Development and validation of the ExPRESS instrument for primary health care providers' evaluation of external supervision.

Science.gov (United States)

Schriver, Michael; Cubaka, Vincent Kalumire; Vedsted, Peter; Besigye, Innocent; Kallestrup, Per

2018-01-01

External supervision of primary health care facilities to monitor and improve services is common in low-income countries. Currently there are no tools to measure the quality of support in external supervision in these countries. To develop a provider-reported instrument to assess the support delivered through external supervision in Rwanda and other countries. "External supervision: Provider Evaluation of Supervisor Support" (ExPRESS) was developed in 18 steps, primarily in Rwanda. Content validity was optimised using systematic search for related instruments, interviews, translations, and relevance assessments by international supervision experts as well as local experts in Nigeria, Kenya, Uganda and Rwanda. Construct validity and reliability were examined in two separate field tests, the first using exploratory factor analysis and a test-retest design, the second for confirmatory factor analysis. We included 16 items in section A ('The most recent experience with an external supervisor'), and 13 items in section B ('The overall experience with external supervisors'). Item-content validity index was acceptable. In field test I, test-retest had acceptable kappa values and exploratory factor analysis suggested relevant factors in sections A and B used for model hypotheses. In field test II, models were tested by confirmatory factor analysis fitting a 4-factor model for section A, and a 3-factor model for section B. ExPRESS is a promising tool for evaluation of the quality of support of primary health care providers in external supervision of primary health care facilities in resource-constrained settings. ExPRESS may be used as specific feedback to external supervisors to help identify and address gaps in the supervision they provide. Further studies should determine optimal interpretation of scores and the number of respondents needed per supervisor to obtain precise results, as well as test the functionality of section B.

Training And Supervision Did Not Meaningfully Improve Quality Of Care For Pregnant Women Or Sick Children In Sub-Saharan Africa.

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Leslie, Hannah H; Gage, Anna; Nsona, Humphreys; Hirschhorn, Lisa R; Kruk, Margaret E

2016-09-01

In-service training courses and supportive supervision of health workers are among the most common interventions to improve the quality of health care in low- and middle-income countries. Despite extensive investment from donors, evaluations of the long-term effect of these two interventions are scarce. We used nationally representative surveys of health systems in seven countries in sub-Saharan Africa to examine the association of in-service training and supervision with provider quality in antenatal and sick child care. The results of our analysis showed that observed quality of care was poor, with fewer than half of evidence-based actions completed by health workers, on average. In-service training and supervision were associated with quality of sick child care; they were associated with quality of antenatal care only when provided jointly. All associations were modest-at most, improvements related to interventions were equivalent to 2 additional provider actions out of the 18-40 actions expected per visit. In-service training and supportive supervision as delivered were not sufficient to meaningfully improve the quality of care in these countries. Greater attention to the quality of health professional education and national health system performance will be required to provide the standard of health care that patients deserve. Project HOPE—The People-to-People Health Foundation, Inc.

What influences palliative care nurses in their choice to engage in or decline clinical supervision?

Science.gov (United States)

Puffett, Nick; Perkins, Paul

2017-11-02

Clinical supervision (CS) has been around since the early 1990s in the UK and has been endorsed by government and professional bodies. Levels of engagement range from 18% to 85%. To investigate what influences palliative care nurses in their choice to engage in or decline clinical supervision. A qualitative study was undertaken in an inpatient hospice in England and employed two focus groups to compare the views of participants and non-participants in CS. Data were audio recorded and transcribed verbatim by the researchers and analysed using systematic text condensation. Palliative care nurses all used informal team support for 'in the moment' support. Some engaged in formal CS to reflect 'on action' and to challenge practice. Nurses reported a lack of clarity regarding CS but, once this was overcome and engagement with CS was established, it led to changes in practice, identification of training needs and team building. The option of choice between group and individual supervision was found to be important. Group supervision led to enhanced understanding of group members which also led to team building, individual sessions were useful for individual issues. Protected time was essential for staff to be able to engage in CS. Staff who worked in larger teams reported higher levels of engagement, whereas a small team reported less need due to more informal team support. These findings are positive as they illuminate the importance of choice for support. Nurses need to be aware of their options for support and ultimately how this support affects the care they provide. The Palliative Care Nurse's Model of Support was developed, which shows the effects of each choice and how this may lead to team-building.

A Model for Art Therapy-Based Supervision for End-of-Life Care Workers in Hong Kong.

Science.gov (United States)

Potash, Jordan S; Chan, Faye; Ho, Andy H Y; Wang, Xiao Lu; Cheng, Carol

2015-01-01

End-of-life care workers and volunteers are particularly prone to burnout given the intense emotional and existential nature of their work. Supervision is one important way to provide adequate support that focuses on both professional and personal competencies. The inclusion of art therapy principles and practices within supervision further creates a dynamic platform for sustained self-reflection. A 6-week art therapy-based supervision group provided opportunities for developing emotional awareness, recognizing professional strengths, securing collegial relationships, and reflecting on death-related memories. The structure, rationale, and feedback are discussed.

Implementing the supportive supervision intervention for registered nurses in a long-term care home: a feasibility study.

Science.gov (United States)

McGilton, Katherine S; Profetto-McGrath, Joanne; Robinson, Angela

2013-11-01

This pilot study was conducted in response to the call in 2009 by the International Association of Gerontology and Geriatrics to focus on effective leadership structures in nursing homes and to develop leadership capacity. Few researchers have evaluated interventions aimed at enhancing the leadership ability of registered nurses in long-term care. The aim of the pilot study was to test the feasibility of a three-part supportive supervisory intervention to improve supervisory skills of registered nurses in long-term care. A repeated measures group design was used. Quantitative data were collected from healthcare aides, licensed practical nurses (i.e., supervised staff), and registered nurses (i.e., supervisors). Focus groups with care managers and supervisors examined perceptions of the intervention. There were nonsignificant changes in both the registered nurse supervisors' job satisfaction and the supervised staff's perception of their supervisors' support. Supervised staff scores indicated an increase in the use of research utilization but did not reflect an increase in job satisfaction. Focus group discussions revealed that the supervisors and care managers perceived the workshop to be valuable; however, the weekly self-reflection, coaching, and mentoring components of the intervention were rare and inconsistent. While the primary outcomes were not influenced by the Supportive Supervision Intervention, further effort is required to understand how best to enhance the supportive supervisory skills of RNs. Examples of how to improve the possibility of a successful intervention are advanced. Effective supervisory skills among registered nurses are crucial for improving the quality of care in long-term care homes. Registered nurses are receptive to interventions that will enhance their roles as supervisors. © 2013 Sigma Theta Tau International.

Fall risk factors in community-dwelling elderly who receive Medicaid-supported home- and community-based care services.

Science.gov (United States)

Yamashita, Takashi; Jeon, Haesang; Bailer, A John; Nelson, Ian M; Mehdizadeh, Shahla

2011-06-01

This study identifies fall risk factors in an understudied population of older people who receive community-based care services. Data were collected from enrollees of Ohio's Medicaid home- and community-based waiver program (preadmission screening system providing options and resources today [PASSPORT]). A total of 23,182 participants receiving PASSPORT services in 2005/2006 was classified as fallers and nonfallers, and a variety of risk factors for falling was analyzed using logistic regressions. The following factors were identified as risk factors for falling: previous fall history, older age, White race, incontinence, higher number of medications, fewer numbers of activity of daily living limitations, unsteady gait, tremor, grasping strength, and absence of supervision. Identifying risk factors for the participants of a Medicaid home- and community-based waiver program are useful for a fall risk assessment, but it would be most helpful if the community-based care service programs incorporate measurements of known fall risk factors into their regular data collection, if not already included.

Mentoring, coaching and supervision

OpenAIRE

McMahon, Samantha; Dyer, Mary; Barker, Catherine

2016-01-01

This chapter considers the purpose of coaching, mentoring and supervision in early childhood eduaction and care. It examines a number of different approaches and considers the key skills required for effective coaching, mentoring and supervision.

Reflecting reflection in supervision

DEFF Research Database (Denmark)

Lystbæk, Christian Tang

associated with reflection and an exploration of alternative conceptions that view reflection within the context of settings which have a more group- and team-based orientation. Drawing on an action research project on health care supervision, the paper questions whether we should reject earlier views...... of reflection, rehabilitate them in order to capture broader connotations or move to new ways of regarding reflection that are more in keeping with not only reflective but also emotive, normative and formative views on supervision. The paper presents a critical perspective on supervision that challenge...... the current reflective paradigm I supervision and relate this to emotive, normative and formative views supervision. The paper is relevant for Nordic educational research into the supervision and guidance...

Multicultural Supervision: What Difference Does Difference Make?

Science.gov (United States)

Eklund, Katie; Aros-O'Malley, Megan; Murrieta, Imelda

2014-01-01

Multicultural sensitivity and competency represent critical components to contemporary practice and supervision in school psychology. Internship and supervision experiences are a capstone experience for many new school psychologists; however, few receive formal training and supervision in multicultural competencies. As an increased number of…

Implementing a sustainable clinical supervision model for Isles nurses in Orkney.

Science.gov (United States)

Hall, Ian

2018-03-02

The Isles Network of Care (INOC) community nurses work at the extreme of the remote and rural continuum, working mostly as lone practitioners. Following the development of sustainable clinical supervision model for Isles nurses in Orkney, clinical supervision was found to improve both peer support and governance for this group of isolated staff. A literature overview identified the transition of clinical supervision in general nursing over 24 years from 'carrot' to 'stick'. The study included a questionnaire survey that was sent to the 2017 Queen's Nursing Institute Scotland cohort to elicit information about the nurses' experience of clinical supervision. The survey found that 55% provide supervision and 40% receive it. Health board encouragement of its use was found to be disappointingly low at 40%. The INOC nurses were surveyed about the new peer-support (restorative) model, which relies on video-conference contact to allow face to face interaction between isolated isles nurses. Feedback prompted a review of clinical supervision pairings, and the frequency and methods of meeting. The need for supervisor training led to agreement with the Remote and Rural Health Education Alliance to provide relevant support. The perceived benefits of supervision included increased support and reflection, and improved relationships with isolated colleagues.

Nursing leadership from the perspective of clinical group supervision: a paradoxical practice.

Science.gov (United States)

Bondas, Terese

2010-05-01

Increase understanding of nursing leadership in group clinical supervision (CS). Leadership in CS has received little interest besides the theories in use and administrative CS. Hermeneutic interpretation of written narratives of 24 clinical nurse supervisors. Continuity in structuring, story and mission and reflection in group and leadership processes and theories of nursing and caring characterize leadership in CS. Leadership by inhibiting and creating fear, inapproachability and indistinctiveness were patterns in content brought to CS. Supervision when leadership was involved illuminated a reflexive change in focus from leadership to nursing care, from particular experiences to nursing and caring science, and from the unfamiliar to the well known and the well known to the unknown. Continuity and reflective changes using nursing and caring theories seem to be core ideas of nursing leadership from the perspective of CS. The poles of separation and communion show opposites of nursing leadership as it is illuminated in CS. The findings add knowledge to Bondas' theory of caritative leadership. CS is a reflexive practice of support and guidance that seems to have an impact on the trajectory of nursing care and staff development using nursing and caring theories.

Why do care workers withdraw from elderly care?

DEFF Research Database (Denmark)

Liveng, Anne

2012-01-01

. The article illustrates how working consciously with the researcher's subjectivity makes it possible to understand apparently irrational patterns. The insights thus gained may be used to prevent withdrawals in care work as an argument for care workers' need for emotional supervision....... relations, independently of whether we are in the role of care providers or care receivers. Through collusion theory, the interpretation accepts both the anxiety which the helpless elderly people arouse in the care workers and their motivation for care work as two sides of a subjectively important theme...

Role of communication systems in coordinating supervising anesthesiologists' activities outside of operating rooms.

Science.gov (United States)

Smallman, Bettina; Dexter, Franklin; Masursky, Danielle; Li, Fenghua; Gorji, Reza; George, Dave; Epstein, Richard H

2013-04-01

Theoretically, communication systems have the potential to increase the productivity of anesthesiologists supervising anesthesia providers. We evaluated the maximal potential of communication systems to increase the productivity of anesthesia care by enhancing anesthesiologists' coordination of care (activities) among operating rooms (ORs). At hospital A, data for 13,368 pages were obtained from files recorded in the internal alphanumeric text paging system. Pages from the postanesthesia care unit were processed through a numeric paging system and thus not included. At hospital B, in a different US state, 3 of the authors categorized each of 898 calls received using the internal wireless audio system (Vocera(®)). Lower and upper 95% confidence limits for percentages are the values reported. At least 45% of pages originated from outside the ORs (e.g., 20% from holding area) at hospital A and at least 56% of calls (e.g., 30% administrative) at hospital B. In contrast, requests from ORs for urgent presence of the anesthesiologist were at most 0.2% of pages at hospital A and 1.8% of calls at hospital B. Approximately half of messages to supervising anesthesiologists are for activity originating outside the ORs being supervised. To use communication tools to increase anesthesia productivity on the day of surgery, their use should include a focus on care coordination outside ORs (e.g., holding area) and among ORs (e.g., at the control desk).

Supervision of care networks for frail community dwelling adults aged 75 years and older: protocol of a mixed methods study

Science.gov (United States)

Verver, Didi; Merten, Hanneke; Robben, Paul; Wagner, Cordula

2015-01-01

Introduction The Dutch healthcare inspectorate (IGZ) supervises the quality and safety of healthcare in the Netherlands. Owing to the growing population of (community dwelling) older adults and changes in the Dutch healthcare system, the IGZ is exploring new methods to effectively supervise care networks that exist around frail older adults. The composition of these networks, where formal and informal care takes place, and the lack of guidelines and quality and risk indicators make supervision complicated in the current situation. Methods and analysis This study consists of four phases. The first phase identifies risks for community dwelling frail older adults in the existing literature. In the second phase, a qualitative pilot study will be conducted to assess the needs and wishes of the frail older adults concerning care and well-being, perception of risks, and the composition of their networks, collaboration and coordination between care providers involved in the network. In the third phase, questionnaires based on the results of phase II will be sent to a larger group of frail older adults (n=200) and their care providers. The results will describe the composition of their care networks and prioritise risks concerning community dwelling older adults. Also, it will provide input for the development of a new supervision framework by the IGZ. During phase IV, a second questionnaire will be sent to the participants of phase III to establish changes of perception in risks and possible changes in the care networks. The framework will be tested by the IGZ in pilots, and the researchers will evaluate these pilots and provide feedback to the IGZ. Ethics and dissemination The study protocol was approved by the Scientific Committee of the EMGO+institute and the Medical Ethical review committee of the VU University Medical Centre. Results will be presented in scientific articles and reports and at meetings. PMID:26307619

Restraint Use in Older Adults Receiving Home Care.

Science.gov (United States)

Scheepmans, Kristien; Dierckx de Casterlé, Bernadette; Paquay, Louis; Van Gansbeke, Hendrik; Milisen, Koen

2017-08-01

To determine the prevalence, types, frequency, and duration of restraint use in older adults receiving home nursing care and to determine factors involved in the decision-making process for restraint use and application. Cross-sectional survey of restraint use in older adults receiving home care completed by primary care nurses. Homes of older adults receiving care from a home nursing organization in Belgium. Randomized sample of older adults receiving home care (N = 6,397; mean age 80.6; 66.8% female). For each participant, nurses completed an investigator-constructed and -validated questionnaire collecting information demographic, clinical, and behavioral characteristics and aspects of restraint use. A broad definition of restraint was used that includes a range of restrictive actions. Restraints were used in 24.7% of the participants, mostly on a daily basis (85%) and often for a long period (54.5%, 24 h/d). The most common reason for restraint use was safety (50.2%). Other reasons were that the individual wanted to remain at home longer, which necessitated the use of restraints (18.2%) and to provide respite for the informal caregiver (8.6%). The latter played an important role in the decision and application process. The physician was less involved in the process. In 64.5% of cases, there was no evaluation after restraint use was initiated. Use of restraints is common in older adults receiving home care nursing in Belgium. These results contribute to a better understanding of the complexity of use of restraints in home care, a situation that may be even more complex than in nursing homes and acute hospital settings. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Defeating abusive supervision: Training supervisors to support subordinates.

Science.gov (United States)

Gonzalez-Morales, M Gloria; Kernan, Mary C; Becker, Thomas E; Eisenberger, Robert

2018-04-01

Although much is known about the antecedents and consequences of abusive supervision, scant attention has been paid to investigating procedures to reduce its frequency. We conducted a quasiexperiment to examine the effects of supervisor support training on subordinate perceptions of abusive supervision and supervisor support. Supervisors (n = 23) in 4 restaurants were trained in 4 supportive supervision strategies (benevolence, sincerity, fairness, and experiential processing) during 4 2-hr sessions over a period of 2 months. We compared perceived supervisor support and abusive supervision before and 9 months after training for 208 employees whose supervisors received support training and 241 employees in 4 similar control restaurants. Compared to employees in the control restaurants, employees whose supervisors received the support training reported higher levels of perceived supervisor support and less abusive supervision. These findings suggest that a relatively brief training program can help managers become more supportive and less abusive. Theoretical and practical implications for effectively managing abusive supervision are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Perceptions of the care received from Australian palliative care services: A caregiver perspective.

Science.gov (United States)

Pidgeon, Tanya M; Johnson, Claire E; Lester, Leanne; Currow, David; Yates, Patsy; Allingham, Samuel F; Bird, Sonia; Eagar, Kathy

2018-04-01

ABSTRACTBackground:Caregiver satisfaction and experience surveys help health professionals to understand, measure, and improve the quality of care provided for patients and their families. Our aim was to explore caregiver perceptions of the care received from Australian specialist palliative care services. Caregivers of patients receiving palliative care in services registered with Australia's Palliative Care Outcomes Collaboration were invited to participate in a caregiver survey. The survey included the FAMCARE-2 and four items from the Ongoing Needs Identification: Caregiver Profile questionnaire. Surveys were completed by 1,592 caregivers from 49 services. Most respondents reported high satisfaction and positive experiences. Caregivers receiving care from community-based palliative care teams were less satisfied with the management of physical symptoms and comfort (odds ratio [OR] = 0.29; 95% confidence interval [CI95%] = 0.14, 0.59), with patient psychological care (OR = 0.56; CI95% = 0.32, 0.98), and with family support (OR = 0.52; CI95% = 0.35, 0.77) than caregivers of patients in an inpatient setting. If aged over 60 years, caregivers were less likely to have their information needs met regarding available support services (OR = 0.98; CI95% = 0.97, 0.98) and carer payments (OR = 0.99; CI95% = 0.98, 1.00). Also, caregivers were less likely to receive adequate information about carer payments if located in an outer regional area (OR = 0.41; CI95% = 0.25, 0.64). With practical training, caregivers receiving care from community services reported inadequate information provision to support them in caring for patients (OR = 0.60; CI95% = 0.45, 0.81). While our study identified caregivers as having positive and satisfactory experiences across all domains of care, there is room for improvement in the delivery of palliative care across symptom management, as well as patient and caregiver support, especially in community settings. Caregiver surveys can facilitate the

Human semi-supervised learning.

Science.gov (United States)

Gibson, Bryan R; Rogers, Timothy T; Zhu, Xiaojin

2013-01-01

Most empirical work in human categorization has studied learning in either fully supervised or fully unsupervised scenarios. Most real-world learning scenarios, however, are semi-supervised: Learners receive a great deal of unlabeled information from the world, coupled with occasional experiences in which items are directly labeled by a knowledgeable source. A large body of work in machine learning has investigated how learning can exploit both labeled and unlabeled data provided to a learner. Using equivalences between models found in human categorization and machine learning research, we explain how these semi-supervised techniques can be applied to human learning. A series of experiments are described which show that semi-supervised learning models prove useful for explaining human behavior when exposed to both labeled and unlabeled data. We then discuss some machine learning models that do not have familiar human categorization counterparts. Finally, we discuss some challenges yet to be addressed in the use of semi-supervised models for modeling human categorization. Copyright © 2013 Cognitive Science Society, Inc.

Clinical supervision reflected in a Danish DPCCQ sample

DEFF Research Database (Denmark)

Nielsen, Jan; Jacobsen, Claus Haugaard

Core Questionnaire (DPCCQ) has only few questions on supervision. To rectify this limitation, a recent Danish version of the DPCCQ included two new sections on supervision, one focusing on supervisees and another on supervisors and their supervisory training. This paper presents our initial findings...... on giving and receiving clinical supervision as reported by therapists in Denmark. Method: Currently, the Danish sample consists of 350 clinical psychologist doing psychotherapy who completed DPCCQ. Data are currently being prepared for statistical analysis. Results: This paper will focus primarily...... on describing the amount and type of supervision received and given by the sample. Findings from these descriptive statistics will be compared within the sample across demographic parameters such as age and sex, and professional characteristics such as career level, theoretical preferences, type of clients...

Adequate supervision for children and adolescents.

Science.gov (United States)

Anderst, James; Moffatt, Mary

2014-11-01

Primary care providers (PCPs) have the opportunity to improve child health and well-being by addressing supervision issues before an injury or exposure has occurred and/or after an injury or exposure has occurred. Appropriate anticipatory guidance on supervision at well-child visits can improve supervision of children, and may prevent future harm. Adequate supervision varies based on the child's development and maturity, and the risks in the child's environment. Consideration should be given to issues as wide ranging as swimming pools, falls, dating violence, and social media. By considering the likelihood of harm and the severity of the potential harm, caregivers may provide adequate supervision by minimizing risks to the child while still allowing the child to take "small" risks as needed for healthy development. Caregivers should initially focus on direct (visual, auditory, and proximity) supervision of the young child. Gradually, supervision needs to be adjusted as the child develops, emphasizing a safe environment and safe social interactions, with graduated independence. PCPs may foster adequate supervision by providing concrete guidance to caregivers. In addition to preventing injury, supervision includes fostering a safe, stable, and nurturing relationship with every child. PCPs should be familiar with age/developmentally based supervision risks, adequate supervision based on those risks, characteristics of neglectful supervision based on age/development, and ways to encourage appropriate supervision throughout childhood. Copyright 2014, SLACK Incorporated.

Is physician supervision of the capsaicin 8% patch administration procedure really necessary? An opinion from health care professionals

Directory of Open Access Journals (Sweden)

Kern KU

2013-07-01

Full Text Available Kai-Uwe Kern,1 Janice England,2 Andrea Roth-Daniek,3 Till Wagner3 1Institute for Pain Medicine/Pain Practice, Wiesbaden, Germany; 2Pain Medicine and Anaesthesia, The Christie National Health Service Foundation Trust, Manchester, UK; 3Pain Therapy and Palliative Care Department, Medizinisches Zentrum Städteregion Aachen, Aachen, Germany Abstract: Neuropathic pain is difficult to treat and can have a severe effect on quality of life. The capsaicin 8% patch is a novel treatment option that directly targets the source of peripheral neuropathic pain. It can provide pain relief for up to 12 weeks in patients with peripheral neuropathic pain. Treatment with the capsaicin 8% patch follows a clearly defined procedure, and patch application must be carried out by a physician or a health care professional under the supervision of a physician. Nonetheless, in our experience, nurses often take the lead role in capsaicin 8% patch application without the involvement of a physician. We believe that the nurse's key role is of benefit to the patients, as he or she may be better placed, because of time constraints and patient relationships, to support the patient through the application procedure than a physician. Moreover, a number of frequently prescribed drugs, including botulinum toxin and infliximab, can be administered by health care professionals without the requirement for physician supervision. Here we argue that current guidance should be amended to remove the requirement for physician supervision during application of the capsaicin 8% patch. Keywords: capsaicin, neuropathic pain, topical, health care professional, physician, nurse

[Suicides committed by patients who receive psychiatric care].

Science.gov (United States)

Rønneberg, Unni; Walby, Fredrik A

2008-01-17

Psychiatric institutions (hospitals and out-patient clinics) are obliged to report cases of suicide to the authorities, but it has not been known to what extent this obligation has been fulfilled. The Norwegian Board of Health Supervision wished to provide an overview of reporting frequencies, descriptions of the extent of the problem, reasons for suicide in patients undergoing psychiatric treatment, whether the institutions use these occurrences to improve the quality of their work and how these cases were handled by the 18 county medical officers. The county medical officers completed registration forms and closing letters for each reported case of suicide committed by patients in psychiatric care (in 2005 and 2006), and sent these documents to the Norwegian Board of Health Supervision. 34/176 (19.3%) suicides were not reported according to the requirements. Almost none of the institutions seemed to use the occurrences in their work to improve quality. There were large differences between the counties both with respect to the number of - and the handling of the reports. The psychiatric hospitals and out-patient clinics must fulfil their obligation to report suicides to the authorities to a larger degree, and to use such occurrences in their work to prevent suicides.

Training, supervision and quality of care in selected integrated community case management (iCCM) programmes: A scoping review of programmatic evidence.

Science.gov (United States)

Bosch-Capblanch, Xavier; Marceau, Claudine

2014-12-01

To describe the training, supervision and quality of care components of integrated Community Case Management (iCCM) programmes and to draw lessons learned from existing evaluations of those programmes. Scoping review of reports from 29 selected iCCM programmes purposively provided by stakeholders containing any information relevant to understand quality of care issues. The number of people reached by iCCM programmes varied from the tens of thousands to more than a million. All programmes aimed at improving access of vulnerable populations to health care, focusing on the main childhood illnesses, managed by Community Health Workers (CHW), often selected bycommunities. Training and supervision were widely implemented, in different ways and intensities, and often complemented with tools (eg, guides, job aids), supplies, equipment and incentives. Quality of care was measured using many outcomes (eg, access or appropriate treatment). Overall, there seemed to be positive effects for those strategies that involved policy change, organisational change, standardisation of clinical practices and alignment with other programmes. Positive effects were mostly achieved in large multi-component programmes. Mild or no effects have been described on mortality reduction amongst the few programmes for which data on this outcome was available to us. Promising strategies included teaming-up of CHW, micro-franchising or social franchising. On-site training and supervision of CHW have been shown to improve clinical practices. Effects on caregivers seemed positive, with increases in knowledge, care seeking behaviour, or caregivers' basic disease management. Evidence on iCCM is often of low quality, cannot relate specific interventions or the ways they are implemented with outcomes and lacks standardisation; this limits the capacity to identify promising strategies to improve quality of care. Large, multi-faceted, iCCM programmes, with strong components of training, supervision, which

Training, supervision and quality of care in selected integrated community case management (iCCM) programmes: A scoping review of programmatic evidence

Science.gov (United States)

Bosch–Capblanch, Xavier; Marceau, Claudine

2014-01-01

Aim To describe the training, supervision and quality of care components of integrated Community Case Management (iCCM) programmes and to draw lessons learned from existing evaluations of those programmes. Methods Scoping review of reports from 29 selected iCCM programmes purposively provided by stakeholders containing any information relevant to understand quality of care issues. Results The number of people reached by iCCM programmes varied from the tens of thousands to more than a million. All programmes aimed at improving access of vulnerable populations to health care, focusing on the main childhood illnesses, managed by Community Health Workers (CHW), often selected bycommunities. Training and supervision were widely implemented, in different ways and intensities, and often complemented with tools (eg, guides, job aids), supplies, equipment and incentives. Quality of care was measured using many outcomes (eg, access or appropriate treatment). Overall, there seemed to be positive effects for those strategies that involved policy change, organisational change, standardisation of clinical practices and alignment with other programmes. Positive effects were mostly achieved in large multi–component programmes. Mild or no effects have been described on mortality reduction amongst the few programmes for which data on this outcome was available to us. Promising strategies included teaming–up of CHW, micro–franchising or social franchising. On–site training and supervision of CHW have been shown to improve clinical practices. Effects on caregivers seemed positive, with increases in knowledge, care seeking behaviour, or caregivers’ basic disease management. Evidence on iCCM is often of low quality, cannot relate specific interventions or the ways they are implemented with outcomes and lacks standardisation; this limits the capacity to identify promising strategies to improve quality of care. Conclusion Large, multi–faceted, iCCM programmes, with strong

Childhood accidents: the relationship of family size to incidence, supervision, and rapidity of seeking medical care.

Science.gov (United States)

Schwartz, Shepard; Eidelman, Arthur I; Zeidan, Amin; Applebaum, David; Raveh, David

2005-09-01

Large family size may be a risk factor for childhood accidents. A possible association with quality of child supervision and rapidity of seeking medical care has not been fully evaluated. To determine whether children with multiple siblings are at increased risk for accidents, to assess whether quality of child supervision varies with family size, and to evaluate the relationship of family size with the rapidity of seeking medical care after an accident. We prospectively studied 333 childhood accidents treated at TEREM (emergency care station) or the Shaare Zedek Medical Center. Details on family composition and the accident were obtained through parental interview. Family size of the study population was compared with that of the Jerusalem population. Families with one to three children (Group 1) and four or more children (Group 2) were compared with regard to type of supervision and different "Gap times" - the time interval from when the accident occurred until medical assistance was sought ("Gap 1"), the time from that medical contact until arrival at Shaare Zedek ("Gap 2"), and the time from the accident until arrival at Shaare Zedek for those children for whom interim medical assistance either was ("Gap 3A") or was not ("Gap 3B") sought. Children from families with 1, 2, 3, 4 and > or =5 children comprised 7.2%, 18.3%, 14.4%, 18.6% and 41.4% of our sample compared to 20.4%, 21.8%, 18.4%, 14.7% and 24.7% in the general population respectively. Children from Group 2 were less often attended to by an adult (44.5% vs. 62.0%) and more often were in the presence only of other children at the time of the accident (27.0% vs. 10.5%). Gaps 1, 2 and 3A in Group 2 (6.3 hours, 16.5 hours, 27.8 hours respectively) were longer than for Group 1 (2.7, 10.7, 13.3 hours respectively). The risk for accidents is increased among children from families with four or more children. The adequacy of child supervision in large families is impaired. There is a relative delay from the time

The Influence of Quality Assurance and Supportive Supervision on the Quality of Medical Care in Children’s Hospitals of the Municipal Level of the Rostov Region

Directory of Open Access Journals (Sweden)

Tatiana V. Kulichenko

2017-01-01

Full Text Available Background. Improving the quality of medical care is the absolute priority of the World Health Organization and all socially-oriented ministries and departments around the world.Objective. Our aim was to evaluate the effectiveness of quality  assurance and supportive supervision in municipal hospitals to improve the quality of medical care for children (by the example of the Rostov region.Methods. The open observational study included 10 second-level hospitals in the Rostov Region. At the start of the project, the quality of inpatient care for children in the region was audited based on recommendations and tools of the World Health Organization, and training of medical personnel was organized. Monitoring visits to hospitals were carried out by experts every 3 months (supportive supervision. Reaudit of the quality of care was conducted a year later.Results. As a result of regular quality assurance and supportive supervision of hospitals during the first year of operation, such indicators of the quality of medical care as the availability of medical equipment for emergency care for children, the infrastructure of children’s departments, the triage and provision of emergency care in children’s departments, managing patients with various acute conditions (fever, diarrhea, respiratory diseases, supporting care, internal quality assurance, accessibility to standards of care and clinical guidelines for the diagnosis and treatment of various diseases, respect for children’s rights were significantly (p < 0.05 improved.Conclusion. Supportive supervision and regular external quality assurances of hospitals contribute to a rapid increase in the quality of medical care for children.

BRONCHIAL ASTHMA SUPERVISION AMONG TEENAGERS

Directory of Open Access Journals (Sweden)

N.M. Nenasheva

2008-01-01

Full Text Available The article highlights the results of the act test based bronchial asthma supervision evaluation among teenagers and defines the interrelation of the objective and subjective asthma supervision parameters. The researchers examined 214 male teenagers aged from 16 to 18, suffering from the bronchial asthma, who were sent to the allergy department to verify the diagnosis. Bronchial asthma supervision evaluation was assisted by the act test. The research has showed that over a half (56% of teenagers, suffering from mild bronchial asthma, mention its un control course, do not receive any adequate pharmacotherapy and are consequently a risk group in terms of the bronchial asthma exacerbation. Act test results correlate with the functional indices (fev1, as well as with the degree of the bronchial hyperresponsiveness, which is one of the markers of an allergic inflammation in the lower respiratory passages.Key words: bronchial asthma supervision, act test, teenagers.

Is supervision necessary? Examining the effects of internet-based CBT training with and without supervision.

Science.gov (United States)

Rakovshik, Sarah G; McManus, Freda; Vazquez-Montes, Maria; Muse, Kate; Ougrin, Dennis

2016-03-01

To investigate the effect of Internet-based training (IBT), with and without supervision, on therapists' (N = 61) cognitive-behavioral therapy (CBT) skills in routine clinical practice. Participants were randomized into 3 conditions: (1) Internet-based training with use of a consultation worksheet (IBT-CW); (2) Internet-based training with CBT supervision via Skype (IBT-S); and (3) "delayed-training" controls (DTs), who did not receive the training until all data collection was completed. The IBT participants received access to training over a period of 3 months. CBT skills were evaluated at pre-, mid- and posttraining/wait using assessor competence ratings of recorded therapy sessions. Hierarchical linear analysis revealed that the IBT-S participants had significantly greater CBT competence at posttraining than did IBT-CW and DT participants at both the mid- and posttraining/wait assessment points. There were no significant differences between IBT-CW and the delayed (no)-training DTs. IBT programs that include supervision may be a scalable and effective method of disseminating CBT into routine clinical practice, particularly for populations without ready access to more-traditional "live" methods of training. There was no evidence for a significant effect of IBT without supervision over a nontraining control, suggesting that merely providing access to IBT programs may not be an effective method of disseminating CBT to routine clinical practice. (c) 2016 APA, all rights reserved).

Nuclear safety culture and nuclear safety supervision

International Nuclear Information System (INIS)

Chai Jianshe

2013-01-01

In this paper, the author reviews systematically and summarizes up the development process and stage characteristics of nuclear safety culture, analysis the connotation and characteristics of nuclear safety culture, sums up the achievements of our country's nuclear safety supervision, dissects the challenges and problems of nuclear safety supervision. This thesis focused on the relationship between nuclear safety culture and nuclear safety supervision, they are essential differences, but there is a close relationship. Nuclear safety supervision needs to introduce some concepts of nuclear safety culture, lays emphasis on humanistic care and improves its level and efficiency. Nuclear safety supervision authorities must strengthen nuclear safety culture training, conduct the development of nuclear safety culture, make sure that nuclear safety culture can play significant roles. (author)

Palliative care for patients with cancer: do patients receive the care they consider important? A survey study.

Science.gov (United States)

Heins, Marianne; Hofstede, Jolien; Rijken, Mieke; Korevaar, Joke; Donker, Gé; Francke, Anneke

2018-04-17

In many countries, GPs and home care nurses are involved in care for patients with advanced cancer. Given the varied and complex needs of these patients, providing satisfactory care is a major challenge for them. We therefore aimed to study which aspects of care patients, GPs and home care nurses consider important and whether patients receive these aspects. Seventy-two Dutch patients with advanced cancer, 87 GPs and 26 home care nurses rated the importance of support when experiencing symptoms, respect for patients' autonomy and information provision. Patients also rated whether they received these aspects. Questionnaires were based on the CQ index palliative care. Almost all patients rated information provision and respect for their autonomy as important. The majority also rated support when suffering from specific symptoms as important, especially support when in pain. In general, patients received the care they considered important. However, 49% of those who considered it important to receive support when suffering from fatigue and 23% of those who wanted to receive information on the expected course of their illness did not receive this or only did so sometimes. For most patients with advanced cancer, the palliative care that they receive matches what they consider important. Support for patients experiencing fatigue may need more attention. When symptoms are difficult to control, GPs and nurses may still provide emotional support and practical advice. Furthermore, we recommend that GPs discuss patients' need for information about the expected course of their illness.

Clinical Supervision of Mental Health Professionals Serving Youth: Format and Microskills.

Science.gov (United States)

Bailin, Abby; Bearman, Sarah Kate; Sale, Rafaella

2018-03-21

Clinical supervision is an element of quality assurance in routine mental health care settings serving children; however, there is limited scientific evaluation of its components. This study examines the format and microskills of routine supervision. Supervisors (n = 13) and supervisees (n = 20) reported on 100 supervision sessions, and trained coders completed observational coding on a subset of recorded sessions (n = 57). Results indicate that microskills shown to enhance supervisee competency in effectiveness trials and experiments were largely absent from routine supervision, highlighting potential missed opportunities to impart knowledge to therapists. Findings suggest areas for quality improvement within routine care settings.

"Unscrambling what's in your head": A mixed method evaluation of clinical supervision for midwives.

Science.gov (United States)

Love, Bev; Sidebotham, Mary; Fenwick, Jennifer; Harvey, Susan; Fairbrother, Greg

2017-08-01

As a strategy to promote workforce sustainability a number of midwives working in one health district in New South Wales, Australia were trained to offer a reflective model of clinical supervision. The expectation was that these midwives would then be equipped to facilitate clinical supervision for their colleagues with the organisational aim of supporting professional development and promoting emotional well-being. To identify understanding, uptake, perceptions of impact, and the experiences of midwives accessing clinical supervision. Mixed Methods. In phase one 225 midwives were invited to complete a self-administered survey. Descriptive and inferential statistics were used to analyse the data. In phase two 12 midwives were interviewed. Thematic analysis was used to deepen understanding of midwives' experiences of receiving clinical supervision. Sixty percent of midwives responding in phase one had some experience of clinical supervision. Findings from both phases were complementary with midwives reporting a positive impact on their work, interpersonal skills, situational responses and career goals. Midwives described clinical supervision as a formal, structured and confidential space for 'safe reflection' that was valued as an opportunity for self-care. Barriers included misconceptions, perceived work related pressures and a sense that taking time out was unjustifiable. Education, awareness raising and further research into reflective clinical supervision, to support emotional well-being and professional midwifery practice is needed. In addition, health organisations need to design, implement and evaluate strategies that support the embedding of clinical supervision within midwives' clinical practice. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Ostomy patients’ perception of the health care received

Directory of Open Access Journals (Sweden)

Candela Bonill-de las Nieves

2017-12-01

Full Text Available ABSTRACT Aim: to describe ostomy patient’s perception about health care received, as well as their needs and suggestions for healthcare system improvement. Method: qualitative phenomenological study was conducted, involving individual and semi-structured interviews on the life experiences of 21 adults who had a digestive stoma. Participants were selected following a purposive sampling approach. The analysis was based on the constant comparison of the data, the progressive incorporation of subjects and triangulation among researchers and stoma therapy nurses. The software Atlas.ti was used. Results: perception of health care received is closely related to the information process, as well as training for caring the stoma from peristomal skin to diet. It is worthy to point out the work performed by stoma care nurses ensuring support during all stages of the process. Conclusion: findings contribute to address the main patients’ needs (better prepared nurses, shorter waiting lists, information about sexual relation, inclusion of family members all along the process and recommendations for improving health care to facilitate their adaptation to a new status of having a digestive stoma.

A case study exploring the experience of resilience-based clinical supervision and its influence on care towards self and others among student nurses

Directory of Open Access Journals (Sweden)

Gemma Stacey

2017-11-01

Full Text Available Background: Healthcare organisations are increasingly recognising their responsibility to support the wellbeing of nurses as a result of the accumulative demands of their role. Resilience-based clinical supervision is a newly developed intervention that encourages practitioners to pay attention and apply reasoning to behaviours and responses to emotive scenarios through a process of stress alleviation and prevention. Aims: To evaluate an intervention aimed at supporting pre-registration nursing students to develop resilience-based competencies that enable them to regulate their response to stress and monitor their own wellbeing using mindfulness, reflective discussion and positive reframing. Method: Case study methodology was used to explore how the characteristics associated with the expression and maintenance of resilience have been influenced by the intervention. Data were collected through focus groups at three timepoints with students and at the end of the intervention period with supervision facilitators, and then analysed by pattern matching to theoretical propositions. Findings: Participants expressed positive experiences of resilience-based clinical supervision. Their perception of the importance of self-care increased and their commitment to caring for others was maintained. They continued to demonstrate competencies of self-care six months after qualifying as nurses, despite the complexities of the workplace. As qualified nurses, participants recognised the implications of limited time and resources on the quality of care they were able to provide to patients, but they externalised this as organisational failings as opposed to personal inadequacy, and worked around such constraints where possible to maintain personal standards. Conclusion: Resilience-based clinical supervision has the potential to support healthcare practitioners in developing resilience-based competencies that allow them to recognise and attend to workplace stressors

Is it possible to strengthen psychiatric nursing staff's clinical supervision?

DEFF Research Database (Denmark)

Gonge, Henrik; Buus, Niels

2015-01-01

AIM: To test the effects of a meta-supervision intervention in terms of participation, effectiveness and benefits of clinical supervision of psychiatric nursing staff. BACKGROUND: Clinical supervision is regarded as a central component in developing mental health nursing practices, but the evidence...... an intervention group (n = 40) receiving the meta-supervision in addition to attending usual supervision or to a control group (n = 43) attending usual supervision. METHODS: Self-reported questionnaire measures of clinical supervision effectiveness and benefits were collected at base line in January 2012...... and at follow-up completed in February 2013. In addition, a prospective registration of clinical supervision participation was carried out over 3 months subsequent to the intervention. RESULTS: The main result was that it was possible to motivate staff in the intervention group to participate significantly more...

Short- and long-term effectiveness of a supervised training program in spirometry use for primary care professionals.

Science.gov (United States)

Represas-Represas, Cristina; Botana-Rial, Maribel; Leiro-Fernández, Virginia; González-Silva, Ana Isabel; García-Martínez, Ana; Fernández-Villar, Alberto

2013-09-01

Despite the importance of spirometry, its use and quality are limited in the Primary Care setting. There are few accredited training programs that have demonstrated improvement in the quality of spirometric studies. In this paper, we analyze the short- and long-term effectiveness of a supervised training program for performing and interpreting spirometries. Ours is an intervention study with before and after measurements. The target population included teams of physicians and nursing staff at 26 health-care centers in the area of Vigo (Galicia, Spain). The structured training program involved 2 theoretical and practical training sessions (that were 2months apart), an intermediate period of 30 supervised spirometries performed in the respective centers and weekly e-mail exercises. Effectiveness was evaluated using exercises at the beginning (test 1) and the end (test 2) of the 1st day, 2nd day (test 3) and one year later (test 4), as well as the analysis of spirometries done in month1, month2 and one year later. Participants also completed a survey about their satisfaction. 74 participants initiated the program; 72 completed the program, but only 45 participated in the one-year evaluation. Mean test scores were: 4.1±1.9 on test 1; 7.5±1.6 on test 2; 8.9±1.3 on test 3, and 8.8±1.4 on test 4. During month1, the percentage of correctly done/interpreted tests was 71%, in month two it was 91% and after one year it was 83% (Ptraining program based on theoretical and practical workshops and a supervised follow-up of spirometries significantly improved the ability of Primary Care professionals to carry out and interpret spirometric testing, although the quality of the tests diminished over time. Copyright © 2012 SEPAR. Published by Elsevier Espana. All rights reserved.

Care satisfaction among older people receiving public care and service at home or in special accommodation.

Science.gov (United States)

Karlsson, Staffan; Edberg, Anna-Karin; Jakobsson, Ulf; Hallberg, Ingalill R

2013-02-01

To explore care satisfaction in relation to place of living, health-related quality of life, functional dependency and health complaints among people 65 years or older, receiving public care and service. The concept public care and service concerns formal care from the municipality, including home help, home nursing care, rehabilitation and a special accommodation. To be able to provide care and service of high quality to older people, knowledge about factors influencing their experience of satisfaction with the care is essential. Cross-sectional, including comparison and correlation. One-hundred sixty-six people receiving public care and service from the municipality were interviewed regarding demography, functional ability, perceived health complaints and care. Health-related quality of life was measured with SF-12, and self-rated care satisfaction was measured with a questionnaire. Low self-rated care satisfaction was associated with dependency in Instrumental Activities of Daily Living, blindness, faeces incontinence and anxiety, while high self-rated care satisfaction was associated with dependency in Personal Activities of Daily Living. Those at home rated an overall higher care satisfaction and were more satisfied with care continuity and personal relations; they thought that the staff had more time and were more respectful and quiet, than the ratings by those in a special accommodation (equivalent to a nursing home). Care satisfaction and health-related quality of life among older people was more associated with functional impairment and health complaints than to whether care and service was received at home or in a special accommodation. An approach using intervention focused on functional ability and health complaints is important for development of improved care satisfaction for older people receiving public care and service. © 2013 Blackwell Publishing Ltd.

Physical activity levels of older adults receiving a home care service.

Science.gov (United States)

Burton, Elissa; Lewin, Gill; Boldy, Duncan

2013-04-01

The 3 study objectives were to compare the activity levels of older people who had received a restorative home care service with those of people who had received "usual" home care, explore the predictors of physical activity in these 2 groups, and determine whether either group met the minimum recommended activity levels for their age group. A questionnaire was posted to 1,490 clients who had been referred for a home care service between 2006 and 2009. Older people who had received a restorative care service were more active than those who had received usual care (p = .049), but service group did not predict activity levels when other variables were adjusted for in a multiple regression. Younger individuals who were in better physical condition, with good mobility and no diagnosis of depression, were more likely to be active. Investigation of alternatives to the current exercise component of the restorative program is needed.

The Quality of Health Care Received by Older Adults

National Research Council Canada - National Science Library

2004-01-01

.... Older adults suffer from a multitude of conditions and are especially susceptible to the effects of poor care, yet we know relatively little about the quality of health care older people receive...

Associated Factors and Quality of Care Received among Maternal ...

African Journals Online (AJOL)

USER

discussions with health staff to assess care received and factors leading to death. A total of 43 maternal deaths ... department with bed capacity of 105, one ..... evidence for emergency obstetric care. ... Planning; 15(2): 170-176. 13. Ray S ...

Assistance received by employed caregivers and their care recipients: who helps care recipients when caregivers work full time?

Science.gov (United States)

Scharlach, Andrew E; Gustavson, Kristen; Dal Santo, Teresa S

2007-12-01

This study examined the association among caregiver labor force participation, employees' caregiving activities, and the amount and quality of care received by care recipients. Telephone interviews were conducted with 478 adults who were employed full time and 705 nonemployed adults who provided care to a family member or friend aged 50 or older, identified through random sampling of California households. We assessed care recipient impairment and service problems; the amounts and types of assistance received from caregivers, family and friends, and paid providers; and caregiver utilization of support services. Care recipients of caregivers employed full time were less likely to receive large amounts of care from their caregivers, more likely to receive personal care from paid care providers, more likely to use community services, and more likely to experience service problems than were care recipients of nonemployed caregivers. Employed caregivers were more likely to use caregiver support services than were nonemployed caregivers. Accommodation to caregiver full-time employment involves selective supplementation by caregivers and their care recipients, reflecting increased reliance on formal support services as well as increased vulnerability to service problems and unmet care recipient needs. These findings suggest the need for greater attention to the well-being of disabled elders whose caregivers are employed full time.

Effective use of technology in clinical supervision

Directory of Open Access Journals (Sweden)

Priya Martin

2017-06-01

Full Text Available Clinical supervision is integral to continuing professional development of health professionals. With advances in technology, clinical supervision too can be undertaken using mediums such as videoconference, email and teleconference. This mode of clinical supervision is termed as telesupervision. While telesupervision could be useful in any context, its value is amplified for health professionals working in rural and remote areas where access to supervisors within the local work environment is often diminished. While telesupervision offers innovative means to undertake clinical supervision, there remain gaps in the literature in terms of its parameters of use in clinical practice. This article outlines ten evidence-informed, practical tips stemming from a review of the literature that will enable health care stakeholders to use technology effectively and efficiently while undertaking clinical supervision. By highlighting the “how to” aspect, telesupervision can be delivered in the right way, to the right health professional, at the right time.

Influence of Intensified Supervision by Health Care Inspectorates on Online Patient Ratings of Hospitals: A Multilevel Study of More Than 43,000 Online Ratings

NARCIS (Netherlands)

Kool, R.B.; Kleefstra, S.M.; Borghans, H.J.; Atsma, F.; Belt, T.H. van de

2016-01-01

BACKGROUND: In the Netherlands, hospitals with quality or safety issues are put under intensified supervision by the Dutch Health Care Inspectorate, which involves frequent announced and unannounced site visits and other measures. Patient rating sites are an upcoming phenomenon in health care.

Miles Apart: Two Art Therapists' Experience of Distance Supervision

Science.gov (United States)

Brandoff, Rachel; Lombardi, Reina

2012-01-01

Distance supervision (or "telesupervision") is a significant and growing trend in health care professions, but it requires advanced planning, ongoing discussion, and investment in technology by both parties in order to be an effective and ethical alternative to traditional face-to-face supervision. This viewpoint presents the perspectives of two…

[Design of a supervision model for administration of the Child Development Evaluation Test at primary care facilities in Mexico].

Science.gov (United States)

Villasís-Keever, Miguel Ángel; Rizzoli-Córdoba, Antonio; Delgado-Ginebra, Ismael; Mares-Serratos, Blanca Berenice; Martell-Valdez, Liliana; Sánchez-Velázquez, Olivia; Reyes-Morales, Hortensia; O'Shea-Cuevas, Gabriel; Aceves-Villagrán, Daniel; Carrasco-Mendoza, Joaquín; Antillón-Ocampo, Fátima Adriana; Villagrán-Muñoz, Víctor Manuel; Halley-Castillo, Elizabeth; Baqueiro-Hernández, César Iván; Pizarro-Castellanos, Mariel; Martain-Pérez, Itzamara Jacqueline; Palma-Tavera, Josuha Alexander; Vargas-López, Guillermo; Muñoz-Hernández, Onofre

The Child Development Evaluation (CDE) test designed and validated in Mexico has been used as a screening tool for developmental problems in primary care facilities across Mexico. Heterogeneous results were found among those states where these were applied, despite using the same standardized training model for application. The objective was to evaluate a supervision model for quality of application of the CDE test at primary care facilities. A study was carried out in primary care facilities from three Mexican states to evaluate concordance of the results between supervisor and primary care personnel who administered the test using two different methods: direct observation (shadow study) or reapplication of the CDE test (consistency study). There were 380 shadow studies applied to 51 psychologists. General concordance of the shadow study was 86.1% according to the supervisor: green 94.5%, yellow 73.2% and red 80.0%. There were 302 re-test evaluations with a concordance of 88.1% (n=266): green 96.8%, yellow 71.7% and red 81.8%. There were no differences between CDE test subgroups by age. Both shadow and re-test study were adequate for the evaluation of the quality of the administration of the CDE Test and may be useful as a model of supervision in primary care facilities. The decision of which test to use relies on the availability of supervisors. Copyright © 2015 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

Clinical Supervision of Substance Abuse Counselors: Current and Preferred Practices.

Science.gov (United States)

Culbreth, John R.

1999-01-01

Reports on a national survey of substance abuse counselors (N=134) to learn their current and preferred supervision practices. Results suggests that substance abuse counselor are receiving supervision similar to other counselors. No preference was indicated for the sex of the supervisor, nor for the 12-step recovery experience. Counselors did…

Preparing supervisors to provide safeguarding supervision for healthcare staff.

Science.gov (United States)

Smikle, Marcia

2017-11-28

This paper outlines why experienced supervisors at a London healthcare provider received skills training so they could offer safeguarding supervision to front-line colleagues with case management responsibilities for vulnerable children and young people. It examines how supervisors use the main functions of supervision and a cycle of reflection in clinical practice with supervisees. As well as the professional issues encountered by supervisors in relation to the benefits, the challenges of providing supervision and the action required to make safeguarding supervision a part of the organisational culture are also explored. ©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.

Exploring paraprofessional and classroom factors affecting teacher supervision.

Science.gov (United States)

Irvin, Dwight W; Ingram, Paul; Huffman, Jonathan; Mason, Rose; Wills, Howard

2018-02-01

Paraprofessionals serve a primary role in supporting students with disabilities in the classroom, which necessitates teachers' supervision as a means to improve their practice. Yet, little is known regarding what factors affect teacher supervision. We sought to identify how paraprofessional competence and classroom type affected the levels of teacher direction. We administered an adapted version of the Paraprofessional Needs, Knowledge & Tasks Survey and the Survey for Teachers Supervising Paraprofessionals to teachers supervising paraprofessionals in elementary schools. Structural Equation Modeling was used to examine the link between paraprofessional competence and classroom factors affecting the level of teacher supervision. Our results indicated that when teachers perceived paraprofessionals as being more skilled, they provided more supervision, and when more supervision was provided the less they thought paraprofessionals should be doing their assigned tasks. Additionally, paraprofessionals working in classrooms with more students with mild disabilities received less supervision than paraprofessionals working in classrooms with more students with moderate-to-severe disabilities. Those paraprofessionals in classrooms serving mostly children with mild disabilities were also perceived as having lower levels of skill competence than those serving in classrooms with students with more moderate-to-severe disabilities. By understanding the factors that affect teacher supervision, policy and professional development opportunities can be refined/developed to better support both supervising teachers and paraprofessionals and, in turn, improve the outcomes of children with disabilities. Copyright © 2017 Elsevier Ltd. All rights reserved.

Baccalaureate nursing students' perceptions of learning and supervision in the clinical environment.

Science.gov (United States)

Dimitriadou, Maria; Papastavrou, Evridiki; Efstathiou, Georgios; Theodorou, Mamas

2015-06-01

This study is an exploration of nursing students' experiences within the clinical learning environment (CLE) and supervision provided in hospital settings. A total of 357 second-year nurse students from all universities in Cyprus participated in the study. Data were collected using the Clinical Learning Environment, Supervision and Nurse Teacher instrument. The dimension "supervisory relationship (mentor)", as well as the frequency of individualized supervision meetings, were found to be important variables in the students' clinical learning. However, no statistically-significant connection was established between successful mentor relationship and team supervision. The majority of students valued their mentor's supervision more highly than a nurse teacher's supervision toward the fulfillment of learning outcomes. The dimensions "premises of nursing care" and "premises of learning" were highly correlated, indicating that a key component of a quality clinical learning environment is the quality of care delivered. The results suggest the need to modify educational strategies that foster desirable learning for students in response to workplace demands. © 2014 Wiley Publishing Asia Pty Ltd.

Factors influencing job satisfaction among Swedish occupational therapists in psychiatric care.

Science.gov (United States)

Eklund, M; Hallberg, I R

2000-01-01

This study examined job satisfaction among occupational therapists in Swedish psychiatric care, and investigated how clinical supervision, organizational aspects and demographic characteristics contributed to job satisfaction. We received 332 returned questionnaires, corresponding to a response rate of 66.9%. Job satisfaction factors that emerged were: general satisfaction with work, communication and co-operation among team members, managerial feedback, the patients' influence on care and the relatives' influence on care. The respondents rated their general satisfaction, co-operation and communication as high. They were least satisfied with the relatives' influence on care. We found few relationships between other factors and job satisfaction, but, for example, satisfaction with the patients' influence on care was higher among occupational therapists working in outpatient care than among those working in hospital wards. Furthermore, having supervision was positively associated with co-operation and communication. This study revealed a fairly satisfactory situation, possibly thanks to social support, advantageous care-planning strategies and supervision. However, managerial staff must be aware that measures need to be taken continuously to counteract detrimental forces. The study pointed to a need for further research that relates occupational therapists' job satisfaction with issues such as support, control and individual need for growth.

Disparities in Health Supervision for Children With Down Syndrome.

Science.gov (United States)

Williams, Katie; Wargowski, David; Eickhoff, Jens; Wald, Ellen

2017-12-01

Increasing evidence suggests children with Down syndrome do not receive recommended health care services. We retrospectively assessed adherence to the 2001 American Academy of Pediatrics health supervision guidelines for 124 children with Down syndrome. Cervical spine radiographs were completed for 94% of children, often preoperatively. Adherence to complete blood count recommendations was 55% (95% CI 44% to 66%); lower for males ( P = .01) and children with private medical insurance ( P = .04). Adherence to thyroid function recommendations was 61% (95% CI 54% to 67%); higher for children seen by a pediatrician ( P = .002) and with known thyroid disease ( P < .0001). Adherence to audiology and ophthalmology recommendations was 33% (95% CI 27% to 40%) and 43% (95% CI 37% to 50%), respectively. Adherence rates were higher for children referred to an otolaryngologist ( P = .0002) and with known eye disease ( P < .0001). Future efforts should identify barriers to care and improve adherence to recommended screening.

Guess Where? Actor-Supervision for Spatiotemporal Action Localization

KAUST Repository

Escorcia, Victor

2018-04-05

This paper addresses the problem of spatiotemporal localization of actions in videos. Compared to leading approaches, which all learn to localize based on carefully annotated boxes on training video frames, we adhere to a weakly-supervised solution that only requires a video class label. We introduce an actor-supervised architecture that exploits the inherent compositionality of actions in terms of actor transformations, to localize actions. We make two contributions. First, we propose actor proposals derived from a detector for human and non-human actors intended for images, which is linked over time by Siamese similarity matching to account for actor deformations. Second, we propose an actor-based attention mechanism that enables the localization of the actions from action class labels and actor proposals and is end-to-end trainable. Experiments on three human and non-human action datasets show actor supervision is state-of-the-art for weakly-supervised action localization and is even competitive to some fully-supervised alternatives.

Guess Where? Actor-Supervision for Spatiotemporal Action Localization

KAUST Repository

Escorcia, Victor; Dao, Cuong D.; Jain, Mihir; Ghanem, Bernard; Snoek, Cees

2018-01-01

This paper addresses the problem of spatiotemporal localization of actions in videos. Compared to leading approaches, which all learn to localize based on carefully annotated boxes on training video frames, we adhere to a weakly-supervised solution that only requires a video class label. We introduce an actor-supervised architecture that exploits the inherent compositionality of actions in terms of actor transformations, to localize actions. We make two contributions. First, we propose actor proposals derived from a detector for human and non-human actors intended for images, which is linked over time by Siamese similarity matching to account for actor deformations. Second, we propose an actor-based attention mechanism that enables the localization of the actions from action class labels and actor proposals and is end-to-end trainable. Experiments on three human and non-human action datasets show actor supervision is state-of-the-art for weakly-supervised action localization and is even competitive to some fully-supervised alternatives.

Who attends clinical supervision? The uptake of clinical supervision by hospital nurses.

Science.gov (United States)

Koivu, Aija; Hyrkäs, Kristiina; Saarinen, Pirjo Irmeli

2011-01-01

The aim of the present study was to identify which nurses decide to participate in clinical supervision (CS) when it is provided for all nursing staff. Clinical supervision is available today for health care providers in many organisations. However, regardless of evidence showing the benefits of CS, some providers decide not to participate in the sessions. A baseline survey on work and health issues was conducted in 2003 with a 3-year follow-up of the uptake of CS by the respondents. Background characteristics and perceptions of work and health were compared between medical and surgical nurses who had undertaken CS (n=124) and their peers who decided not to undertake it (n=204). Differences in the perceptions of work and dimensions of burnout were found between the two groups. Nurses attracted to CS form a distinctive group in the unit, standing out as self-confident, committed and competent professionals supported by empowering and fair leadership. Facilitating clinical supervision for committed and innovative nurses may be seen as part of the empowering leadership of the nurse manager. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

Trichomonas vaginalis and Human Immunodeficiency Virus Coinfection Among Women Under Community Supervision: A Call for Expanded T. vaginalis Screening.

Science.gov (United States)

Davis, Alissa; Dasgupta, Anindita; Goddard-Eckrich, Dawn; El-Bassel, Nabila

2016-10-01

The United States has a large community supervision population, a growing number of whom are women. Trichomonas vaginalis infection is strongly associated with an increased risk of human immunodeficiency virus (HIV) acquisition and transmission, particularly among women, but there is a paucity of research on HIV and T. vaginalis co-infection among women under community supervision. This article examines the prevalence of T. vaginalis infection and T. vaginalis and HIV coinfection at baseline among women under community supervision in New York City. It also examines the 12-month outcomes of women treated for T. vaginalis. Women received biological tests for HIV and T. vaginalis at baseline and 12 months follow-up. Of the 333 women tested for sexually transmitted infections, 77 women (23.1%) tested positive for T. vaginalis at baseline and 44 (13.3%) were HIV positive. Human immunodeficiency virus-positive women had significantly higher rates of T. vaginalis infection than HIV-negative women (36.4% vs 21.3%, P ≤ 0.05). Sixteen women (4.8%) were coinfected with T. vaginalis and HIV. Of the 77 women who were positive for T. vaginalis infection at baseline, 58 (75.3%) received treatment by a health care provider. Of those who received treatment, 17 (29.3%) tested positive for T. vaginalis at the 12-month follow-up. Given the high prevalence of T. vaginalis among this sample of women, particularly among HIV-positive women, and high levels of reinfection or persistent infection, screening for T. vaginalis among women under community supervision may have a substantial impact on reducing HIV acquisition and transmission among this high-risk population.

Antidepressant Medication Management among Older Patients Receiving Home Health Care

Science.gov (United States)

Bao, Yuhua; Shao, Huibo; Bruce, Martha L.; Press, Matthew J.

2014-01-01

Objective Antidepressant management for older patients receiving home health care (HHC) may occur through two pathways: nurse-physician collaboration (without patient visits to the physician) and physician management through office visits. This study examines the relative contribution of the two pathways and how they interplay. Methods Retrospective analysis was conducted using Medicare claims of 7,389 depressed patients 65 or older who received HHC in 2006–7 and who possessed antidepressants at the start of HHC. A change in antidepressant therapy (vs. discontinuation or refill) was the main study outcome and could take the form of a change in dose, switch to a different antidepressant, or augmentation (addition of a new antidepressant). Logistic regressions were estimated to examine how use of home health nursing care, patient visits to physicians, and their interactions predict a change in antidepressant therapy. Results About 30% of patients experienced a change in antidepressants versus 51% who refilled and 18% who discontinued. Receipt of mental health specialty care was associated with a statistically significant, 10–20 percentage-point increase in the probability of antidepressant change; receipt of primary care was associated with a small and statistically significant increase in the probability of antidepressant change among patients with no mental health specialty care and above-average utilization of nursing care. Increased home health nursing care in absence of physician visits was not associated with increased antidepressant change. Conclusions Active antidepressant management resulting in a change in medication occurred on a limited scale among older patients receiving HHC. Addressing knowledge and practice gaps in antidepressant management by primary care providers and home health nurses and improving nurse-physician collaboration will be promising areas for future interventions. PMID:25158915

Effects of a partially supervised conditioning programme in cystic fibrosis: an international multi-centre randomised controlled trial (ACTIVATE-CF): study protocol.

Science.gov (United States)

Hebestreit, Helge; Lands, Larry C; Alarie, Nancy; Schaeff, Jonathan; Karila, Chantal; Orenstein, David M; Urquhart, Don S; Hulzebos, Erik H J; Stein, Lothar; Schindler, Christian; Kriemler, Susi; Radtke, Thomas

2018-02-08

Physical activity (PA) and exercise have become an accepted and valued component of cystic fibrosis (CF) care. Regular PA and exercise can positively impact pulmonary function, improve physical fitness, and enhance health-related quality of life (HRQoL). However, motivating people to be more active is challenging. Supervised exercise programs are expensive and labour intensive, and adherence falls off significantly once supervision ends. Unsupervised or partially supervised programs are less costly and more flexible, but compliance can be more problematic. The primary objective of this study is to evaluate the effects of a partially supervised exercise intervention along with regular motivation on forced expiratory volume in 1 s (FEV 1 ) at 6 months in a large international group of CF patients. Secondary endpoints include patient reported HRQoL, as well as levels of anxiety and depression, and control of blood sugar. It is planned that a total of 292 patients with CF 12 years and older with a FEV 1  ≥ 35% predicted shall be randomised. Following baseline assessments (2 visits) patients are randomised into an intervention and a control group. Thereafter, they will be seen every 3 months for assessments in their centre for one year (4 follow-up visits). Along with individual counselling to increase vigorous PA by at least 3 h per week on each clinic visit, the intervention group documents daily PA and inactivity time and receives a step counter to record their progress within a web-based diary. They also receive monthly phone calls from the study staff during the first 6 months of the study. After 6 months, they continue with the step counter and web-based programme for a further 6 months. The control group receives standard care and keeps their PA level constant during the study period. Thereafter, they receive the intervention as well. This is the first large, international multi-centre study to investigate the effects of a PA intervention in CF with

Theoretical Application of Supervision over Quality and Safety of Agricultural Products

Institute of Scientific and Technical Information of China (English)

Xin; CHENG; Ying; ZHANG

2013-01-01

Supervision over quality and safety of agricultural products has received high attention of management department.Competent authorities have formulated and issued many measures to strengthen supervision over quality and safety of agricultural products and improve China’s agricultural product quality and safety level.From the perspective of management science,this paper elaborates basic contents of two basic management theories,Broken Windows Effect and Effect of Heat Furnace.Then,it analyzes influence of Broken Windows Effect and Effect of Heat Furnace on supervision over quality and safety of agricultural products.Finally,it comes up with recommendations for supervision over quality and safety of agricultural products.

Rethinking attitudes to student clinical supervision and patient care: a change management success story.

Science.gov (United States)

O'Keefe, Maree; Wade, Victoria; McAllister, Sue; Stupans, Ieva; Miller, Jennifer; Burgess, Teresa; LeCouteur, Amanda; Starr, Linda

2014-08-30

The aim of this project was to explore the process of change in a busy community dental clinic following a team development intervention designed to improve the management of student supervision during clinical placements. An action research model was used. Seven members of a community dental clinic team (three dentists, two dental therapists, one dental assistant and the clinic manager), together with the university clinical placement supervisor participated in the team development intervention. The intervention consisted of two profiling activities and associated workshops spread six months apart. These activities focused on individual work preferences and overall team performance with the aim of improving the functioning of the clinic as a learning environment for dental students. Evaluation data consisted of 20 participant interviews, fourteen hours of workplace observation and six sets of field notes. Following initial thematic analysis, project outcomes were re-analysed using activity theory and expansive learning as a theoretical framework. At project commencement students were not well integrated into the day-to-day clinic functioning. Staff expressed a general view that greater attention to student supervision would compromise patient care. Following the intervention greater clinical team cohesion and workflow changes delivered efficiencies in practice, enhanced relationships among team members, and more positive attitudes towards students. The physical layout of the clinic and clinical workloads were changed to achieve greater involvement of all team members in supporting student learning. Unexpectedly, these changes also improved clinic functioning and increased the number of student placements available. In navigating the sequential stages of the expansive learning cycle, the clinical team ultimately redefined the 'object' of their activity and crossed previously impervious boundaries between healthcare delivery and student supervision with benefits to

Psychotherapy and Cognitive Behavioral Therapy Supervision in Danish Psychiatry: Training the Next Generation of Psychiatrists.

Science.gov (United States)

Schmidt, Lasse M; Foli-Andersen, Nina J

2017-02-01

Psychotherapy training is mandatory for physicians to qualify as psychiatrists in Denmark. Evidence for the effectiveness of psychotherapy has increased, and psychotherapy is increasingly included in international treatment guidelines. The authors investigated how psychiatrists in training in Denmark evaluate the opportunities to practice psychotherapy in their training and the quality of the supervision they receive in psychotherapy training, particularly for cognitive behavioral therapy (CBT). The authors conducted a survey regarding psychotherapy training and CBT supervision among psychiatrists in training at Danish psychiatric specialist training courses. They investigated respondents' interest and experience in psychotherapy and respondents' views on the relevance and feasibility of performing psychotherapy and receiving supervision in their psychiatry training. Eighty-eight percent of the psychiatrists in training found psychotherapy to be a relevant part of their training; however, 77 % found it difficult to find time to practice psychotherapy and 44 % felt that practicing psychotherapy was a strain on their employer. Thirty-six percent and 53 %, respectively, had difficulties securing psychodynamic and CBT supervision. In CBT supervision, more than 60 % reported supervision that appeared to be below the expected CBT supervision standard and often so much below it might not qualify as CBT supervision. There is a need to focus on how to better integrate psychotherapy and supervision in the Danish psychiatric training program. Good CBT supervision may be lacking, and a way to ensure high-quality supervision is required.

Supervised and non-supervised Nordic walking in the treatment of chronic low back pain: a single blind randomized clinical trial

Science.gov (United States)

2010-01-01

Background Active approaches including both specific and unspecific exercise are probably the most widely recommended treatment for patients with chronic low back pain but it is not known exactly which types of exercise provide the most benefit. Nordic Walking - power walking using ski poles - is a popular and fast growing type of exercise in Northern Europe that has been shown to improve cardiovascular metabolism. Until now, no studies have been performed to investigate whether Nordic Walking has beneficial effects in relation to back pain. Methods A total of 151 patients with low back and/or leg pain of greater than eight weeks duration were recruited from a hospital based outpatient back pain clinic. Patients continuing to have pain greater than three on the 11-point numeric rating scale after a multidisciplinary intervention were included. Fifteen patients were unable to complete the baseline evaluation and 136 patients were randomized to receive A) Nordic walking supervised by a specially trained instructor twice a week for eight weeks B) One-hour instruction in Nordic walking by a specially trained instructor followed by advice to perform Nordic walking at home as much as they liked for eight weeks or C) Individual oral information consisting of advice to remain active and about maintaining the daily function level that they had achieved during their stay at the backcenter. Primary outcome measures were pain and disability using the Low Back Pain Rating Scale, and functional limitation further assessed using the Patient Specific Function Scale. Furthermore, information on time off work, use of medication, and concurrent treatment for their low back pain was collected. Objective measurements of physical activity levels for the supervised and unsupervised Nordic walking groups were performed using accelerometers. Data were analyzed on an intention-to-treat basis. Results No mean differences were found between the three groups in relation to any of the outcomes

Health system challenges to integration of mental health delivery in primary care in Kenya--perspectives of primary care health workers.

Science.gov (United States)

Jenkins, Rachel; Othieno, Caleb; Okeyo, Stephen; Aruwa, Julyan; Kingora, James; Jenkins, Ben

2013-09-30

Health system weaknesses in Africa are broadly well known, constraining progress on reducing the burden of both communicable and non-communicable disease (Afr Health Monitor, Special issue, 2011, 14-24), and the key challenges in leadership, governance, health workforce, medical products, vaccines and technologies, information, finance and service delivery have been well described (Int Arch Med, 2008, 1:27). This paper uses focus group methodology to explore health worker perspectives on the challenges posed to integration of mental health into primary care by generic health system weakness. Two ninety minute focus groups were conducted in Nyanza province, a poor agricultural region of Kenya, with 20 health workers drawn from a randomised controlled trial to evaluate the impact of a mental health training programme for primary care, 10 from the intervention group clinics where staff had received the training programme, and 10 health workers from the control group where staff had not received the training). These focus group discussions suggested that there are a number of generic health system weaknesses in Kenya which impact on the ability of health workers to care for clients with mental health problems and to implement new skills acquired during a mental health continuing professional development training programmes. These weaknesses include the medicine supply, health management information system, district level supervision to primary care clinics, the lack of attention to mental health in the national health sector targets, and especially its absence in district level targets, which results in the exclusion of mental health from such district level supervision as exists, and the lack of awareness in the district management team about mental health. The lack of mental health coverage included in HIV training courses experienced by the health workers was also striking, as was the intensive focus during district supervision on HIV to the detriment of other

A survey of wound care knowledge in South Africa

African Journals Online (AJOL)

2010-12-09

Dec 9, 2010 ... to manage pressure ulcers, suggesting that they do not receive enough training in this disorder.6 Canadian nurses express little confidence in the knowledge of physicians who supervise treatment of chronic wounds.7. In South Africa, chronic wound care is often left to unsupervised nursing personnel, who ...

"Is supervision necessary? Examining the effects of Internet-based CBT training with and without supervision": Correction to Rakovshik et al. (2016).

Science.gov (United States)

2016-12-01

Reports an error in "Is supervision necessary? Examining the effects of internet-based CBT training with and without supervision" by Sarah G. Rakovshik, Freda McManus, Maria Vazquez-Montes, Kate Muse and Dennis Ougrin ( Journal of Consulting and Clinical Psychology , 2016[Mar], Vol 84[3], 191-199). In the article, the department and affiliation were misspelled for author Kate Muse. The department and affiliation should have read Psychology Department, University of Worcester. All versions of this article has been corrected. (The following abstract of the original article appeared in record 2016-03513-001.) Objective: To investigate the effect of Internet-based training (IBT), with and without supervision, on therapists' (N = 61) cognitive-behavioral therapy (CBT) skills in routine clinical practice. Participants were randomized into 3 conditions: (1) Internet-based training with use of a consultation worksheet (IBT-CW); (2) Internet-based training with CBT supervision via Skype (IBT-S); and (3) "delayed-training" controls (DTs), who did not receive the training until all data collection was completed. The IBT participants received access to training over a period of 3 months. CBT skills were evaluated at pre-, mid- and posttraining/wait using assessor competence ratings of recorded therapy sessions. Hierarchical linear analysis revealed that the IBT-S participants had significantly greater CBT competence at posttraining than did IBT-CW and DT participants at both the mid- and posttraining/wait assessment points. There were no significant differences between IBT-CW and the delayed (no)-training DTs. IBT programs that include supervision may be a scalable and effective method of disseminating CBT into routine clinical practice, particularly for populations without ready access to more-traditional "live" methods of training. There was no evidence for a significant effect of IBT without supervision over a nontraining control, suggesting that merely providing access to

Adherence to Follow-Up Recommendations by Triathlon Competitors Receiving Event Medical Care.

Science.gov (United States)

Joslin, Jeremy D; Lloyd, Jarem B; Copeli, Nikoli; Cooney, Derek R

2017-01-01

Introduction . We sought to investigate triathlete adherence to recommendations for follow-up for participants who received event medical care. Methods . Participants of the 2011 Ironman Syracuse 70.3 (Syracuse, NY) who sought evaluation and care at the designated finish line medical tent were contacted by telephone approximately 3 months after the initial encounter to measure adherence with the recommendation to seek follow-up care after event. Results . Out of 750 race participants, 35 (4.6%) athletes received event medical care. Of these 35, twenty-eight (28/35; 80%) consented to participate in the study and 17 (61%) were available on telephone follow-up. Of these 17 athletes, 11 (11/17; 65%) of participants reported that they had not followed up with a medical professional since the race. Only 5 (5/17; 29%) confirmed that they had seen a medical provider in some fashion since the race; of these, only 2 (2/17; 12%) sought formal medical follow-up resulting from the recommendation whereas the remaining athletes merely saw their medical providers coincidentally or as part of routine care. Conclusion . Only 2 (2/17; 12%) of athletes who received event medical care obtained postrace follow-up within a one-month time period following the race. Event medical care providers must be aware of potential nonadherence to follow-up recommendations.

Adherence to Follow-Up Recommendations by Triathlon Competitors Receiving Event Medical Care

Directory of Open Access Journals (Sweden)

Jeremy D. Joslin

2017-01-01

Full Text Available Introduction. We sought to investigate triathlete adherence to recommendations for follow-up for participants who received event medical care. Methods. Participants of the 2011 Ironman Syracuse 70.3 (Syracuse, NY who sought evaluation and care at the designated finish line medical tent were contacted by telephone approximately 3 months after the initial encounter to measure adherence with the recommendation to seek follow-up care after event. Results. Out of 750 race participants, 35 (4.6% athletes received event medical care. Of these 35, twenty-eight (28/35; 80% consented to participate in the study and 17 (61% were available on telephone follow-up. Of these 17 athletes, 11 (11/17; 65% of participants reported that they had not followed up with a medical professional since the race. Only 5 (5/17; 29% confirmed that they had seen a medical provider in some fashion since the race; of these, only 2 (2/17; 12% sought formal medical follow-up resulting from the recommendation whereas the remaining athletes merely saw their medical providers coincidentally or as part of routine care. Conclusion. Only 2 (2/17; 12% of athletes who received event medical care obtained postrace follow-up within a one-month time period following the race. Event medical care providers must be aware of potential nonadherence to follow-up recommendations.

Medicine management in municipal home care : delegating, administrating and receiving

OpenAIRE

Gransjön Craftman, Åsa

2015-01-01

The general aim of this thesis was to investigate how delegation of medication is handled in municipal home care. Specific aims were to 1) explore the prevalence of medication use in older adults over time; 2) describe district nurses’ experiences of the delegation of medication management to municipal home care personnel; 3) explore and describe how home care assistants experience receiving the actual delegation of the responsibility of medication administration; and 4) to describe how older...

Improvement program of state supervision system for radioactive and nuclear installations

International Nuclear Information System (INIS)

Cardenas, J.

1993-01-01

The current program begins as part of a policy to take care of the development of the cuban nuclear program and with the objective of improving the state supervision system of nuclear and radioactive facilities on the basis of the national experience, good skills internationally accepted and taking into account IAEA recommendations. The program develops the following topics: reorientation and restructure of state supervision, review of the current nuclear legislature, update of regulations of facility safety and qualification and training of state supervision personnel

Breastfeeding: guidance received in prenatal care, delivery and postpartum care

Directory of Open Access Journals (Sweden)

Mayara Caroline Barbieri

2014-07-01

Full Text Available The aim of the study was to analyze the guidelines considering breastfeeding given by health professionals to women during prenatal care, delivery and postpartum care. Quantitative and descriptive work developed at Regional Pinheiros, Maringá-PR, from the registry in SisPreNatal, from May to August 2009. Data were collected through interviews conducted with parents at home, using a structured instrument. Participants were 36 mothers, most of whom received counseling for breastfeeding during prenatal (58.3%, maternity (87.6% and in nursing visits to newborn (84.6%. The prevalence of exclusive breastfeeding was 37.5%, even with the end of maternity leave. The rate is still below the recommended by the World Health Organization for exclusive breastfeeding. The present results may contribute to the monitoring of health actions and development of new strategies in the maintenance of exclusive breastfeeding.

31 CFR Appendix L to Subpart C of... - Office of Thrift Supervision

Science.gov (United States)

2010-07-01

... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Office of Thrift Supervision L Appendix L to Subpart C of Part 1 Money and Finance: Treasury Office of the Secretary of the Treasury... be received by the Corporate Secretary of the Office of Thrift Supervision or the delegate of such...

The Use of E-supervision to Support Speech-Language Pathology Graduate Students during Student Teaching Practica

Directory of Open Access Journals (Sweden)

Charles H. Carlin

2013-12-01

Full Text Available In the present feasibility study, e-supervision was used to provide university liaison supervision to SLP graduate students enrolled in student teaching practica. Utilizing a mixed methodology approach, interview and survey data were compared in order to identify similarities and differences between face-to-face and e-supervision and guide future practice. Results showed e-supervised graduate students received adequate supervision, feedback, support, and communication. Further, e-supervision provided additional benefits to supervisors, children on the caseload, and universities. Despite the benefits, disadvantages emerged. Implications for future practice and limitations of the study were identified.

Mental health measurement among women veterans receiving co-located, collaborative care services.

Science.gov (United States)

Lilienthal, Kaitlin R; Buchholz, Laura J; King, Paul R; Vair, Christina L; Funderburk, Jennifer S; Beehler, Gregory P

2017-12-01

Routine use of measurement to identify patient concerns and track treatment progress is critical to high quality patient care. This is particularly relevant to the Primary Care Behavioral Health model, where rapid symptom assessment and effective referral management are critical to sustaining population-based care. However, research suggests that women who receive treatment in co-located collaborative care settings utilizing the PCBH model are less likely to be assessed with standard measures than men in these settings. The current study utilized regional retrospective data obtained from the Veterans Health Administration's electronic medical record system to: (1) explore rates of mental health measurement for women receiving co-located collaborative care services (N = 1008); and (2) to identify predictors of mental health measurement in women veterans in these settings. Overall, only 8% of women had documentation of standard mental health measures. Measurement was predicted by diagnosis, facility size, length of care episode and care setting. Specifically, women diagnosed with depression were less likely than those with anxiety disorders to have standard mental health measurement documented. Several suggestions are offered to increase the quality of mental health care for women through regular use of measurement in integrated care settings.

Residents' Ratings of Their Clinical Supervision and Their Self-Reported Medical Errors: Analysis of Data From 2009.

Science.gov (United States)

Baldwin, DeWitt C; Daugherty, Steven R; Ryan, Patrick M; Yaghmour, Nicholas A; Philibert, Ingrid

2018-04-01

Medical errors and patient safety are major concerns for the medical and medical education communities. Improving clinical supervision for residents is important in avoiding errors, yet little is known about how residents perceive the adequacy of their supervision and how this relates to medical errors and other education outcomes, such as learning and satisfaction. We analyzed data from a 2009 survey of residents in 4 large specialties regarding the adequacy and quality of supervision they receive as well as associations with self-reported data on medical errors and residents' perceptions of their learning environment. Residents' reports of working without adequate supervision were lower than data from a 1999 survey for all 4 specialties, and residents were least likely to rate "lack of supervision" as a problem. While few residents reported that they received inadequate supervision, problems with supervision were negatively correlated with sufficient time for clinical activities, overall ratings of the residency experience, and attending physicians as a source of learning. Problems with supervision were positively correlated with resident reports that they had made a significant medical error, had been belittled or humiliated, or had observed others falsifying medical records. Although working without supervision was not a pervasive problem in 2009, when it happened, it appeared to have negative consequences. The association between inadequate supervision and medical errors is of particular concern.

Improving the professionalism of post-certification teacher through academic supervision in vocational schools

Science.gov (United States)

Satyawati, Sophia Tri; Widyanto, I. Putu; Suemy

2017-03-01

This paper examines the principal's efforts in improving the professionalism of post-certification teachers through academic supervision in vocational school. The certification of educators is expected to improve the professionalism of teachers, there are significant changes between the before and after receiving the certificate of educators. One of the efforts made by the principal on increasing the professionalism of teachers is to carry out academic supervision completely and continuously. This paper examines about how principals at vocational schools carry out the programmed academic supervision, and continuing through mentoring, evaluation and coaching. Academic supervision is performed by individual supervision techniques which includes: classroom or practical visit, classroom or practical observation, individual meetings, inter-class or practical places visit, and self-assessment.

Do Women With Breast Cancer Who Choose Adjunctive Integrative Oncology Care Receive Different Standard Oncologic Treatment?

Science.gov (United States)

Standish, Leanna J; Dowd, Fred; Sweet, Erin; Dale, Linda; Andersen, M Robyn

2018-04-01

To determine if women with breast cancer who choose adjunctive naturopathic oncology (NO) specialty care receive different standard oncologic treatment when compared with breast cancer patients who receive only standard care. Women with breast cancer stages 0 to 4, aged 18+ who spoke English and sought care from outpatient naturopathic doctor clinics were enrolled in an observational study of clinical and quality of life outcomes. Women who sought NO care 2 or more times within the first 2 years postdiagnosis were identified as NO cases. A matched comparison group of breast cancer patients were identified using the Western Washington Cancer Surveillance System(CSS). A longitudinal cohort design. In addition to self-report data, the CSS provided data on demographics, stage at the time of diagnosis, and initial treatment. Oncology medical records were abstracted in order to provide additional information on standard oncologic treatment for all participants. Cohorts were well matched with regard to demographic, histologic, and prognostic indicators at the time of diagnosis. Approximately 70% of women in both cohorts received standard oncologic care that met the National Comprehensive Cancer Network guidelines. There were no statistically significant differences between the cohorts in treatment received. Fewer women in the NO cohort with estrogen receptor-positive breast cancer appear to have received antiestrogen therapy. Women in both cohorts appear to receive guideline-concordant care. However, women who receive adjunctive NO care may be less likely to receive antiestrogen therapy.

Supervised and non-supervised Nordic walking in the treatment of chronic low back pain: a single blind randomized clinical trial

Directory of Open Access Journals (Sweden)

Bendix Tom

2010-02-01

Full Text Available Abstract Background Active approaches including both specific and unspecific exercise are probably the most widely recommended treatment for patients with chronic low back pain but it is not known exactly which types of exercise provide the most benefit. Nordic Walking - power walking using ski poles - is a popular and fast growing type of exercise in Northern Europe that has been shown to improve cardiovascular metabolism. Until now, no studies have been performed to investigate whether Nordic Walking has beneficial effects in relation to back pain. Methods A total of 151 patients with low back and/or leg pain of greater than eight weeks duration were recruited from a hospital based outpatient back pain clinic. Patients continuing to have pain greater than three on the 11-point numeric rating scale after a multidisciplinary intervention were included. Fifteen patients were unable to complete the baseline evaluation and 136 patients were randomized to receive A Nordic walking supervised by a specially trained instructor twice a week for eight weeks B One-hour instruction in Nordic walking by a specially trained instructor followed by advice to perform Nordic walking at home as much as they liked for eight weeks or C Individual oral information consisting of advice to remain active and about maintaining the daily function level that they had achieved during their stay at the backcenter. Primary outcome measures were pain and disability using the Low Back Pain Rating Scale, and functional limitation further assessed using the Patient Specific Function Scale. Furthermore, information on time off work, use of medication, and concurrent treatment for their low back pain was collected. Objective measurements of physical activity levels for the supervised and unsupervised Nordic walking groups were performed using accelerometers. Data were analyzed on an intention-to-treat basis. Results No mean differences were found between the three groups in

"Just Imagine That…": A Solution Focused Approach to Doctoral Research Supervision in Health and Social Care

Science.gov (United States)

Walsh, Kenneth; Doherty, Kathleen; Andersen, Loretta; Bingham, Sharon; Crookes, Patrick; Ford, Karen; McSherry, Robert

2018-01-01

Effective supervision in doctoral research is critical to successful and timely completion. However, supervision is a complex undertaking with structural as well as relational challenges for both students and supervisors. This instructional paper describes an internationally applicable approach to supervision that we have developed in the health…

28 CFR 43.2 - Obligations of persons receiving care and treatment.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Obligations of persons receiving care and treatment. 43.2 Section 43.2 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) RECOVERY OF COST OF HOSPITAL AND MEDICAL CARE AND TREATMENT FURNISHED BY THE UNITED STATES § 43.2 Obligations of persons...

Psychotropic medication in a randomly selected group of citizens receiving residential or home care

DEFF Research Database (Denmark)

Futtrup, Tina Bergmann; Schultz, Hanne; Jensen, Margit Bak

2014-01-01

INTRODUCTION: Treatment with one or more psychotropic medications (PMs), especially in the elderly, is associated with risk, and the effects of treatment are poorly validated. The aim of this article was to describe the use of PM in a population of citizens receiving either residential care or home...... care with focus on the prevalence of drug use, the combination of different PMs and doses in relation to current recommendations. METHODS: The medication lists of 214 citizens receiving residential care (122) and home care (92) were collected together with information on age, gender and residential...

Food provision for older people receiving home care from the perspectives of home-care workers.

Science.gov (United States)

Watkinson-Powell, Anna; Barnes, Sarah; Lovatt, Melanie; Wasielewska, Anna; Drummond, Barbara

2014-09-01

Malnutrition is a significant cause of morbidity and mortality, particularly among older people. Attention has focused on the inadequacies of food provision in institutions, yet the majority suffering from malnutrition live in the community. The aim of this study was to explore barriers and facilitators to food provision for older people receiving home care. It was a qualitative exploratory study using semi-structured interviews with nine home-care workers in June 2013 employed by independent agencies in a large city in northern England. Data were analysed thematically, based on the principles of grounded theory. Findings showed that significant time pressures limited home-care workers in their ability to socially engage with service users at mealtimes, or provide them with anything other than ready meals. Enabling choice was considered more important than providing a healthy diet, but choice was limited by food availability and reliance on families for shopping. Despite their knowledge of service users and their central role in providing food, home-care workers received little nutritional training and were not involved by healthcare professionals in the management of malnutrition. Despite the rhetoric of individual choice and importance of social engagement and nutrition for health and well-being, nutritional care has been significantly compromised by cuts to social care budgets. The potential role for home-care workers in promoting good nutrition in older people is undervalued and undermined by the lack of recognition, training and time dedicated to food-related care. This has led to a situation whereby good quality food and enjoyable mealtimes are denied to many older people on the basis that they are unaffordable luxuries rather than an integral component of fundamental care. © 2014 John Wiley & Sons Ltd.

Effectiveness of Group Supervision versus Combined Group and Individual Supervision.

Science.gov (United States)

Ray, Dee; Altekruse, Michael

2000-01-01

Investigates the effectiveness of different types of supervision (large group, small group, combined group, individual supervision) with counseling students (N=64). Analyses revealed that all supervision formats resulted in similar progress in counselor effectiveness and counselor development. Participants voiced a preference for individual…

Kollegial supervision

DEFF Research Database (Denmark)

Andersen, Ole Dibbern; Petersson, Erling

Publikationen belyser, hvordan kollegial supervision i en kan organiseres i en uddannelsesinstitution......Publikationen belyser, hvordan kollegial supervision i en kan organiseres i en uddannelsesinstitution...

Automated Spirometry Quality Assurance: Supervised Learning From Multiple Experts.

Science.gov (United States)

Velickovski, Filip; Ceccaroni, Luigi; Marti, Robert; Burgos, Felip; Gistau, Concepcion; Alsina-Restoy, Xavier; Roca, Josep

2018-01-01

Forced spirometry testing is gradually becoming available across different healthcare tiers including primary care. It has been demonstrated in earlier work that commercially available spirometers are not fully able to assure the quality of individual spirometry manoeuvres. Thus, a need to expand the availability of high-quality spirometry assessment beyond specialist pulmonary centres has arisen. In this paper, we propose a method to select and optimise a classifier using supervised learning techniques by learning from previously classified forced spirometry tests from a group of experts. Such a method is able to take into account the shape of the curve as an expert would during visual inspection. We evaluated the final classifier on a dataset put aside for evaluation yielding an area under the receiver operating characteristic curve of 0.88 and specificities of 0.91 and 0.86 for sensitivities of 0.60 and 0.82. Furthermore, other specificities and sensitivities along the receiver operating characteristic curve were close to the level of the experts when compared against each-other, and better than an earlier rules-based method assessed on the same dataset. We foresee key benefits in raising diagnostic quality, saving time, reducing cost, and also improving remote care and monitoring services for patients with chronic respiratory diseases in the future if a clinical decision support system with the encapsulated classifier is to be integrated into the work-flow of forced spirometry testing.

Fully Decentralized Semi-supervised Learning via Privacy-preserving Matrix Completion.

Science.gov (United States)

Fierimonte, Roberto; Scardapane, Simone; Uncini, Aurelio; Panella, Massimo

2016-08-26

Distributed learning refers to the problem of inferring a function when the training data are distributed among different nodes. While significant work has been done in the contexts of supervised and unsupervised learning, the intermediate case of Semi-supervised learning in the distributed setting has received less attention. In this paper, we propose an algorithm for this class of problems, by extending the framework of manifold regularization. The main component of the proposed algorithm consists of a fully distributed computation of the adjacency matrix of the training patterns. To this end, we propose a novel algorithm for low-rank distributed matrix completion, based on the framework of diffusion adaptation. Overall, the distributed Semi-supervised algorithm is efficient and scalable, and it can preserve privacy by the inclusion of flexible privacy-preserving mechanisms for similarity computation. The experimental results and comparison on a wide range of standard Semi-supervised benchmarks validate our proposal.

[Clinical evaluation of bedridden patients with pneumonia receiving home health care].

Science.gov (United States)

Fukuyama, Hajime; Ishida, Tadashi; Tachibana, Hiromasa; Iga, Chiya; Nakagawa, Hiroaki; Ito, Akihiro; Ubukata, Satoshi; Yoshioka, Hiroshige; Arita, Machiko; Hashimoto, Toru

2010-12-01

Pneumonia which develops in patients while living in their own home is categorized as community-acquired pneumonia (CAP), even if these patients are bedridden and receiving home health care. However, because of the differences in patient backgrounds, we speculated that the clinical outcomes and pathogens of bedridden patients with pneumonia who are receiving home health care would be different from those of CAP. We conducted a prospective study of patients with CAP who were hospitalized at our hospital from April 2007 through September 2009. We compared home health care bedridden pneumonia (performance status 4, PS4-CAP) with non-PS4-CAP in a total of 505 enrolled patients in this study. Among these, 66 had PS4-CAP, mostly associated with aspiration. Severity scores, mortality rate, recurrence rate and length of hospital stay of those with PS4-CAP were significantly higher than those with non-PS4-CAP. Drug resistant pathogens were more frequently isolated from patients with PS4-CAP than from those of non-PS4-CAP. The results of patients with PS4-CAP were in agreement with those of previous health care-associated pneumonia (HCAP) reports. The present study suggested home health care bedridden pneumonia should be categorized as HCAP, not CAP.

Drivers of Prenatal Care Quality and Uptake of Supervised Delivery ...

African Journals Online (AJOL)

towards improving maternal health include barriers of access to healthcare ... for non-utilization of supervised delivery services in Ghana is the provision of poor .... information relating to the womens socio-demographic characteristics-age ..... Adjei S, Graham W. The skilled attendance index: Proposal for a new measure.

Economic evaluation of a mentorship and enhanced supervision program to improve quality of integrated management of childhood illness care in rural Rwanda.

Science.gov (United States)

Manzi, Anatole; Mugunga, Jean Claude; Iyer, Hari S; Magge, Hema; Nkikabahizi, Fulgence; Hirschhorn, Lisa R

2018-01-01

Integrated management of childhood illness (IMCI) can reduce under-5 morbidity and mortality in low-income settings. A program to strengthen IMCI practices through Mentorship and Enhanced Supervision at Health centers (MESH) was implemented in two rural districts in eastern Rwanda in 2010. We estimated cost per improvement in quality of care as measured by the difference in correct diagnosis and correct treatment at baseline and 12 months of MESH. Costs of developing and implementing MESH were estimated in 2011 United States Dollars (USD) from the provider perspective using both top-down and bottom-up approaches, from programmatic financial records and site-level data. Improvement in quality of care attributed to MESH was measured through case management observations (n = 292 cases at baseline, 413 cases at 12 months), with outcomes from the intervention already published. Sensitivity analyses were conducted to assess uncertainty under different assumptions of quality of care and patient volume. The total annual cost of MESH was US$ 27,955.74 and the average cost added by MESH per IMCI patient was US$1.06. Salary and benefits accounted for the majority of total annual costs (US$22,400 /year). Improvements in quality of care after 12 months of MESH implementation cost US$2.95 per additional child correctly diagnosed and $5.30 per additional child correctly treated. The incremental costs per additional child correctly diagnosed and child correctly treated suggest that MESH could be an affordable method for improving IMCI quality of care elsewhere in Rwanda and similar settings. Integrating MESH into existing supervision systems would further reduce costs, increasing potential for spread.

Associations Between End-of-Life Discussion Characteristics and Care Received Near Death: A Prospective Cohort Study

Science.gov (United States)

Mack, Jennifer W.; Cronin, Angel; Keating, Nancy L.; Taback, Nathan; Huskamp, Haiden A.; Malin, Jennifer L.; Earle, Craig C.; Weeks, Jane C.

2012-01-01

Purpose National guidelines recommend that discussions about end-of-life (EOL) care planning happen early for patients with incurable cancer. We do not know whether earlier EOL discussions lead to less aggressive care near death. We sought to evaluate the extent to which EOL discussion characteristics, such as timing, involved providers, and location, are associated with the aggressiveness of care received near death. Patients and Methods We studied 1,231 patients with stage IV lung or colorectal cancer in the Cancer Care Outcomes Research and Surveillance Consortium, a population- and health system–based prospective cohort study, who died during the 15-month study period but survived at least 1 month. Our main outcome measure was the aggressiveness of EOL care received. Results Nearly half of patients received at least one marker of aggressive EOL care, including chemotherapy in the last 14 days of life (16%), intensive care unit care in the last 30 days of life (9%), and acute hospital-based care in the last 30 days of life (40%). Patients who had EOL discussions with their physicians before the last 30 days of life were less likely to receive aggressive measures at EOL, including chemotherapy (P = .003), acute care (P EOL discussions are prospectively associated with less aggressive care and greater use of hospice at EOL. PMID:23150700

Where do youth in foster care receive information about preventing unplanned pregnancy and sexually transmitted infections?

Science.gov (United States)

Hudson, Angela L

2012-10-01

Adolescents in foster care are at risk for unplanned pregnancy and sexually transmitted infections, including HIV infection. A study using a qualitative method was conducted to describe how and where foster youth receive reproductive health and risk reduction information to prevent pregnancy and sexually transmitted infections. Participants also were asked to describe their relationship with their primary health care provider while they were in foster care. Nineteen young adults, recently emancipated from foster care, participated in individual interviews. Using grounded theory as the method of analysis, three thematic categories were generated: discomfort visiting and disclosing, receiving and not receiving the bare essentials, and learning prevention from community others. Recommendations include primary health care providers providing a confidential space for foster youth to disclose sexual activity and more opportunities for foster youth to receive reproductive and risk prevention information in the school setting. Copyright © 2012 Elsevier Inc. All rights reserved.

Supervised progressive cross-continuum strength training compared with usual care in older medical patients

DEFF Research Database (Denmark)

Pedersen, Mette Merete; Petersen, Janne; Beyer, Nina

2016-01-01

Background: Hospitalization in older adults is characterized by physical inactivity and a risk of losing function and independence. Systematic strength training can improve muscle strength and functional performance in older adults. Few studies have examined the effect of a program initiated during...... hospitalization and continued after discharge. We conducted a feasibility study prior to this trial and found a progression model for loaded sit-to-stands feasible in older medical patients. This study aims to determine whether a simple supervised strength training program for the lower extremities (based...... on the model), combined with post-training protein supplementation initiated during hospitalization and continued at home for 4 weeks, is superior to usual care on change in mobility 4 weeks after discharge in older medical patients. Methods: Eighty older medical patients (65 years or older) acutely admitted...

Legislation and supervision

International Nuclear Information System (INIS)

1998-01-01

In this part next aspects are described: (1) Legislative and supervision-related framework (reviews of structure of supervisory bodies; legislation; state supervision in the nuclear safety area, and state supervision in the area of health protection against radiation are given); (2) Operator's responsibility

Purchased Behavioral Health Care Received by Military Health System Beneficiaries in Civilian Medical Facilities, 2000-2014.

Science.gov (United States)

Wooten, Nikki R; Brittingham, Jordan A; Pitner, Ronald O; Tavakoli, Abbas S; Jeffery, Diana D; Haddock, K Sue

2018-02-06

Behavioral health conditions are a significant concern for the U.S. military and the Military Health System (MHS) because of decreased military readiness and increased health care utilization. Although MHS beneficiaries receive direct care in military treatment facilities, a disproportionate majority of behavioral health treatment is purchased care received in civilian facilities. Yet, limited evidence exists about purchased behavioral health care received by MHS beneficiaries. This longitudinal study (1) estimated the prevalence of purchased behavioral health care and (2) identified patient and visit characteristics predicting receipt of purchased behavioral health care in acute care facilities from 2000 to 2014. Medical claims with Major Diagnostic Code 19 (mental disorders/diseases) or 20 (alcohol/drug disorders) as primary diagnoses and TRICARE as the primary/secondary payer were analyzed for MHS beneficiaries (n = 17,943) receiving behavioral health care in civilian acute care facilities from January 1, 2000, to December 31, 2014. The primary dependent variable, receipt of purchased behavioral health care, was modeled for select mental health and substance use disorders from 2000 to 2014 using generalized estimating equations. Patient characteristics included time, age, sex, and race/ethnicity. Visit types included inpatient hospitalization and emergency department (ED). Time was measured in days and visits were assumed to be correlated over time. Behavioral health care was described by both frequency of patients and visit type. The University of South Carolina Institutional Review Board approved this study. From 2000 to 2014, purchased care visits increased significantly for post-traumatic stress disorder, adjustment, anxiety, mood, bipolar, tobacco use, opioid/combination opioid dependence, nondependent cocaine abuse, psychosocial problems, and suicidal ideation among MHS beneficiaries. The majority of care was received for mental health disorders (78

Experience with and amount of postpartum maternity care: Comparing women who rated the care they received from the maternity care assistant as 'good' or 'less than good care'.

Science.gov (United States)

Baas, C I; Wiegers, T A; de Cock, T P; Erwich, J J H M; Spelten, E R; Hutton, E K

2017-12-01

The postpartum period is an important time in the lives of new mothers, their children and their families. The aim of postpartum care is 'to detect health problems of mother and/or baby at an early stage, to encourage breastfeeding and to give families a good start' (Wiegers, 2006). The Netherlands maternity care system aims to enable every new family to receive postpartum care in their home by a maternity care assistant (MCA). In order to better understand this approach, in this study we focus on women who experienced the postpartum care by the MCA as 'less than good' care. Our research questions are; among postpartum women in the Netherlands, what is the uptake of MCA care and what factors are significantly associated with women's rating of care provided by the MCA. Design and setting This study uses data from the 'DELIVER study', a dynamic cohort study, which was set up to investigate the organization, accessibility and quality of primary midwifery care in the Netherlands. Participants In the DELIVER population 95.6% of the women indicated that they had received postpartum maternity care by an MCA in their home. We included the responses of 3170 women. To assess the factors that were significantly associated with reporting 'less than good (postpartum) care' by the MCA, a full cases backward logistic regression model was built using the multilevel approach in Generalized Linear Mixed Models. The mean rating of the postpartum care by the MCA was 8.8 (on a scale from 1-10), and 444 women (14%) rated the postpartum maternity care by the MCA as 'less than good care'. In the full cases multivariable analysis model, odds of reporting 'less than good care' by the MCA were significantly higher for women who were younger (women 25-35 years had an OR 1.32, CI 0.96-1.81 and women 35 years), multiparous (OR 1.27, CI 1.01-1.60) and had a higher level of education (women with a middle level had an OR 1.84,CI 1.22-2.79, and women with a high level of education had an OR 2

Effects of aerobic and resistance exercise in breast cancer patients receiving adjuvant chemotherapy: a multicenter randomized controlled trial.

Science.gov (United States)

Courneya, Kerry S; Segal, Roanne J; Mackey, John R; Gelmon, Karen; Reid, Robert D; Friedenreich, Christine M; Ladha, Aliya B; Proulx, Caroline; Vallance, Jeffrey K H; Lane, Kirstin; Yasui, Yutaka; McKenzie, Donald C

2007-10-01

Breast cancer chemotherapy may cause unfavorable changes in physical functioning, body composition, psychosocial functioning, and quality of life (QOL). We evaluated the relative merits of aerobic and resistance exercise in blunting these effects. We conducted a multicenter randomized controlled trial in Canada between 2003 and 2005 that randomly assigned 242 breast cancer patients initiating adjuvant chemotherapy to usual care (n = 82), supervised resistance exercise (n = 82), or supervised aerobic exercise (n = 78) for the duration of their chemotherapy (median, 17 weeks; 95% CI, 9 to 24 weeks). Our primary end point was cancer-specific QOL assessed by the Functional Assessment of Cancer Therapy-Anemia scale. Secondary end points were fatigue, psychosocial functioning, physical fitness, body composition, chemotherapy completion rate, and lymphedema. The follow-up assessment rate for our primary end point was 92.1%, and adherence to the supervised exercise was 70.2%. Unadjusted and adjusted mixed-model analyses indicated that aerobic exercise was superior to usual care for improving self-esteem (P = .015), aerobic fitness (P = .006), and percent body fat (adjusted P = .076). Resistance exercise was superior to usual care for improving self-esteem (P = .018), muscular strength (P exercise groups but did not reach statistical significance. Exercise did not cause lymphedema or adverse events. Neither aerobic nor resistance exercise significantly improved cancer-specific QOL in breast cancer patients receiving chemotherapy, but they did improve self-esteem, physical fitness, body composition, and chemotherapy completion rate without causing lymphedema or significant adverse events.

Collective academic supervision

DEFF Research Database (Denmark)

Nordentoft, Helle Merete; Thomsen, Rie; Wichmann-Hansen, Gitte

2013-01-01

Supervision of students is a core activity in higher education. Previous research on student supervision in higher education focus on individual and relational aspects in the supervisory relationship rather than collective, pedagogical and methodical aspects of the planning of the supervision...... process. This article fills these gaps by discussing potentials and challenges in “Collective Academic Supervision”, a model for supervision at the Master of Education in Guidance at Aarhus University in Denmark. The pedagogical rationale behind the model is that students’ participation and learning...

Social constructionism and supervision: experiences of AAMFT supervisors and supervised therapists.

Science.gov (United States)

Hair, Heather J; Fine, Marshall

2012-10-01

A phenomenological research process was used to investigate the supervision experience for supervisors and therapists when supervisors use a social constructionist perspective. Participants of the one-to-one interviews were six AAMFT Approved Supervisors and six therapists providing counseling to individuals, couples and families. The findings suggest supervisors were committed to their self-identified supervision philosophy and intentionally sought out congruence between epistemology and practice. The shared experience of therapists indicates they associated desirable supervision experiences with their supervisors' social constructionist perspective. Our findings also indicated that supervisors' and therapists' understanding of social constructionism included the more controversial concepts of agency and extra-discursiveness. This research has taken an empirical step in the direction of understanding what the social constructionist supervision experience is like for supervisors and therapists. Our findings suggest a linkage between epistemology and supervision practice and a satisfaction with the supervision process. © 2012 American Association for Marriage and Family Therapy.

Security system signal supervision

International Nuclear Information System (INIS)

Chritton, M.R.; Matter, J.C.

1991-09-01

This purpose of this NUREG is to present technical information that should be useful to NRC licensees for understanding and applying line supervision techniques to security communication links. A review of security communication links is followed by detailed discussions of link physical protection and DC/AC static supervision and dynamic supervision techniques. Material is also presented on security for atmospheric transmission and video line supervision. A glossary of security communication line supervision terms is appended. 16 figs

Implementing the 2009 Institute of Medicine recommendations on resident physician work hours, supervision, and safety.

Science.gov (United States)

Blum, Alexander B; Shea, Sandra; Czeisler, Charles A; Landrigan, Christopher P; Leape, Lucian

2011-01-01

Long working hours and sleep deprivation have been a facet of physician training in the US since the advent of the modern residency system. However, the scientific evidence linking fatigue with deficits in human performance, accidents and errors in industries from aeronautics to medicine, nuclear power, and transportation has mounted over the last 40 years. This evidence has also spawned regulations to help ensure public safety across safety-sensitive industries, with the notable exception of medicine. In late 2007, at the behest of the US Congress, the Institute of Medicine embarked on a year-long examination of the scientific evidence linking resident physician sleep deprivation with clinical performance deficits and medical errors. The Institute of Medicine's report, entitled "Resident duty hours: Enhancing sleep, supervision and safety", published in January 2009, recommended new limits on resident physician work hours and workload, increased supervision, a heightened focus on resident physician safety, training in structured handovers and quality improvement, more rigorous external oversight of work hours and other aspects of residency training, and the identification of expanded funding sources necessary to implement the recommended reforms successfully and protect the public and resident physicians themselves from preventable harm. Given that resident physicians comprise almost a quarter of all physicians who work in hospitals, and that taxpayers, through Medicare and Medicaid, fund graduate medical education, the public has a deep investment in physician training. Patients expect to receive safe, high-quality care in the nation's teaching hospitals. Because it is their safety that is at issue, their voices should be central in policy decisions affecting patient safety. It is likewise important to integrate the perspectives of resident physicians, policy makers, and other constituencies in designing new policies. However, since its release, discussion of the

To evaluate if increased supervision and support of South African Government health workers' home visits improves maternal and child outcomes: study protocol for a randomized control trial.

Science.gov (United States)

Rotheram-Borus, Mary Jane; Le Roux, Karl; Le Roux, Ingrid M; Christodoulou, Joan; Laurenzi, Christina; Mbewu, Nokwanele; Tomlinson, Mark

2017-08-07

Concurrent epidemics of HIV, depression, alcohol abuse, and partner violence threaten maternal and child health (MCH) in South Africa. Although home visiting has been repeatedly demonstrated efficacious in research evaluations, efficacy disappears when programs are scaled broadly. In this cluster randomized controlled trial (RCT), we examine whether the benefits of ongoing accountability and supervision within an existing government funded and implemented community health workers (CHW) home visiting program ensure the effectiveness of home visiting. In the deeply rural, Eastern Cape of South Africa, CHW will be hired by the government and will be initially trained by the Philani Programme to conduct home visits with all pregnant mothers and their children until the children are 2 years old. Eight clinics will be randomized to receive either (1) the Accountable Care Condition in which additional monitoring and accountability systems that Philani routinely uses are implemented (4 clinics, 16 CHW, 450 households); or (2) a Standard Care Condition of initial Philani training, but with supervision and monitoring being delivered by local government structures and systems (4 clinics, 21 CHW, 450 households). In the Accountable Care Condition areas, the CHW's mobile phone reports, which are time-location stamped, will be monitored and data-informed supervision will be provided, as well as monitoring growth, medical adherence, mental health, and alcohol use outcomes. Interviewers will independently assess outcomes at pregnancy at 3, 6, 15, and 24 months post-birth. The primary outcome will be a composite score of documenting maternal HIV/TB testing, linkage to care, treatment adherence and retention, as well as child physical growth, cognitive functioning, and child behavior and developmental milestones. The proposed cluster RCT will evaluate whether routinely implementing supervision and accountability procedures and monitoring CHWs' over time will improve MCH outcomes

Comparison of Effectiveness of Supervised Exercise Program and Cyriax Physiotherapy in Patients with Tennis Elbow (Lateral Epicondylitis: A Randomized Clinical Trial

Directory of Open Access Journals (Sweden)

Rajadurai Viswas

2012-01-01

Full Text Available Objective. To compare the effectiveness of supervised exercise program and Cyriax physiotherapy in the treatment of tennis elbow (lateral epicondylitis. Design. Randomized clinical trial. Setting. Physiotherapy and rehabilitation centre. Subjects. This study was carried out with 20 patients, who had tennis elbow (lateral epicondylitis. Intervention. Group A (=10 had received supervised exercise program. Group B (=10 was treated with Cyriax physiotherapy. All patients received three treatment sessions per week for four weeks (12 treatment sessions. Outcome measures. Pain was evaluated using a visual analogue scale (VAS, and functional status was evaluated by completion of the Tennis Elbow Function Scale (TEFS which were recorded at base line and at the end of fourth week. Results. Both the supervised exercise program and Cyriax physiotherapy were found to be significantly effective in reduction of pain and in the improvement of functional status. The supervised exercise programme resulted in greater improvement in comparison to those who received Cyriax physiotherapy. Conclusion. The results of this clinical trial demonstrate that the supervised exercise program may be the first treatment choice for therapist in managing tennis elbow.

Adherence to Follow-Up Recommendations by Triathlon Competitors Receiving Event Medical Care

OpenAIRE

Joslin, Jeremy D.; Lloyd, Jarem B.; Copeli, Nikoli; Cooney, Derek R.

2017-01-01

Introduction. We sought to investigate triathlete adherence to recommendations for follow-up for participants who received event medical care. Methods. Participants of the 2011 Ironman Syracuse 70.3 (Syracuse, NY) who sought evaluation and care at the designated finish line medical tent were contacted by telephone approximately 3 months after the initial encounter to measure adherence with the recommendation to seek follow-up care after event. Results. Out of 750 race participants, 35 (4.6%) ...

Man-machine supervision; Supervision homme-machine

Energy Technology Data Exchange (ETDEWEB)

Montmain, J. [CEA Valrho, Dir. de l' Energie Nucleaire (DEN), 30 - Marcoule (France)

2005-05-01

Today's complexity of systems where man is involved has led to the development of more and more sophisticated information processing systems where decision making has become more and more difficult. The operator task has moved from operation to supervision and the production tool has become indissociable from its numerical instrumentation and control system. The integration of more and more numerous and sophisticated control indicators in the control room does not necessary fulfill the expectations of the operation team. It is preferable to develop cooperative information systems which are real situation understanding aids. The stake is not the automation of operators' cognitive tasks but the supply of a reasoning help. One of the challenges of interactive information systems is the selection, organisation and dynamical display of information. The efficiency of the whole man-machine system depends on the communication interface efficiency. This article presents the principles and specificities of man-machine supervision systems: 1 - principle: operator's role in control room, operator and automation, monitoring and diagnosis, characteristics of useful models for supervision; 2 - qualitative reasoning: origin, trends, evolutions; 3 - causal reasoning: causality, causal graph representation, causal and diagnostic graph; 4 - multi-points of view reasoning: multi flow modeling method, Sagace method; 5 - approximate reasoning: the symbolic numerical interface, the multi-criteria decision; 6 - example of application: supervision in a spent-fuel reprocessing facility. (J.S.)

Optimizing area under the ROC curve using semi-supervised learning.

Science.gov (United States)

Wang, Shijun; Li, Diana; Petrick, Nicholas; Sahiner, Berkman; Linguraru, Marius George; Summers, Ronald M

2015-01-01

Receiver operating characteristic (ROC) analysis is a standard methodology to evaluate the performance of a binary classification system. The area under the ROC curve (AUC) is a performance metric that summarizes how well a classifier separates two classes. Traditional AUC optimization techniques are supervised learning methods that utilize only labeled data (i.e., the true class is known for all data) to train the classifiers. In this work, inspired by semi-supervised and transductive learning, we propose two new AUC optimization algorithms hereby referred to as semi-supervised learning receiver operating characteristic (SSLROC) algorithms, which utilize unlabeled test samples in classifier training to maximize AUC. Unlabeled samples are incorporated into the AUC optimization process, and their ranking relationships to labeled positive and negative training samples are considered as optimization constraints. The introduced test samples will cause the learned decision boundary in a multidimensional feature space to adapt not only to the distribution of labeled training data, but also to the distribution of unlabeled test data. We formulate the semi-supervised AUC optimization problem as a semi-definite programming problem based on the margin maximization theory. The proposed methods SSLROC1 (1-norm) and SSLROC2 (2-norm) were evaluated using 34 (determined by power analysis) randomly selected datasets from the University of California, Irvine machine learning repository. Wilcoxon signed rank tests showed that the proposed methods achieved significant improvement compared with state-of-the-art methods. The proposed methods were also applied to a CT colonography dataset for colonic polyp classification and showed promising results.

Good supervision and PBL

DEFF Research Database (Denmark)

Otrel-Cass, Kathrin

This field study was conducted at the Faculty of Social Sciences at Aalborg University with the intention to investigate how students reflect on their experiences with supervision in a PBL environment. The overall aim of this study was to inform about the continued work in strengthening supervision...... at this faculty. This particular study invited Master level students to discuss: • How a typical supervision process proceeds • How they experienced and what they expected of PBL in the supervision process • What makes a good supervision process...

Oral health assessment and mouth care for children and young people receiving palliative care. Part two.

Science.gov (United States)

Sargeant, S; Chamley, C

2013-04-01

This is the second part of a two-part article on oral health assessment and mouth care for children and young people receiving palliative care. This article covers basic oral hygiene and management of oral health problems: oral candidiasis, coated tongue/dirty mouth, dry mouth, hypersalivation, ulceration, painful mouth, stomatitis and mucositis. The article also covers treating patients who are immunocompromised and the need to educate families and carers in the basic principles of oral care, including the importance of preventing cross-infection. Part one outlined oral assessment and discussed the adaptation of the Nottingham Oral Health Assessment Tool (Freer 2000).

75 FR 44853 - Woodlands Bank, Bluffton, SC; Notice of Appointment of Receiver

Science.gov (United States)

2010-07-29

... DEPARTMENT OF THE TREASURY Office of Thrift Supervision Woodlands Bank, Bluffton, SC; Notice of... the Home Owners' Loan Act, the Office of Thrift Supervision has duly appointed the Federal Deposit Insurance Corporation as sole Receiver for Woodlands Bank, Bluffton, South Carolina (OTS No. 08464), as of...

75 FR 45012 - Turnberry Bank, Aventura, FL; Notice of Appointment of Receiver

Science.gov (United States)

2010-07-30

... DEPARTMENT OF THE TREASURY Office of Thrift Supervision Turnberry Bank, Aventura, FL; Notice of... the Home Owners' Loan Act, the Office of Thrift Supervision has duly appointed the Federal Deposit Insurance Corporation as sole Receiver for Turnberry Bank, Aventura, Florida (OTS No. 08087), on July 16...

A review of the literature to inform a best-practice clinical supervision model for midwifery students in Australia.

Science.gov (United States)

McKellar, Lois; Graham, Kristen

2017-05-01

Effective clinical supervision in midwifery programs leading to registration is essential to ensure that students can provide safe and competent woman centred care by the completion of their program. A number of different clinical supervision models exist in Australia and internationally, with varying levels of support and facilitation of student learning opportunities. In Australia, midwifery students must achieve specified learning outcomes and midwifery practice requirements to be eligible to register as a midwife. Identifying a best practice clinical supervision model for Australian midwifery students is therefore a priority for all key stakeholders, particularly education and maternity care providers. The aim of this literature review was to explore different types of clinical supervision models in order to develop and implement a best practice model in midwifery education programs. Copyright © 2016 Elsevier Ltd. All rights reserved.

Whither Supervision?

Directory of Open Access Journals (Sweden)

Duncan Waite

2006-11-01

Full Text Available This paper inquires if the school supervision is in decadence. Dr. Waite responds that the answer will depend on which perspective you look at it. Dr. Waite suggests taking in consideration three elements that are related: the field itself, the expert in the field (the professor, the theorist, the student and the administrator, and the context. When these three elements are revised, it emphasizes that there is not a consensus about the field of supervision, but there are coincidences related to its importance and that it is related to the improvement of the practice of the students in the school for their benefit. Dr. Waite suggests that the practice on this field is not always in harmony with what the theorists affirm. When referring to the supervisor or the skilled person, the author indicates that his or her perspective depends on his or her epistemological believes or in the way he or she conceives the learning; that is why supervision can be understood in different ways. About the context, Waite suggests that there have to be taken in consideration the social or external forces that influent the people and the society, because through them the education is affected. Dr. Waite concludes that the way to understand the supervision depends on the performer’s perspective. He responds to the initial question saying that the supervision authorities, the knowledge on this field, the performers, and its practice, are maybe spread but not extinct because the supervision will always be part of the great enterprise that we called education.

Which diabetic patients should receive podiatry care? An objective analysis.

Science.gov (United States)

McGill, M; Molyneaux, L; Yue, D K

2005-08-01

Diabetes is the leading cause of lower limb amputation in Australia. However, due to limited resources, it is not feasible for everyone with diabetes to access podiatry care, and some objective guidelines of who should receive podiatry is required. A total of 250 patients with neuropathy (Biothesiometer; Biomedical Instruments, Newbury, Ohio, USA) ( > 30, age podiatry care (mean of estimates from 10 reports), the NNT to prevent one foot ulcer per year was: no neuropathy (vibration perception threshold (VPT) 30) alone, NNT = 45; +cannot feel monofilament, NNT = 18; +previous ulcer/amputation, NNT = 7. Provision of podiatry care to diabetic patients should not be only economically based, but should also be directed to those with reduced sensation, especially where there is a previous history of ulceration or amputation.

Strengthening malaria service delivery through supportive supervision and community mobilization in an endemic Indian setting: an evaluation of nested delivery models.

Science.gov (United States)

Das, Ashis; Friedman, Jed; Kandpal, Eeshani; Ramana, Gandham N V; Gupta, Rudra Kumar Das; Pradhan, Madan M; Govindaraj, Ramesh

2014-12-08

Malaria continues to be a prominent global public health challenge. This study tested the effectiveness of two service delivery models for reducing the malaria burden, e.g. supportive supervision of community health workers (CHW) and community mobilization in promoting appropriate health-seeking behaviour for febrile illnesses in Odisha, India. The study population comprised 120 villages from two purposively chosen malaria-endemic districts, with 40 villages randomly assigned to each of the two treatment arms, one with both supportive supervision and community mobilization and one with community mobilization alone, as well as an observational control arm. Outcome measures included changes in the utilization of bed nets and timely care-seeking for fever from a trained provider compared to the control group. Analysis was by intention-to-treat. Significant improvements were observed in the reported utilization of bed nets in both intervention arms (84.5% in arm A and 82.4% in arm B versus 78.6% in the control arm; p skilled provider within 24 hours than fever cases from the control arm (50.1%). In particular, women from the combined interventions arm were more likely to have received timely treatment from a skilled provider (61.6% vs. 47.2%; p = 0.028). A community-based intervention combining the supportive supervision of community health workers with intensive community mobilization and can be effective in improving care-seeking and preventive behaviour and may be used to strengthen the national malaria control programme.

Deconstructing Risk Management in Psychotherapy Supervision.

Science.gov (United States)

Kroll, Jerome; Radden, Jennifer

2017-12-01

In the ongoing controversy over how much regulation and standardization to impose on clinical practice and research, it is not surprising that the activity of psychotherapy supervision should be swept up in the drive for uniformity. The managers amongst us want to regulate and institutionalize all aspects of practice. In opposition, many clinicians resist the relentless march toward the safety of uniformity travel alongside managerial imposition of regulations. Psychotherapy supervision's method of a close apprenticeship relationship between supervisor and trainee and its focus on the process and ethics of professional interaction stand at the humanistic core of what is otherwise becoming an increasingly mechanistic model of providing care to persons with mental illness. Our commentary picks up on these themes as it reviews the work by Mehrtens et al about strengthening awareness of liability in psychiatry residency training programs. We argue that the practice of psychiatry is overburdened by documentation requirements. In imposing further record-keeping on psychotherapy supervision, we lose much more than we gain. We recommend that the supervisory process focus on the characterological virtues essential to functioning as an ethical therapist. We also argue that self-protective rules place restraints on possibilities for imaginative insights and innovations in psychotherapy. © 2017 American Academy of Psychiatry and the Law.

How narcissistic employees respond to abusive supervision: two roles of narcissism in decreasing perception and increasing deviance.

Science.gov (United States)

Wang, Rong; Jiang, Jiang

2014-10-01

Abusive supervision, a type of interpersonal mistreatment from direct supervisors toward subordinates, has received growing attention in leadership research. However, the role of narcissism related to abusive supervision is still unclear. The purpose of this study was to investigate the associations of narcissism with subordinates' perceptions of abusive supervision and deviance toward the supervisor. Ratings on the aforementioned variables were collected from 403 full-time employees at two different times with one week in between (95 men, 308 women; M age = 26.0 yr.; M tenure = 5.1 yr.). The results of regression analyses showed that narcissism was significantly and negatively related to abusive supervision. Moreover, narcissism moderated the positive relationship between abusive supervision and deviance toward the supervisor.

Resistance to group clinical supervision

DEFF Research Database (Denmark)

Buus, Niels; Delgado, Cynthia; Traynor, Michael

2018-01-01

This present study is a report of an interview study exploring personal views on participating in group clinical supervision among mental health nursing staff members who do not participate in supervision. There is a paucity of empirical research on resistance to supervision, which has traditiona......This present study is a report of an interview study exploring personal views on participating in group clinical supervision among mental health nursing staff members who do not participate in supervision. There is a paucity of empirical research on resistance to supervision, which has...... traditionally been theorized as a supervisee's maladaptive coping with anxiety in the supervision process. The aim of the present study was to examine resistance to group clinical supervision by interviewing nurses who did not participate in supervision. In 2015, we conducted semistructured interviews with 24...... Danish mental health nursing staff members who had been observed not to participate in supervision in two periods of 3 months. Interviews were audio-recorded and subjected to discourse analysis. We constructed two discursive positions taken by the informants: (i) 'forced non-participation', where...

Analysis of safety supervision effect on coal mine using game theory

Energy Technology Data Exchange (ETDEWEB)

Zhou Min; Xiao Zhong-hai [China University of Mining & Technology, Xuzhou (China). School of Management

2006-07-01

A two-phase game model was constructed based on economic game theory to improve the inefficient supervision conditions of coalmining enterprises' safety production. The inner mechanism of safety supervision system was carefully studied. The strategy set of the dynamic game-theory relations between colliery proprietor and safety supervision department and the strict competitive game-theory relations between safety supervision department and workers at the production line was analyzed. The conditions of achieving the dominant-strategy equilibrium were revealed. Upon this basis, the possible solution set of safety benefit distribution for the cooperative game-theory of triple party was obtained and the effective and cooperative fair solution was formed. Finally, conclusions are drawn as follows: the combination of necessary penalty to supervisors and operators with the fair distribution of safety benefits can realize the zero-defect of operational violation, so that the violation behavior can be completely avoided. 10 refs., 7 figs.

Semi-supervised learning via regularized boosting working on multiple semi-supervised assumptions.

Science.gov (United States)

Chen, Ke; Wang, Shihai

2011-01-01

Semi-supervised learning concerns the problem of learning in the presence of labeled and unlabeled data. Several boosting algorithms have been extended to semi-supervised learning with various strategies. To our knowledge, however, none of them takes all three semi-supervised assumptions, i.e., smoothness, cluster, and manifold assumptions, together into account during boosting learning. In this paper, we propose a novel cost functional consisting of the margin cost on labeled data and the regularization penalty on unlabeled data based on three fundamental semi-supervised assumptions. Thus, minimizing our proposed cost functional with a greedy yet stagewise functional optimization procedure leads to a generic boosting framework for semi-supervised learning. Extensive experiments demonstrate that our algorithm yields favorite results for benchmark and real-world classification tasks in comparison to state-of-the-art semi-supervised learning algorithms, including newly developed boosting algorithms. Finally, we discuss relevant issues and relate our algorithm to the previous work.

Optimal preventive bank supervision

OpenAIRE

Belhaj, Mohamed; Klimenko, Nataliya

2012-01-01

Early regulator interventions into problem banks is one of the key suggestions of Basel Committee on Banking Supervision. However, no guidance is given on their design. To fill this gap, we outline an incentive-based preventive supervision strategy that eliminates bad asset management in banks. Two supervision techniques are combined: temporary regulatory administration and random audits. Our design ensures good management without excessive supervision costs, through a gradual adjustment of...

Patient perspectives on care received at community acupuncture clinics: a qualitative thematic analysis.

Science.gov (United States)

Tippens, Kimberly M; Chao, Maria T; Connelly, Erin; Locke, Adrianna

2013-10-29

Community acupuncture is a recent innovation in acupuncture service delivery in the U.S. that aims to improve access to care through low-cost treatments in group-based settings. Patients at community acupuncture clinics represent a broader socioeconomic spectrum and receive more frequent treatments compared to acupuncture users nationwide. As a relatively new model of acupuncture in the U.S., little is known about the experiences of patients at community acupuncture clinics and whether quality of care is compromised through this high-volume model. The aim of this study was to assess patients' perspectives on the care received through community acupuncture clinics. The investigators conducted qualitative, thematic analysis of written comments from an observational, cross-sectional survey of clients of the Working Class Acupuncture clinics in Portland, Oregon. The survey included an open-ended question for respondents to share comments about their experiences with community acupuncture. Comments were received from 265 community acupuncture patients. Qualitative analysis of written comments identified two primary themes that elucidate patients' perspectives on quality of care: 1) aspects of health care delivery unique to community acupuncture, and 2) patient engagement in health care. Patients identified unique aspects of community acupuncture, including structures that facilitate access, processes that make treatments more comfortable and effective and holistic outcomes including physical improvements, enhanced quality of life, and empowerment. The group setting, community-based locations, and low cost were highlighted as aspects of this model that allow patients to access acupuncture. Patients' perspectives on the values and experiences unique to community acupuncture offer insights on the quality of care received in these settings. The group setting, community-based locations, and low cost of this model potentially reduce access barriers for those who might not

76 FR 35086 - Atlantic Bank & Trust, Charleston, SC; Notice of Appointment of Receiver

Science.gov (United States)

2011-06-15

... DEPARTMENT OF THE TREASURY Office of Thrift Supervision Atlantic Bank & Trust, Charleston, SC... section 5(d)(2) of the Home Owners' Loan Act, the Office of Thrift Supervision has duly appointed the Federal Deposit Insurance Corporation as sole Receiver for Atlantic Bank & Trust, Charleston, South...

Comparison of Effectiveness of Supervised Exercise Program and Cyriax Physiotherapy in Patients with Tennis Elbow (Lateral Epicondylitis): A Randomized Clinical Trial

Science.gov (United States)

Viswas, Rajadurai; Ramachandran, Rejeeshkumar; Korde Anantkumar, Payal

2012-01-01

Objective. To compare the effectiveness of supervised exercise program and Cyriax physiotherapy in the treatment of tennis elbow (lateral epicondylitis). Design. Randomized clinical trial. Setting. Physiotherapy and rehabilitation centre. Subjects. This study was carried out with 20 patients, who had tennis elbow (lateral epicondylitis). Intervention. Group A (n = 10) had received supervised exercise program. Group B (n = 10) was treated with Cyriax physiotherapy. All patients received three treatment sessions per week for four weeks (12 treatment sessions). Outcome measures. Pain was evaluated using a visual analogue scale (VAS), and functional status was evaluated by completion of the Tennis Elbow Function Scale (TEFS) which were recorded at base line and at the end of fourth week. Results. Both the supervised exercise program and Cyriax physiotherapy were found to be significantly effective in reduction of pain and in the improvement of functional status. The supervised exercise programme resulted in greater improvement in comparison to those who received Cyriax physiotherapy. Conclusion. The results of this clinical trial demonstrate that the supervised exercise program may be the first treatment choice for therapist in managing tennis elbow. PMID:22629225

What's in It for Me? Maintenance of Certification as an Incentive for Faculty Supervision of Resident Quality Improvement Projects.

Science.gov (United States)

Rosenbluth, Glenn; Tabas, Jeffrey A; Baron, Robert B

2016-01-01

Residents are required to engage in quality improvement (QI) activities, which requires faculty engagement. Because of increasing program requirements and clinical demands, faculty may be resistant to taking on additional teaching and supervisory responsibilities without incentives. The authors sought to create an authentic benefit for University of California, San Francisco (UCSF) Pediatrics Residency Training Program faculty who supervise pediatrics residents' QI projects by offering maintenance of certification (MOC) Part 4 (Performance in Practice) credit. The authors identified MOC as an ideal framework to both more actively engage faculty who were supervising QI projects and provide incentives for doing so. To this end, in 2011, the authors designed an MOC portfolio program which included faculty development, active supervision of residents, and QI projects designed to improve patient care. The UCSF Pediatrics Residency Training Program's Portfolio Sponsor application was approved by the American Board of Pediatrics (ABP) in 2012, and faculty whose projects were included in the application were granted MOC Part 4 credit. As of December 2013, six faculty had received MOC Part 4 credit for their supervision of residents' QI projects. Based largely on the success of this program, UCSF has transitioned to the MOC portfolio program administered through the American Board of Medical Specialties, which allows the organization to offer MOC Part 4 credit from multiple specialty boards including the ABP. This may require refinements to screening, over sight, and reporting structures to ensure the MOC standards are met. Ongoing faculty development will be essential.

Supervised Learning

Science.gov (United States)

Rokach, Lior; Maimon, Oded

This chapter summarizes the fundamental aspects of supervised methods. The chapter provides an overview of concepts from various interrelated fields used in subsequent chapters. It presents basic definitions and arguments from the supervised machine learning literature and considers various issues, such as performance evaluation techniques and challenges for data mining tasks.

Psykoterapi og supervision

DEFF Research Database (Denmark)

Jacobsen, Claus Haugaard

2014-01-01

Kapitlet beskriver supervisionen funktioner i forhold til psykoterapi. Supervision af psykoterapi henviser i almindelighed til, at en psykoterapeut konsulterer en ofte mere erfaren kollega (supervisor) med henblik på drøftelse af et konkret igangværende psykoterapeutisk behandlingsforløb. Formålet...... er at fremme denne fagpersons (psykoterapeutens) faglige udvikling samt sikre kvaliteten af behandlingen.kan defineres som i. Der redegøres for, hvorfor supervision er vigtig del af psykoterapeutens profession samt vises, hvorledes supervision foruden den faglige udvikling også er vigtigt redskab i...... psykoterapiens kvalitetssikring. Efter at have drøftet nogle etiske forhold ved supervision, fremlægges endelig nogle få forskningsresultater vedr. psykoterapisupervision af danske psykologer....

How Supervisor Experience Influences Trust, Supervision, and Trainee Learning: A Qualitative Study.

Science.gov (United States)

Sheu, Leslie; Kogan, Jennifer R; Hauer, Karen E

2017-09-01

Appropriate trust and supervision facilitate trainees' growth toward unsupervised practice. The authors investigated how supervisor experience influences trust, supervision, and subsequently trainee learning. In a two-phase qualitative inductive content analysis, phase one entailed reviewing 44 internal medicine resident and attending supervisor interviews from two institutions (July 2013 to September 2014) for themes on how supervisor experience influences trust and supervision. Three supervisor exemplars (early, developing, experienced) were developed and shared in phase two focus groups at a single institution, wherein 23 trainees validated the exemplars and discussed how each impacted learning (November 2015). Phase one: Four domains of trust and supervision varying with experience emerged: data, approach, perspective, clinical. Early supervisors were detail oriented and determined trust depending on task completion (data), were rule based (approach), drew on their experiences as trainees to guide supervision (perspective), and felt less confident clinically compared with more experienced supervisors (clinical). Experienced supervisors determined trust holistically (data), checked key aspects of patient care selectively and covertly (approach), reflected on individual experiences supervising (perspective), and felt comfortable managing clinical problems and gauging trainee abilities (clinical). Phase two: Trainees felt the exemplars reflected their experiences, described their preferences and learning needs shifting over time, and emphasized the importance of supervisor flexibility to match their learning needs. With experience, supervisors differ in their approach to trust and supervision. Supervisors need to trust themselves before being able to trust others. Trainees perceive these differences and seek supervision approaches that align with their learning needs.

Predictors of suicidal ideation in older individuals receiving home-care services.

Science.gov (United States)

Park, Jong-Il; Han, Myeong-Il; Kim, Myung Sig; Yoon, Myeong-Sook; Ko, Sung-Hee; Cho, Hye-Chung; Chung, Young-Chul

2014-04-01

Despite the importance of tending to older individuals who are vulnerable to suicide, little is known about suicidal ideation in the portion of this population receiving home-care services in Asian countries. The objective of this cross-sectional study was to examine predictors of suicidal ideation in older individuals using home-care service. Participants were randomly selected from the individuals 50 years old and over using home-care services across Jeollabuk-do Province, Korea. A total of 697 subjects participated in this study. Each participant completed the short version of the Geriatric Depression Scale, the Scale for Suicidal Ideation, the Multidimensional Scale of Perceived Social Support, and the World Health Organization Disability Assessment Schedule II. Hierarchical regression analyses revealed that depression, perceived social support, and disability were significant predictors of suicidal ideation, whereas the roles of subjective health status and fish consumption remained ambiguous in this regard. In terms of social support, we also found that less perceived social support from family members was related to higher levels of suicidal ideation. The associations between various categories of disability and suicidal ideation disappeared after controlling for depression. Our investigation of the mediating effect of depression on the relationship between disability and suicidal ideation revealed that depression was either a complete (disability related to cognition, self-care, getting along with others, and life activities) or partial (disability related to participation) mediator. Preventive strategies focusing on depression, social support, and disability should be emphasized during encounters with older people receiving home-care services. Copyright © 2013 John Wiley & Sons, Ltd.

Rethinking Educational Supervision

OpenAIRE

Burhanettin DÖNMEZ; Kadir BEYCİOĞLU

2009-01-01

The history of educational (school) supervision has been influenced by the history of the interaction of intellectual movements in politics, society, philosophy and industrial movements. The purpose of this conceptual and theoretical study is to have a brief look at the concept of educational supervision with related historical developments in the field. The paper also intends to see the terms and issues critically, and to conceptualize some issues associated with educational supervision in...

76 FR 5432 - United Western Bank Denver, Colorado; Notice of Appointment of Receiver

Science.gov (United States)

2011-01-31

... DEPARTMENT OF THE TREASURY Office of Thrift Supervision United Western Bank Denver, Colorado... section 5(d)(2) of the Home Owners' Loan Act, the Office of Thrift Supervision has duly appointed the Federal Deposit Insurance Corporation as sole Receiver for United Western Bank, Denver, Colorado, (OTS No...

Disparities in unmet dental need and dental care received by pregnant women in Maryland.

Science.gov (United States)

Singhal, Astha; Chattopadhyay, Amit; Garcia, A Isabel; Adams, Amy B; Cheng, Diana

2014-09-01

To examine prenatal dental care needs, utilization and oral health counseling among Maryland women who delivered a live infant during 2001-2003 and identify the factors associated with having a dental visit and having an unmet dental need during pregnancy. Pregnancy Risk Assessment Monitoring System is an ongoing population based surveillance system that collects information of women's attitudes and experiences before, during, and shortly after pregnancy. Logistic regression was used to model dental visits and unmet dental need using predictor variables for Maryland 2001-2003 births. Less than half of all women reported having a dental visit and receiving oral health advice during pregnancy. Twenty-five percent of women reported a need for dental care, of which 33 % did not receive dental care despite their perceived need. Multivariate modeling revealed that racial minorities, women who were not married and those with annual income dental visit. Women who were not married, had low annual income, were older than 40 years of age, had an unintended pregnancy and received prenatal care later than desired were most likely to have an unmet dental need during pregnancy. Despite reported needs and existing recommendations to include oral health as a component of prenatal care, less than half of pregnant women have a dental visit during their pregnancy. One-third of women with a dental problem did not have a dental visit highlighting the unmet need for dental care during pregnancy.

Total cost of care lower among Medicare fee-for-service beneficiaries receiving care from patient-centered medical homes.

Science.gov (United States)

van Hasselt, Martijn; McCall, Nancy; Keyes, Vince; Wensky, Suzanne G; Smith, Kevin W

2015-02-01

To compare health care utilization and payments between NCQA-recognized patient-centered medical home (PCMH) practices and practices without such recognition. Medicare Part A and B claims files from July 1, 2007 to June 30, 2010, 2009 Census, 2007 Health Resources and Services Administration and CMS Utilization file, Medicare's Enrollment Data Base, and the 2005 American Medical Association Physician Workforce file. This study used a longitudinal, nonexperimental design. Three annual observations (July 1, 2008-June 30, 2010) were available for each practice. We compared selected outcomes between practices with and those without NCQA PCMH recognition. Individual Medicare fee-for-service (FFS) beneficiaries and their claims and utilization data were assigned to PCMH or comparison practices based on where they received the plurality of evaluation and management services between July 1, 2007 and June 30, 2008. Relative to the comparison group, total Medicare payments, acute care payments, and the number of emergency room visits declined after practices received NCQA PCMH recognition. The decline was larger for practices with sicker than average patients, primary care practices, and solo practices. This study provides additional evidence about the potential of the PCMH model for reducing health care utilization and the cost of care. © Health Research and Educational Trust.

Examining Fall Recurrence Risk of Homebound Hispanic Older Adults Receiving Home Care Services.

Science.gov (United States)

Solis, Guillermina R; Champion, Jane Dimmitt

2017-03-01

Unintentional falls and injuries is a major problem among older adults and the fourth cause of death in the United States. A previous fall event doubles the risk of recurrence and lessens the person's quality of life. Hispanic older adults have higher rates of disability and lower independent functioning due to poor medical health and risk for fall recurrence. Most fall studies focus on fall risk with few studies on fall recurrence in older adults receiving home health care services unrelated to fall incident. A descriptive pilot study of 30 homebound Hispanic older adults receiving home care services who reported a fall within 3 months was conducted by a multidisciplinary team to evaluate risk of fall recurrence. A heightened risk for fall recurrence was identified with high number of chronic illnesses, high intake of medications, vision problems, and prevalence of urinary incontinence. Findings highlight significant number of intrinsic factors for fall risk recurrence and injuries in a Hispanic older adults population that is homebound and receiving home care services. A multidisciplinary evaluation and culturally appropriate interventions to lessen the risk of fall recurrence are recommended.

Characteristics of HIV-Positive Transgender Men Receiving Medical Care: United States, 2009-2014.

Science.gov (United States)

Lemons, Ansley; Beer, Linda; Finlayson, Teresa; McCree, Donna Hubbard; Lentine, Daniel; Shouse, R Luke

2018-01-01

To present the first national estimate of the sociodemographic, clinical, and behavioral characteristics of HIV-positive transgender men receiving medical care in the United States. This analysis included pooled interview and medical record data from the 2009 to 2014 cycles of the Medical Monitoring Project, which used a 3-stage, probability-proportional-to-size sampling methodology. Transgender men accounted for 0.16% of all adults and 11% of all transgender adults receiving HIV medical care in the United States from 2009 to 2014. Of these HIV-positive transgender men receiving medical care, approximately 47% lived in poverty, 69% had at least 1 unmet ancillary service need, 23% met criteria for depression, 69% were virally suppressed at their last test, and 60% had sustained viral suppression over the previous 12 months. Although they constitute a small proportion of all HIV-positive patients, more than 1 in 10 transgender HIV-positive patients were transgender men. Many experienced socioeconomic challenges, unmet needs for ancillary services, and suboptimal health outcomes. Attention to the challenges facing HIV-positive transgender men may be necessary to achieve the National HIV/AIDS Strategy goals of decreasing disparities and improving health outcomes among transgender persons.

Do Inflammatory Bowel Disease patients with anxiety and depressive symptoms receive the care they need?

Science.gov (United States)

Bennebroek Evertsz', F; Thijssens, N A M; Stokkers, P C F; Grootenhuis, M A; Bockting, C L H; Nieuwkerk, P T; Sprangers, M A G

2012-02-01

Inflammatory Bowel Disease (IBD) patients with anxiety and/or depressive symptoms may not receive the care they need. Provision of care requires insight into the factors affecting these psychiatric symptoms. The study was designed to examine the extent to which: (1) IBD patients with anxiety and/or depressive symptoms receive mental treatment and (2) clinical and socio-demographic variables are associated with these symptoms. 231 adult IBD patients (79% response rate), attending a tertiary care center, completed standardized measures on anxiety and depressive symptoms (HADS), quality of life (SF-12) and mental health care use (TIC-P). Diagnosis and disease activity were determined by the gastroenterologist. 43% had high levels of anxiety and/or depressive symptoms, indicative of a psychiatric disorder (HADS ≥ 8), of whom 18% received psychological treatment and 21% used psychotropic medication. In multivariate analysis, high disease activity was associated with anxiety (OR=2.72 | psymptoms and poor quality of life, psychiatric complaints in IBD patients were undertreated. Screening for and treatment of psychiatric symptoms should become an integral part of IBD medical care. Copyright © 2011 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

Clinical supervision of nurses working with patients with borderline personality disorder.

Science.gov (United States)

Bland, Ann R; Rossen, Eileen K

2005-06-01

Some nurses describe individuals diagnosed with borderline personality disorder (BPD) as among the most challenging and difficult patients encountered in their practice. As a result, the argument has been made for nursing staff to receive clinical supervision to enhance therapeutic effectiveness and treatment outcomes for individuals with BPD. Formal clinical supervision can focus on the stresses of working in a demanding environment within the work place and enable nurses to accept accountability for their own practice and development (Pesut & Herman, 1999). A psychiatric-mental health clinical nurse specialist can provide individual and/or group supervision for the nursing staff, including education about patient dynamics, staff responses, and treatment team decisions. A clinical nurse specialist also can provide emotional support to nursing staff, which enhances job satisfaction, as they struggle to maintain professional therapeutic behavior with these individuals.

Group Supervision and Japanese Students' Successful Completion of Undergraduate Theses

Science.gov (United States)

Yamada, Kiyomi

2013-01-01

This paper explores, from a sociocultural perspective, the nature and functions of "zemi" or seminars in which Japanese undergraduate students received group supervision for research and thesis writing. The study also investigates how the "zemi" contributed to completion of their theses. It was found that the "zemi"…

MULTIPERIOD BANKING SUPERVISION

OpenAIRE

KARL-THEODOR EISELE; PHILIPPE ARTZNER

2013-01-01

This paper is based on a general method for multiperiod prudential supervision of companies submitted to hedgeable and non-hedgeable risks. Having treated the case of insurance in an earlier paper, we now consider a quantitative approach to supervision of commercial banks. The various elements under supervision are the bank’s current amount of tradeable assets, the deposit amount, and four flow processes: future trading risk exposures, deposit flows, flows of loan repayments and of deposit re...

"A constant struggle to receive mental health care": health care professionals' acquired experience of barriers to mental health care services in Rwanda.

Science.gov (United States)

Rugema, Lawrence; Krantz, Gunilla; Mogren, Ingrid; Ntaganira, Joseph; Persson, Margareta

2015-12-16

In Rwanda, many people are still mentally affected by the consequences of the genocide and yet mental health care facilities are scarce. While available literature explains the prevalence and consequences of mental disorders, there is lack of knowledge from low-income countries on health care seeking behavior due to common mental disorders. Therefore, this study sought to explore health care professionals' acquired experiences of barriers and facilitators that people with common mental disorders face when seeking mental health care services in Rwanda. A qualitative approach was applied and data was collected from six focus group discussions (FGDs) conducted in October 2012, including a total of 43 health care professionals, men and women in different health professions. The FGDs were performed at health facilities at different care levels. Data was analyzed using manifest and latent content analysis. The emerging theme "A constant struggle to receive mental health care for mental disorders" embraced a number of barriers and few facilitators at individual, family, community and structural levels that people faced when seeking mental health care services. Identified barriers people needed to overcome were: Poverty and lack of family support, Fear of stigmatization, Poor community awareness of mental disorders, Societal beliefs in traditional healers and prayers, Scarce resources in mental health care and Gender imbalance in care seeking behavior. The few facilitators to receive mental health care were: Collaboration between authorities and organizations in mental health and having a Family with awareness of mental disorders and health insurance. From a public health perspective, this study revealed important findings of the numerous barriers and the few facilitating factors available to people seeking health for mental disorders. Having a supportive family with awareness of mental disorders who also were equipped with a health insurance was perceived as vital for

75 FR 33389 - TierOne Bank Lincoln, Nebraska; Notice of Appointment of Receiver

Science.gov (United States)

2010-06-11

... DEPARTMENT OF THE TREASURY Office of Thrift Supervision TierOne Bank Lincoln, Nebraska; Notice of... the Home Owners' Loan Act, the Office of Thrift Supervision has duly appointed the Federal Deposit Insurance Corporation as sole Receiver for TierOne Bank, Lincoln, Nebraska, (OTS No. 03309), on June 4, 2010...

Paediatric trainee supervision: management changes and perceived education value.

Science.gov (United States)

van den Boom, Mirjam; Pinnock, Ralph; Weller, Jennifer; Reed, Peter; Shulruf, Boaz

2012-07-01

Supervision in postgraduate training is an under-researched area. We measured the amount, type and effect of supervision on patient care and perceived education value in a general paediatric service. We designed a structured observation form and questionnaire to document the type, duration and effect of supervision on patient management and perceived education value. Most supervision occurred without the paediatrician confirming the trainee's findings. Direct observation of the trainee was rare. Management was changed in 30% of patients seen on the inpatient ward round and in 42% of the patients discussed during the chart reviews but not seen by the paediatrician. Management was changed in 48% of the cases when the paediatrician saw the patient with the trainee in outpatients but in only 21% of patients when the patient was but not seen. Changes made to patient management, understanding and perceived education value, differed between inpatient and out patient settings. There was more impact when the paediatrician saw the patient with the trainee in outpatients; while for inpatients, the opposite was true. Trainees rated the value of the supervision more highly than their supervisors did. Trainees' comments on what they learnt from their supervisor related almost exclusively to clinical knowledge rather than professional behaviours. We observed little evidence of supervisors directly observing trainees and trainees learning professional behaviours. A review of supervisory practices to promote more effective learning is needed. Communicating to paediatricians the value their trainees place on their input could have a positive effect on their engagement in supervision. © 2012 The Authors. Journal of Paediatrics and Child Health © 2012 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

A Supervision of Solidarity

Science.gov (United States)

Reynolds, Vikki

2010-01-01

This article illustrates an approach to therapeutic supervision informed by a philosophy of solidarity and social justice activism. Called a "Supervision of Solidarity", this approach addresses the particular challenges in the supervision of therapists who work alongside clients who are subjected to social injustice and extreme marginalization. It…

Student nurses' experience of a system of peer group supervision ...

African Journals Online (AJOL)

Recommendations were made to change the system in order to eliminate the negative aspects and after careful consideration and programme changes, implemented in 2001. It therefore became necessary to evaluate the revised system of peer group supervision and guidance for effectiveness. A qualitative, descriptive ...

Nursing care of patients receiving interventional therapy for hepatic artery stenosis after liver transplantation

International Nuclear Information System (INIS)

Wei Lin; Liu Shiguang

2009-01-01

Objective: To discuss the perioperative nursing care of patients who is going to receive interventional therapy for hepatic artery stenosis after liver transplantation and to provide useful reference for reducing surgery-related complication and for improving the prognosis of patients. Methods: Based on the patient's condition and operative requirement,we provided effective nursing care for 20 patients who were admitted to receive the interventional therapy for hepatic artery stenosis after liver transplantation. The nursing care included preoperative preparation,postoperative nursing and medical guidance at the time of discharge. Results: Interventional therapy was successfully performed in all 20 cases, and no hemorrhagic tendency or acute thrombosis occurred. Marked symptomatic improvement was obtained in all patients. Conclusion: The interventional therapy is an effective treatment for hepatic artery stenosis after liver transplantation. Intensive perioperative nursing care can well prevent the occurrence of surgery-related complications and can surely improve the therapeutic results. (authors)

Effects of increased overnight supervision on resident education, decision-making, and autonomy.

Science.gov (United States)

Haber, Lawrence A; Lau, Catherine Y; Sharpe, Bradley A; Arora, Vineet M; Farnan, Jeanne M; Ranji, Sumant R

2012-10-01

New supervisory regulations highlight the challenge of balancing housestaff supervision and autonomy. To better understand the impact of increased supervision on residency training, we investigated housestaff perceptions of education, autonomy, and clinical decision-making before and after implementation of an in-hospital, overnight attending physician (nocturnist). We established a nocturnist program in July 2010 at our academic, tertiary care medical center. We administered pre-surveys and post-surveys of internal medicine residents on night float rotation during the 2010-2011 academic year. We surveyed residents before and after experiencing the nocturnist program. Housestaff reported an increase in the clinical value of the night float rotation (3.95 vs 4.27, P = 0.01) and the adequacy of overnight supervision (3.65 vs 4.30, P autonomy (4.35 vs 4.45, P = 0.44). Trainees agreed that nocturnist supervision positively impacted patient outcomes (3.79 vs 4.30, P = 0.002). Housestaff contacted attendings more frequently for transfers from outside facilities (2.00 vs 3.20, P = 0.006), during adverse events (2.51 vs 3.25, P = 0.04), prior to ordering invasive diagnostics (1.75 vs 2.76, P = 0.004), and prior to vasopressor use (1.52 vs 2.40, P = 0.004). Residents' fear of revealing knowledge gaps and desire to make decisions independently did not change. Increased overnight supervision enhanced the clinical value of the night float rotation, increased rates of attending contact during critical clinical decision-making, and improved perception of patient care. These changes occurred without a decrease in housestaff's perceived decision-making autonomy. Copyright © 2012 Society of Hospital Medicine.

Organisational and environmental characteristics of residential aged care units providing highly person-centred care: a cross sectional study.

Science.gov (United States)

Sjögren, Karin; Lindkvist, Marie; Sandman, Per-Olof; Zingmark, Karin; Edvardsson, David

2017-01-01

Few studies have empirically investigated factors that define residential aged care units that are perceived as being highly person-centred. The purpose of this study was to explore factors characterising residential aged care units perceived as being highly person-centred, with a focus on organisational and environmental variables, as well as residents' and staff' characteristics. A cross-sectional design was used. Residents ( n  = 1460) and staff ( n  = 1213) data from 151 residential care units were collected, as well as data relating to characteristics of the organisation and environment, and data measuring degree of person-centred care. Participating staff provided self-reported data and conducted proxy ratings on residents . Descriptive and comparative statistics, independent samples t-test, Chi 2 test, Eta Squared and Phi coefficient were used to analyse data. Highly person-centred residential aged care units were characterized by having a shared philosophy of care, a satisfactory leadership, interdisciplinary collaboration and social support from colleagues and leaders, a dementia-friendly physical environment, staff having time to spend with residents, and a smaller unit size. Residential aged care units with higher levels of person-centred care had a higher proportion of staff with continuing education in dementia care, and a higher proportion of staff receiving regular supervision, compared to units with lower levels of person-centred care. It is important to target organisational and environmental factors, such as a shared philosophy of care, staff use of time, the physical environment, interdisciplinary support, and support from leaders and colleagues, to improve person-centred care in residential care units. Managers and leaders seeking to facilitate person-centred care in daily practice need to consider their own role in supporting, encouraging, and supervising staff.

Ensemble learning with trees and rules: supervised, semi-supervised, unsupervised

Science.gov (United States)

In this article, we propose several new approaches for post processing a large ensemble of conjunctive rules for supervised and semi-supervised learning problems. We show with various examples that for high dimensional regression problems the models constructed by the post processing the rules with ...

Peer Support in Negotiating Multiple Relationships within Supervision among Counselor Education Doctoral Students

Science.gov (United States)

Minor, Amanda J.; Pimpleton, Asher; Stinchfield, Tracy; Stevens, Heath; Othman, Nor Asma

2013-01-01

Counselor education doctoral students (CEDSs), like other doctoral students, need assistance and support to ensure their self-care. One area markedly affecting self-care is one's relationships with others. The purpose of this article is to examine the multiple relationships involved within CEDSs supervision, the potential areas to utilize peer…

[Supervised administration of Alzheimer's patients using information communication technology].

Science.gov (United States)

Noda, Yasuha; Sakata, Yoshifumi; Kubota, Masakazu; Uemura, Kengo; Kihara, Takeshi; Kimura, Toru; Ino, Masashi; Tsuji, Teruyuki; Hayashi, Michiyuki; Kinoshita, Ayae

2014-12-01

Drug adherence is central to the treatment of dementia, which might reduce compliance due to memory loss, particularly among home-based patients with dementia. In order to improve drug adherence, we suggest the efficient and effective supervised administration by use of information communication technology(ICT). ICT makes face-to-face real-time communication possible, and it also enables picture sharing. Therefore, it might be useful to apply ICT to controlling and supervising medication for patients with dementia to improve drug adherence. Accordingly, we enrolled patients who were supposed to take a newly prescribed anti-dementia patch containing the choline esterase inhibitor rivastigmine(Rivastach®)and investigated the effect of ICT-based intervention for drug adherence, emotional change, and cognitive change, utilizing Skype, a free communication software program. Scheduled Skype interventions increased drug adherence ratio, levels of subjective satisfaction, and instrumental activities of daily living(IADL). Furthermore, we can provide patients and their caregivers with a feeling of safety through regular bidirectional communication, as patients can easily consult medical staff regarding the adverse effects of newly prescribed drugs. Instead of frequent visits to their primary physicians, ICT-based communications can be used as a substitute for supervision of medication, given the availability of the telecommunication system. By directly connecting the medical institution to the home, we expect that this ICT-based system will expand into the geriatric care field, including the care of elderly individuals living alone.

The perceptions of nurses in a district health system in KwaZulu-Natal of their supervision, self-esteem and job satisfaction

Directory of Open Access Journals (Sweden)

L.R. Uys

2004-09-01

Full Text Available Supervision has been identified as a major issue in quality of care. Although increasing attention is being given to supervision in the District Health System, there have been no studies describing the current situation. This article describes a survey done in two health districts in KwaZulu-Natal involving 319 nurses from all types of government health care settings.

Creation of complexity assessment tool for patients receiving home care

Directory of Open Access Journals (Sweden)

Maria Leopoldina de Castro Villas Bôas

2016-06-01

Full Text Available Abstract OBJECTIVE To create and validate a complexity assessment tool for patients receiving home care from a public health service. METHOD A diagnostic accuracy study, with estimates for the tool's validity and reliability. Measurements of sensitivity and specificity were considered when producing validity estimates. The resulting tool was used for testing. Assessment by a specialized team of home care professionals was used as the gold standard. In the tool's reliability study, the authors used the Kappa statistic. The tool's sensitivity and specificity were analyzed using various cut-off points. RESULTS On the best cut-off point-21-with the gold standard, a sensitivity of 75.5% was obtained, with the limits of confidence interval (95% at 68.3% and 82.8% and specificity of 53.2%, with the limits of confidence interval (95% at 43.8% and 62.7%. CONCLUSION The tool presented evidence of validity and reliability, possibly helping in service organization at patient admission, care type change, or support during the creation of care plans.

Group supervision for general practitioners

DEFF Research Database (Denmark)

Galina Nielsen, Helena; Sofie Davidsen, Annette; Dalsted, Rikke

2013-01-01

AIM: Group supervision is a sparsely researched method for professional development in general practice. The aim of this study was to explore general practitioners' (GPs') experiences of the benefits of group supervision for improving the treatment of mental disorders. METHODS: One long-establish......AIM: Group supervision is a sparsely researched method for professional development in general practice. The aim of this study was to explore general practitioners' (GPs') experiences of the benefits of group supervision for improving the treatment of mental disorders. METHODS: One long...... considered important prerequisites for disclosing and discussing professional problems. CONCLUSION: The results of this study indicate that participation in a supervision group can be beneficial for maintaining and developing GPs' skills in dealing with patients with mental health problems. Group supervision...... influenced other areas of GPs' professional lives as well. However, more studies are needed to assess the impact of supervision groups....

Losing connections and receiving support to reconnect: experiences of frail older people within care programmes implemented in primary care settings.

Science.gov (United States)

Bindels, Jill; Cox, Karen; De La Haye, Jean; Mevissen, Ger; Heijing, Servé; van Schayck, Onno C P; Widdershoven, Guy; Abma, Tineke A

2015-09-01

The objective of this study was to evaluate whether care provided in the care programmes matched the needs of older people. Care programmes were implemented in primary-care settings in the Netherlands to identify frail older people and to prevent further deterioration of health. In total, 23 older people participated in in-depth interviews. Within this study, three older people participated as co-researchers; they gathered and analysed the data together with the academic researchers. Content analysis was used to analyse the data. Two categories emerged from the data: 'Losing connections' and 'Receiving support to reconnect.' 'Losing connections' reflects the needs of older people and 'Receiving support to reconnect' reflects their experience and the appreciated aspects of the provided care. A relationship of trust with the practice nurse (PN) appeared to be an important aspect of care, as it fostered the sharing of feelings and issues other than physical or medical problems that could not be shared with the general practitioner. The PNs are experienced as connectors, who help to restore feelings of connectedness and older peoples' access to resources in the community. The relationship with the PN was experienced as valuable because of the feelings of 'connectedness' it created. Through this connectedness, older people could discuss feelings of loneliness, depression and frustration in receiving and acquiring the appropriate resources and services with the PNs. Furthermore, the relationship with the PN helped the older people to gain access to other health professionals and services. The results imply that care for frail older people should include an awareness of the importance of the trusting relationship. Nurses can play a vital role in creating a trusting relationship and are able to bridge the gap between older people and other professionals and services. © 2014 John Wiley & Sons Ltd.

75 FR 45011 - Olde Cypress Community Bank, Clewiston, FL; Notice of Appointment of Receiver

Science.gov (United States)

2010-07-30

... DEPARTMENT OF THE TREASURY Office of Thrift Supervision Olde Cypress Community Bank, Clewiston, FL... section 5(d)(2) of the Home Owners' Loan Act, the Office of Thrift Supervision has duly appointed the Federal Deposit Insurance Corporation as sole Receiver for Olde Cypress Community Bank, Clewiston, Florida...

75 FR 65404 - Security Savings Bank, FSB; Olathe, KS; Notice of Appointment of Receiver

Science.gov (United States)

2010-10-22

... DEPARTMENT OF THE TREASURY Office of Thrift Supervision Security Savings Bank, FSB; Olathe, KS... section 5(d)(2) of the Home Owners' Loan Act, the Office of Thrift Supervision (OTS) has duly appointed the Federal Deposit Insurance Corporation as sole Receiver for Security Savings Bank, FSB, Olathe...

75 FR 41927 - Ideal Federal Savings Bank, Baltimore, Maryland; Notice of Appointment of Receiver

Science.gov (United States)

2010-07-19

... DEPARTMENT OF THE TREASURY Office of Thrift Supervision Ideal Federal Savings Bank, Baltimore... contained in section 5(d)(2) of the Home Owners' Loan Act, the Office of Thrift Supervision has duly appointed the Federal Deposit Insurance Corporation as sole Receiver for Ideal Federal Savings Bank...

LONG TERM EFFECT OF CYRIAX PHYSIOTHERPY WITH SUPERVISED EXERCISE PROGRAM IN SUBJECTS WITH TENNIS ELBOW

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Pallavi Shridhar Thakare

2014-06-01

Full Text Available Background: The purpose is to find long term effect of Cyriax physiotherapy with supervised exercise program in the reduction of pain and improvement of functional ability for subjects with tennis elbow. Method: An experimental study design, 30 subjects with Tennis Elbow randomized 15 subjects each into Study and Control group. Control group received Supervised Exercise program while Study group received Cyriax Physiotherapy with Supervised exercises program thrice in a week for 4 weeks and post intervention follow up after 2 weeks. Outcome measurements were measured for pain using Visual analogue Scale (VAS and Patient Rated Tennis Elbow Evaluation (PRTEE for functional ability. Results: There is no statistically significant difference in pre- intervention means of VAS and PRTEE when compared between the groups using independent ‘t’ test as a parametric and Mann Whitney U test as a non-parametric test. When means of post intervention and follow-up measurements were compared there is a statistically significant (p<0.05 difference in VAS and PRTEE scores between the groups. However greater percentage of improvements was obtained in study group than control group. Conclusion: It is concluded that there is significant long term effect with greater percentage of improvement in pain and functional ability up to 2 weeks follow-up following 4 weeks of combined Cyriax physiotherapy with supervised exercise program than only supervised exercise program for subjects with tennis elbow.

A systematic review of professional supervision experiences and effects for allied health practitioners working in non-metropolitan health care settings

Directory of Open Access Journals (Sweden)

Ducat WH

2015-08-01

Full Text Available Wendy H Ducat,1,3 Saravana Kumar2 1Cunningham Centre, Darling Downs Hospital and Health Service, Australia; 2School of Health Sciences, International Centre for Allied Health Evidence, Sansom Institute, University of South Australia, Adelaide, SA, Australia; 3Rural Clinical School, School of Medicine, University of Queensland, Brisbane, QLD, Australia Introduction: In regional, rural, and remote settings, allied health professional supervision is one organizational mechanism designed to support and retain the workforce, provide clinical governance, and enhance service delivery. A systematic approach to evaluating the evidence of the experience and effects of professional supervision for non-metropolitan allied health practitioners and their service delivery is needed. Methods: Studies investigating the experience and effects of professional supervision across 17 allied health disciplines in non-metropolitan health services were systematically searched for using standardized keywords across seven databases. The initial search identified 1,574 references. Of these studies, five met inclusion criteria and were subject to full methodological appraisal by both reviewers. Two studies were primarily qualitative with three studies primarily quantitative in their approach. Studies were appraised using McMaster critical appraisal tools and data were extracted and synthesized. Results: Studies reported the context specific benefits and challenges of supervision in non-metropolitan areas and the importance of supervision in enhancing satisfaction and support in these areas. Comparison of findings between metropolitan and non-metropolitan settings within one study suggested that allied health in non-metropolitan settings were more satisfied with supervision though less likely to access it and preferred supervision with other non-metropolitan practitioners over access to more experienced supervisors. One study in a regional health service identified the lack

Evaluering af kollegial supervision

DEFF Research Database (Denmark)

Petersen, Anne Line Bjerre Folsgaard; Bager, Lene Tortzen; Jørgensen, Mette Eg

2015-01-01

Videoen er en evaluering af arbejdet med en metodisk tilgang til kollegial supervision på VIA Ergoterapeutuddannelsen gennem et par år. Evalueringen sætter fokus på selve metoden, der er anvendt til kollegial supervision. Derudover er der fokus på erfaringer og udbytte af at arbejde systematisk med...... kollegial supervision blandt undervisere på VIA Ergoterapeutuddannelsen....

Measuring the Impact of the Home Health Nursing Shortage on Family Caregivers of Children Receiving Palliative Care.

Science.gov (United States)

Weaver, Meaghann S; Wichman, Brittany; Bace, Sue; Schroeder, Denice; Vail, Catherine; Wichman, Chris; Macfadyen, Andrew

2018-06-01

The national nursing shortage translates into a gap in home nursing care available to children with complex, chronic medical conditions and their family caregivers receiving palliative care consultations. A total of 38 home health nursing surveys were completed by families receiving pediatric palliative care consultation services at a freestanding children's hospital in the Midwest. The gap in the average number of nursing hours allotted versus received was 40 h/wk per family, primarily during evening hours. Parents missed an average of 23 hours of employment per week to provide hands-on nursing care at home, ranking stress regarding personal employment due to nursing shortage at 6.2/10. Families invested an average of 10 h/mo searching for additional nursing coverage and often resorted to utilizing more than 6 different home nurse coverage personnel per month. Families reported multiple delays to hospital discharges (mean, 15 days per delay) due to inability to find home nursing coverage. Respiratory technology and lack of Medicaid coverage ( P home nursing access. This study examines how the pediatric home nursing shortage translates into a lived experience for families with children with complex medical conditions receiving palliative care.

Rethinking Educational Supervision

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Burhanettin DÖNMEZ

2009-08-01

Full Text Available The history of educational (school supervision has been influenced by the history of the interaction of intellectual movements in politics, society, philosophy and industrial movements. The purpose of this conceptual and theoretical study is to have a brief look at the concept of educational supervision with related historical developments in the field. The paper also intends to see the terms and issues critically, and to conceptualize some issues associated with educational supervision in practice. In the paper, the issues are discussed and a number of suggestions are addressed for debate.

Patients' perceptions of palliative care: adaptation of the Quality from the Patient's Perspective instrument for use in palliative care, and description of patients' perceptions of care received.

Science.gov (United States)

Sandsdalen, Tuva; Rystedt, Ingrid; Grøndahl, Vigdis Abrahamsen; Hov, Reidun; Høye, Sevald; Wilde-Larsson, Bodil

2015-11-02

Instruments specific to palliative care tend to measure care quality from relative perspectives or have insufficient theoretical foundation. The instrument Quality from the Patient's Perspective (QPP) is based on a model for care quality derived from patients' perceptions of care, although it has not been psychometrically evaluated for use in palliative care. The aim of this study was to adapt the QPP for use in palliative care contexts, and to describe patients' perceptions of the care quality in terms of the subjective importance of the care aspects and the perceptions of the care received. A cross-sectional study was conducted between November 2013 and December 2014 which included 191 patients (73% response rate) in late palliative phase at hospice inpatient units, hospice day-care units, wards in nursing homes that specialized in palliative care and homecare districts, all in Norway. An explorative factor analysis using principal component analysis, including data from 184 patients, was performed for psychometric evaluation. Internal consistency was assessed by Cronbach's alpha and paired t-tests were used to describe patients' perceptions of their care. The QPP instrument was adapted for palliative care in four steps: (1) selecting items from the QPP, (2) modifying items and (3) constructing new items to the palliative care setting, and (4) a pilot evaluation. QPP instrument specific to palliative care (QPP-PC) consists of 51 items and 12 factors with an eigenvalue ≥1.0, and showed a stable factor solution that explained 68.25% of the total variance. The reliability coefficients were acceptable for most factors (0.79-0.96). Patients scored most aspects of care related to both subjective importance and actual care received as high. Areas for improvement were symptom relief, participation, continuity, and planning and cooperation. The QPP-PC is based on a theoretical model of quality of care, and has its roots in patients' perspectives. The instrument was

Supervised physical exercise during pregnancy improves health perception. Randomised controlled trial

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Mireia Peláez

2013-07-01

Full Text Available Aim: To investigate the influence of a moderate exercise program during pregnancy on the maternal health perception. Methods. A randomised controlled trial was performed. 101 primiparous women were allocated into the control group (CG, n=51 and the exercise group (EG, n=50, lost to follow-up 13, 11.4%. Women on the EC were asked to participate in a supervised exercise program during from 10-14 to 36 weeks of gestation (70-75 sessions, 55-60 min/session, three times per week. Women in the CG received usual care. All women were asked to fill in validated questionnaires about health perception and urinary incontinence before and after the intervention. Results. At the end of the intervention there were statistically significant differences between groups on health perception [very good: EG 35, 70% vs. CG 5, 9.8%; good: EG 15, 30% vs. CG 16, 31%; average EG 0, 0.0% vs. CG 26, 51%; poor EG 0, 0.0% vs. CG 3, 5.9%; very poor: EG 0, 0.0% vs. CG 1, 2% (p<.001]. What is more, women in the EG showed less urinary incontinence [ICIQ-SF Score EG 0.30 (SD1.3 vs. CG 3.1 (SD4.1, p<.001]. Conclusions. A supervised physical exercise program during pregnancy which includes pelvic floor muscle training, improves health perception and it is effective on primary prevention of urinary incontinence.

Antenatal and obstetric care in Afghanistan--a qualitative study among health care receivers and health care providers.

Science.gov (United States)

Rahmani, Zuhal; Brekke, Mette

2013-05-06

Despite attempts from the government to improve ante- and perinatal care, Afghanistan has once again been labeled "the worst country in which to be a mom" in Save the Children's World's Mothers' Report. This study investigated how pregnant women and health care providers experience the existing antenatal and obstetric health care situation in Afghanistan. Data were obtained through one-to-one semi-structured interviews of 27 individuals, including 12 women who were pregnant or had recently given birth, seven doctors, five midwives, and three traditional birth attendants. The interviews were carried out in Kabul and the village of Ramak in Ghazni Province. Interviews were taped, transcribed, and analyzed according to the principles of Giorgi's phenomenological analysis. Antenatal care was reported to be underused, even when available. Several obstacles were identified, including a lack of knowledge regarding the importance of antenatal care among the women and their families, financial difficulties, and transportation problems. The women also reported significant dissatisfaction with the attitudes and behavior of health personnel, which included instances of verbal and physical abuse. According to the health professionals, poor working conditions, low salaries, and high stress levels contributed to this matter. Personal contacts inside the hospital were considered necessary for receiving high quality care, and bribery was customary. Despite these serious concerns, the women expressed gratitude for having even limited access to health care, especially treatment provided by a female doctor. Health professionals were proud of their work and enjoyed the opportunity to help their community. This study identified several obstacles which must be addressed to improve reproductive health in Afghanistan. There was limited understanding of the importance of antenatal care and a lack of family support. Financial and transportation problems led to underuse of available care

"They put you on your toes": Physical Therapists' Perceived Benefits from and Barriers to Supervising Students in the Clinical Setting.

Science.gov (United States)

Davies, Robyn; Hanna, Elizabeth; Cott, Cheryl

2011-01-01

To identify the perceived benefits of and barriers to clinical supervision of physical therapy (PT) students. In this qualitative descriptive study, three focus groups and six key-informant interviews were conducted with clinical physical therapists or administrators working in acute care, orthopaedic rehabilitation, or complex continuing care. Data were coded and analyzed for common ideas using a constant comparison approach. Perceived barriers to supervising students tended to be extrinsic: time and space constraints, challenging or difficult students, and decreased autonomy or flexibility for the clinical physical therapists. Benefits tended to be intrinsic: teaching provided personal gratification by promoting reflective practice and exposing clinical educators to current knowledge. The culture of different health care institutions was an important factor in therapists' perceptions of student supervision. Despite different disciplines and models of supervision, there is considerable synchronicity in the issues reported by physical therapists and other disciplines. Embedding the value of clinical teaching in the institution, along with strong communication links among academic partners, institutions, and potential clinical faculty, may mitigate barriers and increase the commitment and satisfaction of teaching staff.

Social support, self-care, and quality of life in cancer patients receiving radiotherapy in Thailand

International Nuclear Information System (INIS)

Hanucharurnkul, S.

1988-01-01

The purpose of the study was two-fold: (1) to examine the relationships among self-care, social support, and quality of life in adult cancer patients receiving radiotherapy while the selected basic conditioning factors of age, marital and socio-economic status, living arrangement, stage and site of cancer were statistically controlled; and (2) to test a theoretical model which postulated that (a) quality of life was predicted jointly by the selected basic conditioning factors, social support and self-care, and (b) self-care was predicted jointly by the selected basic conditioning factors and social support. A convenience sample of 112 adult cervical and head/neck cancer patients receiving radiotherapy was obtained from radiotherapy outpatient clinic in three hospitals located in Bangkok, Thailand. Results of the study indicated positive relationships among self-care, social support, and quality of life. Socio-economic status, site of cancer, and self-care were significant predictors for reported quality of life. Social support appeared to be a significant predictor of quality of life indirectly through self-care. Socio-economic status and social support were also significant predictors of self-care, whereas, stage and site of cancer seemed to predict self-care indirectly through social support

Social construction : discursive perspective towards supervision

OpenAIRE

Naujanienė, Rasa

2010-01-01

The aim of publication is to discuss the development of supervision theory in relation with social and social work theory and practice. Main focus in the analysis is done to social constructionist ideas and its’ relevance to supervision practice. The development of supervision is related with supervision practice. Starting in 19th century supervision from giving practical advices supervision came to 21st century as dialog based on critical and philosophical reflection. Different theory and pr...

Public Supervision over Private Relationships : Towards European Supervision Private Law?

NARCIS (Netherlands)

Cherednychenko, O.O.

2014-01-01

The rise of public supervision over private relationships in many areas of private law has led to the development of what, in the author’s view, could be called ‘European supervision private law’. This emerging body of law forms part of European regulatory private law and is made up of

The nature and structure of supervision in health visiting with victims of child sexual abuse.

Science.gov (United States)

Scott, L

1999-03-01

Part of a higher research degree to explore professional practice. To explore how health visitors work with victims of child sexual abuse and the supervision systems to support them. To seek the views and experiences of practising health visitors relating to complex care in order to consider the nature and structure of supervision. The research reported in this paper used a qualitative method of research and semi-structured interviews with practising health visitors of varying levels of experience in venues around England. Qualitative research enabled the exploration of experiences. Identification of the need for regular, structured, accountable opportunities in a 'private setting' to discuss whole caseload work and current practice issues. Supervision requires a structured, formalized process, in both regularity and content, as a means to explore and acknowledge work with increasingly complex care, to enable full discussion of whole caseloads. Supervision is demonstrated as a vehicle to enable the sharing of good practices and for weak practices to be identified and managed appropriately. Supervision seeks to fulfil the above whilst promoting a stimulating, learning experience, accommodating the notion that individuals learn at their own pace and bring a wealth of human experience to the service. The size of the study was dictated by the amount of time available within which to complete a research master's degree course primarily in the author's own time, over a 2-year period. The majority of participants volunteered their accounts in their own time. For others I obtained permission from their employers for them to participate once they approached me with an interest in being interviewed. This research provides a model of supervision based on practitioner views and experiences. The article highlights the value of research and evidence-based information to enhance practice accountability and the quality of care. Proactive risk management can safeguard the health

Does doctors’ workload impact supervision and ward activities of final-year students? A prospective study

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Celebi Nora

2012-06-01

Full Text Available Abstract Background Hospital doctors face constantly increasing workloads. Besides caring for patients, their duties also comprise the education of future colleagues. The aim of this study was to objectively investigate whether the workload arising from increased patient care interferes with student supervision and is associated with more non-medical activities of final-year medical students. Methods A total of 54 final-year students were asked to keep a diary of their daily activities over a three-week period at the beginning of their internship in Internal Medicine. Students categorized their activities – both medical and non-medical - according to whether they had: (1 only watched, (2 assisted the ward resident, (3 performed the activity themselves under supervision of the ward resident, or (4 performed the activity without supervision. The activities reported on a particular day were matched with a ward specific workload-index derived from the hospital information system, including the number of patients treated on the corresponding ward on that day, a correction factor according to the patient comorbidity complexity level (PCCL, and the number of admissions and discharges. Both students and ward residents were blinded to the study question. Results A total of 32 diaries (59 %, 442 recorded working days were handed back. Overall, the students reported 1.2 ± 1.3 supervised, 1.8 ±1.6 medical and 3.6 ± 1.7 non-medical activities per day. The more supervised activities were reported, the more the number of reported medical activities increased (p  Conclusions There was a significant association between ward doctors’ supervision of students and the number of medical activities performed by medical students. The workload had no significant effect on supervision or the number of medical or non-medical activities of final-year students.

Forskellighed i supervision

DEFF Research Database (Denmark)

Petersen, Birgitte; Beck, Emma

2009-01-01

Indtryk og tendenser fra den anden danske konference om supervision, som blev holdt på Københavns Universitet i oktober 2008......Indtryk og tendenser fra den anden danske konference om supervision, som blev holdt på Københavns Universitet i oktober 2008...

Supervision af psykoterapi

DEFF Research Database (Denmark)

SUPERVISION AF PSYKOTERAPI indtager en central position i uddannelsen og udviklingen af psykoterapeuter. Trods flere lighedspunkter med psykoterapi, undervisning og konsultation er psykoterapisupervision et selvstændigt virksomhedsområde. Supervisor må foruden at være en trænet psykoterapeut kende...... supervisionens rammer og indplacering i forhold til organisation og samfund. En række kapitler drejer sig om supervisors opgaver, roller og kontrolfunktion, supervision set fra supervisandens perspektiv samt betragtninger over relationer og processer i supervision. Der drøftes fordele og ulemper ved de...... forskellige måder, hvorpå en sag kan fremlægges. Bogens første del afsluttes med refleksioner over de etiske aspekter ved psykoterapisupervision. Bogens anden del handler om de særlige forhold, der gør sig gældende ved supervision af en række specialiserede behandlingsformer eller af psykoterapi med bestemte...

75 FR 82146 - Appalachian Community Bank, FSB, McCaysville, GA, Notice of Appointment of Receiver

Science.gov (United States)

2010-12-29

... DEPARTMENT OF THE TREASURY Office of Thrift Supervision Appalachian Community Bank, FSB... contained in section 5(d)(2) of the Home Owners' Loan Act, the Office of Thrift Supervision has duly appointed the Federal Deposit Insurance Corporation as sole Receiver for Appalachian Community Bank, FSB...

75 FR 17463 - Key West Bank, Key West, Florida; Notice of Appointment of Receiver

Science.gov (United States)

2010-04-06

... DEPARTMENT OF THE TREASURY Office of Thrift Supervision Key West Bank, Key West, Florida; Notice... section 5(d)(2) of the Home Owners' Loan Act, the Office of Thrift Supervision has duly appointed the Federal Deposit Insurance Corporation as sole Receiver for Key West Bank, Key West, Florida, (OTS No...

75 FR 4909 - Charter Bank: Santa Fe, New Mexico; Notice of Appointment of Receiver

Science.gov (United States)

2010-01-29

... DEPARTMENT OF THE TREASURY Office of Thrift Supervision Charter Bank: Santa Fe, New Mexico; Notice... section 5(d)(2) of the Home Owners' Loan Act, the Office of Thrift Supervision has duly appointed the Federal Deposit Insurance Corporation as sole Receiver for Charter Bank, Santa Fe, New Mexico, (OTS No...

Researching online supervision

DEFF Research Database (Denmark)

Bengtsen, Søren S. E.; Mathiasen, Helle

2014-01-01

Online supervision and the use of digital media in supervisory dialogues is a fast increasing practice in higher education today. However, the concepts in our pedagogical repertoire often reflect the digital tools used for supervision purposes as either a prolongation of the face-to-face contact...

Implementation of Instructional Supervision in Secondary School ...

African Journals Online (AJOL)

Science, Technology and Arts Research Journal ... Supervision is critical in the development of any educational program in both developed and ... Clinical Supervision, Collegial Supervision, Self-directive supervision, Informal Supervision etc.

Semi-supervised detection of intracranial pressure alarms using waveform dynamics

International Nuclear Information System (INIS)

Scalzo, Fabien; Hu, Xiao

2013-01-01

Patient monitoring systems in intensive care units (ICU) are usually set to trigger alarms when abnormal values are detected. Alarms are generated by threshold-crossing rules that lead to high false alarm rates. This is a recognized issue that causes alarm fatigue, waste of human resources, and increased patient risks. Recently developed smart alarm models require alarms to be validated by experts during the training phase. The manual annotation process involved is time-consuming and virtually impossible to achieve for the thousands of alarms recorded in the ICU every week. To tackle this problem, we investigate in this study if the use of semi-supervised learning methods, that can naturally integrate unlabeled data samples in the model, can be used to improve the accuracy of the alarm detection. As a proof of concept, the detection system is evaluated on intracranial pressure (ICP) signal alarms. Specific morphological and trending features are extracted from the ICP signal waveform to capture the dynamic of the signal prior to alarms. This study is based on a comprehensive dataset of 4791 manually labeled alarms recorded from 108 neurosurgical patients. A comparative analysis is provided between kernel spectral regression (SR-KDA) and support vector machine (SVM) both modified for the semi-supervised setting. Results obtained during the experimental evaluations indicate that the two models can significantly reduce false alarms using unlabeled samples; especially in the presence of a restrained number of labeled examples. At a true alarm recognition rate of 99%, the false alarm reduction rates improved from 9% (supervised) to 27% (semi-supervised) for SR-KDA, and from 3% (supervised) to 16% (semi-supervised) for SVM. (paper)

A systematic review of supportive supervision as a strategy to improve primary healthcare services in Sub-Saharan Africa.

Science.gov (United States)

Bailey, Claire; Blake, Carolyn; Schriver, Michael; Cubaka, Vincent Kalumire; Thomas, Tisa; Martin Hilber, Adriane

2016-01-01

It may be assumed that supportive supervision effectively builds capacity, improves the quality of care provided by frontline health workers, and positively impacts clinical outcomes. Evidence on the role of supervision in Sub-Saharan Africa has been inconclusive, despite the critical need to maximize the workforce in low-resource settings. To review the published literature from Sub-Saharan Africa on the effects of supportive supervision on quality of care, and health worker motivation and performance. A systematic review of seven databases of both qualitative and quantitative studies published in peer-reviewed journals. Selected studies were based in primary healthcare settings in Sub-Saharan Africa and present primary data concerning supportive supervision. Thematic synthesis where data from the identified studies were grouped and interpreted according to prominent themes. Supportive supervision can increase job satisfaction and health worker motivation. Evidence is mixed on whether this translates to increased clinical competence and there is little evidence of the effect on clinical outcomes. Results highlight the lack of sound evidence on the effects of supportive supervision owing to limitations in research design and the complexity of evaluating such interventions. The approaches required a high level of external inputs, which challenge the sustainability of such models. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Comparing minimally supervised home-based and closely supervised gym-based exercise programs in weight reduction and insulin resistance after bariatric surgery: A randomized clinical trial.

Science.gov (United States)

Kaviani, Sara; Dadgostar, Haleh; Mazaherinezhad, Ali; Adib, Hanie; Solaymani-Dodaran, Masoud; Soheilipour, Fahimeh; Hakiminezhad, Mahdi

2017-01-01

Background: Effectiveness of various exercise protocols in weight reduction after bariatric surgery has not been sufficiently explored in the literature. Thus, in the present study, we aimed at comparing the effect of minimally supervised home-based and closely supervised gym-based exercise programs on weight reduction and insulin resistance after bariatric surgery. Methods: Females undergoing gastric bypass surgery were invited to participate in an exercise program and were randomly allocated into 2 groups using a random number generator in Excel. They were either offered a minimally supervised home-based (MSHB) or closely supervised gym-based (CSGB) exercise program. The CSGB protocol constitutes 2 weekly training sessions under ACSM guidelines. In the MSHB protocol, the participants received a notebook containing a list of recommended aerobic and resistance exercises, a log to record their activity, and a schedule of follow-up phone calls and clinic visits. Both groups received a pedometer. We measured their weight, BMI, lipid profile, FBS, and insulin level at baseline and at 20 weeks after the exercises, the results of which were compared using t test or Mann-Whitney U test at the end of the study. All the processes were observed by 1 senior resident in sport medicine. Results: A total of 80 patients were recruited who were all able to complete our study (MSHB= 38 and CSGB= 42). The baseline comparison revealed that the 2 groups were similar. The mean change (reduction) in BMI was slightly better in CSGB (8.61 95% CI 7.76-9.45) compared with the MSHB (5.18 95% CI 3.91-6.46); p< 0.01. However, the 2 groups did not have a statistically significant difference in the amount of change in the other factors including FBS and Homa.ir. Conclusion: As we expected a non-inferiority result, our results showed that both MSHB and CSGB exercise methods are somewhat equally effective in improving lipid profile and insulin resistance in the 2 groups, but a slightly better

20 CFR 656.21 - Supervised recruitment.

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Supervised recruitment. 656.21 Section 656.21... Supervised recruitment. (a) Supervised recruitment. Where the Certifying Officer determines it appropriate, post-filing supervised recruitment may be required of the employer for the pending application or...

Identifying drivers of overall satisfaction in patients receiving HIV primary care: a cross-sectional study.

Directory of Open Access Journals (Sweden)

Bich N Dang

Full Text Available OBJECTIVE: This study seeks to understand the drivers of overall patient satisfaction in a predominantly low-income, ethnic-minority population of HIV primary care patients. The study's primary aims were to determine 1 the component experiences which contribute to patients' evaluations of their overall satisfaction with care received, and 2 the relative contribution of each component experience in explaining patients' evaluation of overall satisfaction. METHODS: We conducted a cross-sectional study of 489 adult patients receiving HIV primary care at two clinics in Houston, Texas, from January 13-April 21, 2011. The participation rate among eligible patients was 94%. The survey included 15 questions about various components of the care experience, 4 questions about the provider experience and 3 questions about overall care. To ensure that the survey was appropriately tailored to our clinic population and the list of component experiences reflected all aspects of the care experience salient to patients, we conducted in-depth interviews with key providers and clinic staff and pre-tested the survey instrument with patients. RESULTS: Patients' evaluation of their provider correlated the strongest with their overall satisfaction (standardized β = 0.445, p<0.001 and accounted for almost half of the explained variance. Access and availability, like clinic hours and ease of calling the clinic, also correlated with overall satisfaction, but less strongly. Wait time and parking, despite receiving low patient ratings, did not correlate with overall satisfaction. CONCLUSIONS: The patient-provider relationship far exceeds other component experiences of care in its association with overall satisfaction. Our study suggests that interventions to improve overall patient satisfaction should focus on improving patients' evaluation of their provider.

Supervision Duty of School Principals

Directory of Open Access Journals (Sweden)

Kürşat YILMAZ

2009-04-01

Full Text Available Supervision by school administrators is becoming more and more important. The change in the roles ofschool administrators has a great effect on that increase. At present, school administrators are consideredmore than as technical directors, but as instructional leaders. This increased the importance of schooladministrators’ expected supervision acts. In this respect, the aim of this study is to make a conceptualanalysis about school administrators’ supervision duties. For this reason, a literature review related withsupervision and contemporary supervision approaches was done, and the official documents concerningsupervision were examined. As a result, it can be said that school administrators’ supervision duties havebecome very important. And these duties must certainly be carried out by school administrators.

A SURVEY OF SEMI-SUPERVISED LEARNING

OpenAIRE

Amrita Sadarangani *, Dr. Anjali Jivani

2016-01-01

Semi Supervised Learning involves using both labeled and unlabeled data to train a classifier or for clustering. Semi supervised learning finds usage in many applications, since labeled data can be hard to find in many cases. Currently, a lot of research is being conducted in this area. This paper discusses the different algorithms of semi supervised learning and then their advantages and limitations are compared. The differences between supervised classification and semi-supervised classific...

Moment constrained semi-supervised LDA

DEFF Research Database (Denmark)

Loog, Marco

2012-01-01

This BNAIC compressed contribution provides a summary of the work originally presented at the First IAPR Workshop on Partially Supervised Learning and published in [5]. It outlines the idea behind supervised and semi-supervised learning and highlights the major shortcoming of many current methods...

75 FR 45011 - MainStreet Savings Bank, FSB, Hastings, MI; Notice of Appointment of Receiver

Science.gov (United States)

2010-07-30

... DEPARTMENT OF THE TREASURY Office of Thrift Supervision MainStreet Savings Bank, FSB, Hastings, MI... section 5(d)(2) of the Home Owners' Loan Act, the Office of Thrift Supervision has duly appointed the Federal Deposit Insurance Corporation as sole Receiver for MainStreet Savings Bank, Hastings, Michigan...

75 FR 47899 - Bayside Savings Bank, Port St. Joe, FL; Notice of Appointment of Receiver

Science.gov (United States)

2010-08-09

... DEPARTMENT OF THE TREASURY Office of Thrift Supervision Bayside Savings Bank, Port St. Joe, FL... section 5(d)(2) of the Home Owners' Loan Act, the Office of Thrift Supervision has duly appointed the Federal Deposit Insurance Corporation as sole Receiver for Bayside Savings Bank, Port St. Joe, Florida...

Alcohol in Primary Care. Differential characteristics between alcohol-dependent patients who are receiving or not receiving treatment.

Science.gov (United States)

Barrio, Pablo; Miquel, Laia; Moreno-España, Jose; Martínez, Alicia; Ortega, Lluisa; Teixidor, Lidia; Manthey, Jakob; Rehm, Jürgen; Gual, Antoni

2016-03-02

primary health care services for other reasons. The aim of the present study is to describe the differential characteristics of AD patients in primary care, distinguishing between those who receive treatment and those who do not, and their reasons for not seeking it. In a cross-sectional study patients were evaluated by their general practitioner (GP) and interviewed by a member of the research team. Sociodemographic, diagnostic and clinical data were collected. From 1,372 patients interviewed in Catalonia, 118 (8.6%) were diagnosed as AD. These patients showed a lower socioeconomic status (48.3% vs 33.3%, odds ratio 2.02), higher unemployment rates (32.2% vs 19.2 %, odds ratio 2.11), and greater psychological distress and disability. Patients with AD receiving treatment (16.9%), were older (44 vs 36 years of age), reported higher unemployment rates (66% vs 25.5%, odds ratio 6.32) and higher daily alcohol consumption (61.5 vs 23.7 grams), suggesting a more advanced disease. Patients with AD in general showed a higher degree of comorbidity compared to other patients, with patients in treatment showing the most elevated level. The main reasons given for not seeking treatment were shame, fear of giving up drinking and barriers to treatment. Taken together, the data suggest the need to implement earlier strategies for the detection and treatment of AD.

Reiki Therapy for Symptom Management in Children Receiving Palliative Care: A Pilot Study.

Science.gov (United States)

Thrane, Susan E; Maurer, Scott H; Ren, Dianxu; Danford, Cynthia A; Cohen, Susan M

2017-05-01

Pain may be reported in one-half to three-fourths of children with cancer and other terminal conditions and anxiety in about one-third of them. Pharmacologic methods do not always give satisfactory symptom relief. Complementary therapies such as Reiki may help children manage symptoms. This pre-post mixed-methods single group pilot study examined feasibility, acceptability, and the outcomes of pain, anxiety, and relaxation using Reiki therapy with children receiving palliative care. A convenience sample of children ages 7 to 16 and their parents were recruited from a palliative care service. Two 24-minute Reiki sessions were completed at the children's home. Paired t tests or Wilcoxon signed-rank tests were calculated to compare change from pre to post for outcome variables. Significance was set at P Reiki therapy did decrease pain, anxiety, heart, and respiratory rates, but small sample size deterred statistical significance. This preliminary work suggests that complementary methods of treatment such as Reiki may be beneficial to support traditional methods to manage pain and anxiety in children receiving palliative care.

Parent and Adolescent Interest in Receiving Adolescent Health Communication Information From Primary Care Clinicians.

Science.gov (United States)

Ford, Carol A; Cheek, Courtney; Culhane, Jennifer; Fishman, Jessica; Mathew, Leny; Salek, Elyse C; Webb, David; Jaccard, James

2016-08-01

Patient-centered health care recognizes that adolescents and parents are stakeholders in adolescent health. We investigate adolescent and parent interest in receiving information about health topics and parent-teen communication from clinicians. Ninety-one parent-adolescent dyads in one practice completed individual interviews. Items assessed levels of interest in receiving health and health communication information from the adolescent's doctor about 18 topics, including routine, mental health, sexual health, substance use, and injury prevention issues. Analyses tested differences between parents and adolescents, within-dyad correlations, and associations with adolescent gender and age. Most parents were female (84%). Adolescents were evenly divided by gender; 36 were aged 12-13 years, 35 were aged 14-15 years, and 20 were aged 16-17 years. Adolescent race reflected the practice population (60% black; 35% white). The vast majority of parents and adolescents reported moderate or high levels of interest in receiving information about all 18 health issues and information to increase parent-teen communication about these topics. Parents' interest in receiving information varied by adolescent age when the expected salience of topics varied by age (e.g., acne, driving safety), whereas adolescents reported similar interest regardless of age. Adolescent gender influenced parent and adolescent interest. Level of interest in receiving information from doctors within adolescent-parent pairs was not significantly correlated for one-half of topics. Parents and adolescents want health care professionals to help them learn and talk about a wide range of adolescent health topics. Feasible primary care interventions that effectively improve parent-teen health communication, and specific adolescent health outcomes are needed. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Asco 2044 nuclear power plant: supervision; Central nuclear Asco 2044: supervision

Energy Technology Data Exchange (ETDEWEB)

Sabartes, J.

2010-07-01

Good supervision constitutes an efficient barrier to avoid the errors caused by inadequate work practices. In this sense, it is necessary to strengthen supervision to make sure that the work is carried out with adequate human performance, tending to avoid error ande provinding safety quality and efficiency at work. (Author).

Whither Supervision?

OpenAIRE

Duncan Waite

2006-01-01

This paper inquires if the school supervision is in decadence. Dr. Waite responds that the answer will depend on which perspective you look at it. Dr. Waite suggests taking in consideration three elements that are related: the field itself, the expert in the field (the professor, the theorist, the student and the administrator), and the context. When these three elements are revised, it emphasizes that there is not a consensus about the field of supervision, but there are coincidences related...

Effects of coaching supervision, mentoring supervision and abusive supervision on talent development among trainee doctors in public hospitals: moderating role of clinical learning environment.

Science.gov (United States)

Subramaniam, Anusuiya; Silong, Abu Daud; Uli, Jegak; Ismail, Ismi Arif

2015-08-13

Effective talent development requires robust supervision. However, the effects of supervisory styles (coaching, mentoring and abusive supervision) on talent development and the moderating effects of clinical learning environment in the relationship between supervisory styles and talent development among public hospital trainee doctors have not been thoroughly researched. In this study, we aim to achieve the following, (1) identify the extent to which supervisory styles (coaching, mentoring and abusive supervision) can facilitate talent development among trainee doctors in public hospital and (2) examine whether coaching, mentoring and abusive supervision are moderated by clinical learning environment in predicting talent development among trainee doctors in public hospital. A questionnaire-based critical survey was conducted among trainee doctors undergoing housemanship at six public hospitals in the Klang Valley, Malaysia. Prior permission was obtained from the Ministry of Health Malaysia to conduct the research in the identified public hospitals. The survey yielded 355 responses. The results were analysed using SPSS 20.0 and SEM with AMOS 20.0. The findings of this research indicate that coaching and mentoring supervision are positively associated with talent development, and that there is no significant relationship between abusive supervision and talent development. The findings also support the moderating role of clinical learning environment on the relationships between coaching supervision-talent development, mentoring supervision-talent development and abusive supervision-talent development among public hospital trainee doctors. Overall, the proposed model indicates a 26 % variance in talent development. This study provides an improved understanding on the role of the supervisory styles (coaching and mentoring supervision) on facilitating talent development among public hospital trainee doctors. Furthermore, this study extends the literature to better

Advanced Music Therapy Supervision Training

DEFF Research Database (Denmark)

Pedersen, Inge Nygaard

2009-01-01

supervision training excerpts live in the workshop will be offered. The workshop will include demonstrating a variety of supervision methods and techniques used in A) post graduate music therapy training programs b) a variety of work contexts such as psychiatry and somatic music psychotherapy. The workshop......The presentation will illustrate training models in supervision for experienced music therapists where transference/counter transference issues are in focus. Musical, verbal and body related tools will be illustrated from supervision practice by the presenters. A possibility to experience small...

Multimodal supervision programme to reduce catheter associated urinary tract infections and its analysis to enable focus on labour and cost effective infection control measures in a tertiary care hospital in India.

Science.gov (United States)

Jaggi, Namita; Sissodia, Pushpa

2012-10-01

Catheter Associated Urinary Tract Infections (CAUTI) contribute 30%-40% of all the nosocomial infections and they are associated with substantially increased institutional death rates. A multimodal supervision program which incorporates training of the staff with respect to infection control measures can be effective in reducing the CAUTIs in hospitals. To assess the impact of a multimodal UTI supervision program on the CAUTI rates over a year, from January 2009 to December 2009, in a tertiary care hospital in India. A 215 bedded tertiary care private hospital. The CAUTI rates were analyzed for the first 6 months (January 2009-June 2009). A UTI supervision program was instituted in the month of July 2009, which included training with respect to the standard protocols for the sample collection and diagnosis, the bundle components of the urinary catheter checklist and hand hygiene practices. The impact was assessed as per the CAUTI rates in the subsequent months. The average CAUTI rate was reduced by 47.1% (from 10.6 to 5.6) after the introduction of the supervision program. This study presented the mean age of the patients with CAUTIs as 54.5 years and it showed an approximately equal contribution of both the sexes (52.94% in males and 47.05% in females). The impact analysis of the supervision program showed a reduction of 8.7% (from 23 days to 21 days) during the average duration of the catheterization. The adherence to the components of the urinary catheter check list was increased by 44.4% (p=0.069) and the hand hygiene compliance was increased by 56.4% (p=0.004) respectively after the interventions. Components like bladder irrigation and practising perineal cleaning were found to show no effect on the CAUTI rates. The most common labour and cost effective infection control measures as revealed by the supervision programme were adherence to the urinary catheter checklist components (indication for catheter insertion and change, asepsis maintenance during and

75 FR 9646 - La Jolla Bank, FSB, La Jolla, CA; Notice of Appointment of Receiver

Science.gov (United States)

2010-03-03

... DEPARTMENT OF THE TREASURY Office of Thrift Supervision La Jolla Bank, FSB, La Jolla, CA; Notice... section 5(d)(2) of the Home Owners' Loan Act, the Office of Thrift Supervision (OTS) has duly appointed the Federal Deposit Insurance Corporation as sole Receiver for La Jolla Bank, FSB, La Jolla...

International Doctoral Students in Counselor Education: Coping Strategies in Supervision Training

Science.gov (United States)

Woo, Hongryun; Jang, Yoo Jin; Henfield, Malik S.

2015-01-01

This study explores 8 international doctoral students' perceptions of coping strategies used in supervision training in counselor education programs. Using human agency as a conceptual framework, the authors found 3 categories: (a) personal and professional self-directed strategies as personal agency, (b) support and care from mentors as proxy…

Older persons' experiences and perspectives of receiving social care: a systematic review of the qualitative literature.

Science.gov (United States)

de São José, José; Barros, Rosanna; Samitca, Sanda; Teixeira, Ana

2016-01-01

The topic of social care for older people has gained increasing attention from the part of academics, professionals, policy makers and media. However, we know little about this topic from the perspectives of older persons, which hinders future developments in terms of theory, empirical research, professional practice and social policy. This article presents and discusses a systematic review of relevant qualitative research-based evidence on the older persons' experiences and perspectives of receiving social care published between 1990 and September 2014. This review aimed to obtain answers to the following questions: How is the reception of social care experienced by the older persons? What are the negative and positive aspects of these experiences? What are the factors which influence the experiences? The synthesis of the findings of reviewed papers identified six analytical themes: asking for care as a major challenge; ambivalences; (dis)engagement in decisions concerning care; multiple losses as outcomes of receiving social care; multiple strategies to deal with losses originated by the ageing process; and properties of 'good care'. These themes are discussed from the point of view of their implications for theory, care practice and social policy, and future research. © 2015 John Wiley & Sons Ltd.

Using a Mixed Model to Explore Evaluation Criteria for Bank Supervision: A Banking Supervision Law Perspective.

Directory of Open Access Journals (Sweden)

Sang-Bing Tsai

Full Text Available Financial supervision means that monetary authorities have the power to supervise and manage financial institutions according to laws. Monetary authorities have this power because of the requirements of improving financial services, protecting the rights of depositors, adapting to industrial development, ensuring financial fair trade, and maintaining stable financial order. To establish evaluation criteria for bank supervision in China, this study integrated fuzzy theory and the decision making trial and evaluation laboratory (DEMATEL and proposes a fuzzy-DEMATEL model. First, fuzzy theory was applied to examine bank supervision criteria and analyze fuzzy semantics. Second, the fuzzy-DEMATEL model was used to calculate the degree to which financial supervision criteria mutually influenced one another and their causal relationship. Finally, an evaluation criteria model for evaluating bank and financial supervision was established.

Using a Mixed Model to Explore Evaluation Criteria for Bank Supervision: A Banking Supervision Law Perspective

Science.gov (United States)

Tsai, Sang-Bing; Chen, Kuan-Yu; Zhao, Hongrui; Wei, Yu-Min; Wang, Cheng-Kuang; Zheng, Yuxiang; Chang, Li-Chung; Wang, Jiangtao

2016-01-01

Financial supervision means that monetary authorities have the power to supervise and manage financial institutions according to laws. Monetary authorities have this power because of the requirements of improving financial services, protecting the rights of depositors, adapting to industrial development, ensuring financial fair trade, and maintaining stable financial order. To establish evaluation criteria for bank supervision in China, this study integrated fuzzy theory and the decision making trial and evaluation laboratory (DEMATEL) and proposes a fuzzy-DEMATEL model. First, fuzzy theory was applied to examine bank supervision criteria and analyze fuzzy semantics. Second, the fuzzy-DEMATEL model was used to calculate the degree to which financial supervision criteria mutually influenced one another and their causal relationship. Finally, an evaluation criteria model for evaluating bank and financial supervision was established. PMID:27992449

Implementation experience during an eighteen month intervention to improve paediatric and newborn care in Kenyan district hospitals

Directory of Open Access Journals (Sweden)

Wamae Annah

2009-07-01

Full Text Available Abstract Background We have conducted an intervention study aiming to improve hospital care for children and newborns in Kenya. In judging whether an intervention achieves its aims, an understanding of how it is delivered is essential. Here, we describe how the implementation team delivered the intervention over 18 months and provide some insight into how health workers, the primary targets of the intervention, received it. Methods We used two approaches. First, a description of the intervention is based on an analysis of records of training, supervisory and feedback visits to hospitals, and brief logs of key topics discussed during telephone calls with local hospital facilitators. Record keeping was established at the start of the study for this purpose with analyses conducted at the end of the intervention period. Second, we planned a qualitative study nested within the intervention project and used in-depth interviews and small group discussions to explore health worker and facilitators' perceptions of implementation. After thematic analysis of all interview data, findings were presented, discussed, and revised with the help of hospital facilitators. Results Four hospitals received the full intervention including guidelines, training and two to three monthly support supervision and six monthly performance feedback visits. Supervisor visits, as well as providing an opportunity for interaction with administrators, health workers, and facilitators, were often used for impromptu, limited refresher training or orientation of new staff. The personal links that evolved with senior staff seemed to encourage local commitment to the aims of the intervention. Feedback seemed best provided as open meetings and discussions with administrators and staff. Supervision, although sometimes perceived as fault finding, helped local facilitators become the focal point of much activity including key roles in liaison, local monitoring and feedback, problem solving

Supervision in banking industry

OpenAIRE

Šmída, David

2012-01-01

The aim of submitted thesis Supervision in banking is to define the nature and the importance of banking supervision, to justify its existence and to analyze the applicable mechanisms while the system of banking regulation and supervision in this thesis is primarily examined in the European context, with a focus on the Czech Republic. The thesis is divided into five main chapters. The first chapter is devoted to the financial system and the importance of banks in this system, it defines the c...

17 CFR 166.3 - Supervision.

Science.gov (United States)

2010-04-01

... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Supervision. 166.3 Section 166.3 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION CUSTOMER PROTECTION RULES § 166.3 Supervision. Each Commission registrant, except an associated person who has no supervisory duties, must diligently supervise the handling b...

Problems in the Research Problem: Critical Feedback and Resistance in Academic Supervision

Science.gov (United States)

Vehvilainen, Sanna

2009-01-01

The paper focuses on a routine activity of academic supervision: Giving and receiving feedback based on the student's master's thesis manuscript. Two case analyses are presented on fundamentally critical feedback. Such feedback constitutes a recommendation to the student to seriously rethink the thesis, but there are various interactional…

28 CFR 810.1 - Supervision contact requirements.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Supervision contact requirements. 810.1 Section 810.1 Judicial Administration COURT SERVICES AND OFFENDER SUPERVISION AGENCY FOR THE DISTRICT OF COLUMBIA COMMUNITY SUPERVISION: ADMINISTRATIVE SANCTIONS § 810.1 Supervision contact requirements. If you are an offender under supervision by th...

Empirical study of supervised gene screening

Directory of Open Access Journals (Sweden)

Ma Shuangge

2006-12-01

Full Text Available Abstract Background Microarray studies provide a way of linking variations of phenotypes with their genetic causations. Constructing predictive models using high dimensional microarray measurements usually consists of three steps: (1 unsupervised gene screening; (2 supervised gene screening; and (3 statistical model building. Supervised gene screening based on marginal gene ranking is commonly used to reduce the number of genes in the model building. Various simple statistics, such as t-statistic or signal to noise ratio, have been used to rank genes in the supervised screening. Despite of its extensive usage, statistical study of supervised gene screening remains scarce. Our study is partly motivated by the differences in gene discovery results caused by using different supervised gene screening methods. Results We investigate concordance and reproducibility of supervised gene screening based on eight commonly used marginal statistics. Concordance is assessed by the relative fractions of overlaps between top ranked genes screened using different marginal statistics. We propose a Bootstrap Reproducibility Index, which measures reproducibility of individual genes under the supervised screening. Empirical studies are based on four public microarray data. We consider the cases where the top 20%, 40% and 60% genes are screened. Conclusion From a gene discovery point of view, the effect of supervised gene screening based on different marginal statistics cannot be ignored. Empirical studies show that (1 genes passed different supervised screenings may be considerably different; (2 concordance may vary, depending on the underlying data structure and percentage of selected genes; (3 evaluated with the Bootstrap Reproducibility Index, genes passed supervised screenings are only moderately reproducible; and (4 concordance cannot be improved by supervised screening based on reproducibility.

32 CFR 727.11 - Supervision.

Science.gov (United States)

2010-07-01

... 32 National Defense 5 2010-07-01 2010-07-01 false Supervision. 727.11 Section 727.11 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL LEGAL ASSISTANCE § 727.11 Supervision. The Judge Advocate General will exercise supervision over all legal assistance activities in the Department of the Navy. Subject to the...

The perceptions of nurses in a district health system in KwaZulu-Natal of their supervision, self-esteem and job satisfaction.

Science.gov (United States)

Uys, L R; Minnaar, A; Reid, S; Naidoo, J R

2004-05-01

Supervision has been identified as a major issue in quality of care. Although increasing attention is being given to supervision in the District Health System, there have been no studies describing the current situation. This article describes a survey done in two health districts in KwaZulu-Natal involving 319 nurses from all types of government health care settings. This was a quantitative descriptive study that described the current supervision, job satisfaction and self-esteem in two (2) health districts, that is the Ugu and the uThukela health districts. The three variables were described using a mailed questionnaire. A total 319 nurses participated in this study. The majority of the nurses (53%) felt that positive supervision behaviours listed in a rating scale, occurred never or seldom. The average self-esteem score was very positive (83%), and the average job satisfaction score was 60%. Nurses were most satisfied with the factor reflecting "personal satisfaction about their contribution to the work" (72%) and the least satisfaction with the factor that has to do with "pay and prospects" (50%). While there was no relationship between any of the demographic variables and supervision, there was a low but significant relationship between supervision and job-satisfaction. A significant relationship was also found between the personal satisfaction factor of job satisfaction and self-esteem. As nurses form the backbone of the health services, it is incumbent that health service managers safeguard the nursing workforce. Targeted strategies are necessary to ensure retention of the nurses for the health care of the South African population.

75 FR 21391 - First Federal Bank of North Florida; Palatka, FL; Notice of Appointment of Receiver

Science.gov (United States)

2010-04-23

... DEPARTMENT OF THE TREASURY Office of Thrift Supervision First Federal Bank of North Florida... contained in section 5(d)(2) of the Home Owners' Loan Act, the Office of Thrift Supervision has duly appointed the Federal Deposit Insurance Corporation as sole Receiver for First Federal Bank of North Florida...

The role of supervision in the training of behavior therapists: Case study

Directory of Open Access Journals (Sweden)

Raquel Martins Sartori

2014-08-01

Full Text Available The therapeutic process therapist requires skills that go beyond the theoretical and technical knowledge, the therapeutic relationship is a prerequisite for the success of behavioral psychotherapy variable. Supervision of clinical care is a fundamental skill development of the future therapist educational resource as well as to increase the supply conditions of a more appropriate psychotherapeutic customer service. The article reports on supervisory experience in the first client of a therapist in training showed behavioral patterns of aggression. The default client produced in therapist behaviors and feelings that hindered progress and therapeutic success. Supervision thus occupied a role in analyzing and modeling the behavior therapist as a strategy to increase the chances of success of the case. As a result of the strategies adopted in supervision, there were changes in the pattern of interaction between therapist and client training with his progress in the case.

The vision in supervision: transference-countertransference dynamics and disclosure in the supervision relationship.

Science.gov (United States)

Coburn, W J

1997-01-01

The centrality of the supervision experience in the development of the supervisee's personal and professional capacities is addressed. The supervision relationship and process are explored in light of the potential effects of transference-countertransference configurations of supervisor and supervisee. Parallels between supervision and treatment are highlighted. The importance of developing and utilizing the capacity for reflectivity is reviewed, as is the impact of supervisee nondisclosure to supervisor. The direct use of countertransference experiences in the context of supervision is explored, and the centrality of self-disclosure is highlighted. It is recommended that supervisor and supervisee remain receptive to exploring these experiences in the service of developing a shared subjective sense of the patient, of increasing the supervisee's capacity to treat his or her patient, and of providing the supervisee with a novel, growth-enhancing relationship.

“They put you on your toes”: Physical Therapists' Perceived Benefits from and Barriers to Supervising Students in the Clinical Setting

Science.gov (United States)

Hanna, Elizabeth; Cott, Cheryl

2011-01-01

ABSTRACT Purpose: To identify the perceived benefits of and barriers to clinical supervision of physical therapy (PT) students. Method: In this qualitative descriptive study, three focus groups and six key-informant interviews were conducted with clinical physical therapists or administrators working in acute care, orthopaedic rehabilitation, or complex continuing care. Data were coded and analyzed for common ideas using a constant comparison approach. Results: Perceived barriers to supervising students tended to be extrinsic: time and space constraints, challenging or difficult students, and decreased autonomy or flexibility for the clinical physical therapists. Benefits tended to be intrinsic: teaching provided personal gratification by promoting reflective practice and exposing clinical educators to current knowledge. The culture of different health care institutions was an important factor in therapists' perceptions of student supervision. Conclusions: Despite different disciplines and models of supervision, there is considerable synchronicity in the issues reported by physical therapists and other disciplines. Embedding the value of clinical teaching in the institution, along with strong communication links among academic partners, institutions, and potential clinical faculty, may mitigate barriers and increase the commitment and satisfaction of teaching staff. PMID:22379263

76 FR 28130 - Coastal Bank, Cocoa Beach, Florida; Notice of Appointment of Receiver

Science.gov (United States)

2011-05-13

... DEPARTMENT OF THE TREASURY Office of Thrift Supervision Coastal Bank, Cocoa Beach, Florida; Notice of Appointment of Receiver Notice is hereby given that, pursuant to the authority contained in... Federal Deposit Insurance Corporation as sole Receiver for Coastal Bank, Cocoa Beach, Florida, (OTS No...

Clinical effectiveness of collaborative care for depression in UK primary care (CADET): cluster randomised controlled trial.

Science.gov (United States)

Richards, David A; Hill, Jacqueline J; Gask, Linda; Lovell, Karina; Chew-Graham, Carolyn; Bower, Peter; Cape, John; Pilling, Stephen; Araya, Ricardo; Kessler, David; Bland, J Martin; Green, Colin; Gilbody, Simon; Lewis, Glyn; Manning, Chris; Hughes-Morley, Adwoa; Barkham, Michael

2013-08-19

To compare the clinical effectiveness of collaborative care with usual care in the management of patients with moderate to severe depression. Cluster randomised controlled trial. 51 primary care practices in three primary care districts in the United Kingdom. 581 adults aged 18 years and older who met ICD-10 (international classification of diseases, 10th revision) criteria for a depressive episode on the revised Clinical Interview Schedule. We excluded acutely suicidal patients and those with psychosis, or with type I or type II bipolar disorder; patients whose low mood was associated with bereavement or whose primary presenting problem was alcohol or drug abuse; and patients receiving psychological treatment for their depression by specialist mental health services. We identified potentially eligible participants by searching computerised case records in general practices for patients with depression. Collaborative care, including depression education, drug management, behavioural activation, relapse prevention, and primary care liaison, was delivered by care managers. Collaborative care involved six to 12 contacts with participants over 14 weeks, supervised by mental health specialists. Usual care was family doctors' standard clinical practice. Depression symptoms (patient health questionnaire 9; PHQ-9), anxiety (generalised anxiety disorder 7; GAD-7), and quality of life (short form 36 questionnaire; SF-36) at four and 12 months; satisfaction with service quality (client satisfaction questionnaire; CSQ-8) at four months. 276 participants were allocated to collaborative care and 305 allocated to usual care. At four months, mean depression score was 11.1 (standard deviation 7.3) for the collaborative care group and 12.7 (6.8) for the usual care group. After adjustment for baseline depression, mean depression score was 1.33 PHQ-9 points lower (95% confidence interval 0.35 to 2.31, P=0.009) in participants receiving collaborative care than in those receiving usual

Supervision som undervisningsform i voksenspecialundervisningen

DEFF Research Database (Denmark)

Kristensen, René

2000-01-01

Supervision som undervisningsform i voksenspecialundervisningen. Procesarbejde i undervisning af voksne.......Supervision som undervisningsform i voksenspecialundervisningen. Procesarbejde i undervisning af voksne....

Multi combined Adlerian supervision in Counseling

OpenAIRE

Gungor, Abdi

2017-01-01

For counselor professional and counselor education, supervision is an important process, in which more experienced professional helps and guides less experienced professional. To provide an effective and beneficial supervision, various therapy, development, or process based approaches and models have been developed. In addition, different eclectic models integrating more than one model have been developed. In this paper, as a supervision model, multi combined Adlerian supervision model is pro...

Learning Dynamics in Doctoral Supervision

DEFF Research Database (Denmark)

Kobayashi, Sofie

investigates learning opportunities in supervision with multiple supervisors. This was investigated through observations and recording of supervision, and subsequent analysis of transcripts. The analyses used different perspectives on learning; learning as participation, positioning theory and variation theory....... The research illuminates how learning opportunities are created in the interaction through the scientific discussions. It also shows how multiple supervisors can contribute to supervision by providing new perspectives and opinions that have a potential for creating new understandings. The combination...... of different theoretical frameworks from the perspectives of learning as individual acquisition and a sociocultural perspective on learning contributed to a nuanced illustration of the otherwise implicit practices of supervision....

Supervision and group dynamics

DEFF Research Database (Denmark)

Hansen, Søren; Jensen, Lars Peter

2004-01-01

 An important aspect of the problem based and project organized study at Aalborg University is the supervision of the project groups. At the basic education (first year) it is stated in the curriculum that part of the supervisors' job is to deal with group dynamics. This is due to the experience...... that many students are having difficulties with practical issues such as collaboration, communication, and project management. Most supervisors either ignore this demand, because they do not find it important or they find it frustrating, because they do not know, how to supervise group dynamics...... as well as at Aalborg University. The first visible result has been participating supervisors telling us that the course has inspired them to try supervising group dynamics in the future. This paper will explore some aspects of supervising group dynamics as well as, how to develop the Aalborg model...

The representations puerperal women have about the care they received during labor

Directory of Open Access Journals (Sweden)

Laura Pinto Torres de Melo

2018-01-01

Full Text Available Objective: to describe the social representations puerperal women have about the care they received during labor and delivery. Methodology: this is a descriptive study, based on the Theory of the Central Nucleus, which was undertaken with 119 women in the postpartum period in a public maternity hospital, located in the city of Fortaleza, Ceará, Brazil. The data were collected through the Free Word Association Test, which included as inductive stimuli: care, labor, delivery and care in labor and delivery. The data were transcribed and analyzed with Evoc software. Results: the structural analysis showed that the words “pain”, “happiness” and “guidance” ocurred more frequency as a central feature of the respective inducing terms. Conclusion: the results confirm that the moment of labor and delivery is crucial for nurses in the planning and implementation of adequate care during parturition insofar, as such measures lessen the impact of negative representations of childbirth.

Quasi-supervised scoring of human sleep in polysomnograms using augmented input variables.

Science.gov (United States)

Yaghouby, Farid; Sunderam, Sridhar

2015-04-01

The limitations of manual sleep scoring make computerized methods highly desirable. Scoring errors can arise from human rater uncertainty or inter-rater variability. Sleep scoring algorithms either come as supervised classifiers that need scored samples of each state to be trained, or as unsupervised classifiers that use heuristics or structural clues in unscored data to define states. We propose a quasi-supervised classifier that models observations in an unsupervised manner but mimics a human rater wherever training scores are available. EEG, EMG, and EOG features were extracted in 30s epochs from human-scored polysomnograms recorded from 42 healthy human subjects (18-79 years) and archived in an anonymized, publicly accessible database. Hypnograms were modified so that: 1. Some states are scored but not others; 2. Samples of all states are scored but not for transitional epochs; and 3. Two raters with 67% agreement are simulated. A framework for quasi-supervised classification was devised in which unsupervised statistical models-specifically Gaussian mixtures and hidden Markov models--are estimated from unlabeled training data, but the training samples are augmented with variables whose values depend on available scores. Classifiers were fitted to signal features incorporating partial scores, and used to predict scores for complete recordings. Performance was assessed using Cohen's Κ statistic. The quasi-supervised classifier performed significantly better than an unsupervised model and sometimes as well as a completely supervised model despite receiving only partial scores. The quasi-supervised algorithm addresses the need for classifiers that mimic scoring patterns of human raters while compensating for their limitations. Copyright © 2015 Elsevier Ltd. All rights reserved.

Clinical Supervision in Denmark

DEFF Research Database (Denmark)

Jacobsen, Claus Haugaard

2011-01-01

Core Questionnaire (DPCCQ) has only few questions on supervision. To rectify this limitation, a recent Danish version of the DPCCQ included two new sections on supervision, one focusing on supervisees and another on supervisors and their supervisory training. This paper presents our initial findings...

Networks of Professional Supervision

Science.gov (United States)

Annan, Jean; Ryba, Ken

2013-01-01

An ecological analysis of the supervisory activity of 31 New Zealand school psychologists examined simultaneously the theories of school psychology, supervision practices, and the contextual qualities that mediated participants' supervisory actions. The findings indicated that the school psychologists worked to achieve the supervision goals of…

Supervised Convolutional Sparse Coding

KAUST Repository

Affara, Lama Ahmed

2018-04-08

Convolutional Sparse Coding (CSC) is a well-established image representation model especially suited for image restoration tasks. In this work, we extend the applicability of this model by proposing a supervised approach to convolutional sparse coding, which aims at learning discriminative dictionaries instead of purely reconstructive ones. We incorporate a supervised regularization term into the traditional unsupervised CSC objective to encourage the final dictionary elements to be discriminative. Experimental results show that using supervised convolutional learning results in two key advantages. First, we learn more semantically relevant filters in the dictionary and second, we achieve improved image reconstruction on unseen data.

Nurse supervisors' actions in relation to their decision-making style and ethical approach to clinical supervision.

Science.gov (United States)

Berggren, Ingela; Severinsson, Elisabeth

2003-03-01

The aim of the study was to explore the decision-making style and ethical approach of nurse supervisors by focusing on their priorities and interventions in the supervision process. Clinical supervision promotes ethical awareness and behaviour in the nursing profession. A focus group comprised of four clinical nurse supervisors with considerable experience was studied using qualitative hermeneutic content analysis. The essence of the nurse supervisors' decision-making style is deliberations and priorities. The nurse supervisors' willingness, preparedness, knowledge and awareness constitute and form their way of creating a relationship. The nurse supervisors' ethical approach focused on patient situations and ethical principles. The core components of nursing supervision interventions, as demonstrated in supervision sessions, are: guilt, reconciliation, integrity, responsibility, conscience and challenge. The nurse supervisors' interventions involved sharing knowledge and values with the supervisees and recognizing them as nurses and human beings. Nurse supervisors frequently reflected upon the ethical principle of autonomy and the concept and substance of integrity. The nurse supervisors used an ethical approach that focused on caring situations in order to enhance the provision of patient care. They acted as role models, shared nursing knowledge and ethical codes, and focused on patient related situations. This type of decision-making can strengthen the supervisees' professional identity. The clinical nurse supervisors in the study were experienced and used evaluation decisions as their form of clinical decision-making activity. The findings underline the need for further research and greater knowledge in order to improve the understanding of the ethical approach to supervision.

SemiBoost: boosting for semi-supervised learning.

Science.gov (United States)

Mallapragada, Pavan Kumar; Jin, Rong; Jain, Anil K; Liu, Yi

2009-11-01

Semi-supervised learning has attracted a significant amount of attention in pattern recognition and machine learning. Most previous studies have focused on designing special algorithms to effectively exploit the unlabeled data in conjunction with labeled data. Our goal is to improve the classification accuracy of any given supervised learning algorithm by using the available unlabeled examples. We call this as the Semi-supervised improvement problem, to distinguish the proposed approach from the existing approaches. We design a metasemi-supervised learning algorithm that wraps around the underlying supervised algorithm and improves its performance using unlabeled data. This problem is particularly important when we need to train a supervised learning algorithm with a limited number of labeled examples and a multitude of unlabeled examples. We present a boosting framework for semi-supervised learning, termed as SemiBoost. The key advantages of the proposed semi-supervised learning approach are: 1) performance improvement of any supervised learning algorithm with a multitude of unlabeled data, 2) efficient computation by the iterative boosting algorithm, and 3) exploiting both manifold and cluster assumption in training classification models. An empirical study on 16 different data sets and text categorization demonstrates that the proposed framework improves the performance of several commonly used supervised learning algorithms, given a large number of unlabeled examples. We also show that the performance of the proposed algorithm, SemiBoost, is comparable to the state-of-the-art semi-supervised learning algorithms.

Coupled dimensionality reduction and classification for supervised and semi-supervised multilabel learning.

Science.gov (United States)

Gönen, Mehmet

2014-03-01

Coupled training of dimensionality reduction and classification is proposed previously to improve the prediction performance for single-label problems. Following this line of research, in this paper, we first introduce a novel Bayesian method that combines linear dimensionality reduction with linear binary classification for supervised multilabel learning and present a deterministic variational approximation algorithm to learn the proposed probabilistic model. We then extend the proposed method to find intrinsic dimensionality of the projected subspace using automatic relevance determination and to handle semi-supervised learning using a low-density assumption. We perform supervised learning experiments on four benchmark multilabel learning data sets by comparing our method with baseline linear dimensionality reduction algorithms. These experiments show that the proposed approach achieves good performance values in terms of hamming loss, average AUC, macro F 1 , and micro F 1 on held-out test data. The low-dimensional embeddings obtained by our method are also very useful for exploratory data analysis. We also show the effectiveness of our approach in finding intrinsic subspace dimensionality and semi-supervised learning tasks.

31 CFR Appendix L to Subpart A of... - Office of Thrift Supervision

Science.gov (United States)

2010-07-01

... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Office of Thrift Supervision L Appendix L to Subpart A of Part 1 Money and Finance: Treasury Office of the Secretary of the Treasury.... Delivery of process. Service of process will be received by the Corporate Secretary of the Office of Thrift...

Educational Supervision Appropriate for Psychiatry Trainee's Needs

Science.gov (United States)

Rele, Kiran; Tarrant, C. Jane

2010-01-01

Objective: The authors studied the regularity and content of supervision sessions in one of the U.K. postgraduate psychiatric training schemes (Mid-Trent). Methods: A questionnaire sent to psychiatry trainees assessed the timing and duration of supervision, content and protection of supervision time, and overall quality of supervision. The authors…

Tværfaglig supervision

DEFF Research Database (Denmark)

Tværfaglig supervision dækker over supervision af forskellige faggrupper. Det er en kompleks disciplin der stiller store krav tl supervisor. Bogens første del præsenterer fire faglige supervisionsmodeller: En almen, en psykodynamisk, en kognitiv adfærdsterapeutisk og en narrativ. Anden del...

Methods of Feminist Family Therapy Supervision.

Science.gov (United States)

Prouty, Anne M.; Thomas, Volker; Johnson, Scott; Long, Janie K.

2001-01-01

Presents three supervision methods which emerged from a qualitative study of the experiences of feminist family therapy supervisors and the therapists they supervised: the supervision contract, collaborative methods, and hierarchical methods. Provides a description of the participants' experiences of these methods and discusses their fit with…

Experiencing maternity care: the care received and perceptions of women from different ethnic groups

Science.gov (United States)

2013-01-01

Background According to the Office for National Statistics, approximately a quarter of women giving birth in England and Wales are from minority ethnic groups. Previous work has indicated that these women have poorer pregnancy outcomes than White women and poorer experience of maternity care, sometimes encountering stereotyping and racism. The aims of this study were to examine service use and perceptions of care in ethnic minority women from different groups compared to White women. Methods Secondary analysis of data from a survey of women in 2010 was undertaken. The questionnaire asked about women’s experience of care during pregnancy, labour and birth, and the postnatal period, as well as demographic factors. Ethnicity was grouped into eight categories: White, Mixed, Indian, Pakistani, Bangladeshi, Black Caribbean, Black African, and Other ethnicity. Results A total of 24,319 women completed the survey. Compared to White women, women from minority ethnic groups were more likely to be younger, multiparous and without a partner. They tended to access antenatal care later in pregnancy, have fewer antenatal checks, fewer ultrasound scans and less screening. They were less likely to receive pain relief in labour and, Black African women in particular, were more likely to deliver by emergency caesarean section. Postnatally, women from minority ethnic groups had longer lengths of hospital stay and were more likely to breastfeed but they had fewer home visits from midwives. Throughout their maternity care, women from minority ethnic groups were less likely to feel spoken to so they could understand, to be treated with kindness, to be sufficiently involved in decisions and to have confidence and trust in the staff. Conclusion Women in all minority ethnic groups had a poorer experience of maternity services than White women. That this was still the case following publication of a number of national policy documents and local initiatives is a cause for concern. PMID

Experiencing maternity care: the care received and perceptions of women from different ethnic groups.

Science.gov (United States)

Henderson, Jane; Gao, Haiyan; Redshaw, Maggie

2013-10-22

According to the Office for National Statistics, approximately a quarter of women giving birth in England and Wales are from minority ethnic groups. Previous work has indicated that these women have poorer pregnancy outcomes than White women and poorer experience of maternity care, sometimes encountering stereotyping and racism. The aims of this study were to examine service use and perceptions of care in ethnic minority women from different groups compared to White women. Secondary analysis of data from a survey of women in 2010 was undertaken. The questionnaire asked about women's experience of care during pregnancy, labour and birth, and the postnatal period, as well as demographic factors. Ethnicity was grouped into eight categories: White, Mixed, Indian, Pakistani, Bangladeshi, Black Caribbean, Black African, and Other ethnicity. A total of 24,319 women completed the survey. Compared to White women, women from minority ethnic groups were more likely to be younger, multiparous and without a partner. They tended to access antenatal care later in pregnancy, have fewer antenatal checks, fewer ultrasound scans and less screening. They were less likely to receive pain relief in labour and, Black African women in particular, were more likely to deliver by emergency caesarean section. Postnatally, women from minority ethnic groups had longer lengths of hospital stay and were more likely to breastfeed but they had fewer home visits from midwives. Throughout their maternity care, women from minority ethnic groups were less likely to feel spoken to so they could understand, to be treated with kindness, to be sufficiently involved in decisions and to have confidence and trust in the staff. Women in all minority ethnic groups had a poorer experience of maternity services than White women. That this was still the case following publication of a number of national policy documents and local initiatives is a cause for concern.

28 CFR 2.91 - Supervision responsibility.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Supervision responsibility. 2.91 Section 2.91 Judicial Administration DEPARTMENT OF JUSTICE PAROLE, RELEASE, SUPERVISION AND RECOMMITMENT OF PRISONERS, YOUTH OFFENDERS, AND JUVENILE DELINQUENTS District of Columbia Code: Prisoners and Parolees § 2.91 Supervision responsibility. (a) Pursuan...

Optimistic semi-supervised least squares classification

DEFF Research Database (Denmark)

Krijthe, Jesse H.; Loog, Marco

2017-01-01

The goal of semi-supervised learning is to improve supervised classifiers by using additional unlabeled training examples. In this work we study a simple self-learning approach to semi-supervised learning applied to the least squares classifier. We show that a soft-label and a hard-label variant ...

The critical role of supervision in retaining staff in obstetric services: a three country study.

Directory of Open Access Journals (Sweden)

Eilish McAuliffe

Full Text Available Millennium Development Goal (MDG 5 commits us to reducing maternal mortality rates by three quarters and MDG 4 commits us to reducing child mortality by two-thirds between 1990 and 2015. In order to reach these goals, greater access to basic emergency obstetric care (EmOC as well as comprehensive EmOC which includes safe Caesarean section, is needed.. The limited capacity of health systems to meet demand for obstetric services has led several countries to utilize mid-level cadres as a substitute to more extensively trained and more internationally mobile healthcare workers. Although this does provide greater capacity for service delivery, concern about the performance and motivation of these workers is emerging. We propose that poor leadership characterized by inadequate and unstructured supervision underlies much of the dissatisfaction and turnover that has been shown to exist amongst these mid-level healthcare workers and indeed health workers more generally. To investigate this, we conducted a large-scale survey of 1,561 mid-level cadre healthcare workers (health workers trained for shorter periods to perform specific tasks e.g. clinical officers delivering obstetric care in Malawi, Tanzania, and Mozambique. Participants indicated the primary supervision method used in their facility and we assessed their job satisfaction and intentions to leave their current workplace. In all three countries we found robust evidence indicating that a formal supervision process predicted high levels of job satisfaction and low intentions to leave. We find no evidence that facility level factors modify the link between supervisory methods and key outcomes. We interpret this evidence as strongly supporting the need to strengthen leadership and implement a framework and mechanism for systematic supportive supervision. This will promote better job satisfaction and improve the retention and performance of obstetric care workers, something which has the potential

The impact of health literacy, patient-centered communication and shared decision-making on patients' satisfaction with care received in German primary care practices.

Science.gov (United States)

Altin, Sibel Vildan; Stock, Stephanie

2016-08-30

Findings on the association between health literacy skills and patient-reported outcomes such as satisfaction with health care delivery are scarce. We explored the extent to which subjective health literacy skills and the perception of the application of patient-centered communication and shared decision-making are associated with patient's satisfaction with care received by their general practitioner (GP). A nationwide cross sectional survey was administered in a random sample of 1125 German adults. A binary logistic regression model controlling for demographics and health status was used to examine the independent contributions of predictor variables (i.e. subjective health literacy, shared decision-making, patient-centered communication) on satisfaction with care received by the GP. Respondents with sufficient health literacy skills were 2.06 times as likely (95 % [CI]: 1.002-4.264) and those who were involved in shared decision-making by their GP were 4.02 times as likely (95 % [CI]: 1.849-8.744) to be satisfied with care received by their GP. Respondents who experienced that their GP explained things in an easy to understand way (OR: 4.44; 95 % [CI]: 1.817-10.869), knew important things about their medical history (OR: 3.46; 95 % [CI]: 1.502-7.994) and spent enough time with them, also reported to be more satisfied (OR: 3.12; 95 % [CI]: 1.410-6.905). German adults having sufficient subjective health literacy skills and experiencing a more patient-centered relationship with their GP are more likely to be satisfied with care. These findings are important for health care organizations aiming to respond to health literacy needs of patients.

Comparison of outcomes for veterans receiving dialysis care from VA and non-VA providers.

Science.gov (United States)

Wang, Virginia; Maciejewski, Matthew L; Patel, Uptal D; Stechuchak, Karen M; Hynes, Denise M; Weinberger, Morris

2013-01-18

Demand for dialysis treatment exceeds its supply within the Veterans Health Administration (VA), requiring VA to outsource dialysis care by purchasing private sector dialysis for veterans on a fee-for-service basis. It is unclear whether outcomes are similar for veterans receiving dialysis from VA versus non-VA providers. We assessed the extent of chronic dialysis treatment utilization and differences in all-cause hospitalizations and mortality between veterans receiving dialysis from VA versus VA-outsourced providers. We constructed a retrospective cohort of veterans in 2 VA regions who received chronic dialysis treatment financed by VA between January 2007 and December 2008. From VA administrative data, we identified veterans who received outpatient dialysis in (1) VA, (2) VA-outsourced settings, or (3) both ("dual") settings. In adjusted analyses, we used two-part and logistic regression to examine associations between dialysis setting and all-cause hospitalization and mortality one-year from veterans' baseline dialysis date. Of 1,388 veterans, 27% received dialysis exclusively in VA, 47% in VA-outsourced settings, and 25% in dual settings. Overall, half (48%) were hospitalized and 12% died. In adjusted analysis, veterans in VA-outsourced settings incurred fewer hospitalizations and shorter hospital stays than users of VA due to favorable selection. Dual-system dialysis patients had lower one-year mortality than veterans receiving VA dialysis. VA expenditures for "buying" outsourced dialysis are high and increasing relative to "making" dialysis treatment within its own system. Outcomes comparisons inform future make-or-buy decisions and suggest the need for VA to consider veterans' access to care, long-term VA savings, and optimal patient outcomes in its placement decisions for dialysis services.

Occupational Therapy experience in family care in a primary health care service

Directory of Open Access Journals (Sweden)

Gisele Baissi

2013-08-01

Full Text Available Occupational therapy is presented as the core knowledge involved in the remodeling and strengthening of Primary Health Care in the Brazilian Unified Health Care System (Sistema Único de Saúde – SUS. In this study, we aimed to describe the interventions in the process of occupational therapy in supervised family care in a primary health care service in the municipality of Várzea Paulista, São Paulo state. In this case study, the moments of care were described and analyzed in light of narratives on the supervised practice of occupational therapy with a family. The results showed forms of intervention that characterize the process of occupational therapy focused on family health needs in favor of creativity and the role for changes in health practices in everyday life. Through the accomplishment of occupational activities directed to self-care, Occupational Therapy can aid families to cope with daily life adversity.

Supportive supervision for volunteers to deliver reproductive health education: a cluster randomized trial.

Science.gov (United States)

Singh, Debra; Negin, Joel; Orach, Christopher Garimoi; Cumming, Robert

2016-10-03

Community Health Volunteers (CHVs) can be effective in improving pregnancy and newborn outcomes through community education. Inadequate supervision of CHVs, whether due to poor planning, irregular visits, or ineffective supervisory methods, is, however, recognized as a weakness in many programs. There has been little research on best practice supervisory or accompaniment models. From March 2014 to February 2015 a proof of concept study was conducted to compare training alone versus training and supportive supervision by paid CHWs (n = 4) on the effectiveness of CHVs (n = 82) to deliver education about pregnancy, newborn care, family planning and hygiene. The pair-matched cluster randomized trial was conducted in eight villages (four intervention and four control) in Budondo sub-county in Jinja, Uganda. Increases in desired behaviors were seen in both the intervention and control arms over the study period. Both arms showed high retention rates of CHVs (95 %). At 1 year follow-up there was a significantly higher prevalence of installed and functioning tippy taps for hand washing (p services. Supportive supervision involves creating a non-threatening, empowering environment in which both the CHV and the supervising CHW learn together and overcome obstacles that might otherwise demotivate the CHV. While the results seem promising for added value with supportive supervision for CHVs undertaking reproductive health activities, further research on a larger scale will be needed to substantiate the effect.

Individualized guidance and telephone monitoring in a self-supervised home-based physiotherapeutic program in Parkinson

Directory of Open Access Journals (Sweden)

Ihana Thaís Guerra de Oliveira Gondim

Full Text Available Abstract Introduction: Home therapeutic exercises have been a target of interest in the treatment of the Parkinson's disease (PD. The way that the physical therapist guides and monitors these exercises can impact the success of therapy. Objective: To evaluate the effects of individualized orientation and monitoring by telephone in a self-supervised home therapeutic exercise program on signs and symptoms of PD and quality of life (QoL. Methods: Single-blind randomized clinical trials with 28 people with PD (Hoehn and Yahr 1 to 3. Patients were randomized into two groups: experimental and control. The experimental group had a meeting with individualized guidance about physiotherapy exercises present in a manual, received the manual to guide their activities at home and obtained subsequent weekly monitoring by telephone. The control group received the usual cares by the service. Both were orientated to carry out exercises three times a week during 12 weeks. Was evaluated: (1 activities of daily living (ADL and motor examination sections of the Unified Parkinson's Disease Rating Scale (UPDRS and QoL by the Parkinson Disease Questionnaire 39 (PDQ-39. The analysis between groups was performed by the Mann-Whitney test and intragroup through the Wilcoxon (p < 0.05. Results: Significant improvement in ADL (p= 0.001 and motor examination (p= 0.0008 of the UPDRS, PDQ-39 total (p = 0.027 and dimensions mobility (p = 0.027, emotional well-being (p= 0.021 and bodily discomfort (p = 0.027 in the experimental group compared to the control group. Conclusion: The individualized guidance and weekly monitoring by telephone in a self-supervised home therapeutic exercises program promoted positive effects on ADL, motor examination and QoL of people in early stages of PD.

20 CFR 655.30 - Supervised recruitment.

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Supervised recruitment. 655.30 Section 655.30... Workers) § 655.30 Supervised recruitment. (a) Supervised recruitment. Where an employer is found to have... failed to adequately conduct recruitment activities or failed in any obligation of this part, the CO may...

Radiation doses received by premature babies in the neonatal intensive care unit

International Nuclear Information System (INIS)

Thierry-Chef, I.; Maccia, C.; Thierry-Chef, I.; Laurier, D.; Tirmarche, M.; Costil, J.

2005-01-01

Purpose. Because of frequent radiological investigations performed in 1 neonatal intensive care unit, a dosimetry study was carried out to assess the level of doses received by premature babies. Materials and methods. In vivo measurements were performed and effective doses were evaluated for single radiographs. Individual cumulative doses received over the period of stay were then estimated, for each premature baby entering the intensive care unit in 2002, taking into account the number of radiographs they underwent. Results. On average, babies stayed for a week and more than one radio-graph was taken per day. Results showed that, even if average doses per radiograph were relatively low (25μSv), cumulative doses strongly depended on the length of stay, and can reach a few mSv. Conclusion. Even if doses per radiograph are in agreement with European recommendations, optimisation of doses is particularly important because premature babies are more sensitive to radiation than adults and because they usually undergo further radiological examinations in other services. On the basis of the results of this dosimetry study, the implementation of a larger study is being discussed. (author)

Man-machine supervision

International Nuclear Information System (INIS)

Montmain, J.

2005-01-01

Today's complexity of systems where man is involved has led to the development of more and more sophisticated information processing systems where decision making has become more and more difficult. The operator task has moved from operation to supervision and the production tool has become indissociable from its numerical instrumentation and control system. The integration of more and more numerous and sophisticated control indicators in the control room does not necessary fulfill the expectations of the operation team. It is preferable to develop cooperative information systems which are real situation understanding aids. The stake is not the automation of operators' cognitive tasks but the supply of a reasoning help. One of the challenges of interactive information systems is the selection, organisation and dynamical display of information. The efficiency of the whole man-machine system depends on the communication interface efficiency. This article presents the principles and specificities of man-machine supervision systems: 1 - principle: operator's role in control room, operator and automation, monitoring and diagnosis, characteristics of useful models for supervision; 2 - qualitative reasoning: origin, trends, evolutions; 3 - causal reasoning: causality, causal graph representation, causal and diagnostic graph; 4 - multi-points of view reasoning: multi flow modeling method, Sagace method; 5 - approximate reasoning: the symbolic numerical interface, the multi-criteria decision; 6 - example of application: supervision in a spent-fuel reprocessing facility. (J.S.)

Evolution in banking supervision

OpenAIRE

Edward J. Stevens

2000-01-01

Banking supervision must keep pace with technical innovations in the banking industry. The international Basel Committee on Banking Supervision currently is reviewing public comments on its proposed new method for judging whether a bank maintains enough capital to absorb unexpected losses. This Economic Commentary explains how existing standards became obsolete and describes the new plan.

Projected estimators for robust semi-supervised classification

DEFF Research Database (Denmark)

Krijthe, Jesse H.; Loog, Marco

2017-01-01

For semi-supervised techniques to be applied safely in practice we at least want methods to outperform their supervised counterparts. We study this question for classification using the well-known quadratic surrogate loss function. Unlike other approaches to semi-supervised learning, the procedure...... specifically, we prove that, measured on the labeled and unlabeled training data, this semi-supervised procedure never gives a lower quadratic loss than the supervised alternative. To our knowledge this is the first approach that offers such strong, albeit conservative, guarantees for improvement over...... the supervised solution. The characteristics of our approach are explicated using benchmark datasets to further understand the similarities and differences between the quadratic loss criterion used in the theoretical results and the classification accuracy typically considered in practice....

[Pharmaceutical care of patients with rheumatoid and psoriatic arthritis receiving etanercept].

Science.gov (United States)

Romero Crespo, I; Antón Torres, R; Borrás Blasco, J; Navarro Ruiz, A

2005-01-01

To evaluate a pharmaceutical care protocol for patients with rheumatoid arthritis (RA) or psoriatic arthritis who begin treatment with etanercept with the objective of identifying potential medication-related problems and implementing therapeutic measures to improve the way this drug is used. An observational, prospective, 3-month study of patients with RA receiving etanercept therapy from March to December 2003 was conducted and a pharmaceutical care protocol was set up. During the first visit, a pharmacotherapeutic record was initiated for each patient, including socio-demographic data, personal history, diagnosis, DMARDs (disease-modifying anti-rheumatic drugs) previously received, and concomitant therapies for other underlying conditions. Patients were briefed on dosage, administration route, and potential adverse events both orally and in writing. Correct drug administration and preservation were verified during the second visit, where potential adverse effects were identified, treatment adherence was confirmed, and, if needed, potential drug interactions with other ongoing medications were disclosed. During the third visit, adherence was assessed, adverse events were recorded, and patients evaluated their response to treatment. Fifty patients were included, 40 with a diagnosis of rheumatoid arthritis (80%) and 10 diagnosed with psoriatic arthritis (20%). In all, 72% had received previous treatment with methotrexate (MTX), 40% with leflunomide, 20% with infliximab, 56% with corticoids, 2% with analgesics, 56% with NSAIDs, and 30% with other DMARDs. No significant drug interactions were found. Regarding adherence to treatment, 7.7% of patients skipped one or more doses, with travelling being the most common reason. Adverse events reported included: injection site reaction (27%), headache (7.7%) and nausea (7.7%). At 3 months after treatment onset, a reduction of MTX doses was seen in 18% of patients, of leflunomide dosage in 8%, of corticoids in 18%, of

The experience of clinical supervision for nurses and healthcare assistants in a secure adolescent service: Affecting service improvement.

Science.gov (United States)

McCarron, R H; Eade, J; Delmage, E

2018-04-01

WHAT IS KNOWN ON THE SUBJECT?: Regular and effective clinical supervision for mental health nurses and healthcare assistants (HCAs) is an important tool in helping to reduce stress and burnout, and in ensuring safe, effective and high-quality mental health care. Previous studies of clinical supervision within secure mental health environments have found both a low availability of clinical supervision, and a low level of staff acceptance of its value, particularly for HCAs. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: In previous studies, the understanding shown by HCAs and nurses around the benefits of clinical supervision may have been limited by the methods used. This study was specifically designed to help them best express their views. In contrast to previous studies, both nurses and HCAs showed a good understanding of the function and value of clinical supervision. Significant improvements in the experience of, and access to, clinical supervision for nurses and HCAs working in secure mental health services may be achieved by raising staff awareness, demonstrating organizational support and increasing monitoring of clinical supervision. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Organizations should consider reviewing their approach to supervision to include raising staff awareness, multidisciplinary supervision, group supervision, and recording and tracking of supervision rates. Organizations should be mindful of the need to provide effective clinical supervision to HCAs as well as nurses. Introduction Studies have found a low availability and appreciation of clinical supervision, especially for healthcare assistants (HCAs). Qualitative research is needed to further understand this. Aims Increase understanding of nurses' and HCAs' experiences of, and access to, clinical supervision. Identify nurses' and HCAs' perceptions of the value and function of clinical supervision. Assess how interventions affect staff's experiences of clinical supervision. Methods In

A possibility for strengthening family life and health: Family members' lived experience when a sick child receives home care in Sweden.

Science.gov (United States)

Castor, Charlotte; Landgren, Kajsa; Hansson, Helena; Kristensson Hallström, Inger

2018-03-01

Families often prefer home care to hospital care, and home-care services for ill children are increasing worldwide with limited knowledge of families' needs during curative and palliative home care. The aim of this study was to elucidate family members' lived experience when a sick child received home care from county-based primary healthcare services. A descriptive qualitative design was chosen and 12 families including sick children receiving home care and their mothers, fathers and siblings in the south of Sweden were interviewed between December 2015 and January 2017. The transcribed interviews were analysed using a hermeneutic phenomenological approach. The family members' lived experience was described in three essential themes: "Strengthening family life" relates to how home care induced freedom and luxury in a strained period of life and supported the families' everyday life. Usual social activities and relations were maintained as time and energy was saved when receiving home care. "Promoting health" relates to how the family members' burden of illness decreased as the child's signs of illness alleviated and the well-being of the whole family increased when the child received care in the home. This provided a peaceful respite for family members' psychosocial recovery. The third theme, "Creating alliances," relates to the importance of creating trustful alliances for communicating participation in care. If trustful alliances were not created, parents felt an overwhelming responsibility and family members became anxious. The findings suggest that care in the family's home is a useful complement to hospital care. Home care should be given with close attention to family members' needs and conditions, as positive effects of home care might be jeopardised when expectations and possibilities are not successfully shared. © 2017 The Authors. Health and Social Care in the Community Published by John Wiley & Sons Ltd.

Current Risk Management Practices in Psychotherapy Supervision.

Science.gov (United States)

Mehrtens, Ilayna K; Crapanzano, Kathleen; Tynes, L Lee

2017-12-01

Psychotherapy competence is a core skill for psychiatry residents, and psychotherapy supervision is a time-honored approach to teaching this skill. To explore the current supervision practices of psychiatry training programs, a 24-item questionnaire was sent to all program directors of Accreditation Council for Graduate Medical Education (ACGME)-approved adult psychiatry programs. The questionnaire included items regarding adherence to recently proposed therapy supervision practices aimed at reducing potential liability risk. The results suggested that current therapy supervision practices do not include sufficient management of the potential liability involved in therapy supervision. Better protections for patients, residents, supervisors and the institutions would be possible with improved credentialing practices and better documentation of informed consent and supervision policies and procedures. © 2017 American Academy of Psychiatry and the Law.

Comparison of outcomes for veterans receiving dialysis care from VA and non-VA providers

Directory of Open Access Journals (Sweden)

Wang Virginia

2013-01-01

Full Text Available Abstract Background Demand for dialysis treatment exceeds its supply within the Veterans Health Administration (VA, requiring VA to outsource dialysis care by purchasing private sector dialysis for veterans on a fee-for-service basis. It is unclear whether outcomes are similar for veterans receiving dialysis from VA versus non-VA providers. We assessed the extent of chronic dialysis treatment utilization and differences in all-cause hospitalizations and mortality between veterans receiving dialysis from VA versus VA-outsourced providers. Methods We constructed a retrospective cohort of veterans in 2 VA regions who received chronic dialysis treatment financed by VA between January 2007 and December 2008. From VA administrative data, we identified veterans who received outpatient dialysis in (1 VA, (2 VA-outsourced settings, or (3 both (“dual” settings. In adjusted analyses, we used two-part and logistic regression to examine associations between dialysis setting and all-cause hospitalization and mortality one-year from veterans’ baseline dialysis date. Results Of 1,388 veterans, 27% received dialysis exclusively in VA, 47% in VA-outsourced settings, and 25% in dual settings. Overall, half (48% were hospitalized and 12% died. In adjusted analysis, veterans in VA-outsourced settings incurred fewer hospitalizations and shorter hospital stays than users of VA due to favorable selection. Dual-system dialysis patients had lower one-year mortality than veterans receiving VA dialysis. Conclusions VA expenditures for “buying” outsourced dialysis are high and increasing relative to “making” dialysis treatment within its own system. Outcomes comparisons inform future make-or-buy decisions and suggest the need for VA to consider veterans’ access to care, long-term VA savings, and optimal patient outcomes in its placement decisions for dialysis services.

A Study of Supervision of China's Commercial Banks from the Perspective of the Trinity-Characteristics of Bank Supervision System

Institute of Scientific and Technical Information of China (English)

LV Jianglin; HUANG Guang

2015-01-01

Based on the theoretical analysis,this paper applies the entropy method to establish a comprehensive index system for the evaluation of the overall level of risk control and comprehensive efficiency of the supervision of China's commercial banks.Considering the trinity-characteristics of bank supervision system consisting of the People's Bank of China(PBC),the CBRC and the financial offices of local governments,the following conclusions have been drawn:the amount of penalties on banking illegal transactions is not correlated with the supervision efficiency of China's commercial banks;the capital adequacy ratio,the loan to deposit ratio,the percentage point of the non-performing loan rate of urban commercial banks higher than that of the national joint-stock banks are negatively correlated with the supervision efficiency of China 's commercial banks;the total asset variation of the PBC and the different loan balance in local and foreign currency of the banks are positively correlated with the supervision efficiency of China's commercial banks,but the effect is minor.Therefore,China should give the capital adequacy ratio a full play in the bank supervision,accelerate the construction of supervision information system and improve the supervision function of the local governments.

Content analysis of resident evaluations of faculty anesthesiologists: supervision encompasses some attributes of the professionalism core competency.

Science.gov (United States)

Dexter, Franklin; Szeluga, Debra; Hindman, Bradley J

2017-05-01

Anesthesiology departments need an instrument with which to assess practicing anesthesiologists' professionalism. The purpose of this retrospective analysis of the content of a cohort of resident evaluations of faculty anesthesiologists was to investigate the relationship between a clinical supervision scale and the multiple attributes of professionalism. From July 1, 2013 to the present, our department has utilized the de Oliveira Filho unidimensional nine-item supervision scale to assess the quality of clinical supervision of residents provided by our anesthesiologists. The "cohort" we examined included all 13,664 resident evaluations of all faculty anesthesiologists from July 1, 2013 through December 31, 2015, including 1,387 accompanying comments. Words and phrases associated with the core competency of professionalism were obtained from previous studies, and the supervision scale was analyzed for the presence of these words and phrases. The supervision scale assesses some attributes of anesthesiologists' professionalism as well as patient care and procedural skills and interpersonal and communication skills. The comments that residents provided with the below-average supervision scores included attributes of professionalism, although numerous words and phrases related to professionalism were not present in any of the residents' comments. The de Oliveira Filho clinical supervision scale includes some attributes of anesthesiologists' professionalism. The core competency of professionalism, however, is multidimensional, and the supervision scale and/or residents' comments did not address many of the other established attributes of professionalism.

Scope of practice and supervision of orthodontic therapists in the United Kingdom: Part 1: a national cross-sectional survey of orthodontists.

Science.gov (United States)

Dugdale, Charlotte A; Ahmed, Farooq; Waring, David; Malik, Ovais H

2018-03-01

Since the introduction of orthodontic therapists (OTs), there has been little research on the scope of practice and the level of supervision they receive. This study investigates how OTs are being utilised and supervised, and how this compares with current recommendations. A postal cross-sectional survey was mailed to all UK General Dental Council (GDC) registered specialist orthodontists. A 59.7% response rate (747) was achieved. 52% of the respondents reported they worked with/employed an OT. The majority of orthodontists worked with an OT in primary care (67%) seeing predominantly NHS (56%) patients and performed a wide range of duties. Orthodontists reported a perceived increase in clinical output (74%) and time available for treatment planning (61%). The majority (85%) of orthodontists indicated they provide a written prescription for the OT. Forty-two per cent reported the prescription did not contain the required information as stipulated by the GDC. OTs are valued members of the orthodontic team, improving productivity and allowing orthodontists more time for treatment planning. The majority of orthodontists appeared to be working to the BOS and GDC recommendations, with greater awareness needed regarding the provision of a written treatment prescription.

Supervision Experiences of Professional Counselors Providing Crisis Counseling

Science.gov (United States)

Dupre, Madeleine; Echterling, Lennis G.; Meixner, Cara; Anderson, Robin; Kielty, Michele

2014-01-01

In this phenomenological study, the authors explored supervision experiences of 13 licensed professional counselors in situations requiring crisis counseling. Five themes concerning crisis and supervision were identified from individual interviews. Findings support intensive, immediate crisis supervision and postlicensure clinical supervision.

Reflections on the supervised relationship and interaction in nursing clinical training

Directory of Open Access Journals (Sweden)

Inês Alves da Rocha e Silva Rocha

2013-05-01

Full Text Available This reflection fits into the area of Clinical Supervision in Nursing focusing on relationships that the student develops during clinical training. It seems that in clinical training the student not only learns but also consolidates verbal, procedural and attitudinal contents. The relationship established with peers, teachers and tutors will contribute to their professional identity. It is underlined the importance of the contribution of clinical supervision for the development of a reflective thinking in students in Portugal, as highlighted here, which influences the changes in nursing practices, as well as ensuring the quality and safety of the care provided. The characteristics that the tutor must have to improve the development of the students are also explained as well as the possible solutions for the existing limitations of clinical training contexts.

Intelligent multivariate process supervision

International Nuclear Information System (INIS)

Visuri, Pertti.

1986-01-01

This thesis addresses the difficulties encountered in managing large amounts of data in supervisory control of complex systems. Some previous alarm and disturbance analysis concepts are reviewed and a method for improving the supervision of complex systems is presented. The method, called multivariate supervision, is based on adding low level intelligence to the process control system. By using several measured variables linked together by means of deductive logic, the system can take into account the overall state of the supervised system. Thus, it can present to the operators fewer messages with higher information content than the conventional control systems which are based on independent processing of each variable. In addition, the multivariate method contains a special information presentation concept for improving the man-machine interface. (author)

On psychoanalytic supervision as signature pedagogy.

Science.gov (United States)

Watkins, C Edward

2014-04-01

What is signature pedagogy in psychoanalytic education? This paper examines that question, considering why psychoanalytic supervision best deserves that designation. In focusing on supervision as signature pedagogy, I accentuate its role in building psychoanalytic habits of mind, habits of hand, and habits of heart, and transforming theory and self-knowledge into practical product. Other facets of supervision as signature pedagogy addressed in this paper include its features of engagement, uncertainty, formation, and pervasiveness, as well as levels of surface, deep, and implicit structure. Epistemological, ontological, and axiological in nature, psychoanalytic supervision engages trainees in learning to do, think, and value what psychoanalytic practitioners in the field do, think, and value: It is, most fundamentally, professional preparation for competent, "good work." In this paper, effort is made to shine a light on and celebrate the pivotal role of supervision in "making" or developing budding psychoanalysts and psychoanalytic psychotherapists. Now over a century old, psychoanalytic supervision remains unparalleled in (1) connecting and integrating conceptualization and practice, (2) transforming psychoanalytic theory and self-knowledge into an informed analyzing instrument, and (3) teaching, transmitting, and perpetuating the traditions, practice, and culture of psychoanalytic treatment.

Supervision and feedback for junior medical staff in Australian emergency departments: findings from the emergency medicine capacity assessment study

Directory of Open Access Journals (Sweden)

Weiland Tracey J

2010-11-01

Full Text Available Abstract Background Clinical supervision and feedback are important for the development of competency in junior doctors. This study aimed to determine the adequacy of supervision of junior medical staff in Australian emergency departments (EDs and perceived feedback provided. Methods Semi-structured telephone surveys sought quantitative and qualitative data from ED Directors, Directors of Emergency Medicine Training, registrars and interns in 37 representative Australian hospitals; quantitative data were analysed with SPSS 15.0 and qualitative data subjected to content analysis identifying themes. Results Thirty six of 37 hospitals took part. Of 233 potential interviewees, 95 (40.1% granted interviews including 100% (36/36 of ED Directors, and 96.2% (25/26 of eligible DEMTs, 24% (19/81 of advanced trainee/registrars, and 17% (15/90 of interns. Most participants (61% felt the ED was adequately supervised in general and (64.2% that medical staff were adequately supervised. Consultants and registrars were felt to provide most intern supervision, but this varied depending on shift times, with registrars more likely to provide supervision on night shift and at weekends. Senior ED medical staff (64% and junior staff (79% agreed that interns received adequate clinical supervision. Qualitative analysis revealed that good processes were in place to ensure adequate supervision, but that service demands, particularly related to access block and overcrowding, had detrimental effects on both supervision and feedback. Conclusions Consultants appear to provide the majority of supervision of junior medical staff in Australian EDs. Supervision and feedback are generally felt to be adequate, but are threatened by service demands, particularly related to access block and ED overcrowding.

Abusive Supervision and Subordinate Performance : Instrumentality Considerations in the Emergence and Consequences of Abusive Supervision

NARCIS (Netherlands)

Walter, Frank; Lam, Catherine K.; van der Vegt, Geert; Huang, X.; Miao, Q.

Drawing from moral exclusion theory, this article examines outcome dependence and interpersonal liking as key boundary conditions for the linkage between perceived subordinate performance and abusive supervision. Moreover, it investigates the role of abusive supervision for subordinates' subsequent,

Supervision of radiation environment management of nuclear facilities

International Nuclear Information System (INIS)

Luo Mingyan

2013-01-01

Through literature and documents, the basis, content and implementation of the supervision of radiation environment management of nuclear facilities were defined. Such supervision was extensive and complicated with various tasks and overlapping duties, and had large social impact. Therefore, it was recommend to make further research on this supervision should be done, clarify and specify responsibilities of the executor of the supervision so as to achieve institutionalization, standardization and routinization of the supervision. (author)

Skærpet bevidsthed om supervision

DEFF Research Database (Denmark)

Pedersen, Inge Nygaard

2002-01-01

This article presents a historical survey of the initiatives which have taken place in european music therapy towards developing a deeper consciousness about supervision. Supervision as a disciplin in music therapy training, as a maintenance of music therapy profession and as a postgraduate...... training for examined music therapists. Definitions are presented and methods developed by working groups in european music therapy supervision are presented....

Human Supervision of Multiple Autonomous Vehicles

Science.gov (United States)

2013-03-22

AFRL-RH-WP-TR-2013-0143 HUMAN SUPERVISION OF MULTIPLE AUTONOMOUS VEHICLES Heath A. Ruff Ball...REPORT TYPE Interim 3. DATES COVERED (From – To) 09-16-08 – 03-22-13 4. TITLE AND SUBTITLE HUMAN SUPERVISION OF MULTIPLE AUTONOMOUS VEHICLES 5a...Supervision of Multiple Autonomous Vehicles To support the vision of a system that enables a single operator to control multiple next-generation

School, Supervision and Adolescent-Sensitive Clinic Care: Combination Social Protection and Reduced Unprotected Sex Among HIV-Positive Adolescents in South Africa.

Science.gov (United States)

Toska, Elona; Cluver, Lucie D; Boyes, Mark E; Isaacsohn, Maya; Hodes, Rebecca; Sherr, Lorraine

2017-09-01

Social protection can reduce HIV-risk behavior in general adolescent populations, but evidence among HIV-positive adolescents is limited. This study quantitatively tests whether social protection is associated with reduced unprotected sex among 1060 ART-eligible adolescents from 53 government facilities in South Africa. Potential social protection included nine 'cash/cash-in-kind' and 'care' provisions. Analyses tested interactive/additive effects using logistic regressions and marginal effects models, controlling for covariates. 18 % of all HIV-positive adolescents and 28 % of girls reported unprotected sex. Lower rates of unprotected sex were associated with access to school (OR 0.52 95 % CI 0.33-0.82 p = 0.005), parental supervision (OR 0.54 95 % CI 0.33-0.90 p = 0.019), and adolescent-sensitive clinic care (OR 0.43 95 % CI 0.25-0.73 p = 0.002). Gender moderated the effect of adolescent-sensitive clinic care. Combination social protection had additive effects amongst girls: without any provisions 49 % reported unprotected sex; with 1-2 provisions 13-38 %; and with all provisions 9 %. Combination social protection has the potential to promote safer sex among HIV-positive adolescents, particularly girls.

Providing effective supervision in clinical neuropsychology.

Science.gov (United States)

Stucky, Kirk J; Bush, Shane; Donders, Jacobus

2010-01-01

A specialty like clinical neuropsychology is shaped by its selection of trainees, educational standards, expected competencies, and the structure of its training programs. The development of individual competency in this specialty is dependent to a considerable degree on the provision of competent supervision to its trainees. In clinical neuropsychology, as in other areas of professional health-service psychology, supervision is the most frequently used method for teaching a variety of skills, including assessment, report writing, differential diagnosis, and treatment. Although much has been written about the provision of quality supervision in clinical and counseling psychology, very little published guidance is available regarding the teaching and provision of supervision in clinical neuropsychology. The primary focus of this article is to provide a framework and guidance for the development of suggested competency standards for training of neuropsychological supervisors, particularly at the residency level. In this paper we outline important components of supervision for neuropsychology trainees and suggest ways in which clinicians can prepare for supervisory roles. Similar to Falender and Shafranske (2004), we propose a competency-based approach to supervision that advocates for a science-informed, formalized, and objective process that clearly delineates the competencies required for good supervisory practice. As much as possible, supervisory competencies are related to foundational and functional competencies in professional psychology, as well as recent legislative initiatives mandating training in supervision. It is our hope that this article will foster further discussion regarding this complex topic, and eventually enhance training in clinical neuropsychology.

Projected estimators for robust semi-supervised classification

NARCIS (Netherlands)

Krijthe, J.H.; Loog, M.

2017-01-01

For semi-supervised techniques to be applied safely in practice we at least want methods to outperform their supervised counterparts. We study this question for classification using the well-known quadratic surrogate loss function. Unlike other approaches to semi-supervised learning, the

Why do patients receive care from a short-term medical mission? Survey study from rural Guatemala.

Science.gov (United States)

Esquivel, Micaela M; Chen, Joy C; Woo, Russell K; Siegler, Nora; Maldonado-Sifuentes, Francisco A; Carlos-Ochoa, Jehidy S; Cardona-Diaz, Andy R; Uribe-Leitz, Tarsicio; Siegler, Dennis; Weiser, Thomas G; Yang, George P

2017-07-01

Hospital de la Familia was established to serve the indigent population in the western highlands of Guatemala and has a full-time staff of Guatemalan primary care providers supplemented by short-term missions of surgical specialists. The reasons for patients seeking surgical care in this setting, as opposed to more consistent care from local institutions, are unclear. We sought to better understand motivations of patients seeking mission-based surgical care. Patients presenting to the obstetric and gynecologic, plastic, ophthalmologic, general, and pediatric surgical clinics at the Hospital de la Familia from July 27 to August 6, 2015 were surveyed. The surveys assessed patient demographics, surgical diagnosis, location of home, mode of travel, and reasons for seeking care at this facility. Of 252 patients surveyed, 144 (59.3%) were female. Most patients reported no other medical condition (67.9%, n = 169) and no consistent income (83.9%, n = 209). Almost half (44.9%, n = 109) traveled >50 km to receive care. The most common reasons for choosing care at this facility were reputation of high quality (51.8%, n = 130) and affordability (42.6%, n = 102); the least common reason was a lack of other options (6.4%, n = 16). Despite long travel distances and the availability of other options, reputation and affordability were primarily cited as the most common reasons for choosing to receive care at this short-term surgical mission site. Our results highlight that although other surgical options may be closer and more readily available, reputation and cost play a large role in choice of patients seeking care. Published by Elsevier Inc.

28 CFR 2.207 - Supervision reports to Commission.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Supervision reports to Commission. 2.207 Section 2.207 Judicial Administration DEPARTMENT OF JUSTICE PAROLE, RELEASE, SUPERVISION AND RECOMMITMENT OF PRISONERS, YOUTH OFFENDERS, AND JUVENILE DELINQUENTS District of Columbia Supervised Releasees § 2.207 Supervision reports to Commission. A...

Postgraduate research supervision in a socially distributed ...

African Journals Online (AJOL)

Postgraduate supervision is a higher education practice with a long history. Through the conventional "apprenticeship" model postgraduate supervision has served as an important vehicle of intellectual inheritance between generations. However, this model of supervision has come under scrutiny as a consequence of the ...

Supervision Experiences of New Professional School Counselors

Science.gov (United States)

Bultsma, Shawn A.

2012-01-01

This qualitative study examined the supervision experiences of 11 new professional school counselors. They reported that their supervision experiences were most often administrative in nature; reports of clinical and developmental supervision were limited to participants whose supervisors were licensed as professional counselors. In addition,…

Online supervision at the university

DEFF Research Database (Denmark)

Bengtsen, Søren Smedegaard; Jensen, Gry Sandholm

2015-01-01

supervision proves unhelpful when trying to understand how online supervision and feedback is a pedagogical phenomenon in its own right, and irreducible to the face-to-face context. Secondly we show that not enough attention has been given to the way different digital tools and platforms influence...... pedagogy we forge a new concept of “format supervision” that enables supervisors to understand and reflect their supervision practice, not as caught in the physical-virtual divide, but as a choice between face-to-face and online formats that each conditions the supervisory dialogue in their own particular...

Multicultural supervision: lessons learned about an ongoing struggle.

Science.gov (United States)

Christiansen, Abigail Tolhurst; Thomas, Volker; Kafescioglu, Nilufer; Karakurt, Gunnur; Lowe, Walter; Smith, William; Wittenborn, Andrea

2011-01-01

This article examines the experiences of seven diverse therapists in a supervision course as they wrestled with the real-world application of multicultural supervision. Existing literature on multicultural supervision does not address the difficulties that arise in addressing multicultural issues in the context of the supervision relationship. The experiences of six supervisory candidates and one mentoring supervisor in addressing multicultural issues in supervision are explored. Guidelines for conversations regarding multicultural issues are provided. © 2011 American Association for Marriage and Family Therapy.

Optimum supervision intervals and order of supervision in nuclear reactor protective systems

International Nuclear Information System (INIS)

Kontoleon, J.M.

1978-01-01

The optimum inspection strategy of an m-out-of-n:G nuclear reactor protective system with nonidentical units is analyzed. A 2-out-of-4:G system is used to formulate a multi-variable optimization problem to determine (a) the optimum order of supervision of the units and (b) the optimum supervision intervals between units. The case of systems with identical units is a special case of the above. Numerical results are derived using a computer algorithm

Oceans apart, yet connected: Findings from a qualitative study on professional supervision in rural and remote allied health services

OpenAIRE

Ducat, Wendy; Martin, Priya; Kumar, Saravana; Burge, Vanessa; Abernathy, LuJuana

2015-01-01

Abstract Objective Improving the quality and safety of health care in Australia is imperative to ensure the right treatment is delivered to the right person at the right time. Achieving this requires appropriate clinical governance and support for health professionals, including professional supervision. This study investigates the usefulness and effectiveness of and barriers to supervision in rural and remote Queensland. Design As part of the evaluation of the Allied Health Rural and Remote ...

Mr. Traore introduces team supervision. Case scenarios for training and group discussion.

Science.gov (United States)

1993-01-01

This supplement to "The Family Planning Manager" presents a case example and five case discussion questions to illustrate the concept of team supervision. In contrast to traditional supervision, where an emphasis is placed on inspection and the uncovering of deficiencies, team supervision uses a facilitative, advocacy-oriented approach. Problem-solving and decision-making responsibilities are assumed by the clinic staff, who identify and analyze problems in group meetings. Thus, the focus shifts from assessing individual performance to evaluating how well they meet clinic objectives as a team. In the team meetings, the visiting supervisor asks the team as a whole to analyze clinic problems and ensures that all staff members are aware of the significance of their contributions. The supervisor also clarifies the division of labor required for implementing solutions and performance standards. Staff are asked if they have concerns they would like communicated to the next organizational level. The supervisory report of the visit can serve as a guide for implementing the recommendations. This approach may require that supervisors and clinic managers receive training in problem solving, motivating staff, team building, and providing constructive feedback.

Experiences of Community-Living Older Adults Receiving Integrated Care Based on the Chronic Care Model: A Qualitative Study.

Science.gov (United States)

Spoorenberg, Sophie L W; Wynia, Klaske; Fokkens, Andrea S; Slotman, Karin; Kremer, Hubertus P H; Reijneveld, Sijmen A

2015-01-01

Integrated care models aim to solve the problem of fragmented and poorly coordinated care in current healthcare systems. These models aim to be patient-centered by providing continuous and coordinated care and by considering the needs and preferences of patients. The objective of this study was to evaluate the opinions and experiences of community-living older adults with regard to integrated care and support, along with the extent to which it meets their health and social needs. Semi-structured interviews were conducted with 23 older adults receiving integrated care and support through "Embrace," an integrated care model for community-living older adults that is based on the Chronic Care Model and a population health management model. Embrace is currently fully operational in the northern region of the Netherlands. Data analysis was based on the grounded theory approach. Responses of participants concerned two focus areas: 1) Experiences with aging, with the themes "Struggling with health," "Increasing dependency," "Decreasing social interaction," "Loss of control," and "Fears;" and 2) Experiences with Embrace, with the themes "Relationship with the case manager," "Interactions," and "Feeling in control, safe, and secure". The prospect of becoming dependent and losing control was a key concept in the lives of the older adults interviewed. Embrace reinforced the participants' ability to stay in control, even if they were dependent on others. Furthermore, participants felt safe and secure, in contrast to the fears of increasing dependency within the standard care system. The results indicate that integrated care and support provided through Embrace met the health and social needs of older adults, who were coping with the consequences of aging.

Safety supervision on high-pressure gas regulations

International Nuclear Information System (INIS)

Lee, Won Il

1991-01-01

The first part lists the regulation on safety supervision of high-pressure gas, enforcement ordinance on high-pressure gas safety supervision and enforcement regulations about high-pressure gas safety supervision. The second part indicates safety regulations on liquefied petroleum gas and business, enforcement ordinance of safety on liquefied petroleum gas and business, enforcement regulation of safety supervision over liquefied petroleum gas and business. The third part lists regulation on gas business, enforcement ordinance and enforcement regulations on gas business. Each part has theory and explanation for questions.

78 FR 52391 - Supervision and Regulation Assessments for Bank Holding Companies and Savings and Loan Holding...

Science.gov (United States)

2013-08-23

... report consolidated financial statements under GAAP. In response to the comments received, to avoid... companies that only file financial statements in accordance with SAP and do not report consolidated... Total Consolidated Assets of $50 Billion or More and Nonbank Financial Companies Supervised by the...

42 CFR 409.21 - Nursing care.

Science.gov (United States)

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Nursing care. 409.21 Section 409.21 Public Health... HOSPITAL INSURANCE BENEFITS Posthospital SNF Care § 409.21 Nursing care. (a) Basic rule. Medicare pays for nursing care as posthospital SNF care when provided by or under the supervision of a registered...

Abusive Supervision Scale Development in Indonesia

OpenAIRE

Wulani, Fenika; Purwanto, Bernadinus M; Handoko, Hani

2014-01-01

The purpose of this study was to develop a scale of abusive supervision in Indonesia. The study was conducted with a different context and scale development method from Tepper’s (2000) abusive supervision scale. The abusive supervision scale from Tepper (2000) was developed in the U.S., which has a cultural orientation of low power distance. The current study was conducted in Indonesia, which has a high power distance. This study used interview procedures to obtain information about superviso...

Environment supervision in a nuclear industry plant: Cogema example in Pierrelatte

International Nuclear Information System (INIS)

Faure, M.L.

1993-07-01

Every nuclear industrial facility must achieve radioactivity measurements of its environment: COGEMA is therefore very careful of its environmental quality and guarantees the supervision of it with a programme corresponding to the activities and to the environment characteristics. We shall study- the atmospheric control- the waters control- the plants control and we shall end on results synthesis, which must be analysed according to the natural omnipresent radioactivity. 6 Annexes

Nursing care for patients receiving percutaneous lumbar discectomy and intradiscal electrothermal treatment for lumbar disc herniation

International Nuclear Information System (INIS)

Mou Ling

2009-01-01

Objective: To summarize the nursing experience in caring patients with lumbar intervertebral disc herniation who received percutaneous lumbar discectomy (PLD) together with intradiscal electrothermal treatment (IDET) under DSA guidance. Methods: The perioperative nursing care measures carried out in 126 patients with lumbar intervertebral disc herniation who underwent PLD and IDET were retrospectively analyzed. Results: Successful treatment of PLD and IDET was accomplished in 112 cases. Under comprehensive and scientific nursing care and observation, no serious complications occurred. Conclusion: Scientific and proper nursing care is a strong guarantee for a successful surgery and a better recovery in treating lumbar intervertebral disc herniation with PLD and IDET under DSA guidance. (authors)

Intuitive expertise in ICT graduate supervision

Directory of Open Access Journals (Sweden)

Jill Jameson

2002-12-01

Full Text Available Intuitive expertise in the application of advanced interdisciplinary facilitation is the subject of this personal reflection on the graduate supervisory style of Professor David Squires in computers in education. This single-case reflective study examines the characteristics of effective supervision observed during masters and doctoral supervision at King's College in the years 1990-9. Interdisciplinarity in ICT graduate studies particularly requires a fluency of supervisory expertise in enabling supervisees to combine multiple complex perspectives from a number of fields of knowledge. Intuitive combinatory aspects of supervision are highlighted in this reflection on the role carried out by an academic expert in facilitating student success. This is examined from a perspective incorporating affective as well as intellectual elements, informed by characteristics identified in professional sports and performing arts coaching/mentoring. Key characteristics comprising a model of intuitive expertise in ICT graduate supervision were outlined. The resultant portrait aims to complement existing literature on graduate supervision, with reference to the field of ICTI computers in education relating to student hypermedia composition.

Objective coding of content and techniques in workplace-based supervision of an EBT in public mental health.

Science.gov (United States)

Dorsey, Shannon; Kerns, Suzanne E U; Lucid, Leah; Pullmann, Michael D; Harrison, Julie P; Berliner, Lucy; Thompson, Kelly; Deblinger, Esther

2018-01-24

Workplace-based clinical supervision as an implementation strategy to support evidence-based treatment (EBT) in public mental health has received limited research attention. A commonly provided infrastructure support, it may offer a relatively cost-neutral implementation strategy for organizations. However, research has not objectively examined workplace-based supervision of EBT and specifically how it might differ from EBT supervision provided in efficacy and effectiveness trials. Data come from a descriptive study of supervision in the context of a state-funded EBT implementation effort. Verbal interactions from audio recordings of 438 supervision sessions between 28 supervisors and 70 clinicians from 17 public mental health organizations (in 23 offices) were objectively coded for presence and intensity coverage of 29 supervision strategies (16 content and 13 technique items), duration, and temporal focus. Random effects mixed models estimated proportion of variance in content and techniques attributable to the supervisor and clinician levels. Interrater reliability among coders was excellent. EBT cases averaged 12.4 min of supervision per session. Intensity of coverage for EBT content varied, with some discussed frequently at medium or high intensity (exposure) and others infrequently discussed or discussed only at low intensity (behavior management; assigning/reviewing client homework). Other than fidelity assessment, supervision techniques common in treatment trials (e.g., reviewing actual practice, behavioral rehearsal) were used rarely or primarily at low intensity. In general, EBT content clustered more at the clinician level; different techniques clustered at either the clinician or supervisor level. Workplace-based clinical supervision may be a feasible implementation strategy for supporting EBT implementation, yet it differs from supervision in treatment trials. Time allotted per case is limited, compressing time for EBT coverage. Techniques that

Effect of Supportive Nursing Care on Self Esteem of Patients Receiving Electroconvulsive Therapy: A Randomized Controlled Clinical Trial

Science.gov (United States)

Ebrahimi, Hossein; Navidian, Ali; Keykha, Roghaieh

2014-01-01

Introduction: Self-esteem is an important potential indicator in etiology, diagnosis and treatment of patients with severe mental illness. ECT is a popular treatment for these patients that can effect on their self-esteem and reinforce their problems. The purpose of this study is to determine the effect of supportive nursing care in increasing self esteem of patients receiving ECT. Methods: This clinical trial was conducted in the Baharan psychiatric hospital of Zahedan. A total of 70 cases of patients who received ECT were randomly allocated to control (n=35) and intervention (n=35) groups. The data were collected by demographic characteristics questionnaire and Rosenberg Self Esteem Scale (RSES). Intervention group received the supportive nursing care. The control group received only routine treatment. Self esteem level was measured and compared before and after intervention for two groups. The data was analyzed by SPSS using the χ2, t-test and ANCOVA. Results: Results showed that both groups were homogeneous on the socio- demographic characteristics. The mean self esteem in the intervention group compared with the control group was significantly increased. While controlling the effects of individual and social variables, the result shows significant differences between two groups in the mean scores of self esteem after the intervention. Conclusion: The results suggest that supportive nursing care can have positive effect on self esteem of patients receiving ECT. It is recommended to use this method for increasing self esteem of these patients. PMID:25276758

Effect of supportive nursing care on self esteem of patients receiving electroconvulsive therapy: a randomized controlled clinical trial.

Science.gov (United States)

Ebrahimi, Hossein; Navidian, Ali; Keykha, Roghaieh

2014-06-01

Self-esteem is an important potential indicator in etiology, diagnosis and treatment of patients with severe mental illness. ECT is a popular treatment for these patients that can effect on their self-esteem and reinforce their problems. The purpose of this study is to determine the effect of supportive nursing care in increasing self esteem of patients receiving ECT. This clinical trial was conducted in the Baharan psychiatric hospital of Zahedan. A total of 70 cases of patients who received ECT were randomly allocated to control (n=35) and intervention (n=35) groups. The data were collected by demographic characteristics questionnaire and Rosenberg Self Esteem Scale (RSES). Intervention group received the supportive nursing care. The control group received only routine treatment. Self esteem level was measured and compared before and after intervention for two groups. The data was analyzed by SPSS using the χ(2), t-test and ANCOVA. RESULTS showed that both groups were homogeneous on the socio- demographic characteristics. The mean self esteem in the intervention group compared with the control group was significantly increased. While controlling the effects of individual and social variables, the result shows significant differences between two groups in the mean scores of self esteem after the intervention. The results suggest that supportive nursing care can have positive effect on self esteem of patients receiving ECT. It is recommended to use this method for increasing self esteem of these patients.

Effect of Supportive Nursing Care on Self Esteem of Patients Receiving Electroconvulsive Therapy: A Randomized Controlled Clinical Trial

Directory of Open Access Journals (Sweden)

Hossein Ebrahimi

2014-06-01

Full Text Available Introduction: Self-esteem is an important potential indicator in etiology, diagnosis and treatment of patients with severe mental illness. ECT is a popular treatment for these patients that can effect on their self-esteem and reinforce their problems. The purpose of this study is to determine the effect of supportive nursing care in increasing self esteem of patients receiving ECT. Methods: This clinical trial was conducted in the Baharan psychiatric hospital of Zahedan. A total of 70 cases of patients who received ECT were randomly allocated to control (n=35 and intervention (n=35 groups. The data were collected by demographic characteristics questionnaire and Rosenberg Self Esteem Scale (RSES. Intervention group received the supportive nursing care. The control group received only routine treatment. Self esteem level was measured and compared before and after intervention for two groups. The data was analyzed by SPSS using the χ2, t-test and ANCOVA. Results: Results showed that both groups were homogeneous on the socio- demographic characteristics. The mean self esteem in the intervention group compared with the control group was significantly increased. While controlling the effects of individual and social variables, the result shows significant differences between two groups in the mean scores of self esteem after the intervention.Conclusion: The results suggest that supportive nursing care can have positive effect on self esteem of patients receiving ECT. It is recommended to use this method for increasing self esteem of these patients.

Individual Supervision to Enhance Reflexivity and the Practice of Patient-Centered Care: Experience at the Undergraduate Level.

Science.gov (United States)

Berney, Alexandre; Bourquin, Céline

2017-12-22

This article reports on what is at work during individual supervision of medical students in the context of teaching breaking bad news (BBN). Surprisingly, there is a relative lack of research and report on the topic of supervision, even though it is regularly used in medical training. Building on our research and teaching experience on BBN at the undergraduate level, as well as interviews of supervisors, the following key elements have been identified: learning objectives (e.g., raising student awareness of structural elements of the interview, emotion (patients and students) handling), pedagogical approach (being centered on student's needs and supportive to promote already existing competences), essentials (e.g., discussing skills and examples from the clinical practice), and enhancing reflexivity while discussing specific issues (e.g., confusion between the needs of the patient and those of the student). Individual supervision has been identified as crucial and most satisfactory by students to provide guidance and to foster a reflexive stance enabling them to critically apprehend their communication style. Ultimately, the challenge is to teach medical students to not only connect with the patient but also with themselves.

46 CFR 131.420 - Manning and supervision.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Manning and supervision. 131.420 Section 131.420 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OFFSHORE SUPPLY VESSELS OPERATIONS Sufficiency and Supervision of Crew of Survival Craft § 131.420 Manning and supervision. (a) There must be enough trained persons aboard each survival craf...

32 CFR 631.3 - Supervision.

Science.gov (United States)

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Supervision. 631.3 Section 631.3 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS ARMED FORCES DISCIPLINARY CONTROL BOARDS AND OFF-INSTALLATION LIAISON AND OPERATIONS General § 631.3 Supervision. The following will...

Online supervision at the university - A comparative study of supervision on student assignments face-to-face and online

Directory of Open Access Journals (Sweden)

Søren Smedegaard Bengtsen

2015-09-01

Full Text Available Through an empirical study of supervision on student assignments at the university across face-to-face and online settings, we show firstly the limiting implications of traditional dichotomies between face-to-face and online supervision. Secondly we show that more attention must be given to the way different digital tools influence the supervisory dialogue. These findings illustrate a form of ‘torn pedagogy’; that online tools and platforms destabilize and tear traditional understandings of supervision pedagogy apart. Also we forge a new concept of “format supervision” that enables supervisors to understand and reflect their supervision practice as a deliberate choice between face-to-face and online formats.

Online supervision at the university - A comparative study of supervision on student assignments face-to-face and online

Directory of Open Access Journals (Sweden)

Søren Smedegaard Bengtsen

2015-02-01

Full Text Available Through an empirical study of supervision on student assignments at the university across face-to-face and online settings, we show firstly the limiting implications of traditional dichotomies between face-to-face and online supervision. Secondly we show that more attention must be given to the way different digital tools influence the supervisory dialogue. These findings illustrate a form of ‘torn pedagogy’; that online tools and platforms destabilize and tear traditional understandings of supervision pedagogy apart. Also we forge a new concept of “format supervision” that enables supervisors to understand and reflect their supervision practice as a deliberate choice between face-to-face and online formats.

Combination of supervised and semi-supervised regression models for improved unbiased estimation

DEFF Research Database (Denmark)

Arenas-Garía, Jeronimo; Moriana-Varo, Carlos; Larsen, Jan

2010-01-01

In this paper we investigate the steady-state performance of semisupervised regression models adjusted using a modified RLS-like algorithm, identifying the situations where the new algorithm is expected to outperform standard RLS. By using an adaptive combination of the supervised and semisupervi......In this paper we investigate the steady-state performance of semisupervised regression models adjusted using a modified RLS-like algorithm, identifying the situations where the new algorithm is expected to outperform standard RLS. By using an adaptive combination of the supervised...

Oral health assessment and mouth care for children and young people receiving palliative care. Part one.

Science.gov (United States)

Sargeant, Stephanie; Chamley, Carol

2013-03-01

This is the first part of two articles exploring oral health problems and treatments for children receiving palliative care, successful management of which can improve considerably the quality of life for this group of children and young people. Part one includes an adapted oral health assessment tool for use in children and young people with complex and palliative healthcare needs that has the potential to help nurses identify and monitor oral health problems and prevent or minimise oral problems from developing. Part two--to be published next month--focuses on basic oral hygiene and the management of specific oral health problems.

Supervision in social work NGOs in Bihor County

Directory of Open Access Journals (Sweden)

Cristiana Marcela MARC

2012-01-01

Full Text Available This paper presents a qualitative research which aims at analyzing supervision in the social services provided by NGOs in Bihor County. We used the method of sociological investigation by means of interview and data collection was accomplished through the technique of individual semi-structured interview. The obtained responses demonstrate that individual supervision was mostly used and in most cases the professional supervisor was from outside the organization. The respondents considered that supervision reduces professional stress. The main problems encountered in the implementation of supervision are the lack of financial resources and the association of supervision with bureaucratic control.

Does clinical supervision of health professionals improve patient safety? A systematic review and meta-analysis.

Science.gov (United States)

Snowdon, David A; Hau, Raphael; Leggat, Sandra G; Taylor, Nicholas F

2016-09-01

To determine whether clinical supervision (CS) of health professionals improves patient safety. Databases MEDLINE, PsychINFO, CINAHL, EMBASE and AMED were searched from earliest date available. Additional studies were identified by searching of reference lists and citation tracking. Two reviewers independently applied inclusion and exclusion criteria. Thirty-two studies across three health professions [medicine (n = 29), nursing (n = 2) and paramedicine (n = 1)] were selected. The quality of each study was rated using the Medical Education Research Study Quality Instrument. Risk ratios (RR) were calculated for patient safety outcomes of mortality, complications, adverse events, reoperation following initial surgery, conversion to more invasive surgery and readmission to hospital. Results of meta-analyses provided low-quality evidence that supervision of medical professionals reduced the risk of mortality (RR 0.76, 95% CI 0.60-0.95, I(2) = 76%) and supervision of medical professionals and paramedics reduced the risk of complications (RR 0.69, 95% CI 0.53-0.89, I(2) = 76%). Due to a high level of statistical heterogeneity, sub-group analyses were performed. Sub-group analyses provided moderate-quality evidence that direct supervision of surgery significantly reduced the risk of mortality (RR 0.68, 95% CI 0.50-0.93, I(2) = 33%) and direct supervision of medical professionals conducting non-surgical invasive procedures significantly reduced the risk of complications (RR 0.33, 95% CI 0.24-0.46, I(2) = 0%). CS was associated with safer surgery and other invasive procedures for medical practitioners. There was a lack of evidence about the relationship between CS and safer patient care for non-medical health professionals. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Medical supervision of radiation workers

International Nuclear Information System (INIS)

Santani, S.B.; Nandakumar, A.N.; Subramanian, G.

1982-01-01

The basic elements of an occupational medical supervision programme for radiation workers are very much the same as those relevant to other professions with some additional special features. This paper cites examples from literature and recommends measures such as spot checks and continuance of medical supervision even after a radiation worker leaves this profession. (author)

Oceans apart, yet connected: Findings from a qualitative study on professional supervision in rural and remote allied health services.

Science.gov (United States)

Ducat, Wendy; Martin, Priya; Kumar, Saravana; Burge, Vanessa; Abernathy, LuJuana

2016-02-01

Improving the quality and safety of health care in Australia is imperative to ensure the right treatment is delivered to the right person at the right time. Achieving this requires appropriate clinical governance and support for health professionals, including professional supervision. This study investigates the usefulness and effectiveness of and barriers to supervision in rural and remote Queensland. As part of the evaluation of the Allied Health Rural and Remote Training and Support program, a qualitative descriptive study was conducted involving semi-structured interviews with 42 rural or remote allied health professionals, nine operational managers and four supervisors. The interviews explored perspectives on their supervision arrangements, including the perceived usefulness, effect on practice and barriers. Themes of reduced isolation; enhanced professional enthusiasm, growth and commitment to the organisation; enhanced clinical skills, knowledge and confidence; and enhanced patient safety were identified as perceived outcomes of professional supervision. Time, technology and organisational factors were identified as potential facilitators as well as potential barriers to effective supervision. This research provides current evidence on the impact of professional supervision in rural and remote Queensland. A multidimensional model of organisational factors associated with effective supervision in rural and remote settings is proposed identifying positive supervision culture and a good supervisor-supervisee fit as key factors associated with effective arrangements. © 2015 Commonwealth of Australia. Australian Journal of Rural Health published by Wiley Publishing Asia Pty Ltd. on behalf of National Rural Health Alliance Inc.

Cultural Humility in Psychotherapy Supervision.

Science.gov (United States)

Hook, Joshua N; Watkins, C Edward; Davis, Don E; Owen, Jesse; Van Tongeren, Daryl R; Ramos, Marciana J

2016-01-01

As a core component of multicultural orientation, cultural humility can be considered an important attitude for clinical supervisees to adopt and practically implement. How can cultural humility be most meaningfully incorporated in supervision? In what ways can supervisors stimulate the development of a culturally humble attitude in our supervisees? We consider those questions in this paper and present a model for addressing cultural humility in clinical supervision. The primary focus is given to two areas: (a) modeling and teaching of cultural humility through interpersonal interactions in supervision, and (b) teaching cultural humility through outside activities and experiences. Two case studies illustrating the model are presented, and a research agenda for work in this area is outlined.

SuperAssist: A User-Assistant Collaborative Environment for the supervision of medical instrument use at home

NARCIS (Netherlands)

Blanson Henkemans, O.A.; Neerincx, M.A.; Lindenberg, J.; Mast, C.A.P.G. van der

2007-01-01

With the rise of Transmural care, patients increasingly use medical instruments at home. Maintenance and troubleshooting greatly determines the safety and accuracy of these instruments. For the supervision of these complex tasks, we developed a User-Assistant Collaborative Environment (U-ACE). We

Burnout and the provision of psychosocial care amongst Australian cancer nurses.

Science.gov (United States)

Mcmillan, Kirsty; Butow, Phyllis; Turner, Jane; Yates, Patsy; White, Kate; Lambert, Sylvie; Stephens, Moira; Lawsin, Catalina

2016-06-01

To assess the prevalence of burnout amongst Australian cancer nurses as well as investigate the systemic and individual factors associated with burnout, including training and supervision for nurses in psychosocial care. Burnout amongst cancer nurses can have serious consequences for the individual nurse, the hospital and patients. Psychosocial care has been demonstrated in many studies to reduce distress in cancer patients; however, previous studies have suggested that providing psychosocial care can be stressful if nurses feel they lack appropriate training. Psychosocial skill training and supervision may be a way of improving job satisfaction and reducing burnout amongst nurses. Two hundred and thirty cancer nurses were recruited between November 2010 and April 2011 and completed an online questionnaire. Burnout levels within this population were found to be below nursing norms. Adequacy of training and supervision, frequency of supervision and percentage of role spent managing psychosocial care were found to be associated with burnout. Workload, Control, Reward and Community were independent predictors of burnout, and nurses with a greater mismatch in these areas identified as having High levels of burnout. Strategies to reduce burnout include providing cancer nurses with a varied and sustainable workload, awarding financial and social recognition of efforts and encouraging nurses to develop a sense of control over their work. Providing regular training and supervision in psychosocial care that is perceived to be adequate may also assist in reducing burnout. Copyright © 2016. Published by Elsevier Ltd.

Assessment of Counselors' Supervision Processes

Science.gov (United States)

Ünal, Ali; Sürücü, Abdullah; Yavuz, Mustafa

2013-01-01

The aim of this study is to investigate elementary and high school counselors' supervision processes and efficiency of their supervision. The interview method was used as it was thought to be better for realizing the aim of the study. The study group was composed of ten counselors who were chosen through purposeful sampling method. Data were…

Proficiency in Motivational Interviewing among Nurses in Child Health Services Following Workshop and Supervision with Systematic Feedback.

Directory of Open Access Journals (Sweden)

Johanna Enö Persson

Full Text Available Research on training in motivational interviewing (MI has shown eroding skills after workshops not followed by additional training input (supervision/coaching. There is a need for more research evaluating different types and lengths of post-workshop training with follow-up periods extending six months. This study is an extension of a previous evaluation of the level of proficiency in MI after workshop and four sessions of supervision among nurses in Swedish child health services.To explore the level of MI proficiency among nurses participating in an intervention to prevent childhood obesity (n = 33, after receiving five additional sessions of supervision including feedback on observed practice, as well as level of proficiency at follow-up.Level of proficiency was measured 4 and 12 months after completed supervision using recorded practice samples coded according to the Motivational Interviewing Treatment Integrity (MITI Code. Potential predictors of outcome were investigated.Proficiency remained on the same levels after nine sessions of supervision as after four sessions, and was generally low. The percentage of nurses reaching the proficiency level ranged from 18.2 to 54.5% across indicators. MI-spirit had increased significantly at follow-up, and the rest of the indicators remained on the same levels. No predictors of outcome were found.Comprehensive training programs with prolonged post-workshop supervision and feedback on observed practice may help to sustain but not improve participants' proficiency in MI. Potential explanations to the results and suggestions for future research are discussed.

Home Health Aides' Perceptions of Quality Care: Goals, Challenges, and Implications for a Rapidly Changing Industry.

Science.gov (United States)

Franzosa, Emily; Tsui, Emma K; Baron, Sherry

2018-02-01

Home care payment models, quality measures, and care plans are based on physical tasks workers perform, ignoring relational care that supports clients' cognitive, emotional, and social well-being. As states seek to rein in costs and improve the efficiency and quality of care, they will need to consider how to measure and support relational care. In four focus groups ( n = 27) of unionized, agency-based New York City home health aides, workers reported aide-client relationships were a cornerstone of high-quality care, and building them required communication, respect, and going the extra mile. Since much of this care was invisible outside the worker-client relationship, aides received little supervisory support and felt excluded from the formal care team. Aligning payment models with quality requires understanding the full scope of services aides provide and a quality work environment that offers support and supervision, engages aides in patient care, and gives them a voice in policy decisions.

Abusive Supervision Scale Development in Indonesia

Directory of Open Access Journals (Sweden)

Fenika Wulani

2014-02-01

Full Text Available The purpose of this study was to develop a scale of abusive supervision in Indonesia. The study was conducted with a different context and scale development method from Tepper’s (2000 abusive supervision scale. The abusive supervision scale from Tepper (2000 was developed in the U.S., which has a cultural orientation of low power distance. The current study was conducted in Indonesia, which has a high power distance. This study used interview procedures to obtain information about supervisor’s abusive behavior, and it was also assessed by experts. The results of this study indicated that abusive supervision was a 3-dimensional construct. There were anger-active abuse (6 items, humiliation-active abuse (4 items, and passive abuse (15 items. These scales have internal reliabilities of 0.947, 0.922, and 0.845, in sequence.

Perceptions on evaluative and formative functions of external supervision of Rwandan primary healthcare facilities: A qualitative study.

Science.gov (United States)

Schriver, Michael; Cubaka, Vincent Kalumire; Itangishaka, Sylvere; Nyirazinyoye, Laetitia; Kallestrup, Per

2018-01-01

External supervision of primary healthcare facilities in low- and middle-income countries often has a managerial main purpose in which the role of support for professional development is unclear. To explore how Rwandan primary healthcare supervisors and providers (supervisees) perceive evaluative and formative functions of external supervision. Qualitative, exploratory study. Focus group discussions: three with supervisors, three with providers, and one mixed (n = 31). Findings were discussed with individual and groups of supervisors and providers. Evaluative activities occupied providers' understanding of supervision, including checking, correcting, marking and performance-based financing. These were presented as sources of motivation, that in self-determination theory indicate introjected regulation. Supervisors preferred to highlight their role in formative supervision, which may mask their own and providers' uncontested accounts that systematic performance evaluations predominated supervisors' work. Providers strongly requested larger focus on formative and supportive functions, voiced as well by most supervisors. Impact of performance evaluation on motivation and professional development is discussed. While external supervisors intended to support providers' professional development, our findings indicate serious problems with this in a context of frequent evaluations and performance marking. Separating the role of supporter and evaluator does not appear as the simple solution. If external supervision is to improve health care services, it is essential that supervisors and health centre managers are competent to support providers in a way that transparently accounts for various performance pressures. This includes delivery of proper formative supervision with useful feedback, maintaining an effective supervisory relationship, as well as ensuring providers are aware of the purpose and content of evaluative and formative supervision functions.

The iOSC3 System: Using Ontologies and SWRL Rules for Intelligent Supervision and Care of Patients with Acute Cardiac Disorders

Directory of Open Access Journals (Sweden)

Marcos Martínez-Romero

2013-01-01

Full Text Available Physicians in the Intensive Care Unit (ICU are specially trained to deal constantly with very large and complex quantities of clinical data and make quick decisions as they face complications. However, the amount of information generated and the way the data are presented may overload the cognitive skills of even experienced professionals and lead to inaccurate or erroneous actions that put patients’ lives at risk. In this paper, we present the design, development, and validation of iOSC3, an ontology-based system for intelligent supervision and treatment of critical patients with acute cardiac disorders. The system analyzes the patient’s condition and provides a recommendation about the treatment that should be administered to achieve the fastest possible recovery. If the recommendation is accepted by the doctor, the system automatically modifies the quantity of drugs that are being delivered to the patient. The knowledge base is constituted by an OWL ontology and a set of SWRL rules that represent the expert’s knowledge. iOSC3 has been developed in collaboration with experts from the Cardiac Intensive Care Unit (CICU of the Meixoeiro Hospital, one of the most significant hospitals in the northwest region of Spain.

Semi-supervised sparse coding

KAUST Repository

Wang, Jim Jing-Yan; Gao, Xin

2014-01-01

Sparse coding approximates the data sample as a sparse linear combination of some basic codewords and uses the sparse codes as new presentations. In this paper, we investigate learning discriminative sparse codes by sparse coding in a semi-supervised manner, where only a few training samples are labeled. By using the manifold structure spanned by the data set of both labeled and unlabeled samples and the constraints provided by the labels of the labeled samples, we learn the variable class labels for all the samples. Furthermore, to improve the discriminative ability of the learned sparse codes, we assume that the class labels could be predicted from the sparse codes directly using a linear classifier. By solving the codebook, sparse codes, class labels and classifier parameters simultaneously in a unified objective function, we develop a semi-supervised sparse coding algorithm. Experiments on two real-world pattern recognition problems demonstrate the advantage of the proposed methods over supervised sparse coding methods on partially labeled data sets.

Semi-supervised sparse coding

KAUST Repository

Wang, Jim Jing-Yan

2014-07-06

Sparse coding approximates the data sample as a sparse linear combination of some basic codewords and uses the sparse codes as new presentations. In this paper, we investigate learning discriminative sparse codes by sparse coding in a semi-supervised manner, where only a few training samples are labeled. By using the manifold structure spanned by the data set of both labeled and unlabeled samples and the constraints provided by the labels of the labeled samples, we learn the variable class labels for all the samples. Furthermore, to improve the discriminative ability of the learned sparse codes, we assume that the class labels could be predicted from the sparse codes directly using a linear classifier. By solving the codebook, sparse codes, class labels and classifier parameters simultaneously in a unified objective function, we develop a semi-supervised sparse coding algorithm. Experiments on two real-world pattern recognition problems demonstrate the advantage of the proposed methods over supervised sparse coding methods on partially labeled data sets.

Opportunities to Learn Scientific Thinking in Joint Doctoral Supervision

Science.gov (United States)

Kobayashi, Sofie; Grout, Brian W.; Rump, Camilla Østerberg

2015-01-01

Research into doctoral supervision has increased rapidly over the last decades, yet our understanding of how doctoral students learn scientific thinking from supervision is limited. Most studies are based on interviews with little work being reported that is based on observation of actual supervision. While joint supervision has become widely…

Framing doctoral supervision as formative assessment

DEFF Research Database (Denmark)

Kobayashi, Sofie

Doctoral supervision has been described through a number of models useful for understanding different aspects of supervision. None of these are all-encompassing, but each emphasizes a particular perspective, like the relationship, personal vs. structural support, process vs. product orientation. ...

Characteristics of Transgender Women Living with HIV Receiving Medical Care in the United States.

Science.gov (United States)

Mizuno, Yuko; Frazier, Emma L; Huang, Ping; Skarbinski, Jacek

2015-09-01

Little has been reported from population-based surveys on the characteristics of transgender persons living with HIV. Using Medical Monitoring Project (MMP) data, we describe the characteristics of HIV-infected transgender women and examine their care and treatment needs. We used combined data from the 2009 to 2011 cycles of MMP, an HIV surveillance system designed to produce nationally representative estimates of the characteristics of HIV-infected adults receiving medical care in the United States, to compare demographic, behavioral, and clinical characteristics, and met and unmet needs for supportive services of transgender women with those of non-transgender persons using Rao-Scott chi-square tests. An estimated 1.3% of HIV-infected persons receiving care in the United States self-identified as transgender women. Transgender women were socioeconomically more marginalized than non-transgender men and women. We found no differences between transgender women and non-transgender men and women in the percentages prescribed antiretroviral therapy (ART). However, a significantly lower percentage of transgender women compared to non-transgender men had 100% ART dose adherence (78.4% vs. 87.4%) and durable viral suppression (50.8% vs. 61.4%). Higher percentages of transgender women needed supportive services. No differences were observed in receipt of most of supportive services, but transgender women had higher unmet needs than non-transgender men for basic services such as food and housing. We found little difference between transgender women and non-transgender persons in regards to receipt of care, treatment, and most of supportive services. However, the noted disparities in durable viral suppression and unmet needs for basic services should be explored further.

Re-thinking reflection in supervision

DEFF Research Database (Denmark)

Lystbæk, Christian Tang

The paper presents a socio-cultural perspective on supervision in professional education, which challenges the current reflective paradigm and move the debate on reflection in supervision in professional education and learning towards a recognition of context, power dynamics and ideological...... of reflective practice has been formalized by regulatory bodies as a way to develop the professionalism of both individual professional practitioners as students through continuing professional developmental processes. Consequently, reflection is often used as a `tool´ for personal and professional development...... al., 2010). This conceptual paper presents a critical, socio-cultural perspective on the current paradigm or dogma of reflective practice within supervision in professional education and learning. The purpose I to challenge the dogma and critically to analyze and move the debate on reflection...

The efficiency of government supervision

International Nuclear Information System (INIS)

Paetzold, H.

1992-01-01

In 1970, fires as events initiating plant failure were included in the accident analyses of nuclear power plant design concepts. In the meantime, they have been expressed in more precise terms and incorporated into the bodies of nuclear technical rules and regulations. Following a suggestion by the Baden-Wuerttemberg State Ministry for the Environment, the efficiency of government supervision has been examined for the example of fire protection measures or the site of Phillipsburg with one BWR and one PWR plant in operation. The result of the examination indicated that pragmatic approaches and the establishment of key areas of supervision could further enhance the efficiency of government supervision under Section 19 of the German Atomic Energy Act and achieve improvements in plant safety. (orig.) [de

PAs and NPs in an emergency room-linked acute care clinic.

Science.gov (United States)

Currey, C J

1984-12-01

The use of hospital emergency rooms for nonurgent care during evenings hours often strains medical resources and may affect the quality of emergency care. One facility's effective use of an after-hours acute care clinic staffed by PAs and NPs to divert nonurgent problems away from its emergency room is outlined. PAs and NPs work during peak demand hours (evenings and weekends) under the supervision of an emergency room physician, and receive supplementary support from other emergency room personnel. Incoming patients are referred to the emergency room or acute care clinic, depending on the nature of their problems. Acute care clinic patients are then treated by the PA or NP and either released or referred to an emergency room physician, if their conditions warrant additional treatment. As a result, use of the acute care clinic has greatly reduced the amount of non-urgent medical treatment in the emergency room and has provided other advantages to both patients and staff as well. These advantages and the encouraging statistics following six months of the clinic's operation are discussed.

Implementing the 2009 Institute of Medicine recommendations on resident physician work hours, supervision, and safety

Science.gov (United States)

Blum, Alexander B; Shea, Sandra; Czeisler, Charles A; Landrigan, Christopher P; Leape, Lucian

2011-01-01

Long working hours and sleep deprivation have been a facet of physician training in the US since the advent of the modern residency system. However, the scientific evidence linking fatigue with deficits in human performance, accidents and errors in industries from aeronautics to medicine, nuclear power, and transportation has mounted over the last 40 years. This evidence has also spawned regulations to help ensure public safety across safety-sensitive industries, with the notable exception of medicine. In late 2007, at the behest of the US Congress, the Institute of Medicine embarked on a year-long examination of the scientific evidence linking resident physician sleep deprivation with clinical performance deficits and medical errors. The Institute of Medicine’s report, entitled “Resident duty hours: Enhancing sleep, supervision and safety”, published in January 2009, recommended new limits on resident physician work hours and workload, increased supervision, a heightened focus on resident physician safety, training in structured handovers and quality improvement, more rigorous external oversight of work hours and other aspects of residency training, and the identification of expanded funding sources necessary to implement the recommended reforms successfully and protect the public and resident physicians themselves from preventable harm. Given that resident physicians comprise almost a quarter of all physicians who work in hospitals, and that taxpayers, through Medicare and Medicaid, fund graduate medical education, the public has a deep investment in physician training. Patients expect to receive safe, high-quality care in the nation’s teaching hospitals. Because it is their safety that is at issue, their voices should be central in policy decisions affecting patient safety. It is likewise important to integrate the perspectives of resident physicians, policy makers, and other constituencies in designing new policies. However, since its release

Organization and competences of nuclear supervision in Poland

International Nuclear Information System (INIS)

Sowinski, M.

1989-01-01

Organization and tasks of nuclear supervision are presented. All supervised nuclear installations are listed. The rights of the president of the National Atomic Energy Agency and the chief inspector of nuclear supervision are given. Licensing and cooperation with the IAEA are described. (A.S.)

Hospitalization for urinary tract infections and the quality of preventive health care received by people with spina bifida.

Science.gov (United States)

Armour, Brian S; Ouyang, Lijing; Thibadeau, Judy; Grosse, Scott D; Campbell, Vincent A; Joseph, David

2009-07-01

The preventive health care needs of people with disabilities often go unmet, resulting in medical complications that may require hospitalization. Such complications could be due, in part, to difficulty accessing care or the quality of ambulatory care services received. To use hospitalizations for urinary tract infections (UTIs) as a marker of the potential quality of ambulatory care services received by people affected by spina bifida. MarketScan inpatient and outpatient medical claims data for 2000 through 2003 were used to identify hospitalizations for UTI, which is an ambulatory care sensitive condition, for people affected by spina bifida and to calculate inpatient discharge rates, average lengths of stay, and average medical care expenditures for such hospitalizations. People affected by spina bifida averaged 0.5 hospitalizations per year, and there were 22.8 inpatient admissions with UTI per 1000 persons with spina bifida during the period 2000-2003, in comparison to an average of 0.44 admission with UTI per 1000 persons for those without spina bifida. If the number of UTI hospitalizations among people affected by spina bifida were reduced by 50%, expenditures could be reduced by $4.4 million per 1000 patients. Consensus on the evaluation and management of bacteriuria could enhance clinical care and reduce the disparity in UTI discharge rates among people affected by spina bifida compared to those without spina bifida. National evidence-based guidelines are needed.

Developing a Strong Direct Care Workforce.

Science.gov (United States)

Stear, Lynda A

The aging population of the United States has led to a need for more direct care workers to provide personal care to older adults and disabled people in their homes. The U.S. Bureau of Labor Statistics predicts employment of paraprofessionals in home care will grow 49% between 2012 and 2022 as the baby boomer generation ages and requires more assistance in activities of daily living. The typical direct care worker is a female aged 25 to 54 years old, a demographic that is projected to remain flat in the coming years. Direct care workers typically are poorly paid for work that is labor-intensive and often work in less than optimal working conditions. It is important that agencies hiring direct care workers understand the challenges these workers face and institute sound hiring practices and provide proper training and ongoing supervision. It is possible to have a quality direct care team. Proper training, role modeling, and supervision will improve employee satisfaction, decrease turnover, and improve care outcomes for patients.

Preventing Urinary Incontinence With Supervised Prenatal Pelvic Floor Exercises: A Randomized Controlled Trial.

Science.gov (United States)

Fritel, Xavier; de Tayrac, Renaud; Bader, Georges; Savary, Denis; Gueye, Ameth; Deffieux, Xavier; Fernandez, Hervé; Richet, Claude; Guilhot, Joëlle; Fauconnier, Arnaud

2015-08-01

To compare, in an unselected population of nulliparous pregnant women, the postnatal effect of prenatal supervised pelvic floor muscle training with written instructions on postpartum urinary incontinence (UI). In a randomized controlled trial in two parallel groups, 282 women were recruited from five university teaching hospitals in France and randomized during the second trimester of pregnancy. The physiotherapy group received prenatal individually supervised exercises. Both groups received written instructions about how to perform exercises at home. Women were blindly assessed at baseline, end of pregnancy, and 2 and 12 months postpartum. The primary outcome measured was UI severity, assessed with an International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form score (range 0-21; 1-5 is slight UI) at 12 months postpartum; other outcomes were UI prevalence and pelvic floor troubles assessed using self-administered questionnaires. To give a 1-point difference in UI severity score, we needed 91 women in each group (standard deviation 2.4, α=0.05, β=0.20, and bilateral analysis). Between February 2008 and June 2010, 140 women were randomized in the physiotherapy group and 142 in the control group. No difference was observed between the two groups in UI severity, prevalence, or pelvic floor troubles at baseline, end of pregnancy, and at 2 and 12 months postpartum. At 12 months postpartum, the primary outcome was available for 190 women (67.4%); mean UI severity was 1.9 in the physiotherapy group compared with 2.1 in the control group (P=.38). Prenatal supervised pelvic floor training was not superior to written instructions in reducing postnatal UI. ClinicalTrials.gov; www.clinicaltrials.gov, NCT00551551. I.

Doctoral Dissertation Supervision: Identification and Evaluation of Models

Directory of Open Access Journals (Sweden)

Ngozi Agu

2014-01-01

Full Text Available Doctoral research supervision is one of the major avenues for sustaining students’ satisfaction with the programme, preparing students to be independent researchers and effectively initiating students into the academic community. This work reports doctoral students’ evaluation of their various supervision models, their satisfaction with these supervision models, and development of research-related skills. The study used a descriptive research design and was guided by three research questions and two hypotheses. A sample of 310 Ph.D. candidates drawn from a federal university in Eastern part of Nigeria was used for this study. The data generated through the questionnaire was analyzed using descriptive statistics and t-tests. Results show that face-to-face interactive model was not only the most frequently used, but also the most widely adopted in doctoral thesis supervision while ICT-based models were rarely used. Students supervised under face-to-face interactive model reported being more satisfied with dissertation supervision than those operating under face-to-face noninteractive model. However, students supervised under these two models did not differ significantly in their perceived development in research-related skills.

Application of Contingency Theories to the Supervision of Student Teachers.

Science.gov (United States)

Phelps, Julia D.

1985-01-01

This article examines selected approaches to student teacher supervision within the context of contingency theory. These include authentic supervision, developmental supervision, and supervision based on the student's level of maturity. (MT)

The Cryogenic Supervision System in NSRRC

CERN Document Server

Li, Hsing-Chieh; Chiou, Wen-Song; Hsiao, Feng-Zone; Tsai, Zong-Da

2005-01-01

The helium cryogenic system in NSRRC is a fully automatic PLC system using the Siemens SIMATIC 300 controller. Modularization in both hardware and software makes it easy in the program reading, the system modification and the problem debug. Based on the Laview program we had developed a supervision system taking advantage of the Internet technology to get system's real-time information in any place. The functions of this supervision system include the real-time data accessing with more than 300 digital/analog signals, the data restore, the history trend display, and the human machine interface. The data is accessed via a Profibus line connecting the PLC system and the supervision system with a maximum baud rate 1.5 Mbit/s. Due to this supervision system, it is easy to master the status of the cryogenic system within a short time and diagnose the problem.

76 FR 10945 - San Luis Trust Bank, FSB, San Luis Obispo, CA; Notice of Appointment of Receiver

Science.gov (United States)

2011-02-28

... DEPARTMENT OF THE TREASURY Office of Thrift Supervision San Luis Trust Bank, FSB, San Luis Obispo, CA; Notice of Appointment of Receiver Notice is hereby given that, pursuant to the authority... appointed the Federal Deposit Insurance Corporation as sole Receiver for San Luis Trust Bank, FSB, San Luis...

Predictive factors for moderate or severe exacerbations in asthma patients receiving outpatient care

OpenAIRE

Guti?rrez, Francisco Javier ?lvarez; Galv?n, Marta Ferrer; Gallardo, Juan Francisco Medina; Mancera, Marta Barrera; Romero, Beatriz Romero; Falc?n, Auxiliadora Romero

2017-01-01

Background Asthma exacerbations are important events that affect disease control, but predictive factors for severe or moderate exacerbations are not known. The objective was to study the predictive factors for moderate (ME) and severe (SE) exacerbations in asthma patients receiving outpatient care. Methods Patients aged?>?12?years with asthma were included in the study and followed-up at 4-monthly intervals over a 12-month period. Clinical (severity, level of control, asthma control test [AC...

Supervision and inspection plans of plants activities; Plan de inspeccion y supervision de actividades en planta

Energy Technology Data Exchange (ETDEWEB)

Feijoo, J. P.

2009-07-01

Any idea of hierarchization between supervisor and supervised in inspection and supervision activities should necessarily be dismissed, and the independence of the supervisor when executing has tasks should be guaranteed. The inspection and supervision program enable the detection and resolution of materials and human problems alike. In addition, they are a solution to anticipate potential problems in the future, which results in a very significant reduction of industrial accidents and human errors, as well as better use and upkeep of equipment. With these programs we improve our management and our work, and without a doubt they help to strengthen the safety culture in Cofrentes Nuclear Power Plant. (Author)

From knowledge to recognition: Evaluation of the process of a supervision group through lexical and textual statistical analysis

Directory of Open Access Journals (Sweden)

Giovanna Di Falco

2014-09-01

Full Text Available The following article shows the process analysis of group supervision within a Therapeutic Community for adolescents with psychiatric problems. The main aim is to explore the influence of the group supervision on the quality of the patients care and, at the same time, the relationship between the therapists. The evaluation was made recording the group meetings and analyzing the transcriptions (representation of therapists’ speeches in written form through the use of statistical text analysis. Data analysis describes the frame of an institution – the TC – where it seems possible to “think” and “rethink” the clinical work and the relationship with patients bearing in mind – at the same time – institutional aspects; patients’ family role; social context; emotional and relational aspects of the therapists.Keywords: Process, Supervision, Therapeutic community

Educational Technology and Distance Supervision in Counselor Education

Science.gov (United States)

Carlisle, Robert Milton; Hays, Danica G.; Pribesh, Shana L.; Wood, Chris T.

2017-01-01

The authors used a nonexperimental descriptive design to examine the prevalence of distance supervision in counselor education programs, educational technology used in supervision, training on technology in supervision, and participants' (N = 673) perceptions of legal and ethical compliance. Program policies are recommended to guide the training…

"To cherish each day as it comes": a qualitative study of spirituality among persons receiving palliative care.

Science.gov (United States)

Asgeirsdottir, Gudlaug Helga; Sigurbjörnsson, Einar; Traustadottir, Rannveig; Sigurdardottir, Valgerdur; Gunnarsdottir, Sigridur; Kelly, Ewan

2013-05-01

Spirituality is one of the main aspects of palliative care. The concept is multidimensional and encompasses the existential realm as well as value-based and religious considerations. The aim of this study was to explore spirituality from the perspective of persons receiving palliative care and examine their experience of spirituality and its influence on their lives and well-being. Qualitative interviews were conducted with ten persons receiving palliative care from Palliative Care Services in Iceland. The interviews were tape-recorded, transcribed and analysed. The study is in the field of practical theology and used the theoretical approach of hermeneutical phenomenology. Thematic analysis found that the spiritual dimension was of significance for the participants who understood it as a vital element connected to seeking meaning, purpose and transcendence in life. Religious and non-religious aspects of spirituality were expressed including strong spiritual components of family relationships, the meaning of God/a higher being and spiritual practices which served as a key factor in giving strength, activating inner resources and motivating hope. Nine of the participants expressed their spirituality as faith. Spirituality was experienced broadly as an important dimension of how participants lived with terminal illness. Religious and non-religious characteristics were recognised which reveals the complex nature of the phenomenon. Faith was a significant part of the participants' spirituality indicating the importance of attending to this aspect of palliative care. The study suggests the potential contributions of theological approaches which are relevant for palliative care research and practice.

State Radiation Protection Supervision and Control

International Nuclear Information System (INIS)

2003-01-01

Radiation Protection Centre is carrying state supervision and control of radiation protection. The main objective of state supervision and control of radiation protection is assessing how licensees comply with requirements of the appropriate legislation and enforcement. Summary of inspections conducted in 2002 is presented

State Radiation Protection Supervision and Control

CERN Document Server

2002-01-01

Radiation Protection Centre is carrying state supervision and control of radiation protection. The main objective of state supervision and control of radiation protection is assessing how licensees comply with requirements of the appropriate legislation and enforcement. Summary of inspections conducted in 2002 is presented.

Life perceptions of patients receiving palliative care and experiencing psycho-social-spiritual healing.

Science.gov (United States)

Li, Lingsheng; Sloan, Danetta H; Mehta, Ambereen K; Willis, Gordon; Weaver, Meaghann S; Berger, Ann C

2017-07-01

It is important to identify, from the patients' perspectives, the different factors that contribute toward psycho-social-spiritual healing. This was a qualitative study that took place at a large research center, an underserved clinic, and a community hospital. We used a needs assessment questionnaire and open-ended questions to assess the constituents of psycho-social-spiritual healing: (I) how previous life experiences affected patients' present situations in dealing with their illnesses; (II) barriers to palliative care, and (III) benefits of palliative care. Of a total of 30 participants from 3 different study sites, 24 (80%) were receiving inpatient or outpatient palliative care at a research center. Thirteen (43%) participants were female, 10 (33%) were Black/African American, and 16 (53%) reported being on disability. While the initial shock of the diagnosis made participants feel unprepared for their illnesses, many looked to role models, previous work experiences, and spiritual as well as religious support as sources of strength and coping mechanisms. Barriers to palliative care were identified as either external (lack of proper resources) or internal (symptom barriers and perceived self-limitations). The feeling of "being seen/being heard" was perceived by many participants as the most beneficial aspect of palliative care. The needs assessment questionnaire and open-ended questions presented in this study may be used in clinical settings to better help patients achieve psycho-social-spiritual healing through palliative care and to help clinicians learn about the person behind the patient.

[Possibilities of supervision in medical practice].

Science.gov (United States)

Lönnqvist, Jouko

2014-01-01

In supervision, a doctor examines in interaction with the supervisor her/his work, work role and collaborative relationships with the aim to develop herself/himself and the associated work community. In clinical supervision, a doctor's way of acting in interactive relationships with the patients is examined through patient cases, based on the doctor's own experience. Supervision can be used to strengthen the physician identity, clarify the work role, assimilate and delve into clinical work, support professional development and working career, manage one's own work and coping at work, develop collaboration and team work, and support the work of medical directors.

Semi-supervised and unsupervised extreme learning machines.

Science.gov (United States)

Huang, Gao; Song, Shiji; Gupta, Jatinder N D; Wu, Cheng

2014-12-01

Extreme learning machines (ELMs) have proven to be efficient and effective learning mechanisms for pattern classification and regression. However, ELMs are primarily applied to supervised learning problems. Only a few existing research papers have used ELMs to explore unlabeled data. In this paper, we extend ELMs for both semi-supervised and unsupervised tasks based on the manifold regularization, thus greatly expanding the applicability of ELMs. The key advantages of the proposed algorithms are as follows: 1) both the semi-supervised ELM (SS-ELM) and the unsupervised ELM (US-ELM) exhibit learning capability and computational efficiency of ELMs; 2) both algorithms naturally handle multiclass classification or multicluster clustering; and 3) both algorithms are inductive and can handle unseen data at test time directly. Moreover, it is shown in this paper that all the supervised, semi-supervised, and unsupervised ELMs can actually be put into a unified framework. This provides new perspectives for understanding the mechanism of random feature mapping, which is the key concept in ELM theory. Empirical study on a wide range of data sets demonstrates that the proposed algorithms are competitive with the state-of-the-art semi-supervised or unsupervised learning algorithms in terms of accuracy and efficiency.

Spiritual well-being among outpatients with cancer receiving concurrent oncologic and palliative care.

Science.gov (United States)

Rabow, Michael W; Knish, Sarah J

2015-04-01

Spiritual well-being is threatened by cancer, but its correlation with other illness symptoms and the efficacy of palliative care (PC) to ameliorate spiritual suffering are not well understood. We conducted a retrospective study using a convenience sample of oncology patients at a comprehensive cancer center who received concurrent oncologic and palliative care between 2008 and 2011 and completed ESAS, QUAL-E, and Steinhauser Spiritual well-being survey questions was conducted. Descriptive, correlation, and t test statistics. Eight hundred eighty-three patients surveyed had an average age of 65.6 years, with 54.1 % female, 69.3 % white, and 49.3 % married. Half (452, 51.2 %) had metastatic disease. Religious affiliation was reported as Christian by 20.3 %, Catholic by 18.7 %, and "none" by 39.0 %. Baseline spiritual well-being was not significantly correlated with age, gender, race, cancer stage, marital status, insurance provider, or having a religious affiliation. Greater spiritual well-being was correlated with greater quality of life (well-being (spiritual well-being and anxiety, depression, fatigue, and quality of life (R (2) = 0.677). Spiritual well-being improved comparing mean scores immediately prior to initial PC consultation with those at first follow-up (2.89 vs. 3.23 on a 1-5 scale, p = 0.005). Among patients with cancer receiving concurrent oncologic and palliative care, spiritual well-being was not associated with patient age, gender, or race, or disease stage. It was correlated with physical and emotional symptoms. Spiritual well-being scores improved from just prior to the initial PC consultation to just prior to the first PC follow-up visit.

gamAID: Greedy CP tensor decomposition for supervised EHR-based disease trajectory differentiation.

Science.gov (United States)

Henderson, Jette; Ho, Joyce; Ghosh, Joydeep

2017-07-01

We propose gamAID, an exploratory, supervised nonnegative tensor factorization method that iteratively extracts phenotypes from tensors constructed from medical count data. Using data from diabetic patients who later on get diagnosed with chronic kidney disorder (CKD) as well as diabetic patients who do not receive a CKD diagnosis, we demonstrate the potential of gamAID to discover phenotypes that characterize patients who are at risk for developing a disease.

Pediatric Patients Receiving Specialized Palliative Home Care According to German Law: A Prospective Multicenter Cohort Study

Directory of Open Access Journals (Sweden)

Silke Nolte-Buchholtz

2018-05-01

Full Text Available In Germany, every child with a life-limiting condition suffering from symptoms that cannot sufficiently be controlled is eligible by law for specialized pediatric palliative home care (SPPHC. It is the aim of this study to describe the demographic and clinical characteristics of children referred to SPPHC and to compare patients with cancer and non-cancer conditions. The prospective multicenter study includes data on 75 children (median age 7.7 years, 50.7% male. The majority had non-cancer conditions (72%. The most common symptoms were cognitive impairment, somatic pain, impairment in communication or swallowing difficulties. Swallowing difficulties, seizures, and spasticity occurred significantly more often in non-cancer patients (p < 0.01. Cancer patients received antiemetics significantly more often (permanent and on demand than non-cancer patients (p < 0.01. Significantly more non-cancer patients had some type of feeding tube (57.3% or received oxygen (33.3% (p < 0.01. Central venous catheters had been fitted in 20% of the patients, mostly in cancer patients (p < 0.001. Tracheostomy tubes (9.3% or ventilation (14.7% were only used in non-cancer patients. In conclusion, patients referred to SPPHC are a diverse cohort with complex conditions including a large range of neurologically originating symptoms. The care of pediatric palliative care patients with cancer is different to the care of non-cancer patients.

Multiplicity in supervision relationships: A factor in improving ...

African Journals Online (AJOL)

Supervision has been identified as an important factor in the success of postgraduate students, even as the most significant variable and a large number of studies have been conducted to identify factors that contribute to supervision success. However the dependent variable in these studies – supervision success – has ...

28 CFR 2.94 - Supervision reports to Commission.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Supervision reports to Commission. 2.94 Section 2.94 Judicial Administration DEPARTMENT OF JUSTICE PAROLE, RELEASE, SUPERVISION AND RECOMMITMENT OF PRISONERS, YOUTH OFFENDERS, AND JUVENILE DELINQUENTS District of Columbia Code: Prisoners and Parolees § 2.94 Supervision reports to Commissio...

48 CFR 836.572 - Government supervision.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Government supervision. 836.572 Section 836.572 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS SPECIAL CATEGORIES OF CONTRACTING CONSTRUCTION AND ARCHITECT-ENGINEER CONTRACTS Contract Clauses 836.572 Government supervision. The contracting officer shal...

Front-line managers as boundary spanners: effects of span and time on nurse supervision satisfaction.

Science.gov (United States)

Meyer, Raquel M; O'Brien-Pallas, Linda; Doran, Diane; Streiner, David; Ferguson-Paré, Mary; Duffield, Christine

2011-07-01

To examine the influence of nurse manager span (number of direct report staff), time in staff contact, transformational leadership practices and operational hours on nurse supervision satisfaction. Increasing role complexity has intensified the boundary spanning functions of managers. Because work demands and scope vary by management position, time in staff contact rather than span may better explain managers' capacity to support staff. A descriptive, correlational design was used to collect cross-sectional survey and prospective work log and administrative data from a convenience sample of 558 nurses in 51 clinical areas and 31 front-line nurse managers from four acute care hospitals in 2007-2008. Data were analysed using hierarchical linear modelling. Span, but not time in staff contact, interacted with leadership and operational hours to explain supervision satisfaction. With compressed operational hours, supervision satisfaction was lower with highly transformational leadership in combination with wider spans. With extended operational hours, supervision satisfaction was higher with highly transformational leadership, and this effect was more pronounced under wider spans. Operational hours, which influence the manager's daily span (average number of direct report staff working per weekday), should be factored into the design of front-line management positions. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

The normalization of nursing supervision in the comprehensive interventional therapy and diagnosis center

International Nuclear Information System (INIS)

Li Xue; Chen Jinhua; Zhang Weiguo; Wang Yi

2009-01-01

Objective: To discuss the normalization of nursing supervision in the comprehensive interventional therapy and diagnosis center in order to improve the nursing quality and work-efficiency. Methods: The following normalization measures were established: to formulate a new system of administration, to consummate interventional rules and regulations, to normalize various operation process and nursing norms, to design interventional nursing record, to cultivate professional interventional nurses, to establish the transversal connecting interventional nursing model, to enhance the interventional quality control of care, to consummate quality evaluation criterion and to enact unified management of the interventional consumed material by computer. Results: The expertise and skill of nursing personnel was significantly raised. The nursing personnel could assume the assistance and salvage in various large and complicate interventional operation. The nursing quality could meet the professional requirements. The administration of the interventional center gained the cohesive force and the nursing supervision became on the right track, right procedure and scientific principle. The nursing quality and work-efficiency was greatly improved. Conclusion: It is necessary to establish comprehensive interventional center and enforce the normalization of the nursing supervision for the development of the subject of interventional radiology. (authors)

Is a nurse-led telephone intervention a viable alternative to nurse-led home care and standard care for patients receiving oral capecitabine? Results from a large prospective audit in patients with colorectal cancer.

Science.gov (United States)

Craven, Olive; Hughes, Carol Anne; Burton, Amy; Saunders, Mark P; Molassiotis, Alex

2013-05-01

Home care nursing has been shown to be a valuable service for patients receiving oral chemotherapy; however, associated costs can be high and telephone-based services may be more cost-effective options. This prospective audit explored the usefulness of a nurse-led telephone intervention for supporting cancer patients treated with Capecitabine, comparing historical findings from a randomised trial evaluating a home-based intervention over standard care with a modified nurse-led telephone follow-up intervention. Self-reported toxicity and service use were assessed in 298 patients who received nurse-led telephone follow-up, compared with historical data from 164 patients (81 receiving standard care and 83 home care intervention). Findings suggested that nurse-led telephone follow-up can potentially lead to reduced toxicity (chest pain, vomiting, oral mucositis, nausea, insomnia) when compared with standard care, and that it has a similar impact on the management of some symptoms when compared with home care (i.e. vomiting, oral mucositis), although it was not as effective as the home care intervention for other toxicities (diarrhoea and insomnia). These encouraging findings need to be explored further using a randomised trial design before we reach any conclusions. Further research should also include a health economics study to assess the cost-effectiveness of the telephone-based services for patients receiving oral chemotherapy. © 2013 Blackwell Publishing Ltd.

New developments in technology-assisted supervision and training: a practical overview.

Science.gov (United States)

Rousmaniere, Tony; Abbass, Allan; Frederickson, Jon

2014-11-01

Clinical supervision and training are now widely available online. In this article, three of the most accessible and widely adopted new developments in clinical supervision and training technology are described: Videoconference supervision, cloud-based file sharing software, and clinical outcome tracking software. Partial transcripts from two online supervision sessions are provided as examples of videoconference-based supervision. The benefits and limitations of technology in supervision and training are discussed, with an emphasis on supervision process, ethics, privacy, and security. Recommendations for supervision practice are made, including methods to enhance experiential learning, the supervisory working alliance, and online security. © 2014 Wiley Periodicals, Inc.

Quality of previous diabetes care among patients receiving services at ophthalmology hospitals in Mexico.

Science.gov (United States)

Rodríguez-Saldana, Joel; Rosales-Campos, Andrea C; Rangel León, Carmen B; Vázquez-Rodríguez, Laura I; Martínez-Castro, Francisco; Piette, John D

2010-12-01

To survey a large sample of type 2 diabetes mellitus (T2DM) patients in Mexico City to determine if patient experience, access to basic services, treatment, and outcomes differed between those with social security coverage and those without. From 2001-2007 a total of 1 000 individuals with T2DM were surveyed in outpatient clinics of the three largest public ophthalmology hospitals in Mexico City. Patients reported information about their health status and receipt of basic diabetes services, such as laboratory glycemic monitoring and diabetes education. Rates were compared between those with (n = 461) and without (n = 539) social security. Almost half of the patients (46%) in these public facilities were social security patients that were unable to access other services and had to pay out-of-pocket for care. Half of respondents were originally identified as potentially diabetic based on symptom complaints (51%), including 11% with visual impairment. Most patients (87.9%) reported that their glycemic level was being monitored exclusively via fasting blood glucose testing or random capillary blood glucose tests; only 5.3% reported ever having a glycated hemoglobin test. While nearly all respondents reported an individual physician encounter ever, only 39% reported ever receiving nutrition counseling and only 21% reported attending one or more sessions of diabetes education in their lifetime. Processes of care and outcomes were no different in patients with and those without social security coverage. In Mexico, the quality of diabetes care is poor. Despite receiving social security, many patients still have to pay out-of-pocket to access needed care. Without policy changes that address these barriers to comprehensive diabetes management, scientific achievements in diagnosis and pharmacotherapy will have limited impact.

Teacher Supervision Practices and Principals' Characteristics

Science.gov (United States)

April, Daniel; Bouchamma, Yamina

2015-01-01

A questionnaire was used to determine the individual and collective teacher supervision practices of school principals and vice-principals in Québec (n = 39) who participated in a research-action study on pedagogical supervision. These practices were then analyzed in terms of the principals' sociodemographic and socioprofessional characteristics…

32 CFR 552.65 - Command supervision.

Science.gov (United States)

2010-07-01

... 32 National Defense 3 2010-07-01 2010-07-01 true Command supervision. 552.65 Section 552.65 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY MILITARY RESERVATIONS AND NATIONAL CEMETERIES REGULATIONS AFFECTING MILITARY RESERVATIONS Solicitation on Military Reservations § 552.65 Command supervision. (a) All insurance...

Ethics in education supervision

Directory of Open Access Journals (Sweden)

Fatma ÖZMEN

2008-06-01

Full Text Available Supervision in education plays a crucial role in attaining educational goals. In addition to determining the present situation, it has a theoretical and practical function regarding the actions to be taken in general and the achievement of teacher development in particular to meet the educational goals in the most effective way. For the education supervisors to act ethically in their tasks while achieving this vital mission shall facilitate them to build up trust, to enhance the level of collaboration and sharing, thus it shall contribute to organizational effectiveness. Ethics is an essential component of educational supervision. Yet, it demonstrates rather vague quality due to the conditions, persons, and situations. Therefore, it is a difficult process to develop the ethical standards in institutions. This study aims to clarify the concept of ethics, to bring up its importance, and to make recommendations for more effective supervisions from the aspect of ethics, based on the literature review, some research results, and sample cases reported by teachers and supervisors.

Clinical Supervision of International Supervisees: Suggestions for Multicultural Supervision

Science.gov (United States)

Lee, Ahram

2018-01-01

An increase of international students in various settings has been noted in a range of disciplines including counseling and other mental health professions. The author examined the literature on international counseling students related to their experiences in counseling training, particularly in supervision. From the counseling literature, five…

Music Therapy is Associated With Family Perception of More Spiritual Support and Decreased Breathing Problems in Cancer Patients Receiving Hospice Care.

Science.gov (United States)

Burns, Debra S; Perkins, Susan M; Tong, Yan; Hilliard, Russell E; Cripe, Larry D

2015-08-01

Music therapy is a common discretionary service offered within hospice; however, there are critical gaps in understanding the effects of music therapy on hospice quality indicators, such as family satisfaction with care. The purpose of this study was to examine whether music therapy affected family perception of patients' symptoms and family satisfaction with hospice care. This was a retrospective, cross-sectional analysis of electronic medical records from 10,534 cancer patients cared for between 2006 and 2010 by a large national hospice. Logistic regression was used to estimate the effect of music therapy using propensity scores to adjust for non-random assignment. Overall, those receiving music therapy had higher odds of being female, having longer lengths of stay, and receiving more services other than music therapy, and lower odds of being married/partnered or receiving home care. Family satisfaction data were available for 1495 (14%) and were more likely available if the patient received music therapy (16% vs. 12%, P music therapy vs. those not. Patients who received music therapy were more likely to report discussions about spirituality (odds ratio [OR] = 1.59, P = 0.01), had marginally less trouble breathing (OR = 0.77, P = 0.06), and were marginally more likely to receive the right amount of spiritual support (OR = 1.59, P = 0.06). Music therapy was associated with perceptions of meaningful spiritual support and less trouble breathing. The results provide preliminary data for a prospective trial to optimize music therapy interventions for integration into clinical practice. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Enhancing the Supervision of Community Health Workers With WhatsApp Mobile Messaging: Qualitative Findings From 2 Low-Resource Settings in Kenya.

Science.gov (United States)

Henry, Jade Vu; Winters, Niall; Lakati, Alice; Oliver, Martin; Geniets, Anne; Mbae, Simon M; Wanjiru, Hannah

2016-06-20

An estimated half of all mobile phone users in Kenya use WhatsApp, an instant messaging platform that provides users an affordable way to send and receive text messages, photos, and other media at the one-to-one, one-to-many, many-to-one, or many-to-many levels. A mobile learning intervention aimed at strengthening supervisory support for community health workers (CHWs) in Kibera and Makueni, Kenya, created a WhatsApp group for CHWs and their supervisors to support supervision, professional development, and team building. We analyzed 6 months of WhatsApp chat logs (from August 19, 2014, to March 1, 2015) and conducted interviews with CHWs and their supervisors to understand how they used this instant messaging tool. During the study period, 1,830 posts were made by 41participants. Photos were a key component of the communication among CHWs and their supervisors: 430 (23.4%) of all posts contained photos or other media. Of the remaining 1,400 text-based posts, 87.6% (n = 1,227) related to at least 1 of 3 defined supervision objectives: (1) quality assurance, (2) communication and information, or (3) supportive environment. This supervision took place in the context of posts about the roll out of the new mobile learning intervention and the delivery of routine health care services, as well as team-building efforts and community development. Our preliminary investigation demonstrates that with minimal training, CHWs and their supervisors tailored the multi-way communication features of this mobile instant messaging technology to enact virtual one-to-one, group, and peer-to-peer forms of supervision and support, and they switched channels of communication depending on the supervisory objectives. We encourage additional research on how health workers incorporate mobile technologies into their practices to develop and implement effective supervisory systems that will safeguard patient privacy, strengthen the formal health system, and create innovative forms of

Improving supervision: a team approach.

Science.gov (United States)

1993-01-01

This issue of "The Family Planning Manager" outlines an interactive team supervision strategy as a means of improving family planning service quality and enabling staff to perform to their maximum potential. Such an approach to supervision requires a shift from a monitoring to a facilitative role. Because supervisory visits to the field are infrequent, the regional supervisor, clinic manager, and staff should form a team to share ongoing supervisory responsibilities. The team approach removes individual blame and builds consensus. An effective team is characterized by shared leadership roles, concrete work problems, mutual accountability, an emphasis on achieving team objectives, and problem resolution within the group. The team supervision process includes the following steps: prepare a visit plan and schedule; meet with the clinic manager and staff to explain how the visit will be conducted; supervise key activity areas (clinical, management, and personnel); conduct a problem-solving team meeting; conduct a debriefing meeting with the clinic manager; and prepare a report on the visit, including recommendations and follow-up plans. In Guatemala's Family Planning Unit, teams identify problem areas on the basis of agreement that a problem exists, belief that the problem can be solved with available resources, and individual willingness to accept responsibility for the specific actions identified to correct the problem.

Asco 2044 nuclear power plant: supervision

International Nuclear Information System (INIS)

Sabartes, J.

2010-01-01

Good supervision constitutes an efficient barrier to avoid the errors caused by inadequate work practices. In this sense, it is necessary to strengthen supervision to make sure that the work is carried out with adequate human performance, tending to avoid error and providing safety quality and efficiency at work. (Author).

28 CFR 551.32 - Staff supervision.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Staff supervision. 551.32 Section 551.32 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT MISCELLANEOUS Inmate Organizations § 551.32 Staff supervision. (a) The Warden shall appoint a staff member as the institution's Inmate Organization Manager (IO...

Perception of the Technicians AND Ancillary as of Sickbay Regarding Supervision on the Unit as of Therapeutics Intensity.

Directory of Open Access Journals (Sweden)

Fabiano Júlio Silva

2010-09-01

Full Text Available Objectives: This work is based on the perception of technicians and nursing assistants, in relation to the supervision of nurses examining what type of monitoring that are submitted, if it is in the form of leadership or managerial where we will work the negative points on supervision, evidenced by technical and nursing assistants, in an Intensive Care Unit (ICU. Method: This is a search with the qualitative methodology, which will be developed in the ICU of a public medical institution in Volta Redonda, where the instrument is to search through a questionnaire that will apply to technicians and nursing assistants, the ICU, in the period from July to August 2008. Conclusion: During this study realized that the quality of nursing care, the interaction of the nursing team and communication, can actually be modified with the leadership of the nurse. The need is urgent for change, the nurse not only becomes unsafe for dealing with this team, and makes it whole team is without prejudice, motivated, with that you get a poor service. Descriptors: Nursing and an Intensive Care Unit (ICU.

History of Overweight/Obesity as Predictor of Care Received at 1-year Follow-Up in Adolescents With Anorexia Nervosa or Atypical Anorexia Nervosa.

Science.gov (United States)

Kennedy, Grace A; Forman, Sara F; Woods, Elizabeth R; Hergenroeder, Albert C; Mammel, Kathleen A; Fisher, Martin M; Ornstein, Rollyn M; Callahan, S Todd; Golden, Neville H; Kapphahn, Cynthia J; Garber, Andrea K; Rome, Ellen S; Richmond, Tracy K

2017-06-01

Previous research has indicated that patients with anorexia nervosa (AN) or atypical AN with premorbid history of overweight/obesity have greater weight loss and longer illness duration than patients with no such history. However, little is known about the association of premorbid overweight/obesity and receiving inpatient medical care during treatment for an eating disorder. Using logistic regression, we sought to determine if history of overweight/obesity was associated with receiving inpatient medical care in a sample of 522 patients (mean age 15.5 years, 88% female) with AN/atypical AN. Binary results demonstrated greater percent weight loss (27.4% vs. 16.2%) and higher percent median body mass index (%mBMI, 99.8% vs. 85.2%) at presentation in those with a history of overweight/obesity (p obesity was associated with lower odds of receiving inpatient medical care (odds ratio .60 [95% confidence interval: .45-.80]) at 1-year follow-up. However, these associations were no longer significant after adjusting for %mBMI. Mediation results suggest that %mBMI fully mediates the relationship between history of overweight/obesity and inpatient medical care, in that those with a history of overweight/obesity are less likely to receive care due to presenting at a higher weight. Our findings suggest that, despite greater degree of weight loss and no difference in duration of illness, participants with a history of overweight/obesity are less likely to receive inpatient medical care. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Development of the Artistic Supervision Model Scale (ASMS)

Science.gov (United States)

Kapusuzoglu, Saduman; Dilekci, Umit

2017-01-01

The purpose of the study is to develop the Artistic Supervision Model Scale in accordance with the perception of inspectors and the elementary and secondary school teachers on artistic supervision. The lack of a measuring instrument related to the model of artistic supervision in the field of literature reveals the necessity of such study. 290…

Experiences of registered nurses who supervise international nursing students in the clinical and classroom setting: an integrative literature review.

Science.gov (United States)

Newton, Louise; Pront, Leeanne; Giles, Tracey M

2016-06-01

To examine the literature reporting the experiences and perceptions of registered nurses who supervise international nursing students in the clinical and classroom setting. Nursing education relies on clinical experts to supervise students during classroom and clinical education, and the quality of that supervision has a significant impact on student development and learning. Global migration and internationalisation of nursing education have led to increasing numbers of registered nurses supervising international nursing students. However, a paucity of relevant literature limits our understanding of these experiences. An integrative literature review. Comprehensive database searches of CINAHL, Informit, PubMed, Journals@Ovid, Findit@flinders and Medline were undertaken. Screening of 179 articles resulted in 10 included for review. Appraisal and analysis using Whittemore and Knafl's (Journal of Advanced Nursing, 52, 2005, 546) five stage integrative review recommendations was undertaken. This review highlighted some unique challenges for registered nurses supervising international nursing students. Identified issues were, a heightened sense of responsibility, additional pastoral care challenges, considerable time investments, communication challenges and cultural differences between teaching and learning styles. It is possible that these unique challenges could be minimised by implementing role preparation programmes specific to international nursing student supervision. Further research is needed to provide an in-depth exploration of current levels of preparation and support to make recommendations for future practice, education and policy development. An awareness of the specific cultural learning needs of international nursing students is an important first step to the provision of culturally competent supervision for this cohort of students. There is an urgent need for education and role preparation for all registered nurses supervising international nursing

THE COMPARISON OF BANKING SUPERVISION MODEL IN INDONESIA, UNITED KINGDOM, SOUTH KOREA AS EFORTS TO IMPROVE INDONESIAN SUPERVISION SYSTEM

OpenAIRE

Sulistyandari; Arief Suryono

2015-01-01

This study aims to revise banking supervision by conducting comparative studies research model of banking supervision in Indonesia, the UK, South Korea and the aspirations of the respondents (Bank, OJK, theorist) in Central Java on efforts to improve banking supervision is now done in Indonesia. The results show Indonesian comparison with the UK and South Korea gives the idea that the OJK in charge of education and consumer protection to enhance its role as practiced by the FCA in...

"Do not resuscitate" orders among deceased patients who received acute neurological care: an observation analysis.

Science.gov (United States)

Chao, Tzu-Hao; Hsieh, Tien-Jen; Wang, Vinchi

2014-12-01

There were many reports about the "do not resuscitate" (DNR) order while practicing in the critical care units and conducting hospice affairs but limited in the neurological issues. This study investigated the possible flaws in the execution of the DNR order among patients who received acute neurological care in Taiwan. Over a 3-year period, we retrospectively reviewed the medical records of 77 deceased patients with neurological conditions for DNR orders. Registry and analysis works included demography, hospital courses, DNR data, and clinical usefulness of the lab and image examinations. Sixty-seven DNR orders were requested by the patients' families, and more than half were signed by the patients' children or grandchildren. The main DNR items were chest compression, cardiac defibrillation, and pacemaker use, although several DNR patients received resuscitation. The mean duration from the coding date to death was 7.6 days. Two-thirds of the patients with DNR requests remained in the intensive care unit, with a mean stay of 6.9 days. Several patients underwent regular roentgenography and blood tests on the day of their death, despite their DNR orders. Hospital courses and DNR items may be valuable information on dealing with the patients with DNR orders. The results of this study also suggest the public education about the DNR orders implemented for neurological illnesses.

Supportive supervision and constructive relationships with healthcare workers support CHW performance: Use of a qualitative framework to evaluate CHW programming in Uganda.

Science.gov (United States)

Ludwick, Teralynn; Turyakira, Eleanor; Kyomuhangi, Teddy; Manalili, Kimberly; Robinson, Sheila; Brenner, Jennifer L

2018-02-13

While evidence supports community health worker (CHW) capacity to improve maternal and newborn health in less-resourced countries, key implementation gaps remain. Tools for assessing CHW performance and evidence on what programmatic components affect performance are lacking. This study developed and tested a qualitative evaluative framework and tool to assess CHW team performance in a district program in rural Uganda. A new assessment framework was developed to collect and analyze qualitative evidence based on CHW perspectives on seven program components associated with effectiveness (selection; training; community embeddedness; peer support; supportive supervision; relationship with other healthcare workers; retention and incentive structures). Focus groups were conducted with four high/medium-performing CHW teams and four low-performing CHW teams selected through random, stratified sampling. Content analysis involved organizing focus group transcripts according to the seven program effectiveness components, and assigning scores to each component per focus group. Four components, 'supportive supervision', 'good relationships with other healthcare workers', 'peer support', and 'retention and incentive structures' received the lowest overall scores. Variances in scores between 'high'/'medium'- and 'low'-performing CHW teams were largest for 'supportive supervision' and 'good relationships with other healthcare workers.' Our analysis suggests that in the Bushenyi intervention context, CHW team performance is highly correlated with the quality of supervision and relationships with other healthcare workers. CHWs identified key performance-related issues of absentee supervisors, referral system challenges, and lack of engagement/respect by health workers. Other less-correlated program components warrant further study and may have been impacted by relatively consistent program implementation within our limited study area. Applying process-oriented measurement tools are

Prescription Pattern of Analgesic Drugs for Patients Receiving Palliative Care in a Teaching Hospital in India.

Science.gov (United States)

Menezes, Vishma Hydie; Nair, Shoba N; Soumya, M S; Tarey, S D

2016-01-01

Drugs used in the palliative care unit for managing symptoms are major contributors toward the expenditure occurring in palliative care. This study was conducted to understand the prescription pattern of analgesic drugs in the patients who are receiving palliative care in a teaching hospital in India by a retrospective study of case records. Case record based, retrospective, descriptive study was conducted at the Pain and Palliative Care Department of St. John's Medical College Hospital, Bengaluru. Case record files of all patients referred to Pain and Palliative Care Department for the treatment of pain in the year of 2012 were studied. Patients' age, gender, diagnoses, numerical pain rating scale (0-10), drugs prescribed, dosage, frequency, route of administration were recorded. The difference in drug utilization between the genders was done using Chi-square test. Data were collected from 502 patients of which 280 (56%) were males and 222 (44%) were females. Twelve percent of patients had mild pain (1-3), 34% had moderate pain (4-6), and 54% had severe pain (7-10). The most commonly used analgesic drugs were opioids (47%), followed by nonsteroidal anti-inflammatory drugs (36%). The opioids used were tramadol (56%), and morphine (38%). Ninety percent of patients with numerical pain scale more than 6 received morphine. There was no difference in analgesic drug utilization with regards to gender. Prescription pattern differed depending on the severity of pain. Opioids were the most commonly used drugs for pain management. The study shows that prescription pattern in palliative care unit of this hospital was in accordance with WHO pain management guidelines. The study showed the current trend in prescription of analgesic drugs in the teaching hospital where the study was conducted.

19 CFR 111.28 - Responsible supervision.

Science.gov (United States)

2010-04-01

... 19 Customs Duties 1 2010-04-01 2010-04-01 false Responsible supervision. 111.28 Section 111.28 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY CUSTOMS BROKERS Duties and Responsibilities of Customs Brokers § 111.28 Responsible supervision. (a) General. Every individual broker...

Weakly supervised classification in high energy physics

Energy Technology Data Exchange (ETDEWEB)

Dery, Lucio Mwinmaarong [Physics Department, Stanford University,Stanford, CA, 94305 (United States); Nachman, Benjamin [Physics Division, Lawrence Berkeley National Laboratory,1 Cyclotron Rd, Berkeley, CA, 94720 (United States); Rubbo, Francesco; Schwartzman, Ariel [SLAC National Accelerator Laboratory, Stanford University,2575 Sand Hill Rd, Menlo Park, CA, 94025 (United States)

2017-05-29

As machine learning algorithms become increasingly sophisticated to exploit subtle features of the data, they often become more dependent on simulations. This paper presents a new approach called weakly supervised classification in which class proportions are the only input into the machine learning algorithm. Using one of the most challenging binary classification tasks in high energy physics — quark versus gluon tagging — we show that weakly supervised classification can match the performance of fully supervised algorithms. Furthermore, by design, the new algorithm is insensitive to any mis-modeling of discriminating features in the data by the simulation. Weakly supervised classification is a general procedure that can be applied to a wide variety of learning problems to boost performance and robustness when detailed simulations are not reliable or not available.

Weakly supervised classification in high energy physics

International Nuclear Information System (INIS)

Dery, Lucio Mwinmaarong; Nachman, Benjamin; Rubbo, Francesco; Schwartzman, Ariel

2017-01-01

As machine learning algorithms become increasingly sophisticated to exploit subtle features of the data, they often become more dependent on simulations. This paper presents a new approach called weakly supervised classification in which class proportions are the only input into the machine learning algorithm. Using one of the most challenging binary classification tasks in high energy physics — quark versus gluon tagging — we show that weakly supervised classification can match the performance of fully supervised algorithms. Furthermore, by design, the new algorithm is insensitive to any mis-modeling of discriminating features in the data by the simulation. Weakly supervised classification is a general procedure that can be applied to a wide variety of learning problems to boost performance and robustness when detailed simulations are not reliable or not available.

Doctoral Supervision in Virtual Spaces: A Review of Research of Web-Based Tools to Develop Collaborative Supervision

Science.gov (United States)

Maor, Dorit; Ensor, Jason D.; Fraser, Barry J.

2016-01-01

Supervision of doctoral students needs to be improved to increase completion rates, reduce attrition rates (estimated to be at 25% or more) and improve quality of research. The current literature review aimed to explore the contribution that technology can make to higher degree research supervision. The articles selected included empirical studies…

Predictors of medication adherence and smoking cessation among smokers under community corrections supervision.

Science.gov (United States)

Cropsey, Karen L; Clark, C Brendan; Stevens, Erin N; Schiavon, Samantha; Lahti, Adrienne C; Hendricks, Peter S

2017-02-01

Individuals in the U.S. criminal justice system now represent over 12% of all current U.S. smokers. With smoking banned in most U.S. jails and prisons, the cessation focus for this population has shifted to individuals who are under community correction supervision (e.g., probation, parole). The aim of this study was to examine predictors of successful smoking cessation among criminal justice individuals supervised in the community. Five hundred participants under community corrections supervision were randomized to receive either four sessions of smoking cessation counseling or no counseling in conjunction with 12weeks of bupropion treatment plus brief physician advice to quit. Logistic regression analyses examined associations of smoking variables with medication adherence and successful abstinence. Mediation analysis evaluated the indirect effects of medication adherence on smoking abstinence. The strongest associate of medication adherence was previous use of bupropion, while the strongest associate of smoking abstinence was medication adherence. Mediation analysis indicated that previous use of bupropion indirectly increased cessation rates through the pathway of increased medication adherence. These results highlight the importance of medication adherence for smoking cessation among community corrections smokers. Providing exposure to medication may be a promising intervention to increase medication adherence and subsequent cessation rates in this population. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Comparison of Banking Supervision Model in Indonesia, United Kingdom, South Korea as Eforts to Improve Indonesian Supervision System

OpenAIRE

Sulistyandari, Sulistyandari

2015-01-01

This study aims to improve banking supervision by conductingcomparative studies research model of banking supervision in Indonesia, the UK, South Korea and the aspirations of the respondents (Bank, OJK, theorist) in Central Java on efforts to improve banking supervision is now done in Indonesia. The results show Indonesian comparison with the UK and South Korea gives the idea that the OJK in charge of education and consumer protection to enhance its role as practiced by the FCA in the UK, and...

The programmed nursing care for lower extremity deep venous thrombus patients receiving interventional thrombolysis: its effect on living quality

International Nuclear Information System (INIS)

Qiao Cuiyun; Wang Zhujun; Lan Guiyun; Liang Zhiqiang; Shi Yonmin

2011-01-01

Objective: Tu study the effect of comprehensive programmed nursing intervention on the living quality in patients with lower extremity deep venous thrombus who receive interventional thrombolysis therapy. Methods: A total of 60 patients receiving interventional thrombolysis due to lower extremity deep venous thrombus were randomly and equally divided into two groups. Patients in study group (n=30) was treated with comprehensive programmed nursing intervention in addition to the conventional therapy and routine nursing care, while patients in control group (n=30) was treated with the conventional therapy and routine nursing care only. The conventional therapy and routine nursing care included the nursing assessment before the operation, observation of the vital signs and the cooperation psychological care during the operation, the performance of medication according to the doctor's orders after the operation, etc. The comprehensive programmed nursing intervention included the nursing assessment of the patient before operation and the scientifically making of the nursing plan, which mainly referred to the cognitive behavior, the psychological care and the health education. They were systematically carried out during the perioperative period. One month after discharge the patients were asked to pay a return visit. The living quality was evaluated with relevant standards, and the results were compared between the two groups. Results: The score of living quality in the study group was significantly higher than that in the control group (P<0.01). Conclusion: The comprehensive programmed nursing intervention can significantly improve the living quality of lower extremity deep venous thrombosis patients who receive interventional thrombolysis therapy. (authors)

19 CFR 146.3 - Customs supervision.

Science.gov (United States)

2010-04-01

... 19 Customs Duties 2 2010-04-01 2010-04-01 false Customs supervision. 146.3 Section 146.3 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) FOREIGN TRADE ZONES General Provisions § 146.3 Customs supervision. (a) Assignment of Customs officers. Customs officers will be...

36 CFR 25.3 - Supervision; suspensions.

Science.gov (United States)

2010-07-01

... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Supervision; suspensions. 25.3 Section 25.3 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR NATIONAL MILITARY PARKS; LICENSED GUIDE SERVICE REGULATIONS § 25.3 Supervision; suspensions. (a) The guide service will operate under the direction...

Changes in Emotion Work at Interdisciplinary Conferences Following Clinical Supervision in a Palliative Outpatient Ward

DEFF Research Database (Denmark)

Nordentoft, Helle Merete

2008-01-01

In this article, I describe changes in emotion work at weekly interdisciplinary conferences in a palliative1 outpatient ward following clinical supervision (CS). I conceive emotions as constantly negotiated in interaction, and I researched the similarity between how this is done during CS and at ...... conclude that CS enhances professional development and may prevent burnout in palliative care....

The effectiveness of banking supervision

OpenAIRE

Davis, EP; Obasi, U

2009-01-01

Banking supervision is an essential aspect of modern financial systems, seeking crucially to monitor risk-taking by banks so as to protect depositors, the government safety net and the economy as a whole against systemic bank failure and its consequences. In this context, this paper seeks to explore the relationship between risk indicators for individual banks and the different approaches to banking supervision adopted around the world. This is the first work to make use of the currently avai...

Cross-Domain Semi-Supervised Learning Using Feature Formulation.

Science.gov (United States)

Xingquan Zhu

2011-12-01

Semi-Supervised Learning (SSL) traditionally makes use of unlabeled samples by including them into the training set through an automated labeling process. Such a primitive Semi-Supervised Learning (pSSL) approach suffers from a number of disadvantages including false labeling and incapable of utilizing out-of-domain samples. In this paper, we propose a formative Semi-Supervised Learning (fSSL) framework which explores hidden features between labeled and unlabeled samples to achieve semi-supervised learning. fSSL regards that both labeled and unlabeled samples are generated from some hidden concepts with labeling information partially observable for some samples. The key of the fSSL is to recover the hidden concepts, and take them as new features to link labeled and unlabeled samples for semi-supervised learning. Because unlabeled samples are only used to generate new features, but not to be explicitly included in the training set like pSSL does, fSSL overcomes the inherent disadvantages of the traditional pSSL methods, especially for samples not within the same domain as the labeled instances. Experimental results and comparisons demonstrate that fSSL significantly outperforms pSSL-based methods for both within-domain and cross-domain semi-supervised learning.

42 CFR 484.18 - Condition of participation: Acceptance of patients, plan of care, and medical supervision.

Science.gov (United States)

2010-10-01

..., and medical supervision. Patients are accepted for treatment on the basis of a reasonable expectation that the patient's medical, nursing, and social needs can be met adequately by the agency in the... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Acceptance of patients...

Counseling Supervision within a Feminist Framework: Guidelines for Intervention

Science.gov (United States)

Degges-White, Suzanne E.; Colon, Bonnie R.; Borzumato-Gainey, Christine

2013-01-01

Feminist supervision is based on the principles of feminist theory. Goals include sharing responsibility for the supervision process, empowering the supervisee, attending to the contextual assumptions about clients, and analyzing gender roles. This article explores feminist supervision and guidelines for providing counseling supervision…

A Break-Even Analysis of Optimum Faculty Assignment for Ambulatory Primary Care Training.

Science.gov (United States)

Xakellis, George C.; And Others

1996-01-01

A computer simulation was developed to estimate the number of medical residents one or two faculty teachers could supervise in a university-based primary medical care teaching clinic. With no non-teaching tasks, it was shown that two teachers could supervise 11 residents, while one teacher was able to supervise only three residents under similar…

21 CFR 640.62 - Medical supervision.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Medical supervision. 640.62 Section 640.62 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) BIOLOGICS ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Source Plasma § 640.62 Medical supervision. A qualified licensed physician shall be on the...

19 CFR 19.34 - Customs supervision.

Science.gov (United States)

2010-04-01

... 19 Customs Duties 1 2010-04-01 2010-04-01 false Customs supervision. 19.34 Section 19.34 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY CUSTOMS WAREHOUSES, CONTAINER STATIONS AND CONTROL OF MERCHANDISE THEREIN Space Bonded for the Storage of Wheat § 19.34 Customs supervision. Port...

40 CFR 35.935-8 - Supervision.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Supervision. 35.935-8 Section 35.935-8 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works-Clean Water Act § 35.935-8 Supervision. In the case of any project involving Step 3,...

How parents of children receiving pediatric palliative care use religion, spirituality, or life philosophy in tough times.

Science.gov (United States)

Hexem, Kari R; Mollen, Cynthia J; Carroll, Karen; Lanctot, Dexter A; Feudtner, Chris

2011-01-01

How parents of children with life threatening conditions draw upon religion, spirituality, or life philosophy is not empirically well described. Participants were parents of children who had enrolled in a prospective cohort study on parental decision-making for children receiving pediatric palliative care. Sixty-four (88%) of the 73 parents interviewed were asked an open-ended question on how religion, spirituality, or life philosophy (RSLP) was helpful in difficult times. Responses were coded and thematically organized utilizing qualitative data analysis methods. Any discrepancies amongst coders regarding codes or themes were resolved through discussion that reached consensus. Most parents of children receiving palliative care felt that RSLP was important in helping them deal with tough times, and most parents reported either participation in formal religious communities, or a sense of personal spirituality. A minority of parents, however, did not wish to discuss the topic at all. For those who described their RSLP, their beliefs and practices were associated with qualities of their overall outlook on life, questions of goodness and human capacity, or that "everything happens for a reason." RSLP was also important in defining the child's value and beliefs about the child's afterlife. Prayer and reading the bible were important spiritual practices in this population, and parents felt that these practices influenced their perspectives on the medical circumstances and decision-making, and their locus of control. From religious participation and practices, parents felt they received support from both their spiritual communities and from God, peace and comfort, and moral guidance. Some parents, however, also reported questioning their faith, feelings of anger and blame towards God, and rejecting religious beliefs or communities. RSLP play a diverse and important role in the lives of most, but not all, parents whose children are receiving pediatric palliative care.

Risk-oriented banking supervision: understanding change of course

Directory of Open Access Journals (Sweden)

Vlasov K. A.

2017-11-01

Full Text Available in this article the existing model of national bank supervision, its substantial party are considered. By means of the legal analysis and comparative jurisprudence foreign models of bank supervision, the international standards of the «soft» right are investigated, the analysis of an opportunity and positive sides of change of approach of the operating bank supervision to substantial (risk-focused is made.

How Supervisees on a Foundation Course in CBT Perceive a Supervision Session and what they Bring Forward to the Next Therapy Session.

Science.gov (United States)

Törnquist, Anna; Rakovshik, Sarah; Carlsson, Jan; Norberg, Joakim

2018-05-01

There is limited research into the effect of supervision in cognitive behavioural therapy (CBT) from the supervisees' perspective. The aim of the study was to acquire knowledge from the supervisees' perspective as to what in particular in the supervision process contributes to the therapy process. Fourteen supervisees on a foundation course participated in the study. A qualitative approach was used with thematic analysis of the participants' written diaries after supervision and therapy sessions. Analyses of supervisees' experiences suggested that a variety of therapeutic interventions were easier to implement if one had the supervisor's support and felt free to decide if and when the suggested interventions could best be implemented. Evaluation in the form of positive feedback from the supervisor indicating that the supervisee was 'doing the right thing' was perceived to be important. A unifying theme when supervisees felt they were not getting anything out of the supervision was that the supervisees did not have a supervision question. The results of this research suggest that the supervisor's support during training is perceived to be important for the supervisee. Receiving positive feedback from one's supervisor in an evaluation is perceived to have a great impact on whether the therapist implements the suggested therapeutic interventions discussed in the previous supervision.

The integrated care of asthma in Switzerland (INCAS)-study: Patients' perspective of received asthma care and their interest in asthma education.

Science.gov (United States)

Dürr, Selina; Hersberger, Kurt E; Zeller, Andreas; Scheuzger, Jonas; Miedinger, David; Gregoriano, Claudia; Leuppi, Jörg D; Steurer-Stey, Claudia

2016-11-01

For successful long-term asthma care, self-management education is a cornerstone. Little is known about associations between patients' interest in education, asthma control and care delivery. We compared patients' characteristics, asthma control and patients' perspective about asthma care in subjects with and without interest in asthma education. Moreover, we assessed reasons, why patients denied participating in asthma education. Baseline data of 223 patients with asthma (age 43 ± 12 years, 38% male, 58% non-smokers, 13% current smokers), who participated in a multicentre longitudinal controlled study, are reported. At baseline, patients completed the Asthma Control Test (ACT), the Patient Assessment Chronic Illness Care questionnaire (PACIC 5A) and stated their interest in an asthma education programme. Overall, 34% of all participants showed uncontrolled asthma. One hundred and twenty-five (56%) patients were interested in education. Compared to patients without interest, they were characterised by male gender (p = 0.013), worse asthma control (p < 0.001), and perception of lower quality of chronic asthma care delivery, in particular lower self-management support (p < 0.001). Main reasons for rejecting asthma education were having sufficient asthma knowledge, having only mild asthma, receiving adequate medical support and lack of time. More than half of the patients were interested in asthma education. Interest was associated with worse asthma control and lower receipt of care according to the Chronic Care Model. Considering these aspects, this approach may help to improve care quality and allow targeting interventions to those patients who are interested in becoming active participants in their care and who might benefit most.

Group Supervision in Psychotherapy. Main Findings from a Swedish Research Project on Psychotherapy Supervision in a Group Format

Science.gov (United States)

Ogren, Marie-Louise; Sundin, Eva C.

2009-01-01

Psychotherapy supervision is considered crucial for psychotherapists in training. During the last decades, group supervision has been a frequently used format in many countries. Until recently, very few studies had evaluated the small-group format for training of beginner psychotherapists and psychotherapy supervisors. This article aims to…

Safe semi-supervised learning based on weighted likelihood.

Science.gov (United States)

Kawakita, Masanori; Takeuchi, Jun'ichi

2014-05-01

We are interested in developing a safe semi-supervised learning that works in any situation. Semi-supervised learning postulates that n(') unlabeled data are available in addition to n labeled data. However, almost all of the previous semi-supervised methods require additional assumptions (not only unlabeled data) to make improvements on supervised learning. If such assumptions are not met, then the methods possibly perform worse than supervised learning. Sokolovska, Cappé, and Yvon (2008) proposed a semi-supervised method based on a weighted likelihood approach. They proved that this method asymptotically never performs worse than supervised learning (i.e., it is safe) without any assumption. Their method is attractive because it is easy to implement and is potentially general. Moreover, it is deeply related to a certain statistical paradox. However, the method of Sokolovska et al. (2008) assumes a very limited situation, i.e., classification, discrete covariates, n(')→∞ and a maximum likelihood estimator. In this paper, we extend their method by modifying the weight. We prove that our proposal is safe in a significantly wide range of situations as long as n≤n('). Further, we give a geometrical interpretation of the proof of safety through the relationship with the above-mentioned statistical paradox. Finally, we show that the above proposal is asymptotically safe even when n(')

Active link selection for efficient semi-supervised community detection

Science.gov (United States)

Yang, Liang; Jin, Di; Wang, Xiao; Cao, Xiaochun

2015-01-01

Several semi-supervised community detection algorithms have been proposed recently to improve the performance of traditional topology-based methods. However, most of them focus on how to integrate supervised information with topology information; few of them pay attention to which information is critical for performance improvement. This leads to large amounts of demand for supervised information, which is expensive or difficult to obtain in most fields. For this problem we propose an active link selection framework, that is we actively select the most uncertain and informative links for human labeling for the efficient utilization of the supervised information. We also disconnect the most likely inter-community edges to further improve the efficiency. Our main idea is that, by connecting uncertain nodes to their community hubs and disconnecting the inter-community edges, one can sharpen the block structure of adjacency matrix more efficiently than randomly labeling links as the existing methods did. Experiments on both synthetic and real networks demonstrate that our new approach significantly outperforms the existing methods in terms of the efficiency of using supervised information. It needs ~13% of the supervised information to achieve a performance similar to that of the original semi-supervised approaches. PMID:25761385

Supervised and Unsupervised Self-Testing for HIV in High- and Low-Risk Populations: A Systematic Review

Science.gov (United States)

Pant Pai, Nitika; Sharma, Jigyasa; Shivkumar, Sushmita; Pillay, Sabrina; Vadnais, Caroline; Joseph, Lawrence; Dheda, Keertan; Peeling, Rosanna W.

2013-01-01

Background Stigma, discrimination, lack of privacy, and long waiting times partly explain why six out of ten individuals living with HIV do not access facility-based testing. By circumventing these barriers, self-testing offers potential for more people to know their sero-status. Recent approval of an in-home HIV self test in the US has sparked self-testing initiatives, yet data on acceptability, feasibility, and linkages to care are limited. We systematically reviewed evidence on supervised (self-testing and counselling aided by a health care professional) and unsupervised (performed by self-tester with access to phone/internet counselling) self-testing strategies. Methods and Findings Seven databases (Medline [via PubMed], Biosis, PsycINFO, Cinahl, African Medicus, LILACS, and EMBASE) and conference abstracts of six major HIV/sexually transmitted infections conferences were searched from 1st January 2000–30th October 2012. 1,221 citations were identified and 21 studies included for review. Seven studies evaluated an unsupervised strategy and 14 evaluated a supervised strategy. For both strategies, data on acceptability (range: 74%–96%), preference (range: 61%–91%), and partner self-testing (range: 80%–97%) were high. A high specificity (range: 99.8%–100%) was observed for both strategies, while a lower sensitivity was reported in the unsupervised (range: 92.9%–100%; one study) versus supervised (range: 97.4%–97.9%; three studies) strategy. Regarding feasibility of linkage to counselling and care, 96% (n = 102/106) of individuals testing positive for HIV stated they would seek post-test counselling (unsupervised strategy, one study). No extreme adverse events were noted. The majority of data (n = 11,019/12,402 individuals, 89%) were from high-income settings and 71% (n = 15/21) of studies were cross-sectional in design, thus limiting our analysis. Conclusions Both supervised and unsupervised testing strategies were highly acceptable

An Approach to Supervision for Doctoral and Entry-Level Group Counseling Students

Science.gov (United States)

Walsh, Robyn; Bambacus, Elizabeth; Gibson, Donna

2017-01-01

The purpose of this article is to provide a supervision approach to experiential groups that replaces professors with doctoral students in the chain of supervision, enlists a faculty member to provide supervision of supervision to the doctoral students, and translates supervision theory to meet the unique needs of group counseling supervision.…

THE COMPARISON OF BANKING SUPERVISION MODEL IN INDONESIA, UNITED KINGDOM, SOUTH KOREA AS EFORTS TO IMPROVE INDONESIAN SUPERVISION SYSTEM

Directory of Open Access Journals (Sweden)

Sulistyandari

2015-05-01

Full Text Available This study aims to revise banking supervision by conducting comparative studies research model of banking supervision in Indonesia, the UK, South Korea and the aspirations of the respondents (Bank, OJK, theorist in Central Java on efforts to improve banking supervision is now done in Indonesia. The results show Indonesian comparison with the UK and South Korea gives the idea that the OJK in charge of education and consumer protection to enhance its role as practiced by the FCA in the UK, and the LPS assignments need to be expanded in order to ensure that all consumers of financial institutions as was done by the FSCS in the UK and KDIC in South Korea. Aspirations of the people of the regulation and supervision of banking include aspects of regulatory, law enforcement, infrastructure, community (the Bank and culture.

Robust Semi-Supervised Manifold Learning Algorithm for Classification

Directory of Open Access Journals (Sweden)

Mingxia Chen

2018-01-01

Full Text Available In the recent years, manifold learning methods have been widely used in data classification to tackle the curse of dimensionality problem, since they can discover the potential intrinsic low-dimensional structures of the high-dimensional data. Given partially labeled data, the semi-supervised manifold learning algorithms are proposed to predict the labels of the unlabeled points, taking into account label information. However, these semi-supervised manifold learning algorithms are not robust against noisy points, especially when the labeled data contain noise. In this paper, we propose a framework for robust semi-supervised manifold learning (RSSML to address this problem. The noisy levels of the labeled points are firstly predicted, and then a regularization term is constructed to reduce the impact of labeled points containing noise. A new robust semi-supervised optimization model is proposed by adding the regularization term to the traditional semi-supervised optimization model. Numerical experiments are given to show the improvement and efficiency of RSSML on noisy data sets.

Emotional Literacy Support Assistants' Views on Supervision Provided by Educational Psychologists: What EPs Can Learn from Group Supervision

Science.gov (United States)

Osborne, Cara; Burton, Sheila

2014-01-01

The Educational Psychology Service in this study has responsibility for providing group supervision to Emotional Literacy Support Assistants (ELSAs) working in schools. To date, little research has examined this type of inter-professional supervision arrangement. The current study used a questionnaire to examine ELSAs' views on the supervision…

Swallowing Function and Nutritional Status in Japanese Elderly People Receiving Home-care Services: A 1-year Longitudinal Study.

Science.gov (United States)

Okabe, Y; Furuta, M; Akifusa, S; Takeuchi, K; Adachi, M; Kinoshita, T; Kikutani, T; Nakamura, S; Yamashita, Y

2016-01-01

Malnutrition is a serious health concern for frail elderly people. Poor oral function leading to insufficient food intake can contribute to the development of malnutrition. In the present study, we explored the longitudinal association of malnutrition with oral function, including oral health status and swallowing function, in elderly people receiving home nursing care. Prospective observational cohort study with 1-year follow-up. Two mid-sized cities in Fukuoka, Japan from November 2010 to March 2012. One hundred and ninety-seven individuals, aged ≥ 60 years, living at home and receiving home-care services because of physical disabilities, without malnutrition. Oral health status, swallowing function, taking modified-texture diets such as minced or pureed foods, nutritional status, cognitive function, and activities of daily living were assessed at baseline. The associations between malnutrition at 1-year follow-up and these related factors were analyzed using a logistic regression model. Swallowing disorders [risk ratio (RR): 5.21, 95% confidence interval (95% CI): 1.65-16.43] were associated with malnutrition. On the other hand, oral health status did not have a direct association with malnutrition. Swallowing disorders may be associated with the incidence of malnutrition in elderly people receiving home-care. The findings indicate that maintaining swallowing function may contribute to the prevention of malnutrition in frail elderly people.

Comparison of effects of Cyriax physiotherapy, a supervised exercise programme and polarized polychromatic non-coherent light (Bioptron light) for the treatment of lateral epicondylitis.

Science.gov (United States)

Stasinopoulos, Dimitrios; Stasinopoulos, Ioannis

2006-01-01

To compare the effectiveness of Cyriax physiotherapy, a supervised exercise programme, and polarized polychromatic non-coherent light (Bioptron light) in the treatment of lateral epicondylitis. Controlled clinical trial. Rheumatology and rehabilitation centre. This study was carried out with 75 patients who had lateral epicondylitis. They were allocated to three groups by sequential allocation. Group A (n = 25) was treated with Cyriax physiotherapy. A supervised exercise programme was given to group B (n = 25). Group C (n = 25) received polarized polychromatic non-coherent light (Bioptron light). All patients received three treatments per week for four weeks. Pain was evaluated using a visual analogue scale and function using a visual analogue scale and pain-free grip strength at the end of the four-week course of treatment (week 4), one month (week 8), three months (week 16) and six months (week 28) after the end of treatment. The supervised exercise programme produced the largest effect in the reduction of pain and in the improvement of function at the end of the treatment (PBioptron light) may be suitable.

Ethical Issues in the Conduct of Supervision.

Science.gov (United States)

Sherry, Patrick

1991-01-01

Uses American Psychological Association code of ethics to understand ethical issues present in the conduct of supervision. Discusses ethical issues of responsibility, client and supervisee welfare, confidentiality, competency, moral and legal standards, public statements, and professional relationships in relation to supervision. (Author/NB)

Challenges for Better thesis supervision.

Science.gov (United States)

Ghadirian, Laleh; Sayarifard, Azadeh; Majdzadeh, Reza; Rajabi, Fatemeh; Yunesian, Masoud

2014-01-01

Conduction of thesis by the students is one of their major academic activities. Thesis quality and acquired experiences are highly dependent on the supervision. Our study is aimed at identifing the challenges in thesis supervision from both students and faculty members point of view. This study was conducted using individual in-depth interviews and Focus Group Discussions (FGD). The participants were 43 students and faculty members selected by purposive sampling. It was carried out in Tehran University of Medical Sciences in 2012. Data analysis was done concurrently with data gathering using content analysis method. Our data analysis resulted in 162 codes, 17 subcategories and 4 major categories, "supervisory knowledge and skills", "atmosphere", "bylaws and regulations relating to supervision" and "monitoring and evaluation". This study showed that more attention and planning in needed for modifying related rules and regulations, qualitative and quantitative improvement in mentorship training, research atmosphere improvement and effective monitoring and evaluation in supervisory area.

Opportunities to learn scientific thinking in joint doctoral supervision

DEFF Research Database (Denmark)

Kobayashi, Sofie; Grout, Brian William Wilson; Rump, Camilla Østerberg

2015-01-01

Research into doctoral supervision has increased rapidly over the last decades, yet our understanding of how doctoral students learn scientific thinking from supervision is limited. Most studies are based on interviews with little work being reported that is based on observation of actual...... supervision. While joint supervision has become widely used, its learning dynamics remains under-researched and this paper aims to address these gaps in research by exploring learning opportunities in doctoral supervision with two supervisors. The study explores how the tensions in scientific discussion...... between supervisors can become learning opportunities. We combine two different theoretical perspectives, using participation and positioning theory as a sociocultural perspective and variation theory as an individual constructivist perspective on learning. Based on our analysis of a complex episode we...

Sleep of Parents Living With a Child Receiving Hospital-Based Home Care: A Phenomenographical Study.

Science.gov (United States)

Angelhoff, Charlotte; Edéll-Gustafsson, Ulla; Mörelius, Evalotte

2015-01-01

Caring for an ill child at home gives the family the chance to be together in a familiar environment. However, this involves several nocturnal sleep disturbances, such as frequent awakenings and bad sleep quality, which may affect parents' ability to take care of the child and themselves. The aim of this study was to describe parents' perceptions of circumstances influencing their own sleep when living with a child enrolled in hospital-based home care (HBHC) services. This is a phenomenographical study with an inductive, exploratory design. Fifteen parents (11 mothers and 4 fathers) with children enrolled in HBHC services were interviewed. Data were analyzed to discover content-related categories describing differences in ways parents experienced sleep when caring for their children receiving HBHC. Four descriptive categories were detected: sleep influences mood and mood influences sleep; support influences safeness and safeness influences sleep; the child's needs influence routines and routines influence sleep; and "me time" influences sleep. Sleep does not affect only the parents' well-being but also the child's care. Symptoms of stress may limit the parents' capacity to meet the child's needs. Support, me time, and physical activity were perceived as essential sources for recovery and sleep. It is important for nurses to acknowledge parental sleep in the child's nursing care plan and help the parents perform self-care to promote sleep and maintain life, health, and well-being.

Nursing care for patients receiving perccutaneous biopsy of the pancreas under CT-guidance

International Nuclear Information System (INIS)

Li Yongli; Wang Zhenfang

2010-01-01

Objective: To discuss the application of nursing care in CT-guided percutaneous biopsy of the pancreas. Methods: The perioperative nursing measures were carried out in 21 patients receiving percutaneous biopsy of the pancreas under CT-guidance. Active, effective and comprehensive nursing procedures were adopted to closely cooperate with the whole process of percutaneous biopsy as far as possible. Results: All the patients could actively cooperate with the physician during the whole process of percutaneous biopsy and the surgery was successfully completed in all patients. The technical success rate with only single puncture was 100%. No obvious complications occurred after the procedure. Conclusion: In order to ensure that the patient will be able to cooperate with the CT-guided percutaneous biopsy of the pancreas, that the operation time can be shortened and that the postoperative complications can be avoided, perioperative nursing care is indispensable. (authors)

Supervised detection of exoplanets in high-contrast imaging sequences

Science.gov (United States)

Gomez Gonzalez, C. A.; Absil, O.; Van Droogenbroeck, M.

2018-06-01

Context. Post-processing algorithms play a key role in pushing the detection limits of high-contrast imaging (HCI) instruments. State-of-the-art image processing approaches for HCI enable the production of science-ready images relying on unsupervised learning techniques, such as low-rank approximations, for generating a model point spread function (PSF) and subtracting the residual starlight and speckle noise. Aims: In order to maximize the detection rate of HCI instruments and survey campaigns, advanced algorithms with higher sensitivities to faint companions are needed, especially for the speckle-dominated innermost region of the images. Methods: We propose a reformulation of the exoplanet detection task (for ADI sequences) that builds on well-established machine learning techniques to take HCI post-processing from an unsupervised to a supervised learning context. In this new framework, we present algorithmic solutions using two different discriminative models: SODIRF (random forests) and SODINN (neural networks). We test these algorithms on real ADI datasets from VLT/NACO and VLT/SPHERE HCI instruments. We then assess their performances by injecting fake companions and using receiver operating characteristic analysis. This is done in comparison with state-of-the-art ADI algorithms, such as ADI principal component analysis (ADI-PCA). Results: This study shows the improved sensitivity versus specificity trade-off of the proposed supervised detection approach. At the diffraction limit, SODINN improves the true positive rate by a factor ranging from 2 to 10 (depending on the dataset and angular separation) with respect to ADI-PCA when working at the same false-positive level. Conclusions: The proposed supervised detection framework outperforms state-of-the-art techniques in the task of discriminating planet signal from speckles. In addition, it offers the possibility of re-processing existing HCI databases to maximize their scientific return and potentially improve

Supervision as transformative leadership in the context of university ...

African Journals Online (AJOL)

This article discusses different models of supervision and promotion of Masters', Doctoral and PhD students. It argues that leadership is inherent in and underpins any model of supervision or promotion of students. The article advances a view that supervision and promotion of the said students should be transformative ...

18 CFR 367.80 - Supervision and engineering.

Science.gov (United States)

2010-04-01

... engineering. 367.80 Section 367.80 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... ACT Operating Expense Instructions § 367.80 Supervision and engineering. (a) The supervision and engineering includible in the operating expense accounts must consist of the pay and expenses of...

Wellness Model of Supervision: A Comparative Analysis

Science.gov (United States)

Lenz, A. Stephen; Sangganjanavanich, Varunee Faii; Balkin, Richard S.; Oliver, Marvarene; Smith, Robert L.

2012-01-01

This quasi-experimental study compared the effectiveness of the Wellness Model of Supervision (WELMS; Lenz & Smith, 2010) with alternative supervision models for developing wellness constructs, total personal wellness, and helping skills among counselors-in-training. Participants were 32 master's-level counseling students completing their…

Semi-supervised Learning with Deep Generative Models

NARCIS (Netherlands)

Kingma, D.P.; Rezende, D.J.; Mohamed, S.; Welling, M.

2014-01-01

The ever-increasing size of modern data sets combined with the difficulty of obtaining label information has made semi-supervised learning one of the problems of significant practical importance in modern data analysis. We revisit the approach to semi-supervised learning with generative models and

State Supervision and Control of Radiation Protection

CERN Document Server

2001-01-01

Radiation Protection Centre is carrying state supervision and control of radiation protection. The main objective of state supervision and control of radiation protection is assessing how licensees comply with requirements of the appropriate legislation and enforcement. Summary of inspections conducted in 1999-2001 is presented.

ECB Banking Supervision and beyond

OpenAIRE

Lannoo, Karel

2014-01-01

With publication of the results of its Comprehensive Assessment at the end of October 2014, the European Central Bank has set the standard for its new mandate as supervisor. But this was only the beginning. The heavy work started in early November, with the day-to-day supervision of the 120 most significant banks in the eurozone under the Single Supervisory Mechanism. The centralisation of the supervision in the eurozone will pose a number of challenges for the ECB in the coming months and ye...

Counseling About Skin Cancer Prevention Among Adolescents: What Do Parents Receive From Health Care Providers?

Science.gov (United States)

McRee, Annie-Laurie; Mays, Darren; Kornides, Melanie L; Gilkey, Melissa B

2017-10-01

Adolescence is a high-risk period for ultraviolet radiation exposure, a primary cause of skin cancer later in life. We sought to characterize receipt of health care provider-delivered counseling about skin cancer prevention (SCP) among parents of adolescents. In 2016, we conducted an online survey with a national sample of parents of adolescents aged 11-17 years (n = 1,253). Multivariable logistic regression assessed correlates of receiving counseling from a health care provider about any of the six skin cancer prevention (SCP) topics. Only half (49%) of parents recalled discussing any SCP topic with their child's provider; the prevalence was highest for sunscreen (39%) and lowest for indoor tanning (3%). Parents had greater odds of receiving counseling if they had a child with more sun-reactive skin (odds ratio [OR] = 1.53); a family history of skin cancer (OR = 1.38); or a higher quality relationship with the provider (OR = 1.47; all p attention to SCP counseling is needed, especially for exposures such as indoor tanning that remain prevalent among adolescents but are rarely addressed in clinical encounters. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Radiation supervision - NPPs A-1, V-1, V-2

International Nuclear Information System (INIS)

2000-01-01

In this leaflet the radiation supervision of the nuclear power plants A-1, V-1, V-2 is presented. Off-site radiation supervision laboratory is a part of monitoring scheme of the NPPs. More than 1150 samples are taken from the environment annually. The tele-dosimetric system was constructed to improve the quality of the Bohunice NPPs operation impacts supervision. It has been running in a continuous operation from 1992 and providing supervision of the nuclear power plant off-site area within 25 kilometres. The tele-dosimetric system is described

A measure of South Africa's health care.

Science.gov (United States)

de Selincourt, K

Nurses provide the bulk of health care in South Africa. For example, in 1 of the biggest and poorest townships Khayelitsha, nurses treat malnourished mothers and children and offer primary health care services. Physicians tend to work in township clinics on a part-time basis and supervise nurse-advised treatments over the telephone. Most physicians do not speak the language of the people living in the township which is Xhosa. Thus they often depend on a nurse to serve as interpreter for Xhosa-speaking patients which takes the nurse away from her duties. Some clinics never receive physician supervision or services. Nurses spend much of their time sharing their skills and knowledge with clients. Nutrition workers and other staff back up nurses at the clinics. They sometimes are mothers whose children were at one time malnourished. Since they have the basic skills and knowledge, clinic staff provide treatment for straightforward conditions such as scabies. Nurses working in hospital in Khayelitsha also have many responsibilities. For example, they do the initial psychiatric assessment and decide whether to send a patient immediately to Valkenburg Psychiatric Hospital or to schedule the patient for an appointment with the physician at the satellite psychiatric clinic at Khayelitsha Hospital where psychiatrists come only twice/week. They sometimes make home visits which results in them also providing primary care. Unlike nurses not working in the hospital, the nurses at the hospital have good medical support. Both black and white nurses in South Africa work in the same clinics despite the country's policy of separateness. A shortage of nurses is 1 reason for this integration. Black nurses still encounter discrimination when applying for jobs and, until recently, made less money for the same work than white nurses.

The LHC string2 supervision system

CERN Document Server

Mayya, Y S; Sicard, Claude Henri

2002-01-01

This paper describes the implementation of the supervision system for the LHC Prototype Full-Cell also known as String 2. The supervision application is based on a commercial package targeted to industrial controls, but because of the complexity and the specifics of such a system, integration with custom components is necessary in order to merge the industrial requirements with the specificity of the accelerator controls.

18 CFR 367.9110 - Account 911, Supervision.

Science.gov (United States)

2010-04-01

... account must include the cost of labor and expenses incurred in the general direction and supervision of sales activities, except merchandising. Direct supervision of a specific activity, such as demonstrating, selling, or advertising, must be charged to the account wherein the costs of such activity are included...

Nurturing compassion through care-giving and care-receiving: the changing moral economy of AIDs in China.

Science.gov (United States)

Kuah-Pearce, Khun Eng; Guiheux, Gilles

2014-01-01

Based on the case study of an Aids clinic operated in Nanning by MSF, this paper looks at how one international NGO, Médecins Sans Frontières (MSF, or Doctors Without Borders), deals with the HIV-carrier patients in Nanning, the capital of Guangxi province in China. It explores the process of care-giving to the HIV patients by MSF employees (both foreign and local) and how the patients react to the 'care-receiving' provided by this foreign NGO. This is especially pertinent in China today as HIV-patients are the victims of discriminating policies and are still very much discriminated by the general population. MSF, viewed by the victims as a foreign NGO, is regarded as an organization seen as promoting a changing and compassionate attitude toward AIDs patients through their anonymous and non-discriminating practices. Through the practices and the discourse of MSF workers and the testimonies of the patients, this paper looks at how the moral economy of AIDs is evolving from a repressive and discriminative attitude towards the compassionate attention to individual suffering. As such, MSF, through its actions, is seen as one of the agents promoting attitudinal changes toward disadvantaged groups and is facilitating the emergence of an emotional and compassionate subject.

Increasing the Number of Outpatients Receiving Spiritual Assessment: A Pain and Palliative Care Service Quality Improvement Project.

Science.gov (United States)

Gomez-Castillo, Blanca J; Hirsch, Rosemarie; Groninger, Hunter; Baker, Karen; Cheng, M Jennifer; Phillips, Jayne; Pollack, John; Berger, Ann M

2015-11-01

Spirituality is a patient need that requires special attention from the Pain and Palliative Care Service team. This quality improvement project aimed to provide spiritual assessment for all new outpatients with serious life-altering illnesses. Percentage of new outpatients receiving spiritual assessment (Faith, Importance/Influence, Community, Address/Action in care, psychosocial evaluation, chaplain consults) at baseline and postinterventions. Interventions included encouraging clinicians to incorporate adequate spiritual assessment into patient care and implementing chaplain covisits for all initial outpatient visits. The quality improvement interventions increased spiritual assessment (baseline vs. postinterventions): chaplain covisits (25.5% vs. 50%), Faith, Importance/Influence, Community, Address/Action in care completion (49% vs. 72%), and psychosocial evaluation (89% vs. 94%). Improved spiritual assessment in an outpatient palliative care clinic setting can occur with a multidisciplinary approach. This project also identifies data collection and documentation processes that can be targeted for improvement. Published by Elsevier Inc.

Theory of Multiple Intelligences at Teacher Supervision

Directory of Open Access Journals (Sweden)

İzzet Döş

2012-07-01

Full Text Available This study aims to determine views of teachers and supervisors related to the multiple intelligences in students’ learning that they took into consideration in the evaluation of teachers during lesson supervision. The study was conducted with 5 supervisors who work at Kahramanmaraş provincial directorate of national education and 10 teachers who work at primary schools in the centre of Kahramanmaraş in 2011-2012 year. Data was gathered with the help of interview form consisting of five open-ended questions. In the analysis of the data content analysis which is one of the qualitative research methods. According to the results of the analysis, it has been found that usage of multiple intelligences theory in the evaluation students’ learning during supervision enabled them to evaluate students’ learning in a more detailed way. It also made it possible for the supervisors to examine supervision evaluations at different levels. It was also mentioned that supervisions made according to multiple intelligence theory has some limitations.

Kontraktetablering i supervision

DEFF Research Database (Denmark)

Mortensen, Karen Vibeke; Jacobsen, Claus Haugaard

2007-01-01

Kapitlet behandler kontraktetablering i supervision, et element, der ofte er blevet negligeret eller endog helt forbigået ved indledningen af supervisionsforløb. Sikre aftaler om emner som tid, sted, procedurer for fremlæggelse, fortrolighed, ansvarsfordeling og evaluering skaber imidlertid trygh...

The impact of mentor mother programs on PMTCT service uptake and retention-in-care at primary health care facilities in Nigeria: a prospective cohort study (MoMent Nigeria).

Science.gov (United States)

Sam-Agudu, Nadia A; Cornelius, Llewellyn J; Okundaye, Joshua N; Adeyemi, Olusegun A; Isah, Haroun O; Wiwa, Owens M; Adejuyigbe, Ebun; Galadanci, Hadiza; Afe, Abayomi J; Jolaoso, Ibidun; Bassey, Emem; Charurat, Manhattan E

2014-11-01

Nigeria is a key target country in the global effort toward elimination of mother-to-child transmission of HIV. Low coverage of prevention of mother-to-child transmission (PMTCT) interventions, adherence, and retention-in-care rates in HIV-positive pregnant women are contributing factors to high mother-to-child transmission of HIV (MTCT) rates. In Nigeria, rural areas, served largely by primary health care facilities, have particularly poor indicators of PMTCT coverage. Mentor Mothers are HIV-positive women who serve as peer counselors for PMTCT clients, provide guidance, and support in keeping appointments and promoting antiretroviral adherence and retention-in-care. The Mother Mentor (MoMent) study aims to investigate the impact of structured Mentor Mother programs on PMTCT outcomes in rural Nigeria. A prospective cohort study will compare rates of retention-in-care among PMTCT clients who are supported by formally-trained supervised Mentor Mothers versus clients who receive standard-of-care, informal peer support. Study sites are 20 primary health care centers (10 intervention, 10 control) in rural North-Central Nigeria. The study population is HIV-positive mothers and exposed infant pairs (MIPs) (N = 480; 240 MIPs per study arm). Primary outcome measures are the proportion of exposed infants receiving early HIV testing by age 2 months, and the proportion of MIPs retained in care at 6 months postpartum. Secondary outcome measures examine antiretroviral adherence, 12-month postpartum MIP retention, and MTCT rates. This article presents details of the study design, the structured Mentor Mother programs, and how their impact on PMTCT outcomes will be assessed.

Adaptation and validation of the instrument Clinical Learning Environment and Supervision for medical students in primary health care

Directory of Open Access Journals (Sweden)

Eva Öhman

2016-12-01

Full Text Available Abstract Background Clinical learning takes place in complex socio-cultural environments that are workplaces for the staff and learning places for the students. In the clinical context, the students learn by active participation and in interaction with the rest of the community at the workplace. Clinical learning occurs outside the university, therefore is it important for both the university and the student that the student is given opportunities to evaluate the clinical placements with an instrument that allows evaluation from many perspectives. The instrument Clinical Learning Environment and Supervision (CLES was originally developed for evaluation of nursing students’ clinical learning environment. The aim of this study was to adapt and validate the CLES instrument to measure medical students’ perceptions of their learning environment in primary health care. Methods In the adaptation process the face validity was tested by an expert panel of primary care physicians, who were also active clinical supervisors. The adapted CLES instrument with 25 items and six background questions was sent electronically to 1,256 medical students from one university. Answers from 394 students were eligible for inclusion. Exploratory factor analysis based on principal component methods followed by oblique rotation was used to confirm the adequate number of factors in the data. Construct validity was assessed by factor analysis. Confirmatory factor analysis was used to confirm the dimensions of CLES instrument. Results The construct validity showed a clearly indicated four-factor model. The cumulative variance explanation was 0.65, and the overall Cronbach’s alpha was 0.95. All items loaded similarly with the dimensions in the non-adapted CLES except for one item that loaded to another dimension. The CLES instrument in its adapted form had high construct validity and high reliability and internal consistency. Conclusion CLES, in its adapted form, appears

Supervised hub-detection for brain connectivity

DEFF Research Database (Denmark)

Kasenburg, Niklas; Liptrot, Matthew George; Reislev, Nina Linde

2016-01-01

, but can smooth discriminative signals in the population, degrading predictive performance. We present a novel hub-detection optimized for supervised learning that both clusters network nodes based on population level variation in connectivity and also takes the learning problem into account. The found......A structural brain network consists of physical connections between brain regions. Brain network analysis aims to find features associated with a parameter of interest through supervised prediction models such as regression. Unsupervised preprocessing steps like clustering are often applied...... hubs are a low-dimensional representation of the network and are chosen based on predictive performance as features for a linear regression. We apply our method to the problem of finding age-related changes in structural connectivity. We compare our supervised hub-detection (SHD) to an unsupervised hub...

Problems of Rural Food Safety and Strategies of Constructing Supervision System

Institute of Scientific and Technical Information of China (English)

2011-01-01

This paper expounds the practical necessity of constructing diversified rural food safety supervision system as follows: it is the necessary requirements of guaranteeing people’s health and life safety; it is an important component of governmental function of social management and the logical extension of administrative responsibilities; it is the basis of maintaining order of rural society and constructing harmonious society. The main problems existing in the supervision of rural food safety are analyzed as follows: first, the legislative work of rural food safety lags behind to some extent; second, the supervision of governmental departments on rural food safety is insufficient; third, the industrial supervision mechanism of rural food security is not perfect; fourth, the role of rural social organizations in supervising food safety is limited; fifth, the farmers’ awareness of food safety supervision is not strong. Based on these problems, the targeted strategies of constructing diversified rural food safety supervision system are put forward as follows: accelerate the legislation of rural food safety, and ensure that there are laws to go by; give play to the dominant role of government, and strengthen administrative supervision on rural food safety; perfect industrial convention of rural food safety, and improve industrial supervision mechanism; actively support the fostering of social organizations, and give play to the role of supervision of organizations; cultivate correct concept of rights and obligations of farmers, and form awareness of food safety supervision.

Principals Performance of Supervision of Instructions in Public ...

African Journals Online (AJOL)

Data were collected from a sample of 604 out of 1640 teachers using stratified ... supervision of instructions in the school since effective supervision improves ... and reduces incidence of students' involvement in examination malpractices.

Short-term supervised inpatient physiotherapy exercise protocol improves cardiac autonomic function after coronary artery bypass graft surgery--a randomised controlled trial.

Science.gov (United States)

Mendes, Renata Gonçalves; Simões, Rodrigo Polaquini; De Souza Melo Costa, Fernando; Pantoni, Camila Bianca Falasco; Di Thommazo, Luciana; Luzzi, Sérgio; Catai, Aparecida Maria; Arena, Ross; Borghi-Silva, Audrey

2010-01-01

Coronary artery bypass grafting (CABG) is accompanied by severe impairment of cardiac autonomous regulation (CAR). This study aimed to determine whether a short-term physiotherapy exercise protocol post-CABG, during inpatient cardiac rehabilitation (CR), might improve CAR. Seventy-four patients eligible for CABG were recruited and randomised into physiotherapy exercise group (EG) or physiotherapy usual care group (UCG). EG patients underwent a short-term supervised inpatient physiotherapy exercise protocol consisting of an early mobilisation with progressive exercises plus usual care (respiratory exercises). UCG only received respiratory exercises. Forty-seven patients (24 EG and 23 UGC) completed the study. Outcome measures of CAR included linear and non-linear measures of heart rate variability (HRV) assessed before discharge. By hospital discharge, EG presented significantly higher parasympathetic HRV values [rMSSD, high frequency (HF), SD1)], global power (STD RR, SD2), non-linear HRV indexes [detrended fluctuation analysis (DFA)alpha1, DFAalpha2, approximate entropy (ApEn)] and mean RR compared to UCG (pexercise protocol during inpatient CR improves CAR at the time of discharge. Thus, exercise-based inpatient CR might be an effective non-pharmacological tool to improve autonomic cardiac tone in patient's post-CABG.

Supervision and inspection plans of plants activities

International Nuclear Information System (INIS)

Feijoo, J. P.

2009-01-01

Any idea of hierarchization between supervisor and supervised in inspection and supervision activities should necessarily be dismissed, and the independence of the supervisor when executing has tasks should be guaranteed. The inspection and supervision program enable the detection and resolution of materials and human problems alike. In addition, they are a solution to anticipate potential problems in the future, which results in a very significant reduction of industrial accidents and human errors, as well as better use and upkeep of equipment. With these programs we improve our management and our work, and without a doubt they help to strengthen the safety culture in Cofrentes Nuclear Power Plant. (Author)

Pengaruh Metode Drill dalam Supervisi Klinis terhadap Spiritual Care Perawat

Directory of Open Access Journals (Sweden)

Nunung Rachmawati

2017-11-01

Full Text Available The holistic nursing service is based on the concept that humans are sick not only physically that cured by drug delivery, but also pay attention to other aspects of mental where the patient needs motivation and spirit to cope with illness, social where the patient wants to meet and gather with family/friends and spiritual where the patient wants to pray and pray for healing. Spiritual care is an important part of the overall care provided to improve the quality of life of patients. The role of nurses is now more involved on treatment measures. Proper methods in clinical supervision are necessary for the implementation of spiritual care to be as important as physical care, one of them using drill method. This study aims to analyze the influence of drill methods in the team leader's clinical supervision on the implementation of nurses spiritual care. The research method used is quasy experiment with pretest-posttest research design with control group design. The population of nurse research in inpatient room of PKU Muhammadiyah Yogyakarta and PKU Muhammadiyah Gamping Hospital. A total of 32 nurses were taken as samples through consecutive sampling technique. To see the implementation of spiritual care used observation sheet refers to the label Nursing Interventions Classification, spiritual care is observed before and after the application of drill methods in clinical supervision. Data were analyzed by paired t-test. The results showed the average of nurses' spiritual care before the drill method applied to the intervention group was 6,56 and 6,13 in the control group, after drill method applied in the intervention group was 17,44 and 6,50 in the control group. The results of statistical tests showed that there was a significant difference in nurse's spiritual care before and after the application of drill methods in the intervention group. It is recommended for the hospital to improve the implementation of clinical supervision to the nurses

Development of well construction and workover supervising in Russian Federation

International Nuclear Information System (INIS)

Sizov, A; Boyarko, G; Shenderova, I

2014-01-01

Despite long history of drilling supervising it still has a number of uncertainties. The period of rapid rise in supervising development at the beginning of the 90's changed in the 2000's. The necessity in the development of this sphere is obvious. The author describes the history of supervising, period of its market condition adaptation. The research also gives principles methods of supervising development and first steps for its position improvement

Applying Services Marketing Principles to Postgraduate Supervision