Open Access Journals (Sweden)

    Ikonović Vesna

    2007-01-01

    Full Text Available Aim and sense of cartographic modeling is to represent essential, typical and characteristically attributes of mapping territory. Cartographic modeling is applying in two phases: 1. trough theoretical modeling and creating mind models (by notice relevant factors of space, modeling is in cartographer’s mind and 2. trough practical modeling and making prototype model (continuing and objectification of mind model which one has bigger degree of concrezation and experimented role. The maps are mathematical and logical models, which are not just representing the contents of the real space, but also their specific and relational traits which can’t be seen at first sight. Atlas is modeled contexture contents of treated thematic of space on optimal map union. Atlases are higher form of cartography. Modern computer's technology and specific software make possible better and faster making of all kinds of maps, atlases and spatial analysis connections and relationships among all elements of contents from concrete space which is, until now, demand much more time or they can not imagine.

  5. Developing the Autism Model of Implementation for Autism spectrum disorder community providers: study protocol

    Directory of Open Access Journals (Sweden)

    Drahota Amy

    2012-09-01

    Full Text Available Abstract Background Currently, 1 out of 88 children are diagnosed with an autism spectrum disorder (ASD, and the estimated cost for treatment services is $126 billion annually. Typically, ASD community providers (ASD-CPs provide services to children with any severity of ASD symptoms using a combination of various treatment paradigms, some with an evidence-base and some without. When evidence-based practices (EBPs are successfully implemented by ASD-CPs, they can result in positive outcomes. Despite this promise, EBPs are often implemented unsuccessfully and other treatments used by ASD-CPs lack supportive evidence, especially for school-age children with ASD. While it is not well understood why ASD-CPs are not implementing EBPs, organizational and individual characteristics likely play a role. As a response to this need and to improve the lives of children with ASD and their families, this study aims to develop and test the feasibility and acceptability of the Autism Model of Implementation (AMI to support the implementation of EBPs by ASD-CPs. Methods/design An academic-community collaboration developed to partner with ASD-CPs will facilitate the development of the AMI, a process specifically for use by ASD community-based agencies. Using a mixed methods approach, the project will assess agency and individual factors likely to facilitate or hinder implementing EBPs in this context; develop the AMI to address identified barriers and facilitators; and pilot test the AMI to examine its feasibility and acceptability using a specific EBP to treat anxiety disorders in school-age children with ASD. Discussion The AMI will represent a data-informed approach to facilitate implementation of EBPs by ASD-CPs by providing an implementation model specifically developed for this context. This study is designed to address the real-world implications of EBP implementation in ASD community-based agencies. In doing so, the AMI will help to provide children with

  6. Quantifying the role of forested lands in providing surface drinking water supply for Puerto Rico

    Science.gov (United States)

    Erika Cohen; Ge Sun; Liangxia Zhang; Peter Caldwell; Suzanne Krieger

    2017-01-01

    The Forest Service, U.S. Department of Agriculture published a General Technical Report (GTR-SRS-197) in 2014 that quantified the role that water originating on National Forest System lands contributed to the drinking water supply and determined what population and communities were being served in the 13 Southern States of Region 8 of the Forest Service. The...

  7. Cameroon mid-level providers offer a promising public health dentistry model

    Directory of Open Access Journals (Sweden)

    Achembong Leo

    2012-11-01

    Full Text Available Background Oral health services are inadequate and unevenly distributed in many developing countries, particularly those in sub-Saharan Africa. Rural areas in these countries and poorer sections of the population in urban areas often do not have access to oral health services mainly because of a significant shortage of dentists and the high costs of care. We reviewed Cameroon’s experience with deploying a mid-level cadre of oral health professionals and the feasibility of establishing a more formal and predictable role for these health workers. We anticipate that a task-shifting approach in the provision of dental care will significantly improve the uneven distribution of oral health services particularly in the rural areas of Cameroon, which is currently served by only 3% of the total number of dentists. Methods The setting of this study was the Cameroon Baptist Convention Health Board (BCHB, which has four dentists and 42 mid-level providers. De-identified data were collected manually from the registries of 10 Baptist Convention clinics located in six of Cameroon’s 10 regions and then entered into an Excel format before importing into STATA. A retrospective abstraction of all entries for patient visits starting October 2010, and going back in time until 1500 visits were extracted from each clinic. Results This study showed that mid-level providers in BCHB clinics are offering a full scope of dental work across the 10 clinics, with the exception of treatment for major facial injuries. Mid-level providers alone performed 93.5% of all extractions, 87.5% of all fillings, 96.5% of all root canals, 97.5% of all cleanings, and 98.1% of all dentures. The dentists also typically played a teaching role in training the mid-level providers. Conclusions The Ministry of Health in Cameroon has an opportunity to learn from the BCHB model to expand access to oral health care across the country. This study shows the benefits of using a simple, workable, low

  8. The Role of Healthcare Providers and Caregivers in Educating Older Adults about Foodborne Illness Prevention

    Science.gov (United States)

    Wohlgenant, Kelly C.; Cates, Sheryl C.; Godwin, Sandria L.; Speller-Henderson, Leslie

    2012-01-01

    Adults aged 60 or older are more likely than younger adults to experience severe complications or even death as a result of foodborne infections. This study investigated which specific groups of healthcare providers or other caregivers are most receptive to providing food safety information to older adults. Telephone-based focus groups were…

  9. Role of community pharmacists in providing oral health advice in the Eastern province of Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Hamad Al-Saleh

    2017-07-01

    Conclusions: Community pharmacists are approached frequently for oral healthcare advices. Majority of them had no oral health training. Almost all of them were willing to provide oral health information in the community. It is essential to provide continuous oral health education to the pharmacists to better serve oral health needs of the community.

  10. What Role Can School Health Providers Play in Health Care Reform?

    Science.gov (United States)

    Fleming, Robin

    2009-01-01

    President Barack Obama is wasting no time in unfolding his plan to provide health coverage for all Americans. He started in February by signing legislation to reinstate the State Children's Health Insurance Program, which expands eligibility criteria to provide 4 million more children access to health care. This first step is one of many needed to…

  11. Mouse xenograft modeling of human adult acute lymphoblastic leukemia provides mechanistic insights into adult LIC biology

    Science.gov (United States)

    Dey, Aditi; Castleton, Anna Z.; Schwab, Claire; Samuel, Edward; Sivakumaran, Janani; Beaton, Brendan; Zareian, Nahid; Zhang, Christie Yu; Rai, Lena; Enver, Tariq; Moorman, Anthony V.; Fielding, Adele K.

    2014-01-01

    The distinct nature of acute lymphoblastic leukemia (ALL) in adults, evidenced by inferior treatment outcome and different genetic landscape, mandates specific studies of disease-initiating mechanisms. In this study, we used NOD/LtSz-scid IL2Rγ nullc (NSG) mouse xenotransplantation approaches to elucidate leukemia-initiating cell (LIC) biology in primary adult precursor B (pre-B) ALL to optimize disease modeling. In contrast with xenografting studies of pediatric ALL, we found that modification of the NSG host environment using preconditioning total body irradiation (TBI) was indispensable for efficient engraftment of adult non-t(4;11) pre-B ALL, whereas t(4;11) pre-B ALL was successfully reconstituted without this adaptation. Furthermore, TBI-based xenotransplantation of non-t(4;11) pre-B ALL enabled detection of a high frequency of LICs (<1:6900) and permitted frank leukemic engraftment from a remission sample containing drug-resistant minimal residual disease. Investigation of TBI-sensitive stromal-derived factor-1/chemokine receptor type 4 signaling revealed greater functional dependence of non-t(4;11) pre-B ALL on this niche-based interaction, providing a possible basis for the differential engraftment behavior. Thus, our studies establish the optimal conditions for experimental modeling of human adult pre-B ALL and demonstrate the critical protumorogenic role of microenvironment-derived SDF-1 in regulating adult pre-B LIC activity that may present a therapeutic opportunity. PMID:24825861

  12. The Roles of Pharmacy and Clinical Pharmacy in Providing Healthcare Services to the People

    OpenAIRE

    Muhammad Haroon Sarwar; Muhammad Farhan Sarwar; Muhammad TaimoorKhalid; Muhammad Sarwar

    2015-01-01

    Article describes a brief outline explaining the profession of Pharmacy, Clinical Pharmacy and the important role of a Pharmacist. This profession, therefore, requires a complex and well developed set of competencies to explore one of the most health and financially rewarding careers. Pharmacy is the science and technique of preparing and dispensing drugs. This is a health profession that links health sciences with chemical sciences and it aims to ensure the safe and effective use of Pharmace...

  13. Big Impact on Small Children: Child-Care Providers' Perceptions of Their Role in Early Childhood Healthy Lifestyle Behaviours

    Science.gov (United States)

    Sisson, Susan B.; Smith, Chelsea L.; Cheney, Marshall

    2017-01-01

    The purpose of this study is to examine childcare providers' perceptions of their role in child health behaviors and attitudes pertaining to physical activity and nutrition. Part and full-time providers in a childcare center or family childcare home were interviewed (n = 30) in this cross-sectional, qualitative study. Transcripts were digitally…

  14. The Role of Special and Incentive Pays in Retaining Military Mental Health Care Providers

    Science.gov (United States)

    2017-01-01

    can be used to update the model in the future and take advantage of an increased sample size, and it may be possible to extend the model in promising... marriage and family therapy, mental health counseling, substance abuse counseling, and occupational therapy. As we discuss in later chapters, we estimate...have specific occupational codes for psychiatric nursing, marriage and family therapy, mental health counseling, and substance abuse counseling

  15. Requirements Engineering Model: Role Based Goal Oriented Model

    Directory of Open Access Journals (Sweden)

    Sandfreni

    2016-01-01

    Full Text Available Requirements engineering approach through intentional perspective is one of the arguments that appear in the field of requirement engineering. That approach can explain the characteristics of the behavior of an actor. The usage Goal Based Workflow and KAOS method in iStar modeling might help the system analyst to gain knowledge about the internal process inside each of actor sequentially, such that the whole sequential activity to achieve the goal are exposed clearly in those actor’s internal process. The adoption of the concept of the role of RACI diagram on Role Based Goal Oriented Model system analyst gain complete knowledge about requirements of actor who involve in a system. System analyst might also distinguish the dependency between each actor in each process. Those dependencies are exhibited in strategic dependency model. In addition, the internal activities of the actor are also shown in strategic rationale model.

  16. Simplified process model discovery based on role-oriented genetic mining.

    Science.gov (United States)

    Zhao, Weidong; Liu, Xi; Dai, Weihui

    2014-01-01

    Process mining is automated acquisition of process models from event logs. Although many process mining techniques have been developed, most of them are based on control flow. Meanwhile, the existing role-oriented process mining methods focus on correctness and integrity of roles while ignoring role complexity of the process model, which directly impacts understandability and quality of the model. To address these problems, we propose a genetic programming approach to mine the simplified process model. Using a new metric of process complexity in terms of roles as the fitness function, we can find simpler process models. The new role complexity metric of process models is designed from role cohesion and coupling, and applied to discover roles in process models. Moreover, the higher fitness derived from role complexity metric also provides a guideline for redesigning process models. Finally, we conduct case study and experiments to show that the proposed method is more effective for streamlining the process by comparing with related studies.

  17. Beyond vulnerability: how the dual role of patient-health care provider can inform health professions education.

    Science.gov (United States)

    Rowland, Paula; Kuper, Ayelet

    2017-04-29

    In order to prepare fully competent health care professionals, health professions education must be concerned with the relational space between patients and providers. Compassion and compassionate care are fundamental elements of this relational space. Traditionally, health professions educators and leaders have gone to two narrative sources when attempting to better under constructs of compassion: patients or providers. Rarely have there been explorations of the perspectives of those who consider themselves as both patients and providers. In this study, we interviewed nineteen health care providers who self-disclosed as having had a substantive patient experience in the health care system. We engaged with these participants to better understand their experience of having these dual roles. Anchored in Foucault's concepts of subjectivity and Goffman's symbolic interactionism, the interviews in this study reveal practices of moving between the two roles of patient and provider. Through this exploration, we consider how it is that providers who have been patients understand themselves to be more compassionate whilst in their provider roles. Rather than describing compassion as a learnable behaviour or an innate virtue, we theoretically engage with one proposed mechanism of how compassion is produced. In particular, we highlight the role of critical reflexivity as an underexplored construct in the enactment of compassion. We discuss these findings in light of their implications for health professions education.

  18. Predicting Perceived Isolation among Midlife and Older LGBT Adults: The Role of Welcoming Aging Service Providers.

    Science.gov (United States)

    Yang, Jie; Chu, Yoosun; Salmon, Mary Anne

    2017-06-16

    Older lesbian, gay, bisexual, and transgender (LGBT) adults are more likely to live alone and less likely to have children compared with their heterosexual counterparts. The lack of immediate family system can render older LGBT adults particularly vulnerable to social isolation and its consequences. The current study utilizes social exclusion theory, which asserts that not only material resources but also engagement with and inclusion into the society are necessary for marginalized people to be integrated into the mainstream. The study examines whether aging service providers (e.g., senior centers, adult day care, transportation, employment services) who are perceived by older LGBT adults as welcoming to LGBT people may reduce this population's perceived isolation. Data were collected through a needs assessment survey designed for the aging LGBT community in North Carolina. Adults aged 45 and over who self-identified as LGBT were recruited at several formal and informal groups. The survey yielded 222 valid responses. The outcome variable was perceived isolation. Key independent variables included having experienced welcoming aging service providers and living alone. After controlling for potential confounders and demographics, logistic regression results showed that having experienced welcoming aging service providers was a protective factor against perceived isolation and it also buffered the negative impact of living alone. The findings provided preliminary evidence for a new direction of intervention research-targeting LGBT cultural competence training for medical and social service providers.

  19. Negotiating substance use stigma: the role of cultural health capital in provider-patient interactions.

    Science.gov (United States)

    Chang, Jamie; Dubbin, Leslie; Shim, Janet

    2016-01-01

    Diverse aspects of life and lifestyles, including stigmatised attributes and behaviors are revealed as providers and patients discuss health. In this article, we examine how the stigma associated with substance use issues shapes clinical interactions. We use the theoretical framework of cultural health capital (CHC) to explain how substance use stigma is created, reinforced and sometimes negotiated as providers and patients engage in health interactions. We present two main findings using examples. First, two theoretical concepts--habitus and field--set the social position and expectations of providers and patients in ways that facilitate the stigmatisation of substance use. Second, we found both providers and patients actively exchanged CHC as a key strategy to reduce the negative effects of stigma. In some clinical encounters, patients possessed and activated CHC, providers acknowledged patient's CHC and CHC was successfully exchanged. These interactions were productive and mutually satisfying, even when patients were actively using substances. However, when CHC was not activated, acknowledged and exchanged, stigma was unchallenged and dominated the interaction. The CHC theoretical framework allows us to examine how the stigma process is operationalized and potentially even counteracted in clinical interactions. © 2015 Foundation for the Sociology of Health & Illness.

  20. The Role of Primary Care Providers in Encouraging Older Patients to Change Their Lifestyle Behaviors.

    Science.gov (United States)

    Bardach, Shoshana H; Schoenberg, Nancy E

    2017-09-08

    This study sought to identify older patients' perceptions of primary care providers' influence on their likelihood of improving diet and physical activity. 104 adults ages 65 and older were interviewed immediately following a routine primary care visit about their plans and motivations for behavior change and how their clinic visit would influence their likelihood of making lifestyle changes. All interviews were recorded, transcribed and analyzed using a constant comparison approach. Participants reported that their providers influence their health behaviors by developing strong relationships, addressing concerns and encouraging change, and providing concrete instruction. When providers did not discuss diet or physical activity, or mentioned these topics only briefly, participants often perceived the message that they should continue their current behaviors. Whether and how diet and physical activity are discussed in primary care influences the likelihood that older adults will make changes in these behaviors. These findings highlight the need for a patient-centered counseling approach and caution providers to think twice before omitting discussion of the need for lifestyle change.

  1. Misattributed paternity in hematopoietic stem cell transplantation: the role of the healthcare provider.

    Science.gov (United States)

    Jacobson, Stephanie; Eggert, Julie; Deluca, Jane; Speckhart, Dawn

    2015-04-01

    With emerging technologies and genetic advancements in the field of oncology, ethical controversies and questions on how to approach them will continue to grow. Advancements in the field of hematopoietic stem cell transplantation have led to increased testing of transplantation recipients' children and parents as potential donors related to an increase in the use of haploidentical transplantations. This testing opens the door for an increased incidence of misattributed paternity findings. This article attempts to address the ethical conflicts and provide potential solutions to assist in the transition from individual-focused care to family-focused care. The principlist approach was used. Healthcare providers should be educated on methods of incidental finding disclosure and how to provide adequate support for those individuals.

  2. Parents or Pop Culture? Children's Heroes and Role Models.

    Science.gov (United States)

    Anderson, Kristin J.; Cavallaro, Donna

    2002-01-01

    Examines the impact of mass media on children's choices of heroes and role models. Addresses questions of which cultural messages children attend to, whether role models vary according to ethnicity and gender, and the role played by educators in exposing children to previously unconsidered role models. (DLH)

  3. The role of Advanced Practice Providers in interdisciplinary oncology care in the United States.

    Science.gov (United States)

    Reynolds, Rae Brana; McCoy, Kimberly

    2016-06-01

    Advanced Practice Registered Nurses (APRNs) and Physician Assistants (PAs), generally referred to as Advanced Practice Providers (APPs), are fundamental to interdisciplinary oncology care. As the projected demand for oncology services is anticipated to outpace the supply of oncologists, APPs will become increasingly vital in the delivery of oncology care and services. The training, education, and scope of practice for APPs gives the interdisciplinary care team professionals that deliver high-quality clinical services and provide valuable contributions and leadership to health care quality improvement initiatives. Optimizing the integration of APPs in oncology care offers immense advantages towards improvement of clinical outcomes.

  4. The Role of the Counsellor and other School Personnel in Providing ...

    African Journals Online (AJOL)

    There has been a widespread criticism of the quality of education provided by Nigerian public schools. This has led to a consistent clamour for quality education for Nigerian citizens. Attention is being focused on how to make use of the resources available in the education system to have a functional education that will lead ...

  5. Community Childcare Providers' Role in the Early Detection of Autism Spectrum Disorders

    Science.gov (United States)

    Branson, Diane; Vigil, Debra C.; Bingham, Ann

    2008-01-01

    The first few years of life represent a crucial period for optimal brain development for young children. Therefore, it is important to identify children at-risk for developmental delays, including autism spectrum disorders, at the earliest age possible. An argument for utilizing community childcare providers for universal developmental screening…

  6. Role of small-scale independent providers in water and sanitation

    NARCIS (Netherlands)

    M.P. van Dijk (Meine Pieter)

    2008-01-01

    textabstractSmall-scale independent providers (SSIPs) and households are good for 10–69% of the household water supply and sometimes up to 95% of the sanitation solutions in cities in developing countries. Different types of SSIP can be distinguished. They could be allowed to make a more important

  7. Provider Strategies and the Greening of Consumption Practices: Exploring the Role of Companies in Sustainable Consumption

    NARCIS (Netherlands)

    Spaargaren, G.; Koppen, van C.S.A.

    2009-01-01

    Making consumption practices more sustainable means incorporating new ideas, information and products into existing consumption routines of citizen-consumers. For a successful incorporation process it is crucial that companies, as main providers of new products and services, develop an active

  8. The demand attributes of assurance services providers and the role of independent accountants

    NARCIS (Netherlands)

    Knechel, W.R.; Wallage, P.; Eilifsen, A.; van Praag, B.

    2006-01-01

    This study reports on desirable attributes of assurance services providers for assurance services based on responses from a sample of Dutch senior accounting and financial officers. In general, overall expertise and objectivity are perceived as the most important attributes for selecting an

  9. A cohesin-independent role for NIPBL at promoters provides insights in CdLS.

    Directory of Open Access Journals (Sweden)

    Jessica Zuin

    2014-02-01

    Full Text Available The cohesin complex is crucial for chromosome segregation during mitosis and has recently also been implicated in transcriptional regulation and chromatin architecture. The NIPBL protein is required for the loading of cohesin onto chromatin, but how and where cohesin is loaded in vertebrate cells is unclear. Heterozygous mutations of NIPBL were found in 50% of the cases of Cornelia de Lange Syndrome (CdLS, a human developmental syndrome with a complex phenotype. However, no defects in the mitotic function of cohesin have been observed so far and the links between NIPBL mutations and the observed developmental defects are unclear. We show that NIPBL binds to chromatin in somatic cells with a different timing than cohesin. Further, we observe that high-affinity NIPBL binding sites localize to different regions than cohesin and almost exclusively to the promoters of active genes. NIPBL or cohesin knockdown reduce transcription of these genes differently, suggesting a cohesin-independent role of NIPBL for transcription. Motif analysis and comparison to published data show that NIPBL co-localizes with a specific set of other transcription factors. In cells derived from CdLS patients NIPBL binding levels are reduced and several of the NIPBL-bound genes have previously been observed to be mis-expressed in CdLS. In summary, our observations indicate that NIPBL mutations might cause developmental defects in different ways. First, defects of NIPBL might lead to cohesin-loading defects and thereby alter gene expression and second, NIPBL deficiency might affect genes directly via its role at the respective promoters.

  10. Value-Added Electricity Services: New Roles for Utilities and Third-Party Providers

    Energy Technology Data Exchange (ETDEWEB)

    Blansfield, J. [Inst. for Electric Innovations, Washington, DC (United States); Wood, L. [Inst. for Electric Innovations, Washington, DC (United States); Katofsky, R. [Advanced Energy Economy, Washington, DC (United States); Stafford, B. [Advanced Energy Economy, Washington, DC (United States); Waggoner, D. [Advanced Energy Economy, Washington, DC (United States); Schwartz, L. C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2017-10-30

    New energy generation, storage, delivery, and end-use technologies support a broad range of value-added electricity services for retail electricity customers. Sophisticated energy management services, distributed generation coupled with storage, and electric vehicle charging are just a few examples of emerging offerings. Who should provide value-added services — utilities or third parties, or both, and under what conditions? What policy and regulatory changes may be needed to promote competition and innovation, to account for utility costs to enable these services, and to protect consumers? The report approaches the issues from three perspectives: utilities, third-party service providers, and consumers: -Jonathan Blansfield and Lisa Wood, Institute for Electric Innovation -Ryan Katofsky, Benjamin Stafford and Danny Waggoner, Advanced Energy Economy -National Association of State Utility Consumer Advocates

  11. Interdepartmental Occupational Standards for Social Service Providers and Their Role in Improving Job Performance

    Directory of Open Access Journals (Sweden)

    Zabrodin Yu.M.,

    2016-04-01

    Full Text Available The paper presents an analysis of the occupational standards development abroad and in Russia. It focuses on interdepartmental occupational standards for social service providers. While creating occupational standards for social services as an integrated industry it is advisable to consider the design of whole system and its macro-level effects in a document called “sectoral qualification framework”. It is pointed out that 1 real professional activity in social sphere has a clear humanitarian focus, and its objects are radically different population groups; 2 the complexity of the social work is often associated with the interaction between various professionals and their activity have to be interdepartmentally organized. The author identifies the factors influencing development and implementation of professional standards in different countries and consider the main strategy directions of development and application of occupational standards of education and social service providers in Russia.

  12. The Role of Rules of Origin to Provide Discipline to the Gatt Article XXIV Exception

    OpenAIRE

    Jong Bum Kim; Joongi Kim

    2011-01-01

    This article examines how the GATT Article XXIV regional trade agreement (RTA) exception can be strengthened to curb the proliferation of RTAs that maintain questionable levels of trade liberalization. The lack of rigorous application of the 'substantially all the trade' requirement and the use of rules of origin in a restrictive manner are persistent problems that have led to the exclusion of products that should otherwise be part of trade liberalization under RTAs. To provide the discipline...

  13. Role of small-scale independent providers in water and sanitation

    OpenAIRE

    Dijk, Meine Pieter van

    2008-01-01

    textabstractSmall-scale independent providers (SSIPs) and households are good for 10–69% of the household water supply and sometimes up to 95% of the sanitation solutions in cities in developing countries. Different types of SSIP can be distinguished. They could be allowed to make a more important contribution to drinking water and sanitation in a situation where many governments cannot be the only one to supply drinking water and sanitary services. Theoretical and practical arguments are use...

  14. The Role of Logistics Service Providers in the Logistics Firms' Supply Chain

    OpenAIRE

    Ajakaiye, Ojo Iseghohime

    2012-01-01

    Competition amongst companies in the global market has resulted in increased production of goods and services. Enterprises are now faced with the challenges of shipments of raw materials, spare parts from vendors, and the finished goods to consumers. Logistics companies are springing up to tackle transportation and other logistics problems. There are various logistics companies such as logistics intermediaries, carriers and third party logistics service providers in the market which are in on...

  15. Transitions from hospital to community care: the role of patient-provider language concordance.

    Science.gov (United States)

    Rayan, Nosaiba; Admi, Hanna; Shadmi, Efrat

    2014-01-01

    Cultural and language discordance between patients and providers constitutes a significant challenge to provision of quality healthcare. This study aims to evaluate minority patients' discharge from hospital to community care, specifically examining the relationship between patient-provider language concordance and the quality of transitional care. This was a multi-method prospective study of care transitions of 92 patients: native Hebrew, Russian or Arabic speakers, with a pre-discharge questionnaire and structured observations examining discharge preparation from a large Israeli teaching hospital. Two weeks post-discharge patients were surveyed by phone, on the transition from hospital to community care (the Care Transition Measure (CTM-15, 0-100 scale)) and on the primary-care post-discharge visit. Overall, ratings on the CTM indicated fair quality of the transition process (scores of 51.8 to 58.8). Patient-provider language concordance was present in 49% of minority patients' discharge briefings. Language concordance was associated with higher CTM scores among minority groups (64.1 in language-concordant versus 49.8 in non-language-concordant discharges, P <0.001). Other aspects significantly associated with CTM scores: extent of discharge explanations (P <0.05), quality of discharge briefing (P <0.001), and post-discharge explanations by the primary care physician (P <0.01). Language-concordant care, coupled with extensive discharge briefings and post-discharge explanations for ongoing care, are important contributors to the quality of care transitions of ethnic minority patients.

  16. The role of the home-based provider in disaster preparedness of a vulnerable population.

    Science.gov (United States)

    Wyte-Lake, Tamar; Claver, Maria; Griffin, Anne; Dobalian, Aram

    2014-01-01

    Veterans receiving home-based primary care (HBPC) are an especially vulnerable population served by the Veterans Health Administration (VHA) due to high rates of physical, functional, and psychological limitations. These vulnerabilities may prevent these persons from being adequately prepared for disasters. HBPC providers connect the community-dwelling population with their regional health care system and thus are appropriate partners for assessing preparedness. The limited literature on this topic suggests that there are issues with the development and implementation of emergency management plans, dissemination to staff, and inconsistencies with preparedness strategies across agencies. To further explore identified issues regarding emergency management planning for patients receiving medical care in their home, including ways in which policy and procedures support the routine assessment of disaster preparedness for patients. This exploratory pilot project, carried out in a single VHA HBPC program located in an urban area, involved seven 15- to 25-min semistructured interviews with practitioners and leadership. Transcripts of the interviews were analyzed using content analysis techniques to develop themes to describe information obtained through the interviews. Six themes emerged from the data: (1) a national policy regarding the inclusion of disaster preparedness assessment in routine HBPC assessment exists in only a skeletal manner and individual HBPC programs are tasked with developing their own policies; (2) the tools used at the initial assessment were rudimentary and, in some cases, individually developed by providers; (3) the comprehension of criteria for assigning risk categories (i.e. acuity levels) varied among providers; (4) the primary challenges identified by respondents to patient engagement in emergency preparedness activities included cognitive impairments, patients' willingness to invest in preparedness activities, and limited resources; (5

  17. Gender role models in fictional novels for emerging adult lesbians.

    Science.gov (United States)

    Cook, Jennifer R; Rostosky, Sharon S; Riggle, Ellen D B

    2013-01-01

    Novels provide role models for young adult lesbians and thus may influence their identity development. This study focused on 16 lesbian protagonists identified in 11 young adult novels that received 2011 Lambda Literary Award nominations. Content analyses revealed six themes. Three themes defied traditional gender stereotypes: Asserting Oneself, Pursuing Intimacy with Another Woman, and Breaking Free of Constraints to Authentic Self-Expression. Three themes reinforced gender stereotypes: Negative Emotional Experiences Associated with Lesbian Identity, Traditional Masculine Gender Expression, and Traditional Gender Role-Based Sexual Scripts. Each theme is discussed in light of its possible contribution to lesbian identity development.

  18. Transitions from hospital to community care: the role of patient–provider language concordance

    Science.gov (United States)

    2014-01-01

    Background Cultural and language discordance between patients and providers constitutes a significant challenge to provision of quality healthcare. This study aims to evaluate minority patients’ discharge from hospital to community care, specifically examining the relationship between patient–provider language concordance and the quality of transitional care. Methods This was a multi-method prospective study of care transitions of 92 patients: native Hebrew, Russian or Arabic speakers, with a pre-discharge questionnaire and structured observations examining discharge preparation from a large Israeli teaching hospital. Two weeks post-discharge patients were surveyed by phone, on the transition from hospital to community care (the Care Transition Measure (CTM-15, 0–100 scale)) and on the primary-care post-discharge visit. Results Overall, ratings on the CTM indicated fair quality of the transition process (scores of 51.8 to 58.8). Patient–provider language concordance was present in 49% of minority patients’ discharge briefings. Language concordance was associated with higher CTM scores among minority groups (64.1 in language-concordant versus 49.8 in non-language-concordant discharges, P <0.001). Other aspects significantly associated with CTM scores: extent of discharge explanations (P <0.05), quality of discharge briefing (P <0.001), and post-discharge explanations by the primary care physician (P <0.01). Conclusion Language-concordant care, coupled with extensive discharge briefings and post-discharge explanations for ongoing care, are important contributors to the quality of care transitions of ethnic minority patients. PMID:25075273

  19. 'Quality signposting': the role of online information prescription in providing patient information.

    Science.gov (United States)

    Brewster, Liz; Sen, Barbara

    2011-03-01

      Information prescriptions (IPs) are part of a Department of Health (DH) initiative to improve patient care. IPs aim to meet health information needs by providing personalised, high quality patient information about conditions and treatment.   This paper identifies current online IP provision and evaluates a sample of IP websites against the original DH aims of IP provision; British Medical Association usability criteria; and information seeking vignettes.   Five UK and one international IP website were randomly selected as a sample. Two checklists designed to appraise the websites were used to review each IP provider. Two patient information seeking vignettes were developed to enable the websites to be assessed from a patient-centred perspective.   Information prescriptions currently vary in content, accessibility and quality. National IP websites score more highly than local IP websites, which are often weak on content for specific conditions and poorly designed but strong on signposting to local services.   Guidelines for IP provision need to be improved to ensure higher quality, more easily accessible information is available. A synthesis of expertise included in national and local websites would improve usability for patients. IP websites should conform to standards of web design and accessibility. © 2010 The authors. Health Information and Libraries Journal © 2010 Health Libraries Group.

  20. Functional genomics provides insights into the role of Propionibacterium freudenreichii ssp. shermanii JS in cheese ripening.

    Science.gov (United States)

    Ojala, Teija; Laine, Pia K S; Ahlroos, Terhi; Tanskanen, Jarna; Pitkänen, Saara; Salusjärvi, Tuomas; Kankainen, Matti; Tynkkynen, Soile; Paulin, Lars; Auvinen, Petri

    2017-01-16

    Propionibacterium freudenreichii is a commercially important bacterium that is essential for the development of the characteristic eyes and flavor of Swiss-type cheeses. These bacteria grow actively and produce large quantities of flavor compounds during cheese ripening at warm temperatures but also appear to contribute to the aroma development during the subsequent cold storage of cheese. Here, we advance our understanding of the role of P. freudenreichii in cheese ripening by presenting the 2.68-Mbp annotated genome sequence of P. freudenreichii ssp. shermanii JS and determining its global transcriptional profiles during industrial cheese-making using transcriptome sequencing. The annotation of the genome identified a total of 2377 protein-coding genes and revealed the presence of enzymes and pathways for formation of several flavor compounds. Based on transcriptome profiling, the expression of 348 protein-coding genes was altered between the warm and cold room ripening of cheese. Several propionate, acetate, and diacetyl/acetoin production related genes had higher expression levels in the warm room, whereas a general slowing down of the metabolism and an activation of mobile genetic elements was seen in the cold room. A few ripening-related and amino acid catabolism involved genes were induced or remained active in cold room, indicating that strain JS contributes to the aroma development also during cold room ripening. In addition, we performed a comparative genomic analysis of strain JS and 29 other Propionibacterium strains of 10 different species, including an isolate of both P. freudenreichii subspecies freudenreichii and shermanii. Ortholog grouping of the predicted protein sequences revealed that close to 86% of the ortholog groups of strain JS, including a variety of ripening-related ortholog groups, were conserved across the P. freudenreichii isolates. Taken together, this study contributes to the understanding of the genomic basis of P. freudenreichii

  1. The role of parental attitudes and provider discussions in uptake of adolescent vaccines.

    Science.gov (United States)

    Rickert, Vaughn I; Rehm, Susan J; Aalsma, Matthew C; Zimet, Gregory D

    2015-01-29

    The purpose of this study was to examine the relationship between parental vaccine attitudes, the number of specific vaccines discussed with a provider, and immunization outcomes including discussing immunization with their teen, knowledge of adolescent vaccine schedule, and their son or daughter being up-to-date on recommended vaccines using a nationally weight sample. Parents completed an internet-based survey between December 2012 and January 2013 and we computed a vaccine attitude scale (higher scores indicating stronger and more positive attitudes toward vaccination of teen) for each parent and categorized them into one of three groups: low (n=76), medium (n=207) or high (n=215). We also constructed a vaccine discussion scale representing the number of vaccines discussed with their adolescent's physician. Parents who were identified as having high vaccine attitudes were significantly more likely to report their physician talked with them about a particular vaccine. Using logistic regression and controlling for respondent's gender and age, income, and teen's gender, we found medium as compared to low-attitude parents had a 6.21 (95%CI=3.08, 12.51) greater odds of reporting that their teen had all recommended vaccines. Similarly, high as compared to low-attitude parents reported a 23.02 (95% CI=11.27, 46.99) greater odds of having a teen who was up-to-date on recommended vaccines. We detected that for each additional vaccine discussed, there was a 1.24 (95%CI=1.11, 1.39) increase in odds of the teen having all recommended vaccines. Parental immunization attitudes and provider discussion about vaccines are key ingredients to improving immunization rates among adolescents. While some parents may be reluctant to immunize their son or daughter with a recommended vaccine, vaccine-specific discussions between physicians and parents represent an important first step to continued discussions with providers regarding vaccination. Moreover, vaccine discussions must occur

  2. The role of UK district nurses in providing care for adult patients with a terminal diagnosis: a meta-ethnography.

    Science.gov (United States)

    Offen, John

    2015-03-01

    To explore the role of UK district nurses in providing care for adult patients with a terminal diagnosis by reviewing qualitative research. Meta-ethnography was used to conduct the synthesis. CINAHL, MEDLINE and British Nursing Index (BNI) were searched comprehensively for primary research relating to the role of UK district nurses in palliative care. The abstracts and titles of 700 papers were screened against inclusion criteria, of these 97 full papers were appraised. Some 24 studies reported in 25 papers were selected for inclusion in the synthesis. In total, five key themes were identified: valuing the role; practical role; relationships with patients and families; providing psychological support; and role uncertainty. Further synthesis yielded two 'lines of argument'. The concept of the 'expert friend' argues that the atypical relationship district nurses cultivate with patients underpins district nurses' provision of palliative care and profoundly influences the nature of psychological support given. Secondly, the concept of 'threat and opportunity' encapsulates the threat district nurses can feel to their traditional role in palliative care through changing health and social policy, while recognising the benefits that access to specialist knowledge and better training can bring. The findings have implications for understanding the motivators and barriers experienced by district nurses delivering palliative care in a time of unprecedented change to community health services.

  3. Role Of Health Agencies In Providing Benzathine Penicillin To Sore Throat Cases

    Directory of Open Access Journals (Sweden)

    Arya R.K

    1992-01-01

    Full Text Available This study (ICMR collaborative has been conducted In Chiraigaon Block of Varanasi District, up, between January 1984 and September 1987. Health personnel of the Primary Health Center (PHC, Rural Health Training Center (RHTC and voluntary Health Agency (VHA were trained to detect sore throats in children in the age group 5 to 15 years. The average number of sore throat cases detected per effective worker month was 12.3 and 8.3 for PHC and RHTC respectively. Injection Benzathine Penicillin was provided as sledgehammer approach compliance ranged from 97.1% to 100%. This study can be helpful for implementation of the national programme for prevention of the Rheumatic Fever and Rheumatic Heart Disease.

  4. An Opportunity for Healing and Holistic Care: Exploring the Roles of Health Care Providers Working Within Northern Canadian Aboriginal Communities.

    Science.gov (United States)

    Rahaman, Zaida; Holmes, Dave; Chartrand, Larry

    2016-05-22

    The purpose of this qualitative study was exploring what the roles and challenges of health care providers working within Northern Canadian Aboriginal communities are and what resources can help support or impede their efforts in working toward addressing health inequities within these communities. The qualitative research conducted was influenced by a postcolonial epistemology. The works of theorists Fanon on colonization and racial construction, Kristeva on semiotics and abjection, and Foucault on power/knowledge, governmentality, and biopower were used in providing a theoretical framework. Critical discourse analysis of 25 semistructured interviews with health care providers was used to gain a better understanding of their roles and challenges while working within Northern Canadian Aboriginal communities. Within this research study, three significant findings emerged from the data. First, the Aboriginal person's identity was constructed in relation to the health care provider's role of delivering essential health services. Second, health care providers were not treating the "ill" patient, but rather treating the patient for being "ill." Third, health care providers were treating the Aboriginal person for being "Aboriginal" by separating the patient from his or her identity. The treatment involved reforming the Aboriginal patient from the condition of being "Aboriginal." © The Author(s) 2016.

  5. On the role of soil fauna in providing soil functions - a meta study

    Science.gov (United States)

    Lang, Birgit; Russell, David J.; Vogel, Hans-Jörg; Wollschläger, Ute

    2017-04-01

    Fertile soils are fundamental for the production of biomass and therefore for the provision of goods such as food or fuel. However, soils are threatened by e.g. land degradation, but once lost their functionality cannot simply be replaced as soils are complex systems developed over long time periods. Thus, to develop strategies for sustainable soil use and management, we need a comprehensive functional understanding of soil systems. To this end, the interdisciplinary research program "Soil as a Natural Resource for the Bio-Economy - BonaRes" was launched by the German Federal Government in 2015. One part of this program is the development of a Knowledge Centre for soil functions and services. As part of the Knowledge Centre, we focus on the identification and quantification of biological drivers of soil functions. Based on a systematic review of existing literature, we assess the importance of different soil faunal groups for the soil functions and processes most relevant to agricultural production (i.e. decomposition, mineralization, soil structuring. Additionally, we investigate direct impacts of soil fauna on soil properties (e.g. aggregation, pore volume). As site specific conditions such as climate, soil type or management practices affect soil fauna and their performance, these responses must also be taken into account. In the end, our findings will be used in the development of modeling tools aiming to predict the impacts of different management measures on soil ecosystem services and functions.

  6. The role of maternity care providers in promoting shared decision making regarding birthing positions during the second stage of labor

    NARCIS (Netherlands)

    Nieuwenhuijze, M.J.; Low, L.K.; Korstjens, I.; Lagro-Janssen, T.

    2014-01-01

    INTRODUCTION: Through the use of a variety of birthing positions during the second stage of labor, a woman can increase progress, improve outcomes, and have a positive birth experience. The role that a maternity care provider has in determining which position a woman uses during the second stage of

  7. Narrowing Racial Gaps in Breast Cancer Chemotherapy Initiation: The Role of the Patient-Provider Relationship

    Science.gov (United States)

    Sheppard, Vanessa B.; Isaacs, Claudine; Luta, George; Willey, Shawna C.; Boisvert, Marc; Harper, Felicity W. K.; Smith, Karen; Horton, Sara; Liu, Minetta C.; Jennings, Yvonne; Hirpa, Fikru; Snead, Felicia; Mandelblatt, Jeanne S.

    2013-01-01

    Purpose Chemotherapy improves breast cancer survival but is underused more often in black than in white women. We examined associations between patient-physician relationships and chemotherapy initiation and timeliness of initiation among black and white patients. Methods Women with primary invasive, non-metastatic breast cancer were recruited via hospitals (in Washington, DC and Detroit) and community outreach between July 2006 and April 2011. Data were collected via telephone interviews and medical records. Logistic regression models evaluated associations between chemotherapy initiation and independent variables. Since there were race interactions, analyses were race-stratified. Factors associated with time from surgery to chemotherapy initiation and delay of ≥ 90 days were evaluated with linear and logistic regressions, respectively. Results Among eligible women, 82.8% were interviewed and 359 (90.9%)of those had complete data. The odds of initiating chemotherapy were 3.26 times (95% CI: 1.51, 7.06) higher among black women reporting greater communication with physicians (vs. lesser), after considering covariates. In contrast, the odds of starting chemotherapy were lower for white women reporting greater communication (vs. lesser) (adjusted OR .22, 95% CI: .07, .73). The opposing direction of associations was also seen among the sub-set of black and white women with definitive clinical indications for chemotherapy. Among those initiating treatment, black women had longer mean time to the start of chemotherapy than whites (71.8 days vs. 55.0 days, p= .005), but race was not significant after considering trust in oncologists, where initiation time decreased as trust increased, controlling for covariates. Black women were also more likely to delay ≥ 90 days than whites (27% vs. 8.3%; p=.024), but this was not significant after considering religiosity. Conclusion The patient-physician dyad and sociocultural factors may represent leverage points to improve

  8. Australian practice nurses' perceptions of their role and competency to provide nutrition care to patients living with chronic disease.

    Science.gov (United States)

    Cass, Sarah; Ball, Lauren; Leveritt, Michael

    2014-01-01

    Nutrition is important in the management of chronic disease, and practice nurses in the Australian primary care setting are increasingly providing nutrition care to patients living with chronic disease. The aim of the present study was to investigate practice nurses' perceptions of their role and competency to provide nutrition care to patients living with chronic disease in Australia. Twenty practice nurses currently employed in general practice participated in an individual semi-structured telephone interview. Interviews were transcribed verbatim and thematically analysed. Practice nurses perceived themselves to be in a prime position to provide opportunistic nutrition care to patients. Participants perceived that the ideal role of a practice nurse is to advocate for nutrition and provide a basic level of nutrition care to patients; however, the interpretation of the term 'basic' varied between participants. Participants perceived that practice nurses are highly trusted and approachable, which they valued as important characteristics for the provision of nutrition care. Barriers to providing nutrition care included time constraints, lack of nutrition knowledge and lack of confidence. Participants were concerned about the availability and accessibility of nutrition education opportunities for practice nurses. The present study has demonstrated that practice nurses perceive themselves as having a significant role in the provision of nutrition care to patients with chronic disease in the Australian primary care setting. Further investigation of strategies to enhance the effectiveness of nutrition care provision by practice nurses is warranted.

  9. The global health workforce shortage: role of surgeons and other providers.

    Science.gov (United States)

    Sheldon, George F; Ricketts, Thomas C; Charles, Anthony; King, Jennifer; Fraher, Erin P; Meyer, Anthony

    2008-01-01

    workforce self sufficiency in health care. The reliance on international graduates for more than 25% of the nation's physicians is a transnational problem. Reliance on IMGs, nurses and other health professions for the United States workforce is an issue of international distributive justice. Wealthy, developed countries, such as the United States, should be able to educate sufficient health professionals without relying on a less fortunate country's educated health workers. The 2000 Report of the Chair of the AAMC, the accrediting agency for United States and Canadian medical schools through the LCME, recommended expansion of medical school class sizes and expansion of medical schools [41]. For the past 25 years, the AAMC has supported a no-growth policy and the goal that 50% of USMGs be primary care physicians. In 2003, the AAMC developed a workforce center,-led by Edward Salsberg. The workforce center has provided valuable data and monitoring of the evolving workforce graduating from medical and and osteopathic schools in the United States. The NRMP, also managed by the AAMC, has begun useful studies analyzing the specialty choices of the more than 20,000 participants in the Match each year. The AAMC workforce policy was altered in 2006, and a 12-point policy statement was issued (see http://aamc.workforceposition.pdf). Three of the 12 points reflected significant change from past positions. They are a call for a 30% increase in physicians graduated by United States allopathic medical schools and an increase in residency positions now limited by the BBA of 1997. The recommendation that students make personal specialty choices reversed the prior recommendation that a majority of students enter primary care practice.

  10. Building the Bridge between Operations and Outcomes : Modelling and Evaluation of Health Service Provider Networks

    NARCIS (Netherlands)

    M. Mahdavi (Mahdi)

    2015-01-01

    markdownabstract__Abstract__ The PhD research has two objectives: - To develop generally applicable operational models which allow developing the evidence base for health service operations in provider networks. - To contribute to the evidence base by validating the model through

  11. Effectiveness of Video Modeling Provided by Mothers in Teaching Play Skills to Children with Autism

    Science.gov (United States)

    Besler, Fatma; Kurt, Onur

    2016-01-01

    Video modeling is an evidence-based practice that can be used to provide instruction to individuals with autism. Studies show that this instructional practice is effective in teaching many types of skills such as self-help skills, social skills, and academic skills. However, in previous studies, videos used in the video modeling process were…

  12. The Role Played by Trust and Its Effect on the Competiveness of Logistics Service Providers in Hungary

    Directory of Open Access Journals (Sweden)

    Judit Oláh

    2017-12-01

    Full Text Available This research focuses on the role of trust and the impact of its level on the revenue, earnings before tax and the degree of flexibility of logistics service providers (LSPs. More specifically, the role of the executive manager is examined in relation to the impact of business relationships (trust levels within and between organizations. In addition, the analysis covers the development of revenue, earnings before tax and degree of flexibility of logistics service providers in the context of the role of the head manager. The data were collected from 51 logistics service providers in Hungary. The results show that the level of trust established in the organization (with the employees, co-workers etc. has a positive impact on the earnings before tax. Furthermore, this paper confirms that the trust executive managers establish around them is an important performance factor which even consumers perceive and that it has major significance in terms of degree of flexibility. This research further increases our understanding of the role and importance of trust as a strategic success factor for LSPs.

  13. Using Role Models to Help Celebrate Paralympic Sport

    Science.gov (United States)

    Mastro, James; Ahrens, Christopher; Statton, Nathan

    2012-01-01

    A role model is a person or challenge that inspires an individual to go beyond what is expected of him or her and to reach a specific goal. Role models can exemplify motivation, passion, and a genuine love of their life's work. All students need role models, and Paralympic sport athletes can be just that, especially for students with disabilities.…

  14. The role of provider-patient communication and trust in online sources in Internet use for health-related activities.

    Science.gov (United States)

    Hou, Jiran; Shim, Minsun

    2010-01-01

    Provider-patient communication is an important factor influencing patients' satisfaction and health outcomes. This study draws upon the uses and gratification theory to examine how individuals' perception of communication with healthcare providers is associated with their Internet use for health-related activities. Using the data from the 2007 Health Information National Trends Survey (HINTS), we found that as individuals perceived their communication with providers to be less patient-centered, they were more likely to engage in various types of online health activities, such as using websites for healthy lifestyles, searching for healthcare providers, and seeking health information. Trust in online health information was also found to be a significant predictor of online health activities. The results of this study emphasized the important role of provider-patient communication in motivating individuals to turn to the Internet for health purposes.

  15. Emerging roles of health care providers to mitigate climate change impacts: a perspective from East Harlem, New York.

    Science.gov (United States)

    Sheffield, Perry E; Durante, Kathleen T; Rahona, Elena; Zarcadoolas, Christina

    2014-06-14

    Professional associations of health care workers are issuing policy statements on climate change and health with greater frequency, calling on their members to act in their duty to protect and fulfill the right to health. These health care providers' perceptions of their roles in the intersection of climate and health, however, have not been well-studied. This article presents results from a qualitative study using focus groups conducted with health care providers serving the low-income, ethnic minority population in East Harlem, New York. The focus groups sought to identify and explore providers' perceived health threats of climate change, as well as their perceived role as frontline disseminators of information and detectors of disease for their patients. Extreme heat events were used to frame the discussion in each group. Three major themes emerged: 1) environmental awareness, 2) an "ecohealth" lens, and 3) heat and health vulnerability. The participants demonstrated their interest in playing a role in climate change adaptation by identifying at-risk patients and helping to tailor clinical care to better serve these individuals. Copyright © 2014 Sheffield, Durante, Rahona, and Zarcadoolas. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

  16. FRAMES-2.0 Software System: Providing Password Protection and Limited Access to Models and Simulations

    Energy Technology Data Exchange (ETDEWEB)

    Whelan, Gene; Pelton, Mitch A.

    2007-08-09

    One of the most important concerns for regulatory agencies is the concept of reproducibility (i.e., reproducibility means credibility) of an assessment. One aspect of reproducibility deals with tampering of the assessment. In other words, when multiple groups are engaged in an assessment, it is important to lock down the problem that is to be solved and/or to restrict the models that are to be used to solve the problem. The objective of this effort is to provide the U.S. Nuclear Regulatory Commission (NRC) with a means to limit user access to models and to provide a mechanism to constrain the conceptual site models (CSMs) when appropriate. The purpose is to provide the user (i.e., NRC) with the ability to “lock down” the CSM (i.e., picture containing linked icons), restrict access to certain models, or both.

  17. Gene expression analysis of E. coli strains provides insights into the role of gene regulation in diversification.

    Science.gov (United States)

    Vital, Marius; Chai, Benli; Østman, Bjørn; Cole, James; Konstantinidis, Konstantinos T; Tiedje, James M

    2015-05-01

    Escherichia coli spans a genetic continuum from enteric strains to several phylogenetically distinct, atypical lineages that are rare in humans, but more common in extra-intestinal environments. To investigate the link between gene regulation, phylogeny and diversification in this species, we analyzed global gene expression profiles of four strains representing distinct evolutionary lineages, including a well-studied laboratory strain, a typical commensal (enteric) strain and two environmental strains. RNA-Seq was employed to compare the whole transcriptomes of strains grown under batch, chemostat and starvation conditions. Highly differentially expressed genes showed a significantly lower nucleotide sequence identity compared with other genes, indicating that gene regulation and coding sequence conservation are directly connected. Overall, distances between the strains based on gene expression profiles were largely dependent on the culture condition and did not reflect phylogenetic relatedness. Expression differences of commonly shared genes (all four strains) and E. coli core genes were consistently smaller between strains characterized by more similar primary habitats. For instance, environmental strains exhibited increased expression of stress defense genes under carbon-limited growth and entered a more pronounced survival-like phenotype during starvation compared with other strains, which stayed more alert for substrate scavenging and catabolism during no-growth conditions. Since those environmental strains show similar genetic distance to each other and to the other two strains, these findings cannot be simply attributed to genetic relatedness but suggest physiological adaptations. Our study provides new insights into ecologically relevant gene-expression and underscores the role of (differential) gene regulation for the diversification of the model bacterial species.

  18. The role of non-governmental organizations in providing curative health services in North Darfur State, Sudan.

    Science.gov (United States)

    Yagub, Abdallah I A; Mtshali, Khondlo

    2015-09-01

    Conflict in North Darfur state, Western Sudan started in 2003, and the delivering of curative health services was becoming a greater challenge for the country's limited resources. NGOs have played an important role in providing curative health services. To examine the role that Non-Governmental Organizations (NGOs) have played in providing curative health services, as well as to identify the difficulties and challenges that affect NGOs in delivering curative health services. Secondary data was collected from different sources, including government offices and medical organizations in Sudan and in North Darfur state. Primary data was obtained through interviews with government and NGOs representatives. The interviews were conducted with (1) expatriates working for international NGOs (N=15) (2) health professionals and administrators working in health sector (N= 45) in the period from November 2010 to January 2011. The government in North Darfur state spent 70% of its financial budget on security, while it spent it less than 1% on providing health services. The international NGOs have been providing 70% of curative health services to the State's population by contributing 52.9% of the health budget and 1 390 health personnel. Since 2003 NGOs have provided technical assistance to the health staff. As a result, more than fifty nurses have been trained to provide care and treatment, more than twenty-three doctors have been trained in laboratory equipment operation, and approximately six senior doctors and hospital directors have received management training. NGOs have been managing and supporting 89 public health facilities, and established 24 health centres in IDP camps, and 20 health centres across all the districts in North Darfur state. The NGOs have played an important role in providing curative health services and in establishing good health facilities, but a future problem is how the government will run these health facilities after a peaceful settlement has been

  19. Excellence in role modelling: insight and perspectives from the pros.

    Science.gov (United States)

    Wright, Scott M; Carrese, Joseph A

    2002-09-17

    Role modelling is an effective teaching method in medical education. We sought to better understand role modelling by examining the insights of respected physician role models. We conducted 30-minute in-depth interviews with 29 highly regarded role models at 2 large teaching hospitals. We coded the transcripts independently, and compared our coding for agreement. Content analysis identified several major categories of themes. The informants identified specific characteristics related to role modelling. Subcategories under the domain of personal qualities included interpersonal skills, a positive outlook, a commitment to excellence and growth, integrity and leadership. Under the domain of teaching, the subcategories were establishing rapport with learners, developing specific teaching philosophies and methods, and being committed to the growth of learners. Subjects thought there was some overlap between teaching and role modelling, but felt that the latter was more implicit and more encompassing. Being a strong clinician was regarded as necessary but not sufficient for being an exemplary physician role model. Perceived barriers to effective role modelling included being impatient and overly opinionated, being quiet, being overextended, and having difficulty remembering names and faces. Physician role models described role modeling consciousness, in that they specifically think about being role models when interacting with learners. Subjects believed that medical learners should emulate multiple role models. Highly regarded physician role models possess personal qualities, teaching abilities and exceptional clinical skills that outweigh their own barriers to serving as effective role models. Many of these positive attributes of role models represent behaviours that can be modified or skills that can be acquired.

  20. A joint choice model of the decision to seek depression treatment and choice of provider sector.

    Science.gov (United States)

    Fortney, J; Rost, K; Zhang, M

    1998-03-01

    Using a community-based sample of currently depressed subjects, this research modeled the joint decision to seek depression treatment and choice of provider sector (primary care or specialty mental health). The objective was to identify those subject-specific case-mix factors and those provider sector-specific access measures that significantly impacted this joint decision. A community-based sample of 435 Arkansans with current depression symptoms was compiled using random digit dialing and the Burnam depression screener. Study subjects were administered baseline and 6-month follow-up surveys. All medical, pharmaceutical, and insurance records were collected and abstracted to verify service use and depression treatment. Three discrete choice model specifications were tested: sequential binary logit models, a multinomial logit model, and a nested logit model. The nested logit model makes less restrictive assumptions about the patterns of substitution across treatment alternatives than the other model specifications. In the 6 months after baseline, 73.3% of the sample did not seek depression treatment, 18.9% sought care from a primary care provider, and 7.8% sought care from a mental health specialist. A likelihood ratio test identified the nested logit model as the preferred model specification (chi 2 < or = 0.05), indicating that the expected maximum utility of sector choice significantly affects the decision to seek treatment. Provider sector-specific access measures (e.g., insurance coverage and availability) significantly impacted sector choice and, thus, the decision to seek treatment. Subject-specific case-mix factors (e.g., age, gender, employment status, depression severity, and psychiatric comorbidity) significantly affected the decision to seek treatment. Sector-specific access measures significantly impact both provider sector choice and the decision to seek treatment. Because the primary care and specialty care treatment alternatives were more

  1. Exploring mental health students' perceptions of role models.

    Science.gov (United States)

    Illingworth, Paul

    This article describes and reflects on a qualitative study that attempted to develop further understanding of the concept of role models, using the experiences of third-year students undertaking mental health nurse education. Although there is a wealth of literature regarding role models, little exists that acknowledges what, in this case, students want of a role model, or how the students identify the positive attributes of a significant role model. The researcher used a qualitative approached based on phenomenological methods. The research question used, was: 'From the viewpoint of a third-year student undertaking mental health nurse education, what is the phenomenon referred to as role model?'

  2. Registered nurse and health care chaplains experiences of providing the family support person role during family witnessed resuscitation.

    Science.gov (United States)

    James, Jayne; Cottle, Elita; Hodge, Reverend Debbie

    2011-02-01

    To provide an in-depth exploration regarding the Registered Nurse (RN) and Healthcare Chaplains' (HCC) perspective of the role of the family support person (FSP) during family witnessed resuscitation (FWR). A phenomenological approach utilising in-depth interviews were undertaken outside of the work setting. A purposive sample of 4 RN's and 3 HCC were recruited from four sites within the United Kingdom. All interviews were tape recorded, transcribed verbatim and analysed utilising Husserl's framework. Seven key themes emerged which included assessment, managing choice, navigating the setting, on-going commentary, coming to terms with death, conflicts and support. This study has provided an insight regarding the intense clinical engagement associated with the role of the FSP and highlighted the importance of this role for family member's optimal care and support. It is vital that adequate professional development is instigated and that support mechanisms are in place for those health care professionals (HCP) undertaking this role in order to help family members through this difficult experience. Copyright © 2010 Elsevier Ltd. All rights reserved.

  3. Structural equation modelling of determinants of customer satisfaction of mobile network providers: Case of Kolkata, India

    Directory of Open Access Journals (Sweden)

    Shibashish Chakraborty

    2014-12-01

    Full Text Available The Indian market of mobile network providers is growing rapidly. India is the second largest market of mobile network providers in the world and there is intense competition among existing players. In such a competitive market, customer satisfaction becomes a key issue. The objective of this paper is to develop a customer satisfaction model of mobile network providers in Kolkata. The results indicate that generic requirements (an aggregation of output quality and perceived value, flexibility, and price are the determinants of customer satisfaction. This study offers insights for mobile network providers to understand the determinants of customer satisfaction.

  4. Public's perception and satisfaction on the roles and services provided by pharmacists - Cross sectional survey in Sultanate of Oman.

    Science.gov (United States)

    Jose, Jimmy; Al Shukili, Marwa Nasser; Jimmy, Beena

    2015-11-01

    An important factor that will help in advancement of the pharmacy services in any country would be to understand the public needs, expectation and satisfaction. There are limited published studies conducted in Sultanate of Oman regarding the perception and satisfaction of public on the role and services provided by pharmacists. The present study was conducted to assess the perception and satisfaction of general public in Sultanate of Oman on the roles, and services received from the pharmacists. The survey was conducted among public in the Governorates of A'Dahera and Muscat in Oman during 2013. The questionnaire had items to assess two aspects: perception on the roles and responsibilities of pharmacists and satisfaction on the services provided. The responses to the questions marked in a five point Likert scale were assessed using a scoring scheme. Accordingly, the median perception, and satisfaction score and median total score for the participants were estimated. The median scores of the participants were related with the demographics of the participants and frequency of visit to pharmacy. A total of 390 completed questionnaires were obtained. The median total score of the participants based on all the questions was 79 (Inter Quartile Range (IQR), 12) which represents a moderate score. The median perception and satisfaction scores were 44 (IQR 5) and 34 (IQR 7) which represent a good and moderate score, respectively. Perception of the participants differed based on employment status, frequency of visit to pharmacy and governorate represented by participants while satisfaction was influenced by educational qualification and frequency of visit to pharmacy. Public had a good perception regarding the roles of the pharmacists while they were only moderately satisfied with the services provided. Steps have to be taken to improve the services and relationship of pharmacists, and thereby improve the satisfaction of the customers. An extended study in a broader

  5. Social models provide a norm of appropriate food intake for young women.

    Directory of Open Access Journals (Sweden)

    Lenny R Vartanian

    Full Text Available It is often assumed that social models influence people's eating behavior by providing a norm of appropriate food intake, but this hypothesis has not been directly tested. In three experiments, female participants were exposed to a low-intake model, a high-intake model, or no model (control condition. Experiments 1 and 2 used a remote-confederate manipulation and were conducted in the context of a cookie taste test. Experiment 3 used a live confederate and was conducted in the context of a task during which participants were given incidental access to food. Participants also rated the extent to which their food intake was influenced by a variety of factors (e.g., hunger, taste, how much others ate. In all three experiments, participants in the low-intake conditions ate less than did participants in the high-intake conditions, and also reported a lower perceived norm of appropriate intake. Furthermore, perceived norms of appropriate intake mediated the effects of the social model on participants' food intake. Despite the observed effects of the social models, participants were much more likely to indicate that their food intake was influenced by taste and hunger than by the behavior of the social models. Thus, social models appear to influence food intake by providing a norm of appropriate eating behavior, but people may be unaware of the influence of a social model on their behavior.

  6. The emotional impact of errors or adverse events on healthcare providers in the NICU: The protective role of coworker support.

    Science.gov (United States)

    Winning, Adrien M; Merandi, Jenna M; Lewe, Dorcas; Stepney, Lois M C; Liao, Nancy N; Fortney, Christine A; Gerhardt, Cynthia A

    2017-07-26

    To examine the impact of errors or adverse events on emotional distress and professional quality of life in healthcare providers in the neonatal intensive care unit, and the moderating role of coworker support. Errors or adverse events can result in negative outcomes for healthcare providers. However, the role of coworker support in improving emotional and professional outcomes has not been examined. A cross-sectional online survey from a quality improvement initiative to train peer supporters in a neonatal intensive care unit. During 2015, 463 healthcare providers in a neonatal intensive care unit completed a survey assessing their experiences with an error or adverse event, anxiety, depression, professional quality of life and coworker support. Compared with those who did not experience an error or adverse event (58%), healthcare providers who observed (23%) or were involved (19%) in an incident reported higher levels of anxiety and secondary traumatic stress. Those who were involved in an event reported higher levels of depression and burnout. Differences between the three groups (no event, observation and involvement) for compassion satisfaction were non-significant. Perceived coworker support moderated the association between experiencing an event and both anxiety and depression. Specifically, experiencing an event was associated with higher levels of anxiety and depression when coworkers were perceived as low in supportiveness, but not when they were viewed as highly supportive. Findings suggest that errors or adverse events can have a harmful impact on healthcare providers and that coworker support may reduce emotional distress. © 2017 John Wiley & Sons Ltd.

  7. The nurse's role in providing information to surgical patients and family members in Turkey: a descriptive study.

    Science.gov (United States)

    Sayin, Yazile; Aksoy, Güler

    2012-06-01

    In 2008, we conducted a nonexperimental, cross-sectional, descriptive study in the surgical services department of a hospital in Istanbul, Turkey, with the aim of determining how much information was required by perioperative patients and their family members, the extent to which this information was provided, and the role that nurses play in this process. We included a total of 394 outpatients and inpatients and their family members (ie, 197 patients, 197 family members) and 30 nurses in the study. We collected the research data by using one questionnaire for patients, a second for family members of patients, and a third for nurses. We discovered that the patients and their family members wanted to be given more information about the surgical process than they had received. Patients wanted more information about the intraoperative period, whereas their family members wanted more information about the postoperative period. We also found that nurses were aware that they did not play an effective role in providing information to patients and their family members because of a lack of knowledge about what information they were responsible for providing and insufficient staffing. We concluded that nurses should know what education they are responsible for providing, put more effort into understanding patient and family member information needs, and plan a better means of providing information to meet those needs. Copyright © 2012 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  8. Value-added strategy models to provide quality services in senior health business.

    Science.gov (United States)

    Yang, Ya-Ting; Lin, Neng-Pai; Su, Shyi; Chen, Ya-Mei; Chang, Yao-Mao; Handa, Yujiro; Khan, Hafsah Arshed Ali; Elsa Hsu, Yi-Hsin

    2017-06-20

    The rapid population aging is now a global issue. The increase in the elderly population will impact the health care industry and health enterprises; various senior needs will promote the growth of the senior health industry. Most senior health studies are focused on the demand side and scarcely on supply. Our study selected quality enterprises focused on aging health and analyzed different strategies to provide excellent quality services to senior health enterprises. We selected 33 quality senior health enterprises in Taiwan and investigated their excellent quality services strategies by face-to-face semi-structured in-depth interviews with CEO and managers of each enterprise in 2013. A total of 33 senior health enterprises in Taiwan. Overall, 65 CEOs and managers of 33 enterprises were interviewed individually. None. Core values and vision, organization structure, quality services provided, strategies for quality services. This study's results indicated four type of value-added strategy models adopted by senior enterprises to offer quality services: (i) residential care and co-residence model, (ii) home care and living in place model, (iii) community e-business experience model and (iv) virtual and physical portable device model. The common part in these four strategy models is that the services provided are elderly centered. These models offer virtual and physical integrations, and also offer total solutions for the elderly and their caregivers. Through investigation of successful strategy models for providing quality services to seniors, we identified opportunities to develop innovative service models and successful characteristics, also policy implications were summarized. The observations from this study will serve as a primary evidenced base for enterprises developing their senior market and, also for promoting the value co-creation possibility through dialogue between customers and those that deliver service.

  9. Innovative models for providing clinical pharmacy services to remote locations using clinical video telehealth.

    Science.gov (United States)

    Perdew, Cassie; Erickson, Katie; Litke, Jessica

    2017-07-15

    The use of videoconferencing and other telehealth technologies to expand access to clinical pharmacy services at multiple Veterans Affairs (VA) clinics in rural areas of Alaska and the northwestern United States is described. Beginning in 2014, clinical pharmacy specialists at a regional VA Telehealth Hub based at Boise VA Medical Center in Idaho have provided telehealth services for 16 clinics. In one telehealth model, a pharmacist and other remotely located primary care team members (a medical provider, a medical support assistant, a social worker, and a psychologist) conduct telehealth visits with veterans located at VA clinics, with support provided by clinic-based nursing staff; this model has been used to improve medication management services for veterans in sparsely populated areas. In the second VA telehealth model, a remotely located pharmacist uses telehealth technology to participate in clinical encounters along with primary care team members located at the patient site; this model allows on-demand remote coverage in the event of planned or unplanned absences of clinic-based pharmacists. Since the Telehealth Hub was established, pharmacists have engaged in video encounters and provided other telehealth-based clinical services to more than 1,200 veterans with diabetes, hyperlipidemia, hypertension, and other chronic conditions. Within the VA healthcare system, telehealth technology has been demonstrated to be a cost-effective and well-received means of providing clinical pharmacy services in rural areas. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  10. Medicine sellers' perspectives on their role in providing health care in North-West Cameroon: a qualitative study.

    Science.gov (United States)

    Hughes, R; Chandler, C R; Mangham-Jefferies, L J; Mbacham, W

    2013-09-01

    Increasing recognition of the importance of medicine sellers in low-resource settings has emerged alongside assumptions that their motives and capacities primarily relate to profit maximization. This article suggests a need to reframe thinking about the role of medicine sellers in developing country health systems. We used in-depth interviews to explore perceptions of medicine seller roles among a restricted random sample of 20 medicine sellers in North-West Cameroon. Interviews and analysis explored self-perception of their work/role, community perceptions, skills and knowledge, regulation, future plans, links with the formal health system and diversity among medicine sellers. Medicine sellers in our study were a varied, yet distinct group. They saw themselves as closely integrated in the social and medical landscapes of clients. Although some client interactions were described as simple sales, many respondents presented themselves as gatekeepers of medicines and knowledge, reflecting a conceptualization of the distinctness of medicines over other commodities. Acknowledgement of limits in knowledge and resources led to recognition of the need for formal healthcare providers and justified a restricted scope of practice and the need for referral. Motivation was derived from a desire for both financial and social capital combined with a proximity to medicines and repeated exposure to ill health. Legitimacy was perceived to be derived from: a historical mandate; informal and formal training and effective 'community regulation'. The distinct role that medicine sellers describe themselves as occupying in this study area can be characterized as provision of 'first aid', urgent, reactive and sometimes providing intermediate care prior to referral. Medicine sellers suggest that they do not aspire to be doctors and emphasize the complementary, rather than competitive, nature of their relationship with formal providers. We discuss the challenges and opportunities of

  11. Are Universities Role Models for Communities? A Gender Perspective

    Directory of Open Access Journals (Sweden)

    Felicia Cornelia MACARIE

    2012-12-01

    Full Text Available The present paper explores the degree in which universities could/should serve as role models for communities from the perspective of gender integration. Although the theoretical/ moral answer would be affirmative (universities should be in such a position that would allow local communities to regard them as role models of gender integration, the primary empirical analysis leads to another conclusion. A brief theoretical review (that connects gender discrimination, sustainable development, universities and local communities is followed by an empirical analysis that compares the management structures of 12 Romanian Universities of Advanced Research and Education (the best Romanian universities according to a national ranking with those of four local communities where they are located (as geographic proximity would lead to a better diffusion of best practices. Contrary to initial expectations, even in higher education institutions, women are underrepresented both in executive and legislative positions. Since universities are subject to the same major patterns of gender discrimination (such as role theory, glass ceiling and glass elevator as private and public organizations, they lose the moral high ground that theory would suggest. However, medicine and pharmacy universities that can be connected with the traditional roles attributed to women provide better gender integration, but glass escalator phenomena remain present even in these limited fields.

  12. Kinetic model of Nav1.5 channel provides a subtle insight into slow inactivation associated excitability in cardiac cells.

    Directory of Open Access Journals (Sweden)

    Zheng Zhang

    Full Text Available Voltage-gated sodium channel Nav1.5 has been linked to the cardiac cell excitability and a variety of arrhythmic syndromes including long QT, Brugada, and conduction abnormalities. Nav1.5 exhibits a slow inactivation, corresponding to a duration-dependent bi-exponential recovery, which is often associated with various arrhythmia syndromes. However, the gating mechanism of Nav1.5 and the physiological role of slow inactivation in cardiac cells remain elusive. Here a 12-state two-step inactivation Markov model was successfully developed to depict the gating kinetics of Nav1.5. This model can simulate the Nav1.5 channel in not only steady state processes, but also various transient processes. Compared with the simpler 8-state model, this 12-state model is well-behaved in simulating and explaining the processes of slow inactivation and slow recovery. This model provides a good framework for further studying the gating mechanism and physiological role of sodium channel in excitable cells.

  13. Simulation modelling: educational development roles for learning technologists

    Directory of Open Access Journals (Sweden)

    David Riley

    2002-12-01

    Full Text Available Simulation modelling was in the mainstream of CAL development in the 1980s when the late David Squires introduced this author to the Dynamic Modelling System. Since those early days, it seems that simulation modelling has drifted into a learning technology backwater to become a member of Laurillard's underutilized, 'adaptive and productive' media. Referring to her Conversational Framework, Laurillard constructs a pedagogic case for modelling as a productive student activity but provides few references to current practice and available resources. This paper seeks to complement her account by highlighting the pioneering initiatives of the Computers in the Curriculum Project and more recent developments in systems modelling within geographic and business education. The latter include improvements to system dynamics modelling programs such as STELLA®, the publication of introductory textbooks, and the emergence of online resources. The paper indicates several ways in which modelling activities may be approached and identifies some educational development roles for learning technologists. The paper concludes by advocating simulation modelling as an exemplary use of learning technologies - one that realizes their creative-transformative potential.

  14. Human Papillomavirus Vaccination and Pap Smear Uptake Among Young Women in the United States: Role of Provider and Patient.

    Science.gov (United States)

    Guo, Fangjian; Hirth, Jacqueline M; Berenson, Abbey B

    2017-10-01

    It has been reported that Pap smear use is higher among U.S. women who received the human papillomavirus (HPV) vaccine than unvaccinated women. This study assessed the role of provider and patient in the difference of Pap smear use by vaccination status. We conducted a cross-sectional study of 5416 young women (21-30 years of age) with detailed information on Pap smear use and HPV vaccination status from the National Health Interview Survey (NHIS) 2013-2015. Vaccinated women received at least one dose of HPV vaccine. Main outcomes included Pap smear in the past year, provider's recommendation for Pap smear, and patient-initiated Pap smear. The prevalence of Pap smear in the past year was much higher among vaccinated women than unvaccinated women (67.5% vs. 52.8%, p Pap testing (60.8% vs. 50.8%, p Pap testing after receiving a provider's recommendation (75.1% vs. 67.9%, p = 0.004), and to initiate Pap testing themselves (57.7% vs. 38.2%, p Pap smear recommendation and uptake vanished. Unvaccinated women who have not visited an OB/GYN in the past year are less likely to receive a recommendation for Pap testing from their providers or to initiate Pap testing themselves without a provider's recommendation. They should be encouraged to visit an OB/GYN provider for cervical cancer screening.

  15. Communication Skills Training in Pediatric Oncology: Moving Beyond Role Modeling.

    Science.gov (United States)

    Feraco, Angela M; Brand, Sarah R; Mack, Jennifer W; Kesselheim, Jennifer C; Block, Susan D; Wolfe, Joanne

    2016-06-01

    Communication is central to pediatric oncology care. Pediatric oncologists disclose life-threatening diagnoses, explain complicated treatment options, and endeavor to give honest prognoses, to maintain hope, to describe treatment complications, and to support families in difficult circumstances ranging from loss of function and fertility to treatment-related or disease-related death. However, parents, patients, and providers report substantial communication deficits. Poor communication outcomes may stem, in part, from insufficient communication skills training, overreliance on role modeling, and failure to utilize best practices. This review summarizes evidence for existing methods to enhance communication skills and calls for revitalizing communication skills training within pediatric oncology. © 2016 Wiley Periodicals, Inc.

  16. MODEL OF PROVIDING WITH DEVELOPMENT STRATEGY FOR INFORMATION TECHNOLOGIES IN AN ORGANIZATION

    Directory of Open Access Journals (Sweden)

    A. A. Kuzkin

    2015-03-01

    Full Text Available Subject of research. The paper presents research and instructional tools for assessment of providing with the development strategy for information technologies in an organization. Method. The corresponding assessment model is developed which takes into consideration IT-processes equilibrium according to selected efficiency factors of information technologies application. Basic results. The model peculiarity resides in applying neuro-fuzzy approximators where the conclusion is drawn upon fuzzy logic, and membership functions are adjusted through the use of neural networks. For the adequacy testing of the suggested model, due diligence result analysis has been carried out for the IT-strategy executed in the “Navigator” group of companies at the stage of implementation and support of new technologies and production methods. Data visualization with a circle diagram is applied for the comparative evaluation of the analysis results. The chosen model adequacy is proved by the agreement between predictive assessments for IT-strategy performance targets derived by means of the fuzzy cognitive model over 12 months planning horizon and the real values of these targets upon the expiry of the given planning term. Practical significance. The developed model application gives the possibility to solve the problem of sustainability assessment for the process of providing the required IT-strategy realization level based upon the fuzzy cognitive map analysis and to reveal IT-objectives changing tendencies for an organization over the stated planning interval.

  17. Mendelian randomization provides no evidence for a causal role of serum urate in increasing serum triglyceride levels.

    Science.gov (United States)

    Rasheed, Humaira; Hughes, Kim; Flynn, Tanya J; Merriman, Tony R

    2014-12-01

    Triglycerides and their lipoprotein transport molecules are risk factors for heart disease. Observational studies have associated elevated levels of serum urate (SU) with triglycerides and risk of heart disease. However, owing to unmeasured confounding, observational studies do not provide insight into the causal relationship between SU and triglyceride. The aim of this study was to test for a causal role of SU in increasing triglyceride using Mendelian randomization that accounts for unmeasured confounding. Subjects were of European ancestry from the atherosclerosis risk in communities (n=5237) and Framingham heart (n=2971) studies. Mendelian randomization by the 2-stage least squares regression method was done with SU as the exposure, a uric acid transporter genetic risk score as instrumental variable, and triglyceride as the outcome. In ordinary linear regression, SU was significantly associated with triglyceride levels (β=2.69 mmol/L change in triglyceride per mmol/L increase in SU). However, Mendelian randomization-based estimation showed no evidence for a direct causal association of SU with triglyceride concentration-there was a nonsignificant 1.01 mmol/L decrease in triglyceride per mmol/L increase in SU attributable to the genetic risk score (P=0.21). The reverse analysis using a triglyceride genetic risk score provided evidence of a causal role for triglyceride in raising urate in men (P(Corrected)=0.018). These data provide no evidence for a causal role for SU in raising triglyceride levels, consistent with a previous Mendelian randomization report of no association between SU and ischemic heart disease. © 2014 American Heart Association, Inc.

  18. Majoring in Information Systems: An Examination of Role Model Influence

    Science.gov (United States)

    Akbulut, Asli Y.

    2016-01-01

    The importance of role models on individuals' academic and career development and success has been widely acknowledged in the literature. The purpose of this study was to understand the influence of role models on students' decisions to major in information systems (IS). Utilizing a model derived from the social cognitive career theory, we…

  19. [Barriers to the normalization of telemedicine in a healthcare system model based on purchasing of healthcare services using providers' contracts].

    Science.gov (United States)

    Roig, Francesc; Saigí, Francesc

    2011-01-01

    Despite the clear political will to promote telemedicine and the large number of initiatives, the incorporation of this modality in clinical practice remains limited. The objective of this study was to identify the barriers perceived by key professionals who actively participate in the design and implementation of telemedicine in a healthcare system model based on purchasing of healthcare services using providers' contracts. We performed a qualitative study based on data from semi-structured interviews with 17 key informants belonging to distinct Catalan health organizations. The barriers identified were grouped in four areas: technological, organizational, human and economic. The main barriers identified were changes in the healthcare model caused by telemedicine, problems with strategic alignment, resistance to change in the (re)definition of roles, responsibilities and new skills, and lack of a business model that incorporates telemedicine in the services portfolio to ensure its sustainability. In addition to suitable management of change and of the necessary strategic alignment, the definitive normalization of telemedicine in a mixed healthcare model based on purchasing of healthcare services using providers' contracts requires a clear and stable business model that incorporates this modality in the services portfolio and allows healthcare organizations to obtain reimbursement from the payer. 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

  20. Student Perception of Faculty Role Models.

    Science.gov (United States)

    Lange, Brian; Friedman, Richard

    1985-01-01

    Questionnaires to compare faculty self-perceptions with dental students' perceptions of the role they desired to achieve are described. Results indicated a minimal relationship between the self-perceptions of faculty and the students' identification of their desired future role in the dental profession. (Author/MLW)

  1. The Impact of Role Model Similarity on Women's Leadership Outcomes

    OpenAIRE

    Shah, Yashna Jitendra

    2015-01-01

    Role models can serve as a means to counteract the prevalent 'Think Leader, Think Male' stereotype. This study was designed to assess the impact of role model similarity on women's leadership self-efficacy, task performance and future leadership behavior, using two conceptualizations of similarity – match with leadership self-concept and attainability of the role model. Additionally, the process by which one's self-perceptions of leadership impact judgments of one's own behavior was also inve...

  2. Patients' perceptions of the interpersonal sensitivity of their healthcare providers: the potential role of patient-provider racial/ethnic concordance.

    Science.gov (United States)

    Phillips, Karon L; Chiriboga, David A; Jang, Yuri

    2012-01-01

    Preliminary studies have revealed an association between cultural competence and an improvement in the quality of healthcare services, increased patient satisfaction, and increased effectiveness of services. This study examined factors that helped to explain patients' perceptions of their providers' interpersonal sensitivity - one component of cultural competence. The respondents were 2075 racially/ethnically diverse adults, aged 50 years and older, who responded to a national telephone survey. Results indicate that one of the main factors predicting interpersonal sensitivity is self-rated physical health: those who reported better health were more likely to see their provider as exhibiting higher levels of sensitivity. This was true for Hispanic/Latino patients. The results also suggest that having a provider of the same race/ethnicity was a significant factor only for Hispanic/Latino patients. Despite findings from previous research, racial/ethnic concordance may not be universally effective in improving interpersonal sensitivity in healthcare settings for all racial/ethnic groups.

  3. Relationship between anaerobic parameters provided from MAOD and critical power model in specific table tennis test.

    Science.gov (United States)

    Zagatto, A M; Gobatto, C A

    2012-08-01

    The aim of this study was to verify the validity of the curvature constant parameter (W'), calculated from 2-parameter mathematical equations of critical power model, in estimating the anaerobic capacity and anaerobic work capacity from a table tennis-specific test. Specifically, we aimed to i) compare constants estimated from three critical intensity models in a table tennis-specific test (Cf); ii) correlate each estimated W' with the maximal accumulated oxygen deficit (MAOD); iii) correlate each W' with the total amount of anaerobic work (W ANAER) performed in each exercise bout performed during the Cf test. Nine national-standard male table tennis players participated in the study. MAOD was 63.0(10.8) mL · kg - 1 and W' values were 32.8(6.6) balls for the linear-frequency model, 38.3(6.9) balls for linear-total balls model, 48.7(8.9) balls for Nonlinear-2 parameter model. Estimated W' from the Nonlinear 2-parameter model was significantly different from W' from the other 2 models (P0.13). Thus, W' estimated from the 2-parameter mathematical equations did not correlate with MAOD or W ANAER in table tennis-specific tests, indicating that W' may not provide a strong and valid estimation of anaerobic capacity and anaerobic capacity work. © Georg Thieme Verlag KG Stuttgart · New York.

  4. Perception of CPR quality: Influence of CPR feedback, Just-in-Time CPR training and provider role.

    Science.gov (United States)

    Cheng, Adam; Overly, Frank; Kessler, David; Nadkarni, Vinay M; Lin, Yiqun; Doan, Quynh; Duff, Jonathan P; Tofil, Nancy M; Bhanji, Farhan; Adler, Mark; Charnovich, Alex; Hunt, Elizabeth A; Brown, Linda L

    2015-02-01

    Many healthcare providers rely on visual perception to guide cardiopulmonary resuscitation (CPR), but little is known about the accuracy of provider perceptions of CPR quality. We aimed to describe the difference between perceived versus measured CPR quality, and to determine the impact of provider role, real-time visual CPR feedback and Just-in-Time (JIT) CPR training on provider perceptions. We conducted secondary analyses of data collected from a prospective, multicenter, randomized trial of 324 healthcare providers who participated in a simulated cardiac arrest scenario between July 2012 and April 2014. Participants were randomized to one of four permutations of: JIT CPR training and real-time visual CPR feedback. We calculated the difference between perceived and measured quality of CPR and reported the proportion of subjects accurately estimating the quality of CPR within each study arm. Participants overestimated achieving adequate chest compression depth (mean difference range: 16.1-60.6%) and rate (range: 0.2-51%), and underestimated chest compression fraction (0.2-2.9%) across all arms. Compared to no intervention, the use of real-time feedback and JIT CPR training (alone or in combination) improved perception of depth (pPerception of depth is more accurate in CPR providers versus team leaders (27.8% vs. 7.4%; p=0.043) when using real-time feedback. Healthcare providers' visual perception of CPR quality is poor. Perceptions of CPR depth are improved by using real-time visual feedback and with prior JIT CPR training. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  5. Parameter sensitivity analysis of stochastic models provides insights into cardiac calcium sparks.

    Science.gov (United States)

    Lee, Young-Seon; Liu, Ona Z; Hwang, Hyun Seok; Knollmann, Bjorn C; Sobie, Eric A

    2013-03-05

    We present a parameter sensitivity analysis method that is appropriate for stochastic models, and we demonstrate how this analysis generates experimentally testable predictions about the factors that influence local Ca(2+) release in heart cells. The method involves randomly varying all parameters, running a single simulation with each set of parameters, running simulations with hundreds of model variants, then statistically relating the parameters to the simulation results using regression methods. We tested this method on a stochastic model, containing 18 parameters, of the cardiac Ca(2+) spark. Results show that multivariable linear regression can successfully relate parameters to continuous model outputs such as Ca(2+) spark amplitude and duration, and multivariable logistic regression can provide insight into how parameters affect Ca(2+) spark triggering (a probabilistic process that is all-or-none in a single simulation). Benchmark studies demonstrate that this method is less computationally intensive than standard methods by a factor of 16. Importantly, predictions were tested experimentally by measuring Ca(2+) sparks in mice with knockout of the sarcoplasmic reticulum protein triadin. These mice exhibit multiple changes in Ca(2+) release unit structures, and the regression model both accurately predicts changes in Ca(2+) spark amplitude (30% decrease in model, 29% decrease in experiments) and provides an intuitive and quantitative understanding of how much each alteration contributes to the result. This approach is therefore an effective, efficient, and predictive method for analyzing stochastic mathematical models to gain biological insight. Copyright © 2013 Biophysical Society. Published by Elsevier Inc. All rights reserved.

  6. Health promotion competencies: providing a road map for health promotion to assume a prominent role in global health.

    Science.gov (United States)

    Shilton, Trevor

    2009-06-01

    Understanding of health and its determinants is rapidly expanding and changing. The emergence of chronic diseases as the leading cause of global disease burden and improved understanding of social determinants of health has brought greater focus to the role of prevention in health. The IUHPE has shown outstanding leadership through the Galway Consensus Statement. Its three recommendations appropriately focus on stimulating dialogue, developing global consensus and communicating the results to key stakeholders. The IUHPE can further enhance progress of the statement by developing participative processes to ensure engagement and ownership by its members. The Galway Consensus Statement can be used to advance professional standards in global health promotion by: (1) providing a common language by which health promotion and its meaning can be communicated to others; (2) providing a framework for building capacity in the health promotion workforce and in the health workforce in general; (3) providing international consensus for consistency in university health promotion courses; (4) providing a framework for credentialing in health promotion; (5) better informing health promotion engagement with other significant workforce sectors and advancing partnership as a key way of working. A vital further application of the Galway Consensus Statement is to inform advocacy. Advocacy is vital to ensure health promotion is better resourced and prioritized by policy makers. Advocacy and communication are vital tools to highlight the evidence, establish the policy fit and infrastructure requirements of health promotion, and present health promotion solutions based on evidence of effectiveness.

  7. Family child care providers' self-perceived role in obesity prevention: working with children, parents, and external influences.

    Science.gov (United States)

    Rosenthal, Marjorie S; Crowley, Angela A; Curry, Leslie

    2013-01-01

    To describe the perspective and strategies of family child care providers (FCCPs) to reduce children's suboptimal weight trajectories. In-person, in-depth interviews with FCCPs. Family child care homes. Seventeen FCCPs caring for children 6 weeks to 9 years old; 94% caring for children paying with a state subsidy. Strategies of FCCP to reduce children's suboptimal weight trajectories. Constant comparative method of qualitative data analysis. Family child care providers described 3 core strategies: (1) improving children's behavior, (2) engaging and educating parents, and (3) leveraging influences external to their relationship with parents to effect positive change and to avoid parental conflict. These strategies were framed within their knowledge of child development, parental communication, and community services. The findings suggest that FCCPs' role in obesity prevention may be framed within knowledge that may be commonly expected of a child care provider. Partnerships between public health policy makers and FCCP may reduce obesigenic environments by employing training and resources that link obesity prevention and child care provider expertise. Copyright © 2013 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  8. Governance in Health - The Need for Exchange and Evidence Comment on "Governance, Government, and the Search for New Provider Models".

    Science.gov (United States)

    Chanturidze, Tata; Obermann, Konrad

    2016-05-17

    Governance in health is cited as one of the key factors in balancing the concerns of the government and public sector with the interests of civil society/private players, but often remains poorly described and operationalized. Richard Saltman and Antonio Duran look at two aspects in the search for new provider models in a context of health markets signalling liberalisation: (i) the role of the government to balance public and private interests and responsibilities in delivering care through modernised governance arrangements, and (ii) the finding that operational complexities may hinder well-designed provider governance models, unless governance reflects country-specific realities. This commentary builds on the discussion by Saltman and Duran, and argues that the concept of governance needs to be clearly defined and operationalized in order to be helpful for policy debate as well as for the development of an applicable framework for performance improvement. It provides a working definition of governance and includes a reflection on the prevailing cultural norms in an organization or society upon which any governance needs to be build. It proposes to explore whether the "evidence-based governance" concept can be introduced to generate knowledge about innovative and effective governance models, and concludes that studies similar to the one by Saltman and Duran can inform this debate. © 2016 by Kerman University of Medical Sciences.

  9. Pharmacists providing care in the outpatient setting through telemedicine models: a narrative review

    OpenAIRE

    Littauer, Sydney L.; Dixon, Dave L.; Mishra, Vimal K.; Sisson, Evan M.; Salgado, Teresa M.

    2017-01-01

    Telemedicine refers to the delivery of clinical services using technology that allows two-way, real time, interactive communication between the patient and the clinician at a distant site. Commonly, telemedicine is used to improve access to general and specialty care for patients in rural areas. This review aims to provide an overview of existing telemedicine models involving the delivery of care by pharmacists via telemedicine (including telemonitoring and video, but excluding follow-up tele...

  10. Predictors of addiction treatment providers' beliefs in the disease and choice models of addiction.

    Science.gov (United States)

    Russell, Christopher; Davies, John B; Hunter, Simon C

    2011-03-01

    Addiction treatment providers working in the United States (n = 219) and the United Kingdom (n = 372) were surveyed about their beliefs in the disease and choice models of addiction, as assessed by the 18-item Addiction Belief Scale of J. Schaler (1992). Factor analysis of item scores revealed a three-factor structure, labeled "addiction is a disease," "addiction is a choice," and "addiction is a way of coping with life," and factor scores were analyzed in separate hierarchical multiple regression analyses. Controlling for demographic and addiction history variables, treatment providers working in the United States more strongly believe addiction is a disease, whereas U.K.-based providers more strongly believe that addiction is a choice and a way of coping with life. Beliefs that addiction is a disease were stronger among those who provide for-profit treatment, have stronger spiritual beliefs, have had a past addiction problem, are older, are members of a group of addiction professionals, and have been treating addiction longer. Conversely, those who viewed addiction as a choice were more likely to provide public/not-for-profit treatment, be younger, not belong to a group of addiction professionals, and have weaker spiritual beliefs. Additionally, treatment providers who have had a personal addiction problem in the past were significantly more likely to believe addiction is a disease the longer they attend a 12-step-based group and if they are presently abstinent. Copyright © 2011 Elsevier Inc. All rights reserved.

  11. Analysis and proposed model of family caregivers' relationships with home health providers and perceptions of the quality of formal services.

    Science.gov (United States)

    Funk, Laura; Stajduhar, Kelli

    2013-03-01

    Relationships between families and home health nurses promote effective care and service access for those at end of life, positive caregiver experiences, and satisfaction with care. This study explores family caregivers' accounts of relationships with home care nurses; findings inform a model of relationships and satisfaction with home health services. Ethnographic, qualitative interviews were conducted with 26 bereaved caregivers in one Western Canadian regional health agency. Data analysis was informed by symbolic interactionism. Participants described their relationships with home care nurses and spoke about their assessments of the care provided. Findings highlighted the importance of the length, frequency, and continuity of contact, conversation, socializing, and sharing information. Participants were cognizant of their own and care recipients' roles in building relationship. Nurse behaviors demonstrating affection, acknowledgment, commitment, and understanding were appreciated. A model links relationship preconditions, relational demonstrations, and perceived care quality and may be used to identify points of intervention.

  12. Modeling Key Drivers of Cholera Transmission Dynamics Provides New Perspectives for Parasitology.

    Science.gov (United States)

    Rinaldo, Andrea; Bertuzzo, Enrico; Blokesch, Melanie; Mari, Lorenzo; Gatto, Marino

    2017-08-01

    Hydroclimatological and anthropogenic factors are key drivers of waterborne disease transmission. Information on human settlements and host mobility on waterways along which pathogens and hosts disperse, and relevant hydroclimatological processes, can be acquired remotely and included in spatially explicit mathematical models of disease transmission. In the case of epidemic cholera, such models allowed the description of complex disease patterns and provided insight into the course of ongoing epidemics. The inclusion of spatial information in models of disease transmission can aid in emergency management and the assessment of alternative interventions. Here, we review the study of drivers of transmission via spatially explicit approaches and argue that, because many parasitic waterborne diseases share the same drivers as cholera, similar principles may apply. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Modeling fMRI signals can provide insights into neural processing in the cerebral cortex

    Science.gov (United States)

    Sharifian, Fariba; Heikkinen, Hanna; Vigário, Ricardo

    2015-01-01

    Every stimulus or task activates multiple areas in the mammalian cortex. These distributed activations can be measured with functional magnetic resonance imaging (fMRI), which has the best spatial resolution among the noninvasive brain imaging methods. Unfortunately, the relationship between the fMRI activations and distributed cortical processing has remained unclear, both because the coupling between neural and fMRI activations has remained poorly understood and because fMRI voxels are too large to directly sense the local neural events. To get an idea of the local processing given the macroscopic data, we need models to simulate the neural activity and to provide output that can be compared with fMRI data. Such models can describe neural mechanisms as mathematical functions between input and output in a specific system, with little correspondence to physiological mechanisms. Alternatively, models can be biomimetic, including biological details with straightforward correspondence to experimental data. After careful balancing between complexity, computational efficiency, and realism, a biomimetic simulation should be able to provide insight into how biological structures or functions contribute to actual data processing as well as to promote theory-driven neuroscience experiments. This review analyzes the requirements for validating system-level computational models with fMRI. In particular, we study mesoscopic biomimetic models, which include a limited set of details from real-life networks and enable system-level simulations of neural mass action. In addition, we discuss how recent developments in neurophysiology and biophysics may significantly advance the modelling of fMRI signals. PMID:25972586

  14. Evaluating a novel resident role-modelling programme.

    Science.gov (United States)

    Sternszus, Robert; Steinert, Yvonne; Bhanji, Farhan; Andonian, Sero; Snell, Linda S

    2017-05-09

    Role modelling is a fundamental method by which students learn from residents. To our knowledge, however, resident-as-teacher curricula have not explicitly addressed resident role modelling. The purpose of this project was to design, implement and evaluate an innovative programme to teach residents about role modelling. The authors designed a resident role-modelling programme and incorporated it into the 2015 and 2016 McGill University resident-as-teacher curriculum. Influenced by experiential and social learning theories, the programme incorporated flipped-classroom and simulation approaches to teach residents to be aware and deliberate role models. Outcomes were assessed through a pre- and immediate post-programme questionnaire evaluating reaction and learning, a delayed post-programme questionnaire evaluating learning, and a retrospective pre-post questionnaire (1 month following the programme) evaluating self-reported behaviour changes. Thirty-three of 38 (87%) residents who participated in the programme completed the evaluation, with 25 residents (66%) completing all questionnaires. Participants rated the programme highly on a five-point Likert scale (where 1 = not helpful and 5 = very helpful; mean score, M = 4.57; standard deviation, SD = 0.50), and showed significant improvement in their perceptions of their importance as role models and their knowledge of deliberate role modelling. Residents also reported an increased use of deliberate role-modelling strategies 1 month after completing the programme. Resident-as-teacher curricula have not explicitly addressed resident role modelling DISCUSSION: The incorporation of resident role modelling into our resident-as-teacher curriculum positively influenced the participants' perceptions of their role-modelling abilities. This programme responds to a gap in resident training and has the potential to guide further programme development in this important and often overlooked area. © 2017 John Wiley & Sons

  15. The climate4impact platform: Providing, tailoring and facilitating climate model data access

    Science.gov (United States)

    Pagé, Christian; Pagani, Andrea; Plieger, Maarten; Som de Cerff, Wim; Mihajlovski, Andrej; de Vreede, Ernst; Spinuso, Alessandro; Hutjes, Ronald; de Jong, Fokke; Bärring, Lars; Vega, Manuel; Cofiño, Antonio; d'Anca, Alessandro; Fiore, Sandro; Kolax, Michael

    2017-04-01

    One of the main objectives of climate4impact is to provide standardized web services and tools that are reusable in other portals. These services include web processing services, web coverage services and web mapping services (WPS, WCS and WMS). Tailored portals can be targeted to specific communities and/or countries/regions while making use of those services. Easier access to climate data is very important for the climate change impact communities. To fulfill this objective, the climate4impact (http://climate4impact.eu/) web portal and services has been developed, targeting climate change impact modellers, impact and adaptation consultants, as well as other experts using climate change data. It provides to users harmonized access to climate model data through tailored services. It features static and dynamic documentation, Use Cases and best practice examples, an advanced search interface, an integrated authentication and authorization system with the Earth System Grid Federation (ESGF), a visualization interface with ADAGUC web mapping tools. In the latest version, statistical downscaling services, provided by the Santander Meteorology Group Downscaling Portal, were integrated. An innovative interface to integrate statistical downscaling services will be released in the upcoming version. The latter will be a big step in bridging the gap between climate scientists and the climate change impact communities. The climate4impact portal builds on the infrastructure of an international distributed database that has been set to disseminate the results from the global climate model results of the Coupled Model Intercomparison project Phase 5 (CMIP5). This database, the ESGF, is an international collaboration that develops, deploys and maintains software infrastructure for the management, dissemination, and analysis of climate model data. The European FP7 project IS-ENES, Infrastructure for the European Network for Earth System modelling, supports the European

  16. Do NHS walk-in centres in England provide a model of integrated care?

    Directory of Open Access Journals (Sweden)

    C. Salisbury

    2003-08-01

    Full Text Available Purpose: To undertake a comprehensive evaluation of NHS walk-in centres against criteria of improved access, quality, user satisfaction and efficiency. Context: Forty NHS walk-in centres have been opened in England, as part of the UK governments agenda to modernise the NHS. They are intended to improve access to primary care, provide high quality treatment at convenient times, and reduce inappropriate demand on other NHS providers. Care is provided by nurses rather than doctors, using computerised algorithms, and nurses use protocols to supply treatments previously only available from doctors. Data sources: Several linked studies were conducted using different sources of data and methodologies. These included routinely collected data, site visits, patient interviews, a survey of users of walk-in centres, a study using simulated patients to assess quality of care, analysis of consultation rates in NHS services near to walk-in centres, and audit of compliance with protocols. Conclusion & discussion: The findings illustrate many of the issues described in a recent WHO reflective paper on Integrated Care, including tensions between professional judgement and use of protocols, problems with incompatible IT systems, balancing users' demands and needs, the importance of understanding health professionals' roles and issues of technical versus allocative efficiency.

  17. The LES model's role in jet noise

    Science.gov (United States)

    Tucker, Paul

    2008-08-01

    Problem definition, near wall modeling and other factors, including grid structure along with its implications on filter definition, are suggested to be of potentially greater importance for practical jet simulations than the LES (large eddy simulation) model. This latter element in itself can be theoretically questionable. When moving to realistic engine conditions, it is noted that disentangling numerical influences from the LES model's appear difficult and negates the model value with its omission potentially being beneficial. Evidence cited suggests that if using an LES model for jets, choosing the numerically best conditioned or the one the code has or, for a dissipative solver, even LES model omission seems sensible. This view point precludes combustion modeling. Tensors of additional derivatives, used in non-linear LES models, when expanded, can yield potentially several hundred interesting derivatives. It is suggested that the MILES (monotone-integrated LES) and LES communities should move towards seeing where modified equation derivatives connect with derivatives that appear in more state of the art non-linear LES models. Then the best features could be combined to form mixed MILES-LES models or even mixed MILES-LES-RANS models. Combustion modeling also presents hybridization potential but in a different context. Most MILES-modified equation analysis focus on the spatial discretization and not the temporal. However, with some codes the spatial discretization terms are deliberately constructed to cancel temporal truncation error terms. Hence, the two things work in harmony and the temporal discretization can make a strong impact on resolved scales.

  18. Agents of change: how do complementary and alternative medicine providers play a role in health behavior change?

    Science.gov (United States)

    Williams-Piehota, Pamela A; Sirois, Fuschia M; Bann, Carla M; Isenberg, Karen B; Walsh, Edith G

    2011-01-01

    Recent investigations indicate that complementary and alternative medicine (CAM) use may be conducive to health behavior change. The goal of this study was to investigate how this change occurs. Using Social Cognitive Theory and Self-determination Theory as guiding frameworks, we surveyed a convenience sample of 216 CAM consumers abouttheir CAM therapy and iors and conducted focus groups with 36 CAM consumers. Consumers reported encouragement from providers and improved energy resulting from treatments as reasons for making health behavior changes. Multivariate analysis showed that increased odds of self-reported dietary change were significantly associated with increasing body awareness as a result of therapy, endorsing the statement that sustained improvement for their health conditions required self-care, using an acupuncturist, and being 44 years or younger. Comparable results were found for exercise change, except using an acupuncturist was a significant negative predictor and age was not significant. Focus group findings echoed these themes. This initial investigation into how CAM providers may play a role in health behavior change suggests that provider support, increased responsibility for one's health, and the CAM treatments themselves contribute to behavior change, although additional research in this area is warranted.

  19. Capabilities of stochastic rainfall models as data providers for urban hydrology

    Science.gov (United States)

    Haberlandt, Uwe

    2017-04-01

    For planning of urban drainage systems using hydrological models, long, continuous precipitation series with high temporal resolution are needed. Since observed time series are often too short or not available everywhere, the use of synthetic precipitation is a common alternative. This contribution compares three precipitation models regarding their suitability to provide 5 minute continuous rainfall time series for a) sizing of drainage networks for urban flood protection and b) dimensioning of combined sewage systems for pollution reduction. The rainfall models are a parametric stochastic model (Haberlandt et al., 2008), a non-parametric probabilistic approach (Bárdossy, 1998) and a stochastic downscaling of dynamically simulated rainfall (Berg et al., 2013); all models are operated both as single site and multi-site generators. The models are applied with regionalised parameters assuming that there is no station at the target location. Rainfall and discharge characteristics are utilised for evaluation of the model performance. The simulation results are compared against results obtained from reference rainfall stations not used for parameter estimation. The rainfall simulations are carried out for the federal states of Baden-Württemberg and Lower Saxony in Germany and the discharge simulations for the drainage networks of the cities of Hamburg, Brunswick and Freiburg. Altogether, the results show comparable simulation performance for the three models, good capabilities for single site simulations but low skills for multi-site simulations. Remarkably, there is no significant difference in simulation performance comparing the tasks flood protection with pollution reduction, so the models are finally able to simulate both the extremes and the long term characteristics of rainfall equally well. Bárdossy, A., 1998. Generating precipitation time series using simulated annealing. Wat. Resour. Res., 34(7): 1737-1744. Berg, P., Wagner, S., Kunstmann, H., Schädler, G

  20. The computational-based structure of Dwarf14 provides evidence for its role as potential strigolactone receptor in plants

    Directory of Open Access Journals (Sweden)

    Gaiji Noura

    2012-06-01

    Full Text Available Abstract Background Strigolactones (SLs are recently identified plant hormones modulating root and shoot branching. Besides their endogenous role within the producing organism, SLs are also key molecules in the communication of plants with arbuscular mycorrhizal (AM fungi and parasitic weeds. In fact SLs are exuded into the rhizosphere where they act as a host-derived signal, stimulating the germination of the seeds of parasitic plants which would not survive in the absence of a host root to colonize. Similarly, their perception by AM fungi causes extensive hyphal branching; this is a prerequisite for effective root colonization, since it increases the number of potential contact points with the host surface. In spite of the crucial and multifaceted biological role of SLs, there is no information on the receptor(s which bind(s such active molecules, neither in the producing plants, or in parasitic weeds or AM fungi. Results In this work, we applied homology modelling techniques to investigate the structure of the protein encoded by the gene Dwarf14, which was first identified in rice as conferring SLs insensitivity when mutated. The best sequence identity was with bacterial RsbQ. Both proteins belong to the superfamily of alpha/beta-fold hydrolases, some members of which play a role in the metabolism or signalling of plant hormones. The Dwarf14 (D14 structure was refined by means of molecular dynamics simulations. In order to support the hypothesis that D14 could be an endogenous SLs receptor, we performed docking experiments with a natural ligand. Conclusions It is suggested that D14 interacts with and thereby may act as a receptor for SLs in plants. This hypothesis offers a starting point to experimentally study the mechanism of its activity in vivo by means of structural, molecular and genetic approaches. Lastly, knowledge of the putative receptor structure will boost the research on analogues of the natural substrates as required for

  1. A Diverging View of Role Modeling in Medical Education

    Directory of Open Access Journals (Sweden)

    Gurjit Sandhu

    2015-03-01

    Full Text Available Research in the area of role modeling has primarily focused on the qualities and attributes of exceptional role models, and less attention has been given to the act of role modeling itself (Elzubeir & Rizk, 2001; Jochemsen-van der Leeuw, van Dijk, van Etten-Jamaludin, & Wieringa-de Waard, 2013; Wright, 1996; Wright, Wong, & Newill, 1997. A standardized understanding of role modeling in medical education remains elusive (Kenny, Mann, & MacLeod, 2003. This is problematic given that role modeling is pervasively documented as an approach to teaching (Reuler & Nardone, 1994. Our study attempts to fill a void in this body of research by looking at what faculty are thinking, saying, and doing when they say they are role modeling. Individual semi-structured interviews with faculty members were conducted in the Department of General Surgery at Queen’s University, Kingston, Ontario, Canada. Interviews were recorded, transcribed, and analyzed using qualitative methods for themes surrounding teaching and role modeling. Three major themes emerged from the data: (1 faculty members think they are teaching when they are acting professionally; (2 faculty members become aware of teaching opportunities and act on them; and (3 faculty members employ evidence-based teaching methods, but they are incorrectly labeling them as “role modeling.” As a whole, our findings should help distinguish between role modeling as roles and responsibilities enacted while doing one’s job well, and teaching as facilitated instruction that helps connect knowledge with action (Clayton, 2006; Fassbinder, 2007. Contributing to a better understanding of how teaching is separate from role modeling has the potential to improve the scope and quality of teaching, ultimately enhancing the learning experience for trainees.

  2. runjags: An R Package Providing Interface Utilities, Model Templates, Parallel Computing Methods and Additional Distributions for MCMC Models in JAGS

    Directory of Open Access Journals (Sweden)

    Matthew J. Denwood

    2016-07-01

    Full Text Available The runjags package provides a set of interface functions to facilitate running Markov chain Monte Carlo models in JAGS from within R. Automated calculation of appropriate convergence and sample length diagnostics, user-friendly access to commonly used graphical outputs and summary statistics, and parallelized methods of running JAGS are provided. Template model specifications can be generated using a standard lme4-style formula interface to assist users less familiar with the BUGS syntax. Automated simulation study functions are implemented to facilitate model performance assessment, as well as drop-k type cross-validation studies, using high performance computing clusters such as those provided by parallel. A module extension for JAGS is also included within runjags, providing the Pareto family of distributions and a series of minimally-informative priors including the DuMouchel and half-Cauchy priors. This paper outlines the primary functions of this package, and gives an illustration of a simulation study to assess the sensitivity of two equivalent model formulations to different prior distributions.

  3. Monte Carlo modeling provides accurate calibration factors for radionuclide activity meters.

    Science.gov (United States)

    Zagni, F; Cicoria, G; Lucconi, G; Infantino, A; Lodi, F; Marengo, M

    2014-12-01

    Accurate determination of calibration factors for radionuclide activity meters is crucial for quantitative studies and in the optimization step of radiation protection, as these detectors are widespread in radiopharmacy and nuclear medicine facilities. In this work we developed the Monte Carlo model of a widely used activity meter, using the Geant4 simulation toolkit. More precisely the "PENELOPE" EM physics models were employed. The model was validated by means of several certified sources, traceable to primary activity standards, and other sources locally standardized with spectrometry measurements, plus other experimental tests. Great care was taken in order to accurately reproduce the geometrical details of the gas chamber and the activity sources, each of which is different in shape and enclosed in a unique container. Both relative calibration factors and ionization current obtained with simulations were compared against experimental measurements; further tests were carried out, such as the comparison of the relative response of the chamber for a source placed at different positions. The results showed a satisfactory level of accuracy in the energy range of interest, with the discrepancies lower than 4% for all the tested parameters. This shows that an accurate Monte Carlo modeling of this type of detector is feasible using the low-energy physics models embedded in Geant4. The obtained Monte Carlo model establishes a powerful tool for first instance determination of new calibration factors for non-standard radionuclides, for custom containers, when a reference source is not available. Moreover, the model provides an experimental setup for further research and optimization with regards to materials and geometrical details of the measuring setup, such as the ionization chamber itself or the containers configuration. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. A model program: neonatal nurse practitioners providing community health care for high-risk infants.

    Science.gov (United States)

    Vasquez, Elias Provencio; Pitts, Kathleen; Mejia, Nilson Enrique

    2008-01-01

    Perinatal drug exposure costs our communities millions of dollars each year in hospital fees and in services such as foster care, child protection, and drug treatment. Infants and their families in this group require substantial long-term health care and community resources. Neonatal health care providers should take an active role in developing and implementing home visitation programs to support early hospital discharge and continuity of care for these high-risk infants and their families. Neonatal nurse practitioners should prepare in the future to practice not only in secondary-- and tertiary--level neonatal centers, but also in follow-up clinics, long-term developmental centers, and the community This article describes a home intervention program delivered by neonatal nurse practitioners for high-risk infants and their mothers. The target population is infants exposed prenatally to drugs and/or alcohol.

  5. Magnesium Sulfate Provides Neuroprotection in Eclampsia-Like Seizure Model by Ameliorating Neuroinflammation and Brain Edema.

    Science.gov (United States)

    Li, Xiaolan; Han, Xinjia; Yang, Jinying; Bao, Junjie; Di, Xiaodan; Zhang, Guozheng; Liu, Huishu

    2016-11-22

    Eclampsia is a hypertensive disorder of pregnancy that is defined by the new onset of grand mal seizures on the basis of preeclampsia and a leading cause of maternal and fetal mortality worldwide. Presently, magnesium sulfate (MgSO4) is the most effective treatment, but the mechanism by which MgSO4 prevents eclampsia has yet to be fully elucidated. We previously showed that systemic inflammation decreases the seizure threshold in a rat eclampsia-like model, and MgSO4 treatment can decrease systemic inflammation. Here, we hypothesized that MgSO4 plays a neuroprotective role in eclampsia by reducing neuroinflammation and brain edema. Pregnant Sprague-Dawley rats were given an intraperitoneal injection of pentylenetetrazol following a tail vein injection of lipopolysaccharide to establish the eclampsia-like seizure model. Seizure activity was assessed by behavioral testing. Neuronal loss in the hippocampal CA1 region (CA1) was detected by Nissl staining. Cerebrospinal fluid levels of S100-B and ferritin, indicators of neuroinflammation, were detected by enzyme-linked immunosorbent assay, and ionized calcium binder adapter molecule 1 (Iba-1, a marker for microglia) and glial fibrillary acid protein (GFAP, a marker for astrocytes) expression in the CA1 area was determined by immunofluorescence staining. Brain edema was measured. Our results revealed that MgSO4 effectively attenuated seizure severity and CA1 neuronal loss. In addition, MgSO4 significantly reduced cerebrospinal fluid levels of S100-B and ferritin, Iba-1 and GFAP activation in the CA1 area, and brain edema. Our results indicate that MgSO4 plays a neuroprotective role against eclampsia-like seizure by reducing neuroinflammation and brain edema.

  6. Providing a more complete view of ice-age palaeoclimates using model inversion and data interpolation

    Science.gov (United States)

    Cleator, Sean; Harrison, Sandy P.; Roulstone, Ian; Nichols, Nancy K.; Prentice, Iain Colin

    2017-04-01

    Site-based pollen records have been used to provide quantitative reconstructions of Last Glacial Maximum (LGM) climates, but there are too few such records to provide continuous climate fields for the evaluation of climate model simulations. Furthermore, many of the reconstructions were made using modern-analogue techniques, which do not account for the direct impact of CO2 on water-use efficiency and therefore reconstruct considerably drier conditions under low CO2 at the LGM than indicated by other sources of information. We have shown that it is possible to correct analogue-based moisture reconstructions for this effect by inverting a simple light-use efficiency model of productivity, based on the principle that the rate of water loss per unit carbon gain of a plant is the same under conditions of the true moisture, palaeotemperature and palaeo CO2 concentration as under reconstructed moisture, modern CO2 concentration and modern temperature (Prentice et al., 2016). In this study, we use data from the Bartlein el al. (2011) dataset, which provides reconstructions of one or more of six climate variables (mean annual temperature, mean temperature of the warmest and coldest months, the length of the growing seasons, mean annual precipitation, and the ratio of actual to potential evapotranspiration) at individual LGM sites. We use the SPLASH water-balance model to derive a moisture index (MI) at each site from mean annual precipitation and monthly values of sunshine fraction and average temperature, and correct this MI using the Prentice et al. (2016) inversion approach. We then use a three-dimensional variational (3D-Var) data assimilation scheme with the SPLASH model and Prentice et al. (2016) inversion approach to derive reconstructions of all six climate variables at each site, using the Bartlein et al. (2011) data set as a target. We use two alternative background climate states (or priors): modern climate derived from the CRU CL v2.0 data set (New et al., 2002

  7. Glycogen metabolism has a key role in the cancer microenvironment and provides new targets for cancer therapy.

    Science.gov (United States)

    Zois, Christos E; Harris, Adrian L

    2016-02-01

    Metabolic reprogramming is a hallmark of cancer cells and contributes to their adaption within the tumour microenvironment and resistance to anticancer therapies. Recently, glycogen metabolism has become a recognised feature of cancer cells since it is upregulated in many tumour types, suggesting that it is an important aspect of cancer cell pathophysiology. Here, we provide an overview of glycogen metabolism and its regulation, with a focus on its role in metabolic reprogramming of cancer cells under stress conditions such as hypoxia, glucose deprivation and anticancer treatment. The various methods to detect glycogen in tumours in vivo as well as pharmacological modulators of glycogen metabolism are also reviewed. Finally, we discuss the therapeutic value of targeting glycogen metabolism as a strategy for combinational approaches in cancer treatment.

  8. Listen to the Children: Where Adolescents Obtain Role Models.

    Science.gov (United States)

    Phillips, Theodore M.; And Others

    1995-01-01

    A survey of 150 poor rural students in grades 4-8 revealed that age is relevant in choosing role models, that there are major gender differences in the types of glamour figures selected as role models and as simple figures of success, and that age and gender appear to affect youth's perceptions of success and their occupational choice. (LP)

  9. Daily Suction Provided by External Volume Expansion Inducing Regeneration of Grafted Fat in a Murine Model.

    Science.gov (United States)

    Ye, Yuan; Liao, Yunjun; Lu, Feng; Gao, Jianhua

    2017-02-01

    Fat grafting has variable and sometimes poor outcomes, and therefore new methods are needed. Multiple studies have demonstrated the excellent performance of external volume expansion and focused only on preexpansion with emphasis on the recipient. Two mouse models (a suction model and a fat-exchange transplantation model) were established to investigate changes in the origins and biological behaviors of regeneration-related cells in grafted fat under daily suction provided by external volume expansion. Blood supply increased from new host-derived capillaries or macrophage infiltration under suction. CD34-positive cells showed increased migration from the host into the grafts under suction. At week 12, nearly half of the mature adipocytes regenerated in the grafts in the suction group were derived from the host. Peroxisome proliferator-activated receptor γ expression of the suction group was significantly higher than that of controls at weeks 2 and 4 during adipogenesis. The normalized sample weight of the grafted fat was significantly greater than that of controls at 1 (0.081 ± 0.001 versus 0.072 ± 0.005; p suction provided by external volume expansion favors the regeneration of grafted fat and improves retention by promoting the migration of regeneration-related cells and the differentiation of adipocytes. Thus, more mature fat tissue with a well-organized structure was formed under suction.

  10. A study comparing public and medical librarians' perceptions of the role and duties of health information-providing librarians.

    Science.gov (United States)

    Noh, Younghee

    2015-12-01

    This study proposed to define the role and duties of librarians who provide health information service in public and medical libraries. Appropriate education, career experience and starting salary for this position are also presented. This study analysed previous research and job advertisements to understand the current needs for this position. Almost all job advertisements studied were eventually retrieved from Salary.com (US job posting site). Public libraries seeking to fill health informationist positions were even more difficult to find in any of the above locations. Therefore, the researcher attempted to find cases using various search engines, including Google, and noticed that public libraries usually post job advertisements on their website. Finally, 32 job postings were selected as suitable. Fifty-four public and medical librarians were surveyed to validate the results in Korea. Public librarians chose 'health information librarian' as the most appropriate title for this position, while medical librarians answered 'medical librarian'. Therefore, librarians providing health information service in public libraries should be called 'health information librarians', while the position in medical libraries should be called 'medical librarian'. Accordingly, job postings and academic articles will be easily accessible. Both groups marked that the position should require a bachelor's degree in both LIS and a health science field, 2 years library experience and health-related user training. Other requirements included knowledge of health resources and medical terminology, search capabilities and a focus on user-centric service. For required duties, public librarians chose accessing information resources, while medical librarians selected collection management. Health information librarians will play a vital role in the future and must therefore be educated accordingly. © 2015 Health Libraries Group.

  11. Probabilistic Role Models and the Guarded Fragment

    DEFF Research Database (Denmark)

    Jaeger, Manfred

    2004-01-01

    We propose a uniform semantic framework for interpreting probabilistic concept subsumption and probabilistic role quantification through statistical sampling distributions. This general semantic principle serves as the foundation for the development of a probabilistic version of the guarded fragm...... fragment of first-order logic. A characterization of equivalence in that logic in terms of bisimulations is given....

  12. Probabilistic role models and the guarded fragment

    DEFF Research Database (Denmark)

    Jaeger, Manfred

    2006-01-01

    We propose a uniform semantic framework for interpreting probabilistic concept subsumption and probabilistic role quantification through statistical sampling distributions. This general semantic principle serves as the foundation for the development of a probabilistic version of the guarded fragm...... fragment of first-order logic. A characterization of equivalence in that logic in terms of bisimulations is given....

  13. ER/LA opioid REMS and accredited education: Survey results provide insight into clinical roles, educational needs, and learner preferences.

    Science.gov (United States)

    Kear, Cynthia; McKeithen, Tom; Robertson, Sheila

    2017-01-01

    The Collaborative for REMS (Risk Evaluation and Mitigation Strategy) Education (CO*RE) includes 13 organizations that provide REMS Program Companies (RPC) grant-supported accredited education on extended-release and long-acting (ER/LA) opioid therapy. This report summarizes results of a survey designed to investigate the impact of participant criteria and to better understand the roles and preferences of continuing medical education/continuing education (CME/CE) participants. In April 2015, the authors made an online survey available to an estimated 10,000 clinicians who had completed a CO*RE CME/CE activity since 2013. The purpose of the survey was to (1) examine possible reasons learners may underreport prescribing status, (2) investigate ways in which learners engage in nonprescribing roles relevant to reducing adverse patient outcomes, and (3) determine the acceptability of a potential test-based learning tool that allows participants with mastery to test out in lieu of participating in 2- to 3-hour education. Findings revealed that there was little confusion or reluctance by learners to answer questions about Drug Enforcement Administration (DEA) licensing and whether they prescribed opioids in the past year. REMS "prescriber" education covers opioid management responsibilities that are distributed among team members who play critical nonprescribing roles in reducing serious adverse outcomes from both ER/LA and immediate-release (IR) opioids. Seventy-three percent of study participants would favor a test-based learning tool should future circumstances warrant it. The authors concluded the likelihood of underreporting is small, but there is an opportunity to clarify license and prescribing questions; opioid management responsibilities are distributed among nonprescribing team members who play roles in reducing adverse outcomes from both ER/LA and IR opioids, who would therefore benefit from REMS education; and clinicians favor a test-based learning tool, should

  14. The perspective of medical students regarding the roles and characteristics of a clinical role model.

    Science.gov (United States)

    Bahmanbijari, Bahareh; Beigzadeh, Amin; Etminan, Abbas; Najarkolai, Atena Rahmati; Khodaei, Marzieh; Askari, Seyed Mostafa Seyed

    2017-04-01

    As medical students spend most of their time with their clinical teachers and imitate their roles and characteristics during the school year, it is important to identify the roles and characteristics that they find essential in their role models. These traits play a part in their future professions as doctors. The aim of this study was to determine the perspective of students, interns, and residents regarding the roles and characteristics of a clinical role model. In an analytical cross-sectional study, a structured and self-developed questionnaire was completed by 185 medical students at educational hospitals of Kerman University of Medical Sciences during April and May 2015. Participants were selected using convenience sampling method. For data analysis, we used descriptive and inferential statistics. SPSS software version 16 was used as needed. In total, 90 medical students (48.7%), 65 interns (35.1%), and 30 residents (16.2%) participated in this study. Male respondents (n=75) comprised 40.5% and female respondents (n=110) 59.5% of the study sample. The three most important roles of a clinical teacher were organizer role (99.7), teacher role (101.7), and supporter role (109.5) for students, interns, and residents respectively. On the other hand, supporter role (85.4), communicator role (86.4) and organizer role (83.4) were ranked as the least important for students, interns, and residents respectively. There was no significant association among the three batches and the roles of a clinical teacher (p>0.05). Conversely, Females rated the roles of a clinical teacher significantly higher than males (pstudents as role models in medical schools, great attention should be given to their roles. Teachers must be aware that their roles have an impact on students' professional development and performance.

  15. Continuous Care Provided Through Comprehensive Medication Management in an Acute Care Practice Model.

    Science.gov (United States)

    Marr, T David; Pinelli, Nicole R; Jarmul, Jamie A; Waldron, Kayla M; Eckel, Stephen F; Cicci, Jonathan D; Bates, Jill S; Amerine, Lindsey B

    2017-10-01

    Pharmacy practice models that foster pharmacists' accountability for medication-related outcomes are imperative for the profession. Comprehensive medication management (CMM) is an opportunity to advance patient care. The objective of this study was to evaluate the impact of a CMM practice model in the acute care setting on organizational, patient, and financial outcomes. Three adult service lines focused on at-risk patients identified using internal risk stratification methodology were implemented. Core CMM elements included medication reconciliation, differentiated clinical pharmacy services, inpatient MTM consultations, discharge services, and documentation. Mixed methods compared the effect of the CMM model before and after implementation. Historical patients served as comparative controls in an observational design. Pharmacists completed a 60-minute interview regarding their experiences. Qualitative data were analyzed using thematic coding to characterize perception of the model. Three pharmacists implemented the model on cardiology, hematology/oncology, and surgery transplant services and provided services to 75 patients during the study. A total of 145 medication-related problems were identified and resolved. CMM was associated with a nonsignificant reduction of 8.8% in 30-day hospital readmission rates ( P = 0.64) and a 24.9% reduction in 30-day hospital utilization ( P = 0.41) as well as a significant reduction of 86.5% in emergency department visits ( P = 0.02). Patients receiving discharge prescriptions from our outpatient pharmacies increased by 21.4%, resulting in an 11.3% increase in discharge prescription capture and additional revenue of $5780. Themes identified from qualitative interviews included CMM structure, challenges, value, and resources. This study demonstrated successful implementation of a CMM model that positively affected organizational, patient, and financial outcomes.

  16. A Distributed Service and Business Model for Providing Cloud Computing Service

    OpenAIRE

    Shreya Bhadra; Tirthankar Gayen

    2013-01-01

    Cloud Computing model has enabled IT organizations to serve the users globally. It gives the services like Platform as a Service, Software as a Service and Infrastructure as a Service without users being much aware of the details in which the services are provided. As in File Access System Service the users are not aware of the locations of the files in Clouds. File access seems to them as a single coherent file system. Considering this aspect, this paper is concerned with an effective servic...

  17. State and Alternative Fuel Provider Fleets - Fleet Compliance Annual Report: Model Year 2015, Fiscal Year 2016

    Energy Technology Data Exchange (ETDEWEB)

    2016-12-01

    The U.S. Department of Energy (DOE) regulates covered state government and alternative fuel provider fleets, pursuant to the Energy Policy Act of 1992 (EPAct), as amended. Covered fleets may meet their EPAct requirements through one of two compliance methods: Standard Compliance or Alternative Compliance. For model year (MY) 2015, the compliance rate with this program for the more than 3011 reporting fleets was 100%. More than 294 fleets used Standard Compliance and exceeded their aggregate MY 2015 acquisition requirements by 8% through acquisitions alone. The seven covered fleets that used Alternative Compliance exceeded their aggregate MY 2015 petroleum use reduction requirements by 46%.

  18. Epsilon Aminocaproic Acid Pretreatment Provides Neuroprotection Following Surgically Induced Brain Injury in a Rat Model.

    Science.gov (United States)

    Komanapalli, Esther S; Sherchan, Prativa; Rolland, William; Khatibi, Nikan; Martin, Robert D; Applegate, Richard L; Tang, Jiping; Zhang, John H

    2016-01-01

    Neurosurgical procedures can damage viable brain tissue unintentionally by a wide range of mechanisms. This surgically induced brain injury (SBI) can be a result of direct incision, electrocauterization, or tissue retraction. Plasmin, a serine protease that dissolves fibrin blood clots, has been shown to enhance cerebral edema and hemorrhage accumulation in the brain through disruption of the blood brain barrier. Epsilon aminocaproic acid (EAA), a recognized antifibrinolytic lysine analogue, can reduce the levels of active plasmin and, in doing so, potentially can preserve the neurovascular unit of the brain. We investigated the role of EAA as a pretreatment neuroprotective modality in a SBI rat model, hypothesizing that EAA therapy would protect brain tissue integrity, translating into preserved neurobehavioral function. Male Sprague-Dawley rats were randomly assigned to one of four groups: sham (n = 7), SBI (n = 7), SBI with low-dose EAA, 150 mg/kg (n = 7), and SBI with high-dose EAA, 450 mg/kg (n = 7). SBI was induced by partial right frontal lobe resection through a frontal craniotomy. Postoperative assessment at 24 h included neurobehavioral testing and measurement of brain water content. Results at 24 h showed both low- and high-dose EAA reduced brain water content and improved neurobehavioral function compared with the SBI groups. This suggests that EAA may be a useful pretherapeutic modality for SBI. Further studies are needed to clarify optimal therapeutic dosing and to identify mechanisms of neuroprotection in rat SBI models.

  19. The teacher educator as a role model

    NARCIS (Netherlands)

    Lunenberg, Mieke; Korthagen, Fred; Swennen, Anja

    New visions of learning have entered education. This article discusses the consequences for teacher education, and examines modelling by teacher educators as a means of changing the views and practices of future teachers. The results of a literature search and a multiple case study on modelling are

  20. The teacher educator as a role model

    NARCIS (Netherlands)

    Lunenberg, M; Korthagen, F; Swennen, A

    2007-01-01

    New visions of learning have entered education. This article discusses the consequences for teacher education, and examines modelling by teacher educators as a means of changing the views and practices of future teachers. The results of a literature search and a multiple case study on modelling are

  1. A Spirulina-Enhanced Diet Provides Neuroprotection in an α-Synuclein Model of Parkinson's Disease

    Science.gov (United States)

    Pabon, Mibel M.; Jernberg, Jennifer N.; Morganti, Josh; Contreras, Jessika; Hudson, Charles E.; Klein, Ronald L.; Bickford, Paula C.

    2012-01-01

    Inflammation in the brain plays a major role in neurodegenerative diseases. In particular, microglial cell activation is believed to be associated with the pathogenesis of neurodegenerative diseases, including Parkinson’s disease (PD). An increase in microglia activation has been shown in the substantia nigra pars compacta (SNpc) of PD models when there has been a decrease in tyrosine hydroxylase (TH) positive cells. This may be a sign of neurotoxicity due to prolonged activation of microglia in both early and late stages of disease progression. Natural products, such as spirulina, derived from blue green algae, are believed to help reverse this effect due to its anti-inflammatory/anti-oxidant properties. An adeno-associated virus vector (AAV9) for α-synuclein was injected in the substantia nigra of rats to model Parkinson's disease and to study the effects of spirulina on the inflammatory response. One month prior to surgeries, rats were fed either a diet enhanced with spirulina or a control diet. Immunohistochemistry was analyzed with unbiased stereological methods to quantify lesion size and microglial activation. As hypothesized, spirulina was neuroprotective in this α-synuclein model of PD as more TH+ and NeuN+ cells were observed; spirulina concomitantly decreased the numbers of activated microglial cells as determined by MHCII expression. This decrease in microglia activation may have been due, in part, to the effect of spirulina to increase expression of the fractalkine receptor (CX3CR1) on microglia. With this study we hypothesize that α-synuclein neurotoxicity is mediated, at least in part, via an interaction with microglia. We observed a decrease in activated microglia in the rats that received a spirulina- enhanced diet concomitant to neuroprotection. The increase in CX3CR1 in the groups that received spirulina, suggests a potential mechanism of action. PMID:23028885

  2. A spirulina-enhanced diet provides neuroprotection in an α-synuclein model of Parkinson's disease.

    Science.gov (United States)

    Pabon, Mibel M; Jernberg, Jennifer N; Morganti, Josh; Contreras, Jessika; Hudson, Charles E; Klein, Ronald L; Bickford, Paula C

    2012-01-01

    Inflammation in the brain plays a major role in neurodegenerative diseases. In particular, microglial cell activation is believed to be associated with the pathogenesis of neurodegenerative diseases, including Parkinson's disease (PD). An increase in microglia activation has been shown in the substantia nigra pars compacta (SNpc) of PD models when there has been a decrease in tyrosine hydroxylase (TH) positive cells. This may be a sign of neurotoxicity due to prolonged activation of microglia in both early and late stages of disease progression. Natural products, such as spirulina, derived from blue green algae, are believed to help reverse this effect due to its anti-inflammatory/anti-oxidant properties. An adeno-associated virus vector (AAV9) for α-synuclein was injected in the substantia nigra of rats to model Parkinson's disease and to study the effects of spirulina on the inflammatory response. One month prior to surgeries, rats were fed either a diet enhanced with spirulina or a control diet. Immunohistochemistry was analyzed with unbiased stereological methods to quantify lesion size and microglial activation. As hypothesized, spirulina was neuroprotective in this α-synuclein model of PD as more TH+ and NeuN+ cells were observed; spirulina concomitantly decreased the numbers of activated microglial cells as determined by MHCII expression. This decrease in microglia activation may have been due, in part, to the effect of spirulina to increase expression of the fractalkine receptor (CX3CR1) on microglia. With this study we hypothesize that α-synuclein neurotoxicity is mediated, at least in part, via an interaction with microglia. We observed a decrease in activated microglia in the rats that received a spirulina- enhanced diet concomitant to neuroprotection. The increase in CX3CR1 in the groups that received spirulina, suggests a potential mechanism of action.

  3. A spirulina-enhanced diet provides neuroprotection in an α-synuclein model of Parkinson's disease.

    Directory of Open Access Journals (Sweden)

    Mibel M Pabon

    Full Text Available Inflammation in the brain plays a major role in neurodegenerative diseases. In particular, microglial cell activation is believed to be associated with the pathogenesis of neurodegenerative diseases, including Parkinson's disease (PD. An increase in microglia activation has been shown in the substantia nigra pars compacta (SNpc of PD models when there has been a decrease in tyrosine hydroxylase (TH positive cells. This may be a sign of neurotoxicity due to prolonged activation of microglia in both early and late stages of disease progression. Natural products, such as spirulina, derived from blue green algae, are believed to help reverse this effect due to its anti-inflammatory/anti-oxidant properties. An adeno-associated virus vector (AAV9 for α-synuclein was injected in the substantia nigra of rats to model Parkinson's disease and to study the effects of spirulina on the inflammatory response. One month prior to surgeries, rats were fed either a diet enhanced with spirulina or a control diet. Immunohistochemistry was analyzed with unbiased stereological methods to quantify lesion size and microglial activation. As hypothesized, spirulina was neuroprotective in this α-synuclein model of PD as more TH+ and NeuN+ cells were observed; spirulina concomitantly decreased the numbers of activated microglial cells as determined by MHCII expression. This decrease in microglia activation may have been due, in part, to the effect of spirulina to increase expression of the fractalkine receptor (CX3CR1 on microglia. With this study we hypothesize that α-synuclein neurotoxicity is mediated, at least in part, via an interaction with microglia. We observed a decrease in activated microglia in the rats that received a spirulina- enhanced diet concomitant to neuroprotection. The increase in CX3CR1 in the groups that received spirulina, suggests a potential mechanism of action.

  4. The Role of Social Work in Providing Mental Health Services and Care Coordination in an Urban Trauma Center Emergency Department.

    Science.gov (United States)

    Moore, Megan; Whiteside, Lauren K; Dotolo, Danae; Wang, Jin; Ho, Leyna; Conley, Bonnie; Forrester, Mollie; Fouts, Susan O; Vavilala, Monica S; Zatzick, Douglas F

    2016-12-01

    This study examined the role of emergency department (ED) social workers and identified predictors of receipt of social work services and length of ED stay. Comprehensive reviews were conducted of medical records of all patients (N=49,354) treated in a level 1 trauma center ED from January 1, 2012, to March 31, 2013. Content analysis of chart notes was used to categorize the types of social work services provided. Poisson regression was used to assess associations between demographic and clinical characteristics, receipt of social work services, and length of ED stay. Social work services were provided to 18,532 (38%) patients. Most were mental health services (54%), followed by care coordination (31%) and material support or other referrals (15%). Patients seen by social workers had complex presentations, involving mental disorder diagnoses (18%), substance use disorder diagnoses (29%), comorbid diagnoses (32%), and injuries (51%); a quarter of patients had multiple ED visits (26%). In adjusted regression analysis, females (relative risk [RR]=1.15), patients not discharged home (RR=1.44), and those with two or more comorbid diagnoses (RR=1.80), injuries due to assault (RR=1.37), and traumatic brain injury (RR=1.20) were more likely to receive social work services. Such services were associated with an increased length of ED stay (RR=1.34). Social workers provided services to patients with multifaceted needs resulting from complex presentations. Provision of social work services modestly increased length of ED stay. Triage algorithms are needed to target efficiencies, systematize provision of ED social work services, and improve access to services for all patients.

  5. Regulatory roles of phosphorylation in model and pathogenic fungi.

    Science.gov (United States)

    Albataineh, Mohammad T; Kadosh, David

    2016-05-01

    Over the past 20 years, considerable advances have been made toward our understanding of how post-translational modifications affect a wide variety of biological processes, including morphology and virulence, in medically important fungi. Phosphorylation stands out as a key molecular switch and regulatory modification that plays a critical role in controlling these processes. In this article, we first provide a comprehensive and up-to-date overview of the regulatory roles that both Ser/Thr and non-Ser/Thr kinases and phosphatases play in model and pathogenic fungi. Next, we discuss the impact of current global approaches that are being used to define the complete set of phosphorylation targets (phosphoproteome) in medically important fungi. Finally, we provide new insights and perspectives into the potential use of key regulatory kinases and phosphatases as targets for the development of novel and more effective antifungal strategies. © The Author 2015. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. Mobile-based patient-provider communication in cancer survivors: The roles of health literacy and patient activation.

    Science.gov (United States)

    Jiang, Shaohai; Hong, Y Alicia

    2017-11-28

    Thanks to rapid penetration of mobile tools, more and more cancer survivors have adopted mobile-based patient-provider communication (MBPPC). The relationship between MBPPC and patients' health outcomes, however, remains unclear; how health literacy and patient activation interact with such relationship is unexplored. Data were drawn from National Cancer Institute's Health Information National Trends Survey 4 Cycle 3. A sample of 459 cancer survivors were included in the analysis. Based on the 3-stage model of health promotion using interactive media, this study empirically tested a moderated mediation model. MBPPC (eg, patient use of email, text message, mobile app, and social media to communicate with providers) had no direct effect on cancer survivors' emotional health. Instead, health literacy completely mediated this path. Patient activation positively moderated the effect of health literacy on emotional health and further increased the indirect effect of MBPPC on emotional health. MBPPC alone does not directly result in better emotional health outcomes; health literacy is the key to realize its health benefits; patient activation significantly strengthens the effects of MBPPC. As we embrace the mHealth movement, innovative programs are needed to promote MBPPC, and improve health literacy and activation of cancer survivors, particularly in underserved communities, to reduce health disparities. Copyright © 2017 John Wiley & Sons, Ltd.

  7. Providing Context for Complexity: Using Infographics and Conceptual Models to Teach Global Change Processes

    Science.gov (United States)

    Bean, J. R.; White, L. D.

    2015-12-01

    Understanding modern and historical global changes requires interdisciplinary knowledge of the physical and life sciences. The Understanding Global Change website from the UC Museum of Paleontology will use a focal infographic that unifies diverse content often taught in separate K-12 science units. This visualization tool provides scientists with a structure for presenting research within the broad context of global change, and supports educators with a framework for teaching and assessing student understanding of complex global change processes. This new approach to teaching the science of global change is currently being piloted and refined based on feedback from educators and scientists in anticipation of a 2016 website launch. Global change concepts are categorized within the infographic as causes of global change (e.g., burning of fossil fuels, volcanism), ongoing Earth system processes (e.g., ocean circulation, the greenhouse effect), and the changes scientists measure in Earth's physical and biological systems (e.g., temperature, extinctions/radiations). The infographic will appear on all website content pages and provides a template for the creation of flowcharts, which are conceptual models that allow teachers and students to visualize the interdependencies and feedbacks among processes in the atmosphere, hydrosphere, biosphere, and geosphere. The development of this resource is timely given that the newly adopted Next Generation Science Standards emphasize cross-cutting concepts, including model building, and Earth system science. Flowchart activities will be available on the website to scaffold inquiry-based lessons, determine student preconceptions, and assess student content knowledge. The infographic has already served as a learning and evaluation tool during professional development workshops at UC Berkeley, Stanford University, and the Smithsonian National Museum of Natural History. At these workshops, scientists and educators used the infographic

  8. Mathematical modeling provides kinetic details of the human immune response to vaccination

    Directory of Open Access Journals (Sweden)

    Dustin eLe

    2015-01-01

    Full Text Available With major advances in experimental techniques to track antigen-specific immune responses many basic questions on the kinetics of virus-specific immunity in humans remain unanswered. To gain insights into kinetics of T and B cell responses in human volunteers we combine mathematical models and experimental data from recent studies employing vaccines against yellow fever and smallpox. Yellow fever virus-specific CD8 T cell population expanded slowly with the average doubling time of 2 days peaking 2.5 weeks post immunization. Interestingly, we found that the peak of the yellow fever-specific CD8 T cell response is determined by the rate of T cell proliferation and not by the precursor frequency of antigen-specific cells as has been suggested in several studies in mice. We also found that while the frequency of virus-specific T cells increases slowly, the slow increase can still accurately explain clearance of yellow fever virus in the blood. Our additional mathematical model describes well the kinetics of virus-specific antibody-secreting cell and antibody response to vaccinia virus in vaccinated individuals suggesting that most of antibodies in 3 months post immunization are derived from the population of circulating antibody-secreting cells. Taken together, our analysis provides novel insights into mechanisms by which live vaccines induce immunity to viral infections and highlight challenges of applying methods of mathematical modeling to the current, state-of-the-art yet limited immunological data.

  9. MODEL REQUEST FOR PROPOSALS TO PROVIDE ENERGY AND OTHER ATTRIBUTES FROM AN OFFSHORE WIND POWER PROJECT

    Energy Technology Data Exchange (ETDEWEB)

    Jeremy Firestone; Dawn Kurtz Crompton

    2011-10-22

    This document provides a model RFP for new generation. The 'base' RFP is for a single-source offshore wind RFP. Required modifications are noted should a state or utility seek multi-source bids (e.g., all renewables or all sources). The model is premised on proposals meeting threshold requirements (e.g., a MW range of generating capacity and a range in terms of years), RFP issuer preferences (e.g., likelihood of commercial operation by a date certain, price certainty, and reduction in congestion), and evaluation criteria, along with a series of plans (e.g., site, environmental effects, construction, community outreach, interconnection, etc.). The Model RFP places the most weight on project risk (45%), followed by project economics (35%), and environmental and social considerations (20%). However, if a multi-source RFP is put forward, the sponsor would need to either add per-MWh technology-specific, life-cycle climate (CO2), environmental and health impact costs to bid prices under the 'Project Economics' category or it should increase the weight given to the 'Environmental and Social Considerations' category.

  10. Mathematical modeling provides kinetic details of the human immune response to vaccination.

    Science.gov (United States)

    Le, Dustin; Miller, Joseph D; Ganusov, Vitaly V

    2014-01-01

    With major advances in experimental techniques to track antigen-specific immune responses many basic questions on the kinetics of virus-specific immunity in humans remain unanswered. To gain insights into kinetics of T and B cell responses in human volunteers we combined mathematical models and experimental data from recent studies employing vaccines against yellow fever and smallpox. Yellow fever virus-specific CD8 T cell population expanded slowly with the average doubling time of 2 days peaking 2.5 weeks post immunization. Interestingly, we found that the peak of the yellow fever-specific CD8 T cell response was determined by the rate of T cell proliferation and not by the precursor frequency of antigen-specific cells as has been suggested in several studies in mice. We also found that while the frequency of virus-specific T cells increased slowly, the slow increase could still accurately explain clearance of yellow fever virus in the blood. Our additional mathematical model described well the kinetics of virus-specific antibody-secreting cell and antibody response to vaccinia virus in vaccinated individuals suggesting that most of antibodies in 3 months post immunization were derived from the population of circulating antibody-secreting cells. Taken together, our analysis provided novel insights into mechanisms by which live vaccines induce immunity to viral infections and highlighted challenges of applying methods of mathematical modeling to the current, state-of-the-art yet limited immunological data.

  11. Guarana provides additional stimulation over caffeine alone in the planarian model.

    Science.gov (United States)

    Moustakas, Dimitrios; Mezzio, Michael; Rodriguez, Branden R; Constable, Mic Andre; Mulligan, Margaret E; Voura, Evelyn B

    2015-01-01

    The stimulant effect of energy drinks is primarily attributed to the caffeine they contain. Many energy drinks also contain other ingredients that might enhance the tonic effects of these caffeinated beverages. One of these additives is guarana. Guarana is a climbing plant native to the Amazon whose seeds contain approximately four times the amount of caffeine found in coffee beans. The mix of other natural chemicals contained in guarana seeds is thought to heighten the stimulant effects of guarana over caffeine alone. Yet, despite the growing use of guarana as an additive in energy drinks, and a burgeoning market for it as a nutritional supplement, the science examining guarana and how it affects other dietary ingredients is lacking. To appreciate the stimulant effects of guarana and other natural products, a straightforward model to investigate their physiological properties is needed. The planarian provides such a system. The locomotor activity and convulsive response of planarians with substance exposure has been shown to provide an excellent system to measure the effects of drug stimulation, addiction and withdrawal. To gauge the stimulant effects of guarana we studied how it altered the locomotor activity of the planarian species Dugesia tigrina. We report evidence that guarana seeds provide additional stimulation over caffeine alone, and document the changes to this stimulation in the context of both caffeine and glucose.

  12. Guarana provides additional stimulation over caffeine alone in the planarian model.

    Directory of Open Access Journals (Sweden)

    Dimitrios Moustakas

    Full Text Available The stimulant effect of energy drinks is primarily attributed to the caffeine they contain. Many energy drinks also contain other ingredients that might enhance the tonic effects of these caffeinated beverages. One of these additives is guarana. Guarana is a climbing plant native to the Amazon whose seeds contain approximately four times the amount of caffeine found in coffee beans. The mix of other natural chemicals contained in guarana seeds is thought to heighten the stimulant effects of guarana over caffeine alone. Yet, despite the growing use of guarana as an additive in energy drinks, and a burgeoning market for it as a nutritional supplement, the science examining guarana and how it affects other dietary ingredients is lacking. To appreciate the stimulant effects of guarana and other natural products, a straightforward model to investigate their physiological properties is needed. The planarian provides such a system. The locomotor activity and convulsive response of planarians with substance exposure has been shown to provide an excellent system to measure the effects of drug stimulation, addiction and withdrawal. To gauge the stimulant effects of guarana we studied how it altered the locomotor activity of the planarian species Dugesia tigrina. We report evidence that guarana seeds provide additional stimulation over caffeine alone, and document the changes to this stimulation in the context of both caffeine and glucose.

  13. Guarana Provides Additional Stimulation over Caffeine Alone in the Planarian Model

    Science.gov (United States)

    Moustakas, Dimitrios; Mezzio, Michael; Rodriguez, Branden R.; Constable, Mic Andre; Mulligan, Margaret E.; Voura, Evelyn B.

    2015-01-01

    The stimulant effect of energy drinks is primarily attributed to the caffeine they contain. Many energy drinks also contain other ingredients that might enhance the tonic effects of these caffeinated beverages. One of these additives is guarana. Guarana is a climbing plant native to the Amazon whose seeds contain approximately four times the amount of caffeine found in coffee beans. The mix of other natural chemicals contained in guarana seeds is thought to heighten the stimulant effects of guarana over caffeine alone. Yet, despite the growing use of guarana as an additive in energy drinks, and a burgeoning market for it as a nutritional supplement, the science examining guarana and how it affects other dietary ingredients is lacking. To appreciate the stimulant effects of guarana and other natural products, a straightforward model to investigate their physiological properties is needed. The planarian provides such a system. The locomotor activity and convulsive response of planarians with substance exposure has been shown to provide an excellent system to measure the effects of drug stimulation, addiction and withdrawal. To gauge the stimulant effects of guarana we studied how it altered the locomotor activity of the planarian species Dugesia tigrina. We report evidence that guarana seeds provide additional stimulation over caffeine alone, and document the changes to this stimulation in the context of both caffeine and glucose. PMID:25880065

  14. Role modeling in undergraduate nursing education: an integrative literature review.

    Science.gov (United States)

    Baldwin, Adele; Mills, Jane; Birks, Melanie; Budden, Lea

    2014-06-01

    The transition of nursing education from the hospital setting to the university sector over recent decades has opened dialog about who is guiding the development of nursing students' professional identity. In addition, there is ongoing debate over real or perceived gaps between nursing student learning in the university and the clinical area, how this translates into professional behaviors and how well students make the transition between the two settings. This paper presents the findings of an integrative literature review into the topic of role modeling in undergraduate nursing education. This review was conducted to identify and appraise research findings about role modeling of professional behaviors for undergraduate nursing students. Literature reviewed from 2000 onwards assesses what is currently known about role modeling of undergraduate nursing students. A systematic search of the databases of CINAHL, Scopus and PubMed from 2000 onwards resulted in the selection of 33 articles for deeper analysis. Two clear themes emerged from the literature, the first relating to nurse clinicians as role models for students during clinical placements and the second relating to nurse academics as role models in the academic setting. Findings from this integrative literature review show an imbalance in the recognition of the role modeling of professional behaviors in the clinical versus the academic setting. Nurses in academic settings have more contact with the students over their period of study and as such, the significance of nurse academics as student role models requires further investigation. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Comparing Video Modeling and Graduated Guidance Together and Video Modeling Alone for Teaching Role Playing Skills to Children with Autism

    Science.gov (United States)

    Akmanoglu, Nurgul; Yanardag, Mehmet; Batu, E. Sema

    2014-01-01

    Teaching play skills is important for children with autism. The purpose of the present study was to compare effectiveness and efficiency of providing video modeling and graduated guidance together and video modeling alone for teaching role playing skills to children with autism. The study was conducted with four students. The study was conducted…

  16. A model of cell biological signaling predicts a phase transition of signaling and provides mathematical formulae.

    Directory of Open Access Journals (Sweden)

    Tatsuaki Tsuruyama

    Full Text Available A biological signal is transmitted by interactions between signaling molecules in the cell. To date, there have been extensive studies regarding signaling pathways using numerical simulation of kinetic equations that are based on equations of continuity and Fick's law. To obtain a mathematical formulation of cell signaling, we propose a stability kinetic model of cell biological signaling of a simple two-parameter model based on the kinetics of the diffusion-limiting step. In the present model, the signaling is regulated by the binding of a cofactor, such as ATP. Non-linearity of the kinetics is given by the diffusion fluctuation in the interaction between signaling molecules, which is different from previous works that hypothesized autocatalytic reactions. Numerical simulations showed the presence of a critical concentration of the cofactor beyond which the cell signaling molecule concentration is altered in a chaos-like oscillation with frequency, which is similar to a discontinuous phase transition in physics. Notably, we found that the frequency is given by the logarithm function of the difference of the outside cofactor concentration from the critical concentration. This implies that the outside alteration of the cofactor concentration is transformed into the oscillatory alteration of cell inner signaling. Further, mathematical stability kinetic analysis predicted a discontinuous dynamic phase transition in the critical state at which the cofactor concentration is equivalent to the critical concentration. In conclusion, the present model illustrates a unique feature of cell signaling, and the stability analysis may provide an analytical framework of the cell signaling system and a novel formulation of biological signaling.

  17. The roles of clinical psychologists: a comparison of faculty models and student practicuum roles.

    Science.gov (United States)

    Prien, E P; Khanna, P

    1990-07-01

    This article focuses on the definition of faculty education and training models, as compared to student field placement job roles. Both faculty models and student roles are described in terms of tasks and job skills that were judged important. An inverse factor analysis was performed for the task importance judgements, separately for the faculty sample and the student sample. Group membership was used to calculate both task and job skill profiles. Those profiles were compared to determine the similarities and differences between the faculty and student models. Overall, there is a lack of similarity between faculty members' education and training models and student field placement job roles, as identified by the multidomain job analysis technique. One must conclude either that the faculty models represent a developmental view, rather than the current reality as represented by field placement jobs, or that those jobs are artificial roles that are irrelevant insofar as education and training are concerned.

  18. The role of prescriptive models in learning

    NARCIS (Netherlands)

    Sandberg, J.A.C.; Wielinga, B.J.; Christoph, L.H.

    2012-01-01

    The main research question in this article concerns the added value of a prescriptive model in a simulation/gaming environment: KM Quest. KM Quest is meant to support students in the acquisition of both declarative and procedural knowledge in the domain of Knowledge Management (KM). The prescriptive

  19. The role of prescriptive models in learning.

    NARCIS (Netherlands)

    Sandberg, J.; Wielinga, B.J.; Christoph, L.H.

    2012-01-01

    The main research question in this article concerns the added value of a prescriptive model in a simulation/gaming environment: KM Quest. KM Quest is meant to support students in the acquisition of both declarative and procedural knowledge in the domain of Knowledge Management (KM). The prescriptive

  20. A career roles model of career development

    NARCIS (Netherlands)

    Hoekstra, Hans A.

    Career development is described as the interactive progression of internal career identity formation and the growth of external career significance. Argued is the need for a content model of career development where the field is dominated by process theories. A theory is put forward of career

  1. Modeling the Drift Towards Sex Role Deviance.

    Science.gov (United States)

    James, Jennifer; Vitaliano, Peter Paul

    The interrelationships of deviant life experiences and current status, i.e., prostitution versus non-prostitution, were investigated by the application of multivariate analyses. Variables were studied involving early home life, pregnancy history, sexual history, and criminal involvement. Based on the analyses, three models were developed that…

  2. Support options provided and required for modeling with DynaLearn - A case study

    NARCIS (Netherlands)

    Or-Bach, R.; Bredeweg, B.

    2013-01-01

    Science educators strongly advocate the importance of scientific modeling within science education. Although widely advocated for students, modeling is a complex task involving integration of topics, "languages" and abstraction levels. Thus support for the modeling task and for developing modeling

  3. The Role of Business Education Provided Through Lifelong Learning in Enhancing Profesional Competencies. Evidence from the Eu-27 Dataset

    Directory of Open Access Journals (Sweden)

    Vlad Dumitrache

    2014-08-01

    Full Text Available This paper examines the macroeconomic implications of business education provided by the process of lifelong learning, based on a panel dataset comprising the EU-27 countries. Business education is a valuable component of adult education, and the lifelong learning represents the main channel facilitating the transfer of this knowledge. A number of three panel regression models are conducted separately for the New Member States (NMS and Old Member States (OMS. The positive effects of business education on economic growth and duration of working life are found to be more significant and powerful in the NMS than in the OMS. The empirical analysis also shows that business education is a determinant of the subjective poverty reduction only in the OMS, while the third-level education attainment contributes to the poverty reduction in the NMS, only when been accompanied by business education.

  4. More accurate neuronavigation data provided by biomechanical modeling instead of rigid registration.

    Science.gov (United States)

    Garlapati, Revanth Reddy; Roy, Aditi; Joldes, Grand Roman; Wittek, Adam; Mostayed, Ahmed; Doyle, Barry; Warfield, Simon Keith; Kikinis, Ron; Knuckey, Neville; Bunt, Stuart; Miller, Karol

    2014-06-01

    It is possible to improve neuronavigation during image-guided surgery by warping the high-quality preoperative brain images so that they correspond with the current intraoperative configuration of the brain. In this paper, the accuracy of registration results obtained using comprehensive biomechanical models is compared with the accuracy of rigid registration, the technology currently available to patients. This comparison allows investigation into whether biomechanical modeling provides good-quality image data for neuronavigation for a larger proportion of patients than rigid registration. Preoperative images for 33 neurosurgery cases were warped onto their respective intraoperative configurations using both the biomechanics-based method and rigid registration. The Hausdorff distance-based evaluation process, which measures the difference between images, was used to quantify the performance of both registration methods. A statistical test for difference in proportions was conducted to evaluate the null hypothesis that the proportion of patients for whom improved neuronavigation can be achieved is the same for rigid and biomechanics-based registration. The null hypothesis was confidently rejected (p registration was rejected at a significance level of 5% (p = 0.02). The biomechanics-based method proved particularly effective in cases demonstrating large craniotomy-induced brain deformations. The outcome of this analysis suggests that nonlinear biomechanics-based methods are beneficial to a large proportion of patients and can be considered for use in the operating theater as a possible means of improving neuronavigation and surgical outcomes.

  5. A Novel Stackelberg-Bertrand Game Model for Pricing Content Provider

    Directory of Open Access Journals (Sweden)

    Cheng Zhang

    2015-11-01

    Full Text Available With the popularity of smart devices such as smartphone, tablet, contents that traditionally be viewed on a personal computer, can also be viewed on these smart devices. The demand for contents thus is increasing year by year, which makes the content providers (CPs get great revenue from either users’ subscription or advertisement. On the other hand, Internet service providers (ISPs, who keep investing in the network technology or capacity capacity to support the huge traffic generated by contents, do not benefit directly from the content traffic. One choice for ISPs is to charge CPs to share the revenue from the huge content traffic. Then ISPs have enough incentives to invest in network infrastructure to improve quality of services (QoS, which eventually benefit CPs and users. This paper presents a novel economic model called Stackelberg-Bertrand game to capture the interaction and competitions among ISPs, CPs and users when ISPs charge CPs. A generic user demand function is assumed to capture the sensitivity of demand to prices of ISPs and CPs. The numerical results show that the price elasticity of ISP and CP plays an important part on the payoff of the ISP and CP.

  6. Extra-role behavior modelling: personality concept and the role of servant leadership

    OpenAIRE

    ISMAIL VERNI Y.; ARMANU A.; HADIWIDJOJO DJUMILAH; INDRAWATI NUR KHUSNIYAH

    2016-01-01

    Nowadays, extra-role behavior has become one of the important outcomes for organization. Because in order to achieve their success; organizations need employees who are willing to do more work than what they are supposed to do. The purpose of this article is to develop extra-role behavior model based on personality concept as employee’s internal factor, and the role of servant leadership in organizational environment. Personality concept is developed using two approaches, namely traits approa...

  7. The Managerial Roles of Academic Library Directors: The Mintzberg Model.

    Science.gov (United States)

    Moskowitz, Michael Ann

    1986-01-01

    A study based on a model developed by Henry Mintzberg examined the internal and external managerial roles of 126 New England college and university library directors. Survey results indicate that the 97 responding directors were primarily involved with internal managerial roles and work contacts. (CDD)

  8. The CEO's role in business model reinvention.

    Science.gov (United States)

    Govindarajan, Vijay; Trimble, Chris

    2011-01-01

    Fending off new competitors is a perennial struggle for established companies. Govindarajan and Trimble, of Dartmouth's Tuck School of Business, explain why: Many corporations become too comfortable with their existing business models and neglect the necessary work of radically reinventing them. The authors map out an alternative in their "three boxes" framework. They argue that while a CEO manages the present (box 1), he or she must also selectively forget the past (box 2) in order to create the future (box 3). Infosys chairman N.R. Narayana Murthy mastered the three boxes to reinvigorate his company and greatly increased its changes of enduring for generations.

  9. The role of specialist units to provide focused care and complication avoidance following traumatic spinal cord injury: a systematic review.

    Science.gov (United States)

    Maharaj, Monish M; Hogan, Jarred A; Phan, Kevin; Mobbs, Ralph J

    2016-06-01

    Current recommendations for traumatic spinal cord injury treatment recommend immediate transfer to a spinal injury unit (SIU) where available following patient stabilisation. Although transfer is dependent on a variety of factors, the largest review was unable to justify implementation of such units on the basis of insufficient and lack of quality data in favour of care at the SIU as opposed to non-SIU centres. Our study sought to investigate: are subspecialty spinal injury units (SIUs) able to provide superior care compared with traditional trauma/rehab units? Is the standard of care of acute spinal cord injured patients to be managed in SIU's? A literature search was conducted across five major databases using the key terms: "spinal cord injury" AND "Spinal Injury Unit" OR "spinal rehabilitation" OR "spinal injury centre" OR "specialist care" OR "care requirements." After review of over 500 studies, only 9 met inclusion criteria, 3 of which were past reviews. There were no relevant RCT's obtained. Standardised roles of global SIU units are needed to deliver equitable and high quality care as current evidence demonstrates variable standards of care and service (mean LOS range: 16-174 days). There is low quality evidence supporting earlier admission into SIU units being associated with improved neurological outcome, complication rates and reduced LOS, despite variations in the definition of "early admission" across studies. Our review demonstrates a lack of standardisation within SIU on a global scale, with significantly different outcomes reported across published studies. New and higher quality evidence directly comparing SIU to non-SIU based care is required. Earlier transfer (injury and stabilisation is advised.

  10. In silico characterization of tandem repeats in Trichophyton rubrum and related dermatophytes provides new insights into their role in pathogenesis

    Science.gov (United States)

    Franco, Matheus Eloy; Bitencourt, Tamires Aparecida; Marins, Mozart

    2017-01-01

    Abstract Trichophyton rubrum is the most common etiological agent of dermatophytoses worldwide, which is able to degrade keratinized tissues. The sequencing of the genome of different dermatophyte species has provided a large amount of data, including tandem repeats that may play a role in genetic variability and in the pathogenesis of these fungi. Tandem repeats are adjacent DNA sequences of 2–200 nucleotides in length, which exert regulatory and adaptive functions. These repetitive DNA sequences are found in different classes of fungal proteins, especially those involved in cell adhesion, a determinant factor for the establishment of fungal infection. The objective of this study was to develop a Dermatophyte Tandem Repeat Database (DTRDB) for the storage and identification of tandem repeats in T. rubrum and six other dermatophyte species. The current version of the database contains 35 577 tandem repeats detected in 16 173 coding sequences. The repeats can be searched using entry parameters such as repeat unit length (nt—nucleotide), repeat number, variability score, and repeat sequence motif. These data were used to study the relative frequency and distribution of repeats in the sequences, as well as their possible functions in dermatophytes. A search of the database revealed that these repeats occur in 22–33% of genes transcribed in dermatophytes where they could be involved in the success of adaptation to the host tissue and establishment of infection. The repeats were detected in transcripts that are mainly related to three biological processes: regulation, adhesion, and metabolism. The database developed enables users to identify and analyse tandem repeat regions in target genes related to pathogenicity and fungal–host interactions in dermatophytes and may contribute to the discovery of new targets for the development of antifungal agents. Database URL: http://comp.mch.ifsuldeminas.edu.br/dtrdb/

  11. Public-private partnerships to improve primary healthcare surgeries: clarifying assumptions about the role of private provider activities.

    Science.gov (United States)

    Mudyarabikwa, Oliver; Tobi, Patrick; Regmi, Krishna

    2017-07-01

    Aim To examine assumptions about public-private partnership (PPP) activities and their role in improving public procurement of primary healthcare surgeries. PPPs were developed to improve the quality of care and patient satisfaction. However, evidence of their effectiveness in delivering health benefits is limited. A qualitative study design was employed. A total of 25 interviews with public sector staff (n=23) and private sector managers (n=2) were conducted to understand their interpretations of assumptions in the activities of private investors and service contractors participating in Local Improvement Finance Trust (LIFT) partnerships. Realist evaluation principles were applied in the data analysis to interpret the findings. Six thematic areas of assumed health benefits were identified: (i) quality improvement; (ii) improved risk management; (iii) reduced procurement costs; (iv) increased efficiency; (v) community involvement; and (vi) sustainable investment. Primary Care Trusts that chose to procure their surgeries through LIFT were expected to support its implementation by providing an environment conducive for the private participants to achieve these benefits. Private participant activities were found to be based on a range of explicit and tacit assumptions perceived helpful in achieving government objectives for LIFT. The success of PPPs depended upon private participants' (i) capacity to assess how PPP assumptions added value to their activities, (ii) effectiveness in interpreting assumptions in their expected activities, and (iii) preparedness to align their business principles to government objectives for PPPs. They risked missing some of the expected benefits because of some factors constraining realization of the assumptions. The ways in which private participants preferred to carry out their activities also influenced the extent to which expected benefits were achieved. Giving more discretion to public than private participants over critical

  12. On the foundation for roles in RM-ODP: contributions from conceptual modelling

    NARCIS (Netherlands)

    Guizzardi, G.; Andrade Almeida, João; Linington, P.F.; Vallecillo, A.; Wood, B.

    2007-01-01

    In this paper, we attempt to provide a semantic foundation for the role-related concepts in the RM-ODP. We believe that some theories of conceptual modelling may help us to provide a well-founded underpinning for these concepts, and to harmonize competing proposals for them. As a starting point of

  13. Estimated Nutritive Value of Low-Price Model Lunch Sets Provided to Garment Workers in Cambodia.

    Science.gov (United States)

    Makurat, Jan; Pillai, Aarati; Wieringa, Frank T; Chamnan, Chhoun; Krawinkel, Michael B

    2017-07-21

    The establishment of staff canteens is expected to improve the nutritional situation of Cambodian garment workers. The objective of this study is to assess the nutritive value of low-price model lunch sets provided at a garment factory in Phnom Penh, Cambodia. Exemplary lunch sets were served to female workers through a temporary canteen at a garment factory in Phnom Penh. Dish samples were collected repeatedly to examine mean serving sizes of individual ingredients. Food composition tables and NutriSurvey software were used to assess mean amounts and contributions to recommended dietary allowances (RDAs) or adequate intake of energy, macronutrients, dietary fiber, vitamin C (VitC), iron, vitamin A (VitA), folate and vitamin B12 (VitB12). On average, lunch sets provided roughly one third of RDA or adequate intake of energy, carbohydrates, fat and dietary fiber. Contribution to RDA of protein was high (46% RDA). The sets contained a high mean share of VitC (159% RDA), VitA (66% RDA), and folate (44% RDA), but were low in VitB12 (29% RDA) and iron (20% RDA). Overall, lunches satisfied recommendations of caloric content and macronutrient composition. Sets on average contained a beneficial amount of VitC, VitA and folate. Adjustments are needed for a higher iron content. Alternative iron-rich foods are expected to be better suited, compared to increasing portions of costly meat/fish components. Lunch provision at Cambodian garment factories holds the potential to improve food security of workers, approximately at costs of <1 USD/person/day at large scale. Data on quantitative total dietary intake as well as physical activity among workers are needed to further optimize the concept of staff canteens.

  14. EG And: Providing the Missing Link Required for Modelling Red Giant Mass-loss

    Science.gov (United States)

    Espey, Brian

    2009-07-01

    For the majority of red giant stars the basic mass-loss processes at work are unknown. Indeed, for stars of spectral types between K0 III and M5-M6 III, much remains unknown about the regions above the visible photosphere and the transportation of the processed material outwards to the ISM. Eclipsing symbiotic binary systems, consisting of an evolved giant in orbit with a white dwarf, provide an opportunity to take advantage of the finite size of the hot component to probe different levels of the chromosphere and wind acceleration region in absorption. This provides spatially resolved thermal, ionisation and dynamic information on the wind which can then be compared against predictions of hydrodynamical stellar atmosphere codes. The symbiotic binary EG And can be considered as a rosetta stone for understanding the winds of these objects. The system is ideal on a number of counts for utilising the ultraviolet eclipse of the white dwarf {WD} component to probe, layer-by-layer, the thermal and dynamic conditions at the very base of the wind and chromosphere of the RG. This information is vital for constraining, testing and calibrating the new generation of cool giant wind+chromosphere models and is not possible to obtain for isolated RGs. This team has studied the UV eclipses of this system in depth and detail, however in order to definitively constrain the wind acceleration profile and identify the location of the temperature rise just above the photosphere we require 4 STIS E140M observations of EG And at specific orbital phases. We are also requesting a E230M observation of an isolated spectral standard, corresponding to the RG inthe binary, which will help place the EG And results into the context of the general RG population from analysis of the MgII wind diagnostic lines.

  15. Estimated Nutritive Value of Low-Price Model Lunch Sets Provided to Garment Workers in Cambodia

    Directory of Open Access Journals (Sweden)

    Jan Makurat

    2017-07-01

    Full Text Available Background: The establishment of staff canteens is expected to improve the nutritional situation of Cambodian garment workers. The objective of this study is to assess the nutritive value of low-price model lunch sets provided at a garment factory in Phnom Penh, Cambodia. Methods: Exemplary lunch sets were served to female workers through a temporary canteen at a garment factory in Phnom Penh. Dish samples were collected repeatedly to examine mean serving sizes of individual ingredients. Food composition tables and NutriSurvey software were used to assess mean amounts and contributions to recommended dietary allowances (RDAs or adequate intake of energy, macronutrients, dietary fiber, vitamin C (VitC, iron, vitamin A (VitA, folate and vitamin B12 (VitB12. Results: On average, lunch sets provided roughly one third of RDA or adequate intake of energy, carbohydrates, fat and dietary fiber. Contribution to RDA of protein was high (46% RDA. The sets contained a high mean share of VitC (159% RDA, VitA (66% RDA, and folate (44% RDA, but were low in VitB12 (29% RDA and iron (20% RDA. Conclusions: Overall, lunches satisfied recommendations of caloric content and macronutrient composition. Sets on average contained a beneficial amount of VitC, VitA and folate. Adjustments are needed for a higher iron content. Alternative iron-rich foods are expected to be better suited, compared to increasing portions of costly meat/fish components. Lunch provision at Cambodian garment factories holds the potential to improve food security of workers, approximately at costs of <1 USD/person/day at large scale. Data on quantitative total dietary intake as well as physical activity among workers are needed to further optimize the concept of staff canteens.

  16. An integrated Biophysical CGE model to provide Sustainable Development Goal insights

    Science.gov (United States)

    Sanchez, Marko; Cicowiez, Martin; Howells, Mark; Zepeda, Eduardo

    2016-04-01

    Future projected changes in the energy system will inevitably result in changes to the level of appropriation of environmental resources, particularly land and water, and this will have wider implications for environmental sustainability, and may affect other sectors of the economy. An integrated climate, land, energy and water (CLEW) system will provide useful insights, particularly with regard to the environmental sustainability. However, it will require adequate integration with other tools to detect economic impacts and broaden the scope for policy analysis. A computable general equilibrium (CGE) model is a well suited tool to channel impacts, as detected in a CLEW analysis, onto all sectors of the economy, and evaluate trade-offs and synergies, including those of possible policy responses. This paper will show an application of such integration in a single-country CGE model with the following key characteristics. Climate is partly exogenous (as proxied by temperature and rainfall) and partly endogenous (as proxied by emissions generated by different sectors) and has an impact on endogenous variables such as land productivity and labor productivity. Land is a factor of production used in agricultural and forestry activities which can be of various types if land use alternatives (e.g., deforestation) are to be considered. Energy is an input to the production process of all economic sectors and a consumption good for households. Because it is possible to allow for substitution among different energy sources (e.g. renewable vs non-renewable) in the generation of electricity, the production process of energy products can consider the use of natural resources such as oil and water. Water, data permitting, can be considered as an input into the production process of agricultural sectors, which is particularly relevant in case of irrigation. It can also be considered as a determinant of total factor productivity in hydro-power generation. The integration of a CLEW

  17. Tsunami-HySEA: A GPU based model for the Italian candidate Tsunami Service Provider

    Science.gov (United States)

    Gonzalez Vida, Jose Manuel; Macias, Jorge; Castro, Manuel; de la Asuncion, Marc; Melini, Daniele; Romano, Fabrizio; Tonini, Roberto; Lorito, Stefano; Piatanesi, Alessio; Molinari, Irene

    2015-04-01

    Tsunami Service Providers (TSP), providing tsunami warnings in the framework of the systems coordinated by IOC/UNESCO worldwide, and other national tsunami warning centers, are striving to complement, or replace, decision matrices and pre-calculated tsunami scenario databases with FTRT (Faster Than Real Time) tsunami simulations. The aim is to increase the accuracy of tsunami forecast by assimilating the largest possible amount of data in quasi real time, and performing simulations in a few minutes wall-clock time, possibly including the coastal inundation stage. This strategy of direct real time computation, that could seem unfeasible a decade ago, it is now foreseeable thanks to the astonishingly recent increase in the computational power and bandwidth evolution of modern GPUs. The INGV in collaboration with the EDANYA Group (University of Málaga) are developing and implementing a FTRT Tsunami Simulation approach for the Italian candidate TSP, namely the Centro Allerta Tsunami (CAT), which is in pre-operational stage starting from 1 October 2014, in the 24/7 seismic monitoring room at INGV. The mandate of CAT is to provide warnings for potential tsunamis within the Mediterranean basin to its subscribers, in the framework of NEAMTWS (http://www.ioc-tsunami.org/index.php?option=com_content&view=article&id=70:neamtws-home&catid=9&Itemid=14&lang=es). CAT also performs global monitoring, for continuous testing, training, and validation purposes. The tsunami-HySEA model, developed by EDANYA Group, implements in the same code the three phases of an earthquake generated tsunami: generation, propagation and coastal inundation. At the same time it is implemented in nested meshes with different resolution and multi-GPU environment, which allows much faster than real time simulations. The challenge set by the Italian TSP for warning in the NEAMTWS region is twofold: to be able to reasonably constrain the earthquake source in the absence of deep sea tsunami sensors, and to

  18. Provide a Model to Determine of Importance the Characteristics of Iranian Digital Libraries User Interface

    Directory of Open Access Journals (Sweden)

    Yaghoub Norouzi

    2012-03-01

    Full Text Available User interfaces in digital libraries are responsible for interaction among users and information environment and creation the feedback. Therefore, the aim of this study was offering a model to find of importance the characteristics of Iranian digital libraries user interface based of Delphi method. In relation, after study of the related literature and providing the researcher constructed checklist regarding the Delphi panel, ten key criteria (search, consistency, guidance, navigation, design, error correction, presentation, user control, interface language, and simplicity included 114 features and sub-components were selected to find of importance of them in the design of Iranian digital libraries user interfaces. Then, based on obtained scores from the Delphi panel, importance of each sub-feature determined in the design of Iranian digital libraries user interfaces. Finally, the criteria of the interface language and error correction in sequence gained the highest and lowest score. Although the difference among of criteria's and sub-components were low and according to the Delphi panel using them in the design of Iranian digital libraries user interface offered. It was hope that the results of this study could present needed features and their importance in designing in digital libraries user interface. On the other hand, it could be used as a tool for the determination of capabilities of Iran digital libraries user interfaces from experts and their user's opinion.

  19. Could implantable cardioverter defibrillators provide a human model supporting the learned helplessness theory of depression?

    Science.gov (United States)

    Goodman, M; Hess, B

    1999-01-01

    Affective symptoms were examined retrospectively in 25 patients following placement of implantable cardioverter defibrillators (ICD) which can produce intermittent shocks without warning in response to cardiac ventricular arrhythmias. The number of ICD random, uncontrollable discharge shocks and pre-ICD history of psychological distress (i.e., depression and/or anxiety) were documented in all patients using a demographics questionnaire and a standardized behavioral/psychological symptoms questionnaire (i.e., Symptom Checklist-90 Revised). ICD patients were dichotomized into two groups: those without a history of psychological distress prior to ICD (n = 18) and those with a history of psychological distress prior to ICD (n = 7). In ICD patients without a prior history, results indicated that quantity of ICD discharge shocks was significantly predictive of current reported depression (r = 0.45, p = 0.03) and current reported anxiety (r = 0.51, p = 0.02). Conversely, in patients with a reported history of psychological distress, there was no significant relationship found between quantity of discharge shocks and current reported depression or anxiety. This study may provide evidence in support of a human model of learned helplessness in that it supports the notion that exposure to an unavoidable and inescapable aversive stimulus was found to be related to patients' reported depression. Further studies may wish to prospectively consider a larger sample as well as a more comprehensive assessment of premorbid psychological symptoms.

  20. PENERAPAN MODEL UPAYA PENURUNAN UNMET NEED MELALUI INTERVENSI LANGSUNG TERHADAP MASYARAKAT DAN PROVIDER DI PROVINSI BALI

    Directory of Open Access Journals (Sweden)

    A.A.I.N Marhaeni

    2012-11-01

    Full Text Available Fenomena unmet need di Propinsi Bali masih relatif tinggi, meskipun masih lebih rendah daripada angka nasional. Dari data hasil SDKI tahun 2002-2003 unmet need di Provinsi Bali relatif tinggi yaitu sekitar 6,9 persen dari pasangan usia subur. Mengingat demikian pentingnya fenomena unmet need di Propinsi ini, maka sudah dilakukan pengkajian pada tahap pertama yaitu pada tahun 2004 untuk mengidentifikasi faktor-faktor yang diperkirakan berpengaruh terhadap fenomena unmet need tersebut. Setelah dapat diidentifikasi faktor-faktor tersebut maka pada tahun 2005 dilakukan intervensi yang berupa: (1 sosialisasi; (2 pelayanan pemasangan alat kontrasepsi untuk menurunkan secara langsung persentase unmet need, serta (3 evaluasi terhadap kepuasan PUS yang tergolong unmet need yang telah bersedia menggunakan kontrasepsi setelah beberapa waktu dari saat pemasangan dilakukan. Beberapa temuan spesifik dari hasil intervensi yang telah dilakukan pada tahun sebelumnya antara lain diuraikan sebagai berikut. Beberapa alasan PUS unmet need bersedia menggunakan kontrasepsi setelah intervensi dilakukan berkaitan dengan faktor internal program maupun faktor eksternal. Dari hasil intervensi yang telah dilakukan pada tahun 2005, tahun 2006 terdapat 2 kelompok target/sasaran yaitu: (1 kelompok PUS yang tergolong unmet need yang tetap tidak bersedia menggunakan kontrasepsi meskipun telah dilakukan intervensi; (2 kelompok PUS tergolong unmet need yang telah bersedia menggunakan kontrasepsi setelah dilakukan intervensi. Dari kegiatan intervensi yang telah dilakukan melalui penerapan model ?Optimalisasi Peran Provider?, dapat disimpulkan bahwa kegiatan tersebut dinilai sangat berhasil dalam menurunkan proporsi unmet need.

  1. Predicting Intentions to Read Suicide Awareness Stories. The Role of Depression and Characteristics of the Suicidal Role Model.

    Science.gov (United States)

    Niederkrotenthaler, Thomas; Arendt, Florian; Till, Benedikt

    2015-01-01

    Research on factors that influence the intention to read suicide awareness material is lacking. To identify how social and state similarities between the featured protagonist of a suicide awareness story and the audience impact on the intent to read similar stories. Laboratory experiment with n = 104 students. Participants were randomly assigned to study groups. In the first group, the role model provided his personal story of crisis and was a student. In the second group, the content was identical but the model was socially dissimilar. The third group read about a topic unrelated to suicide. Depression, identification, and exposure intent were measured after the experiment. Conditional process analysis was carried out. In the group featuring a once-suicidal role model with high social similarity, depression in the audience increased the intention to read similar material in the future via identification with the role model; 82% of individuals wanted to read similar material in the future, but only 50% wanted to do so in the group featuring a dissimilar person. Exposure intention increases via identification when role model and audience characteristics align regarding social traits and the experience of depression. These factors are relevant when developing campaigns targeting individuals with stories of recovery.

  2. Complementing System Dynamics with Object-Role Modelling

    NARCIS (Netherlands)

    Tulinayo, F.P.; Grössler, A.; Hoppenbrouwers, S.J.B.A.; Bommel, P. van

    2009-01-01

    In this paper we use Object-Role Modeling (ORM) to complement System Dynamics (SD). The art of SD modeling lies in discovering and representing feedback processes and other elements that determine the dynamics of the system. However, SD shows a lack of instruments for discovering and expressing

  3. Complementing System Dynamics with Object-role Modeling

    NARCIS (Netherlands)

    Tulinayo, F.P.; Grössler, A.; Hoppenbrouwers, S.J.B.A.; Bommel, P. van

    2009-01-01

    In this paper we use Object-Role Modeling (ORM) to complement System Dynamics (SD). The art of SD modeling lies in discovering and representing feedback processes and other elements that determine the dynamics of the system. However, SD shows a lack of instruments for discovering and expressing

  4. Role Models for boosting mobility of women scientists in geosciences

    Science.gov (United States)

    Avellis, Giovanna; Theodoridou, Magdalini

    2017-04-01

    More and more women today are choosing to study science and undertake scientific careers. Likewise mobility during one's career is increasingly important as research tends to be undertaken via international collaboration, often within networks based on the researchers mobility, especially in geosciences. We have developed an ebook on Role Models for boosting mobility of women scientists to showcase the careers of women scientists who have undertaken mobility during their careers. It is hoped that their stories will provide young women who are just starting out in their science careers with inspirational role models, and that these stories give them realistic information about career opportunities: many of them are women scientists in geosciences. These are not famous scientists, but rather real examples of people who express all the passion of the world of science. It is hoped that reading about successful scientists who have achieved a healthy work-life balance while moving to new locations will be particularly helpful for those individuals considering mobility in their own career. The ebook is available to be used by programs that support the development of systematic approaches to increasing the representation and advancement of women in science, engineering and technology, since mobility plays a key role in these programs. The stories contained herein will be useful to mentoring or advising program focusing on career, networking opportunities, discussion and grants opportunities in conjunction with mobility. There is still a gap between female graduates and the pool of female job applicants - even though the proportion of female graduate students and postdocs in most scientific fields is higher today than it is ever been. Therefore we suggest that focus should be placed on examining the real challenges which women need to overcome, particularly when "mobility" comes into play. Role models who have overcome these challenges will continue to play an important

  5. Experiences of role model instructors and nursing students about facilitator factors of role-modeling process: A qualitative research.

    Science.gov (United States)

    Nouri, Jamileh Mokhtari; Ebadi, Abbas; Alhani, Fatemeh; Rejeh, Nahid

    2014-05-01

    One of the key strategies in students' learning is the influence of models on them. Understanding the factors affecting the implementation of role-modeling process in education will help to make greater use of this training strategy. This study aimed to understand the experiences of role model instructors and nursing students about the facilitator factors in the role-modeling process. This qualitative study was carried out by using thematic analysis method and purposeful sampling. Data were collected until saturation by using three focus group discussions (n = 20) and two individual interviews with nursing instructors, as well as six semi-structured face-to-face interviews with role model instructors from five nursing faculties of Tehran universities in 2011. Six themes, "effort for humanistic and professional growth of students," "individual and managerial empowerment of instructor," "instructor and student's modeling," "motivation and effort of student," "strategies governing the education system," and "appropriate facilities and equipment," were extracted as the facilitating factors. For development of role-modeling process in nursing education, paying attention to personal and environmental factors, especially effort for professional and humanistic growth of nursing students is necessary.

  6. Primary Care Providers' Perceptions of and Experiences with an Integrated Healthcare Model

    Science.gov (United States)

    Westheimer, Joshua M.; Steinley-Bumgarner, Michelle; Brownson, Chris

    2008-01-01

    Objective and Participants: The authors examined the experiences of primary care providers participating in an integrated healthcare service between mental health and primary care in a university health center. In this program, behavioral health providers work collaboratively with primary care providers in the treatment of students. Participants…

  7. Medical Students' Perceptions of Clinical Teachers as Role Model.

    Science.gov (United States)

    Haider, Sonia Ijaz; Snead, David R J; Bari, Muhammad Furqan

    2016-01-01

    Role models facilitate student learning and assists in the development of professional identity. However, social organization and cultural values influence the choice of role models. Considering that the social organization and cultural values in South East Asia are different from other countries, it is important to know whether this affects the characteristics medical students look for in their role models in these societies. A 32 item questionnaire was developed and self-administered to undergraduate medical students. Participants rated the characteristics on a three point scale (0 = not important, 1 = mildly important, 2 = very important). One way ANOVA and student's t-test were used to compare the groups. A total of 349 (65.23%) distributed questionnaires were returned. The highest ranked themes were teaching and facilitating learning, patient care and continuing professional development followed by communication and professionalism. Safe environment and guiding personal and professional development was indicated least important. Differences were also observed between scores obtained by males and females. Globally there are attributes which are perceived as essential for role models, while others are considered desirable. An understanding of the attributes which are essential and desirable for role models can help medical educators devise strategies which can reinforce those attributes within their institutions.

  8. Variations on a Theme: The Shift from Distinction to Commonality in Philadelphia's Diverse Provider Model 2002-2008

    Science.gov (United States)

    Bulkley, Katrina E.; Travers, Eva

    2013-01-01

    Recent years have seen a growing push toward Portfolio Management Models that incorporate a variety of "providers" operating public schools. One rationale for this is that such organizations can offer distinct and innovative educational practices. This article describes the Diverse Provider Model implemented in Philadelphia from…

  9. The Adoption of Roles by Primary Care Providers during Implementation of the New Chronic Disease Guidelines in Urban Mongolia: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Oyun Chimeddamba

    2016-04-01

    Full Text Available (1 Background: In 2011, new chronic disease guidelines were introduced across Mongolia. No formal advice was provided regarding role delineation. This study aimed to analyse the roles that different primary care providers adopted, and the variations in these, in the implementation of the guidelines in urban Mongolia; (2 Methods: Ten group interviews with nurses and ten individual interviews each with practice doctors and practice directors were conducted. Data was analysed using a thematic approach based on the identified themes relevant to role delineation; (3 Results: There was some variability and flexibility in role delineation. Factors involving teamwork, task rotation and practice flexibility facilitated well the guideline implementation. However, factors including expectations and decision making, nursing shortage, and training gaps adversely influenced in the roles and responsibilities. Some role confusion and dissatisfaction was identified, often associated with a lack of training or staff turnover; (4 Conclusions: Findings suggest that adequate ongoing training is required to maximize the range of roles particular provider types, especially primary care nurses, are competent to perform. Ensuring that role delineation is specified in guidelines could remove confusion and enhance implementation of such guidelines.

  10. If You Could Read My Mind: The Role of Healthcare Providers' Empathic and Communicative Competencies in Clients' Satisfaction with Consultations.

    Science.gov (United States)

    Schrooten, Iete; de Jong, Menno D T

    2017-01-01

    This article investigates the relationship between healthcare providers' empathic and communicative competencies and clients' overall satisfaction with consultations. Two aspects of empathy were included: empathic attitude (sensitivity to the clients' perspective) and empathic skills (ability to estimate clients' evaluations). Communicative competencies were narrowed down to the clarity of the information provided. In the context of work disability examinations, 90 healthcare providers (44% physicians, 56% vocational experts) participated. For each provider, up to 20 dyads with clients were investigated. Within every dyad, clients rated their experiences and healthcare providers estimated clients' scores. The results show that both aspects of empathy and clarity of information significantly contribute to clients' overall satisfaction and as such confirm the importance of empathy and communication in medical consultations. Specifically, healthcare providers' empathic dispositions, in addition to their overt communicative behavior, appear to contribute to clients' overall satisfaction. Of the two aspects of empathy, only empathic attitude is significantly related to the clarity of information.

  11. Women in mathematics, science, and engineering college majors: A model predicting career aspirations based on ability, self-efficacy, role model influence, and role conflict

    Science.gov (United States)

    Nauta, Margaret Mary

    1997-09-01

    This study investigated a model of predictors of career aspirations among two groups of women: students in mathematics, physical science, and engineering majors and students in biological science majors. Based on theories of women's career development and social-cognitive theories, it was hypothesized that ability, self-efficacy, positivity of role model influence, and role conflict would influence the career aspirations of these women. It was further hypothesized that the students' year in school would contribute to this model as a predictor variable. Five hundred forty-six students (representing a 71% response rate) from Iowa State University were surveyed by mail to evaluate the fit of this model. The structural equation modeling procedure revealed that the career aspirations of the two groups of women were directly predicted by self-efficacy and role conflict and indirectly predicted by year in school, academic ability, and positivity of role model influence. The model for this combined group of students represented a good overall fit, explaining 94% of the covariation among the measured variables. When the two groups of students were compared, identical models for women in the two groups revealed different relationships among the variables. In contrast to the women in math, physical science, and engineering majors, the relationships between ability and self-efficacy and between positivity of role model influence and self-efficacy were significantly lower in magnitude for women in the biological sciences group. In addition to providing a parsimonious model for conceptualizing the experiences of women in traditionally male fields, this study's findings have implications for increasing the number of women who aspire to advanced careers in these occupations. Primarily, this study suggests that interventions designed to increase the degree to which students are influenced positively by role models may increase their self-efficacy expectations and may decrease the

  12. Population modeling and its role in toxicological studies

    Science.gov (United States)

    Sauer, John R.; Pendleton, Grey W.; Hoffman, David J.; Rattner, Barnett A.; Burton, G. Allen; Cairns, John

    1995-01-01

    A model could be defined as any abstraction from reality that is used to provide some insight into the real system. In this discussion, we will use a more specific definition that a model is a set of rules or assumptions, expressed as mathematical equations, that describe how animals survive and reproduce, including the external factors that affect these characteristics. A model simplifies a system, retaining essential components while eliminating parts that are not of interest. ecology has a rich history of using models to gain insight into populations, often borrowing both model structures and analysis methods from demographers and engineers. Much of the development of the models has been a consequence of mathematicians and physicists seeing simple analogies between their models and patterns in natural systems. Consequently, one major application of ecological modeling has been to emphasize the analysis of dynamics of often complex models to provide insight into theoretical aspects of ecology.1

  13. Cytotoxicity Profile of Endodontic Sealers Provided by 3D Cell Culture Experimental Model.

    Science.gov (United States)

    Silva, Emmanuel João Nogueira Leal; Carvalho, Nancy Kudsi de; Ronconi, Carina Taboada; De-Deus, Gustavo; Zuolo, Mario Luis; Zaia, Alexandre Augusto

    2016-01-01

    The aim of the present study was to evaluate the cytotoxic effects of five endodontic sealers (AH Plus, Endomethasone N, EndoSequence BC, MTA Fillapex and Pulp Canal Sealer EWT) using a three-dimensional (3D) cell culture model. A conventional bi-dimensional (2D) cell culture model was used as reference technique for comparison. Balb/c 3T3 fibroblasts were cultured in conventional bi-dimensional cell culture and in rat-tail collagen type I three-dimensional cell culture models. Then, both cell cultures were incubated with elutes of freshly mixed endodontic sealers for 24 h. Cell viability was measured by the methyl-thiazol-diphenyltetrazolium assay (MTT). Data were statistically analyzed using ANOVA and the Tukey test at a significance level of pculture model- and sealer-dependent. Sealers showed higher cytotoxicity in 2D than in 3D cell culture model (pculture model (p>0.05). Endomethasone N and Pulp Canal Sealer EWT showed lower cytotoxic effects than AH Plus in 2D cell culture model (p3D cell culture model. It may be concluded that cytotoxicity was higher in 2D cell culture compared to 3D cell culture. EndoSequence BC sealer exhibited the highest cytocompatibility and MTA Fillapex the lowest cytocompatibility.

  14. Does Parallel Distributed Processing Provide a Plausible Framework for Modeling Early Reading Acquisition?

    Science.gov (United States)

    McEneaney, John E.

    A study compared a parallel distributed processing (PDP) model with a more traditional symbolic information processing model that accounts for early reading acquisition by human subjects. Two experimental paradigms were simulated. In one paradigm (a "savings" paradigm) subjects were divided into two groups and trained with two sets of…

  15. "I Didn't Even Know You Cared About That Stuff": Youths' Perceptions of Health Care Provider Roles in Addressing Bullying.

    Science.gov (United States)

    Vessey, Judith A; DiFazio, Rachel L; Strout, Tania D

    Youth bullying is a critical public health problem, with those exposed to bullying at risk for development of serious sequelae lasting into adulthood. The purpose of this study was to explore youths' perceptions regarding the role that advanced practice nurses and physicians play in addressing bullying. A qualitative descriptive approach was used; focus groups were used to generate study data. Twenty-four adolescents participated in focus groups centered on exploring health care providers' roles in addressing bullying. Three themes emerged through qualitative analysis: (a) Not sure that's part of their job, (b) That's way too personal, and (c) They couldn't help anyway. Participants described a very limited role for health care providers in addressing bullying. Youths recognized a narrow role for health care providers in addressing bullying, characterizing bullying as a school- or-community-related issue rather than one influencing health. Copyright © 2017 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  16. Ski patrollers: Reluctant role models for helmet use

    Science.gov (United States)

    Evans, Bruce; Gervais, Jack T.; Heard, Kennon; Valley, Morgan; Lowenstein, Steven R.

    2009-01-01

    Objective Ski helmets reduce the risk of traumatic brain injury (TBI), but usage rates are low. Ski patrollers could serve as role models for helmet use, but little is known about their practices and beliefs. Design A written survey was distributed to ski patrollers attending continuing education conferences. Questions addressed helmet use rates; prior TBI experiences; perceptions of helmet risks and benefits; and willingness to serve as safety role models for the public. To assess predictors of helmet use, odds ratios were calculated, after adjusting for skiing experience. Subjects Ninety-three ski patrollers participated. Main Outcome Self-reported helmet use of 100% while patrolling. Results Helmet use was 23% (95% CI 15–32%). Common reasons for non-use included impaired hearing (35%) and discomfort (29%). Most patrollers believed helmets prevent injuries (90%; 95% CI 84–96%) and that they are safety role models (92%; 95% CI 86–98%). However, many believed helmets encourage recklessness (39%; 95% CI 29–49%) and increase injury risks (16%; 95% CI 7–25%). Three factors predicted 100% helmet use: perceived protection from exposure (OR = 9.68; 95% CI 3.14–29.82) or cold (OR = 5.68; 95% CI 1.27–25.42); and belief that role modeling is an advantage of helmets (OR = 4.06; 95% CI 1.29–12.83). Patrollers who believed helmets encourage recklessness were 8 times less likely to wear helmets (OR = 0.13; 95% CI 0.03–0.58). Conclusions Ski patrollers know helmets reduce serious injury and believe they are role models for the public, but most do not wear helmets regularly. To increase helmet use, manufacturers should address hearing- and comfort-related factors. Education programs should address the belief that helmets encourage recklessness and stress role modeling as a professional responsibility. PMID:19225971

  17. The role of health care providers and significant others in evaluating the quality of life of patients with chronic disease

    NARCIS (Netherlands)

    Sneeuw, Kommer C. A.; Sprangers, Mirjam A. G.; Aaronson, Neil K.

    2002-01-01

    Health-related quality of life (HRQL) studies sometimes rely, in part, on proxy information obtained from patients' significant others (spouse or close companion) or health care providers. This review: (1) provides a quantitative analysis of the results that have been reported in recent studies

  18. Attributes Enhanced Role-Based Access Control Model

    DEFF Research Database (Denmark)

    Mahmood Rajpoot, Qasim; Jensen, Christian D.; Krishnan, Ram

    2015-01-01

    Attribute-based access control (ABAC) and role-based access control (RBAC) are currently the two most popular access control models. Yet, they both have known limitations and offer features com- plimentary to each other. Due to this fact, integration of RBAC and ABAC has recently emerged as an im......Attribute-based access control (ABAC) and role-based access control (RBAC) are currently the two most popular access control models. Yet, they both have known limitations and offer features com- plimentary to each other. Due to this fact, integration of RBAC and ABAC has recently emerged...

  19. Evaluation of the role of access providers. Discussion of Dutch Pirate Bay case law and introducing principles on directness, effectiveness, costs, relevance, and time

    NARCIS (Netherlands)

    Lodder, A.R.; van der Meulen, N.S.

    2013-01-01

    Internet service providers (ISPs) play a pivotal role in contemporary society because they provide access to the Internet. The primary task of ISPs – to blindly transfer information across the network – has recently come under pressure, as has their status as neutral third parties. Both the public

  20. The Roles of Individual and Organizational Factors in Burnout among Community-Based Mental Health Service Providers

    Science.gov (United States)

    Green, Amy E.; Albanese, Brian J.; Shapiro, Nicole M.; Aarons, Gregory A.

    2014-01-01

    Public sector mental health care providers are at high risk for burnout which negatively affects not only provider well-being but also the quality of services for clients and the functioning of organizations. This study examines the influence of demographics, work characteristic, and organizational variables on levels of burnout among child and adolescent mental health service providers operating within a public sector mental health service system. Additionally, given the dearth of research examining differences in burnout levels among mental health sub-disciplines (e.g., social work, psychology, marital and family therapy) and mental health programs (e.g., outpatient, day treatment, Wraparound, case management), analyses were conducted to compare levels of burnout among multiple mental health disciplines and program types. Surveys were completed by 285 providers across 49 mental health programs in a large urban public mental health system. Variables representing dimensions of organizational climate and transformational leadership accounted for the greatest amount of variance in provider reported burnout. Analyses demonstrated significantly lower levels of depersonalization among Wraparound providers compared to traditional case managers. Age was the only demographic variable related to burnout. Additionally, no significant effects were found for provider discipline or for agency tenure and caseload size. Results suggest the need to consider organizational development strategies aimed at creating more functional and less stressful climates and increasing levels of transformational leadership behaviors in order to reduce levels of burnout among clinicians working in public mental health settings for youth and families. PMID:24564442

  1. Adolescents of the U.S. National Longitudinal Lesbian Family Study: male role models, gender role traits, and psychological adjustment

    NARCIS (Netherlands)

    Bos, H.; Goldberg, N.; van Gelderen, L.; Gartrell, N.

    2012-01-01

    This article focuses on the influence of male role models on the lives of adolescents (N = 78) in the U.S. National Longitudinal Lesbian Family Study. Half of the adolescents had male role models; those with and those without male role models had similar scores on the feminine and masculine scales

  2. Pilot Survey of Physician Assistants Regarding Lesbian, Gay, Bisexual, and Transgender Providers Suggests Role for Workplace Nondiscrimination Policies.

    Science.gov (United States)

    Ewton, Tiffany A; Lingas, Elena O

    2015-12-01

    Lesbian, gay, bisexual, and transgender (LGBT) medical providers in the United States have historically faced discrimination from their peers. To assess current workplace culture and attitudes, and to evaluate awareness of workplace and professional policies regarding LGBT discrimination, we sent a cross-sectional survey to 163 PAs (Physician Assistants). Respondents had an overall positive attitude towards LGBT providers, yet the majority was not aware of relevant policy statements (>60%). A significant association existed between policy awareness and LGBT inclusivity (PLGBT providers, non-discriminatory work environments for LGBT physician assistants may relate to greater awareness of specific workplace policy standards.

  3. Parameter Sensitivity Analysis of Stochastic Models Provides Insights into Cardiac Calcium Sparks

    OpenAIRE

    Lee, Young-Seon; Liu, Ona Z.; Hwang, Hyun Seok; Knollmann, Bjorn C.; Sobie, Eric A.

    2013-01-01

    We present a parameter sensitivity analysis method that is appropriate for stochastic models, and we demonstrate how this analysis generates experimentally testable predictions about the factors that influence local Ca2+ release in heart cells. The method involves randomly varying all parameters, running a single simulation with each set of parameters, running simulations with hundreds of model variants, then statistically relating the parameters to the simulation results using regression met...

  4. An integrated decision making model for the selection of sustainable forward and reverse logistic providers

    DEFF Research Database (Denmark)

    Govindan, Kannan; Agarwal, Vernika; Darbari, Jyoti Dhingra

    2017-01-01

    strategies and taking a formalized approach towards a sustainable partnership with logistics providers. To begin with, it is imperative to associate with sustainable forward and reverse logistics providers to manage effectively the upward and downstream flows simultaneously. In this context, this paper...... proposes an integrated SC network for the evaluation and selection of forward distribution partners (FDP) and third party reverse logistic providers (3PRLP) from a sustainable perspective of an Indian electronic ME. The sustainable evaluation of the logistic partners is performed using fuzzy analytic...... forward and reverse logistics providers. The novelty of the study is its ranking of the FDPs and 3PRLPs on the economic, environmental, and social dimensions of sustainability and the simultaneous integration of logistics outsourcing decisions for the forward and reverse flow of products. Goal programming...

  5. Supportive accountability: a model for providing human support to enhance adherence to eHealth interventions.

    Science.gov (United States)

    Mohr, David C; Cuijpers, Pim; Lehman, Kenneth

    2011-03-10

    The effectiveness of and adherence to eHealth interventions is enhanced by human support. However, human support has largely not been manualized and has usually not been guided by clear models. The objective of this paper is to develop a clear theoretical model, based on relevant empirical literature, that can guide research into human support components of eHealth interventions. A review of the literature revealed little relevant information from clinical sciences. Applicable literature was drawn primarily from organizational psychology, motivation theory, and computer-mediated communication (CMC) research. We have developed a model, referred to as "Supportive Accountability." We argue that human support increases adherence through accountability to a coach who is seen as trustworthy, benevolent, and having expertise. Accountability should involve clear, process-oriented expectations that the patient is involved in determining. Reciprocity in the relationship, through which the patient derives clear benefits, should be explicit. The effect of accountability may be moderated by patient motivation. The more intrinsically motivated patients are, the less support they likely require. The process of support is also mediated by the communications medium (eg, telephone, instant messaging, email). Different communications media each have their own potential benefits and disadvantages. We discuss the specific components of accountability, motivation, and CMC medium in detail. The proposed model is a first step toward understanding how human support enhances adherence to eHealth interventions. Each component of the proposed model is a testable hypothesis. As we develop viable human support models, these should be manualized to facilitate dissemination.

  6. Building new roles and relationships in research: a model of patient engagement research.

    Science.gov (United States)

    Marlett, Nancy; Shklarov, Svetlana; Marshall, Deborah; Santana, Maria Jose; Wasylak, Tracy

    2015-05-01

    Patient engagement is influenced by institutional ideologies, professional attitudes and patient readiness to accept new, engaged roles. This article provides an opportunity to consider a new role for patients who are trained to conduct patient experience research using qualitative methods. The emergence of the role of patient engagement researcher was studied using a grounded theory with 21 patients over one-year internship and 125 research participants. Data were collected using tape recordings, field notes and student assignments. These were analyzed using open and selective coding, memoing, categorizing themes. Patients' education level (from high school to PhD), cultural background (immigrant experience, seniors), employment (employed full or part time, receiving disability benefits or retired), age (late 30 s-75) and gender (17 women and four men) were diverse. Main categories (emancipating patient experience; qualifying for research; leading sitting down; working data together; seeding change) are organized by the dialectic of co-creation as the roles of patient and researcher merge. A theoretical model is proposed. The theoretical model provides a glimpse into the process of merging two distinct roles of patient and researcher and in the process unleashes a force for change. The emergence of a dialectic from polar opposite roles is difficult to locate in health or other institutions where power differentials exist but there are indications that this new role might become a template for other merged roles in patient-led medical teams.

  7. Application service provider (ASP) financial models for off-site PACS archiving

    Science.gov (United States)

    Ratib, Osman M.; Liu, Brent J.; McCoy, J. Michael; Enzmann, Dieter R.

    2003-05-01

    For the replacement of its legacy Picture Archiving and Communication Systems (approx. annual workload of 300,000 procedures), UCLA Medical Center has evaluated and adopted an off-site data-warehousing solution based on an ASP financial with a one-time single payment per study archived. Different financial models for long-term data archive services were compared to the traditional capital/operational costs of on-site digital archives. Total cost of ownership (TCO), including direct and indirect expenses and savings, were compared for each model. Financial parameters were considered: logistic/operational advantages and disadvantages of ASP models versus traditional archiving systems. Our initial analysis demonstrated that the traditional linear ASP business model for data storage was unsuitable for large institutions. The overall cost markedly exceeds the TCO of an in-house archive infrastructure (when support and maintenance costs are included.) We demonstrated, however, that non-linear ASP pricing models can be cost-effective alternatives for large-scale data storage, particularly if they are based on a scalable off-site data-warehousing service and the prices are adapted to the specific size of a given institution. The added value of ASP is that it does not require iterative data migrations from legacy media to new storage media at regular intervals.

  8. The roles of individual and organizational factors in burnout among community-based mental health service providers.

    Science.gov (United States)

    Green, Amy E; Albanese, Brian J; Shapiro, Nicole M; Aarons, Gregory A

    2014-02-01

    Public-sector mental health care providers are at high risk for burnout, which negatively affects not only provider well-being but also the quality of services for clients and the functioning of organizations. This study examines the influence of demographics, work characteristic, and organizational variables on levels of burnout among child and adolescent mental health service providers operating within a public-sector mental health service system. Additionally, given the dearth of research examining differences in burnout levels among mental health subdisciplines (e.g., social work, psychology, marital and family therapy) and mental health programs (e.g., outpatient, day treatment, wraparound, case management), analyses were conducted to compare levels of burnout among multiple mental health disciplines and program types. Surveys were completed by 285 providers across 49 mental health programs in a large urban public mental health system. Variables representing dimensions of organizational climate and transformational leadership accounted for the greatest amount of variance in provider reported burnout. Analyses demonstrated significantly lower levels of depersonalization among wraparound providers compared to traditional case managers. Age was the only demographic variable related to burnout. Additionally, no significant effects were found for provider discipline or for agency tenure and caseload size. Results suggest the need to consider organizational development strategies aimed at creating more functional and less stressful climates and increasing levels of transformational leadership behaviors in order to reduce levels of burnout among clinicians working in public mental health settings for youth and families. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  9. A conceptual model: Redesigning how we provide palliative care for patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Philip, Jennifer; Crawford, Gregory; Brand, Caroline; Gold, Michelle; Miller, Belinda; Hudson, Peter; Smallwood, Natasha; Lau, Rosalind; Sundararajan, Vijaya

    2017-05-31

    Despite significant needs, patients with chronic obstructive pulmonary disease (COPD) make limited use of palliative care, in part because the current models of palliative care do not address their key concerns. Our aim was to develop a tailored model of palliative care for patients with COPD and their family caregivers. Based on information gathered within a program of studies (qualitative research exploring experiences, a cohort study examining service use), an expert advisory committee evaluated and integrated data, developed responses, formulated principles to inform care, and made recommendations for practice. The informing studies were conducted in two Australian states: Victoria and South Australia. A series of principles underpinning the model were developed, including that it must be: (1) focused on patient and caregiver; (2) equitable, enabling access to components of palliative care for a group with significant needs; (3) accessible; and (4) less resource-intensive than expansion of usual palliative care service delivery. The recommended conceptual model was to have the following features: (a) entry to palliative care occurs routinely triggered by clinical transitions in care; (b) care is embedded in routine ambulatory respiratory care, ensuring that it is regarded as "usual" care by patients and clinicians alike; (c) the tasks include screening for physical and psychological symptoms, social and community support, provision of information, and discussions around goals and preferences for care; and (d) transition to usual palliative care services is facilitated as the patient nears death. Our proposed innovative and conceptual model for provision of palliative care requires future formal testing using rigorous mixed-methods approaches to determine if theoretical propositions translate into effectiveness, feasibility, and benefits (including economic benefits). There is reason to consider adaptation of the model for the palliative care of patients with

  10. The anti-human trafficking collaboration model and serving victims: Providers' perspectives on the impact and experience.

    Science.gov (United States)

    Kim, Hea-Won; Park, Taekyung; Quiring, Stephanie; Barrett, Diana

    2018-01-01

    A coalition model is often used to serve victims of human trafficking but little is known about whether the model is adequately meeting the needs of the victims. The purpose of this study was to examine anti-human trafficking collaboration model in terms of its impact and the collaborative experience, including challenges and lessons learned from the service providers' perspective. Mixed methods study was conducted to evaluate the impact of a citywide anti-trafficking coalition model from the providers' perspectives. Web-based survey was administered with service providers (n = 32) and focus groups were conducted with Core Group members (n = 10). Providers reported the coalition model has made important impacts in the community by increasing coordination among the key agencies, law enforcement, and service providers and improving quality of service provision. Providers identified the improved and expanded partnerships among coalition members as the key contributing factor to the success of the coalition model. Several key strategies were suggested to improve the coalition model: improved referral tracking, key partner and protocol development, and information sharing.

  11. Multidimensional Model of Disability and Role Functioning in Rheumatoid Arthritis.

    Science.gov (United States)

    Ormseth, Sarah R; Draper, Taylor L; Irwin, Michael R; Weisman, Michael H; Aréchiga, Adam E; Hartoonian, Narineh; Bui, Thuy; Nicassio, Perry M

    2015-12-01

    To examine a model addressing the roles of rheumatoid arthritis (RA) disease burden, mood disturbance, and disability as determinants of impairments in role functioning. In a cross-sectional design, 103 RA patients recruited from the community to participate in a clinical trial completed assessments of self-assessed disease burden (total joint pain and disease activity), mood disturbance (Center for Epidemiological Studies Depression Scale depressed mood, somatic symptoms, lack of positive affect, and interpersonal problems), disability (Health Assessment Questionnaire disability index gross and fine motor), and role functioning (Short Form 36 health survey physical and social). Structural equation modeling (SEM) was used to examine direct and indirect mechanisms linking disease burden to role functioning. SEM results indicated that the model had excellent fit: S-Bχ(2)(30) = 38.59, P = 0.135; comparative fit index = 0.977, standardized root mean residual = 0.062, and root mean square error of approximation = 0.053. Mediational analyses demonstrated that, while disease burden was associated with poor role functioning, its effects were jointly mediated by mood disturbance and disability. After the effects of mood disturbance and disability were taken into account, the effect of disease burden on role functioning was not significant. The results indicate that mood disturbance and disability may serve as important pathways through which RA disease burden affects role functioning. Future longitudinal research is suggested to replicate these findings and further explore the mediational mechanisms examined in this study. © 2015, American College of Rheumatology.

  12. Using Dynamic Classes and Role Classes to Model Object Migration

    NARCIS (Netherlands)

    Wieringa, Roelf J.; de Jonge, Wiebren; Spruit, Paul

    1995-01-01

    n this paper, we argue that object-oriented models must be able to represent three kinds of taxonomic structures: static classes, dynamic classes, and role classes, that behave differently with respect to object migration. If CAR is a static subclass of V EHICLE, then a vehicle that is not a car can

  13. The Video Role Model as an Enterprise Teaching Aid

    Science.gov (United States)

    Robertson, Martyn; Collins, Amanda

    2003-01-01

    This article examines the need to develop a more enterprising approach to learning by adopting an experiential approach. It specifically examines the use of video case studies of entrepreneurial role models within an enterprise module at Leeds Metropolitan University. The exercise enables students to act as a consultant or counsellor and apply…

  14. Effects of Role Models and Gender on Students’ Entrepreneurial Intentions

    NARCIS (Netherlands)

    Karimi, S.; Biemans, H.J.A.; Lans, T.; Chizari, M.; Mulder, M.

    2014-01-01

    Purpose – This paper aims to, drawing on the theory of planned behaviour (TPB), explore the effects of entrepreneurial role models on entrepreneurial intention (EI) and its antecedents and examines the question of whether the effects vary by gender. Design/methodology/approach – Data were collected

  15. Stop Saying No: Start Empowering Copyright Role Models

    Science.gov (United States)

    Disclafani, Carrie Bertling; Hall, Renee

    2012-01-01

    The Excelsior College Library is turning fearful faculty members into empowered copyright role models. Geared towards institutions operating without a copyright policy or department, this article outlines a three-step process for fostering faculty collaboration surrounding copyright practices: (1) Give faculty and course developers the tools and…

  16. The Importance of Men as Role Models in Literacy.

    Science.gov (United States)

    Willoughby-Herb, Sara J.; Herb, Steven L.

    1994-01-01

    Discussion of children in single-parent families focuses on contributions fathers make to children's development; proposes a model for viewing fathers' roles in literacy; and suggests programs for libraries and schools to involve fathers and compensate for fathers' absences, including a bibliography of children's literature with positive male role…

  17. Female Leaders: Injurious or Inspiring Role Models for Women?

    Science.gov (United States)

    Hoyt, Crystal L.; Simon, Stefanie

    2011-01-01

    The impact of female role models on women's leadership aspirations and self-perceptions after a leadership task were assessed across two laboratory studies. These studies tested the prediction that upward social comparisons to high-level female leaders will have a relatively detrimental impact on women's self-perceptions and leadership aspirations…

  18. Learning from a role model: A cascade or whirlpool effect?

    NARCIS (Netherlands)

    Jochemsen-van der Leeuw, H. G. A. Ria; Buwalda, Nienke; Wieringa-de Waard, Margreet; van Dijk, Nynke

    2015-01-01

    Continuing Professional Development (CPD) and Faculty Development (FD) courses have been designed in the expectation that a cascade effect will occur, consisting of a conveyance of information from the courses to clinical trainers to daily practice and/or to trainees by means of role modeling. The

  19. A social marketing model for disseminating research-based treatments to addictions treatment providers.

    Science.gov (United States)

    Martin, G W; Herie, M A; Turner, B J; Cunningham, J A

    1998-11-01

    Researchers must develop effective strategies for disseminating research-based treatments. This study evaluates the application of a dissemination model based on principles of social marketing and diffusion theory. A case study describes how the model was implemented. A qualitative design was employed to examine rates of adoption and adaptation of an early intervention program by a targeted system of addictions agencies. The interventions were developed at the Addiction Research Foundation in Toronto and disseminated to Assessment and Referral (A/R) Centres in Ontario, Canada. Study participants included the managers and a designated therapist for 33 participating A/R centres. Managers were asked mainly open-ended questions concerning whether their agency had made a formal decision to adopt the intervention and whether therapists in their agency were using the early intervention program. "Adoption" was operationalized as offering the complete four-session intervention to at least one client. At 12 months after the completion of training workshops, 68% of 34 agencies in the target system had adopted the program while 85% of the agencies were using some components of the intervention with clients. The dissemination model appeared to be effective although its application proved to be time-consuming and labour-intensive. The "market analysis", systems focus and field-test components of the model appeared to contribute to its success.

  20. Models Provide Specificity: Testing a Proposed Mechanism of Visual Working Memory Capacity Development

    Science.gov (United States)

    Simmering, Vanessa R.; Patterson, Rebecca

    2012-01-01

    Numerous studies have established that visual working memory has a limited capacity that increases during childhood. However, debate continues over the source of capacity limits and its developmental increase. Simmering (2008) adapted a computational model of spatial cognitive development, the Dynamic Field Theory, to explain not only the source…

  1. A Context-Aware Model to Provide Positioning in Disaster Relief Scenarios

    Directory of Open Access Journals (Sweden)

    Daniel Moreno

    2015-09-01

    Full Text Available The effectiveness of the work performed during disaster relief efforts is highly dependent on the coordination of activities conducted by the first responders deployed in the affected area. Such coordination, in turn, depends on an appropriate management of geo-referenced information. Therefore, enabling first responders to count on positioning capabilities during these activities is vital to increase the effectiveness of the response process. The positioning methods used in this scenario must assume a lack of infrastructure-based communication and electrical energy, which usually characterizes affected areas. Although positioning systems such as the Global Positioning System (GPS have been shown to be useful, we cannot assume that all devices deployed in the area (or most of them will have positioning capabilities by themselves. Typically, many first responders carry devices that are not capable of performing positioning on their own, but that require such a service. In order to help increase the positioning capability of first responders in disaster-affected areas, this paper presents a context-aware positioning model that allows mobile devices to estimate their position based on information gathered from their surroundings. The performance of the proposed model was evaluated using simulations, and the obtained results show that mobile devices without positioning capabilities were able to use the model to estimate their position. Moreover, the accuracy of the positioning model has been shown to be suitable for conducting most first response activities.

  2. NPSNET: JANUS-3D Providing Three-Dimensional Displays for a Traditional Combat Model

    Science.gov (United States)

    1992-09-24

    thanked for his extreme patience when pestered by our numerous phone calls concerning the UNIX version of JANUS. His advice was invaluable. A very warm...prototype for connecting DoD combat models to the DoD Defense Simulation Internet . Likewise, when "two-way" communication between the three-dimensional

  3. Application of a Health Service Growth Model to Determine the Management Requirements of Health Service Providers.

    Science.gov (United States)

    1980-09-01

    BACKGROUND AND INTRODUCTION ...... ............. 9 II. APPROACH ......... ...................... 13 Methodology ........ ................... .13 Data...1 N ~12 II. APPROACH Methodology In contemplating which methods were to be used in this study to determine whether a physician or an administrator...system, while sig- nificant, does not have as large a scope. 51 Kaiser is rated highest in provider compensation because the Permanente Medical Group ( PMG

  4. Simulation model for tracheotomy education for primary health-care providers.

    Science.gov (United States)

    Dorton, LeighAnne H; Lintzenich, Catherine Rees; Evans, Adele K

    2014-01-01

    We performed this study to evaluate the competency of health-care providers managing patients with tracheotomies, and assess the need for, and efficacy of, a multidisciplinary educational program incorporating patient simulation. The prospective observational study included 87 subjects who manage patients with tracheotomies within a tertiary-care hospital. The subjects completed self-assessment questionnaires and objective multiple-choice tests before and after attending a comprehensive educational course using patient simulation. The outcome measurements included pre-course and post-course questionnaire and test scores, as well as observational data collected during recorded patient simulation sessions. Before the education and simulation, the subjects reported an average comfort level of 3.3 on a 5-point Likert scale across 10 categories in the questionnaire, which improved to 4.4 after the training (p tracheotomy tube types, misunderstanding of speaking valve physiology, and delayed recognition and treatment of a plugged or dislodged tracheotomy tube. There is a significant need for improved tracheotomy education among primary health-care providers. Incorporating patient simulation into a comprehensive tracheotomy educational program was effective in improving provider confidence, increasing provider knowledge, and teaching the skills necessary for managing patients with a tracheotomy.

  5. Can "Ubuntu" Provide a Model for Citizenship Education in African Democracies?

    Science.gov (United States)

    Enslin, Penny; Horsthemke, Kai

    2004-01-01

    Some proponents of Africanism argue that African traditional education and the principles of "ubuntu" should provide the framework for citizenship education. While conceding that understandable concerns lie behind defences of "ubuntu" as underpinning African democracy, we argue that the Africanist perspective faces various problems and makes…

  6. Community Youth Program: A Model for Providing Field Experiences for Pre-Student Teachers.

    Science.gov (United States)

    Lydecker, Ann M.

    A Saturday morning youth program was developed by Gustavus Adolphus College (Minnesota) for the purpose of providing field expereinces for pre-student teaching elementary education majors. Children from the community attend enrichment classes in social studies and science, taught by teams of students from the college of education. One objective of…

  7. Multitype Bellman-Harris branching model provides biological predictors of early stages of adult hippocampal neurogenesis.

    Science.gov (United States)

    Li, Biao; Sierra, Amanda; Deudero, Juan Jose; Semerci, Fatih; Laitman, Andrew; Kimmel, Marek; Maletic-Savatic, Mirjana

    2017-10-03

    Adult hippocampal neurogenesis, the process of formation of new neurons, occurs throughout life in the hippocampus. New neurons have been associated with learning and memory as well as mood control, and impaired neurogenesis has been linked to depression, schizophrenia, autism and cognitive decline during aging. Thus, understanding the biological properties of adult neurogenesis has important implications for human health. Computational models of neurogenesis have attempted to derive biologically relevant knowledge, hard to achieve using experimentation. However, the majority of the computational studies have predominantly focused on the late stages of neurogenesis, when newborn neurons integrate into hippocampal circuitry. Little is known about the early stages that regulate proliferation, differentiation, and survival of neural stem cells and their immediate progeny. Here, based on the branching process theory and biological evidence, we developed a computational model that represents the early stage hippocampal neurogenic cascade and allows prediction of the overall efficiency of neurogenesis in both normal and diseased conditions. Using this stochastic model with a simulation program, we derived the equilibrium distribution of cell population and simulated the progression of the neurogenic cascade. Using BrdU pulse-and-chase experiment to label proliferating cells and their progeny in vivo, we quantified labeled newborn cells and fit the model on the experimental data. Our simulation results reveal unknown but meaningful biological parameters, among which the most critical ones are apoptotic rates at different stages of the neurogenic cascade: apoptotic rates reach maximum at the stage of neuroblasts; the probability of neuroprogenitor cell renewal is low; the neuroblast stage has the highest temporal variance within the cell types of the neurogenic cascade, while the apoptotic stage is short. At a practical level, the stochastic model and simulation framework

  8. Which Cognitive Processes Support Learning during Small-Group Discussion? The Role of Providing Explanations and Listening to Others

    Science.gov (United States)

    van Blankenstein, Floris M.; Dolmans, Diana H. J. M.; van der Vleuten, Cees P. M.; Schmidt, Henk G.

    2011-01-01

    Seventy students participated in an experiment to measure the effects of either providing explanations or listening during small group discussions on recall of related subject-matter studied after the discussion. They watched a video of a small group discussing a problem. In the first experimental condition, the video was stopped at various points…

  9. Providing Students with an Easystart to Higher Education: The Emerging Role of Digital Technologies to Facilitate Students' Transitions

    Science.gov (United States)

    Hamshire, Claire; Cullen, W. Rod

    2014-01-01

    The transition to higher education can be problematic for some students as they adapt to institutional procedures and degree level working at the same time as developing new social networks. To help facilitate these complex transitions institutions are increasingly turning towards digital technologies to provide both flexible access to resources…

  10. Dialogue and collaboration for Energy Efficient Facilities Management: municipal sector strategies and the role of external service providers

    DEFF Research Database (Denmark)

    Stenqvist, Christian; Nielsen, Susanne Balslev; Bengtsson, Per-Otto

    2015-01-01

    reorientations on the Swedish energy efficiency service market, e.g. municipal organisations show greater preference for in-house capacity as opposed to long-term contractual arrangements with external companies. Collaborations are sought with energy efficiency service providers that can deliver real...

  11. Role of ethical beliefs and attitudes of dental students in providing care for HIV/AIDS patients

    Directory of Open Access Journals (Sweden)

    Saad Ahmed Khan

    2017-01-01

    Conclusion: Dental students’ ethical beliefs about HIV/AIDS were not consistent with the ethical principles as stated in the code of ethics and they held negative attitudes towards PLWHAs. Ethical beliefs were found to be a determinant that may influence future attitudes of these students towards individuals with HIV/AIDS when providing care.

  12. Quantifying the role of National Forest system lands in providing surface drinking water supply for the Southern United States

    Science.gov (United States)

    Peter Caldwell; Corinne Muldoon; Chelcy Ford-Miniat; Erika Cohen; Suzanne Krieger; Ge Sun; Steven McNulty; Paul V. Bolstad

    2014-01-01

    Forests and water are inextricably linked, and people are dependent on forested lands to provide clean, reliable water supplies for drinking and to support local economies. These water supplies are at risk of degradation from a growing population, continued conversion of forests to other land uses, and climate change. Given the variety of threats to surface water, it...

  13. Using Model-Based System Engineering to Provide Artifacts for NASA Project Life-Cycle and Technical Reviews Presentation

    Science.gov (United States)

    Parrott, Edith L.; Weiland, Karen J.

    2017-01-01

    This is the presentation for the AIAA Space conference in September 2017. It highlights key information from Using Model-Based Systems Engineering to Provide Artifacts for NASA Project Life-cycle and Technical Reviews paper.

  14. The attributes of the clinical trainer as a role model: a systematic review

    NARCIS (Netherlands)

    Jochemsen-van der Leeuw, H. G. A. Ria; van Dijk, Nynke; van Etten-Jamaludin, Faridi S.; Wieringa-de Waard, Margreet

    2013-01-01

    Medical trainees (interns and residents) and their clinical trainers need to be aware of the differences between positive and negative role modeling to ensure that trainees imitate and that trainers demonstrate the professional behavior required to provide high-quality patient care. The authors

  15. A bridge role metric model for nodes in software networks.

    Directory of Open Access Journals (Sweden)

    Bo Li

    Full Text Available A bridge role metric model is put forward in this paper. Compared with previous metric models, our solution of a large-scale object-oriented software system as a complex network is inherently more realistic. To acquire nodes and links in an undirected network, a new model that presents the crucial connectivity of a module or the hub instead of only centrality as in previous metric models is presented. Two previous metric models are described for comparison. In addition, it is obvious that the fitting curve between the Bre results and degrees can well be fitted by a power law. The model represents many realistic characteristics of actual software structures, and a hydropower simulation system is taken as an example. This paper makes additional contributions to an accurate understanding of module design of software systems and is expected to be beneficial to software engineering practices.

  16. Pharmacy residents' perception of preceptors as role models.

    Science.gov (United States)

    Bochenek, Samantha H; Fugit, Ann M; Cook, Aaron M; Smith, Kelly M

    2016-06-01

    Pharmacy residents' perception of preceptors as role models was evaluated. A 55-item survey instrument was developed, pilot tested, and distributed to pharmacy residents in Kentucky. Respondents used a 5-point Likert scale to rate the importance of selected preceptor characteristics in current and ideal preceptors. The percentage of residents who viewed their preceptors as role models was the primary outcome. The secondary outcome was the lack of concordance, if any, between each characteristic, quality, and component by comparing characteristics valued by residents versus characteristics exemplified by current preceptors. A total of 69 pharmacy residents (77% response rate) responded to the survey. There was no significant difference between the proportion of residents who thought it was important for a preceptor to be a role model (67 of 69 residents [97%]) and the proportion who perceived their current preceptor as a role model (59 of 69 residents [86%]) (p = 0.271). The mean resident response showed that current preceptors exhibited clinical (p = 0.014) and teaching (p < 0.001) qualities significantly less than did ideal preceptors. The mean resident response showed no significant difference in ideal and current preceptors' personal qualities. Pharmacy preceptors in Kentucky were perceived by pharmacy residents to be role models with excellent personal qualities but needing improvement in teaching and clinical qualities. Preceptors with less than 10 years of experience were perceived to have better teaching and clinical qualities and to be more effective when compared with preceptors with more years of experience. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  17. System and Method for Providing Model-Based Alerting of Spatial Disorientation to a Pilot

    Science.gov (United States)

    Conner, Kevin J (Inventor); Mathan, Santosh (Inventor); Johnson, Steve (Inventor)

    2015-01-01

    A system and method monitor aircraft state parameters, for example, aircraft movement and flight parameters, applies those inputs to a spatial disorientation model, and makes a prediction of when pilot may become spatially disoriented. Once the system predicts a potentially disoriented pilot, the sensitivity for alerting the pilot to conditions exceeding a threshold can be increased and allow for an earlier alert to mitigate the possibility of an incorrect control input.

  18. Development and research of differential mode GNSS model for intelligent transport functioning providing

    Directory of Open Access Journals (Sweden)

    Anatoliy KULIK

    2012-01-01

    Full Text Available Description of the modeling system of differential GNSS mode for the operation ITS is considered. Differential method of navigation allows to precise determination of the coordinates and is not very complicated for technical realization. The coordinates of the consumer are calculated with high accuracy because the base station and the user are located in a short distance from each other. Determination of the origin location is on the same satellite and method of local correction is implemented.

  19. Maintenance of health care providers clinical proficiency: Transdisciplinary analysis, modeling and intervention

    Science.gov (United States)

    2015-10-13

    and those that do, we added an analytical step to classify those metrics prior to model inclusion . A dynamic measure of time (t) was constructed...60, March 30, 2015. 2. Institute of Medicine. Digital infrastructure for the Learning Health System: The foundation of continuous improvement in...Prescribing Safety in Ambulatory Elderly Patients. Journal American Geriatric Society, Vol. 55(7), 977-985. Reed, D., & Price E.G., W. D. (2005). Challenges

  20. Learned graphical models for probabilistic planning provide a new class of movement primitives.

    Science.gov (United States)

    Rückert, Elmar A; Neumann, Gerhard; Toussaint, Marc; Maass, Wolfgang

    2012-01-01

    BIOLOGICAL MOVEMENT GENERATION COMBINES THREE INTERESTING ASPECTS: its modular organization in movement primitives (MPs), its characteristics of stochastic optimality under perturbations, and its efficiency in terms of learning. A common approach to motor skill learning is to endow the primitives with dynamical systems. Here, the parameters of the primitive indirectly define the shape of a reference trajectory. We propose an alternative MP representation based on probabilistic inference in learned graphical models with new and interesting properties that complies with salient features of biological movement control. Instead of endowing the primitives with dynamical systems, we propose to endow MPs with an intrinsic probabilistic planning system, integrating the power of stochastic optimal control (SOC) methods within a MP. The parameterization of the primitive is a graphical model that represents the dynamics and intrinsic cost function such that inference in this graphical model yields the control policy. We parameterize the intrinsic cost function using task-relevant features, such as the importance of passing through certain via-points. The system dynamics as well as intrinsic cost function parameters are learned in a reinforcement learning (RL) setting. We evaluate our approach on a complex 4-link balancing task. Our experiments show that our movement representation facilitates learning significantly and leads to better generalization to new task settings without re-learning.

  1. Model of a multiverse providing the dark energy of our universe

    Science.gov (United States)

    Rebhan, E.

    2017-09-01

    It is shown that the dark energy presently observed in our universe can be regarded as the energy of a scalar field driving an inflation-like expansion of a multiverse with ours being a subuniverse among other parallel universes. A simple model of this multiverse is elaborated: Assuming closed space geometry, the origin of the multiverse can be explained by quantum tunneling from nothing; subuniverses are supposed to emerge from local fluctuations of separate inflation fields. The standard concept of tunneling from nothing is extended to the effect that in addition to an inflationary scalar field, matter is also generated, and that the tunneling leads to an (unstable) equilibrium state. The cosmological principle is assumed to pertain from the origin of the multiverse until the first subuniverses emerge. With increasing age of the multiverse, its spatial curvature decays exponentially so fast that, due to sharing the same space, the flatness problem of our universe resolves by itself. The dark energy density imprinted by the multiverse on our universe is time-dependent, but such that the ratio w = ϱ/(c2p) of its mass density and pressure (times c2) is time-independent and assumes a value - 1 + 𝜖 with arbitrary 𝜖 > 0. 𝜖 can be chosen so small, that the dark energy model of this paper can be fitted to the current observational data as well as the cosmological constant model.

  2. Using an established telehealth model to train urban primary care providers on hypertension management.

    Science.gov (United States)

    Masi, Christopher; Hamlish, Tamara; Davis, Andrew; Bordenave, Kristine; Brown, Stephen; Perea, Brenda; Aduana, Glen; Wolfe, Marcus; Bakris, George; Johnson, Daniel

    2012-01-01

    The objective of this study was to determine whether a videoconference-based telehealth network can increase hypertension management knowledge and self-assessed competency among primary care providers (PCPs) working in urban Federally Qualified Health Centers (FQHCs). We created a telehealth network among 6 urban FQHCs and our institution to support a 12-session educational program designed to teach state-of-the-art hypertension management. Each 1-hour session included a brief lecture by a university-based hypertension specialist, case presentations by PCPs, and interactive discussions among the specialist and PCPs. Twelve PCPs (9 intervention and 3 controls) were surveyed at baseline and immediately following the curriculum. The mean number of correct answers on the 26-item hypertension knowledge questionnaire increased in the intervention group (13.11 [standard deviation (SD)]=3.06) to 17.44 [SD=1.59], Phypertension management self-assessed competency scale increased in the intervention group (4.68 [SD=0.94] to 5.41 [SD=0.89], Phypertension care provided by urban FQHC providers. © 2011 Wiley Periodicals, Inc.

  3. RESEARCH OF PROBLEMS OF DESIGN OF COMPLEX TECHNICAL PROVIDING AND THE GENERALIZED MODEL OF THEIR DECISION

    Directory of Open Access Journals (Sweden)

    A. V. Skrypnikov

    2015-01-01

    Full Text Available Summary. In this work the general ideas of a method of V. I. Skurikhin taking into account the specified features develop and questions of the analysis and synthesis of a complex of technical means, with finishing them to the level suitable for use in engineering practice of design of information management systems are in more detail considered. In work the general system approach to the solution of questions of a choice of technical means of the information management system is created, the general technique of the sys tem analysis and synthesis of a complex of the technical means and its subsystems providing achievement of extreme value of criterion of efficiency of functioning of a technical complex of the information management system is developed. The main attention is paid to the applied party of system researches of complex technical providing, in particular, to definition of criteria of quality of functioning of a technical complex, development of methods of the analysis of information base of the information management system and definition of requirements to technical means, and also methods of structural synthesis of the main subsystems of complex technical providing. Thus, the purpose is research on the basis of system approach of complex technical providing the information management system and development of a number of methods of the analysis and the synthesis of complex technical providing suitable for use in engineering practice of design of systems. The well-known paradox of development of management information consists of that parameters of the system, and consequently, and requirements to the complex hardware, can not be strictly reasonable to development of algorithms and programs, and vice versa. The possible method of overcoming of these difficulties is prognostication of structure and parameters of complex hardware for certain management informations on the early stages of development, with subsequent clarification and

  4. Does computation provide a model for creativity? An epistemological perspective in neuroscience.

    Science.gov (United States)

    Sandri, G

    2004-01-01

    In 1939 Alan Turing, a major scholar in the field of mechanical computation, described a system whose computational power was beyond that of a discrete, finite state machine (Turing Machine). The composition of this system was likely the first example of what is now called an hybrid computational system. Since then, development of neural networks and brain automata has made aware that forms of computation might exist that are likely to go beyond Turing's limits. Natural systems, like the central nervous system in Mammals and man, are likely to use such a type of computation, especially to perform highly integrating activities, like feedback controls and mental creative processes. The latter are usually understood as processes that involve infinitary procedures, ending up in a complex information network, the computational maps, in which both digital, Turing-like computation and continuous, analog forms of calculus are expected to occur. Pictorial representation may be a fruitful example, mostly metaphorical, to analyze the use of this hybrid forms of computation by higher order computational maps, and the possible role of these types of computational processes in painting creativity is briefly analyzed in comparing 15th vs 16th century Renaissance Art. An open challenge for neuroscience in the 21st century is to clarify whether a hybrid neural learning network might represent a reasonable clue to scientifically interpret the theme of "creativity".

  5. Rabbit model provides new insights in liver regeneration after transection with portal vein ligation.

    Science.gov (United States)

    Liao, Mingheng; Zhang, Tao; Wang, Haichuan; Liu, Ying; Lu, Minxun; Huang, Jiwei; Zeng, Yong

    2017-03-01

    The rabbit model of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has not been reported before. New Zealand white rabbits were allocated to two protocols. Protocol 1 involved either liver parenchymal transection (LPT, n = 5) or portal vein ligation (PVL, n = 5). Protocol 2 involved the ligation of different portal vein branches combined with liver partition, including the LPT + 20% PVL group (n = 5; the caudate portal vein was ligated), the LPT + 50% PVL group (n = 5; the left portal vein was ligated), and the LPT + 70% PVL group (n = 10; both veins were ligated). Computed tomography liver volumetry was performed immediately after operation. Blood samples were harvested before surgery and at days 1, 3, 7, or 14 after surgery for liver function evaluation. Most rabbits were humanely euthanized on day 7. The livers were harvested, divided into lobes, and weighed; biopsies of each lobe and immunohistochemical staining were performed. In this article, we present a new rabbit model to simulate ALPPS procedure, with a description of the regional anatomical features, surgical routes, and key techniques. The growth rate of remnant right lobe volume increased with proportionally PVL combined with LPT. Specifically, right lobe volume growth rate of the LPT + 50% PVL group overwhelmed 70% PVL alone. There were putative underlying mechanisms other than portal inflow redistribution in triggering residual liver regeneration after ALPPS procedure. This rabbit model is feasible for further mechanism research of this special clinical phenomenon. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Rat tibial osteotomy model providing a range of normal to impaired healing.

    Science.gov (United States)

    Miles, Joan D; Weinhold, Paul; Brimmo, Olubusola; Dahners, Laurence

    2011-01-01

    The purpose of this study was to develop an inexpensive and easily implemented rat tibial osteotomy model capable of producing a range of healing outcomes. A saw blade was used to create a transverse osteotomy of the tibia in 89 Sprague-Dawley rats. A 0.89 mm diameter stainless steel wire was then inserted as an intramedullary nail to stabilize the fracture. To impair healing, 1, 2, or 3 mm cylindrical polyetheretherketone (PEEK) spacer beads were threaded onto the wires, between the bone ends. Fracture healing was evaluated radiographically, biomechanically, and histologically at 5 weeks. Means were compared for statistical differences by one-way ANOVA and Holm-Sidak multiple comparison testing. The mean number of "cortices bridged" for the no spacer group was 3.4 (SD ± 0.8), which was significantly greater than in the 1 mm (2.3 ± 1.4), 2 mm (0.8 ± 0.7), and 3 mm (0.3 ± 0.4) groups (p < 0.003). Biomechanical results correlated with radiographic findings, with an ultimate torque of 172 ± 53, 137 ± 41, 90 ± 38, and 24 ± 23 N/mm with a 0, 1, 2, or 3 mm defect, respectively. In conclusion, we have demonstrated that this inexpensive, technically straightforward model can be used to create a range of outcomes from normal healing to impaired healing, to nonunions. This model may be useful for testing new therapeutic strategies to promote fracture healing, materials thought to be able to heal critical-sized defects, or evaluating agents suspected of impairing healing. Copyright © 2010 Orthopaedic Research Society.

  7. User modeling and adaptation for daily routines providing assistance to people with special needs

    CERN Document Server

    Martín, Estefanía; Carro, Rosa M

    2013-01-01

    User Modeling and Adaptation for Daily Routines is motivated by the need to bring attention to how people with special needs can benefit from adaptive methods and techniques in their everyday lives. Assistive technologies, adaptive systems and context-aware applications are three well-established research fields. There is, in fact, a vast amount of literature that covers HCI-related issues in each area separately. However, the contributions in the intersection of these areas have been less visible, despite the fact that such synergies may have a great impact on improving daily living.Presentin

  8. JSBML 1.0: providing a smorgasbord of options to encode systems biology models

    DEFF Research Database (Denmark)

    Rodriguez, Nicolas; Thomas, Alex; Watanabe, Leandro

    2015-01-01

    JSBML, the official pure Java programming library for the Systems Biology Markup Language (SBML) format, has evolved with the advent of different modeling formalisms in systems biology and their ability to be exchanged and represented via extensions of SBML. JSBML has matured into a major, active...... open-source project with contributions from a growing, international team of developers who not only maintain compatibility with SBML, but also drive steady improvements to the Java interface and promote ease-of-use with end users. Source code, binaries and documentation for JSBML can be freely...

  9. The preferred provider organization development process: models for applying a systematic approach.

    Science.gov (United States)

    Jackovitz, D S

    1984-10-01

    To date, the preferred provider organization (PPO) concept has received considerable attention. Current literature, however, has focused on conceptual explanations and case studies of this new alternative delivery system as opposed to the process involved in developing operational PPOs. This paper focuses on the application of analytical techniques to strengthen PPO development activities. These techniques range from network analysis for planning PPO development to system flowcharts that depict new PPO operations. Since PPOs are used as the application base for the above tools, a brief description of PPOs will be addressed prior to explaining the techniques.

  10. The Role of Board Certification as a Cue to Competence of Eye Care Providers: An Empirical Analysis

    Directory of Open Access Journals (Sweden)

    Thomas J. Maronick

    2016-02-01

    Full Text Available Authors have long known of the need for “cues” to assess the competence and training of providers of credence services.  In the case of health care providers such as eye care professionals, one such cue is whether the eye care professional is “board certified.” This study of 500 consumers who had had an eye exam either from an optometrist or an ophthalmologist examines four questions: what factors are important to a consumer seeking an eye-care provider, what is communicated by an eye-care provider’s claim of being board certified, whether there are differences in perception between board certification as applied to an optometrist and an ophthalmologist, and whether there are differences in the perceptions of optometrists who are board certified compared to those who are not board certified. The results show that board certification is an important cue for consumers in assessing the competence and expertise of optometrists and that board certification can be used to distinguish between an optometrist and an ophthalmologist. The results also show that optometrists who are board certified as seen as better trained and more competent than optometrists who are not board certified. The results also raise questions about at the effectiveness of board certification as a cue for competence and expertise since most consumers believe optometrists are board certified when, in fact, board certification is voluntary and a very small percentage of optometrists licensed to practice in any state are actually board certified by either of the major certifying optometric organizations. Policy implications are also discussed, including the need for uniform standards for certification at the Federal and State level and the need for rigorous certification practices by third-party certifying organizations, including additional coursework and periodic assessment of optometrists’ performance to accurately reflect the enhanced quality and competence

  11. Metabolomic perfusate analysis during kidney machine perfusion: the pig provides an appropriate model for human studies.

    Directory of Open Access Journals (Sweden)

    Jay Nath

    Full Text Available Hypothermic machine perfusion offers great promise in kidney transplantation and experimental studies are needed to establish the optimal conditions for this to occur. Pig kidneys are considered to be a good model for this purpose and share many properties with human organs. However it is not established whether the metabolism of pig kidneys in such hypothermic hypoxic conditions is comparable to human organs.Standard criteria human (n = 12 and porcine (n = 10 kidneys underwent HMP using the LifePort Kidney Transporter 1.0 (Organ Recovery Systems using KPS-1 solution. Perfusate was sampled at 45 minutes and 4 hours of perfusion and metabolomic analysis performed using 1-D 1H-NMR spectroscopy.There was no inter-species difference in the number of metabolites identified. Of the 30 metabolites analysed, 16 (53.3% were present in comparable concentrations in the pig and human kidney perfusates. The rate of change of concentration for 3-Hydroxybutyrate was greater for human kidneys (p<0.001. For the other 29 metabolites (96.7%, there was no difference in the rate of change of concentration between pig and human samples.Whilst there are some differences between pig and human kidneys during HMP they appear to be metabolically similar and the pig seems to be a valid model for human studies.

  12. Can an energy balance model provide additional constraints on how to close the energy imbalance?

    Science.gov (United States)

    Wohlfahrt, Georg; Widmoser, Peter

    2013-01-01

    Elucidating the causes for the energy imbalance, i.e. the phenomenon that eddy covariance latent and sensible heat fluxes fall short of available energy, is an outstanding problem in micrometeorology. This paper tests the hypothesis that the full energy balance, through incorporation of additional independent measurements which determine the driving forces of and resistances to energy transfer, provides further insights into the causes of the energy imbalance and additional constraints on energy balance closure options. Eddy covariance and auxiliary data from three different biomes were used to test five contrasting closure scenarios. The main result of our study is that except for nighttime, when fluxes were low and noisy, the full energy balance generally did not contain enough information to allow further insights into the causes of the imbalance and to constrain energy balance closure options. Up to four out of the five tested closure scenarios performed similarly and in up to 53% of all cases all of the tested closure scenarios resulted in plausible energy balance values. Our approach may though provide a sensible consistency check for eddy covariance energy flux measurements. PMID:24465072

  13. Penerapan Model Multidimensional Scaling dalam Pemetaan Brand Positioning Internet Service Provider

    Directory of Open Access Journals (Sweden)

    Robertus Tang Herman

    2010-03-01

    Full Text Available In this high-tech era, there have been tremendous advances in tech-based products and services. Internet is one of them that have widened the world’s eyes to a new borderless marketplace. High competition among internet service providers has pushed companies to create competitive advantage and brilliant marketing strategies. They undertake positioning mapping to describe product or service’s positioning amongst many competitors. The right positioning strategy becomes a powerful weapon to win in the battle. This research is designed to create positioning mapping based on perceptual mapping. The researcher uses Multidimensional Scaling and image mapping to achieve this research goal. Sampling is using non-probability sampling in Jakarta. Based on non-attribute approach, the research findings show that there is similarity between two different brands. Thus, both brands are competing against one another. On the other hand, CBN and Netzap provider reflect some differences to others. And some brands require some improvements in terms of network reliability.

  14. Effectiveness of different models of DOTS providers under RNTCP in Ahmedabad City, Gujarat

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    Bhagyalaxmi A

    2010-01-01

    Full Text Available Background: The most effective DOTS provider will be the one who is accessible, acceptable to the patient, and accountable to the health system. Objectives: The objective was to assess the effectiveness of the different types of DOTS providers functioning under Revised National Tuberculosis Control Programme (RNTCP. Materials and Methods: A total of 200 patients, treated under RNTCP during September to December 2004, were selected for the study. Results: A total of 105 and 95 patients were under the supervision of tuberculosis health visitors (TBHVs and non-TBHVs, respectively. During the intensive phase, around 95% of the patients took the medicine under the direct observation in both the groups. Supervision of the first dose of treatment in a week during the continuation phase was significantly better with the TBHV (94.74% as compared to the non-TBHV (79.31%. However, there was no significant difference in the cure and the completed rate which was 76.19% with the TBHV and 86.13% with the non-TBHV. Conclusion: The available community workforce could be involved in supervising the intermittent short course chemotherapy.

  15. Separating the Roles of Chairman and CEO: A Model of Leadership and Authority

    OpenAIRE

    Illoong Kwon

    2008-01-01

    This paper provides a simple model of authority and leadership to discuss the issue of splitting the roles of CEO and Chairman. The board has the formal authority, but can delegate the leadership to the CEO by providing the title of chairman to the CEO. The paper shows that the optimal leadership structure differs depending on the board's independence. However, once we endogenize the board's indepence and the CEO's type, there exists a unique equilibrium where the board chooses the maximum in...

  16. Food Safety Management in a Global Environment: The Role of Risk Assessment Models

    OpenAIRE

    Fuentes-Pila, Joaquin; Jimeno, Vicente; Manzano, Amparo; Rodriguez Monroy, Carlos; Mar Fernandez, Maria Del

    2006-01-01

    Quantitative risk assessment models are playing a minor role in the development of the new EU legal framework for food safety. There is a tendency of the EU institutions to apply the precautionary principle versus the predisposition of the USA institutions to rely on risk analysis. This paper provides a comparison of the role played by quantitative risk assessment models in the development of new policies on food safety in the EU and in the USA, focusing on a study case: the supply chain of s...

  17. Modeling mixed culture fermentations; the role of different electron carriers.

    Science.gov (United States)

    Kleerebezem, R; Rodríguez, J; Temudo, M F; van Loosdrecht, M C M

    2008-01-01

    A recently established mixed culture fermentation (MCF) model has been modified to account for the role of different electron carriers in the process. The MCF-model predicts the product spectrum as a function of the actual environmental conditions using a thermodynamic optimization criterion while satisfying a number of constraints. Other improvements made to the original model are the inclusion of formate as fermentation end-product, and gas-liquid mass transfer. The model is adequately capable of reproducing experimental results in terms of butyrate and formate versus hydrogen/carbon dioxide production. The model is not capable of predicting the production of an ethanol/acetate mixture as measured at higher pH-values, suggesting specific biochemical control. Catabolic acetate production can potentially be explained by anabolic requirements for a specific electron donor like NADH.

  18. A dual role of the transcriptional regulator TstR provides insights into cyanide detoxification in Lactobacillus brevis

    Science.gov (United States)

    Pagliai, Fernando A.; Murdoch, Caitlin C.; Brown, Sara M.; Gonzalez, Claudio F.; Lorca, Graciela L.

    2014-01-01

    Summary In this study we uncover two genes in Lactobacillus brevis ATCC367, tstT and tstR, encoding for a rhodanese and a transcriptional regulator involved in cyanide detoxification. TstT (LVIS_0852) belongs to a new class of thiosulfate:cyanide sulfurtransferases. We found that TstR (LVIS_0853) modulates both the expression and the activity of the downstream-encoded tstT. The TstR binding site was identified at −1 to +33, from tstR transcriptional start site. EMSA revealed that sulfite, a product of the reaction catalyzed by TstT, improved the interaction between TstR:PtstR, while Fe(III) disrupted this interaction. Site-directed mutagenesis in TstR identified M64 as a key residue in sulfite recognition, while residues H136-H139-C167-M171 formed a pocket for ferric iron coordination. In addition to its role as a transcriptional repressor, TstR is also involved in regulating the thiosulfate:cyanide sulfurtransferase activity of TstT. A 3-fold increase in TstT activity was observed in the presence of TstR, which was enhanced by the addition of Fe(III). Overexpression of the tstRT operon was found to increase the cyanide tolerance of L. brevis and Escherichia coli. The protein-protein interaction between TstR and TstT described herein represents a novel mechanism for regulation of enzymatic activity by a transcriptional regulator. PMID:24684290

  19. A dual role of the transcriptional regulator TstR provides insights into cyanide detoxification in Lactobacillus brevis.

    Science.gov (United States)

    Pagliai, Fernando A; Murdoch, Caitlin C; Brown, Sara M; Gonzalez, Claudio F; Lorca, Graciela L

    2014-05-01

    In this study we uncover two genes in Lactobacillus brevis ATCC 367, tstT and tstR, encoding for a rhodanese and a transcriptional regulator involved in cyanide detoxification. TstT (LVIS_0852) belongs to a new class of thiosulphate:cyanide sulphurtransferases. We found that TstR (LVIS_0853) modulates both the expression and the activity of the downstream-encoded tstT. The TstR binding site was identified at -1 to +33, from tstR transcriptional start site. EMSA revealed that sulphite, a product of the reaction catalysed by TstT, improved the interaction between TstR:P(tstR), while Fe(III) disrupted this interaction. Site-directed mutagenesis in TstR identified M64 as a key residue in sulphite recognition, while residues H136-H139-C167-M171 formed a pocket for ferric iron co-ordination. In addition to its role as a transcriptional repressor, TstR is also involved in regulating the thiosulphate:cyanide sulphurtransferase activity of TstT. A threefold increase in TstT activity was observed in the presence of TstR, which was enhanced by the addition of Fe(III). Overexpression of the tstRT operon was found to increase the cyanide tolerance of L. brevis and Escherichia coli. The protein-protein interaction between TstR and TstT described herein represents a novel mechanism for regulation of enzymatic activity by a transcriptional regulator. © 2014 John Wiley & Sons Ltd.

  20. JSBML 1.0: providing a smorgasbord of options to encode systems biology models.

    Science.gov (United States)

    Rodriguez, Nicolas; Thomas, Alex; Watanabe, Leandro; Vazirabad, Ibrahim Y; Kofia, Victor; Gómez, Harold F; Mittag, Florian; Matthes, Jakob; Rudolph, Jan; Wrzodek, Finja; Netz, Eugen; Diamantikos, Alexander; Eichner, Johannes; Keller, Roland; Wrzodek, Clemens; Fröhlich, Sebastian; Lewis, Nathan E; Myers, Chris J; Le Novère, Nicolas; Palsson, Bernhard Ø; Hucka, Michael; Dräger, Andreas

    2015-10-15

    JSBML, the official pure Java programming library for the Systems Biology Markup Language (SBML) format, has evolved with the advent of different modeling formalisms in systems biology and their ability to be exchanged and represented via extensions of SBML. JSBML has matured into a major, active open-source project with contributions from a growing, international team of developers who not only maintain compatibility with SBML, but also drive steady improvements to the Java interface and promote ease-of-use with end users. Source code, binaries and documentation for JSBML can be freely obtained under the terms of the LGPL 2.1 from the website http://sbml.org/Software/JSBML. More information about JSBML can be found in the user guide at http://sbml.org/Software/JSBML/docs/. jsbml-development@googlegroups.com or andraeger@eng.ucsd.edu Supplementary data are available at Bioinformatics online. © The Author 2015. Published by Oxford University Press.

  1. Pharmacological targeting of GSK-3 and NRF2 provides neuroprotection in a preclinical model of tauopathy

    Directory of Open Access Journals (Sweden)

    Antonio Cuadrado

    2018-04-01

    Full Text Available Tauopathies are a group of neurodegenerative disorders where TAU protein is presented as aggregates or is abnormally phosphorylated, leading to alterations of axonal transport, neuronal death and neuroinflammation. Currently, there is no treatment to slow progression of these diseases. Here, we have investigated whether dimethyl fumarate (DMF, an inducer of the transcription factor NRF2, could mitigate tauopathy in a mouse model. The signaling pathways modulated by DMF were also studied in mouse embryonic fibroblast (MEFs from wild type or KEAP1-deficient mice. The effect of DMF on neurodegeneration, astrocyte and microglial activation was examined in Nrf2+/+ and Nrf2−/− mice stereotaxically injected in the right hippocampus with an adeno-associated vector expressing human TAUP301L and treated daily with DMF (100 mg/kg, i.g during three weeks. DMF induces the NRF2 transcriptional through a mechanism that involves KEAP1 but also PI3K/AKT/GSK-3-dependent pathways. DMF modulates GSK-3β activity in mouse hippocampi. Furthermore, DMF modulates TAU phosphorylation, neuronal impairment measured by calbindin-D28K and BDNF expression, and inflammatory processes involved in astrogliosis, microgliosis and pro-inflammatory cytokines production. This study reveals neuroprotective effects of DMF beyond disruption of the KEAP1/NRF2 axis by inhibiting GSK3 in a mouse model of tauopathy. Our results support repurposing of this drug for treatment of these diseases. Keywords: DMF, Inflammation, Neurodegeneration, NRF2, Oxidative stress, TAU/ GSK-3

  2. Bridging the financial gap through providing contract services: a model for publicly funded clinical biobanks.

    Science.gov (United States)

    Kozlakidis, Zisis; Mant, Christine; Cason, John

    2012-08-01

    Biobanks offer translational researchers a novel method of obtaining clinical research materials, patient data, and relevant ethical and legal permissions. However, such tissue collections are expensive to establish and maintain. Current opinion is that such initiatives can only survive with core funding from Government or major funding bodies. Given the present climate of financial austerity, funding agencies may be tempted to invest in fast-return research projects rather than in maintaining tissue collections, whose benefits will only become apparent in much longer timescales. Thus, securing additional funding for biobanks could provide a valuable boost enabling an extension of core services. Here we suggest that using biobank expertise to offer contract services to clinicians and industry may be an alternative approach to obtaining such extra funding.

  3. The human sebocyte culture model provides new insights into development and management of seborrhoea and acne.

    Science.gov (United States)

    Zouboulis, C C; Xia, L; Akamatsu, H; Seltmann, H; Fritsch, M; Hornemann, S; Rühl, R; Chen, W; Nau, H; Orfanos, C E

    1998-01-01

    Seborrhoea and acne are exclusively human diseases and sebaceous gland differentiation is species specific. Therefore, fundamental research on human sebaceous cell function and control requires human in vitro models. The human sebocyte culture model, introduced in 1989, has been used in several studies to elucidate sebaceous gland activity and its regulation at the cellular level. Cultured human sebocytes have been shown to preserve important sebocytic characteristics, although they undergo an incomplete terminal differentiation in vitro. In vitro synthesis of free fatty acids without bacterial involvement and marked interleukin 1 alpha expression at the mRNA and protein levels with no further induction by lipopolysaccharides lead to the assumption that human sebocytes may initiate acne lesions by an intrinsic mechanism. Androgens affected sebocyte activity in vitro in a manner dependent on the localization of the sebaceous glands. In vitro stimulation of sebocyte proliferation by androgens could be completely abolished by spironolactone. Cultured sebocytes strongly expressed type 1 5 alpha-reductase and metabolized testosterone to androstenedione, 5 alpha-androstanedione, 5 alpha-dihydrotestosterone, androsterone and 5 alpha-androstanediol, whereas the levels of 5 alpha-reductase activity were probably not feedback regulated. 4,7 beta-Dimethyl-4-aza-5 alpha-cholestan-3-one, a type 1 5 alpha-reductase inhibitor, induced an early, marked down-regulation of 5 alpha-reductase activity in human sebocytes in vitro, while hydrofinasteride, a type 2 inhibitor, required 10(3)-fold higher concentrations to induce similar effects. Stimulation of sebocyte proliferation by insulin, thyroid-stimulating hormone and hydrocortisone indicates that the hormonal control of the sebaceous gland could be a complex mechanism. Retinoids inhibited sebocyte proliferation in a dose-dependent manner and down-regulated lipid synthesis and sebocyte differentiation in vitro. Isotretinoin was the

  4. Mammary Gland Involution Provides a Unique Model to Study the TGF-β Cancer Paradox

    Directory of Open Access Journals (Sweden)

    Qiuchen Guo

    2017-01-01

    Full Text Available Transforming Growth Factor-β (TGF-β signaling in cancer has been termed the “TGF-β paradox”, acting as both a tumor suppresser and promoter. The complexity of TGF-β signaling within the tumor is context dependent, and greatly impacted by cellular crosstalk between TGF-β responsive cells in the microenvironment including adjacent epithelial, endothelial, mesenchymal, and hematopoietic cells. Here we utilize normal, weaning-induced mammary gland involution as a tissue microenvironment model to study the complexity of TGF-β function. This article reviews facets of mammary gland involution that are TGF-β regulated, namely mammary epithelial cell death, immune activation, and extracellular matrix remodeling. We outline how distinct cellular responses and crosstalk between cell types during physiologically normal mammary gland involution contribute to simultaneous tumor suppressive and promotional microenvironments. We also highlight alternatives to direct TGF-β blocking anti-cancer therapies with an emphasis on eliciting concerted microenvironmental-mediated tumor suppression.

  5. Assistance dogs provide a useful behavioral model to enrich communicative skills of assistance robots.

    Science.gov (United States)

    Gácsi, Márta; Szakadát, Sára; Miklósi, Adám

    2013-01-01

    These studies are part of a project aiming to reveal relevant aspects of human-dog interactions, which could serve as a model to design successful human-robot interactions. Presently there are no successfully commercialized assistance robots, however, assistance dogs work efficiently as partners for persons with disabilities. In Study 1, we analyzed the cooperation of 32 assistance dog-owner dyads performing a carrying task. We revealed typical behavior sequences and also differences depending on the dyads' experiences and on whether the owner was a wheelchair user. In Study 2, we investigated dogs' responses to unforeseen difficulties during a retrieving task in two contexts. Dogs displayed specific communicative and displacement behaviors, and a strong commitment to execute the insoluble task. Questionnaire data from Study 3 confirmed that these behaviors could successfully attenuate owners' disappointment. Although owners anticipated the technical competence of future assistance robots to be moderate/high, they could not imagine robots as emotional companions, which negatively affected their acceptance ratings of future robotic assistants. We propose that assistance dogs' cooperative behaviors and problem solving strategies should inspire the development of the relevant functions and social behaviors of assistance robots with limited manual and verbal skills.

  6. The role of micro health insurance in providing financial risk protection in developing countries- a systematic review

    Directory of Open Access Journals (Sweden)

    Shifa Salman Habib

    2016-03-01

    Full Text Available Abstract Background Out of pocket payments are the predominant method of financing healthcare in many developing countries, which can result in impoverishment and financial catastrophe for those affected. In 2010, WHO estimated that approximately 100 million people are pushed below the poverty line each year by payments for healthcare. Micro health insurance (MHI has been used in some countries as means of risk pooling and reducing out of pocket health expenditure. A systematic review was conducted to assess the extent to which MHI has contributed to providing financial risk protection to low-income households in developing countries, and suggest how the findings can be applied in the Pakistani setting. Methods We conducted a systematic search for published literature using the search terms “Community based health insurance AND developing countries”, “Micro health insurance AND developing countries”, “Mutual health insurance AND developing countries”, “mutual OR micro OR community based health insurance” “Health insurance AND impact AND poor” “Health insurance AND financial protection” and “mutual health organizations” on three databases, Pubmed, Google Scholar and Science Direct (Elsevier. Only those records that were published in the last ten years, in English language with their full texts available free of cost, were considered for inclusion in this review. Hand searching was carried out on the reference lists of the retrieved articles and webpages of international organizations like World Bank, World Health Organization and International Labour Organization. Results Twenty-three articles were eligible for inclusion in this systematic review (14 from Asia and 9 from Africa. Our analysis shows that MHI, in the majority of cases, has been found to contribute to the financial protection of its beneficiaries, by reducing out of pocket health expenditure, catastrophic health expenditure, total health expenditure

  7. The role of micro health insurance in providing financial risk protection in developing countries--a systematic review.

    Science.gov (United States)

    Habib, Shifa Salman; Perveen, Shagufta; Khuwaja, Hussain Maqbool Ahmed

    2016-03-22

    Out of pocket payments are the predominant method of financing healthcare in many developing countries, which can result in impoverishment and financial catastrophe for those affected. In 2010, WHO estimated that approximately 100 million people are pushed below the poverty line each year by payments for healthcare. Micro health insurance (MHI) has been used in some countries as means of risk pooling and reducing out of pocket health expenditure. A systematic review was conducted to assess the extent to which MHI has contributed to providing financial risk protection to low-income households in developing countries, and suggest how the findings can be applied in the Pakistani setting. We conducted a systematic search for published literature using the search terms "Community based health insurance AND developing countries", "Micro health insurance AND developing countries", "Mutual health insurance AND developing countries", "mutual OR micro OR community based health insurance" "Health insurance AND impact AND poor" "Health insurance AND financial protection" and "mutual health organizations" on three databases, Pubmed, Google Scholar and Science Direct (Elsevier). Only those records that were published in the last ten years, in English language with their full texts available free of cost, were considered for inclusion in this review. Hand searching was carried out on the reference lists of the retrieved articles and webpages of international organizations like World Bank, World Health Organization and International Labour Organization. Twenty-three articles were eligible for inclusion in this systematic review (14 from Asia and 9 from Africa). Our analysis shows that MHI, in the majority of cases, has been found to contribute to the financial protection of its beneficiaries, by reducing out of pocket health expenditure, catastrophic health expenditure, total health expenditure, household borrowings and poverty. MHI also had a positive safeguarding effect on

  8. Directed evolution of a model primordial enzyme provides insights into the development of the genetic code.

    Directory of Open Access Journals (Sweden)

    Manuel M Müller

    Full Text Available The contemporary proteinogenic repertoire contains 20 amino acids with diverse functional groups and side chain geometries. Primordial proteins, in contrast, were presumably constructed from a subset of these building blocks. Subsequent expansion of the proteinogenic alphabet would have enhanced their capabilities, fostering the metabolic prowess and organismal fitness of early living systems. While the addition of amino acids bearing innovative functional groups directly enhances the chemical repertoire of proteomes, the inclusion of chemically redundant monomers is difficult to rationalize. Here, we studied how a simplified chorismate mutase evolves upon expanding its amino acid alphabet from nine to potentially 20 letters. Continuous evolution provided an enhanced enzyme variant that has only two point mutations, both of which extend the alphabet and jointly improve protein stability by >4 kcal/mol and catalytic activity tenfold. The same, seemingly innocuous substitutions (Ile→Thr, Leu→Val occurred in several independent evolutionary trajectories. The increase in fitness they confer indicates that building blocks with very similar side chain structures are highly beneficial for fine-tuning protein structure and function.

  9. Planarians as models of cadmium-induced neoplasia provide measurable benchmarks for mechanistic studies.

    Science.gov (United States)

    Voura, Evelyn B; Montalvo, Melissa J; Dela Roca, Kevin T; Fisher, Julia M; Defamie, Virginie; Narala, Swami R; Khokha, Rama; Mulligan, Margaret E; Evans, Colleen A

    2017-08-01

    Bioassays of planarian neoplasia highlight the potential of these organisms as useful standards to assess whether environmental toxins such as cadmium promote tumorigenesis. These studies complement other investigations into the exceptional healing and regeneration of planarians - processes that are driven by a population of active stem cells, or neoblasts, which are likely transformed during planarian tumor growth. Our goal was to determine if planarian tumorigenesis assays are amenable to mechanistic studies of cadmium carcinogenesis. To that end we demonstrate, by examining both counts of cell populations by size, and instances of mitosis, that the activity of the stem cell population can be monitored. We also provide evidence that specific biomodulators can affect the potential of planarian neoplastic growth, in that an inhibitor of metalloproteinases effectively blocked the development of the lesions. From these results, we infer that neoblast activity does respond to cadmium-induced tumor growth, and that metalloproteinases are required for the progression of cancer in the planarian. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Question No. 5: What Role Can Satellites Take, as a Complement to Ground Based Measurement Systems, to Provide Sustained Observations to Monitor GHG Emissions?

    Science.gov (United States)

    Chahine, Moustafa; Olsen, Edward

    2011-01-01

    What role can satellites take, as a complement to ground based measurement systems, to provide sustained observations to monitor GHG emissions (e.g., CO2, CH4, O3, N2O, CFC s, NH3, and NF3) that contribute to global warming?

  11. Role and value of nitrogen regulation provided by oysters (Crassostrea virginica in the Mission-Aransas Estuary, Texas, USA.

    Directory of Open Access Journals (Sweden)

    Jennifer Beseres Pollack

    Full Text Available Suspension-feeding activities of oysters impart a potentially significant benefit to estuarine ecosystems via reduction of water column nutrients, plankton and seston biomass, and primary productivity which can have a significant impact on human well-being. This study considered nitrogen regulation by eastern oysters Crassostrea virginica in the Mission-Aransas Estuary, Texas, USA, as a function of denitrification, burial, and physical transport from the system via harvest. Oyster reefs were estimated to remove 502.5 kg N km(-2 through denitrification of biodeposits and 251.3 kg N km(-2 in burial of biodeposits to sediments. Nitrogen is also physically transported out of the estuary via harvest of oysters. Commercial harvest of oysters in the Mission-Aransas Estuary can remove approximately 21,665 kg N per year via physical transport from the system. We developed a transferable method to value the service of nitrogen regulation by oysters, where the potential cost equivalent value of nitrogen regulation is quantified via cost estimates for a constructed biological nutrient removal (BNR supplement to a wastewater treatment plant. The potential annual engineered cost equivalent of the service of nitrogen regulation and removal provided by reefs in the Mission-Aransas Estuary is $293,993 yr(-1. Monetizing ecosystem services can help increase awareness at the stakeholder level of the importance of oysters beyond commercial fishery values alone.

  12. Evaluating the role of key learning theories in ECHO: a telehealth educational program for primary care providers.

    Science.gov (United States)

    Socolovsky, Carmela; Masi, Christopher; Hamlish, Tamara; Aduana, Glen; Arora, Sanjeev; Bakris, George; Johnson, Daniel

    2013-01-01

    ECHO (Extension for Community Healthcare Outcomes) is a telehealth educational program that uses videoconference technology to train community-based primary care providers (PCP's) on the management of complex, chronic diseases. The main components of ECHO are didactics, case presentations, and case-based learning. ECHO was developed using the key principles of Social Cognitive Theory, Situated Learning Theory, and Community of Practice Theory. In a prior study, we implemented an ECHO curriculum to improve management of resistant hypertension. The goals of the current study were to determine the extent to which the learning theories served as the foundation of the ECHO curriculum and identify opportunities to more effectively incorporate key principles of these theories into the ECHO program. We conducted semi-structured interviews with the nine clinicians who participated in the pilot curriculum. A community-based PCP assisted with question development, analysis, and manuscript preparation. We analyzed the interview transcripts using Directed Content Analysis. Transcript analysis supported the contention that ECHO is based upon Social Cognitive Theory, Situated Learning Theory, and Community of Practice Theory. Comments from study participants highlighted benefits of each theory's principles. Conversely, they also suggested we could improve our implementation of ECHO by adhering more closely to specific learning theory strategies. Our results indicate that ECHO indeed reflects the key tenants of Social Cognitive Theory, Situated Learning Theory, and Community of Practice Theory. Several aspects of our ECHO curriculum can be improved by more complete application of these learning theories.

  13. The Role of Molecular Modeling in TiO₂ Photocatalysis.

    Science.gov (United States)

    Cinar, Zekiye

    2017-03-30

    Molecular Modeling methods play a very important role in TiO₂ photocatalysis. Recent advances in TiO₂ photocatalysis have produced a number of interesting surface phenomena, reaction products, and various novel visible light active photocatalysts with improved properties. Quantum mechanical calculations appear promising as a means of describing the mechanisms and the product distributions of the photocatalytic degradation reactions of organic pollutants in both gas and aqueous phases. Since quantum mechanical methods utilize the principles of particle physics, their use may be extended to the design of new photocatalysts. This review introduces molecular modeling methods briefly and emphasizes the use of these methods in TiO₂ photocatalysis. The methods used for obtaining information about the degradabilities of the pollutant molecules, predicting reaction mechanisms, and evaluating the roles of the dopants and surface modifiers are explained.

  14. THE POLISH BUSINESS ENVIRONMENT FOR LANGUAGE SERVICE PROVIDERS IN VIEW OF THE PORTER’S FIVE FORCES MODEL

    OpenAIRE

    Kowalska, Monika

    2014-01-01

    After the Polish accession to the European Union in 2004, language services have considerably grown in importance. Intensive contacts with foreign companies and institutions coupled with information technology developments have increased the role of English as a linguistic medium of international cooperation. The overall aim of this paper is to examine the Polish business environment for Language Service Providers (LSPs) offering specialized English courses and translation services (EN-PL and...

  15. The Charrette Design Model Provides a Means to Promote Collaborative Design in Higher Education

    Directory of Open Access Journals (Sweden)

    Webber Steven B.

    2016-02-01

    Full Text Available Higher education is typically compartmentalized by field and expertise level leading to a lack of collaboration across disciplines and reduced interaction among students of the same discipline that possess varying levels of expertise. The divisions between disciplines and expertise levels can be perforated through the use of a concentrated, short-term design problem called a charrette. The charrette is commonly used in architecture and interior design, and applications in other disciplines are possible. The use of the charrette in an educational context provides design students the opportunity to collaborate in teams where members have varying levels of expertise and consult with experts in allied disciplines in preparation for a profession that will expect the same. In the context of a competitive charrette, this study examines the effectiveness of forming teams of design students that possess a diversity of expertise. This study also looks at the effectiveness of integrating input from professional experts in design-allied disciplines (urban planning, architecture, mechanical and electrical engineering and a design-scenario-specific discipline (medicine into the students' design process. Using a chi-square test of goodness-of-fit, it is possible to determine student preferences in terms of the team configurations as well as their preferences on the experts. In this charrette context, the students indicated that the cross-expertise student team make-up had a positive effect for both the more experienced students and the less experienced students. Overall, the students placed high value on the input from experts in design-allied fields for the charrette. They also perceived a preference of input from external experts that had an immediate and practical implication to their design process. This article will also show student work examples as additional evidence of the successful cross-expertise collaboration among the design students and evidence

  16. Building capacity in mental health interventions in low resource countries: an apprenticeship model for training local providers.

    Science.gov (United States)

    Murray, Laura K; Dorsey, Shannon; Bolton, Paul; Jordans, Mark Jd; Rahman, Atif; Bass, Judith; Verdeli, Helena

    2011-11-18

    Recent global mental health research suggests that mental health interventions can be adapted for use across cultures and in low resource environments. As evidence for the feasibility and effectiveness of certain specific interventions begins to accumulate, guidelines are needed for how to train, supervise, and ideally sustain mental health treatment delivery by local providers in low- and middle-income countries (LMIC). MODEL AND CASE PRESENTATIONS: This paper presents an apprenticeship model for lay counselor training and supervision in mental health treatments in LMIC, developed and used by the authors in a range of mental health intervention studies conducted over the last decade in various low-resource settings. We describe the elements of this approach, the underlying logic, and provide examples drawn from our experiences working in 12 countries, with over 100 lay counselors. We review the challenges experienced with this model, and propose some possible solutions. We describe and discuss how this model is consistent with, and draws on, the broader dissemination and implementation (DI) literature. In our experience, the apprenticeship model provides a useful framework for implementation of mental health interventions in LMIC. Our goal in this paper is to provide sufficient details about the apprenticeship model to guide other training efforts in mental health interventions.

  17. Changes in sexual roles and quality of life for gay men after prostate cancer: challenges for sexual health providers.

    Science.gov (United States)

    Hart, Tae L; Coon, David W; Kowalkowski, Marc A; Zhang, Karen; Hersom, Justin I; Goltz, Heather H; Wittmann, Daniela A; Latini, David M

    2014-09-01

    Gay men with prostate cancer (GMPCa) may have differential health-related quality of life (HRQOL) and sexual health outcomes than heterosexual men with prostate cancer (PCa), but existing information is based on clinical experience and small studies. Our goals were to: (i) describe HRQOL and examine changes in sexual functioning and bother; (ii) explore the psychosocial aspects of sexual health after PCa; and (iii) examine whether there were significant differences on HRQOL and sexual behavior between GMPCa and published norms. A convenience sample of GMPCa completed validated disease-specific and general measures of HRQOL, ejaculatory function and bother, fear of cancer recurrence, and satisfaction with prostate cancer care. Measures of self-efficacy for PCa management, illness intrusiveness, and disclosure of sexual orientation were also completed. Where possible, scores were compared against published norms. Main outcome measures were self-reported sexual functioning and bother on the Expanded Prostate Cancer Index. Compared with norms, GMPCa reported significantly worse functioning and more severe bother scores on urinary, bowel, hormonal symptom scales (Ps sexual functioning scores (P sexual bother scores were similar to that of published samples. GMPCa tended to be more "out" about their sexual orientation than other samples of gay men. GMPCa reported substantial changes in sexual functioning after PCa treatment. They also reported significantly worse disease-specific and general HRQOL, fear of recurrence, and were less satisfied with their medical care than other published PCa samples. Sexual health providers must have an awareness of the unique functional and HRQOL differences between gay and heterosexual men with PCa. © 2014 International Society for Sexual Medicine.

  18. The role of somatosensory models in vocal autonomous exploration

    OpenAIRE

    Acevedo Valle, Juan Manuel; Angulo Bahón, Cecilio; Moulin-Frier, Clément; Trejo Ramírez, Karla Andrea

    2016-01-01

    The present work focuses on two main objectives. Firstly, it highlights the relevance of studying the early stages of language development using machines as an approach to contribute to the future of speech recognizers and synthesizers, user interfaces, active learning techniques, and to the field of robotics and artificial intelligence in general. Secondly, this work introduces some results on the study of the role of somatosensory models in vocal autonomous exploration. In previous works, t...

  19. Role Models in Science - An Effective Dissemination Strategy

    Science.gov (United States)

    Chatzichristou, Eleni; Daglis, Ioannis A.; Anastasiadis, Anastasios; Balasis, George; Bourdarie, Sebastien; Horne, Richard B.; Khotyaintsev, Yuri; Mann, Ian R.; Santolik, Ondrej; Turner, Drew L.; Giannakis, Omiros; Ropokis, George

    2014-05-01

    successful career path to both act as role model and to show the challenges that young scientists are facing today. The work leading to this paper has received funding from the European Union's Seventh Framework Programme (FP7-SPACE-2011-1) under grant agreement no. 284520 for the MAARBLE (Monitoring, Analyzing and Assessing Radiation Belt Energization and Loss) collaborative research project. This paper reflects only the authors' views and the Union is not liable for any use that may be made of the information contained therein.

  20. Social Influences in the Voter Model: the Role of Conformity

    CERN Document Server

    Javarone, Marco Alberto

    2014-01-01

    We introduce a model to study the effects of social influences in opinion dynamics. In particular, we analyze the voter model, from a socio psychological perspective, by considering the role of conformity. Conformity is a central issue in social psychology as it represents one of people's behaviors that emerge as result of their interactions. We introduce a voter model where agents, linked in a network, change their opinion according to those of their neighbors and to their degree of conformity. In particular, agents can behave as conformists or non-conformists. In the former case, agents change opinion according to that of the majority of their social circle (i.e., the majority of their neighbors); in the latter case, they do the opposite, i.e., they assume the opposite opinion. We perform a computational study of the proposed model, with the aim to analyze the role of conformity in the voter model. Moreover, we want to investigate whether it is possible to achieve some kind of equilibrium or of order in the...

  1. Adapting to change: The role of the right hemisphere in mental model building and updating.

    Science.gov (United States)

    Filipowicz, Alex; Anderson, Britt; Danckert, James

    2016-09-01

    We recently proposed that the right hemisphere plays a crucial role in the processes underlying mental model building and updating. Here, we review the evidence we and others have garnered to support this novel account of right hemisphere function. We begin by presenting evidence from patient work that suggests a critical role for the right hemisphere in the ability to learn from the statistics in the environment (model building) and adapt to environmental change (model updating). We then provide a review of neuroimaging research that highlights a network of brain regions involved in mental model updating. Next, we outline specific roles for particular regions within the network such that the anterior insula is purported to maintain the current model of the environment, the medial prefrontal cortex determines when to explore new or alternative models, and the inferior parietal lobule represents salient and surprising information with respect to the current model. We conclude by proposing some future directions that address some of the outstanding questions in the field of mental model building and updating. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  2. Helping parents live with the hole in their heart: The role of health care providers and institutions in the bereaved parents' grief journeys.

    Science.gov (United States)

    Snaman, Jennifer M; Kaye, Erica C; Torres, Carlos; Gibson, Deborah V; Baker, Justin N

    2016-09-01

    Bereaved parents experience significant psychosocial and health sequelae, suggesting that this population may benefit from the ongoing extension of support and resources throughout the grief journey. The interaction of hospital staff with patients and families at the end of a child's life and after death profoundly affects parental grief, offering a unique opportunity for the medical community to positively impact the bereavement experience. The current study was conducted to explore the role of the health care team and medical institutions in the grief journeys of parents whose child died a cancer-related death. Eleven bereaved parents participated in 2 focus groups. Responses to each of the 3 main prompts were coded and analyzed independently using semantic content analysis techniques. Four main concepts were identified within the parental narratives, including the importance of strong and ongoing relationships between providers and bereaved families, the importance of high-quality communication, the effect of negative experiences between providers and families on parental grief, and the importance of the institution's role in the grief journeys of bereaved parents. Bereaved parents consistently identified the critical role played by medical staff and medical institutions throughout the grief journey. Key components of bereavement support identified by parents should serve to guide the actions of providers as well as provide a template for the development of a comprehensive bereavement program within an institution. Cancer 2016. © 2016 American Cancer Society. Cancer 2016;122:2757-2765. © 2016 American Cancer Society. © 2016 American Cancer Society.

  3. Racial disparities in birth care: Exploring the perceived role of African-American women providing midwifery care and birth support in the United States.

    Science.gov (United States)

    Guerra-Reyes, Lucia; Hamilton, Lydia J

    2017-02-01

    Midwifery care has been linked to positive birth outcomes. Despite the broad racial disparities in maternal and infant outcomes in the United States (US), little is known about the role of minority women in either providing or receiving this type of care. A vibrant community of minority women, who self-identify as providing these services, exists online. In this exploratory study we ask how they describe their role; view their practice; and position themselves in the broader discussions of racial health disparities in the US. Using an internet mediated qualitative design we analyse online narratives from self-described African-American nurse-midwives, lay midwives and birth assistants; we found 28 unique websites. We collected and analysed narrative material from each site. We used a thematic analysis approach to identify recurrent and emergent themes in relation to the study question. Narratives identified a strong link to the past, as providers viewed their practice in a historical perspective linking African roots, to the diaspora, and to current African-American struggles. Providers engaged both in direct clinical work, and in activist roles. Advocacy efforts sought to expand numbers of minority birth care workers and to extend the benefits of woman-centred birth care to underserved communities. Results demonstrate the continued existence and important role of diverse types of African-American birth care providers in minority communities in the US. Recognition, support, and increasing the number of midwives of colour is important in tackling racial inequalities in health. Further research should explore minority access to woman-centred care. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  4. Wanted: role models - medical students’ perceptions of professionalism

    Directory of Open Access Journals (Sweden)

    Byszewski Anna

    2012-11-01

    Full Text Available Abstract Background Transformation of medical students to become medical professionals is a core competency required for physicians in the 21st century. Role modeling was traditionally the key method of transmitting this skill. Medical schools are developing medical curricula which are explicit in ensuring students develop the professional competency and understand the values and attributes of this role. The purpose of this study was to determine student perception of professionalism at the University of Ottawa and gain insights for improvement in promotion of professionalism in undergraduate medical education. Methods Survey on student perception of professionalism in general, the curriculum and learning environment at the University of Ottawa, and the perception of student behaviors, was developed by faculty and students and sent electronically to all University of Ottawa medical students. The survey included both quantitative items including an adapted Pritzker list and qualitative responses to eight open ended questions on professionalism at the Faculty of Medicine, University of Ottawa. All analyses were performed using SAS version 9.1 (SAS Institute Inc. Cary, NC, USA. Chi-square and Fischer’s exact test (for cell count less than 5 were used to derive p-values for categorical variables by level of student learning. Results The response rate was 45.6% (255 of 559 students for all four years of the curriculum. 63% of the responses were from students in years 1 and 2 (preclerkship. Students identified role modeling as the single most important aspect of professionalism. The strongest curricular recommendations included faculty-led case scenario sessions, enhancing interprofessional interactions and the creation of special awards to staff and students to “celebrate” professionalism. Current evaluation systems were considered least effective. The importance of role modeling and information on how to report lapses and breaches was

  5. Wanted: role models--medical students' perceptions of professionalism.

    Science.gov (United States)

    Byszewski, Anna; Hendelman, Walter; McGuinty, Caroline; Moineau, Geneviève

    2012-11-15

    Transformation of medical students to become medical professionals is a core competency required for physicians in the 21st century. Role modeling was traditionally the key method of transmitting this skill. Medical schools are developing medical curricula which are explicit in ensuring students develop the professional competency and understand the values and attributes of this role. The purpose of this study was to determine student perception of professionalism at the University of Ottawa and gain insights for improvement in promotion of professionalism in undergraduate medical education. Survey on student perception of professionalism in general, the curriculum and learning environment at the University of Ottawa, and the perception of student behaviors, was developed by faculty and students and sent electronically to all University of Ottawa medical students. The survey included both quantitative items including an adapted Pritzker list and qualitative responses to eight open ended questions on professionalism at the Faculty of Medicine, University of Ottawa. All analyses were performed using SAS version 9.1 (SAS Institute Inc. Cary, NC, USA). Chi-square and Fischer's exact test (for cell count less than 5) were used to derive p-values for categorical variables by level of student learning. The response rate was 45.6% (255 of 559 students) for all four years of the curriculum. 63% of the responses were from students in years 1 and 2 (preclerkship). Students identified role modeling as the single most important aspect of professionalism. The strongest curricular recommendations included faculty-led case scenario sessions, enhancing interprofessional interactions and the creation of special awards to staff and students to "celebrate" professionalism. Current evaluation systems were considered least effective. The importance of role modeling and information on how to report lapses and breaches was highlighted in the answers to the open ended questions. Students

  6. Creation of a Collaborative Disaster Preparedness Video for Daycare Providers: Use of the Delphi Model for the Creation of a Comprehensive Disaster Preparedness Video for Daycare Providers.

    Science.gov (United States)

    Mar, Pamela; Spears, Robert; Reeb, Jeffrey; Thompson, Sarah B; Myers, Paul; Burke, Rita V

    2018-02-22

    Eight million American children under the age of 5 attend daycare and more than another 50 million American children are in school or daycare settings. Emergency planning requirements for daycare licensing vary by state. Expert opinions were used to create a disaster preparedness video designed for daycare providers to cover a broad spectrum of scenarios. Various stakeholders (17) devised the outline for an educational pre-disaster video for child daycare providers using the Delphi technique. Fleiss κ values were obtained for consensus data. A 20-minute video was created, addressing the physical, psychological, and legal needs of children during and after a disaster. Viewers completed an anonymous survey to evaluate topic comprehension. A consensus was attempted on all topics, ranging from elements for inclusion to presentation format. The Fleiss κ value of 0.07 was obtained. Fifty-seven of the total 168 video viewers completed the 10-question survey, with comprehension scores ranging from 72% to 100%. Evaluation of caregivers that viewed our video supports understanding of video contents. Ultimately, the technique used to create and disseminate the resources may serve as a template for others providing pre-disaster planning education. (Disaster Med Public Health Preparedness. 2018;page 1 of 5).

  7. Developing Students' Reflections on the Function and Status of Mathematical Modeling in Different Scientific Practices: History as a Provider of Cases

    Science.gov (United States)

    Kjeldsen, Tinne Hoff; Blomhøj, Morten

    2013-01-01

    Mathematical models and mathematical modeling play different roles in the different areas and problems in which they are used. The function and status of mathematical modeling and models in the different areas depend on the scientific practice as well as the underlying philosophical and theoretical position held by the modeler(s) and the…

  8. Emerging revenue model structure for mobile industry: the case for traditional and OTT service providers in Sub-Sahara

    CSIR Research Space (South Africa)

    Mahola, U

    2015-08-01

    Full Text Available With the emergence of internet-based service providers, known as Over-the-top (OTT), the business landscape has changed massively, hence the current traditional service provider’s business models are transforming. The question treated in this paper...

  9. Investigating Effective Components of Higher Education Marketing and Providing a Marketing Model for Iranian Private Higher Education Institutions

    Science.gov (United States)

    Kasmaee, Roya Babaee; Nadi, Mohammad Ali; Shahtalebi, Badri

    2016-01-01

    Purpose: The purpose of this paper is to study and identify the effective components of higher education marketing and providing a marketing model for Iranian higher education private sector institutions. Design/methodology/approach: This study is a qualitative research. For identifying the effective components of higher education marketing and…

  10. Alzheimer's disease: analysis of a mathematical model incorporating the role of prions

    OpenAIRE

    Helal, Mohamed; Hingant, Erwan; Pujo-Menjouet, Laurent; Webb, Glenn F.

    2013-01-01

    We introduce a mathematical model of the in vivo progression of Alzheimer's disease with focus on the role of prions in memory impairment. Our model consists of differential equations that describe the dynamic formation of {\\beta}-amyloid plaques based on the concentrations of A{\\beta} oligomers, PrPC proteins, and the A{\\beta}-x-PrPC complex, which are hypothesized to be responsible for synaptic toxicity. We prove the well-posedness of the model and provided stability results for its unique ...

  11. Modelling Gas Adsorption in Porous Solids: Roles of Surface ...

    Indian Academy of Sciences (India)

    Modelling the adsorption of small molecule gases such as N2 , CH4 and CO2 in porous solids can provide valuable insights for the development of next generation materials. Employing a grand canonical Monte Carlo simulation code developed in our group, the adsorption isotherms of CH4 and CO2 in many metal organic ...

  12. Modelling Gas Adsorption in Porous Solids: Roles of Surface ...

    Indian Academy of Sciences (India)

    Abstract. Modelling the adsorption of small molecule gases such as N2, CH4 and CO2 in porous solids can provide valuable insights for the development of next generation materials. Employing a grand canonical Monte. Carlo simulation code developed in our group, the adsorption isotherms of CH4 and CO2 in many ...

  13. Effects of work-family-school role conflicts and role-related social support on burnout in Registered Nurses: a structural equation modelling approach.

    Science.gov (United States)

    Goong, Hwasoo; Xu, Lijuan; Li, Chun-Yu

    2016-11-01

    To examine the effects of work-family-school role conflicts and role-related social support (RRSS) on burnout of nurses pursuing an advanced degree. A predictive correlational cross-sectional study design was used. Nurses were found to be a high-risk group for burnout, even more so among nurses pursuing an advanced degree. When nurses with a professional career marry and decide to become students, inter-role conflicts and burnout are possible outcomes of the resulting multiple roles. Using convenience sampling, data were collected from October 2011-May 2012. A questionnaire about work-family-school role conflicts, RRSS, burnout and general information was completed by 286 nurses pursuing an advanced degree at 12 hospitals in Korea. Data were analysed using SPSS and structural equation modelling with the Analysis of Moment Structures program. The proposed model provided a good fit to the obtained data. Work-family-school role conflicts and social support exerted significant effects on burnout. Role-related social support was found to play a partial mediating role between work-family-school role conflicts and burnout. The findings of this study imply that RRSS significantly directly and indirectly influences burnout among the nurses pursuing an advanced degree. It is necessary for nursing managers to consider implementing family- and school-friendly policies (e.g. flexible work schedules) to help nurses to manage their multiple roles and thereby decrease their burnout rate. © 2016 John Wiley & Sons Ltd.

  14. Teacher’s role model ingender education of students

    Directory of Open Access Journals (Sweden)

    Elvira Dode

    2015-07-01

    Full Text Available Gender education as an important part of education, affects by the role and attitudes of teachers. Including gender perspective in schools is a prerequisite in alienable of human development, instead insuring gender equality it is considered as respecting human rights. Elimination of the gender stereotypes has a two-fold significance since itemsurest gender equality not only in the school system but even in the society as a whole. Gender stereotype messages, regardless by hidden or displayed form, unilaterally influence the development of the personality in its appearance as well as the formation of the individual. Children learn about gender identity simply by observing what happens in different circumstances around. In education exist gender disparities, which can be assessed by means of measurable indicators. So, the content of the curricula and instructive texts, the interactive relationships teacher-students, the institutional ambiance, etc. play an important role into the preservation and transmission of the gender disparity stereotypes through the messages they convey. The purpose of thestudy is to perform a systematic research in order to show the scale and shape in which gender stereotypes are portrayed and shown in social life, even through the role model of teacher and their affecting the education for a democratic society. To achieve this goal, we use the method of studying the existing literature; a detailed analysis of the questionnaires and interviews content with school directors and teachers of pre-university education in city: Shkodër, Tiranë, Elbasan, Pogradec, Korçë. Parents and teachers attitudes, seems to be a role model and affect the education of students. Therefore it is necessary before to teach students about gender equality, teachers need to be careful in their behavior about gender equality as an integral part of thinking. Need to have successful teacher, to get successful students otherwise should be successful

  15. The role of optimization in structural model refinement

    Science.gov (United States)

    Lehman, L. L.

    1984-01-01

    To evaluate the role that optimization can play in structural model refinement, it is necessary to examine the existing environment for the structural design/structural modification process. The traditional approach to design, analysis, and modification is illustrated. Typically, a cyclical path is followed in evaluating and refining a structural system, with parallel paths existing between the real system and the analytical model of the system. The major failing of the existing approach is the rather weak link of communication between the cycle for the real system and the cycle for the analytical model. Only at the expense of much human effort can data sharing and comparative evaluation be enhanced for the two parallel cycles. Much of the difficulty can be traced to the lack of a user-friendly, rapidly reconfigurable engineering software environment for facilitating data and information exchange. Until this type of software environment becomes readily available to the majority of the engineering community, the role of optimization will not be able to reach its full potential and engineering productivity will continue to suffer. A key issue in current engineering design, analysis, and test is the definition and development of an integrated engineering software support capability. The data and solution flow for this type of integrated engineering analysis/refinement system is shown.

  16. Role of eosinophilic airway inflammation in models of asthma

    Directory of Open Access Journals (Sweden)

    Lapa e Silva José R

    1997-01-01

    Full Text Available Eosinophils play a central role in the establishment and outcome of bronchial inflammation in asthma. Animal models of allergy are useful to answer questions related to mechanisms of allergic inflammation. We have used models of sensitized and boosted guinea pigs to investigate the nature of bronchial inflammation in allergic conditions. These animals develop marked bronchial infiltration composed mainly of CD4+ T-lymphocytes and eosinophils. Further provocation with antigen leads to degranulation of eosinophils and ulceration of the bronchial mucosa. Eosinophils are the first cells to increase in numbers in the mucosa after antigen challenge and depend on the expression of alpha 4 integrin to adhere to the vascular endothelium and transmigrate to the mucosa. Blockage of alpha4 integrin expression with specific antibody prevents not only the transmigration of eosinophils but also the development of bronchial hyperresponsiveness (BHR to agonists in sensitized and challenged animals, clearly suggesting a role for this cell type in this altered functional state. Moreover, introduction of antibody against Major Basic Protein into the airways also prevents the development of BHR in similar model. BHR can also be suppressed by the use of FK506, an immunosuppressor that reduces in almost 100% the infiltration of eosinophils into the bronchi of allergic animals. These data support the concept that eosinophil is the most important pro-inflammatory factor in bronchial inflammation associated with allergy.

  17. Entrepreneurial Women in Radiology: Role Models of Success.

    Science.gov (United States)

    Anzai, Yoshimi; Meltzer, Carolyn C; DeStigter, Kristen K; Destounis, Stamatia; Pawley, Barbara K; Oates, M Elizabeth

    2016-11-01

    Radiology is undeniably male dominated. Alongside surgery and orthopedic surgery, academic radiology ranks near the bottom in having the lowest proportion of full-time female faculty members. Despite many efforts to recruit talented women, the pipeline entering the radiologic disciplines continues to flow at a trickle. One factor is the relative lack of role models for female medical students. Entrepreneurial women in radiology can lead the field with their innovation and creativity, courage, and commitment. In this article, the authors highlight two entrepreneurial female radiologists who shared their success stories at the American Association for Women Radiologists' session at the 2015 ACR annual meeting. Their successes underscore the potential for such women to serve as role models to female medical students and even college undergraduates. Despite the gender gap in radiology, the field has yielded some exceptional women who can take on challenges, overcome barriers and assume risks, create strategies and processes to operationalize their visions, secure funding, and expand their enterprises to make sustainable impacts both at home and abroad. As we move toward more patient- and family-centered care models and become increasingly visible to diverse populations, there is no better time for female leaders in radiology to inspire the next generation to join our essential and rewarding specialty. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  18. Public’s perception and satisfaction on the roles and services provided by pharmacists – Cross sectional survey in Sultanate of Oman

    Science.gov (United States)

    Jose, Jimmy; Al Shukili, Marwa Nasser; Jimmy, Beena

    2015-01-01

    Background and objectives: An important factor that will help in advancement of the pharmacy services in any country would be to understand the public needs, expectation and satisfaction. There are limited published studies conducted in Sultanate of Oman regarding the perception and satisfaction of public on the role and services provided by pharmacists. The present study was conducted to assess the perception and satisfaction of general public in Sultanate of Oman on the roles, and services received from the pharmacists. Methods: The survey was conducted among public in the Governorates of A’Dahera and Muscat in Oman during 2013. The questionnaire had items to assess two aspects: perception on the roles and responsibilities of pharmacists and satisfaction on the services provided. The responses to the questions marked in a five point Likert scale were assessed using a scoring scheme. Accordingly, the median perception, and satisfaction score and median total score for the participants were estimated. The median scores of the participants were related with the demographics of the participants and frequency of visit to pharmacy. Results: A total of 390 completed questionnaires were obtained. The median total score of the participants based on all the questions was 79 (Inter Quartile Range (IQR), 12) which represents a moderate score. The median perception and satisfaction scores were 44 (IQR 5) and 34 (IQR 7) which represent a good and moderate score, respectively. Perception of the participants differed based on employment status, frequency of visit to pharmacy and governorate represented by participants while satisfaction was influenced by educational qualification and frequency of visit to pharmacy. Conclusions: Public had a good perception regarding the roles of the pharmacists while they were only moderately satisfied with the services provided. Steps have to be taken to improve the services and relationship of pharmacists, and thereby improve the

  19. Do STEM fields need a makeover?: The effect of role model femininity on men and women's interest in STEM

    Science.gov (United States)

    Howard, Carolynn

    Women continue to be underrepresented in science, technology, engineering, and mathematics (STEM) fields. This lack of women is problematic because it diminishes perspective, input, and expertise that women could provide. Consequently, this thesis examined the benefits of exposure to peer role models for increasing women's interest in STEM, which may ultimately lead more women to enter STEM fields. The role model research to date has amassed considerable evidence showing that role model exposure is beneficial; yet, questions still remain about what makes these role models effective. Accordingly, this thesis investigated whether feminine female role models increase women's interest in STEM and improve their perceptions of female STEM role models relative to "neutral" female role models. Across three experiments men and women were exposed to role models and their interest in STEM was measured. All experiments exposed participants to one of three articles about a peer role model (a female role model who embodies femininity (e.g. wears makeup), a female role model who has gender neutral qualities/behaviors [e.g., works hard], or a male role model who embodies neutral traits) and Experiments 2 and 3 had a fourth control condition in which participants read about the history of SDSU (a control condition). In the first two experiments interest in physics was measured using an adapted version of the STEM Career Interest Survey (CIS). Experiment 3 used an adapted version of the STEM CIS scale, but measured overall interest in STEM by including subscales for each of the four STEM areas with a composite score serving as the primary dependent variable. Experiments 1 and 2 demonstrated that women's interest in physics was no different than men's after exposure to a feminine female role model compared to a neutral female and neutral male role model. Furthermore, women's interest in physics was greater in the feminine condition compared to all other conditions for the first two

  20. A structural model of teacher role stress, satisfaction, commitment, and intentions to leave: a comment on Conley and You (2009).

    Science.gov (United States)

    Smith, Kenneth J

    2010-04-01

    Conley and You assessed the plausibility of three alternative model specifications of the relations between role stressors (i.e., role conflict, role ambiguity, and role overload) and organizational commitment, satisfaction, and turnover intentions among a sample of 178 teachers employed in four Southern California high schools. Using structural equations modeling procedures to evaluate their data, the authors reported the best fit for their "fully mediated effects" model wherein there was a "strong causal path from role ambiguity and role conflict --> satisfaction --> commitment --> intentions to leave" (p. 781). This note addresses methodological issues with the present study and provides suggestions for follow-up efforts designed to replicate and/or extend this line of research.

  1. Female role models in physics education in Ireland

    Science.gov (United States)

    Chormaic, Síle Nic; Fee, Sandra; Tobin, Laura; Hennessy, Tara

    2013-03-01

    In this paper we consider the statistics on undergraduate student representation in Irish universities and look at student numbers in secondary (high) schools in one region in Ireland. There seems to be no significant change in female participation in physics from 2002 to 2011. Additionally, we have studied the influence of an educator's gender on the prevalence of girls studying physics in secondary schools in Co. Louth, Ireland, and at the postgraduate level in Irish universities. It would appear that strong female role models have a positive influence and lead to an increase in girls' participation in physics.

  2. Providing the meta-model of development of competency using the meta-ethnography approach: Part 2. Synthesis of the available competency development models

    Directory of Open Access Journals (Sweden)

    Somayeh Akbari Farmad

    2016-06-01

    Full Text Available Background and Purpose: Considering the importance and necessity of competency-based education at a global level and with respect to globalization and the requirement of minimum competencies in medical fields, medical education communities and organizations worldwide have tried to determine the competencies, present frameworks and education models to respond to be sure of the ability of all graduates. In the literature, we observed numerous competency development models that refer to the same issues with different terminologies. It seems that evaluation and synthesis of all these models can finally result in designing a comprehensive meta-model for competency development. Methods: Meta-ethnography is a useful method for synthesis of qualitative research that is used to develop models that interpret the results in several studies. Considering that the aim of this study is to ultimately provide a competency development meta-model, in the previous section of the study, the literature review was conducted to achieve competency development models. Models obtained through the search were studied in details, and the key concepts of the models and overarching concepts were extracted in this section, models’ concepts were reciprocally translated and the available competency development models were synthesized. Results: A presentation of the competency development meta-model and providing a redefinition of the Dreyfus brothers model. Conclusions: Given the importance of competency-based education at a global level and the need to review curricula and competency-based curriculum design, it is required to provide competency development as well as meta-model to be the basis for curriculum development. As there are a variety of competency development models available, in this study, it was tried to develop the curriculum using them. Keywords: Meta-ethnography, Competency development, Meta-model, Qualitative synthesis

  3. Modeling grating contrast discrimination dippers: The role of surround suppression.

    Science.gov (United States)

    To, Michelle P S; Chirimuuta, Mazviita; Tolhurst, David J

    2017-10-01

    We consider the role of nonlinear inhibition in physiologically realistic multineuronal models of V1 to predict the dipper functions from contrast discrimination experiments with sinusoidal gratings of different geometries. The dip in dipper functions has been attributed to an expansive transducer function, which itself is attributed to two nonlinear inhibitory mechanisms: contrast normalization and surround suppression. We ran five contrast discrimination experiments, with targets and masks of different sizes and configurations: small Gabor target/small mask, small target/large mask, large target/large mask, small target/in-phase annular mask, and small target/out-of-phase annular mask. Our V1 modeling shows that the results for small Gabor target/small mask, small target/large mask, large target/large mask configurations are easily explained only if the model includes surround suppression. This is compatible with the finding that an in-phase annular mask generates only little threshold elevation while the out-of-phase mask was more effective. Surrounding mask gratings cannot be equated with surround suppression at the receptive-field level. We examine whether normalization and surround suppression occur simultaneously (parallel model) or sequentially (a better reflection of neurophysiology). The Akaike Criterion Difference showed that the sequential model was better than the parallel, but the difference was small. The large target/large mask dipper experiment was not well fit by our models, and we suggest that this may reflect selective attention for its uniquely larger test stimulus. The best-fit model replicates some behaviors of single V1 neurons, such as the decrease in receptive-field size with increasing contrast.

  4. The role of business models in Finnish construction companies

    Directory of Open Access Journals (Sweden)

    Aki Pekuri

    2013-09-01

    Full Text Available Business models are seen as an essential part of successful businesses as they define the way companies create value for their customers and subsequently make profit from their operations. A good business model has a potential to separate a company from its competitors by creating a competitive advantage. The purpose of this research is to explore how managers understand and deploy the business model concept in construction. For this, eight experienced managers have been interviewed and their answers have been analysed using the theoretical aspects of business models as a reference. In the interviews, managers deployed business model concept very differently than what is accustomed in practice and in academia; they relate these models to different project delivery and contract structures or to companies’ business segments rather than to analysing how their companies provide value for customers in the selected markets. The results of the interviews indicate that the managers in construction do neither understand the concept properly nor exploit any similar value creation analysis in their business. The interviewees had significant problems describing their companies’ business models and value creation logic, pointing out the lack of analysis and understanding of customer values and needs in the project delivery process. This may be one of the overtones of the persistent client dissatisfaction in the construction industry. 

  5. The role of business models in Finnish construction companies

    Directory of Open Access Journals (Sweden)

    Aki Pekuri

    2013-09-01

    Full Text Available Business models are seen as an essential part of successful businesses as they define the way companies create value for their customers and subsequently make profit from their operations. A good business model has a potential to separate a company from its competitors by creating a competitive advantage. The purpose of this research is to explore how managers understand and deploy the business model concept in construction. For this, eight experienced managers have been interviewed and their answers have been analysed using the theoretical aspects of business models as a reference. In the interviews, managers deployed business model concept very differently than what is accustomed in practice and in academia; they relate these models to different project delivery and contract structures or to companies’ business segments rather than to analysing how their companies provide value for customers in the selected markets. The results of the interviews indicate that the managers in construction do neither understand the concept properly nor exploit any similar value creation analysis in their business. The interviewees had significant problems describing their companies’ business models and value creation logic, pointing out the lack of analysis and understanding of customer values and needs in the project delivery process. This may be one of the overtones of the persistent client dissatisfaction in the construction industry.

  6. Fourier power, subjective distance and object categories all provide plausible models of BOLD responses in scene-selective visual areas

    Directory of Open Access Journals (Sweden)

    Mark Daniel Lescroart

    2015-11-01

    Full Text Available Perception of natural visual scenes activates several functional areas in the human brain, including the Parahippocampal Place Area (PPA, Retrosplenial Complex (RSC, and the Occipital Place Area (OPA. It is currently unclear what specific scene-related features are represented in these areas. Previous studies have suggested that PPA, RSC, and/or OPA might represent at least three qualitatively different classes of features: (1 2D features related to Fourier power; (2 3D spatial features such as the distance to objects in a scene; or (3 abstract features such as the categories of objects in a scene. To determine which of these hypotheses best describes the visual representation in scene-selective areas, we applied voxel-wise modeling (VM to BOLD fMRI responses elicited by a set of 1,386 images of natural scenes. VM provides an efficient method for testing competing hypotheses by comparing predictions of brain activity based on encoding models that instantiate each hypothesis. Here we evaluated three different encoding models that instantiate each of the three hypotheses listed above. We used linear regression to fit each encoding model to the fMRI data recorded from each voxel, and we evaluated each fit model by estimating the amount of variance it predicted in a withheld portion of the data set. We found that voxel-wise models based on Fourier power or the subjective distance to objects in each scene predicted much of the variance predicted by a model based on object categories. Furthermore, the response variance explained by these three models is largely shared, and the individual models explain little unique variance in responses. Based on an evaluation of previous studies and the data we present here, we conclude that there is currently no good basis to favor any one of the three alternative hypotheses about visual representation in scene-selective areas. We offer suggestions for further studies that may help resolve this issue.

  7. Fourier power, subjective distance, and object categories all provide plausible models of BOLD responses in scene-selective visual areas

    Science.gov (United States)

    Lescroart, Mark D.; Stansbury, Dustin E.; Gallant, Jack L.

    2015-01-01

    Perception of natural visual scenes activates several functional areas in the human brain, including the Parahippocampal Place Area (PPA), Retrosplenial Complex (RSC), and the Occipital Place Area (OPA). It is currently unclear what specific scene-related features are represented in these areas. Previous studies have suggested that PPA, RSC, and/or OPA might represent at least three qualitatively different classes of features: (1) 2D features related to Fourier power; (2) 3D spatial features such as the distance to objects in a scene; or (3) abstract features such as the categories of objects in a scene. To determine which of these hypotheses best describes the visual representation in scene-selective areas, we applied voxel-wise modeling (VM) to BOLD fMRI responses elicited by a set of 1386 images of natural scenes. VM provides an efficient method for testing competing hypotheses by comparing predictions of brain activity based on encoding models that instantiate each hypothesis. Here we evaluated three different encoding models that instantiate each of the three hypotheses listed above. We used linear regression to fit each encoding model to the fMRI data recorded from each voxel, and we evaluated each fit model by estimating the amount of variance it predicted in a withheld portion of the data set. We found that voxel-wise models based on Fourier power or the subjective distance to objects in each scene predicted much of the variance predicted by a model based on object categories. Furthermore, the response variance explained by these three models is largely shared, and the individual models explain little unique variance in responses. Based on an evaluation of previous studies and the data we present here, we conclude that there is currently no good basis to favor any one of the three alternative hypotheses about visual representation in scene-selective areas. We offer suggestions for further studies that may help resolve this issue. PMID:26594164

  8. Providing a theoretical basis for nanotoxicity risk analysis departing from traditional physiologically-based pharmacokinetic (PBPK) modeling

    Science.gov (United States)

    Yamamoto, Dirk P.

    The same novel properties of engineered nanoparticles that make them attractive may also present unique exposure risks. But, the traditional physiologically-based pharmacokinetic (PBPK) modeling assumption of instantaneous equilibration likely does not apply to nanoparticles. This simulation-based research begins with development of a model that includes diffusion, active transport, and carrier mediated transport. An eigenvalue analysis methodology was developed to examine model behavior to focus future research. Simulations using the physico-chemical properties of size, shape, surface coating, and surface charge were performed and an equation was determined which estimates area under the curve for arterial blood concentration, which is a surrogate of nanoparticle dose. Results show that the cellular transport processes modeled in this research greatly affect the biokinetics of nanoparticles. Evidence suggests that the equation used to estimate area under the curve for arterial blood concentration can be written in terms of nanoparticle size only. The new paradigm established by this research leverages traditional in vitro, in vivo, and PBPK modeling, but includes area under the curve to bridge animal testing results to humans. This new paradigm allows toxicologists and policymakers to then assess risk to a given exposure and assist in setting appropriate exposure limits for nanoparticles. This research provides critical understanding of nanoparticle biokinetics and allows estimation of total exposure at any toxicological endpoint in the body. This effort is a significant contribution as it highlights future research needs and demonstrates how modeling can be used as a tool to advance nanoparticle risk assessment.

  9. Emerging Business Models in Education Provisioning: A Case Study on Providing Learning Support as Education-as-a-Service

    Directory of Open Access Journals (Sweden)

    Loina Prifti

    2017-09-01

    Full Text Available This study aims to give a deeper understanding on emerging business models in the context of education. Industry 4.0/the Industrial Internet in general and especially recent advances in cloud computing enable a new kind of service offering in the education sector and lead to new business models for education: Education-as-a-Service (EaaS. Within EaaS, learning, and teaching contents are delivered as services. By combining a literature review with a qualitative case study, this paper makes a three-fold contribution to the field of business models in education: First, we provide a theoretical definition for a common understanding of EaaS. Second, we present the state-of-the-art research on this new paradigm. Third, in the case study we describe a “best practices” business model of an existing EaaS provider. These insights build a theoretical foundation for further research in this area. The paper concludes with a research agenda for further research in this emerging field.

  10. A Mathematical Model of Metabolism and Regulation Provides a Systems-Level View of How Escherichia coli Responds to Oxygen

    Directory of Open Access Journals (Sweden)

    Michael eEderer

    2014-03-01

    Full Text Available The efficient redesign of bacteria for biotechnological purposes, such as biofuel production, waste disposal or specific biocatalytic functions, requires a quantitative systems-level understanding of energy supply, carbon and redox metabolism. The measurement of transcript levels, metabolite concentrations and metabolic fluxes per se gives an incomplete picture. An appreciation of the interdependencies between the different measurement values is essential for systems-level understanding. Mathematical modeling has the potential to provide a coherent and quantitative description of the interplay between gene expression, metabolite concentrations and metabolic fluxes. Escherichia coli undergoes major adaptations in central metabolism when the availability of oxygen changes. Thus, an integrated description of the oxygen response provides a benchmark of our understanding of carbon, energy and redox metabolism. We present the first comprehensive model of the central metabolism of E. coli that describes steady-state metabolism at different levels of oxygen availability. Variables of the model are metabolite concentrations, gene expression levels, transcription factor activities, metabolic fluxes and biomass concentration. We analyze the model with respect to the production capabilities of central metabolism of E. coli. In particular, we predict how precursor and biomass concentration are affected by product formation.

  11. A mathematical model of metabolism and regulation provides a systems-level view of how Escherichia coli responds to oxygen.

    Science.gov (United States)

    Ederer, Michael; Steinsiek, Sonja; Stagge, Stefan; Rolfe, Matthew D; Ter Beek, Alexander; Knies, David; Teixeira de Mattos, M Joost; Sauter, Thomas; Green, Jeffrey; Poole, Robert K; Bettenbrock, Katja; Sawodny, Oliver

    2014-01-01

    The efficient redesign of bacteria for biotechnological purposes, such as biofuel production, waste disposal or specific biocatalytic functions, requires a quantitative systems-level understanding of energy supply, carbon, and redox metabolism. The measurement of transcript levels, metabolite concentrations and metabolic fluxes per se gives an incomplete picture. An appreciation of the interdependencies between the different measurement values is essential for systems-level understanding. Mathematical modeling has the potential to provide a coherent and quantitative description of the interplay between gene expression, metabolite concentrations, and metabolic fluxes. Escherichia coli undergoes major adaptations in central metabolism when the availability of oxygen changes. Thus, an integrated description of the oxygen response provides a benchmark of our understanding of carbon, energy, and redox metabolism. We present the first comprehensive model of the central metabolism of E. coli that describes steady-state metabolism at different levels of oxygen availability. Variables of the model are metabolite concentrations, gene expression levels, transcription factor activities, metabolic fluxes, and biomass concentration. We analyze the model with respect to the production capabilities of central metabolism of E. coli. In particular, we predict how precursor and biomass concentration are affected by product formation.

  12. The role of dental care providers and oral and maxillofacial surgeons in the surgical and medical management of oral cancer in the United States.

    Science.gov (United States)

    Kim, Beomjune B; Kim, Dongsoo D

    2013-01-01

    Oral cancer results in significant morbidity and mortality in those afflicted. Despite modern treatments, mortality is high, with overall 5-year survival rates that approximate 50%. However, early stage disease (Stages 1 and 2) carries a significantly better prognosis than late stage disease (Stages 3 and 4), therefore, prevention and early detection continue to be important in improving oral cancer control. The role of dental care providers in routine oral cancer screenings, smoking cessation, treatment, and rehabilitation of oral cancer patients is emphasized in this article. This article also discusses the epidemiology, etiology, diagnosis, and treatment of oral cancer and the role of oral and maxillofacial surgeons in the surgical and medical management of oral cancer patients in the United States.

  13. A Hybrid Artificial Reputation Model Involving Interaction Trust, Witness Information and the Trust Model to Calculate the Trust Value of Service Providers

    Directory of Open Access Journals (Sweden)

    Gurdeep Singh Ransi

    2014-02-01

    Full Text Available Agent interaction in a community, such as the online buyer-seller scenario, is often uncertain, as when an agent comes in contact with other agents they initially know nothing about each other. Currently, many reputation models are developed that help service consumers select better service providers. Reputation models also help agents to make a decision on who they should trust and transact with in the future. These reputation models are either built on interaction trust that involves direct experience as a source of information or they are built upon witness information also known as word-of-mouth that involves the reports provided by others. Neither the interaction trust nor the witness information models alone succeed in such uncertain interactions. In this paper we propose a hybrid reputation model involving both interaction trust and witness information to address the shortcomings of existing reputation models when taken separately. A sample simulation is built to setup buyer-seller services and uncertain interactions. Experiments reveal that the hybrid approach leads to better selection of trustworthy agents where consumers select more reputable service providers, eventually helping consumers obtain more gains. Furthermore, the trust model developed is used in calculating trust values of service providers.

  14. Understanding the roles of faith-based health-care providers in Africa: review of the evidence with a focus on magnitude, reach, cost, and satisfaction.

    Science.gov (United States)

    Olivier, Jill; Tsimpo, Clarence; Gemignani, Regina; Shojo, Mari; Coulombe, Harold; Dimmock, Frank; Nguyen, Minh Cong; Hines, Harrison; Mills, Edward J; Dieleman, Joseph L; Haakenstad, Annie; Wodon, Quentin

    2015-10-31

    At a time when many countries might not achieve the health targets of the Millennium Development Goals and the post-2015 agenda for sustainable development is being negotiated, the contribution of faith-based health-care providers is potentially crucial. For better partnership to be achieved and for health systems to be strengthened by the alignment of faith-based health-providers with national systems and priorities, improved information is needed at all levels. Comparisons of basic factors (such as magnitude, reach to poor people, cost to patients, modes of financing, and satisfaction of patients with the services received) within faith-based health-providers and national systems show some differences. As the first report in the Series on faith-based health care, we review a broad body of published work and introduce some empirical evidence on the role of faith-based health-care providers, with a focus on Christian faith-based health providers in sub-Saharan Africa (on which the most detailed documentation has been gathered). The restricted and diverse evidence reported supports the idea that faith-based health providers continue to play a part in health provision, especially in fragile health systems, and the subsequent reports in this Series review controversies in faith-based health care and recommendations for how public and faith sectors might collaborate more effectively. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Salmonids, stream temperatures, and solar loading--modeling the shade provided to the Klamath River by vegetation and geomorphology

    Science.gov (United States)

    Forney, William M.; Soulard, Christopher E.; Chickadel, C. Christopher

    2013-01-01

    The U.S. Geological Survey is studying approaches to characterize the thermal regulation of water and the dynamics of cold water refugia. High temperatures have physiological impacts on anadromous fish species. Factors affecting the presence, variability, and quality of thermal refugia are known, such as riverine and watershed processes, hyporheic flows, deep pools and bathymetric factors, thermal stratification of reservoirs, and other broader climatic considerations. This research develops a conceptual model and methodological techniques to quantify the change in solar insolation load to the Klamath River caused by riparian and floodplain vegetation, the morphology of the river, and the orientation and topographic characteristics of its watersheds. Using multiple scales of input data from digital elevation models and airborne light detection and ranging (LiDAR) derivatives, different analysis methods yielded three different model results. These models are correlated with thermal infrared imagery for ground-truth information at the focal confluence with the Scott River. Results from nonparametric correlation tests, geostatistical cross-covariograms, and cross-correlograms indicate that statistical relationships between the insolation models and the thermal infrared imagery exist and are significant. Furthermore, the use of geostatistics provides insights to the spatial structure of the relationships that would not be apparent otherwise. To incorporate a more complete representation of the temperature dynamics in the river system, other variables including the factors mentioned above, and their influence on solar loading, are discussed. With similar datasets, these methods could be applied to any river in the United States—especially those listed as temperature impaired under Section 303(d) of the Clean Water Act—or international riverine systems. Considering the importance of thermal refugia for aquatic species, these methods can help investigate opportunities

  16. Consumer providers' experiences of recovery and concerns as members of a psychiatric multidisciplinary outreach team: A qualitative descriptive study from the Japan Outreach Model Project 2011-2014.

    Directory of Open Access Journals (Sweden)

    Yoshifumi Kido

    Full Text Available The objective of this study was to clarify consumer providers (CPs subjective experiences as members of a psychiatric multidisciplinary outreach team that provided services to individuals with a mental illness living in the community.A qualitative descriptive study was conducted through semi-structured interviews. Participants were clients hired as CPs in the Japanese Outreach Model Project from September 2011 until March 2014. Of the seventeen CPs, nine participated in this study. We looked at the CPs' subjective experiences of fulfillment and difficulty.In the process of providing services, CPs experienced both achievements and concerns. They had a sense of achievement by caring for their clients and they experienced that they themselves were recovering. They were also concerned about having inadequate knowledge and skills to provide psychiatric services to their clients. Further, there were concerns about their dual role on the multidisciplinary team and being support staff while they were still using mental health services themselves.The results show that the activities of CPs included fulfillment, recovery, and dilemmas. Clarifications will likely contribute to an increase in understanding and cooperation between CPs and other professionals with whom they work. Further studies are needed to investigate policies related to mental health consumers who are also providers of mental health services.

  17. Examining intergenerational violence: violent role modeling or weak parental controls?

    Science.gov (United States)

    Chapple, Constance L

    2003-04-01

    Family violence research has uncovered a positive relationship between parental violence and children's later involvement in intimate violence. In a similar vein, criminology's social control theory suggests that weak or absent parental controls are associated with a variety of delinquent acts. Little research, however, investigates the link between parental violence, parental controls, and dating violence. This article asks two research questions: How is inter-parental violence associated with parent-child attachments, monitoring, adolescent dating, attitudes toward violence, and dating violence? And second, are there independent and interactive effects of inter-parental violence, and parental controls on dating violence offending and attitudes towards violence? Dating violence offending is significantly associated with witnessed inter-parental violence, high dating frequency, and low parental monitoring. Attitudes towards violence are associated with witnessed inter-parental violence, lower parental attachment, and the interaction of witnessed inter-parental violence and parental attachment. The implications for role modeling and social control theory are discussed.

  18. GORouter: an RDF model for providing semantic query and inference services for Gene Ontology and its associations.

    Science.gov (United States)

    Xu, Qingwei; Shi, Yixiang; Lu, Qiang; Zhang, Guoqing; Luo, Qingming; Li, Yixue

    2008-01-01

    The most renowned biological ontology, Gene Ontology (GO) is widely used for annotations of genes and gene products of different organisms. However, there are shortcomings in the Resource Description Framework (RDF) data file provided by the GO consortium: 1) Lack of sufficient semantic relationships between pairs of terms coming from the three independent GO sub-ontologies, that limit the power to provide complex semantic queries and inference services based on it. 2) The term-centric view of GO annotation data and the fact that all information is stored in a single file. This makes attempts to retrieve GO annotations based on big volume datasets unmanageable. 3) No support of GOSlim. We propose a RDF model, GORouter, which encodes heterogeneous original data in a uniform RDF format, creates additional ontology mappings between GO terms, and introduces a set of inference rulebases. Furthermore, we use the Oracle Network Data Model (NDM) as the native RDF data repository and the table function RDF_MATCH to seamlessly combine the result of RDF queries with traditional relational data. As a result, the scale of GORouter is minimized; information not directly involved in semantic inference is put into relational tables. Our work demonstrates how to use multiple semantic web tools and techniques to provide a mixture of semantic query and inference solutions of GO and its associations. GORouter is licensed under Apache License Version 2.0, and is accessible via the website: http://www.scbit.org/gorouter/.

  19. A multi-objective location-inventory model for 3PL providers with sustainable considerations under uncertainty

    Directory of Open Access Journals (Sweden)

    R. Daghigh

    2016-09-01

    Full Text Available In recent years, logistics development is considered as an important aspect of any country’s development. Outsourcing logistics activities to third party logistics (3PL providers is a common way to achieve logistics development. On the other hand, globalization and increasing customers’ concern about the environmental impact of activities as well as the appearance of the issue of social responsibility have led companies employ sustainable supply chain management, which considers economic, environmental and social benefits, simultaneously. This paper proposes a multi-objective model to design logistics network for 3PL providers by considering sustainable objectives under uncertainty. Objective functions include minimizing the total cost, minimizing greenhouse gas emission and maximizing social responsibility subject to fair access to products, number of created job opportunities and local community development. It is worth mentioning that in the present paper the perishability of products is also considered. A numerical example is provided to solve and validate model using augmented Epsilon-Constraint method. The results show that three sustainable objectives were in conflict and as the one receives more desirable values, the others fall into more undesirable values. In addition, by increasing maximum perishable time periods and by considering lateral transshipment among facilities of a level one can improve sustainability indices of the problem, which indicates the necessity of such policy in improving network sustainability.

  20. Context-dependent codon partition models provide significant increases in model fit in atpB and rbcL protein-coding genes.

    Science.gov (United States)

    Baele, Guy; Van de Peer, Yves; Vansteelandt, Stijn

    2011-05-27

    Accurate modelling of substitution processes in protein-coding sequences is often hampered by the computational burdens associated with full codon models. Lately, codon partition models have been proposed as a viable alternative, mimicking the substitution behaviour of codon models at a low computational cost. Such codon partition models however impose independent evolution of the different codon positions, which is overly restrictive from a biological point of view. Given that empirical research has provided indications of context-dependent substitution patterns at four-fold degenerate sites, we take those indications into account in this paper. We present so-called context-dependent codon partition models to assess previous empirical claims that the evolution of four-fold degenerate sites is strongly dependent on the composition of its two flanking bases. To this end, we have estimated and compared various existing independent models, codon models, codon partition models and context-dependent codon partition models for the atpB and rbcL genes of the chloroplast genome, which are frequently used in plant systematics. Such context-dependent codon partition models employ a full dependency scheme for four-fold degenerate sites, whilst maintaining the independence assumption for the first and second codon positions. We show that, both in the atpB and rbcL alignments of a collection of land plants, these context-dependent codon partition models significantly improve model fit over existing codon partition models. Using Bayes factors based on thermodynamic integration, we show that in both datasets the same context-dependent codon partition model yields the largest increase in model fit compared to an independent evolutionary model. Context-dependent codon partition models hence perform closer to codon models, which remain the best performing models at a drastically increased computational cost, compared to codon partition models, but remain computationally interesting

  1. Translating sustainability from strategy to operations: how can decision support mod-els help logistics service providers to attain strategic as well as operational goals?

    NARCIS (Netherlands)

    Reinder Pieters; Stef Weijers; Hans-Heinrich Glöckner

    2010-01-01

    Decision Support Models could help Logistic Service Providers as a means to make transportation more sustainable. When researching this hypothesis, we discovered that Logistic Service Providers were reluctant to use Decision Support Models when making transportation more sustainable.

  2. A friction model for cold forging of aluminum, steel and stainless steel provided with conversion coating and solid film lubricant

    DEFF Research Database (Denmark)

    Bay, Niels; Eriksen, Morten; Tan, Xincai

    2011-01-01

    Adopting a simulative tribology test system for cold forging the friction stress for aluminum, steel and stainless steel provided with typical lubricants for cold forging has been determined for varying normal pressure, surface expansion, sliding length and tool/work piece interface temperature....... The results show, that friction is strongly influenced by normal pressure and tool/work piece interface temperature, whereas the other process parameters investigated show minor influence on friction. Based on the experimental results a mathematical model has been established for friction as a function...... of normal pressure and tool/work piece interface temperature. The model is verified by process testing measuring friction at varying reduction in cold forward rod extrusion....

  3. Web-based collaboration in individual care planning challenges the user and the provider roles – toward a power transition in caring relationships

    Directory of Open Access Journals (Sweden)

    Bjerkan J

    2014-12-01

    Full Text Available Jorunn Bjerkan,1,2 Solfrid Vatne,3 Anne Hollingen4 1Norwegian Research Centre for Electronic Health Records (EHR, Medical Faculty, Norwegian University of Science and Technology, Trondheim, 2Faculty of Health Science, Nord-Trøndelag University College, Levanger, 3Faculty of Health Science, Molde University College, 4Møre og Romsdal Hospital Trust, Molde, Norway Background and objective: The Individual Care Plan (ICP was introduced in Norway to meet new statutory requirements for user participation in health care planning, incorporating multidisciplinary and cross-sector collaboration. A web-based solution (electronic ICP [e-ICP] was used to support the planning and documentation. The aim of this study was to investigate how web-based collaboration challenged user and professional roles. Methods: Data were obtained from 15 semistructured interviews with users and eight with care professionals, and from two focus-group interviews with eight care professionals in total. The data were analyzed using systematic text condensation in a stepwise analysis model. Results: Users and care professionals took either a proactive or a reluctant role in e-ICP collaboration. Where both user and care professionals were proactive, the pairing helped to ensure that the planning worked well; so did pairings of proactive care professionals and reluctant users. Proactive users paired with reluctant care professionals also made care planning work, thanks to the availability of information and the users' own capacity or willingness to conduct the planning. Where both parties were reluctant, no planning activities occurred. Conclusion: Use of the e-ICP challenged the user–professional relationship. In some cases, a power transition took place in the care process, which led to patient empowerment. This knowledge might be used to develop a new understanding of how role function can be challenged when users and care professionals have equal access to health care

  4. Modeling the Ecosystem Services Provided by Trees in Urban Ecosystems: Using Biome-BGC to Improve i-Tree Eco

    Science.gov (United States)

    Brown, Molly E.; McGroddy, Megan; Spence, Caitlin; Flake, Leah; Sarfraz, Amna; Nowak, David J.; Milesi, Cristina

    2012-01-01

    As the world becomes increasingly urban, the need to quantify the effect of trees in urban environments on energy usage, air pollution, local climate and nutrient run-off has increased. By identifying, quantifying and valuing the ecological activity that provides services in urban areas, stronger policies and improved quality of life for urban residents can be obtained. Here we focus on two radically different models that can be used to characterize urban forests. The i-Tree Eco model (formerly UFORE model) quantifies ecosystem services (e.g., air pollution removal, carbon storage) and values derived from urban trees based on field measurements of trees and local ancillary data sets. Biome-BGC (Biome BioGeoChemistry) is used to simulate the fluxes and storage of carbon, water, and nitrogen in natural environments. This paper compares i-Tree Eco's methods to those of Biome-BGC, which estimates the fluxes and storage of energy, carbon, water and nitrogen for vegetation and soil components of the ecosystem. We describe the two models and their differences in the way they calculate similar properties, with a focus on carbon and nitrogen. Finally, we discuss the implications of further integration of these two communities for land managers such as those in Maryland.

  5. Using Model-Based Systems Engineering to Provide Artifacts for NASA Project Life-cycle and Technical Reviews

    Science.gov (United States)

    Parrott, Edith L.; Weiland, Karen J.

    2017-01-01

    This paper is for the AIAA Space Conference. The ability of systems engineers to use model-based systems engineering (MBSE) to generate self-consistent, up-to-date systems engineering products for project life-cycle and technical reviews is an important aspect for the continued and accelerated acceptance of MBSE. Currently, many review products are generated using labor-intensive, error-prone approaches based on documents, spreadsheets, and chart sets; a promised benefit of MBSE is that users will experience reductions in inconsistencies and errors. This work examines features of SysML that can be used to generate systems engineering products. Model elements, relationships, tables, and diagrams are identified for a large number of the typical systems engineering artifacts. A SysML system model can contain and generate most systems engineering products to a significant extent and this paper provides a guide on how to use MBSE to generate products for project life-cycle and technical reviews. The use of MBSE can reduce the schedule impact usually experienced for review preparation, as in many cases the review products can be auto-generated directly from the system model. These approaches are useful to systems engineers, project managers, review board members, and other key project stakeholders.

  6. Using Model-Based Systems Engineering To Provide Artifacts for NASA Project Life-Cycle and Technical Reviews

    Science.gov (United States)

    Parrott, Edith L.; Weiland, Karen J.

    2017-01-01

    The ability of systems engineers to use model-based systems engineering (MBSE) to generate self-consistent, up-to-date systems engineering products for project life-cycle and technical reviews is an important aspect for the continued and accelerated acceptance of MBSE. Currently, many review products are generated using labor-intensive, error-prone approaches based on documents, spreadsheets, and chart sets; a promised benefit of MBSE is that users will experience reductions in inconsistencies and errors. This work examines features of SysML that can be used to generate systems engineering products. Model elements, relationships, tables, and diagrams are identified for a large number of the typical systems engineering artifacts. A SysML system model can contain and generate most systems engineering products to a significant extent and this paper provides a guide on how to use MBSE to generate products for project life-cycle and technical reviews. The use of MBSE can reduce the schedule impact usually experienced for review preparation, as in many cases the review products can be auto-generated directly from the system model. These approaches are useful to systems engineers, project managers, review board members, and other key project stakeholders.

  7. 'Providing good and comfortable care by building a bond of trust': nurses views regarding their role in patients' perception of safety in the intensive care unit.

    Science.gov (United States)

    Wassenaar, Annelies; van den Boogaard, Mark; van der Hooft, Truus; Pickkers, Peter; Schoonhoven, Lisette

    2015-11-01

    To describe and understand intensive care unit (ICU) nurses' views regarding their role in ICU patients' perception of safety. Feeling safe is an important issue for ICU patients. Not feeling safe may result in adverse effects including traumatic experiences, having nightmares and feeling depressed. Nursing care plays a major role in patients' perception of safety. However, it is unknown whether ICU nurses are aware of this role. A grounded theory approach following Corbin and Strauss. A total of 13 participants were included in the study following maximum variation sampling, by selecting ICU nurses who differed in gender, age, work experience as registered ICU nurse, and were employed in different IC units. In-depth interviews were performed using open-ended questions guided by a topic list with broad question areas. Data collection and analysis were executed during an iterative process. The core category, building a bond of trust to provide good and comfortable care, arose from four main categories: explaining and informing ICU patients, using patients' family bond, ICU nurses' attitudes and expertise, and creating physical safety. The ICU nurses stated that they were not explicitly aware of ICU patients' perception of safety, but that they strived to provide good and comfortable care, through building a bond of trust with their patients. According to the nurses, a bond of trust is essential for patients to feel safe in the ICU. The importance of feeling safe in ICU patients should be addressed within the education and clinical practice of ICU nurses, to ensure that they become aware of ICU patients' perception of safety. © 2015 John Wiley & Sons Ltd.

  8. Financial implications of a model heart failure disease management program for providers, hospital, healthcare systems, and payer perspectives.

    Science.gov (United States)

    Whellan, David J; Reed, Shelby D; Liao, Lawrence; Gould, Stuart D; O'connor, Christopher M; Schulman, Kevin A

    2007-01-15

    Although heart failure disease management (HFDM) programs improve patient outcomes, the implementation of these programs has been limited because of financial barriers. We undertook the present study to understand the economic incentives and disincentives for adoption of disease management strategies from the perspectives of a physician (group), a hospital, an integrated health system, and a third-party payer. Using the combined results of a group of randomized controlled trials and a set of financial assumptions from a single academic medical center, a financial model was developed to compute the expected costs before and after the implementation of a HFDM program by 3 provider types (physicians, hospitals, and health systems), as well as the costs incurred from a payer perspective. The base-case model showed that implementation of HFDM results in a net financial loss to all potential providers of HFDM. Implementation of HFDM as described in our base-case analysis would create a net loss of US dollars 179,549 in the first year for a physician practice, US dollars 464,132 for an integrated health system, and US dollars 652,643 in the first year for a hospital. Third-party payers would be able to save US dollars 713,661 annually for the care of 350 patients with heart failure in a HFDM program. In conclusion, although HFDM programs may provide patients with improved clinical outcomes and decreased hospitalizations that save third-party payers money, limited financial incentives are currently in place for healthcare providers and hospitals to initiate these programs.

  9. The influence of socioeconomic status on women's preferences for modern contraceptive providers in Nigeria: a multilevel choice modeling

    Directory of Open Access Journals (Sweden)

    Aremu O

    2013-12-01

    Full Text Available Olatunde Aremu School of Health, Sport, and Bioscience, Health Studies Field, University of East London, London, United Kingdom Background: Contraceptives are one of the most cost effective public health interventions. An understanding of the factors influencing users' preferences for contraceptives sources, in addition to their preferred methods of contraception, is an important factor in increasing contraceptive uptake. This study investigates the effect of women’s contextual and individual socioeconomic positions on their preference for contraceptive sources among current users in Nigeria. Methods: A multilevel modeling analysis was conducted using the most recent 2008 Nigerian Demographic and Health Surveys data of women aged between 15 and 49 years old. The analysis included 1,834 ever married women from 888 communities across the 36 states of the federation, including the Federal Capital Territory of Abuja. Three outcome variables, private, public, and informal provisions of contraceptive sources, were considered in the modeling. Results: There was variability in women's preferences for providers across communities. The result shows that change in variance accounted for about 31% and 19% in the odds of women's preferences for both private and public providers across communities. Younger age and being from the richest households are strongly associated with preference for both private and public providers. Living in rural areas and economically deprived neighborhoods were the community level determinants of women's preferences. Conclusion: This study documents the independent association of contextual socioeconomic characteristics and individual level socioeconomic factors with women's preferences for contraceptive commodity providers in Nigeria. Initiatives that seek to improve modern contraceptive uptake should jointly consider users’ preferences for sources of these commodities in addition to their preference for contraceptive type

  10. Deaf college students' attitudes toward racial/ethnic diversity, campus climate, and role models.

    Science.gov (United States)

    Parasnis, Ila; Samar, Vincent J; Fischer, Susan D

    2005-01-01

    Deaf college students' attitudes toward a variety of issues related to racial/ethnic diversity were surveyed by contacting all racial/ethnic minority deaf students and a random sample of Caucasian deaf students attending the National Technical Institute for the Deaf (NTID), Rochester Institute of Technology; 38% completed the survey. Although racial/ethnic groups similarly perceived NTID's commitment and efforts related to diversity, they differed significantly on some items related to campus climate and role models. Furthermore, the racial/ethnic minority groups differed from each other in their perceptions of campus comfort level, racial conflict, friendship patterns, and availability of role models. Educational satisfaction was positively correlated with campus comfort level; both correlated negatively with perception of discrimination and racial conflict. Qualitative data analyses supported quantitative data analyses and provided rich detail that facilitated interpretation of deaf students' experiences related to racial/ethnic diversity.

  11. Roles and responsibilities in the secondary level eye care model

    Directory of Open Access Journals (Sweden)

    Saibaba Saravanan

    2005-12-01

    Full Text Available In any secondary level eye care clinic, a number of tasks must be completed. In different countries and different settings, different people will carry out these tasks. The manager is responsible for ensuring that all the tasks are covered, that people are carefully selected to perform them, and that staff are supported and managed. The International Centre for Advancement of Rural Eye Care (ICARE, within the L.V. Prasad Eye Institute (LVPEI in India, has evolved an eye care team to provide secondary level eye care services to a population of 0.5 to 1 million. The ICARE model emphasises that all cadres of clinical and non-clinical personnel are equally important. Below is a description of the range of jobs at secondary level centres. The tertiary centre at LVPEI manages leadership and training for this model.

  12. Potential role of complementary and alternative health care providers in chronic disease prevention and health promotion: an analysis of National Health Interview Survey data.

    Science.gov (United States)

    Hawk, Cheryl; Ndetan, Harrison; Evans, Marion Willard

    2012-01-01

    To make a preliminary assessment of the potential role of the most frequently used licensed or certified United States complementary and alternative medicine (CAM) providers in chronic disease prevention and health promotion. This was a secondary analysis of the 2007 United States National Health Interview Survey (NHIS), the most recent to include CAM use. The Adult Core Sample, Person and Adult Complementary and Alternative Medicine data files were included. NHIS's complete survey design structure (strata, cluster and survey weights) was applied in generating national population estimates for CAM usage. Chiropractic or osteopathic manipulation (8.4%) and massage (8.1%) were most commonly used; acupuncture was used by 1.4% and naturopathy by 0.3% of respondents. Substantial proportions of respondents reported using CAM for wellness and disease prevention, and informed their medical physician of use. Fifty-four percent were overweight or obese, 22.0% physically inactive, and 17.4% smokers; 18.0% reported hypertension, 19.6% high cholesterol, and 9.1% prediabetes or diabetes. CAM users present with risk factors which are priority public health issues. This implies a need to train CAM providers in evidence-based health promotion counseling. CAM encounters may provide opportunities to coordinate health promotion and prevention messages with patients' primary care providers. Copyright © 2011 Elsevier Inc. All rights reserved.

  13. The role of plant phenology in stomatal ozone flux modeling.

    Science.gov (United States)

    Anav, Alessandro; Liu, Qiang; De Marco, Alessandra; Proietti, Chiara; Savi, Flavia; Paoletti, Elena; Piao, Shilong

    2018-01-01

    Plant phenology plays a pivotal role in the climate system as it regulates the gas exchange between the biosphere and the atmosphere. The uptake of ozone by forest is estimated through several meteorological variables and a specific function describing the beginning and the termination of plant growing season; actually, in many risk assessment studies, this function is based on a simple latitude and topography model. In this study, using two satellite datasets, we apply and compare six methods to estimate the start and the end dates of the growing season across a large region covering all Europe for the year 2011. Results show a large variability between the green-up and dormancy dates estimated using the six different methods, with differences greater than one month. However, interestingly, all the methods display a common spatial pattern in the uptake of ozone by forests with a marked change in the magnitude, up to 1.9 TgO3 /year, and corresponding to a difference of 25% in the amount of ozone that enters the leaves. Our results indicate that improved estimates of ozone fluxes require a better representation of plant phenology in the models used for O3 risk assessment. © 2017 John Wiley & Sons Ltd.

  14. Computer simulation models as a tool to investigate the role of microRNAs in osteoarthritis.

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    Carole J Proctor

    Full Text Available The aim of this study was to show how computational models can be used to increase our understanding of the role of microRNAs in osteoarthritis (OA using miR-140 as an example. Bioinformatics analysis and experimental results from the literature were used to create and calibrate models of gene regulatory networks in OA involving miR-140 along with key regulators such as NF-κB, SMAD3, and RUNX2. The individual models were created with the modelling standard, Systems Biology Markup Language, and integrated to examine the overall effect of miR-140 on cartilage homeostasis. Down-regulation of miR-140 may have either detrimental or protective effects for cartilage, indicating that the role of miR-140 is complex. Studies of individual networks in isolation may therefore lead to different conclusions. This indicated the need to combine the five chosen individual networks involving miR-140 into an integrated model. This model suggests that the overall effect of miR-140 is to change the response to an IL-1 stimulus from a prolonged increase in matrix degrading enzymes to a pulse-like response so that cartilage degradation is temporary. Our current model can easily be modified and extended as more experimental data become available about the role of miR-140 in OA. In addition, networks of other microRNAs that are important in OA could be incorporated. A fully integrated model could not only aid our understanding of the mechanisms of microRNAs in ageing cartilage but could also provide a useful tool to investigate the effect of potential interventions to prevent cartilage loss.

  15. Role of Self-Efficacy in the Relationship Between Patient-Provider Relationships and Psychological Insulin Resistance Among Patients with Type 2 Diabetes.

    Science.gov (United States)

    Nam, Soohyun; Nam, Soohyun; Song, Youngshin

    Psychological insulin resistance (PIR) affects patients' self-care behaviors and quality of life due to the delay of insulin treatment for optimal glycemic control. Although effective patient-provider communication and relationships have been shown to improve patients' overall treatment adherence and attitude toward treatment, little is known about the potential mechanisms by which effective patient-provider communication and relationships decrease PIR and whether these relationships are mediated by diabetes self-efficacy. The purpose of this study is to examine whether diabetes self-efficacy among patients with type 2 diabetes (T2D) mediates the relationships between PIR and perceived patient-provider relationships. A total of 178 patients with T2D participated in a cross-sectional study. Data were obtained by patient interview using validated measures of diabetes attitude, diabetes knowledge, self-efficacy, and patient-provider communication. PIR was measured by using a validated measure, Barriers to Insulin Treatment. A structural equation model was developed to estimate direct and indirect effects of patient-provider relationship on PIR when self-efficacy was controlled as a mediator. Diabetes knowledge and attitude were not significantly associated with PIR. Better patient-provider relationship was directly associated with lower PIR (β = -.40, p = 0.008). When diabetes self-efficacy was included as a mediator, the direct effect between patient-provider relationship and PIR changed (β = -.27, p = 0.034), indicating that better patient-provider relationship that reduces PIR is due to greater diabetes self-efficacy. The findings suggest that development of intervention programs aimed at improving diabetes self-efficacy-which may be positively correlated with better patient-provider relationship-is needed to reduce PIR.

  16. On the role of model structure in hydrological modeling : Understanding models

    NARCIS (Netherlands)

    Gharari, S.

    2016-01-01

    Modeling is an essential part of the science of hydrology. Models enable us to formulate what we know and perceive from the real world into a neat package. Rainfall-runoff models are abstract simplifications of how a catchment works. Within the research field of scientific rainfall-runoff modeling,

  17. DART: A Community Facility Providing State-of-the-Art, Efficient Ensemble Data Assimilation for Large (Coupled) Geophysical Models

    Science.gov (United States)

    Hoar, T. J.; Anderson, J. L.; Collins, N.; Kershaw, H.; Hendricks, J.; Raeder, K.; Mizzi, A. P.; Barré, J.; Gaubert, B.; Madaus, L. E.; Aydogdu, A.; Raeder, J.; Arango, H.; Moore, A. M.; Edwards, C. A.; Curchitser, E. N.; Escudier, R.; Dussin, R.; Bitz, C. M.; Zhang, Y. F.; Shrestha, P.; Rosolem, R.; Rahman, M.

    2016-12-01

    Strongly-coupled ensemble data assimilation with multiple high-resolution model components requires massive state vectors which need to be efficiently stored and accessed throughout the assimilation process. Supercomputer architectures are tending towards increasing the number of cores per node but have the same or less memory per node. Recent advances in the Data Assimilation Research Testbed (DART), a freely-available community ensemble data assimilation facility that works with dozens of large geophysical models, have addressed the need to run with a smaller memory footprint on a higher node count by utilizing MPI-2 one-sided communication to do non-blocking asynchronous access of distributed data. DART runs efficiently on many computational platforms ranging from laptops through thousands of cores on the newest supercomputers. Benefits of the new DART implementation will be shown. In addition, overviews of the most recently supported models will be presented: CAM-CHEM, WRF-CHEM, CM1, OpenGGCM, FESOM, ROMS, CICE5, TerrSysMP (COSMO, CLM, ParFlow), JULES, and CABLE. DART provides a comprehensive suite of software, documentation, and tutorials that can be used for ensemble data assimilation research, operations, and education. Scientists and software engineers at NCAR are available to support DART users who want to use existing DART products or develop their own applications. Current DART users range from university professors teaching data assimilation, to individual graduate students working with simple models, through national laboratories and state agencies doing operational prediction with large state-of-the-art models.

  18. Human neural stem cells over-expressing VEGF provide neuroprotection, angiogenesis and functional recovery in mouse stroke model.

    Directory of Open Access Journals (Sweden)

    Hong J Lee

    Full Text Available BACKGROUND: Intracerebral hemorrhage (ICH is a lethal stroke type. As mortality approaches 50%, and current medical therapy against ICH shows only limited effectiveness, an alternative approach is required, such as stem cell-based cell therapy. Previously we have shown that intravenously transplanted human neural stem cells (NSCs selectively migrate to the brain and induce behavioral recovery in rat ICH model, and that combined administration of NSCs and vascular endothelial growth factor (VEGF results in improved structural and functional outcome from cerebral ischemia. METHODS AND FINDINGS: We postulated that human NSCs overexpressing VEGF transplanted into cerebral cortex overlying ICH lesion could provide improved survival of grafted NSCs, increased angiogenesis and behavioral recovery in mouse ICH model. ICH was induced in adult mice by unilateral injection of bacterial collagenase into striatum. HB1.F3.VEGF human NSC line produced an amount of VEGF four times higher than parental F3 cell line in vitro, and induced behavioral improvement and 2-3 fold increase in cell survival at two weeks and eight weeks post-transplantation. CONCLUSIONS: Brain transplantation of F3 human NSCs over-expressing VEGF near ICH lesion sites provided differentiation and survival of grafted human NSCs and renewed angiogenesis of host brain and functional recovery of ICH animals. These results suggest a possible application of the human neural stem cell line, which is genetically modified to over-express VEGF, as a therapeutic agent for ICH-stroke.

  19. Motivation by positive or negative role models: regulatory focus determines who will best inspire us.

    Science.gov (United States)

    Lockwood, Penelope; Jordan, Christian H; Kunda, Ziva

    2002-10-01

    In 3 studies, the authors demonstrated that individuals are motivated by role models who encourage strategies that fit their regulatory concerns: Promotion-focused individuals, who favor a strategy of pursuing desirable outcomes, are most inspired by positive role models, who highlight strategies for achieving success; prevention-focused individuals, who favor a strategy of avoiding undesirable outcomes, are most motivated by negative role models, who highlight strategies for avoiding failure. In Studies 1 and 2, the authors primed promotion and prevention goals and then examined the impact of role models on motivation. Participants' academic motivation was increased by goal-congruent role models but decreased by goal-incongruent role models. In Study 3, participants were more likely to generate real-life role models that matched their chronic goals.

  20. Xenon and Sevoflurane Provide Analgesia during Labor and Fetal Brain Protection in a Perinatal Rat Model of Hypoxia-Ischemia

    Science.gov (United States)

    Yang, Ting; Zhuang, Lei; Rei Fidalgo, António M.; Petrides, Evgenia; Terrando, Niccolo; Wu, Xinmin; Sanders, Robert D.; Robertson, Nicola J.; Johnson, Mark R.; Maze, Mervyn; Ma, Daqing

    2012-01-01

    It is not possible to identify all pregnancies at risk of neonatal hypoxic-ischemic encephalopathy (HIE). Many women use some form of analgesia during childbirth and some anesthetic agents have been shown to be neuroprotective when used as analgesics at subanesthetic concentrations. In this study we sought to understand the effects of two anesthetic agents with presumptive analgesic activity and known preconditioning-neuroprotective properties (sevoflurane or xenon), in reducing hypoxia-induced brain damage in a model of intrauterine perinatal asphyxia. The analgesic and neuroprotective effects at subanesthetic levels of sevoflurane (0.35%) or xenon (35%) were tested in a rat model of intrauterine perinatal asphyxia. Analgesic effects were measured by assessing maternal behavior and spinal cord dorsal horn neuronal activation using c-Fos. In separate experiments, intrauterine fetal asphyxia was induced four hours after gas exposure; on post-insult day 3 apoptotic cell death was measured by caspase-3 immunostaining in hippocampal neurons and correlated with the number of viable neurons on postnatal day (PND) 7. A separate cohort of pups was nurtured by a surrogate mother for 50 days when cognitive testing with Morris water maze was performed. Both anesthetic agents provided analgesia as reflected by a reduction in the number of stretching movements and decreased c-Fos expression in the dorsal horn of the spinal cord. Both agents also reduced the number of caspase-3 positive (apoptotic) neurons and increased cell viability in the hippocampus at PND7. These acute histological changes were mirrored by improved cognitive function measured remotely after birth on PND 50 compared to control group. Subanesthetic doses of sevoflurane or xenon provided both analgesia and neuroprotection in this model of intrauterine perinatal asphyxia. These data suggest that anesthetic agents with neuroprotective properties may be effective in preventing HIE and should be tested in clinical

  1. Providing competency-based family medicine residency training in substance abuse in the new millennium: a model curriculum

    Directory of Open Access Journals (Sweden)

    Shellenberger Sylvia

    2010-05-01

    Full Text Available Abstract Background This article, developed for the Betty Ford Institute Consensus Conference on Graduate Medical Education (December, 2008, presents a model curriculum for Family Medicine residency training in substance abuse. Methods The authors reviewed reports of past Family Medicine curriculum development efforts, previously-identified barriers to education in high risk substance use, approaches to overcoming these barriers, and current training guidelines of the Accreditation Council for Graduate Medical Education (ACGME and their Family Medicine Residency Review Committee. A proposed eight-module curriculum was developed, based on substance abuse competencies defined by Project MAINSTREAM and linked to core competencies defined by the ACGME. The curriculum provides basic training in high risk substance use to all residents, while also addressing current training challenges presented by U.S. work hour regulations, increasing international diversity of Family Medicine resident trainees, and emerging new primary care practice models. Results This paper offers a core curriculum, focused on screening, brief intervention and referral to treatment, which can be adapted by residency programs to meet their individual needs. The curriculum encourages direct observation of residents to ensure that core skills are learned and trains residents with several "new skills" that will expand the basket of substance abuse services they will be equipped to provide as they enter practice. Conclusions Broad-based implementation of a comprehensive Family Medicine residency curriculum should increase the ability of family physicians to provide basic substance abuse services in a primary care context. Such efforts should be coupled with faculty development initiatives which ensure that sufficient trained faculty are available to teach these concepts and with efforts by major Family Medicine organizations to implement and enforce residency requirements for

  2. Examining the Support Peer Supporters Provide Using Structural Equation Modeling: Nondirective and Directive Support in Diabetes Management.

    Science.gov (United States)

    Kowitt, Sarah D; Ayala, Guadalupe X; Cherrington, Andrea L; Horton, Lucy A; Safford, Monika M; Soto, Sandra; Tang, Tricia S; Fisher, Edwin B

    2017-12-01

    Little research has examined the characteristics of peer support. Pertinent to such examination may be characteristics such as the distinction between nondirective support (accepting recipients' feelings and cooperative with their plans) and directive (prescribing "correct" choices and feelings). In a peer support program for individuals with diabetes, this study examined (a) whether the distinction between nondirective and directive support was reflected in participants' ratings of support provided by peer supporters and (b) how nondirective and directive support were related to depressive symptoms, diabetes distress, and Hemoglobin A1c (HbA1c). Three hundred fourteen participants with type 2 diabetes provided data on depressive symptoms, diabetes distress, and HbA1c before and after a diabetes management intervention delivered by peer supporters. At post-intervention, participants reported how the support provided by peer supporters was nondirective or directive. Confirmatory factor analysis (CFA), correlation analyses, and structural equation modeling examined the relationships among reports of nondirective and directive support, depressive symptoms, diabetes distress, and measured HbA1c. CFA confirmed the factor structure distinguishing between nondirective and directive support in participants' reports of support delivered by peer supporters. Controlling for demographic factors, baseline clinical values, and site, structural equation models indicated that at post-intervention, participants' reports of nondirective support were significantly associated with lower, while reports of directive support were significantly associated with greater depressive symptoms, altogether (with control variables) accounting for 51% of the variance in depressive symptoms. Peer supporters' nondirective support was associated with lower, but directive support was associated with greater depressive symptoms.

  3. THE MODEL OF PREVENTION OF VANDAL BEHAVIOR PROVIDED BY THE DEFORMATIONS AND DESTRUCTIONS OF VALUABLE SPHERE OF YOUTH

    Directory of Open Access Journals (Sweden)

    Irina V. Vorobyeva

    2015-01-01

    model involves personal values that are considered as a dynamic system. Fundamentally new approach to prevention interventions is realised: the model focuses not so much on sanctions actions as on technologies of psychological influences on the problem personality; and formation of steady prosocial strategy of person’s behaviour. Practical significance. The research findings and the application of the proposed model can be useful while planning of educative work in terms of educational institutions by the teachers, administrators and parents, as it provides the possibility to organize selective and point events to prevent destructive behavior of pupils and students, taking into account the characteristics of their value and the scope of actual problems in the manifestation of activity.  

  4. Medicare Provider Data - Hospice Providers

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Hospice Utilization and Payment Public Use File provides information on services provided to Medicare beneficiaries by hospice providers. The Hospice PUF...

  5. Teacher role stress, satisfaction, commitment, and intentions to leave: a structural model.

    Science.gov (United States)

    Conley, Sharon; You, Sukkyung

    2009-12-01

    Structural equation modeling was used to assess the plausibility of a conceptual model specifying hypothesized linkages among teachers' perceptions of the role stresses of role ambiguity, role conflict, and role overload and commitment, satisfaction, and intentions to leave their employing school. 178 teachers in four high schools in a southern coastal region of California responded to survey questions designed to capture the above constructs. Confirmatory factor analysis was used to assess whether the role-stress items fit hypothesized constructs. Structural equation modeling results indicated that satisfaction and commitment are two mediators in the role stresses-intentions to leave relationship.

  6. A new glucocerebrosidase-deficient neuronal cell model provides a tool to probe pathophysiology and therapeutics for Gaucher disease.

    Science.gov (United States)

    Westbroek, Wendy; Nguyen, Matthew; Siebert, Marina; Lindstrom, Taylor; Burnett, Robert A; Aflaki, Elma; Jung, Olive; Tamargo, Rafael; Rodriguez-Gil, Jorge L; Acosta, Walter; Hendrix, An; Behre, Bahafta; Tayebi, Nahid; Fujiwara, Hideji; Sidhu, Rohini; Renvoise, Benoit; Ginns, Edward I; Dutra, Amalia; Pak, Evgenia; Cramer, Carole; Ory, Daniel S; Pavan, William J; Sidransky, Ellen

    2016-07-01

    Glucocerebrosidase is a lysosomal hydrolase involved in the breakdown of glucosylceramide. Gaucher disease, a recessive lysosomal storage disorder, is caused by mutations in the gene GBA1 Dysfunctional glucocerebrosidase leads to accumulation of glucosylceramide and glycosylsphingosine in various cell types and organs. Mutations in GBA1 are also a common genetic risk factor for Parkinson disease and related synucleinopathies. In recent years, research on the pathophysiology of Gaucher disease, the molecular link between Gaucher and Parkinson disease, and novel therapeutics, have accelerated the need for relevant cell models with GBA1 mutations. Although induced pluripotent stem cells, primary rodent neurons, and transfected neuroblastoma cell lines have been used to study the effect of glucocerebrosidase deficiency on neuronal function, these models have limitations because of challenges in culturing and propagating the cells, low yield, and the introduction of exogenous mutant GBA1 To address some of these difficulties, we established a high yield, easy-to-culture mouse neuronal cell model with nearly complete glucocerebrosidase deficiency representative of Gaucher disease. We successfully immortalized cortical neurons from embryonic null allele gba(-/-) mice and the control littermate (gba(+/+)) by infecting differentiated primary cortical neurons in culture with an EF1α-SV40T lentivirus. Immortalized gba(-/-) neurons lack glucocerebrosidase protein and enzyme activity, and exhibit a dramatic increase in glucosylceramide and glucosylsphingosine accumulation, enlarged lysosomes, and an impaired ATP-dependent calcium-influx response; these phenotypical characteristics were absent in gba(+/+) neurons. This null allele gba(-/-) mouse neuronal model provides a much-needed tool to study the pathophysiology of Gaucher disease and to evaluate new therapies. © 2016. Published by The Company of Biologists Ltd.

  7. A new glucocerebrosidase-deficient neuronal cell model provides a tool to probe pathophysiology and therapeutics for Gaucher disease

    Directory of Open Access Journals (Sweden)

    Wendy Westbroek

    2016-07-01

    Full Text Available Glucocerebrosidase is a lysosomal hydrolase involved in the breakdown of glucosylceramide. Gaucher disease, a recessive lysosomal storage disorder, is caused by mutations in the gene GBA1. Dysfunctional glucocerebrosidase leads to accumulation of glucosylceramide and glycosylsphingosine in various cell types and organs. Mutations in GBA1 are also a common genetic risk factor for Parkinson disease and related synucleinopathies. In recent years, research on the pathophysiology of Gaucher disease, the molecular link between Gaucher and Parkinson disease, and novel therapeutics, have accelerated the need for relevant cell models with GBA1 mutations. Although induced pluripotent stem cells, primary rodent neurons, and transfected neuroblastoma cell lines have been used to study the effect of glucocerebrosidase deficiency on neuronal function, these models have limitations because of challenges in culturing and propagating the cells, low yield, and the introduction of exogenous mutant GBA1. To address some of these difficulties, we established a high yield, easy-to-culture mouse neuronal cell model with nearly complete glucocerebrosidase deficiency representative of Gaucher disease. We successfully immortalized cortical neurons from embryonic null allele gba−/− mice and the control littermate (gba+/+ by infecting differentiated primary cortical neurons in culture with an EF1α-SV40T lentivirus. Immortalized gba−/− neurons lack glucocerebrosidase protein and enzyme activity, and exhibit a dramatic increase in glucosylceramide and glucosylsphingosine accumulation, enlarged lysosomes, and an impaired ATP-dependent calcium-influx response; these phenotypical characteristics were absent in gba+/+ neurons. This null allele gba−/− mouse neuronal model provides a much-needed tool to study the pathophysiology of Gaucher disease and to evaluate new therapies.

  8. A dynamic neuro-fuzzy model providing bio-state estimation and prognosis prediction for wearable intelligent assistants.

    Science.gov (United States)

    Wang, Yu; Winters, Jack M

    2005-06-28

    Intelligent management of wearable applications in rehabilitation requires an understanding of the current context, which is constantly changing over the rehabilitation process because of changes in the person's status and environment. This paper presents a dynamic recurrent neuro-fuzzy system that implements expert-and evidence-based reasoning. It is intended to provide context-awareness for wearable intelligent agents/assistants (WIAs). The model structure includes the following types of signals: inputs, states, outputs and outcomes. Inputs are facts or events which have effects on patients' physiological and rehabilitative states; different classes of inputs (e.g., facts, context, medication, therapy) have different nonlinear mappings to a fuzzy "effect." States are dimensionless linguistic fuzzy variables that change based on causal rules, as implemented by a fuzzy inference system (FIS). The FIS, with rules based on expertise and evidence, essentially defines the nonlinear state equations that are implemented by nuclei of dynamic neurons. Outputs, a function of weighing of states and effective inputs using conventional or fuzzy mapping, can perform actions, predict performance, or assist with decision-making. Outcomes are scalars to be extremized that are a function of outputs and states. The first example demonstrates setup and use for a large-scale stroke neurorehabilitation application (with 16 inputs, 12 states, 5 outputs and 3 outcomes), showing how this modelling tool can successfully capture causal dynamic change in context-relevant states (e.g., impairments, pain) as a function of input event patterns (e.g., medications). The second example demonstrates use of scientific evidence to develop rule-based dynamic models, here for predicting changes in muscle strength with short-term fatigue and long-term strength-training. A neuro-fuzzy modelling framework is developed for estimating rehabilitative change that can be applied in any field of rehabilitation

  9. A Dynamic Neuro-Fuzzy Model Providing Bio-State Estimation and Prognosis Prediction for Wearable Intelligent Assistants

    Directory of Open Access Journals (Sweden)

    Winters Jack M

    2005-06-01

    Full Text Available Abstract Background Intelligent management of wearable applications in rehabilitation requires an understanding of the current context, which is constantly changing over the rehabilitation process because of changes in the person's status and environment. This paper presents a dynamic recurrent neuro-fuzzy system that implements expert-and evidence-based reasoning. It is intended to provide context-awareness for wearable intelligent agents/assistants (WIAs. Methods The model structure includes the following types of signals: inputs, states, outputs and outcomes. Inputs are facts or events which have effects on patients' physiological and rehabilitative states; different classes of inputs (e.g., facts, context, medication, therapy have different nonlinear mappings to a fuzzy "effect." States are dimensionless linguistic fuzzy variables that change based on causal rules, as implemented by a fuzzy inference system (FIS. The FIS, with rules based on expertise and evidence, essentially defines the nonlinear state equations that are implemented by nuclei of dynamic neurons. Outputs, a function of weighing of states and effective inputs using conventional or fuzzy mapping, can perform actions, predict performance, or assist with decision-making. Outcomes are scalars to be extremized that are a function of outputs and states. Results The first example demonstrates setup and use for a large-scale stroke neurorehabilitation application (with 16 inputs, 12 states, 5 outputs and 3 outcomes, showing how this modelling tool can successfully capture causal dynamic change in context-relevant states (e.g., impairments, pain as a function of input event patterns (e.g., medications. The second example demonstrates use of scientific evidence to develop rule-based dynamic models, here for predicting changes in muscle strength with short-term fatigue and long-term strength-training. Conclusion A neuro-fuzzy modelling framework is developed for estimating

  10. Biological phosphorus removal in an extended ASM2 model: Roles of extracellular polymeric substances and kinetic modeling.

    Science.gov (United States)

    Yang, Shan-Shan; Pang, Ji-Wei; Guo, Wan-Qian; Yang, Xiao-Yin; Wu, Zhong-Yang; Ren, Nan-Qi; Zhao, Zhi-Qing

    2017-05-01

    This paper presents the results of an extended ASM2 model for the modeling and calibration of the role of extracellular polymeric substances (EPS) in phosphorus (P) removal in an anaerobic-aerobic process. In this extended ASM2 model, two new components, the bound EPS (XEPS) and the soluble EPS (SEPS), are introduced. Compared with the ASM2, 7.71, 8.53, and 9.28% decreases in polyphosphate (polyP) were observed in the extended ASM2 in three sequencing batch reactors feeding with different COD/P ratios, indicating that 7.71-9.28% of P in the liquid was adsorbed by EPS. Sensitive analysis indicated that, five parameters were the significant influential parameters and had been chosen for further model calibration by using the least square method to simulate by MATLAB. This extended ASM2 has been successfully established to simulate the output variables and provides a useful reference for the mathematic simulations of the role of EPS in biological phosphorus removal process. Copyright © 2017. Published by Elsevier Ltd.

  11. The Hispanic Clinic for Pediatric Surgery: A model to improve parent-provider communication for Hispanic pediatric surgery patients.

    Science.gov (United States)

    Jaramillo, Joshua; Snyder, Elizabeth; Dunlap, Jonathan L; Wright, Robert; Mendoza, Fernando; Bruzoni, Matias

    2016-04-01

    26 million Americans have limited English proficiency (LEP). It is well established that language barriers adversely affect health and health care. Despite growing awareness of language barriers, there is essentially a void in the medical literature regarding the influence of language disparity on pediatric surgery patients. This study was designed to assess the impact of patient-provider language concordance on question-asking behavior and patient satisfaction for pediatric surgery patients. Participants included families of patients in a General Pediatric Surgery Clinic categorized into 3 groups by patient-provider language concordance: concordant English-speaking, LEP concordant Spanish-speaking, and LEP discordant Spanish-speaking using an interpreter. Clinical visits were audio recorded and the number of patient-initiated questions and the length of clinical encounter were measured. Families were administered a surgery-specific, 5-point Likert scale questionnaire modeled after validated surveys concerning communication, trust, perceived discrimination and patient-provider language concordance. Regression models were performed to analyze associations between language concordance and patient's question-asking behavior and between language concordance and survey results. A total of 156 participants were enrolled including 57 concordant-English, 52 LEP concordant-Spanish and 47 LEP-discordant-Spanish. There was significant variation in the mean number of patient-initiated questions among the groups (p=0.002). Both the English and Spanish concordant groups asked a similar number of questions (p=0.9), and they both asked more questions compared to the Spanish-discordant participants (p=0.002 and p=0.001). Language discordance was associated with fewer questions asked after adjustment for socioeconomic status. Language concordant participants rated higher scores of communication. Both Spanish-concordant and Spanish-discordant patients reported significantly increased

  12. Modelling the fathering role: Experience in the family of origin and father involvement

    Directory of Open Access Journals (Sweden)

    Mihić Ivana

    2012-01-01

    Full Text Available The study presented in this paper deals with the effects of experiences with father in the family of origin on the fathering role in the family of procreation. The results of the studies so far point to great importance of such experiences in parental role modelling, while recent approaches have suggested the concept of introjected notion or an internal working model of the fathering role as the way to operationalise the transgenerational transfer. The study included 247 two-parent couple families whose oldest child attended preschool education. Fathers provided information on self-assessed involvement via the Inventory of father involvement, while both fathers and mothers gave information on introjected experiences from the family of origin via the inventory Presence of the father in the family of origin. It was shown that father’s experiences from the family of origin had significant direct effects on his involvement in child-care. Very important experiences were those of negative emotional exchange, physical closeness and availability of the father, as well as beliefs about the importance of the father as a parent. Although maternal experiences from the family of origin did not contribute significantly to father involvement, shared beliefs about father’s importance as a parent in the parenting alliance had an effect on greater involvement in child-care. The data provide confirmation of the hypotheses on modelling of the fathering role, but also open the issue of the factor of intergenerational maintenance of traditional forms of father involvement in families in Serbia.

  13. The Role of Health Advocacy in Transitions from Pediatric to Adult Care for Children with Special Health Care Needs: Bridging Families, Provider and Community Services.

    Science.gov (United States)

    Okumura, Megumi J; Saunders, Mara; Rehm, Roberta S

    2015-01-01

    Youth and young adults with special healthcare needs (YASHCN) experience challenges during transition from pediatric to adult care. Prior studies have not examined how community and healthcare resources can work together to assist YASHCN in transitioning from child-focused care and services to adult-oriented providers. The aim of this study was to develop a theoretical understanding of how family, healthcare providers and community supports can assist YASHCN during the transition from pediatric to adult healthcare and services. We conducted 41 semi-structured interviews with YASHCN aged 16-25, their family members and healthcare and community providers. We focused our interviews on support mechanisms, both within the traditional healthcare system, and those available in the community. Using grounded theory methods, we performed a multi-step analysis process. The theoretical code "Transition Advocacy" was developed from the data. This theoretical perspective arose from three major categories, which were developed in the analysis: "Fighting for healthcare", "Obtaining resources", and "Getting ready to transition". Transition Advocacy consists of the presence of, or need for, a healthcare "advocate" who did or can assist the YASHCN with the healthcare transition, particularly to navigate complex health or community services. The "advocate" role was performed by family members, healthcare or agency professionals, or sometimes the YASHCN themselves. If advocates were identified, youth were more likely to obtain needed services. Parents, health providers, and community agencies are potentially well-poised to assist transitioning YASHCN. Efforts to encourage development of strong advocacy skills will facilitate better transitions for YASHCN. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Modeling Studying the Role of Bacteria on ice Nucleation Processes

    Science.gov (United States)

    Sun, J.

    2006-12-01

    Certain air-borne bacteria have been recognized as active ice nuclei at the temperatures warm than - 10°C. Ice nucleating bacteria commonly found in plants and ocean surface. These ice nucleating bacteria are readily disseminated into the atmosphere and have been observed in clouds and hailstones, and their importance in cloud formation process and precipitation, as well as causing diseases in plants and animal kingdom, have been considered for over two decades, but their significance in atmospheric processes are yet to be understood. A 1.5-D non-hydrostatic cumulus cloud model with bin-resolved microphysics is developed and is to used to examine the relative importance of sulphate aerosol concentrations on the evolution of cumulus cloud droplet spectra and ice multiplication process, as well as ice initiation process by ice nucleating bacteria in the growing stage of cumulus clouds and the key role of this process on the ice multiplication in the subsequent dissipating stage of cumulus clouds. In this paper, we will present some sensitivity test results of the evolution of cumulus cloud spectra, ice concentrations at various concentrations of sulfate aerosols, and at different ideal sounding profiles. We will discuss the implication of our results in understanding of ice nucleation processes.

  15. Two-dimensional modelling of internal arc effects in an enclosed MV cell provided with a protection porous filter

    Energy Technology Data Exchange (ETDEWEB)

    Rochette, D [Laboratoire Arc Electrique et Plasmas Thermiques, CNRS UMR 6069, Universite Blaise Pascal, IUT de Montlucon, Avenue Aristide Briand, BP 2235, 03101 Montlucon Cedex (France); Clain, S [Laboratoire de Mathematiques pour l' Industrie et la Physique, CNRS UMR 5640, Universite Paul Sabatier Toulouse 3, 118 route de Narbonne, 31062 Toulouse Cedex 4 (France); Andre, P [Laboratoire Arc Electrique et Plasmas Thermiques, CNRS UMR 6069, Universite Blaise Pascal, IUT de Montlucon, Avenue Aristide Briand, BP 2235, 03101 Montlucon Cedex (France); Bussiere, W [Laboratoire Arc Electrique et Plasmas Thermiques, CNRS UMR 6069, Universite Blaise Pascal, IUT de Montlucon, Avenue Aristide Briand, BP 2235, 03101 Montlucon Cedex (France); Gentils, F [Schneider Electric-Science and Technology Division-Research Center A2, 38050 Grenoble Cedex 9 (France)

    2007-05-21

    Medium voltage (MV) cells have to respect standards (for example IEC ones (IEC TC 17C 2003 IEC 62271-200 High Voltage Switchgear and Controlgear-Part 200 1st edn)) that define security levels against internal arc faults such as an accidental electrical arc occurring in the apparatus. New protection filters based on porous materials are developed to provide better energy absorption properties and a higher protection level for people. To study the filter behaviour during a major electrical accident, a two-dimensional model is proposed. The main point is the use of a dedicated numerical scheme for a non-conservative hyperbolic problem. We present a numerical simulation of the process during the first 0.2 s when the safety valve bursts and we compare the numerical results with tests carried out in a high power test laboratory on real electrical apparatus.

  16. Modelling the effect of perceived interdependence among mental healthcare professionals on their work role performance.

    Science.gov (United States)

    Markon, Marie-Pierre; Chiocchio, François; Fleury, Marie-Josée

    2017-07-01

    The purpose of mental healthcare system reform was to enhance service efficiency by strengthening primary mental healthcare and increasing service integration in communities. Reinforcing interprofessional teamwork also intended to address the extensive and multidimensional needs of patients with mental disorders by bringing together a broader array of expertise. In this context, mental healthcare professionals (MHCPs) from various health and social care professions are more interdependent in many aspects of their work (tasks, resources, and goals). We wanted to examine the effect of perceived interdependence among MHCPs on their work role performance in the context of mental healthcare. For this purpose, we developed and tested a model coherent with the Input-Mediator-Outcome-Input (IMOI) framework of team effectiveness. Data from questionnaires administered to 315 MHCPs from four local health service networks in Quebec, Canada were analysed through structural equation modelling and mediation analysis. The structural equation model provided a good fit for the data and explained 51% of the variance of work role performance. Perceived collaboration, confidence in the advantages of interprofessional collaboration, involvement in the decision process, knowledge sharing, and satisfaction with the nature of the work partially mediated the effect of perceived interdependence among team members on work role performance. Therefore, perceived interdependence among team members had a positive impact on the work role performance of MHCPs mostly through its effect on favourable team functioning features. This implies, in practice, that increased interdependence of MHCPs would be more likely to truly enhance work role performance if team-based interventions to promote collaborative work and interprofessional teaching and training programs to support work within interprofessional teams were jointly implemented. Participation in the decision process and knowledge sharing should

  17. Does the macaque monkey provide a good model for studying human executive control? A comparative behavioral study of task switching.

    Directory of Open Access Journals (Sweden)

    Luana Caselli

    Full Text Available The ability to swiftly and smoothly switch from one task set to another is central to intelligent behavior, because it allows an organism to flexibly adapt to ever changing environmental conditions and internal needs. For this reason, researchers interested in executive control processes have often relied on task-switching paradigms as powerful tools to uncover the underlying cognitive and brain architecture. In order to gather fundamental information at the single-cell level, it would be greatly helpful to demonstrate that non-human primates, especially the macaque monkey, share with us similar behavioral manifestations of task-switching and therefore, in all likelihood, similar underlying brain mechanisms. Unfortunately, prior attempts have provided negative results (e.g., Stoet & Snyder, 2003b, in that it was reported that macaques do not show the typical signature of task-switching operations at the behavioral level, represented by switch costs. If confirmed, this would indicate that the macaque cannot be used as a model approach to explore human executive control mechanisms by means of task-switching paradigms. We have therefore decided to re-explore this issue, by conducting a comparative experiment on a group of human participants and two macaque monkeys, whereby we measured and compared performance costs linked to task switching and resistance to interference across the two species. Contrary to what previously reported, we found that both species display robust task switching costs, thus supporting the claim that macaque monkeys provide an exquisitely suitable model to study the brain mechanisms responsible for maintaining and switching task sets.

  18. A model for determining when an analysis contains sufficient detail to provide adequate NEPA coverage for a proposed action

    Energy Technology Data Exchange (ETDEWEB)

    Eccleston, C.H.

    1994-11-01

    Neither the National Environmental Policy Act (NEPA) nor its subsequent regulations provide substantive guidance for determining the Level of detail, discussion, and analysis that is sufficient to adequately cover a proposed action. Yet, decisionmakers are routinely confronted with the problem of making such determinations. Experience has shown that no two decisionmakers are Likely to completely agree on the amount of discussion that is sufficient to adequately cover a proposed action. one decisionmaker may determine that a certain Level of analysis is adequate, while another may conclude the exact opposite. Achieving a consensus within the agency and among the public can be problematic. Lacking definitive guidance, decisionmakers and critics alike may point to a universe of potential factors as the basis for defending their claim that an action is or is not adequately covered. Experience indicates that assertions are often based on ambiguous opinions that can be neither proved nor disproved. Lack of definitive guidance slows the decisionmaking process and can result in project delays. Furthermore, it can also Lead to inconsistencies in decisionmaking, inappropriate Levels of NEPA documentation, and increased risk of a project being challenged for inadequate coverage. A more systematic and less subjective approach for making such determinations is obviously needed. A paradigm for reducing the degree of subjectivity inherent in such decisions is presented in the following paper. The model is specifically designed to expedite the decisionmaking process by providing a systematic approach for making these determination. In many cases, agencies may find that using this model can reduce the analysis and size of NEPA documents.

  19. Supplementary Material for: Mycobacterium tuberculosis whole genome sequencing and protein structure modelling provides insights into anti-tuberculosis drug resistance

    KAUST Repository

    Phelan, Jody

    2016-01-01

    Abstract Background Combating the spread of drug resistant tuberculosis is a global health priority. Whole genome association studies are being applied to identify genetic determinants of resistance to anti-tuberculosis drugs. Protein structure and interaction modelling are used to understand the functional effects of putative mutations and provide insight into the molecular mechanisms leading to resistance. Methods To investigate the potential utility of these approaches, we analysed the genomes of 144 Mycobacterium tuberculosis clinical isolates from The Special Programme for Research and Training in Tropical Diseases (TDR) collection sourced from 20 countries in four continents. A genome-wide approach was applied to 127 isolates to identify polymorphisms associated with minimum inhibitory concentrations for first-line anti-tuberculosis drugs. In addition, the effect of identified candidate mutations on protein stability and interactions was assessed quantitatively with well-established computational methods. Results The analysis revealed that mutations in the genes rpoB (rifampicin), katG (isoniazid), inhA-promoter (isoniazid), rpsL (streptomycin) and embB (ethambutol) were responsible for the majority of resistance observed. A subset of the mutations identified in rpoB and katG were predicted to affect protein stability. Further, a strong direct correlation was observed between the minimum inhibitory concentration values and the distance of the mutated residues in the three-dimensional structures of rpoB and katG to their respective drugs binding sites. Conclusions Using the TDR resource, we demonstrate the usefulness of whole genome association and convergent evolution approaches to detect known and potentially novel mutations associated with drug resistance. Further, protein structural modelling could provide a means of predicting the impact of polymorphisms on drug efficacy in the absence of phenotypic data. These approaches could ultimately lead to novel

  20. Mycobacterium tuberculosis whole genome sequencing and protein structure modelling provides insights into anti-tuberculosis drug resistance

    KAUST Repository

    Phelan, Jody

    2016-03-23

    Background Combating the spread of drug resistant tuberculosis is a global health priority. Whole genome association studies are being applied to identify genetic determinants of resistance to anti-tuberculosis drugs. Protein structure and interaction modelling are used to understand the functional effects of putative mutations and provide insight into the molecular mechanisms leading to resistance. Methods To investigate the potential utility of these approaches, we analysed the genomes of 144 Mycobacterium tuberculosis clinical isolates from The Special Programme for Research and Training in Tropical Diseases (TDR) collection sourced from 20 countries in four continents. A genome-wide approach was applied to 127 isolates to identify polymorphisms associated with minimum inhibitory concentrations for first-line anti-tuberculosis drugs. In addition, the effect of identified candidate mutations on protein stability and interactions was assessed quantitatively with well-established computational methods. Results The analysis revealed that mutations in the genes rpoB (rifampicin), katG (isoniazid), inhA-promoter (isoniazid), rpsL (streptomycin) and embB (ethambutol) were responsible for the majority of resistance observed. A subset of the mutations identified in rpoB and katG were predicted to affect protein stability. Further, a strong direct correlation was observed between the minimum inhibitory concentration values and the distance of the mutated residues in the three-dimensional structures of rpoB and katG to their respective drugs binding sites. Conclusions Using the TDR resource, we demonstrate the usefulness of whole genome association and convergent evolution approaches to detect known and potentially novel mutations associated with drug resistance. Further, protein structural modelling could provide a means of predicting the impact of polymorphisms on drug efficacy in the absence of phenotypic data. These approaches could ultimately lead to novel resistance

  1. Role modeling in medical education: the importance of a reflective imitation.

    Science.gov (United States)

    Benbassat, Jochanan

    2014-04-01

    The medical literature almost uniformly addresses the positive aspects of role modeling. Still, some authors have questioned its educational value, a disagreement that is probably due to differing definitions of role modeling. If defined as demonstration of skills, provision of feedback, and emulation of specific professional behaviors, then role modeling is an important component of clinical training. However, if it is defined as a learner's unselective imitation of role models and uncritical adoption of the messages of the learning environment, then the benefits of role modeling should be weighed against its unintended harm.In this Perspective, the author argues that imitation of role models may initially help students adapt to the clinical environment. However, if sustained, imitation may perpetuate undesirable practices, such as doctor-centered patient interviewing, and unintended institutional norms, such as discrimination between private and public patients. The author suggests that the value of role modeling can be advanced not only by targeting role models and improving faculty performance but also by enhancing students' reflective assessment of their preceptors' behaviors, especially so that they can better discern those that are worth imitating. This student-centered approach may be accomplished by first, warning students against uncritically imitating preceptors who are perceived as role models; second, showing students that their preceptors share their doubts and uncertainties; third, gaining an insight into possible undesirable messages of the learning environment; and finally, developing policies for faculty recruitment and promotion that consider whether a clinical preceptor is a role model.

  2. A model to identify mathematics topics in MXit lingo to provide tutors quick access to supporting documentation

    Directory of Open Access Journals (Sweden)

    Laurie Butgereit

    2011-11-01

    Full Text Available Dr MathTM is a mobile, online tutoring system where learners can use MXitTM on their mobile phones to receive help with their mathematics homework from volunteer tutors. These conversations between learners and Dr Math are held in MXit lingo. MXit lingo is a heavily abbreviated, English-like language that is evolving between users of mobile phones that communicate using MXit. The Dr Math project has been running since January 2007 and uses volunteer tutors who are mostly university students who readily understand and use MXit lingo. However, due to the large number of simultaneous conversations that the tutors are often involved in and the diversity of topics discussed, it would often be beneficial to provide assistance regarding the mathematics topic to the tutors. This article explains how the μ model identifies the mathematics topic in the conversation. The model identifies appropriate mathematics topics in just over 75% of conversations in a corpus of conversations identified to be about mathematics topics in the school curriculum.

  3. A Multi-Period Optimization Model for Service Providers Using Online Reservation Systems: An Application to Hotels.

    Directory of Open Access Journals (Sweden)

    Ming Xu

    Full Text Available This paper presents a multi-period optimization model for high margin and zero salvage products in online distribution channels with classifying customers based on number of products required. Taking hotel customers as an example, one is regular customers who reserve rooms for one day, and the other is long term stay (LTS customers who reserve rooms for a number of days. LTS may guarantee a specific amount of demand and generate opportunity income for a certain number of periods, meanwhile with risk of punishment incurred by overselling. By developing an operational optimization model and exploring the effects of parameters on optimal decisions, we suggest that service providers should make decisions based on the types of customers, number of products required, and duration of multi-period to reduce the loss of reputation and obtain more profit; at the same time, multi-period buying customers should buy products early. Finally, the paper conducts a numerical experiment, and the results are consistent with prevailing situations.

  4. A Multi-Period Optimization Model for Service Providers Using Online Reservation Systems: An Application to Hotels

    Science.gov (United States)

    Xu, Ming; Jiao, Yan; Li, Xiaoming; Cao, Qingfeng; Wang, Xiaoyang

    2015-01-01

    This paper presents a multi-period optimization model for high margin and zero salvage products in online distribution channels with classifying customers based on number of products required. Taking hotel customers as an example, one is regular customers who reserve rooms for one day, and the other is long term stay (LTS) customers who reserve rooms for a number of days. LTS may guarantee a specific amount of demand and generate opportunity income for a certain number of periods, meanwhile with risk of punishment incurred by overselling. By developing an operational optimization model and exploring the effects of parameters on optimal decisions, we suggest that service providers should make decisions based on the types of customers, number of products required, and duration of multi-period to reduce the loss of reputation and obtain more profit; at the same time, multi-period buying customers should buy products early. Finally, the paper conducts a numerical experiment, and the results are consistent with prevailing situations. PMID:26147663

  5. A New Model for Providing Cell-Free DNA and Risk Assessment for Chromosome Abnormalities in a Public Hospital Setting

    Directory of Open Access Journals (Sweden)

    Robert Wallerstein

    2014-01-01

    Full Text Available Objective. Cell-free DNA (cfDNA offers highly accurate noninvasive screening for Down syndrome. Incorporating it into routine care is complicated. We present our experience implementing a novel program for cfDNA screening, emphasizing patient education, genetic counseling, and resource management. Study Design. Beginning in January 2013, we initiated a new patient care model in which high-risk patients for aneuploidy received genetic counseling at 12 weeks of gestation. Patients were presented with four pathways for aneuploidy risk assessment and diagnosis: (1 cfDNA; (2 integrated screening; (3 direct-to-invasive testing (chorionic villus sampling or amniocentesis; or (4 no first trimester diagnostic testing/screening. Patients underwent follow-up genetic counseling and detailed ultrasound at 18–20 weeks to review first trimester testing and finalize decision for amniocentesis. Results. Counseling and second trimester detailed ultrasound were provided to 163 women. Most selected cfDNA screening (69% over integrated screening (0.6%, direct-to-invasive testing (14.1%, or no screening (16.6%. Amniocentesis rates decreased following implementation of cfDNA screening (19.0% versus 13.0%, P<0.05. Conclusion. When counseled about screening options, women often chose cfDNA over integrated screening. This program is a model for patient-directed, efficient delivery of a newly available high-level technology in a public health setting. Genetic counseling is an integral part of patient education and determination of plan of care.

  6. Non-Model-Based Control of a Wheeled Vehicle Pulling Two Trailers to Provide Early Powered Mobility and Driving Experiences.

    Science.gov (United States)

    Sanders Td Vr, David A

    2018-01-01

    Non-model-based control of a wheeled vehicle pulling two trailers is proposed. It is a fun train for disabled children consisting of a locomotive and two carriages. The fun train has afforded opportunities for both disabled and able bodied young people to share an activity and has provided early driving experiences for disabled children; it has introduced them to assistive and powered mobility. The train is a nonlinear system and subject to nonholonomic kinematic constraints, so that position and state depend on the path taken to get there. The train is described, and then, a robust control algorithm using proportional-derivative filtered errors is proposed to control the locomotive. The controller was not dependent on an accurate model of the train, because the mass of the vehicle and two carriages changed depending on the number, size, and shape of children and wheelchair seats on the train. The controller was robust and stable in uncertainty. Results are presented to show the effectiveness of the approach, and the suggested control algorithm is shown to be acceptable without knowing the exact plant dynamics.

  7. Arbovirus models to provide practical management tools for mosquito control and disease prevention in the Northern Territory, Australia.

    Science.gov (United States)

    Jacups, Susan P; Whelan, Peter I; Harley, David

    2011-03-01

    Ross River virus (RRV) causes the most common human arbovirus disease in Australia. Although the disease is nonfatal, the associated arthritis and postinfection fatigue can be debilitating for many months, impacting on workforce participation. We sought to create an early-warning system to notify of approaching RRV disease outbreak conditions for major townships in the Northern Territory. By applying a logistic regression model to meteorologic factors, including rainfall, a postestimation analysis of sensitivity and specificity can create rainfall cut-points. These rainfall cut-points indicate the rainfall level above which previous epidemic conditions have occurred. Furthermore, rainfall cut-points indirectly adjust for vertebrate host data from the agile wallaby (Macropus agilis) as the life cycle of the agile wallaby is intricately meshed with the wet season. Once generated, cut-points can thus be used prospectively to allow timely implementation of larval survey and control measures and public health warnings to preemptively reduce RRV disease incidence. Cut-points are location specific and have the capacity to replace previously used models, which require data management and input, and rarely provide timely notification for vector control requirements and public health warnings. These methods can be adapted for use elsewhere.

  8. A Multi-Period Optimization Model for Service Providers Using Online Reservation Systems: An Application to Hotels.

    Science.gov (United States)

    Xu, Ming; Jiao, Yan; Li, Xiaoming; Cao, Qingfeng; Wang, Xiaoyang

    2015-01-01

    This paper presents a multi-period optimization model for high margin and zero salvage products in online distribution channels with classifying customers based on number of products required. Taking hotel customers as an example, one is regular customers who reserve rooms for one day, and the other is long term stay (LTS) customers who reserve rooms for a number of days. LTS may guarantee a specific amount of demand and generate opportunity income for a certain number of periods, meanwhile with risk of punishment incurred by overselling. By developing an operational optimization model and exploring the effects of parameters on optimal decisions, we suggest that service providers should make decisions based on the types of customers, number of products required, and duration of multi-period to reduce the loss of reputation and obtain more profit; at the same time, multi-period buying customers should buy products early. Finally, the paper conducts a numerical experiment, and the results are consistent with prevailing situations.

  9. Hospital pharmacists' roles and attitudes in providing information on the safety of non-steroidal anti-inflammatory drugs in Thailand.

    Science.gov (United States)

    Phueanpinit, Pacharaporn; Jarernsiripornkul, Narumol; Pongwecharak, Juraporn; Krska, Janet

    2014-12-01

    Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used for patients to manage pain and inflammation, especially in older adults. Failure to cope with some adverse drug reactions (ADRs) of NSAIDs could lead to more serious symptoms, therefore, providing useful information about medicine is an important step in protecting patients from developing serious ADRs. The pharmacy service should be a frequent source of medicine information for patients, however in Thailand, little is known about pharmacists' provision of safety information to patients for management and prevention of these ADRs. Aims of this study were to determine Thai hospital pharmacists' roles in providing drug safety information and to assess their attitudes towards the importance of giving drug safety education to patients. All government hospitals in north-eastern Thailand. This study was a cross-sectional survey. A total of 761 pharmacists in 287 hospitals in north-eastern Thailand were selected by stratified random sampling. Self-administered questionnaires were sent by post, with two reminders. Proportion of hospital pharmacists providing ADR information on NSAIDs to patients, factors affecting this provision, and pharmacist attitudes towards drug safety education for patients. The response rate was 54.8% (N = 417), the majority of respondents worked in community hospitals (57.2%). A total of 347 pharmacists (83.6%) had informed patients about ADRs, although less than half had informed patients about ADR monitoring and management (36.6% and 44.1% respectively). The proportion of time spent in direct patient contact, type of hospital, and other routine work were associated with the frequency of drug safety information provision. Pharmacists had moderately good attitudinal scores towards drug safety education (62.2 ± 5.4), with significantly higher scores found in those who provided most ADR information to patients (60.3 ± 5.2 vs. 62.6 ± 5.4, P = 0.002). The majority (82.2%) agreed that

  10. The pathway from glandular fever to chronic fatigue syndrome: can the cognitive behavioural model provide the map?

    Science.gov (United States)

    Moss-Morris, R; Spence, M J; Hou, R

    2011-05-01

    The cognitive behavioural model of chronic fatigue syndrome (CFS) suggests that the illness is caused through reciprocal interactions between physiology, cognition, emotion and behaviour. The purpose of this study was to investigate whether the psychological factors operationalized in this model could predict the onset of CFS following an acute episode of infectious mononucleosis commonly known as glandular fever (GF). A total of 246 patients with GF were recruited into this prospective cohort study. Standardized self-report measures of perceived stress, perfectionism, somatization, mood, illness beliefs and behaviour were completed at the time of their acute illness. Follow-up questionnaires determined the incidence of new-onset chronic fatigue (CF) at 3 months and CFS at 6 months post-infection. Of the participants, 9.4% met the criteria for CF at 3 months and 7.8% met the criteria for CFS at 6 months. Logistic regression revealed that factors proposed to predispose people to CFS including anxiety, depression, somatization and perfectionism were associated with new-onset CFS. Negative illness beliefs including perceiving GF to be a serious, distressing condition, that will last a long time and is uncontrollable, and responding to symptoms in an all-or-nothing behavioural pattern were also significant predictors. All-or-nothing behaviour was the most significant predictor of CFS at 6 months. Perceived stress and consistently limiting activity at the time of GF were not significantly associated with CFS. The findings from this study provide support for the cognitive behavioural model and a good basis for developing prevention and early intervention strategies for CFS.

  11. Formative evaluation of a telemedicine model for delivering clinical neurophysiology services part I: Utility, technical performance and service provider perspective

    Directory of Open Access Journals (Sweden)

    Breen Patricia

    2010-09-01

    Full Text Available Abstract Background Formative evaluation is conducted in the early stages of system implementation to assess how it works in practice and to identify opportunities for improving technical and process performance. A formative evaluation of a teleneurophysiology service was conducted to examine its technical and sociological dimensions. Methods A teleneurophysiology service providing routine EEG investigation was established. Service use, technical performance and satisfaction of clinical neurophysiology personnel were assessed qualitatively and quantitatively. These were contrasted with a previously reported analysis of the need for teleneurophysiology, and examination of expectation and satisfaction with clinical neurophysiology services in Ireland. A preliminary cost-benefit analysis was also conducted. Results Over the course of 40 clinical sessions during 20 weeks, 142 EEG investigations were recorded and stored on a file server at a satellite centre which was 130 miles away from the host clinical neurophysiology department. Using a virtual private network, the EEGs were accessed by a consultant neurophysiologist at the host centre for interpretation. The model resulted in a 5-fold increase in access to EEG services as well as reducing average waiting times for investigation by a half. Technically the model worked well, although a temporary loss of virtual private network connectivity highlighted the need for clarity in terms of responsibility for troubleshooting and repair of equipment problems. Referral quality, communication between host and satellite centres, quality of EEG recordings, and ease of EEG review and reporting indicated that appropriate organisational processes were adopted by the service. Compared to traditional CN service delivery, the teleneurophysiology model resulted in a comparable unit cost per EEG. Conclusion Observations suggest that when traditional organisational boundaries are crossed challenges associated with the

  12. Module structure of interphotoreceptor retinoid-binding protein (IRBP may provide bases for its complex role in the visual cycle – structure/function study of Xenopus IRBP

    Directory of Open Access Journals (Sweden)

    Ghosh Debashis

    2007-08-01

    Full Text Available Abstract Background Interphotoreceptor retinoid-binding protein's (IRBP remarkable module structure may be critical to its role in mediating the transport of all-trans and 11-cis retinol, and 11-cis retinal between rods, cones, RPE and Müller cells during the visual cycle. We isolated cDNAs for Xenopus IRBP, and expressed and purified its individual modules, module combinations, and the full-length polypeptide. Binding of all-trans retinol, 11-cis retinal and 9-(9-anthroyloxy stearic acid were characterized by fluorescence spectroscopy monitoring ligand-fluorescence enhancement, quenching of endogenous protein fluorescence, and energy transfer. Finally, the X-ray crystal structure of module-2 was used to predict the location of the ligand-binding sites, and compare their structures among modules using homology modeling. Results The full-length Xenopus IRBP cDNA codes for a polypeptide of 1,197 amino acid residues beginning with a signal peptide followed by four homologous modules each ~300 amino acid residues in length. Modules 1 and 3 are more closely related to each other than either is to modules 2 and 4. Modules 1 and 4 are most similar to the N- and C-terminal modules of the two module IRBP of teleosts. Our data are consistent with the model that vertebrate IRBPs arose through two genetic duplication events, but that the middle two modules were lost during the evolution of the ray finned fish. The sequence of the expressed full-length IRBP was confirmed by liquid chromatography-tandem mass spectrometry. The recombinant full-length Xenopus IRBP bound all-trans retinol and 11-cis retinaldehyde at 3 to 4 sites with Kd's of 0.2 to 0.3 μM, and was active in protecting all-trans retinol from degradation. Module 2 showed selectivity for all-trans retinol over 11-cis retinaldehyde. The binding data are correlated to the results of docking of all-trans-retinol to the crystal structure of Xenopus module 2 suggesting two ligand-binding sites

  13. Beliefs and emotions have different roles in generating attitudes toward providing personal help and state-sponsored help for people with a mental illness.

    Science.gov (United States)

    Obonsawin, Marc C; Lindsay, Amanda; Hunter, Simon C

    2013-07-01

    The aim of this study was to examine the role of emotions like pity and anger in mediating the relationship between beliefs about the controllability of a mental illness, and the willingness to help someone with a mental illness. In particular, we tested the hypothesis that the effects of beliefs about controllability on the willingness to provide personal help are mediated by the emotions of pity and anger, but that the effects of beliefs about controllability on the willingness to condone state-organised help were more direct, and not mediated by emotions. A between-groups design was employed to investigate the effects of manipulating controllability attributions via 3 hypothetical vignettes. ANOVA analysis of responses to a revised version of the AQ-27 from 371 participants demonstrated that beliefs about controllability lead to significantly higher personal responsibility beliefs, negative affective reactions and decreased helping intentions in comparison to when the cause of mental illness was believed to be uncontrollable. A mediation analysis demonstrated that pity and anger fully mediate the relationship between beliefs about controllability and the willingness to offer personal help, and also demonstrated that pity and anger partially mediate the relationship between beliefs about controllability and the willingness to condone help provided by the state. The partial mediation may indicate that the effects of beliefs about controllability on state-sponsored may be mediated by pity in some people, but that in other people, beliefs have a more proximal effect on behavior. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. Biophysical model of the role of actin remodeling on dendritic spine morphology

    Science.gov (United States)

    Miermans, C. A.; Kusters, R. P. T.; Hoogenraad, C. C.; Storm, C.

    2017-01-01

    Dendritic spines are small membranous structures that protrude from the neuronal dendrite. Each spine contains a synaptic contact site that may connect its parent dendrite to the axons of neighboring neurons. Dendritic spines are markedly distinct in shape and size, and certain types of stimulation prompt spines to evolve, in fairly predictable fashion, from thin nascent morphologies to the mushroom-like shapes associated with mature spines. It is well established that the remodeling of spines is strongly dependent upon the actin cytoskeleton inside the spine. A general framework that details the precise role of actin in directing the transitions between the various spine shapes is lacking. We address this issue, and present a quantitative, model-based scenario for spine plasticity validated using realistic and physiologically relevant parameters. Our model points to a crucial role for the actin cytoskeleton. In the early stages of spine formation, the interplay between the elastic properties of the spine membrane and the protrusive forces generated in the actin cytoskeleton propels the incipient spine. In the maturation stage, actin remodeling in the form of the combined dynamics of branched and bundled actin is required to form mature, mushroom-like spines. Importantly, our model shows that constricting the spine-neck aids in the stabilization of mature spines, thus pointing to a role in stabilization and maintenance for additional factors such as ring-like F-actin structures. Taken together, our model provides unique insights into the fundamental role of actin remodeling and polymerization forces during spine formation and maturation. PMID:28158194

  15. Influence of Role Models and Hospital Design on the Hand Hygiene of Health-Care Workers

    OpenAIRE

    Lankford, Mary G.; Zembower, Teresa R.; Trick, William E.; Hacek, Donna M.; Noskin, Gary A.; Peterson, Lance R.

    2003-01-01

    We assessed the effect of medical staff role models and the number of health-care worker sinks on hand-hygiene compliance before and after construction of a new hospital designed for increased access to handwashing sinks. We observed health-care worker hand hygiene in four nursing units that provided similar patient care in both the old and new hospitals: medical and surgical intensive care, hematology/oncology, and solid organ transplant units. Of 721 hand-hygiene opportunities, 304 (42%) we...

  16. When Gender Identity Doesn't Equal Sex Recorded at Birth: The Role of the Laboratory in Providing Effective Healthcare to the Transgender Community.

    Science.gov (United States)

    Goldstein, Zil; Corneil, Trevor A; Greene, Dina N

    2017-08-01

    Transgender is an umbrella term used to describe individuals who identify with a gender incongruent to or variant from their sex recorded at birth. Affirming gender identity through a variety of social, medical, and surgical interventions is critical to the mental health of transgender individuals. In recent years, awareness surrounding transgender identities has increased, which has highlighted the health disparities that parallel this demographic. These disparities are reflected in the experience of transgender patients and their providers when seeking clinical laboratory services. Little is known about the effect of gender-affirming hormone therapy and surgery on optimal laboratory test interpretation. Efforts to diminish health disparities encountered by transgender individuals and their providers can be accomplished by increasing social and clinical awareness regarding sex/gender incongruence and gaining insight into the physiological manifestations and laboratory interpretations of gender-affirming strategies. This review summarizes knowledge required to understand transgender healthcare including current clinical interventions for gender dysphoria. Particular attention is paid to the subsequent impact of these interventions on laboratory test utilization and interpretation. Common nomenclature and system barriers are also discussed. Understanding gender incongruence, the clinical changes associated with gender transition, and systemic barriers that maintain a gender/sex binary are key to providing adequate healthcare to transgender community. Transgender appropriate reference interval studies are virtually absent within the medical literature and should be explored. The laboratory has an important role in improving the physiological understanding, electronic medical system recognition, and overall social awareness of the transgender community. © 2017 American Association for Clinical Chemistry.

  17. Using reactive transport codes to provide mechanistic biogeochemistry representations in global land surface models: CLM-PFLOTRAN 1.0

    Science.gov (United States)

    Tang, G.; Yuan, F.; Bisht, G.; Hammond, G. E.; Lichtner, P. C.; Kumar, J.; Mills, R. T.; Xu, X.; Andre, B.; Hoffman, F. M.; Painter, S. L.; Thornton, P. E.

    2015-12-01

    update tolerance. As some biogeochemical processes (e.g., methane and nitrous oxide production and consumption) involve very low half saturation and threshold concentrations, this work provides insights for addressing nonphysical negativity issues and facilitates the representation of a mechanistic biogeochemical description in earth system models to reduce climate prediction uncertainty.

  18. Determining the optimal model for role-substitution in NHS dental services in the United Kingdom.

    Science.gov (United States)

    Brocklehurst, Paul; Birch, Stephen; McDonald, Ruth; Tickle, Martin

    2013-09-24

    Role-substitution describes a model of dental care where Dental Care Professionals (DCPs) provide some of the clinical activity previously undertaken by General Dental Practitioners. This has the potential to increase technical efficiency, the capacity to care and reduce costs. Technical efficiency is defined as the production of the maximum amount of output from a given amount of input so that the service operates at the production frontier i.e. optimal level of productivity. Academic research into technical efficiency is becoming increasingly utilised in health care, although no studies have investigated the efficiency of NHS dentistry or role-substitution in high-street dental practices. The aim of this study is to examine the barriers and enablers that exist for role-substitution in general dental practices in the NHS and to determine the most technically efficient model for role-substitution. A screening questionnaire will be sent to DCPs to determine the type and location of role-substitutive models employed in NHS dental practices in the United Kingdom (UK). Semi-structured interviews will then be conducted with practice owners, DCPs and patients at selected sites identified by the questionnaire. Detail will be recorded about the organisational structure of the dental team, the number of NHS hours worked and the clinical activity undertaken. The interviews will continue until saturation and will record the views and attitudes of the members of the dental team. Final numbers of interviews will be determined by saturation.The second work-stream will examine the technical efficiency of the selected practices using Data Envelopment Analysis and Stochastic Frontier Modeling. The former is a non-parametric technique and is considered to be a highly flexible approach for applied health applications. The latter is parametric and is based on frontier regression models that estimate a conventional cost function. Maximising health for a given level and mix of resources

  19. Towards a Definition of Role-related Concepts for Business Modeling

    NARCIS (Netherlands)

    Meertens, Lucas Onno; Iacob, Maria Eugenia; Nieuwenhuis, Lambertus Johannes Maria

    2010-01-01

    Abstract—While several role-related concepts play an important role in business modeling, their definitions, relations, and use differ greatly between languages, papers, and reports. Due to this, the knowledge captured by models is not transferred correctly, and models are incomparable. In this

  20. Dissolving decision making? : Models and their roles in decision-making processes and policy at large

    NARCIS (Netherlands)

    Zeiss, Ragna; van Egmond, S.

    2014-01-01

    This article studies the roles three science-based models play in Dutch policy and decision making processes. Key is the interaction between model construction and environment. Their political and scientific environments form contexts that shape the roles of models in policy decision making.

  1. Gender, Race, and the Politics of Role Modelling: The Influence of Male Teachers. Routledge Research in Education

    Science.gov (United States)

    Martino, Wayne; Rezai-Rashti, Goli

    2011-01-01

    This book provides an illuminating account of teachers' own reflections on their experiences of teaching in urban schools. It was conceived as a direct response to policy-related and media-generated concerns about male teacher shortage and offers a critique of the call for more male role models in elementary schools to address important issues…

  2. Science teacher candidates' perceptions about roles and nature of scientific models

    Science.gov (United States)

    Yenilmez Turkoglu, Ayse; Oztekin, Ceren

    2016-05-01

    Background: Scientific models have important roles in science and science education. For scientists, they provide a means for generating new knowledge or function as an accessible summary of scientific studies. In science education, on the other hand, they are accessible representations of abstract concepts, and are also organizational frameworks to teach and learn inaccessible facts. As being indispensable parts of learning and doing science, use of scientific models in science classes should be reinforced. At this point, uncovering pre-service science teachers' (PSTs) understandings of scientific models are of great importance since they will design and conduct teaching situations for their students. Purpose: The study aimed to provide an answer to the research question: What understandings do PSTs possess about scientific models? Sample: The sample of the study consisted of 14 PSTs enrolled in an Elementary Science Education program in a public university in Ankara, Turkey. Design and methods: Data were collected by using an open-item instrument and semi-structured interviews, and were analyzed by using qualitative data analysis methods. Results: Findings showed that PSTs held fragmented views of models by having informed views in some aspects while having naïve views on others. That is, although they displayed a constructivist orientation by acknowledging the presence of multiple models for the same phenomenon depending on scientists' perspectives or creativity involved in the production of scientific knowledge, PSTs also expressed logical positivist views by believing that models should be close to the real phenomena that they represent. Findings further revealed that PSTs generally conceptualized models' materialistic uses, yet they did not think much about their theoretical and conceptual uses. It was observed that roles like reifying and visualizing were overestimated and models were dominantly characterized as three-dimensional representations

  3. Prospective molecular profiling of canine cancers provides a clinically relevant comparative model for evaluating personalized medicine (PMed trials.

    Directory of Open Access Journals (Sweden)

    Melissa Paoloni

    Full Text Available BACKGROUND: Molecularly-guided trials (i.e. PMed now seek to aid clinical decision-making by matching cancer targets with therapeutic options. Progress has been hampered by the lack of cancer models that account for individual-to-individual heterogeneity within and across cancer types. Naturally occurring cancers in pet animals are heterogeneous and thus provide an opportunity to answer questions about these PMed strategies and optimize translation to human patients. In order to realize this opportunity, it is now necessary to demonstrate the feasibility of conducting molecularly-guided analysis of tumors from dogs with naturally occurring cancer in a clinically relevant setting. METHODOLOGY: A proof-of-concept study was conducted by the Comparative Oncology Trials Consortium (COTC to determine if tumor collection, prospective molecular profiling, and PMed report generation within 1 week was feasible in dogs. Thirty-one dogs with cancers of varying histologies were enrolled. Twenty-four of 31 samples (77% successfully met all predefined QA/QC criteria and were analyzed via Affymetrix gene expression profiling. A subsequent bioinformatics workflow transformed genomic data into a personalized drug report. Average turnaround from biopsy to report generation was 116 hours (4.8 days. Unsupervised clustering of canine tumor expression data clustered by cancer type, but supervised clustering of tumors based on the personalized drug report clustered by drug class rather than cancer type. CONCLUSIONS: Collection and turnaround of high quality canine tumor samples, centralized pathology, analyte generation, array hybridization, and bioinformatic analyses matching gene expression to therapeutic options is achievable in a practical clinical window (<1 week. Clustering data show robust signatures by cancer type but also showed patient-to-patient heterogeneity in drug predictions. This lends further support to the inclusion of a heterogeneous population of

  4. Aire-deficient mice provide a model of corneal and lacrimal gland neuropathy in Sjögren's syndrome.

    Science.gov (United States)

    Chen, Feeling Y; Lee, Albert; Ge, Shaokui; Nathan, Sara; Knox, Sarah M; McNamara, Nancy A

    2017-01-01

    Sjögren's syndrome (SS) is a chronic, autoimmune exocrinopathy that leads to severe dryness of the mouth and eyes. Exocrine function is highly regulated by neuronal mechanisms but little is known about the link between chronic inflammation, innervation and altered exocrine function in the diseased eyes and exocrine glands of SS patients. To gain a better understanding of neuronal regulation in the immunopathogenesis of autoimmune exocrinopathy, we profiled a mouse model of spontaneous, autoimmune exocrinopathy that possess key characteristics of peripheral neuropathy experienced by SS patients. Mice deficient in the autoimmune regulator (Aire) gene developed spontaneous, CD4+ T cell-mediated exocrinopathy and aqueous-deficient dry eye that were associated with loss of nerves innervating the cornea and lacrimal gland. Changes in innervation and tear secretion were accompanied by increased proliferation of corneal epithelial basal cells, limbal expansion of KRT19-positive progenitor cells, increased vascularization of the peripheral cornea and reduced nerve function in the lacrimal gland. In addition, we found extensive loss of MIST1+ secretory acinar cells in the Aire -/- lacrimal gland suggesting that acinar cells are a primary target of the disease, Finally, topical application of ophthalmic steroid effectively restored corneal innervation in Aire -/- mice thereby functionally linking nerve loss with local inflammation in the aqueous-deficient dry eye. These data provide important insight regarding the relationship between chronic inflammation and neuropathic changes in autoimmune-mediated dry eye. Peripheral neuropathies characteristic of SS appear to be tightly linked with the underlying immunopathological mechanism and Aire -/- mice provide an excellent tool to explore the interplay between SS-associated immunopathology and peripheral neuropathy.

  5. SNP discovery and chromosome anchoring provide the first physically-anchored hexaploid oat map and reveal synteny with model species.

    Directory of Open Access Journals (Sweden)

    Rebekah E Oliver

    Full Text Available A physically anchored consensus map is foundational to modern genomics research; however, construction of such a map in oat (Avena sativa L., 2n = 6x = 42 has been hindered by the size and complexity of the genome, the scarcity of robust molecular markers, and the lack of aneuploid stocks. Resources developed in this study include a modified SNP discovery method for complex genomes, a diverse set of oat SNP markers, and a novel chromosome-deficient SNP anchoring strategy. These resources were applied to build the first complete, physically-anchored consensus map of hexaploid oat. Approximately 11,000 high-confidence in silico SNPs were discovered based on nine million inter-varietal sequence reads of genomic and cDNA origin. GoldenGate genotyping of 3,072 SNP assays yielded 1,311 robust markers, of which 985 were mapped in 390 recombinant-inbred lines from six bi-parental mapping populations ranging in size from 49 to 97 progeny. The consensus map included 985 SNPs and 68 previously-published markers, resolving 21 linkage groups with a total map distance of 1,838.8 cM. Consensus linkage groups were assigned to 21 chromosomes using SNP deletion analysis of chromosome-deficient monosomic hybrid stocks. Alignments with sequenced genomes of rice and Brachypodium provide evidence for extensive conservation of genomic regions, and renewed encouragement for orthology-based genomic discovery in this important hexaploid species. These results also provide a framework for high-resolution genetic analysis in oat, and a model for marker development and map construction in other species with complex genomes and limited resources.

  6. SNP Discovery and Chromosome Anchoring Provide the First Physically-Anchored Hexaploid Oat Map and Reveal Synteny with Model Species

    Science.gov (United States)

    Chao, Shiaoman; Jellen, Eric N.; Carson, Martin L.; Rines, Howard W.; Obert, Donald E.; Lutz, Joseph D.; Shackelford, Irene; Korol, Abraham B.; Wight, Charlene P.; Gardner, Kyle M.; Hattori, Jiro; Beattie, Aaron D.; Bjørnstad, Åsmund; Bonman, J. Michael; Jannink, Jean-Luc; Sorrells, Mark E.; Brown-Guedira, Gina L.; Mitchell Fetch, Jennifer W.; Harrison, Stephen A.; Howarth, Catherine J.; Ibrahim, Amir; Kolb, Frederic L.; McMullen, Michael S.; Murphy, J. Paul; Ohm, Herbert W.; Rossnagel, Brian G.; Yan, Weikai; Miclaus, Kelci J.; Hiller, Jordan; Maughan, Peter J.; Redman Hulse, Rachel R.; Anderson, Joseph M.; Islamovic, Emir

    2013-01-01

    A physically anchored consensus map is foundational to modern genomics research; however, construction of such a map in oat (Avena sativa L., 2n = 6x = 42) has been hindered by the size and complexity of the genome, the scarcity of robust molecular markers, and the lack of aneuploid stocks. Resources developed in this study include a modified SNP discovery method for complex genomes, a diverse set of oat SNP markers, and a novel chromosome-deficient SNP anchoring strategy. These resources were applied to build the first complete, physically-anchored consensus map of hexaploid oat. Approximately 11,000 high-confidence in silico SNPs were discovered based on nine million inter-varietal sequence reads of genomic and cDNA origin. GoldenGate genotyping of 3,072 SNP assays yielded 1,311 robust markers, of which 985 were mapped in 390 recombinant-inbred lines from six bi-parental mapping populations ranging in size from 49 to 97 progeny. The consensus map included 985 SNPs and 68 previously-published markers, resolving 21 linkage groups with a total map distance of 1,838.8 cM. Consensus linkage groups were assigned to 21 chromosomes using SNP deletion analysis of chromosome-deficient monosomic hybrid stocks. Alignments with sequenced genomes of rice and Brachypodium provide evidence for extensive conservation of genomic regions, and renewed encouragement for orthology-based genomic discovery in this important hexaploid species. These results also provide a framework for high-resolution genetic analysis in oat, and a model for marker development and map construction in other species with complex genomes and limited resources. PMID:23533580

  7. Bulbar microcircuit model predicts connectivity and roles of interneurons in odor coding.

    Directory of Open Access Journals (Sweden)

    Aditya Gilra

    Full Text Available Stimulus encoding by primary sensory brain areas provides a data-rich context for understanding their circuit mechanisms. The vertebrate olfactory bulb is an input area having unusual two-layer dendro-dendritic connections whose roles in odor coding are unclear. To clarify these roles, we built a detailed compartmental model of the rat olfactory bulb that synthesizes a much wider range of experimental observations on bulbar physiology and response dynamics than has hitherto been modeled. We predict that superficial-layer inhibitory interneurons (periglomerular cells linearize the input-output transformation of the principal neurons (mitral cells, unlike previous models of contrast enhancement. The linearization is required to replicate observed linear summation of mitral odor responses. Further, in our model, action-potentials back-propagate along lateral dendrites of mitral cells and activate deep-layer inhibitory interneurons (granule cells. Using this, we propose sparse, long-range inhibition between mitral cells, mediated by granule cells, to explain how the respiratory phases of odor responses of sister mitral cells can be sometimes decorrelated as observed, despite receiving similar receptor input. We also rule out some alternative mechanisms. In our mechanism, we predict that a few distant mitral cells receiving input from different receptors, inhibit sister mitral cells differentially, by activating disjoint subsets of granule cells. This differential inhibition is strong enough to decorrelate their firing rate phases, and not merely modulate their spike timing. Thus our well-constrained model suggests novel computational roles for the two most numerous classes of interneurons in the bulb.

  8. Simplified Process Model Discovery Based on Role-Oriented Genetic Mining

    OpenAIRE

    Weidong Zhao; Xi Liu; Weihui Dai

    2014-01-01

    Process mining is automated acquisition of process models from event logs. Although many process mining techniques have been developed, most of them are based on control flow. Meanwhile, the existing role-oriented process mining methods focus on correctness and integrity of roles while ignoring role complexity of the process model, which directly impacts understandability and quality of the model. To address these problems, we propose a genetic programming approach to mine the simplified proc...

  9. No doubt about it: when doubtful role models undermine men's and women's math performance under threat.

    Science.gov (United States)

    Marx, David M; Monroe, Allyce H; Cole, Chris E; Gilbert, Patricia N

    2013-01-01

    Past work has shown that female role models are effective buffers against stereotype threat. The present research examines the boundary conditions of this role model effect. Specifically, we argue that female role models should avoid expressing doubt about their math abilities; otherwise they may cease to buffer women from stereotype threat. For men, a non-doubtful male role model should be seen as threatening, thus harming performance. A doubtful male role model, however, should be seen as non-threatening, thus allowing men to perform up to their ability in math. To test this reasoning, men and women were exposed to either an outgroup or ingroup role model who either expressed doubt or did not. Participants then took a math exam under stereotype threat conditions. As expected, doubtful ingroup role models hurt women, but helped men's performance. Outgroup role models' expressed doubt had no differential effect on performance. We also show that expressions of doubt take on a different meaning when expressed by a female rather than a male role model.

  10. Shade-lux simulation model for the evaluation of energy savings in buildings provided with external non homogeneous shading devices

    Energy Technology Data Exchange (ETDEWEB)

    Ferro, P. [CIRPS, Centro Interuniv. de Ricerca per i Paesi in Via di Sviluppo, Roma (Italy); Maccari, A. [ENEA, Ente Nazionale per l' Energia e l' Ambiente, Roma (Italy)

    2000-07-01

    During the hot season, an important amount of energy is necessary to guarantee good internal conditions in tertiary buildings, especially in those used during the daytime and provided with large glazed surfaces exposed to the sun. In order to reduce such amount of energy consumption specific shading devices are required, in particular in buildings located in the Mediterranean area where the solar radiation values are very high. The main purpose of this work is to develop a simulation model that allows to evaluate the energy performances of a building equipped with external non-homogeneous shading devices, traditional or innovative glass surfaces, and internal curtains (complex building envelope transparent systems, BETS) taking also into account the lighting load necessary to guarantee an adequate level of illuminance. In a widely diffused computer code two new routines have been added in order to evaluate the shading factor of the above-mentioned shading devices and the internal daylighting performance. Several runs of the modified program were carried out considering three different sizes of shading devices, with two values of reflectance coefficient, in horizontal position located a south facade with 33%, 50% and 65% of glass surface in three different Italian locations: Milan, Rome and Palermo. The results show that significant energy savings, up to about 40% in terms of primary energy and a diminution of up to 45% of the cooling system power, can be obtained. (au)

  11. The Role of Dispersion in Radionuclide Transport - Data and Modeling Requirements: Revision No. 1

    Energy Technology Data Exchange (ETDEWEB)

    Stoller-Navarro Joint Venture

    2004-02-01

    This document is the collaborative effort of the members of an ad hoc subcommittee of the Underground Test Area Project Technical Working Group. This subcommittee was to answer questions and concerns raised by the Nevada Division of Environmental Protection to the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office, regarding Pahute Mesa Corrective Action Units (CAUs) 101 and 102. The document attempts to synthesize the combined comments made by each member of this subcommittee into insights made in the role of dispersion in radionuclide transport data and modeling. Dispersion is one of many processes that control the concentration of radionuclides in groundwater beneath the Nevada Test Site where CAUs 101 and 102 are located. In order to understand the role of dispersion in radionuclide transport, there is a critical need for CAU- or site-specific data related to transport parameters which is currently lacking, particularly in the case of Western a nd Central Pahute Mesa. The purpose of this technical basis document is to: (1) define dispersion and its role in contaminant transport, (2) present a synopsis of field-scale dispersion measurements, (3) provide a literature review of theories to explain field-scale dispersion, (4) suggest approaches to account for dispersion in CAU-scale radionuclide modeling, and (5) to determine if additional dispersion measurements should be made at this time.

  12. A Model for Implementing HR’S Strategic Role

    Directory of Open Access Journals (Sweden)

    Anca SERBAN

    2015-03-01

    Full Text Available Understanding HR deliverables is an essential process for acknowledging its important role in driving organizational performance, in contrast with its traditionally elusive role. An organization can quantify the HR’s overall strategic impact by finding the proper ways for measuring its impact on the success drivers. This paper aims to identify and describe the steps needed in order to implement HR’s strategic role. The article reviews the relevant literature regarding the integration of HR into business performance measurement and suggests some guidelines for creating a HR scorecard.

  13. The role of models in measurement outside the laboratory

    NARCIS (Netherlands)

    Boumans, M.

    2013-01-01

    For measurement outside the laboratory, uncertainty evaluations have to be model-based. Therefore models should not only represent the measurand but also its environment. For measurement in social science these models will be too complex, therefore instead of white-box models, grey-box

  14. Impact of climate change on crop yield and role of model for achieving food security.

    Science.gov (United States)

    Kumar, Manoj

    2016-08-01

    In recent times, several studies around the globe indicate that climatic changes are likely to impact the food production and poses serious challenge to food security. In the face of climate change, agricultural systems need to adapt measures for not only increasing food supply catering to the growing population worldwide with changing dietary patterns but also to negate the negative environmental impacts on the earth. Crop simulation models are the primary tools available to assess the potential consequences of climate change on crop production and informative adaptive strategies in agriculture risk management. In consideration with the important issue, this is an attempt to provide a review on the relationship between climate change impacts and crop production. It also emphasizes the role of crop simulation models in achieving food security. Significant progress has been made in understanding the potential consequences of environment-related temperature and precipitation effect on agricultural production during the last half century. Increased CO2 fertilization has enhanced the potential impacts of climate change, but its feasibility is still in doubt and debates among researchers. To assess the potential consequences of climate change on agriculture, different crop simulation models have been developed, to provide informative strategies to avoid risks and understand the physical and biological processes. Furthermore, they can help in crop improvement programmes by identifying appropriate future crop management practises and recognizing the traits having the greatest impact on yield. Nonetheless, climate change assessment through model is subjected to a range of uncertainties. The prediction uncertainty can be reduced by using multimodel, incorporating crop modelling with plant physiology, biochemistry and gene-based modelling. For devloping new model, there is a need to generate and compile high-quality field data for model testing. Therefore, assessment of

  15. Flexines’ role model extensions for the smart energy market

    NARCIS (Netherlands)

    Wim Timmerman; Mente Konsman; Rolf Velthuijs

    2013-01-01

    In this paper we focus on the inclusion of decentralized energy production in the current energy infrastructure, and the changing role of the consumer towards a producer and an active participant in the energy value network

  16. Role Playing Using a Simulated Pharmacy and Therapeutics Committee Model

    Science.gov (United States)

    Fletcher, H. Patrick; Popvich, Nicholas G.

    1977-01-01

    Within a simulated Pharmacy and Therapeutics Committee format, role play is used at Purdue University to illustrate to students the concepts of drug product evaluation and selection as these apply to a hospital formulary system. (Author/LBH)

  17. Advances in Geoscience Modeling: Smart Modeling Frameworks, Self-Describing Models and the Role of Standardized Metadata

    Science.gov (United States)

    Peckham, Scott

    2016-04-01

    Over the last decade, model coupling frameworks like CSDMS (Community Surface Dynamics Modeling System) and ESMF (Earth System Modeling Framework) have developed mechanisms that make it much easier for modelers to connect heterogeneous sets of process models in a plug-and-play manner to create composite "system models". These mechanisms greatly simplify code reuse, but must simultaneously satisfy many different design criteria. They must be able to mediate or compensate for differences between the process models, such as their different programming languages, computational grids, time-stepping schemes, variable names and variable units. However, they must achieve this interoperability in a way that: (1) is noninvasive, requiring only relatively small and isolated changes to the original source code, (2) does not significantly reduce performance, (3) is not time-consuming or confusing for a model developer to implement, (4) can very easily be updated to accommodate new versions of a given process model and (5) does not shift the burden of providing model interoperability to the model developers. In tackling these design challenges, model framework developers have learned that the best solution is to provide each model with a simple, standardized interface, i.e. a set of standardized functions that make the model: (1) fully-controllable by a caller (e.g. a model framework) and (2) self-describing with standardized metadata. Model control functions are separate functions that allow a caller to initialize the model, advance the model's state variables in time and finalize the model. Model description functions allow a caller to retrieve detailed information on the model's input and output variables, its computational grid and its timestepping scheme. If the caller is a modeling framework, it can use the self description functions to learn about each process model in a collection to be coupled and then automatically call framework service components (e.g. regridders

  18. THE BIGGS AND MOORE MODEL IN E-LEARNING: The Role of Motivation and Collaboration as Moderators

    Directory of Open Access Journals (Sweden)

    Matti J. HAVERILA

    2012-04-01

    Full Text Available The purpose of this paper is to report the findings of a research conducted to evaluate the effect of e-learning experience on students’ perceived learning outcomes, and more specifically the role of motivation and collaboration as moderators between the e-learning experience and the learning outcome. The perceived learning outcome was measured with whether the students perceived to learn more in e-learning vis-à-vis traditional learning context. The participants came from an undergraduate course at Tamk University of Applied Sciences in Tampere, Finland. The Biggs and Moore learning model indicates that the process variables (motivation and collaboration in this study have a mediating role. It was found out in this study, however, that these process variables have a moderating role rather than mediating role. Specific recommendations for the practitioners are provided, and implications for educators are discussed. Finally suggestions for further research on e-learning are provided.

  19. Mouse models to evaluate the role of estrogen receptor α in skeletal maintenance and adaptation.

    Science.gov (United States)

    Rooney, Amanda M; van der Meulen, Marjolein C H

    2017-12-01

    Estrogen signaling and mechanical loading have individual and combined effects on skeletal maintenance and adaptation. Previous work investigating estrogen signaling both in vitro and in vivo using global estrogen receptor α (ERα) gene knockout mouse models has provided information regarding the role of ERα in regulating bone mass and adaptation to mechanical stimulation. However, these models have inherent limitations that confound interpretation of the data. Therefore, recent studies have focused on mice with targeted deletion of ERα from specific bone cells and their precursors. Cell stage, tissue type, and mouse sex all influence the effects of ERα gene deletion. Lack of ERα in osteoblast progenitor and precursor cells generally affects the periosteum of female and male mice. The absence of ERα in differentiated osteoblasts, osteocytes, and osteoclasts in mice generally resulted in reduced cancellous bone mass, with differing reports of the effect by animal sex and greater deficiencies in bone mass typically occurring in cancellous bone in female mice. Limited data exist for the role of bone cell-specific ERα in skeletal adaptation in vivo. Cell-specific ERα gene knockout mice provide an excellent platform for investigating the function of ERα in regulating skeletal phenotype and response to mechanical loading by sex and age. © 2017 New York Academy of Sciences.

  20. Utilizing gnotobiotic models to inform the role of the microbiome in vaccine response heterogeneity.

    Science.gov (United States)

    Cram, Jacob A; Hager, Kevin W; Kublin, James G

    2018-01-01

    Gnotobiotic models have the potential to provide substantial insight into how the microbiome shapes its host's response to vaccines. This review aims to summarize literature about the role of the microbiome in shaping the immune system and vaccine response heterogeneity, summarize gnotobiotic and other murine models that help us understand the immune system and vaccine response, and suggest novel ways that these models could be used to further understand vaccine response heterogeneity. Clinical data have suggested that numerous vaccines' effectiveness are regulated by the microbiome and often correlate with the abundance of specific taxa. Gnotobiotic and other animal models are beginning to illuminate the complex effects induced by the presence of particular microbial groups and communities. Such models have identified microbial groups that improve vaccine response to rotavirus vaccine and identified pathways by which the microbiome influences response to influenza and other vaccines. By applying a range of vaccines across gnotobiotic mouse models, researchers may be able to identify the effects of single microorganisms as well as interacting communities of microorganisms on the immune response.

  1. Role of hemostatic factors in hepatic injury and disease: animal models de-liver.

    Science.gov (United States)

    Kopec, A K; Joshi, N; Luyendyk, J P

    2016-07-01

    Chronic liver damage is associated with unique changes in the hemostatic system. Patients with liver disease often show a precariously rebalanced hemostatic system, which is easily tipped towards bleeding or thrombotic complications by otherwise benign stimuli. In addition, some clinical studies have shown that hemostatic system components contribute to the progression of liver disease. There is a strong basic science foundation for clinical studies with this particular focus. Chronic and acute liver disease can be modeled in rodents and large animals with a variety of approaches, which span chronic exposure to toxic xenobiotics, diet-induced obesity, and surgical intervention. These experimental approaches have now provided strong evidence that, in addition to perturbations in hemostasis caused by liver disease, elements of the hemostatic system have powerful effects on the progression of experimental liver toxicity and disease. In this review, we cover the basis of the animal models that are most often utilized to assess the impact of the hemostatic system on liver disease, and highlight the role that coagulation proteases and their targets play in experimental liver toxicity and disease, emphasizing key similarities and differences between models. The need to characterize hemostatic changes in existing animal models and to develop novel animal models recapitulating the coagulopathy of chronic liver disease is highlighted. Finally, we emphasize the continued need to translate knowledge derived from highly applicable animal models to improve our understanding of the reciprocal interaction between liver disease and the hemostatic system in patients. © 2016 International Society on Thrombosis and Haemostasis.

  2. The huge plastic potential of adult brain and the role of connectomics: new insights provided by serial mappings in glioma surgery.

    Science.gov (United States)

    Duffau, Hugues

    2014-09-01

    While prominent in the traditional literature, the localizationist and static view of brain processing does not explain numerous observations of functional recovery following cerebral damages. Here, the goal is to revisit this classical modular and inflexible model by proposing a dynamic organization of brain circuits, which allows postlesional cerebral adaptative phenomena able to maintain neurological and cognitive functions, even in adults. In this state of mind, recent data provided by serial mappings performed in patients who underwent awake surgery for diffuse glioma infiltrating eloquent structures will be reviewed. Firstly, the use of intraoperative electrical mapping enables the realization of on-line anatomo-functional correlations both at cortical and subcortical levels, supporting a network distribution of the brain, and resulting in the reappraisal of cognitive models - notably regarding language. Secondly, combination of neuropsychological assessments and functional neuroimaging before and after operation demonstrates that it is possible to achieve massive resections of "critical" regions without eliciting permanent sequelae, thanks to reorganization of cerebral circuits. Thirdly, repeated surgeries in cases of tumor relapse show functional remapping in the same patients over time. Taken together, these findings open the window toward a huge plastic potential of human central nervous system (CNS) in adults. However, a better understanding of cerebral connectomics leads to the conclusion that the white matter connectivity constitutes a main limitation of such brain plasticity, explaining the lack of recovery in patients with extensive subcortical damages. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Healthcare provider perceptions of the role of interprofessional care in access to and outcomes of primary care in an underserved area.

    Science.gov (United States)

    Wan, Shaowei; Teichman, Peter G; Latif, David; Boyd, Jennifer; Gupta, Rahul

    2018-03-01

    To meet the needs of an aging population who often have multiple chronic conditions, interprofessional care is increasingly adopted by patient-centred medical homes and Accountable Care Organisations to improve patient care coordination and decrease costs in the United States, especially in underserved areas with primary care workforce shortages. In this cross-sectional survey across multiple clinical settings in an underserved area, healthcare providers perceived overall outcomes associated with interprofessional care teams as positive. This included healthcare providers' beliefs that interprofessional care teams improved patient outcomes, increased clinic efficiency, and enhanced care coordination and patient follow-up. Teams with primary care physician available each day were perceived as better able to coordinate care and follow up with patients (p = .031), while teams that included clinical pharmacists were perceived as preventing medication-associated problems (p interprofessional care model as a useful strategy to improve various outcomes across different clinical settings in the context of a shortage of primary care physicians.

  4. Role of community pharmacists in asthma – Australian research highlighting pathways for future primary care models

    Directory of Open Access Journals (Sweden)

    Saini B

    2011-04-01

    Full Text Available Asthma is one of the most common chronic conditions affecting the Australian population. Amongst primary healthcare professionals, pharmacists are the most accessible and this places pharmacists in an excellent position to play a role in the management of asthma. Globally, trials of many community pharmacy-based asthma care models have provided evidence that pharmacist delivered interventions can improve clinical, humanistic and economic outcomes for asthma patients. In Australia, a decade of coordinated research efforts, in various aspects of asthma care, has culminated in the implementation trial of the Pharmacy Asthma Management Service (PAMS, a comprehensive disease management model. There has been research investigating asthma medication adherence through data mining, ways in which usual asthma care can be improved. Our research has focused on self-management education, inhaler technique interventions, spirometry trials, interprofessional models of care, and regional trials addressing the particular needs of rural communities. We have determined that inhaler technique education is a necessity and should be repeated if correct technique is to be maintained. We have identified this effectiveness of health promotion and health education, conducted within and outside the confines of the pharmacy, in public for a and settings such as schools, and established that this outreach role is particularly well received and increases the opportunity for people with asthma to engage in their asthma management. Our research has identified that asthma patients have needs which pharmacists delivering specialized models of care, can address. There is a lot of evidence for the effectiveness of asthma care by pharmacists, the future must involve integration of this role into primary care.

  5. The role of advection in a two-species competition model

    CERN Document Server

    Averill, Isabel; Lou, Yuan

    2017-01-01

    The effects of weak and strong advection on the dynamics of reaction-diffusion models have long been studied. In contrast, the role of intermediate advection remains poorly understood. For example, concentration phenomena can occur when advection is strong, providing a mechanism for the coexistence of multiple populations, in contrast with the situation of weak advection where coexistence may not be possible. The transition of the dynamics from weak to strong advection is generally difficult to determine. In this work the authors consider a mathematical model of two competing populations in a spatially varying but temporally constant environment, where both species have the same population dynamics but different dispersal strategies: one species adopts random dispersal, while the dispersal strategy for the other species is a combination of random dispersal and advection upward along the resource gradient. For any given diffusion rates the authors consider the bifurcation diagram of positive steady states by u...

  6. An Integral Model to Provide Reactive and Proactive Services in an Academic CSIRT Based on Business Intelligence

    Directory of Open Access Journals (Sweden)

    Walter Fuertes

    2017-11-01

    Full Text Available Cyber-attacks have increased in severity and complexity. That requires, that the CERT/CSIRT research and develops new security tools. Therefore, our study focuses on the design of an integral model based on Business Intelligence (BI, which provides reactive and proactive services in a CSIRT, in order to alert and reduce any suspicious or malicious activity on information systems and data networks. To achieve this purpose, a solution has been assembled, that generates information stores, being compiled from a continuous network transmission of several internal and external sources of an organization. However, it contemplates a data warehouse, which is focused like a correlator of logs, being formed by the information of feeds with diverse formats. Furthermore, it analyzed attack detection and port scanning, obtained from sensors such as Snort and Passive Vulnerability Scanner, which are stored in a database, where the logs have been generated by the systems. With such inputs, we designed and implemented BI systems using the phases of the Ralph Kimball methodology, ETL and OLAP processes. In addition, a software application has been implemented using the SCRUM methodology, which allowed to link the obtained logs to the BI system for visualization in dynamic dashboards, with the purpose of generating early alerts and constructing complex queries using the user interface through objects structures. The results demonstrate, that this solution has generated early warnings based on the level of criticality and level of sensitivity of malware and vulnerabilities as well as monitoring efficiency, increasing the level of security of member institutions.

  7. Solar Week 2000: Using role models to encourage an interest in science

    Science.gov (United States)

    Alexander, D.

    2000-12-01

    Solar Week 2000 is a week-long set of games and activities allowing students to interact directly with solar science and solar scientists. The main goal of Solar Week was to provide young women, primarily in grades 6-8, with access to role models in the sciences. The scientists participating in Solar Week are women from a variety of backgrounds and with a variety of scientific expertise. An online bulletin board was used to foster discussion between the students and the scientists about both science and career issues. In this presentation I will discuss the successes and failures of the first run of Solar Week which occurred on 9-13 October 2000. Our aim is to provide some insight into doing activity-based space science on the web and to discuss the lessons-learned from tailoring to a specific group of participants.

  8. Does brain slices from pentylenetetrazole-kindled mice provide a more predictive screening model for antiepileptic drugs?

    DEFF Research Database (Denmark)

    Hansen, Suzanne L.; Sterjev, Zoran; Werngreen, Marie

    2012-01-01

    The cortical wedge is a commonly applied model for in vitro screening of new antiepileptic drugs (AEDs) and has been extensively used in characterization of well-known AEDs. However, the predictive validity of this model as a screening model has been questioned as, e.g., carbamazepine has been re...

  9. Predicting Ecological Roles in the Rhizosphere Using Metabolome and Transportome Modeling.

    Directory of Open Access Journals (Sweden)

    Peter E Larsen

    Full Text Available The ability to obtain complete genome sequences from bacteria in environmental samples, such as soil samples from the rhizosphere, has highlighted the microbial diversity and complexity of environmental communities. However, new algorithms to analyze genome sequence information in the context of community structure are needed to enhance our understanding of the specific ecological roles of these organisms in soil environments. We present a machine learning approach using sequenced Pseudomonad genomes coupled with outputs of metabolic and transportomic computational models for identifying the most predictive molecular mechanisms indicative of a Pseudomonad's ecological role in the rhizosphere: a biofilm, biocontrol agent, promoter of plant growth, or plant pathogen. Computational predictions of ecological niche were highly accurate overall with models trained on transportomic model output being the most accurate (Leave One Out Validation F-scores between 0.82 and 0.89. The strongest predictive molecular mechanism features for rhizosphere ecological niche overlap with many previously reported analyses of Pseudomonad interactions in the rhizosphere, suggesting that this approach successfully informs a system-scale level understanding of how Pseudomonads sense and interact with their environments. The observation that an organism's transportome is highly predictive of its ecological niche is a novel discovery and may have implications in our understanding microbial ecology. The framework developed here can be generalized to the analysis of any bacteria across a wide range of environments and ecological niches making this approach a powerful tool for providing insights into functional predictions from bacterial genomic data.

  10. Predicting Ecological Roles in the Rhizosphere Using Metabolome and Transportome Modeling

    Energy Technology Data Exchange (ETDEWEB)

    Larsen, Peter E.; Collart, Frank R.; Dai, Yang; Blanchard, Jeffrey L.

    2015-09-02

    The ability to obtain complete genome sequences from bacteria in environmental samples, such as soil samples from the rhizosphere, has highlighted the microbial diversity and complexity of environmental communities. However, new algorithms to analyze genome sequence information in the context of community structure are needed to enhance our understanding of the specific ecological roles of these organisms in soil environments. We present a machine learning approach using sequenced Pseudomonad genomes coupled with outputs of metabolic and transportomic computational models for identifying the most predictive molecular mechanisms indicative of a Pseudomonad's ecological role in the rhizosphere: a biofilm, biocontrol agent, promoter of plant growth, or plant pathogen. Computational predictions of ecological niche were highly accurate overall with models trained on transportomic model output being the most accurate (Leave One Out Validation F-scores between 0.82 and 0.89). The strongest predictive molecular mechanism features for rhizosphere ecological niche overlap with many previously reported analyses of Pseudomonad interactions in the rhizosphere, suggesting that this approach successfully informs a system-scale level understanding of how Pseudomonads sense and interact with their environments. The observation that an organism's transportome is highly predictive of its ecological niche is a novel discovery and may have implications in our understanding microbial ecology. The framework developed here can be generalized to the analysis of any bacteria across a wide range of environments and ecological niches making this approach a powerful tool for providing insights into functional predictions from bacterial genomic data.

  11. THE UNIFICATION OF THE CODE LISTS PROVIDED WITHIN THE DATA MODEL ORIGINATING FROM THE INSPIRE TECHNICAL GUIDELINES AND THE ONES PROVIDED FOR GESUT DATABASES IN THE CONTEXT OF POTENTIAL EXPLOITATION IN THE MINING INDUSTRY

    Directory of Open Access Journals (Sweden)

    Andrzej ZYGMUNIAK

    2016-07-01

    Full Text Available This study is aimed at exposing differences between two data models in case of code lists values provided there. The first of them is an obligatory one for managing Geodesic Register of Utility Networks databases in Poland [9] and the second is the model originating from the Technical Guidelines issued to the INSPIRE Directive. Since the second one mentioned is the basis for managing spatial databases among European parties, correlating these two data models has an effect in easing the way of harmonizing and, in consequence, exchanging spatial data. Therefore, the study presents the possibilities of increasing compatibility between the values of the code lists concerning attributes for objects provid-ed in both models. In practice, it could lead to an increase of the competitiveness of entities managing or processing such databases and to greater involvement in scientific or research projects when it comes to the mining industry. More-over, since utility networks located on mining areas are under particular protection, the ability of making them more fitted to their own needs will make it possible for mining plants to exchange spatial data in a more efficient way.

  12. The Role of Empirical Evidence in Modeling Speech Segmentation

    Science.gov (United States)

    Phillips, Lawrence

    2015-01-01

    Choosing specific implementational details is one of the most important aspects of creating and evaluating a model. In order to properly model cognitive processes, choices for these details must be made based on empirical research. Unfortunately, modelers are often forced to make decisions in the absence of relevant data. My work investigates the…

  13. Modeling Flight: The Role of Dynamically Scaled Free-Flight Models in Support of NASA's Aerospace Programs

    Science.gov (United States)

    Chambers, Joseph

    2010-01-01

    community, Leonardo da Vinci, George Cayley, and the Wright brothers are examples of early aviation pioneers who frequently used models during their scientific efforts to understand and develop flying machines. Progress in the technology associated with model testing in worldwide applications has firmly established model aircraft as a key element in new aerospace research and development programs. Models are now routinely used in many applications and roles, including aerodynamic data gathering in wind tunnel investigations for the analysis of full-scale aircraft designs, proof-of-concept demonstrators for radical aeronautical concepts, and problem-solving exercises for vehicles already in production. The most critical contributions of aerospace models are to provide confidence and risk reduction for new designs and to enhance the safety and efficiency of existing configurations.

  14. Yeast Interspecies Comparative Proteomics Reveals Divergence in Expression Profiles and Provides Insights into Proteome Resource Allocation and Evolutionary Roles of Gene Duplication*

    Science.gov (United States)

    Kito, Keiji; Ito, Haruka; Nohara, Takehiro; Ohnishi, Mihoko; Ishibashi, Yuko; Takeda, Daisuke

    2016-01-01

    nonoptimal culture conditions but also provide valuable insights into intriguing biological principles, including the balance of proteome resource allocation and the role of gene duplication in evolutionary history. PMID:26560065

  15. I can do that: the impact of implicit theories on leadership role model effectiveness.

    Science.gov (United States)

    Hoyt, Crystal L; Burnette, Jeni L; Innella, Audrey N

    2012-02-01

    This research investigates the role of implicit theories in influencing the effectiveness of successful role models in the leadership domain. Across two studies, the authors test the prediction that incremental theorists ("leaders are made") compared to entity theorists ("leaders are born") will respond more positively to being presented with a role model before undertaking a leadership task. In Study 1, measuring people's naturally occurring implicit theories of leadership, the authors showed that after being primed with a role model, incremental theorists reported greater leadership confidence and less anxious-depressed affect than entity theorists following the leadership task. In Study 2, the authors demonstrated the causal role of implicit theories by manipulating participants' theory of leadership ability. They replicated the findings from Study 1 and demonstrated that identification with the role model mediated the relationship between implicit theories and both confidence and affect. In addition, incremental theorists outperformed entity theorists on the leadership task.

  16. The role of flexibility in the Context-adaptive Model for language ...

    African Journals Online (AJOL)

    In turn, an emphasis on the role of flexibility in language programme evaluation models to guide context-adaptive evaluations has grown. Lynch (1996; 2003) highlights the flexibility and adaptability of his Context-adaptive Model (CAM). This article explores the role of flexibility in the CAM in theory and in practice. The first ...

  17. Scientist Role Models in the Classroom: How Important Is Gender Matching?

    Science.gov (United States)

    Conner, Laura D. Carsten; Danielson, Jennifer

    2016-01-01

    Gender-matched role models are often proposed as a mechanism to increase identification with science among girls, with the ultimate aim of broadening participation in science. While there is a great deal of evidence suggesting that role models can be effective, there is mixed support in the literature for the importance of gender matching. We used…

  18. The teacher, the physician and the person: how faculty's teaching performance influences their role modelling

    NARCIS (Netherlands)

    Boerebach, Benjamin C. M.; Lombarts, Kiki M. J. M. H.; Keijzer, Christiaan; Heineman, Maas Jan; Arah, Onyebuchi A.