Infectious Disease Specialist: What Is an Infectious Disease Specialist?

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... medical professionals? When do I need an ID specialist? Many common infections can be treated by your ... diseases. Back to Top How was my ID specialist trained? Your ID Physician has 9-10 years ...

TRAINING SYSTEM OF FUTURE SPECIALISTS: QUALITY CONTROL

Directory of Open Access Journals (Sweden)

Vladimir A. Romanov

2015-01-01

Full Text Available The aim of the investigation is development of innovative strategy of quality control training of engineers and skilled workers (hereinafter – future specialists in educational professional organizations on the principles of social partnership.Methods. Theoretic: theoretic and methodological analysis, polytheoretic synthesis, modeling. Empirical: research and generalization of the system, process and competence – based approaches experience, experiment, observation, surveys, expert evaluation, SWOT-analysis as a method of strategic planning which is to identify the internal and external factors (socio-cultural of the organization surrounding.Results. The strategy of the development of the process of quality control training in educational professional organizations and a predictive model of the system of quality control training for future engineers and workers have been created on the analysis and synthesis of a quantitative specification of the quality, the obtained experience and success in control training of future specialists in educational professional organizations in recent economic and educational conditions.Scientific novelty. There has been built a predicative model of quality control training of future specialists to meet modern standards and the principles of social partnership; the control algorithm of the learning process, developed in accordance with the standards (international of quality ISO in the implementation of the quality control systems of the process approach (matrix-based responsibility, competence and remit of those responsible for the education process in the educational organization, the «problem» terms and diagnostic tools for assessing the quality of professional training of future specialists. The perspective directions of innovation in the control of the quality of future professionals training have been determined; the parameters of a comprehensive analysis of the state of the system to ensure the

Respiratory health in Latin America: number of specialists and human resources training.

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Vázquez-García, Juan-Carlos; Salas-Hernández, Jorge; Pérez Padilla, Rogelio; Montes de Oca, María

2014-01-01

Latin America is made up of a number of developing countries. Demographic changes are occurring in the close to 600 million inhabitants, in whom a significant growth in population is combined with the progressive ageing of the population. This part of the world poses great challenges for general and respiratory health. Most of the countries have significant, or even greater, rates of chronic respiratory diseases or exposure to risk. Human resources in healthcare are not readily available, particularly in the area of respiratory disease specialists. Academic training centers are few and even non-existent in the majority of the countries. The detailed analysis of these conditions provides a basis for reflection on the main challenges and proposals for the management and training of better human resources in this specialist area. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

Few older people in New Zealand who commit suicide receive specialist psychogeriatric services.

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Cheung, Gary; Casey, Jane

2014-08-01

Suicide in older people is a growing public health concern in many parts of the world. The literature on this issue is lacking in New Zealand. The aim of this study is to ascertain whether this group is accessing specialist psychogeriatric services. A retrospective case series study of completed suicides in older people (≥65 years) during a three-year period from January 2010 to December 2012 was performed. An online survey detailing demographic and clinical information was completed by psychiatrists in 15 of the 20 District Health Boards in New Zealand. Only about 15% of older people who committed suicide were accessing specialist psychogeriatric services and the group with the highest suicide rate (men≥85 years) did not feature in specialist services. Depression (61%) was the most common diagnosis and nearly half (35%) had had contact with specialist services within three days prior to the suicide. Over half (52%) had a history of past suicide attempt(s). Older people who complete suicide are infrequently accessing specialist services. In those that do, there are questions to be answered regarding suicide prediction and prevention for this high-risk group of vulnerable individuals. More research is required targeting those not accessing specialist services, in particular the high risk group of older men. The role of general practitioner, community care, the assessment and management of depression and whether there is any access issue to specialist psychogeriatric services require elucidation. © The Royal Australian and New Zealand College of Psychiatrists 2014.

Specialist Bibliographic Databases

OpenAIRE

Gasparyan, Armen Yuri; Yessirkepov, Marlen; Voronov, Alexander A.; Trukhachev, Vladimir I.; Kostyukova, Elena I.; Gerasimov, Alexey N.; Kitas, George D.

2016-01-01

Specialist bibliographic databases offer essential online tools for researchers and authors who work on specific subjects and perform comprehensive and systematic syntheses of evidence. This article presents examples of the established specialist databases, which may be of interest to those engaged in multidisciplinary science communication. Access to most specialist databases is through subscription schemes and membership in professional associations. Several aggregators of information and d...

Specialist teams for neonatal transport to neonatal intensive care units for prevention of morbidity and mortality.

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Chang, Alvin S M; Berry, Andrew; Jones, Lisa J; Sivasangari, Subramaniam

2015-10-28

Maternal antenatal transfers provide better neonatal outcomes. However, there will inevitably be some infants who require acute transport to a neonatal intensive care unit (NICU). Because of this, many institutions develop services to provide neonatal transport by specially trained health personnel. However, few studies report on relevant clinical outcomes in infants requiring transport to NICU. To determine the effects of specialist transport teams compared with non-specialist transport teams on the risk of neonatal mortality and morbidity among high-risk newborn infants requiring transport to neonatal intensive care. We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (CENTRAL 2015, Issue 7), MEDLINE (1966 to 31 July 2015), EMBASE (1980 to 31 July 2015), CINAHL (1982 to 31 July 2015), conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. randomised, quasi-randomised or cluster randomised controlled trials. neonates requiring transport to a neonatal intensive care unit. transport by a specialist team compared to a non-specialist team. any of the following outcomes - death; adverse events during transport leading to respiratory compromise; and condition on admission to the neonatal intensive care unit. The methodological quality of the trials was assessed using the information provided in the studies and by personal communication with the author. Data on relevant outcomes were extracted and the effect size estimated and reported as risk ratio (RR), risk difference (RD), number needed to treat for an additional beneficial outcome (NNTB) or number needed to treat for an additional harmful outcome (NNTH) and mean difference (MD) for continuous outcomes. Data from cluster randomised trials were not combined for analysis. One trial met the inclusion criteria of this review but was considered ineligible owing to

Supporting smoking cessation in the medical specialist practice

NARCIS (Netherlands)

Schippers, G. M.

2004-01-01

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

Frequent inaccuracies in ABCD(2) scoring in non-stroke specialists' referrals to a daily Rapid Access Stroke Prevention service.

LENUS (Irish Health Repository)

Bradley, David

2013-09-15

The \\'accuracy\\' of age, blood pressure, clinical features, duration and diabetes (ABCD(2)) scoring by non-stroke specialists referring patients to a daily Rapid Access Stroke Prevention (RASP) service is unclear, as is the accuracy of ABCD(2) scoring by trainee residents. In this prospective study, referrals were classified as \\'confirmed TIAs\\' if the stroke specialist confirmed a clinical diagnosis of possible, probable or definite TIA, and \\'non-TIAs\\' if patients had a TIA mimic or completed stroke. ABCD(2) scores from referring physicians were compared with scores by experienced stroke specialists and neurology\\/geriatric medicine residents at a daily RASP clinic; inter-observer agreement was examined. Data from 101 referrals were analysed (mean age=60.0years, 58% male). The median interval between referral and clinic assessment was 1day. Of 101 referrals, 52 (52%) were \\'non-TIAs\\': 45 (86%) of 52 were \\'TIA mimics\\' and 7 (14%) of 52 were completed strokes. There was only \\'fair\\' agreement in total ABCD(2) scoring between referring physicians and stroke specialists (κ=0.37). Agreement was \\'excellent\\' between residents and stroke specialists (κ=0.91). Twenty of 29 patients scored as \\'moderate to high risk\\' (score 4-6) by stroke specialists were scored \\'low risk\\' (score 0-3) by referring physicians. ABCD(2) scoring by referring doctors is frequently inaccurate, with a tendency to underestimate stroke risk. These findings emphasise the importance of urgent specialist assessment of suspected TIA patients, and that ABCD(2) scores by non-stroke specialists cannot be relied upon in isolation to risk-stratify patients. Inter-observer agreement in ABCD(2) scoring was \\'excellent\\' between residents and stroke specialists, indicating short-term training may improve accuracy.

Specialist Bibliographic Databases.

Science.gov (United States)

Gasparyan, Armen Yuri; Yessirkepov, Marlen; Voronov, Alexander A; Trukhachev, Vladimir I; Kostyukova, Elena I; Gerasimov, Alexey N; Kitas, George D

2016-05-01

Specialist bibliographic databases offer essential online tools for researchers and authors who work on specific subjects and perform comprehensive and systematic syntheses of evidence. This article presents examples of the established specialist databases, which may be of interest to those engaged in multidisciplinary science communication. Access to most specialist databases is through subscription schemes and membership in professional associations. Several aggregators of information and database vendors, such as EBSCOhost and ProQuest, facilitate advanced searches supported by specialist keyword thesauri. Searches of items through specialist databases are complementary to those through multidisciplinary research platforms, such as PubMed, Web of Science, and Google Scholar. Familiarizing with the functional characteristics of biomedical and nonbiomedical bibliographic search tools is mandatory for researchers, authors, editors, and publishers. The database users are offered updates of the indexed journal lists, abstracts, author profiles, and links to other metadata. Editors and publishers may find particularly useful source selection criteria and apply for coverage of their peer-reviewed journals and grey literature sources. These criteria are aimed at accepting relevant sources with established editorial policies and quality controls.

Specialist Bibliographic Databases

Science.gov (United States)

2016-01-01

Specialist bibliographic databases offer essential online tools for researchers and authors who work on specific subjects and perform comprehensive and systematic syntheses of evidence. This article presents examples of the established specialist databases, which may be of interest to those engaged in multidisciplinary science communication. Access to most specialist databases is through subscription schemes and membership in professional associations. Several aggregators of information and database vendors, such as EBSCOhost and ProQuest, facilitate advanced searches supported by specialist keyword thesauri. Searches of items through specialist databases are complementary to those through multidisciplinary research platforms, such as PubMed, Web of Science, and Google Scholar. Familiarizing with the functional characteristics of biomedical and nonbiomedical bibliographic search tools is mandatory for researchers, authors, editors, and publishers. The database users are offered updates of the indexed journal lists, abstracts, author profiles, and links to other metadata. Editors and publishers may find particularly useful source selection criteria and apply for coverage of their peer-reviewed journals and grey literature sources. These criteria are aimed at accepting relevant sources with established editorial policies and quality controls. PMID:27134485

Sailing a safe ship: improving patient safety by enhancing the leadership skills of new consultant specialist surgeons.

Science.gov (United States)

Shah, Peter; Cross, Vinette; Sii, Freda

2013-01-01

The potential for "discontinuities in care" arising from the turbulent transition from specialist trainee to consultant specialist presents risks to patient safety. But it is easy to lose sight of the affective needs of individuals facing the burden of keeping patients safe. This article describes a 2-day program focused on new and prospective consultant specialist ophthalmic surgeons entitled "Sailing a Safe Ship" (SASS). The purpose was to facilitate understanding and analysis of their personal holistic learning needs and enhance individual agency in optimizing learning during the transition period. The program used gaming, team challenges, meta-planning, role play and professional actors, interactive presentations, and self-analysis tools to portray the real world of consultant specialist practice in terms of ill-defined problems requiring "elite communication" and effective negotiation of value differences and priorities for their resolution. Participants' insights into their individual learning were recorded in scheduled reflective sessions. The immediate impact on their learning was also considered in terms of direct (instructional) and indirect (nurturant) effects. Participants' insights reflected 4 key themes: admitting vulnerability and uncertainty, taking responsibility for managing risk, being self-aware and reflexive, and internalizing authentic leadership. Four instructional and 4 nurturant effects were revealed. Preliminary findings on long-term impact on participants' practice are outlined. Evidence from the evaluation indicated that participants felt empowered to construct a personal strategic response to unfamiliar and unanticipated workplace demands and pressures, adopt a capability mindset that would accelerate their capacity to fulfill an enhanced leadership role, and take a holistic approach to their continuing self-directed development as leaders and educators. Copyright © 2013 The Alliance for Continuing Education in the Health Professions

The internal medicine specialist and neurosurgery

Directory of Open Access Journals (Sweden)

A. Pizzini

2013-05-01

Full Text Available BACKGROUND The neurosurgical patient is often a real challenge for the physicians, because of a frequent multimorbidity and a higher risk for severe complications. Cooperation between internal medicine specialist and neurosurgeon is essential to prevent the fatal effects of cranial and spinal injuries. The topic issues of medical interest in neurosurgery are the disorders of sodium balance, the glycemic control, the thromboembolic risk, the intracerebral bleeding management and the infective problems. The neurosurgeons could be worried by treating these complications that are mostly of internal medicine interest and that could unfortunately rise the risk of death or irreversible insults. AIM OF THE REVIEW This review summarizes the modality of diagnosis and therapy of the foremost concerns in neurosurgical field.

A Comparison of Selected Supervisory Skills of Content Specialist and Non-Content Specialist University Supervisors

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Hunt, Kevin; Mitchell, Murray; Maina, Michael; Griffin, Lisa

2015-01-01

The purpose of this study was to describe and contrast selected approaches to the supervision of student teachers between Content Specialist and Non-Content Specialist university supervisors. Content Specialist supervisors were identified as trained university supervisors with a background in physical education. Non-Content Specialist supervisors…

The need for PGY2-trained clinical pharmacy specialists.

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Ragucci, Kelly R; O'Bryant, Cindy L; Campbell, Kristin Bova; Buck, Marcia L; Dager, William E; Donovan, Jennifer L; Emerson, Kayleigh; Gubbins, Paul O; Haight, Robert J; Jackevicius, Cynthia; Murphy, John E; Prohaska, Emily

2014-06-01

The American College of Clinical Pharmacy and other stakeholder organizations seek to advance clinical pharmacist practitioners, educators, and researchers. Unfortunately, there remains an inadequate supply of residency-trained clinical specialists to meet the needs of our health care system, and nonspecialists often are called on to fill open specialist positions. The impact of clinical pharmacy specialists on pharmacotherapy outcomes in both acute care and primary care settings demonstrates the value of these specialists. This commentary articulates the need for postgraduate year two (PGY2)-trained clinical specialists within the health care system by discussing various clinical and policy rationales, interprofessional support, economic justifications, and their impact on quality of care and drug safety. The integrated practice model that has grown out of the American Society of Health-System Pharmacists Pharmacy Practice Model Initiative (PPMI) could threaten the growth and development of future clinical specialists. Therefore, the ways in which PGY2-trained clinical pharmacist specialists are deployed in the PPMI require further consideration. PGY2 residencies provide education and training opportunities that cannot be achieved in traditional professional degree programs or postgraduate year one residencies. These specialists are needed to provide direct patient care to complex patient populations and to educate and train pharmacy students and postgraduate residents. Limitations to training and hiring PGY2-trained clinical pharmacy specialists include site capacity limitations and lack of funding. A gap analysis is needed to define the extent of the mismatch between the demand for specialists by health care systems and educational institutions versus the capacity to train clinical pharmacists at the specialty level. © 2014 Pharmacotherapy Publications, Inc.

The predictability of phytophagous insect communities: host specialists as habitat specialists.

Directory of Open Access Journals (Sweden)

Jörg Müller

Full Text Available The difficulties specialized phytophagous insects face in finding habitats with an appropriate host should constrain their dispersal. Within the concept of metacommunities, this leads to the prediction that host-plant specialists should sort into local assemblages according to the local environmental conditions, i.e. habitat conditions, whereas assemblages of host-plant generalists should depend also on regional processes. Our study aimed at ranking the importance of local environmental factors and species composition of the vegetation for predicting the species composition of phytophagous moth assemblages with either a narrow or a broad host range. Our database consists of 351,506 specimens representing 820 species of nocturnal Macrolepidoptera sampled between 1980 and 2006 using light traps in 96 strict forest reserves in southern Germany. Species were grouped as specialists or generalists according to the food plants of the larvae; specialists use host plants belonging to one genus. We used predictive canonical correspondence and co-correspondence analyses to rank the importance of local environmental factors, the species composition of the vegetation and the role of host plants for predicting the species composition of host-plant specialists and generalists. The cross-validatory fit for predicting the species composition of phytophagous moths was higher for host-plant specialists than for host-plant generalists using environmental factors as well as the composition of the vegetation. As expected for host-plant specialists, the species composition of the vegetation was a better predictor of the composition of these assemblages than the environmental variables. But surprisingly, this difference for specialized insects was not due to the occurrence of their host plants. Overall, our study supports the idea that owing to evolutionary constraints in finding a host, host-plant specialists and host-plant generalists follow two different models of

The impact of specialist trauma service on major trauma mortality.

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Wong, Ting Hway; Lumsdaine, William; Hardy, Benjamin M; Lee, Keegan; Balogh, Zsolt J

2013-03-01

Trauma services throughout the world have had positive effects on trauma-related mortality. Australian trauma services are generally more consultative in nature rather than the North American model of full trauma admission service. We hypothesized that the introduction of a consultative specialist trauma service in a Level I Australian trauma center would reduce mortality of the severely injured. A 10-year retrospective study (January 1, 2002-December 31, 2011) was performed on all trauma patients admitted with an Injury Severity Score (ISS) > 15. Patients were identified from the trauma registry, and data for age, sex, mechanism of injury, ISS, survival to discharge, and length of stay were collected. Mortality was examined for patients with severe injury (ISS > 15) and patients with critical injury (ISS > 24) and compared for the three periods: 2002-2004 (without trauma specialist), 2005-2007 (with trauma specialist), and 2008-2011 (with specialist trauma service). A total of 3,869 severely injured (ISS > 15) trauma patients were identified during the 10-year period. Of these, 2,826 (73%) were male, 1,513 (39%) were critically injured (ISS > 24), and more than 97% (3,754) were the victim of blunt trauma. Overall mortality decreased from 12.4% to 9.3% (relative risk, 0.75) from period one to period three and from 25.4% to 20.3% (relative risk, 0.80) for patients with critical injury. A 0.46% per year decrease (p = 0.018) in mortality was detected (odds ratio, 0.63; p 24), the trend was (0.61% per year; odds ratio, 0.68; p = 0.039). The introduction of a specialist trauma service decreased the mortality of patients with severe injury, the model of care should be considered to implement state- and nationwide in Australia. Epidemiologic study, level III.

UK HSE Training of HM Radiation Specialist Inspectors

International Nuclear Information System (INIS)

Nattres, E.; Barrett, J. A.

2004-01-01

HSE's mission is to ensure that risks to people's health and safety from work activities are properly controlled. Radiation Specialist Inspectors make an essential contribution to HSE's objectives through the application of their professional skills and knowledge. The role of the Radiation Specialist Inspector includes inspection work in the field to ensure compliance by employers with the Health and Safety at Work etc Act 1974, Ionising Radiations Regulations 1999 and associated legislation. They also contribute to research, and the development of technical policy, legislation, standards, and guidance on protection against the possible harm from exposure to electromagnetic fields, optical or ionizing radiation. This paper explains how Radiation Specialist Inspectors are trained. It starts with the recruitment process, with an emphasis on recruiting people who have already gained relevant experience from radiation work practices in previous employments. The interview process is explored, which includes both technical and behavioural interviews, making a presentation and completing a personality questionnaire. The initial twelve months training is then discussed in detail, including the six months as a general Health and Safety Inspector where inspector' skills and techniques' are developed by practical involvement in inspection, followed by a challenging six months with a Radiation Specialist group. The programme for this period is designed to broaden and develop skills and knowledge within the radiation protection specialist. After the initial twelve months probationary period, new Inspectors are expected to confirm and establish themselves in their role of Radiation Specialist Inspectors. However, it does not end there, continuing professional development to ensure that Inspectors have cutting edge knowledge of the latest advances within the radiation field and health and safety as a whole is essential and will be discussed in more detail. (Author) 6 refs

Service innovation in glaucoma management: using a Web-based electronic patient record to facilitate virtual specialist supervision of a shared care glaucoma programme.

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Wright, Heathcote R; Diamond, Jeremy P

2015-03-01

To assess the importance of specialist supervision in a new model of glaucoma service delivery. An optometrist supported by three technicians managed each glaucoma clinic. Patients underwent testing and clinical examination before the optometrist triaged them into one of five groups: 'normal', 'stable', 'low risk', 'unstable' and 'high risk'. Patient data were uploaded to an electronic medical record to facilitate virtual review by a glaucoma specialist. 24 257 glaucoma reviews at three glaucoma clinics during a 31-month period were analysed. The clinic optometrists and glaucoma specialists had substantial agreement (κ 0.69). 13 patients were identified to be high risk by the glaucoma specialist that had not been identified as such by the optometrist. Glaucoma specialists amended 13% of the optometrists' interim decisions resulting in an overall reduction in review appointments by 2.4%. Employing technicians and optometrists to triage glaucoma patients into groups defined by risk of blindness allows higher risk patients to be directed to a glaucoma specialist. Virtual review allows the glaucoma specialist to remain in overall control while reducing the risk that patients are treated or followed-up unnecessarily. Demand for glaucoma appointments can be reduced allowing scarce medical resources to be directed to patients most in need. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Differences in quality standards when prescribing nutritional support: Differences between specialist and non-specialist physicians.

Science.gov (United States)

Morán López, Jesús Manuel; Piedra León, María; Enciso Izquierdo, Fidel Jesús; Luengo Pérez, Luis Miguel; Amado Señaris, José Antonio

2016-01-01

Adequate nutritional support includes many different aspects, but poor understanding of clinical nutrition by health care professionales often results in an inadequate prescription. A study was conducted to compare enteral and parenteral nutritional support plans prescribed by specialist and non-specialist physicians. Non-specialist physicians recorded anthropometric data from only 13.3% of patients, and none of them performed nutritional assessments. Protein amounts provided by non-specialist physicians were lower than estimated based on ESPEN (10.29g of nitrogen vs 14.62; Pspecialist group (14.88g of nitrogen; P=.072). Calorie and glutamine provision and laboratory controls prescribed by specialists were significantly closer to those recommended by clinical guidelines. Nutritional support prescribed by specialists in endocrinology and nutrition at San Pedro de Alcántara Hospital was closer to clinical practice guideline standards and of higher quality as compared to that prescribed by non-specialists. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

Interobserver agreement in ABCD scoring between non-stroke specialists and vascular neurologists following suspected TIA is only fair.

LENUS (Irish Health Repository)

Kinsella, Justin A

2012-02-01

The appropriateness of use and accuracy of age, blood pressure, clinical features and duration of symptoms (ABCD) scoring by non-stroke specialists while risk-stratifying patients with suspected transient ischaemic attack (TIA) are unknown. We reviewed all available ABCD data from referrals to a specialist neurovascular clinic. ABCD scoring was defined as \\'appropriate\\' in this study if an experienced vascular neurologist subsequently confirmed a clinical diagnosis of possible, probable or definite TIA, and \\'inappropriate\\' if the patient had an alternative diagnosis or stroke. Interobserver agreement between the referring physician and the neurologist was calculated. One hundred and four patients had completed ABCD referral proformas available for analysis. Forty-five (43%) were deemed appropriate, and 59 (57%) inappropriate. In the entire dataset, the neurologist agreed with the referring physician\\'s total ABCD score in only 42% of cases [kappa = 0.28]. The two most unreliable components of the scoring system were clinical features [kappa = 0.51], and duration of symptoms [kappa = 0.48]. ABCD scoring by non-stroke specialists is frequently inappropriate and inaccurate in routine clinical practice, emphasising the importance of urgent specialist assessment of suspected TIA patients.

Pharmacy specialists' attitudes toward pharmaceutical service quality at community pharmacies.

Science.gov (United States)

Urbonas, Gvidas; Jakušovaitė, Irayda; Savickas, Arūnas

2010-01-01

The main objective of this study was to analyze pharmacy specialists' attitudes toward the quality of pharmaceutical services at Lithuanian community pharmacies. Between April and June 2009, a total of 471 Lithuanian community pharmacy specialists completed a questionnaire designed to evaluate their attitudes toward the quality of pharmaceutical services at community pharmacies. The main dimensions of pharmaceutical service quality were extracted by principal component analysis. Two main dimensions of pharmaceutical service quality were extracted: pharmacotherapeutic aspects (provision of information about drug therapy, possible side effects, health promotion, the amount of time spent with a patient, and the ascertainment that a patient understood the provided information) and socioeconomic aspects (considering patient's needs and financial capabilities, making a patient confident with the services provided). Pharmacy specialists evaluated the quality of both dimensions positively, but the quality of the first dimension was rated significantly worse than that of the second dimension. The attitudes of pharmacy specialists working at independent pharmacies were more positive toward pharmacotherapeutic aspects as compared to the specialists working at chain or state pharmacies. Pharmacotherapeutic aspects were rated better by pharmacy specialists, aged ≥ 55 years, than those younger than 45 years. Moreover, the attitudes of 45-54-year-old pharmacy specialists toward the socioeconomic aspects were more positive as compared with those of 35-44-year olds. Pharmacists rated the socioeconomic aspects of pharmaceutical service quality worse as compared with pharmacy technicians. The attitudes of pharmacy specialists working at pharmacies with 6-9 specialists were more negative toward pharmacotherapeutic aspects than those of the pharmacies with 1-2 specialists. Pharmacy specialists working at pharmacies with ≥ 10 specialists reported lower scores of socioeconomic

Effect of Early Referral to Specialist in Dementia on Institutionalization and Functional Decline: Findings from a Population-Based Study.

Science.gov (United States)

Pimouguet, Clément; Le-Goff, Mélanie; Rizzuto, Debora; Berr, Claudine; Leffondré, Karen; Pérès, Karine; Dartigues, Jean FranÇois; Helmer, Catherine

2016-01-01

Although early diagnosis has been hypothesized to benefit both patients and caregivers, until now studies evaluating the effect of early dementia diagnosis are lacking. To investigate the influence of early specialist referral for dementia on the risk of institutionalization and functional decline in Activity of Daily Living (ADL). Incident dementia cases were screened in a prospective population-based cohort, the Three-City Study, and initial specialist consultation for cognitive complaint was assessed at dementia diagnosis. Proportional hazard regression and illness-death models were used to test the association between specialist referral and, respectively, institutionalization and functional decline. Only one third of the incident individuals with dementia had consulted a specialist for cognitive problems early (36%). After adjustment on potential confounders (including cognitive and functional decline) and competing risk of death, participants who had consulted a specialist early in the disease course presented a higher rate of being institutionalized than those who did not (Hazard Ratio = 2.00, 95% Confidence Interval (CI): 1.09- 3.64). But early specialist referral was not associated with further functional decline (HR = 1.09, 95% CI: 0.71- 1.67). Early specialist referral in dementia is associated with increased risk of institutionalization but not with functional decline in ADL. These findings suggest that early care referral in dementia may be a marker of concern for patients and/or caregivers; subsequent medical and social care could be suboptimal or inappropriate to allow patients to stay longer at home.

Burnout Syndrome of Leisure Time Activities Specialist.

OpenAIRE

REBROVÁ, Iveta

2012-01-01

This thesis is dealing with burnout syndrome among leisure time specialists. Theoretical part describes burnout syndrome, its historical basis, symptoms and causes, protective factors and preventive techniques, which prevent from burnout syndrome risk. Next part deals with common stress, its causes and symptoms, and psychosocial stress, which is closely related with burnout syndrome. Ending of the theoretical part is focused on understanding the differences between jobs of common teacher and ...

Art Appreciation as a Learned Competence: A Museum-based Qualitative Study of Adult Art Specialist and Art Non-Specialist Visitors

Directory of Open Access Journals (Sweden)

Rajka Bračun Sova

2015-12-01

Full Text Available Since Bourdieu, it has been argued that art appreciation requires “knowledge”. The focus of this qualitative study was to examine art appreciation as a learned competence by exploring two different groups of museum visitors: art specialists and art non-specialists. The research was conducted at Moderna galerija in Ljubljana. Twenty-three adults were recruited and accompanied during their visit to the museum. Participants were requested to “think out loud”, which meant to talk about what they saw, thought, and felt about the artworks. There was a short interview conducted with each participant before entering the museum to gain insight into their art-related and museum-visiting experience. The analysis of the data revealed that some processes of art appreciation were similar within the two groups. Both art specialists and art non-specialists interact with museum objects physically and intellectually; they see contents and formal qualities as a whole; they respond emotionally to artworks; appreciation includes their personal experience; they search museum interpretation/information for their understanding. Some noticeable differences were found. Art specialists respond to artworks with more understanding and are willing to put more effort into art appreciation, whereas art non-specialists respond with less understanding and put less effort into art appreciation. This paper focuses on the differences between the two groups; reflective and spontaneous appreciation of art, objective and subjective appreciation of art and the effort put into art appreciation. The paper ends with a discussion of the implications of the study for the teaching of art and museum education.

48 CFR 552.236-72 - Specialist.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Specialist. 552.236-72... FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text of Provisions and Clauses 552.236-72 Specialist. As prescribed in 536.570-3, insert the following clause: Specialist (APR 1984) The term “Specialist...

US Influence on the Education System in Turkey: An Analysis of Reports by American Education Specialists

Science.gov (United States)

Keskin, Yusuf

2014-01-01

This study aimed to analyse reports prepared by American education specialists visiting Turkey from the Proclamation of the Republic till the end of the 1950's to inspect Turkey's education system. In accordance with this purpose, first, the foreign specialists' reports are briefly introduced chronologically and then American specialist reports…

PRA and Risk Informed Analysis

International Nuclear Information System (INIS)

Bernsen, Sidney A.; Simonen, Fredric A.; Balkey, Kenneth R.

2006-01-01

The Boiler and Pressure Vessel Code (BPVC) of the American Society of Mechanical Engineers (ASME) has introduced a risk based approach into Section XI that covers Rules for Inservice Inspection of Nuclear Power Plant Components. The risk based approach requires application of the probabilistic risk assessments (PRA). Because no industry consensus standard existed for PRAs, ASME has developed a standard to evaluate the quality level of an available PRA needed to support a given risk based application. The paper describes the PRA standard, Section XI application of PRAs, and plans for broader applications of PRAs to other ASME nuclear codes and standards. The paper addresses several specific topics of interest to Section XI. Important consideration are special methods (surrogate components) used to overcome the lack of PRA treatments of passive components in PRAs. The approach allows calculations of conditional core damage probabilities both for component failures that cause initiating events and failures in standby systems that decrease the availability of these systems. The paper relates the explicit risk based methods of the new Section XI code cases to the implicit consideration of risk used in the development of Section XI. Other topics include the needed interactions of ISI engineers, plant operating staff, PRA specialists, and members of expert panels that review the risk based programs

A qualitative evaluation of the Scottish Staff and Associate Specialist Development Programme.

Science.gov (United States)

Cleland, Jennifer; Burr, Jacqueline; Johnston, Peter

2016-05-01

The continued professional development of staff and associate specialist doctors in the UK was ill served prior to the introduction of the new staff and associate specialist doctor's contract in 2008. The aim of this study was to independently evaluate NHS Education for Scotland's approach to improving professional development for staff and associate specialist doctors, the staff and associate specialist Professional Development Fund. Semi-structured telephone interviews with key stakeholders, framed by a realistic approach to evaluate what works, for whom and in how and under what circumstances. An inductive and data-driven thematic analysis was carried out and then the realist framework was applied to the data. We interviewed 22 key stakeholders: staff and associate specialist doctors, staff and associate specialist educational advisors, programme architects and clinical directors, between end February and May 2014. The resultant data indicated five broad themes: organisational barriers to continued professional development for staff and associate specialist doctors, the purpose of funding, gains from funding, the need for better communication about the staff and associate specialist Programme Development Fund, and the interplay between individual and systems factors. The staff and associate specialist Programme Development Fund has changed the opportunities available to staff and associate specialist doctors in Scotland and, in that sense, has changed the context for this group - or at least those who have realised the opportunities. © The Author(s) 2016.

Expected roles and utilization of specialist nurses in Japan: the nurse administrators' perspective.

Science.gov (United States)

Onishi, Mami; Kanda, Katsuya

2010-04-01

This study explored (1) expected roles for specialist nurses in Japan and (2) nurse administrators' experience-based management strategies for effective implementation of these roles. Background In Japan, specialist nurses have begun to be recognized as valuable human resources. However, managerial issues in utilizing specialist nurses, including unclear roles and lack of reports on effective management strategies, remain. Three focus-group discussions were conducted. Nine nurse administrators participated. Data were analysed using qualitative content analysis techniques. The expected roles for specialist nurses were: (1) facilitating general nurses' learning; (2) monitoring and improving the patient care standard; and (3) developing new roles for nursing. Two management strategies were: (1) enhancing specialist nurses' influence, and (2) enhancing specialist nurses' motivation. Specialist nurses are important human resources able to assume responsibility for process improvement in nursing care. Effective ways to enhance specialist nurses' influence and motivation include developing their management and communication skills, and coordinating their workload and relationships with other health care professionals. Process improvement indicators may be useful for evaluating specialist nurses' work. Nurse administrators can contribute to effective implementation of specialist nurses' roles not only by clarifying their roles but also by empowering them to keep up with changing organizational needs.

Evaluation of vocal acoustic and efficiency analysis parameters in medical students and academic teachers with use of iris and diagnoscope specialist software.

Science.gov (United States)

Zielińska-Bliźniewska, Hanna; Sułkowski, Wiesław J; Pietkiewicz, Piotr; Miłoński, Jarosław; Mazurek, Agnieszka; Olszewski, Jurek

2012-06-01

The aim of this study was to compare the parameters of vocal acoustic and vocal efficiency analyses in medical students and academic teachers with use of the IRIS and DiagnoScope Specialist software and to evaluate their usefulness in prevention and certification of occupational disease. The study group comprised 40 women, including students and employees of the Military Medical Faculty, Medical University of Łodź. After informed consent had been obtained from the participant women, the primary medical history was taken, videolaryngoscopic and stroboscopic examinations were performed and diagnostic vocal acoustic analysis was carried out with the use of the IRIS and Diagno-Scope Specialist software. Based on the results of the performed measurements, the statistical analysis evidenced the compatibility between two software programs, IRIS and DiagnoScope Specialist, with the only exception of the F4 formant. The mean values of vocal acoustic parameters in medical students and academic teachers, obtained by means of the IRIS software, can be used as standards for the female population not yet developed by the producer. When using the DiagnoScope Specialist software, some mean values were higher and some lower than the standards specified by the producer. The study evidenced the compatibility between two measurement software programs, IRIS and DiagnoScope Specialist, except for the F4 formant. It should be noted that the later has advantage over the former since the standard values of vocal acoustic parameters have been worked out by the producer. Moreover, they only slightly departed from the values obtained in our study and may be useful in diagnostics of occupational voice disorders.

Professional Insiders/Outsiders? Teacher Professionalism and the Primary School Physical Education Specialist

Science.gov (United States)

Brooks, Caroline; DinanThompson, Maree

2013-01-01

This paper provides a context for exploring the positioning of Physical Education specialist teachers (PE specialist teachers) in primary schools in Queensland in the discourses of teacher professionalism. A critical analysis of literature on the history and status of the subject and its practitioners aims to contextualize discourses in and about…

Proceedings of the specialist research meeting on 'the latest study on analysis of trace amount of elements using activation analysis and the results and future prospects of activation analysis using KUR'

International Nuclear Information System (INIS)

Ebihara, Mitsuru; Shibata, Seiichi; Sekimoto, Shun

2014-01-01

This Specialist Research Meeting report is the summary of the lectures that were delivered at the Specialist Research Meeting of Kyoto University Reactor Research Institute on January 25, 2013 and October 30, 2013. These meetings were held under the subtitles of 'Current state of trace element analysis using activation analysis' and 'Achievements and future prospects of activation analysis using Kyoto University research reactor (KUR)', respectively. At the former meeting, 14 speeches were delivered including the following: (1) introduction of Australia Nuclear Science and Technology Organisation (ANSTO), (2) determination of element concentration in the hairs in frequent ALS (amyotrophic lateral sclerosis) occurrence zones, (3) effects of vegetation on the acid neutralizing capacity of soil, (4) activation analysis of geological samples, and (5) current situation of KUR. At the latter meeting, 15 speeches were delivered including the following: (1) neutron activation analysis of iron meteorites and Chinese herbal medicines / herbs, (2) neutron activation analysis at KUR using IAEA-k0 method, (3) current state of KUR, (4) development and applications of automatic prompt gamma-ray analysis equipment. (A.O.)

14 CFR 1214.305 - Payload specialist responsibilities.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Payload specialist responsibilities. 1214... Payload Specialists for Space Transportation System (STS) Missions § 1214.305 Payload specialist... commander has ultimate responsibility and authority for all assigned crew duties. The payload specialist is...

48 CFR 536.570-3 - Specialist.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Specialist. 536.570-3... CATEGORIES OF CONTRACTING CONSTRUCTION AND ARCHITECT-ENGINEER CONTRACTS Contract Clauses 536.570-3 Specialist. Insert 552.236-72, Specialist, in solicitations and contracts for construction if the technical sections...

Do specialists exit the firm outsourcing its R&D?

DEFF Research Database (Denmark)

Wang, Wenjing

Do specialists exit the firm increasingly outsourcing its research and development (R&D) work? Although this question is critical in understanding how R&D outsourcing links to innovation performance, the answer is not yet clear. This paper proposes that the optimal level of firm's internal...... employment of R&D specialists decreases with the deepening of R&D outsourcing but increases with the broadening of R&D outsourcing. These relations can be inferred from previous empirical studies as well as our theoretical analysis, and are supported by the empirical evidence from estimations of correlated...

Information security risk analysis

CERN Document Server

Peltier, Thomas R

2001-01-01

Effective Risk AnalysisQualitative Risk AnalysisValue AnalysisOther Qualitative MethodsFacilitated Risk Analysis Process (FRAP)Other Uses of Qualitative Risk AnalysisCase StudyAppendix A: QuestionnaireAppendix B: Facilitated Risk Analysis Process FormsAppendix C: Business Impact Analysis FormsAppendix D: Sample of ReportAppendix E: Threat DefinitionsAppendix F: Other Risk Analysis OpinionsIndex

The Role of the Technical Specialist in Disaster Response and Recovery

Science.gov (United States)

Curtis, J. C.

2017-12-01

Technical Specialists provide scientific expertise for making operational decisions during natural hazards emergencies. Technical Specialists are important members of any Incident Management Team (IMT) as is described in in the National Incident Management System (NIMS) that has been designed to respond to emergencies. Safety for the responders and the threatened population is the foremost consideration in command decisions and objectives, and the Technical Specialist is on scene and in the command post to support and promote safety while aiding decisions for incident objectives. The Technical Specialist's expertise can also support plans, logistics, and even finance as well as operations. This presentation will provide actual examples of the value of on-scene Technical Specialists, using National Weather Service "Decision Support Meteorologists" and "Incident Meteorologists". These examples will demonstrate the critical role of scientists that are trained in advising and presenting life-critical analysis and forecasts during emergencies. A case will be made for local, state, and/or a national registry of trained and deployment-ready scientists that can support emergency response.

Professional Training of Marketing Specialists: Foreign Experience

Science.gov (United States)

Zakharchenko, Yuliia

2017-01-01

Due to content-based analysis of marketing specialists' professional training and approaches to development of their educational trajectory, it has been revealed that curricula and their content are given much attention by employers whose demands are focused on meeting current labour market conditions. It has been justified that despite the…

Reasons why specialist doctors undertake rural outreach services: an Australian cross-sectional study.

Science.gov (United States)

O'Sullivan, Belinda G; McGrail, Matthew R; Stoelwinder, Johannes U

2017-01-07

The purpose of the study is to explore the reasons why specialist doctors travel to provide regular rural outreach services, and whether reasons relate to (1) salaried or private fee-for-service practice and (2) providing rural outreach services in more remote locations. A national cross-sectional study of specialist doctors from the Medicine in Australia: Balancing Employment and Life (MABEL) survey in 2014 was implemented. Specialists providing rural outreach services self-reported on a 5-point scale their level of agreement with five reasons for participating. Chi-squared analysis tested association between agreement and variables of interest. Of 567 specialists undertaking rural outreach services, reasons for participating include to grow the practice (54%), maintain a regional connection (26%), provide complex healthcare (18%), healthcare for disadvantaged people (12%) and support rural staff (6%). Salaried specialists more commonly participated to grow the practice compared with specialists in fee-for-service practice (68 vs 49%). This reason was also related to travelling further and providing outreach services in outer regional/remote locations. Private fee-for-service specialists more commonly undertook outreach services to provide complex healthcare (22 vs 14%). Specialist doctors undertake rural outreach services for a range of reasons, mainly to complement the growth and diversity of their main practice or maintain a regional connection. Structuring rural outreach around the specialist's main practice is likely to support participation and improve service distribution.

Prevalence of Methicillin-resistant Staphyloccocus Aureus and associated risk factors on admission to a specialist care eye hospital

International Nuclear Information System (INIS)

Islam, Sara I.; Moore, C.

2002-01-01

Staphyloccocus aureus is known to be a frequent pathogen in hospital settings, with its well-known and resistant forms to the anti-staphylococcal penicillins. Reports on community carriage outside hospital settings have been feared to be on the increase due to the due to the frequency of reported cases on admission to hospitals. We undertook this study to determine the prevalence of and to establish predictors for, nasal carriage of methicillin-resistant S.aureus (MRSA) at the time of admission to a specialist care eye hospital. A prospective survey was conducted at King Khaled Eye Specialist Hospital (KKESH), Riyadh during the three differing weeks randomly selected from the year 1999. The first 100 patients admitted during those three weeks were selected according to inclusion criteria. The hospital is a 220-bed tertiary ophthalmic care facility, with an average 7,500admission per year. Nasal bacterial swabs were taken within 48 hours of admission and tested for all strains of S.aureus and sensitivity to methicillin. Detailed interviews were conducted about medical history and habitual environment. Of 306 nasal cultures tested, none was isolated for MRSA and 102 (33%) were sensitive to methicillin (MSSA).We found 0% nasal carriage rate for MRSA. Respondents have difficulty with questions related to antibiotic administration. No identifiable medical or environmental risk factors could be found. Nasal swabs of patients admitted to KKESH did not reveal MRSA colonization, indicating that MRSA may not be prevalent in the community at present. (author)

Burns education for non-burn specialist clinicians in Western Australia.

Science.gov (United States)

McWilliams, Tania; Hendricks, Joyce; Twigg, Di; Wood, Fiona

2015-03-01

Burn patients often receive their initial care by non-burn specialist clinicians, with increasingly collaborative burn models of care. The provision of relevant and accessible education for these clinicians is therefore vital for optimal patient care. A two phase design was used. A state-wide survey of multidisciplinary non-burn specialist clinicians throughout Western Australia identified learning needs related to paediatric burn care. A targeted education programme was developed and delivered live via videoconference. Pre-post-test analysis evaluated changes in knowledge as a result of attendance at each education session. Non-burn specialist clinicians identified numerous areas of burn care relevant to their practice. Statistically significant differences between perceived relevance of care and confidence in care provision were reported for aspects of acute burn care. Following attendance at the education sessions, statistically significant increases in knowledge were noted for most areas of acute burn care. Identification of learning needs facilitated the development of a targeted education programme for non-burn specialist clinicians. Increased non-burn specialist clinician knowledge following attendance at most education sessions supports the use of videoconferencing as an acceptable and effective method of delivering burns education in Western Australia. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Provision and practice of specialist preterm labour clinics: a UK survey of practice.

Science.gov (United States)

Sharp, A N; Alfirevic, Z

2014-03-01

To identify the current status of specialist preterm labour (PTL) clinic provision and management within the UK. Postal survey of clinical practice. All consultant-led obstetric units within the UK. A questionnaire was sent by post to all 210 NHS consultant-led obstetric units within the UK. Units that had a specialist PTL clinic were asked to complete a further 20 questions defining their protocol for risk stratification and management. Current practice in specialist preterm labour clinics. We have identified 23 specialist clinics; the most common indications for attendance were previous PTL (100%), preterm prelabour rupture of membranes (95%), two large loop excisions of the transformation zone (95%) or cone biopsy (95%). There was significant heterogeneity in the indications for and method of primary treatment for short cervix, with cervical cerclage used in 45% of units, progesterone in 18% of units and Arabin cervical pessary in 5%. A further 23% used multiple treatment modalities in combination. A significant heterogeneity in all topics surveyed suggests an urgent need for networking, more evidence-based guidelines and prospective comparative audits to ascertain the real impact of specialist PTL clinics on the reduction in preterm birth and its sequelae. © 2013 Royal College of Obstetricians and Gynaecologists.

What Is a Pediatric Infectious Diseases Specialist?

Science.gov (United States)

... Text Size Email Print Share What is a Pediatric Infectious Diseases Specialist? Page Content Article Body If ... the teen years. What Kind of Training Do Pediatric Infectious Diseases Specialists Have? Pediatric infectious diseases specialists ...

What Is a Pediatric Critical Care Specialist?

Science.gov (United States)

... Text Size Email Print Share What is a Pediatric Critical Care Specialist? Page Content Article Body If ... in the PICU. What Kind of Training Do Pediatric Critical Care Specialists Have? Pediatric critical care specialists ...

Characterizing Mathematics Teaching Research Specialists' Mentoring in the Context of Chinese Lesson Study

Science.gov (United States)

Gu, Feishi; Gu, Lingyuan

2016-01-01

This study examines how mathematics teaching research specialists mentor practicing teachers during post-lesson debriefs of a lesson study in China. Based on a systematic, fine-grained analysis of 107 h of videotaped mentoring meetings of 20 groups of teachers and teaching research specialists from different elementary schools, this study reveals…

Specialist clinics for reducing emergency admissions in patients with heart failure: a systematic review and meta-analysis of randomised controlled trials

NARCIS (Netherlands)

Thomas, R.; Huntley, A.; Mann, M.; Huws, D.; Paranjothy, S.; Elwyn, G.; Purdy, S.

2013-01-01

Unplanned admissions for heart failure are common and some are considered preventable. OBJECTIVE: Undertake a systematic literature review and meta-analysis to evaluate the effectiveness of specialist clinics in reducing unplanned hospital admissions in people with heart failure. DATA SOURCES: 18

Risk analysis of emergent water pollution accidents based on a Bayesian Network.

Science.gov (United States)

Tang, Caihong; Yi, Yujun; Yang, Zhifeng; Sun, Jie

2016-01-01

To guarantee the security of water quality in water transfer channels, especially in open channels, analysis of potential emergent pollution sources in the water transfer process is critical. It is also indispensable for forewarnings and protection from emergent pollution accidents. Bridges above open channels with large amounts of truck traffic are the main locations where emergent accidents could occur. A Bayesian Network model, which consists of six root nodes and three middle layer nodes, was developed in this paper, and was employed to identify the possibility of potential pollution risk. Dianbei Bridge is reviewed as a typical bridge on an open channel of the Middle Route of the South to North Water Transfer Project where emergent traffic accidents could occur. Risk of water pollutions caused by leakage of pollutants into water is focused in this study. The risk for potential traffic accidents at the Dianbei Bridge implies a risk for water pollution in the canal. Based on survey data, statistical analysis, and domain specialist knowledge, a Bayesian Network model was established. The human factor of emergent accidents has been considered in this model. Additionally, this model has been employed to describe the probability of accidents and the risk level. The sensitive reasons for pollution accidents have been deduced. The case has also been simulated that sensitive factors are in a state of most likely to lead to accidents. Copyright © 2015 Elsevier Ltd. All rights reserved.

[What is parents' and medical health care specialists knowledge about vaccinations?].

Science.gov (United States)

Tarczoń, Izabela; Domaradzka, Ewa; Czajka, Hanna

2009-01-01

The aim of the study was to become familiar with parents' and Medical Health Care specialists knowledge and attitude towards vaccinations. The influence of information, provided to patients from various sources, on general opinion about immunization and its coverage within the last year were evaluated. Analysis of questionnaires about vaccinations performed among 151 parents and 180 Medical Health Care specialists. Medical Health Care specialists knowledge was considerably higher in comparison to questioned parents. Surprisingly enough, only approximately 90% of Medical Health Care workers knew about prophylaxis of Hib infections. A doctor is the main and the most reliable source of information for parents. Significant impact on parents' attitude to vaccinations is made not only by campaigns promoting vaccinations, but also by widespread opinions about their harmfulness. The doctor is the major source of reliable information about vaccinations for parents. Therefore, there is the need of continuous improvement of Medical Health Care specialists knowledge, but also the ability of successfully communicating it to parents.

Applying research to practice: generalist and specialist (visual ergonomics) consultancy.

Science.gov (United States)

Long, Jennifer; Long, Airdrie

2012-01-01

Ergonomics is a holistic discipline encompassing a wide range of special interest groups. The role of an ergonomics consultant is to provide integrated solutions to improve comfort, safety and productivity. In Australia, there are two types of consultants--generalists and specialists. Both have training in ergonomics but specialist knowledge may be the result of previous education or work experience. This paper presents three projects illustrating generalist and specialist (visual ergonomics) consultancy: development of a vision screening protocol, solving visual discomfort in an office environment and solving postural discomfort in heavy industry. These case studies demonstrate how multiple ergonomics consultants may work together to solve ergonomics problems. It also describes some of the challenges for consultants, for those engaging their services and for the ergonomics profession, e.g. recognizing the boundaries of expertise, sharing information with business competitors, the costs-benefits of engaging multiple consultants and the risk of fragmentation of ergonomics knowledge and solutions. Since ergonomics problems are often multifaceted, ergonomics consultants should have a solid grounding in all domains of ergonomics, even if they ultimately only practice in one specialty or domain. This will benefit the profession and ensure that ergonomics remains a holistic discipline.

From Professional Competencies to Capacity: A Study of Education and Training for Subject Specialists

Directory of Open Access Journals (Sweden)

Ming-Hsin Phoebe Chiu

2009-12-01

Full Text Available Subject specialists are important assets in academic and research libraries. They possess not only the specialized knowledge of a particular subject field, but also the skills in library and information services. Looming shortage of qualified subject specialists resulting from the retirement of current professionals, most likely the baby-boomer generation, persuasively suggests that education and training are in urgent need of rethinking. This empirical study was conducted within the context of Library and Information Science education and academic librarianship in North America. Survey, content analysis, and focus group were employed as data collection methods. This study aims to analyze the status of LIS education for subject specialists, education needs and personal attributes of subject specialists, and the qualifications and responsibilities of becoming subject specialists. The goal of the study is to understand the knowledge, skills, and attitude of becoming subject specialists. Results of the study may provide insight into planning of formal curriculum and on-the-job training. [Article content in Chinese

Pain chronification: what should a non-pain medicine specialist know?

Science.gov (United States)

Morlion, Bart; Coluzzi, Flaminia; Aldington, Dominic; Kocot-Kepska, Magdalena; Pergolizzi, Joseph; Mangas, Ana Cristina; Ahlbeck, Karsten; Kalso, Eija

2018-04-12

Pain is one of the most common reasons for an individual to consult their primary care physician, with most chronic pain being treated in the primary care setting. However, many primary care physicians/non-pain medicine specialists lack enough awareness, education and skills to manage pain patients appropriately, and there is currently no clear, common consensus/formal definition of "pain chronification". This article, based on an international Change Pain Chronic Advisory Board meeting which was held in Wiesbaden, Germany, in October 2016, provides primary care physicians/non-pain medicine specialists with a narrative overview of pain chronification, including underlying physiological and psychosocial processes, predictive factors for pain chronification, a brief summary of preventive strategies, and the role of primary care physicians and non-pain medicine specialists in the holistic management of pain chronification. Based on currently available evidence, we propose the following consensus-based definition of pain chronification which provides a common framework to raise awareness among non-pain medicine specialists: "Pain chronification describes the process of transient pain progressing into persistent pain; pain processing changes as a result of an imbalance between pain amplification and pain inhibition; genetic, environmental and biopsychosocial factors determine the risk, the degree, and time-course of chronification." Early intervention plays an important role in preventing pain chronification and, as key influencers in the management of patients with acute pain, it is critical that primary care physicians are equipped with the necessary awareness, education and skills to manage pain patients appropriately.

Images of psychiatry: Attitude survey of teaching medical specialists of India

Directory of Open Access Journals (Sweden)

Suravi Patra

2017-01-01

Full Text Available Context: Attitude of teaching medical specialists shapes those of future doctors. Region-specific data on teaching medical specialists' attitudes toward psychiatry (ATP are lacking from India. Aims: This study aimed to assess the attitudes of teaching medical specialists toward psychiatry and its association with sociodemographic profile and career stage. Settings and Design: This is a cross-sectional descriptive survey. Materials and Methods: Attitude towards psychiatry (ATP was assessed from 188 specialists from All India Institute of Medical Sciences (AIIMS Bhubaneswar and AIIMS Jodhpur using modified ATP scale-30. Statistical Analysis: Descriptive statistical analysis was done using SPSS version 16.0. Associations of ATP with sociodemographic status, career stage, and family history of psychiatric illness were done using logistic regression analysis. Results: Overall response rate was 81.68%, and gender (confidence interval [C.I.]: 2.026–7.410, P = 0.000 and super-specialization (C.I.: 2.167–19.479, P = 0.021 were independent significant predictors for difference in attitudes. Female gender and super-specialization were associated with better attitudes. Ninety percent of participants had favorable attitude toward psychiatric illness. Four-fifth felt psychiatric patients to be as human as other patients and found psychiatric treatments effective. More than half felt that psychiatry does not stand among the three most exciting specialties and psychiatrists get less work satisfaction. Only one third said that they would have liked to be a psychiatrist. Conclusions: Attitudes were favorable toward patients and psychiatric interventions whereas unfavorable toward psychiatry as a discipline.

Clarifying the role of the mental health peer specialist in Massachusetts, USA: insights from peer specialists, supervisors and clients.

Science.gov (United States)

Cabral, Linda; Strother, Heather; Muhr, Kathy; Sefton, Laura; Savageau, Judith

2014-01-01

Mental health peer specialists develop peer-to-peer relationships of trust with clients to improve their health and well-being, functioning in ways similar to community health workers. Although the number of peer specialists in use has been increasing, their role in care teams is less defined than that of the community health worker. This qualitative study explored how the peer specialist role is defined across different stakeholder groups, the expectations for this role and how the peer specialist is utilised and integrated across different types of mental health services. Data were collected through interviews and focus groups conducted in Massachusetts with peer specialists (N = 44), their supervisors (N = 14) and clients (N = 10) between September 2009 and January 2011. A consensus coding approach was used and all data outputs were reviewed by the entire team to identify themes. Peer specialists reported that their most important role is to develop relationships with clients and that having lived mental health experience is a key element in creating that bond. They also indicated that educating staff about the recovery model and peer role is another important function. However, they often felt a lack of clarity about their role within their organisation and care team. Supervisors valued the unique experience that peer specialists bring to an organisation. However, without a defined set of expectations for this role, they struggled with training, guiding and evaluating their peer specialist staff. Clients reported that the shared lived experience is important for the relationship and that working with a peer specialist has improved their mental health. With increasing support for person-centred integrated healthcare delivery models, the demand for mental health peer specialist services will probably increase. Therefore, clearer role definition, as well as workforce development focused on team orientation, is necessary for peer specialists to be fully integrated

29 CFR 42.9 - Farm Labor Specialist (ESA).

Science.gov (United States)

2010-07-01

... 29 Labor 1 2010-07-01 2010-07-01 true Farm Labor Specialist (ESA). 42.9 Section 42.9 Labor Office of the Secretary of Labor COORDINATED ENFORCEMENT § 42.9 Farm Labor Specialist (ESA). (a) The Assistant Secretary for ESA shall designate ESA Compliance Officers as Farm Labor Specialists (Specialists...

Fostering a "Feeling of Worth" Among Vulnerable HIV Populations: The Role of Linkage to Care Specialists.

Science.gov (United States)

Broaddus, Michelle R; Owczarzak, Jill; Schumann, Casey; Koester, Kimberly A

2017-10-01

To address barriers to adequate engagement in medical care among people living with HIV, Wisconsin's AIDS/HIV Program created a new position, the Linkage to Care (LTC) Specialist. Specialists provide intensive, short-term case management and patient navigation services for small caseloads of individuals at high risk of disengaging with medical care. Clients are eligible if they are newly diagnosed with HIV or new to medical care, recently released from incarceration, recently out of care, nonadherent to scheduled medical care visits, or have detectable viral load while in care. Interviews with 30 clients of Specialists were conducted to understand experiences with the program and medical care. Common themes included the ability of Specialists to navigate complex systems of care and support services, the unique role Specialists played in their clients' lives, and the challenges of transitioning out of the program. Although the primary goal of Specialists is to address barriers to medical care, they often adopted a holistic approach that also included housing, financial assistance, and other social determinants of health. Descriptions of the Specialist's role in implementation manuals focus on their functional roles and the services provided. However, clients often discussed the emotional support they received, especially for clients without strong social support networks. Many clients also desired an ongoing relationship with their Specialists even after discharge, but had been able to establish independence and self-efficacy. The LTC Specialists are resource-intensive considering their small caseloads, but fill an important gap in existing, often overtaxed case management systems.

Acoustic and capacity analysis of voice academic teachers with diagnosed hyperfunctional dysphonia by using DiagnoScope Specialist software.

Science.gov (United States)

Zielińska-Bliźniewska, Hanna; Pietkiewicz, Piotr; Miłoński, Jarosław; Urbaniak, Joanna; Olszewski, Jurek

2013-01-01

The aim of the study was to assess the acoustic and capacity analyses of voice in academic teachers with hyperfunctional dysphonia using DiagnoScope Specialist software. The study covered 46 female academic teachers aged 34-48 years. The women were diagnosed with hyperfunctional dysphonia (with absence of organic pathologies). Having obtained the informed consent, a primary medical history was taken, videolaryngoscopic and stroboscopic examinations were performed and diagnostic voice acoustic and capacity analyses were carried out using DiagnoScope Specialist software. The acoustic analysis carried out of academic teachers with diagnosed hyperfunctional dysphonia showed enhancement in the following parameters: fundamental frequency (FO) by 1.2%; relative average perturbation (Jitter by 100.0% and RAP by 81.8%); relative amplitude perturbation quotient (APQ) by 2.9%; non-harmonic to harmonic ratio (U2H) by 16.0%; and noise to harmonic ratio (NHR) by 13.4%. A decrease of 2.5% from normal values was noted in relative amplitude perturbation (Shimmer). Formant frequencies also showed reduction (F1 by 10.7%, F2 by 5.1%, F3 by 2.2%, and F4 by 3.5%). The harmonic perturbation quotient (HPQ) was 0.8% lower and the residual harmonic perturbation quotient (RHPQ) 16.8% lower, with the residual to harmonic (R2H) decreasing by 35.1 per cent; the sub-harmonic to harmonic (S2H) by 2.4%; and the Yanagihara coefficient by 20.2%. The capacity analysis with the DiagnoScope Specialist software showed figures significantly lower than normal values of the following parameters: phonation time, true phonation time, phonation break coefficients, vocal capacity coefficient and mean vocal capacity. Copyright © 2013 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.

The role and organisation of community palliative specialist nursing teams in rural England.

Science.gov (United States)

Leadbeater, Maria; Staton, Wendy

2014-11-01

This article describes a study that used a qualitative approach, purposive sampling and semi-structured telephone interviews conducted with specialist palliative care nurses from six rural community teams in England. The study investigated how services were organised and the issues of delivering specialist palliative nursing care in a rural area. Qualitative content analysis was used to analyse the data. The findings showed many similarities in that the majority of patients in rural areas were not accessing hospice services and there was a greater reliance on care at home. However, the challenges in delivering care ranged from managing patient expectations, geographical distance, lack of technology to support remote working and education for the specialist palliative care teams. The study makes specific recommendations for rural community specialist palliative care teams.

[Cooperation, Job Satisfaction and Burn Out - Sustainability in Outpatient Mental Health Care among Medical Specialists in Germany].

Science.gov (United States)

Baumgardt, Johanna; Moock, Jörn; Rössler, Wulf; Kawohl, Wolfram

2017-04-01

Objective Cooperation, job satisfaction, and burn out risk are indicators of sustainability in mental health services. Thus they were assessed among registered medical specialists in outpatient mental health care in Germany. Method A postal survey consisting of three questionnaires about cooperation, job satisfaction, and burnout was carried out among all registered medical specialists in outpatient mental health care in Germany (n = 4,430). Results 14.1 % (n = 626) of the specialists responded to the survey. Quality and quantity of cooperation regarding mental health care services were rated diverse, job satisfaction was assessed medium to high, and burnout risk was low to medium. Higher job satisfaction correlated with good quality of cooperation, fewer years of practice, fewer patients' chronically ill, more patients who as well seek psychotherapy, and less time spent on cooperation. Low burn out risk correlated with good quality of cooperation, higher age, single practice setting and a higher amount of patients who as well seek psychotherapy. Conclusion Quality and quantity of cooperation in outpatient mental health care - especially regarding community mental health care institutions - should be fostered. Aspects to be considered to reinforce job satisfaction and minimize burn out risk are age, years of practice, quality and quantity of cooperation, practice setting, and the mixture of patients. © Georg Thieme Verlag KG Stuttgart · New York.

Comparative risk analysis

International Nuclear Information System (INIS)

Niehaus, F.

1988-01-01

In this paper, the risks of various energy systems are discussed considering severe accidents analysis, particularly the probabilistic safety analysis, and probabilistic safety criteria, and the applications of these criteria and analysis. The comparative risk analysis has demonstrated that the largest source of risk in every society is from daily small accidents. Nevertheless, we have to be more concerned about severe accidents. The comparative risk analysis of five different energy systems (coal, oil, gas, LWR and STEC (Solar)) for the public has shown that the main sources of risks are coal and oil. The latest comparative risk study of various energy has been conducted in the USA and has revealed that the number of victims from coal is 42 as many than victims from nuclear. A study for severe accidents from hydro-dams in United States has estimated the probability of dam failures at 1 in 10,000 years and the number of victims between 11,000 and 260,000. The average occupational risk from coal is one fatal accident in 1,000 workers/year. The probabilistic safety analysis is a method that can be used to assess nuclear energy risks, and to analyze the severe accidents, and to model all possible accident sequences and consequences. The 'Fault tree' analysis is used to know the probability of failure of the different systems at each point of accident sequences and to calculate the probability of risks. After calculating the probability of failure, the criteria for judging the numerical results have to be developed, that is the quantitative and qualitative goals. To achieve these goals, several systems have been devised by various countries members of AIEA. The probabilistic safety ana-lysis method has been developed by establishing a computer program permit-ting to know different categories of safety related information. 19 tabs. (author)

Education of nuclear energy specialists

International Nuclear Information System (INIS)

Paulikas, V.

1999-01-01

Preparation system of nuclear energy specialists in Lithuania is presented. Nuclear engineers are being prepared at Kaunas University of Technology. Post-graduates students usually continue studies at Obninsk Nuclear Energy Institute in Russia. Many western countries like Sweden, Finland and US is providing assistance in education of Lithuanian specialists. Many of them were trained in these countries

Impact of specialist palliative care on coping with Parkinson's disease: patients and carers.

Science.gov (United States)

Badger, Nathan J; Frizelle, Dorothy; Adams, Debi; Johnson, Miriam J

2018-01-09

UK guidelines recommend palliative care access for people with Parkinson's disease; however, this remains sporadic, and it is unknown whether specialist palliative care helps patients and carers cope with this distressing condition. This study aimed to explore whether, and how, access to specialist palliative care services affected patients' and carers' coping with Parkinson's disease. Semistructured interviews were conducted, audio-recorded and verbatim transcribed. Data were analysed using interpretative phenomenological analysis. Participants were patients with advanced idiopathic Parkinson's disease (n=3), and carers of people with Parkinson's disease (n=5, however, one diagnosis was reviewed) receiving care from an integrated specialist palliative care and Parkinson's disease service in North East England. Access to specialist palliative care helped participants cope with some aspects of advanced Parkinson's disease. Three superordinate themes were developed:' managing uncertainty', 'impacts on the self' and 'specialist palliative care maintaining a positive outlook'. Specialist palliative care helped patients and carers cope with advanced Parkinson's disease. Specialist palliative care is a complex intervention that acknowledges the complex and holistic nature of Parkinson's disease, enabling health in some domains despite continued presence of pathology. These exploratory findings support the utility of this approach for people living with Parkinson's disease. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

E-learning for medical imaging specialists: introducing blended learning in a nuclear medicine specialist course.

Science.gov (United States)

Haslerud, Torjan; Tulipan, Andreas Julius; Gray, Robert M; Biermann, Martin

2017-07-01

While e-learning has become an important tool in teaching medical students, the training of specialists in medical imaging is still dominated by lecture-based courses. To assess the potential of e-learning in specialist education in medical imaging. An existing lecture-based five-day course in Clinical Nuclear Medicine (NM) was enhanced by e-learning resources and activities, including practical exercises. An anonymized survey was conducted after participants had completed and passed the multiple choice electronic course examination. Twelve out of 15 course participants (80%) responded. Overall satisfaction with the new course format was high, but 25% of the respondents wanted more interactive elements such as discussions and practical exercises. The importance of lecture handouts and supplementary online material such as selected original articles and professional guidelines was affirmed by all the respondents (92% fully, 8% partially), while 75% fully and 25% partially agreed that the lectures had been interesting and relevant. E-learning represents a hitherto unrealized potential in the education of medical specialists. It may expedite training of medical specialists while at the same time containing costs.

Maternal Mortality At The State Specialist Hospital Bauchi, Northern ...

African Journals Online (AJOL)

Objective: To analyse and document our experiences with maternal mortality with the view of finding the trends over the last seven years, common causes and attributing socio-demographic factors. Design: A prospective analysis of maternal mortality. Setting: State Specialists Hospital Bauchi, Bauchi Northeastern Nigeria.

Foundations of Risk Analysis

CERN Document Server

Aven, Terje

2012-01-01

Foundations of Risk Analysis presents the issues core to risk analysis - understanding what risk means, expressing risk, building risk models, addressing uncertainty, and applying probability models to real problems. The author provides the readers with the knowledge and basic thinking they require to successfully manage risk and uncertainty to support decision making. This updated edition reflects recent developments on risk and uncertainty concepts, representations and treatment. New material in Foundations of Risk Analysis includes:An up to date presentation of how to understand, define and

Attitudes regarding specialist referrals in periodontics.

Science.gov (United States)

Sharpe, G; Durham, J A; Preshaw, P M

2007-02-24

To examine the attitudes of dental practitioners towards specialist periodontal referral in the North East of England. Semi-structured interviews were conducted with a purposive sample of 10 practitioners. Interviews continued until data saturation occurred. The data were organised using a framework and analysed by two researchers working independently. Perceptions of periodontal disease and treatment appear to be heavily influenced by the NHS remuneration system. Treatment in general practice was limited to simple scaling and there was an apparent reluctance to treat advanced periodontitis. Such cases were commonly referred to specialists, confirming the demand for a referral service in periodontics. The perceived potential for medico-legal consequences was a strong driver of referrals. Distance to the referral centre and the perceived costs of treatment were significant barriers to referral. Dentists valued the specialist's personal reputation and clinical skills more highly than academic status. Deficiencies in communication between primary and secondary care were highlighted. Increased resources are required to manage periodontal diseases within the NHS. There is a need for a periodontal referral service in the North East of England to improve accessibility to specialist care. This would appear to be most appropriately delivered by increased numbers of specialist practitioners.

Probabilistic risk analysis and terrorism risk.

Science.gov (United States)

Ezell, Barry Charles; Bennett, Steven P; von Winterfeldt, Detlof; Sokolowski, John; Collins, Andrew J

2010-04-01

Since the terrorist attacks of September 11, 2001, and the subsequent establishment of the U.S. Department of Homeland Security (DHS), considerable efforts have been made to estimate the risks of terrorism and the cost effectiveness of security policies to reduce these risks. DHS, industry, and the academic risk analysis communities have all invested heavily in the development of tools and approaches that can assist decisionmakers in effectively allocating limited resources across the vast array of potential investments that could mitigate risks from terrorism and other threats to the homeland. Decisionmakers demand models, analyses, and decision support that are useful for this task and based on the state of the art. Since terrorism risk analysis is new, no single method is likely to meet this challenge. In this article we explore a number of existing and potential approaches for terrorism risk analysis, focusing particularly on recent discussions regarding the applicability of probabilistic and decision analytic approaches to bioterrorism risks and the Bioterrorism Risk Assessment methodology used by the DHS and criticized by the National Academies and others.

MATHEMATICAL RISK ANALYSIS: VIA NICHOLAS RISK MODEL AND BAYESIAN ANALYSIS

Directory of Open Access Journals (Sweden)

Anass BAYAGA

2010-07-01

Full Text Available The objective of this second part of a two-phased study was to explorethe predictive power of quantitative risk analysis (QRA method andprocess within Higher Education Institution (HEI. The method and process investigated the use impact analysis via Nicholas risk model and Bayesian analysis, with a sample of hundred (100 risk analysts in a historically black South African University in the greater Eastern Cape Province.The first findings supported and confirmed previous literature (KingIII report, 2009: Nicholas and Steyn, 2008: Stoney, 2007: COSA, 2004 that there was a direct relationship between risk factor, its likelihood and impact, certiris paribus. The second finding in relation to either controlling the likelihood or the impact of occurrence of risk (Nicholas risk model was that to have a brighter risk reward, it was important to control the likelihood ofoccurrence of risks as compared with its impact so to have a direct effect on entire University. On the Bayesian analysis, thus third finding, the impact of risk should be predicted along three aspects. These aspects included the human impact (decisions made, the property impact (students and infrastructural based and the business impact. Lastly, the study revealed that although in most business cases, where as business cycles considerably vary dependingon the industry and or the institution, this study revealed that, most impacts in HEI (University was within the period of one academic.The recommendation was that application of quantitative risk analysisshould be related to current legislative framework that affects HEI.

Information Data Security Specialists' and Business Leaders' Experiences Regarding Communication Challenges

Science.gov (United States)

Lopez, Robert H.

2012-01-01

The problem addressed was the need to maintain data security in the field of information technology. Specifically, the breakdown of communication between business leaders and data security specialists create risks to data security. The purpose of this qualitative phenomenological study was to determine which factors would improve communication…

Mission Specialist Scott Parazynski arrives at KSC

Science.gov (United States)

1998-01-01

STS-95 Mission Specialist Scott E. Parazynski notes the time on his watch upon his late arrival aboard a T-38 jet at the Shuttle Landing Facility. Parazynski's first plane experienced problems at the stop at Tyndall AFB and he had to wait for another jet and pilot to finish the flight to KSC. He joined other crewmembers Mission Commander Curtis L. Brown Jr., Pilot Steven W. Lindsey, Mission Specialist Stephen K. Robinson, Payload Specialist John H. Glenn Jr., senator from Ohio, Mission Specialist Pedro Duque, with the European Space Agency (ESA), and Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA), for final pre-launch preparations. STS-95 is expected to launch at 2 p.m. EST on Oct. 29, last 8 days, 21 hours and 49 minutes, and land at 11:49 a.m. EST on Nov. 7.

Impact of a Clinical Pharmacy Specialist in an Emergency Department for Seniors.

Science.gov (United States)

Shaw, Paul B; Delate, Thomas; Lyman, Alfred; Adams, Jody; Kreutz, Heather; Sanchez, Julia K; Dowd, Mary Beth; Gozansky, Wendolyn

2016-02-01

This study assesses outcomes associated with the implementation of an emergency department (ED) for seniors in which a clinical pharmacy specialist, with specialized geriatric training that included medication management training, is a key member of the ED care team. This was a retrospective cohort analysis of patients aged 65 years or older who presented at an ED between November 1, 2012, and May 31, 2013. Three groups of seniors were assessed: treated by the clinical pharmacy specialist in the ED for seniors, treated in the ED for seniors but not by the clinical pharmacy specialist, and not treated in the ED for seniors. Outcomes included rates of an ED return visit, mortality and hospital admissions, and follow-up total health care costs. Multivariable regression modeling was used to adjust for any potential confounders in the associations between groups and outcomes. A total of 4,103 patients were included, with 872 (21%) treated in the ED for seniors and 342 (39%) of these treated by the clinical pharmacy specialist. Groups were well matched overall in patient characteristics. Patients who received medication review and management by the clinical pharmacy specialist did not experience a reduction in ED return visits, mortality, cost of follow-up care, or hospital admissions compared with the other groups. Of the patients treated by the clinical pharmacy specialist, 154 (45.0%) were identified as having at least 1 medication-related problem. Although at least 1 medication-related problem was identified in almost half of patients treated by the clinical pharmacy specialist in the ED for seniors, incorporation of a clinical pharmacy specialist into the ED staff did not improve clinical outcomes. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Peculiarities of self-regulation of extreme profile specialists

Directory of Open Access Journals (Sweden)

Kabanova T.N.

2017-04-01

Full Text Available Individually-psychological characteristics were studied and profiles of the styles of self-regulation of the employees engaged in hazardous were determined. The mainly group consisted of 30 men aged 21 to 60 years, who are specialists of dangerous professions. The comparison group included 30 men from 22 to 60 years, whose professional activity was not associated with risk. The following methods were used: questionnaire "Style of self-regulation of behavior" by V. I. Morosanova; questionnaire of self-control (H. Grasmik, 1993, adaptation Bulygina V. G., Abdrazakova A. M., 2009; the questionnaire BIS/BAS, used to study the sensitivity to punishment and reward; the questionnaire formal-dynamic properties of individuality by V. M. Rusalov; the aggression questionnaire by A. Buss and M. Perry (adaptation Enikolopov S. N., Cybulski N. P., 2007; the scale of anxiety Charles D. Spielberger (State-Trait Anxiety Inventory – STAI; personal questionnaire of the G. and S. Eysenck – EPQ. It was found that specialists hazardous professions are distinguished by: a higher level of development of the regulatory flexibility and individual system of conscious self-regulation activity; higher levels of extroversion, communication activity, the total adaptability; a lower level of reactive anxiety, trait anxiety and general emotional. Moreover, impulsiveness, egocentrism, lack of restraint and physical activity in the structure of self-monitoring specialists of dangerous professions associated with high levels of affective component of aggression and incoherence of parts of the process of self-regulation. There were allocated a 3 profile of self-regulation in specialists of dangerous professions: a a high level of self-regulation – coupled with a high intellectual and physical development, the highest level of adaptability and general activity; b medium – rapid response to emerging changes in the situation, the successful production alternatives, greater

Medicare rebate for specialist medical practitioners from physiotherapy referrals: analysis of the potential impact on the Australian healthcare system.

Science.gov (United States)

Byrnes, Joshua M; Comans, Tracy A

2015-02-01

Abstract To identify and examine the likely impact on referrals to specialist medical practitioners, cost to government and patient out-of-pocket costs by providing a rebate under the Medicare Benefits Scheme to patients who attend a specialist medical practitioner upon referral direct from a physiotherapist. A model was constructed to synthesise the costs and benefits of referral with a rebate. Data to inform the model was obtained from administrative sources and from a direct survey of physiotherapists. Given that six referrals per month are made by physiotherapists for a specialist consultation, allowing direct referral to medical specialists and providing patients with a Medicare rebate would result in a likely cost saving to the government ofup to $13 million per year. A range of sensitivity analyses were conducted with all scenarios resulting in some cost savings. The impact of the proposed policy shift to allow direct referral of patients by physiotherapists to specialist medical practitioners and provide patients with a Medicare rebate would be cost saving.

Brazilian infectious diseases specialists: who and where are they?

Science.gov (United States)

Cassenote, Alex Jones Flores; Scheffer, Mario César; Segurado, Aluísio Augusto Cotrim

2016-01-01

The infectious diseases specialist is a medical doctor dedicated to the management of infectious diseases in their individual and collective dimensions. The aim of this paper was to evaluate the current profile and distribution of infectious diseases specialists in Brazil. This is a cross-sectional study using secondary data obtained from institutions that register medical specialists in Brazil. Variables of interest included gender, age, type of medical school (public or private) the specialist graduated from, time since finishing residency training in infectious diseases, and the interval between M.D. graduation and residency completion. Maps are used to study the geographical distribution of infectious diseases specialists. A total of 3229 infectious diseases specialist registries were counted, with 94.3% (3045) of individual counts (heads) represented by primary registries. The mean age was 43.3 years (SD 10.5), and a higher proportion of females was observed (57%; 95% CI 55.3-58.8). Most Brazilian infectious diseases specialists (58.5%) practice in the Southeastern region. However, when distribution rates were calculated, several states exhibited high concentration of infectious diseases specialists, when compared to the national rate (16.06). Interestingly, among specialists working in the Northeastern region, those trained locally had completed their residency programs more recently (8.7yrs; 95% CI 7.9-9.5) than physicians trained elsewhere in the country (13.6yrs: 95% CI 11.8-15.5). Our study shows that Brazilian infectious diseases specialists are predominantly young and female doctors. Most have concluded a medical residency training program. The absolute majority practice in the Southeastern region. However, some states from the Northern, Northeastern and Southeastern regions exhibit specialist rates above the national average. In these areas, nonetheless, there is a strong concentration of infectious diseases specialists in state capitals and in

Is risk analysis scientific?

Science.gov (United States)

Hansson, Sven Ove; Aven, Terje

2014-07-01

This article discusses to what extent risk analysis is scientific in view of a set of commonly used definitions and criteria. We consider scientific knowledge to be characterized by its subject matter, its success in developing the best available knowledge in its fields of study, and the epistemic norms and values that guide scientific investigations. We proceed to assess the field of risk analysis according to these criteria. For this purpose, we use a model for risk analysis in which science is used as a base for decision making on risks, which covers the five elements evidence, knowledge base, broad risk evaluation, managerial review and judgment, and the decision; and that relates these elements to the domains experts and decisionmakers, and to the domains fact-based or value-based. We conclude that risk analysis is a scientific field of study, when understood as consisting primarily of (i) knowledge about risk-related phenomena, processes, events, etc., and (ii) concepts, theories, frameworks, approaches, principles, methods and models to understand, assess, characterize, communicate, and manage risk, in general and for specific applications (the instrumental part). © 2014 Society for Risk Analysis.

Specialist physician knowledge of chronic kidney disease: A comparison of internists and family physicians in West Africa

Directory of Open Access Journals (Sweden)

Emmanuel I. Agaba

2012-05-01

Full Text Available Background: Postgraduate training is aimed at equipping the trainee with the necessary skills to practise as an expert. Non-nephrology specialist physicians render the bulk of pre-end-stage renal disease care for patients with chronic kidney disease (CKD. We sought to ascertain the knowledge of CKD amongst non-nephrology specialist physicians who serve as trainers and examiners for a training, accrediting and certifying body in postgraduate medicine in West Africa. We also compared the knowledge of family physicians and non-nephrology internists. Methods: Self-administered questionnaires were distributed to non-nephrology specialist physicians who serve as examiners for the West African College of Physicians. Results: Only 19 (27.5% of the respondents were aware of the Kidney Disease Outcomes Quality Initiatives guidelines for CKD management. Twenty five (36.2% of the respondents had adequate knowledge of CKD. There was no significant difference in the proportion of family physicians and non-nephrology internists who had adequate knowledge of CKD (27.3% vs. 40.4% respectively; p = 0.28. Hypertension and diabetes mellitus were identified by all of the physicians as risk factors for CKD. Non-nephrology internists more frequently identified systemic lupus erythematosus as a risk factor for CKD, urinalysis with microscopy as a laboratory test for CKD evaluation, and bone disease as a complication of CKD than family physicians. Conclusion: There is a lack of adequate CKD knowledge amongst non-nephrology specialist physicians, since many of them are unaware of the CKD management guidelines. Educational efforts are needed to improve the knowledge of CKD amongst non-nephrology specialist physicians. Guidelines on CKD need to be widely disseminated amongst these physicians.

Professional communications of Russian technical and engineering specialists: empirical analysis

Directory of Open Access Journals (Sweden)

R N Abramov

2016-12-01

Full Text Available Sociology of professions focus on the role of interpersonal and intergroup communications in the professional communities as an element of professional culture. The article considers forms and features of professional communications of Russian engineers and technicians in the context of their professional culture defined as the constellation of ideology, values, beliefs, language, and forms of activity typical for the community, which rarely becomes an object of Russian sociologists’ studies. The author shows that interpersonal professional communications on the various aspects of professional activity is an important element of professional culture. The article is based on the results of online survey of Russian engineers and expert interviews with Russian technical specialists - they were questioned on the ways of updating their professional knowledge and on the role of various channels of communication in this process. At the beginning of the article, the author provides an overview of approaches to the study of professional culture in Russia and abroad, and underlines the significant role of the Internet and the declining role of literature as a source of new knowledge for the engineering and technical staff. The results of the study also revealed an important role of informal and direct communications in the transfer of professional knowledge within the engineering community, while organizational environment has a relatively low impact on the updating of professional knowledge, which can be explained by the lack of management attention to the professional development of specialists.

Preparing Elementary Mathematics-Science Teaching Specialists.

Science.gov (United States)

Miller, L. Diane

1992-01-01

Describes a professional development program to train math/science specialists for the upper elementary school grades. Using results from an interest survey, 30 teachers were chosen to participate in a 3-year program to become math/science specialists. Presents the teaching model used and the advantages for teachers and students in having subject…

Inter-observer agreement of canine and feline paroxysmal event semiology and classification by veterinary neurology specialists and non-specialists

DEFF Research Database (Denmark)

Packer, Rowena M A; Berendt, Mette; Bhatti, Sofie

2015-01-01

neurology specialists and non-specialists) on the description and classification of videos depicting paroxysmal events, without knowing any results of diagnostic workup. An online questionnaire study was conducted, where participants watched 100 videos of dogs and cats exhibiting paroxysmal events...... low levels of agreement described here highlight the need for further discussions between neurology experts regarding classifying and describing epileptic seizures, and additional training of non-specialists to facilitate accurate diagnosis. There is a need for diagnostic tools (e...

Environmental modeling and health risk analysis (ACTS/RISK)

National Research Council Canada - National Science Library

Aral, M. M

2010-01-01

... presents a review of the topics of exposure and health risk analysis. The Analytical Contaminant Transport Analysis System (ACTS) and Health RISK Analysis (RISK) software tools are an integral part of the book and provide computational platforms for all the models discussed herein. The most recent versions of these two softwa...

[New business model for medical specialists].

Science.gov (United States)

Houwen, L G H J Louis

2013-01-01

The reforms in the field of medical specialist care have important implications for the professional practice of medical specialists and their working relationship with the hospital. This leads to a considerable amount of pressure placed upon the way physicians have traditionally practiced their liberal professions, which is by forming partnerships and practicing from within the hospitals based on an admission agreement. As of 2015, the tax benefits for entrepreneurs will be abolished and the formation of regional partnerships will be discouraged. These developments not only pose threats but also offer opportunities for both the entrepreneurial medical specialist and the innovative hospital. In this article, the prospect of a future business model for specialist medical care will be outlined and explored by proposing three new organizational forms. The central vision of this model is that physicians who wish to retain their status of liberal professional practitioners in the twenty-first century should be more involved in the ownership structure of hospitals. The social importance of responsible patient care remains paramount.

Irradiation effects and mitigation. Proceedings of the IAEA Specialists Meeting. Working material

International Nuclear Information System (INIS)

1997-01-01

The IAEA Specialists Meeting on Irradiation Effects and Mitigation organised in co-operation with the Russian Research Centre 'Kurchatov Institute' was held at Vladimir, Russian Federation from 15 to 19 September 1997. Topics of the Meeting covered a number of problems including mechanisms of radiation damage, results of surveillance programmes and their analysis, effects of operating parameters, fracture mechanics tests and evaluation, annealing and optimisation of the process and reembrittlement after annealing. Specialists from 17 countries presented 31 paper, published in this proceedings each with a separate abstract

Rural outreach by specialist doctors in Australia: a national cross-sectional study of supply and distribution.

Science.gov (United States)

O'Sullivan, Belinda G; Joyce, Catherine M; McGrail, Matthew R

2014-09-04

Outreach has been endorsed as an important global strategy to promote universal access to health care but it depends on health workers who are willing to travel. In Australia, rural outreach is commonly provided by specialist doctors who periodically visit the same community over time. However information about the level of participation and the distribution of these services nationally is limited. This paper outlines the proportion of Australian specialist doctors who participate in rural outreach, describes their characteristics and assesses how these characteristics influence remote outreach provision. We used data from the Medicine in Australia: Balancing Employment and Life (MABEL) survey, collected between June and November 2008. Weighted logistic regression analyses examined the effect of covariates: sex, age, specialist residential location, rural background, practice arrangements and specialist group on rural outreach. A separate logistic regression analysis studied the effect of covariates on remote outreach compared with other rural outreach. Of 4,596 specialist doctors, 19% (n = 909) provided outreach; of which, 16% (n = 149) provided remote outreach. Most (75%) outreach providers were metropolitan specialists. In multivariate analysis, outreach was associated with being male (OR 1.38, 1.12 to 1.69), having a rural residence (both inner regional: OR 2.07, 1.68 to 2.54; and outer regional/remote: OR 3.40, 2.38 to 4.87) and working in private consulting rooms (OR 1.24, 1.01 to 1.53). Remote outreach was associated with increasing 5-year age (OR1.17, 1.05 to 1.31) and residing in an outer regional/remote location (OR 10.84, 5.82 to 20.19). Specialists based in inner regional areas were less likely than metropolitan-based specialists to provide remote outreach (OR 0.35, 0.17 to 0.70). There is a healthy level of interest in rural outreach work, but remote outreach is less common. Whilst most providers are metropolitan-based, rural doctors are more

14 CFR 1214.306 - Payload specialist relationship with sponsoring institutions.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Payload specialist relationship with... ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.306 Payload specialist relationship with sponsoring institutions. Specialists who are not U.S. Government employees must...

Academic learning for specialist nurses: a grounded theory study.

Science.gov (United States)

Millberg, Lena German; Berg, Linda; Brämberg, Elisabeth Björk; Nordström, Gun; Ohlén, Joakim

2014-11-01

The aim was to explore the major concerns of specialist nurses pertaining to academic learning during their education and initial professional career. Specialist nursing education changed in tandem with the European educational reform in 2007. At the same time, greater demands were made on the healthcare services to provide evidence-based and safe patient-care. These changes have influenced specialist nursing programmes and consequently the profession. Grounded Theory guided the study. Data were collected by means of a questionnaire with open-ended questions distributed at the end of specialist nursing programmes in 2009 and 2010. Five universities were included. Further, individual, pair and group interviews were used to collect data from 12 specialist nurses, 5-14 months after graduation. A major concern for specialist nurses was that academic learning should be "meaningful" for their professional future. The specialist nurses' "meaningful academic learning process" was characterised by an ambivalence of partly believing in and partly being hesitant about the significance of academic learning and partly receiving but also lacking support. Specialist nurses were influenced by factors in two areas: curriculum and healthcare context. They felt that the outcome of contribution to professional confidence was critical in making academic learning meaningful. Copyright © 2014 Elsevier Ltd. All rights reserved.

ProRisk : risk analysis instrument : developed for William properties

NARCIS (Netherlands)

van Doorn, W.H.W.; Egeberg, Ingrid; Hendrickx, Kristoff; Kahramaner, Y.; Masseur, B.; Waijers, Koen; Weglicka, K.A.

2005-01-01

This report presents a Risk Analysis Instrument developed for William Properties. Based on the analysis, it appears that the practice of Risk Analysis exists within the organization, yet rather implicit. The Risk Analysis Instrument comes with a package of four components: an activity diagram, a

Patients' Experiences with Specialist Care via Video Consultation in Primary Healthcare in Rural Areas.

Science.gov (United States)

Johansson, Annette M; Lindberg, Inger; Söderberg, Siv

2014-01-01

Introduction. Video consultation (VC) can improve access to specialist care, especially for individuals who live in rural areas that are long distances from specialist clinics. Aim. The aim of this study was to describe patients' experiences with specialist care via VC encounters. Method. Interviews were conducted with 26 patients who had participated in a VC encounter. The data were analysed using thematic content analysis. Result. The analysis resulted in two themes. The theme "confident with the technology" was constructed from the categories "possibilities and obstacles in using VC encounters" and "advantages and disadvantages of the technology." The theme "personal satisfaction with the VC encounters" was constructed from the categories "support from the healthcare personnel," "perceived security," and "satisfaction with the specialist consultation." Conclusion. The patients who did not think that the VC was the best care still considered that the visit was adequate because they did not have to travel. An important finding was that the patients' perceived even short distances to specialty care as expensive journeys because many patients had low incomes. Among the patients who had more than one VC, the second encounter was perceived as safer. Additionally, good communication was essential for the patient's perception of security during the VC encounter.

Observations on risk analysis

International Nuclear Information System (INIS)

Thompson, W.A. Jr.

1979-11-01

This paper briefly describes WASH 1400 and the Lewis report. It attempts to define basic concepts such as risk and risk analysis, common mode failure, and rare event. Several probabilistic models which go beyond the WASH 1400 methodology are introduced; the common characteristic of these models is that they recognize explicitly that risk analysis is time dependent whereas WASH 1400 takes a per demand failure rate approach which obscures the important fact that accidents are time related. Further, the presentation of a realistic risk analysis should recognize that there are various risks which compete with one another for the lives of the individuals at risk. A way of doing this is suggested

Cooperation among medical specialists : "pain" or "gain"?

NARCIS (Netherlands)

Stoffels, Antoinette Marie-Rose Renée

2008-01-01

This thesis investigates the cooperation among medical specialists in multidisciplinary teams as well as its antecedents and consequences. During meetings, medical specialists combine their knowledge and expertise, discuss the health problems of patients, weigh possible treatment options and decide

Mission Specialist Scott Parazynski arrives late at KSC

Science.gov (United States)

1998-01-01

The T-38 jet aircraft arrives at the Shuttle Landing Facility carrying STS-95 Mission Specialist Scott E. Parazynski (second seat). The pilot is astronaut Kent Rominger. Parazynski's first plane experienced problems at the stop at Tyndall AFB and he had to wait for another jet and pilot to finish the flight to KSC. He joined other crewmembers Mission Commander Curtis L. Brown Jr., Pilot Steven W. Lindsey, Mission Specialist Stephen K. Robinson, Payload Specialist John H. Glenn Jr., senator from Ohio, Mission Specialist Pedro Duque, with the European Space Agency (ESA), and Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA), for final pre-launch preparations. STS-95 is expected to launch at 2 p.m. EST on Oct. 29, last 8 days, 21 hours and 49 minutes, and land at 11:49 a.m. EST on Nov. 7.

The Predictability of Phytophagous Insect Communities: Host Specialists as Habitat Specialists

NARCIS (Netherlands)

Müller, J.; Stadler, J.; Jarzabek-Müller, A.; Hacker, H.; Braak, ter C.J.F.; Brandl, R.

2011-01-01

The difficulties specialized phytophagous insects face in finding habitats with an appropriate host should constrain their dispersal. Within the concept of metacommunities, this leads to the prediction that host-plant specialists should sort into local assemblages according to the local

Thromboembolism prophylaxis in patients with Philadelphia-negative myeloproliferative neoplasms-Clinical practice among Nordic specialists.

Science.gov (United States)

Bjerrum, Ole Weis; Samuelsson, Jan; Ghanima, Waleed; Kauppila, Marjut; Andersen, Christen Lykkegaard

2018-05-01

Patients with Philadelphia chromosome-negative myeloproliferative neoplasms (MPNs) have higher risks of developing thromboembolisms compared to the general population. International guidelines on the management of MPNs therefore include recommendations concerning thromboembolism prophylaxis. In clinical practice, strict adherence to guidelines may be challenging and dependent on factors such as physician experience, outpatient clinic setting, and access to therapy; however, no data exist on physician adherence or patient compliance to thromboembolism prophylaxis in MPNs. The Nordic Myeloproliferative Neoplasm Study Group (NMPN) performed a survey among Nordic hematology specialists with the aim of documenting the implementation of international recommendations in a region of Northern Europe with similar healthcare systems. The study showed that Nordic specialists managed their patients in accordance with international guidelines concerning medical intervention, but to a lesser degree regarding the management of additional cardiovascular risk factors. The survey also drew attention to the common clinical dilemma of combining antiaggregatory agents with vitamin K antagonists (VKA), or novel oral anticoagulants (NOAC), as well as phlebotomy limits in female polycythemia vera patients. The results of this study highlight the importance of considering all risk factors for thrombosis and an optimal collaboration with the primary healthcare sector. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Work-family balance by women GP specialist trainees in Slovenia: a qualitative study.

Science.gov (United States)

Petek, Davorina; Gajsek, Tadeja; Petek Ster, Marija

2016-01-28

Women physicians face many challenges while balancing their many roles: doctor, specialist trainee, mother and partner. The most opportune biological time for a woman to start a family coincides with a great deal of demands and requirements at work. In this study we explored the options and capabilities of women GP specialist trainees in coordinating their family and career. This is a phenomenological qualitative research. Ten GP specialist trainees from urban and rural areas were chosen by the purposive sampling technique, and semi-structured in-depth interviews were conducted, recorded, transcribed and analysed by using thematic analysis process. Open coding and the book of codes were formed. Finally, we performed the process of code reduction by identifying the themes, which were compared, interpreted and organised in the highest analytical units--categories. One hundred fifty-five codes were identified in the analysis, which were grouped together into eleven themes. The identified themes are: types, causes and consequences of burdens, work as pleasure and positive attitude toward self, priorities, planning and help, and understanding of superiors, disburdening and changing in specialisation. The themes were grouped into four large categories: burdens, empowerment, coordination and needs for improvement. Women specialist trainees encounter intense burdens at work and home due to numerous demands and requirements during their specialisation training. In addition, there is also the issue of the work-family conflict. There are many consequences regarding burden and strain; however, burnout stands out the most. In contrast, reconciliation of work and family life and needs can be successful. The key element is empowerment of women doctors. The foremost necessary systemic solution is the reinforcement of general practitioners in primary health care and their understanding of the specialisation training scheme with more flexible possibilities for time adaptations of

CSHCN in Texas: meeting the need for specialist care.

Science.gov (United States)

Young, M Cherilyn; Drayton, Vonna L C; Menon, Ramdas; Walker, Lesa R; Parker, Colleen M; Cooper, Sam B; Bultman, Linda L

2005-06-01

Assuring the sufficiency and suitability of systems of care and services for children with special health care needs (CSHCN) presents a challenge to Texas providers, agencies, and state Title V programs. To meet the need for specialist care, referrals from primary care doctors are often necessary. The objective of this study was to describe the factors associated with the need for specialist care and problems associated with obtaining referrals in Texas. Bivariate and multivariate analyses were performed using the National Survey of Children with Special Health Care Needs (NS-CSHCN) weighted sample for Texas (n = 719,014) to identify variables associated with the need for specialist care and problems obtaining referrals for specialist care. Medical need of the CSHCN and sensitivity to family values/customs was associated with greater need for specialist care, and Hispanic ethnicity and lower maternal education were associated with less need. Medical need, amount of time spent with doctors and sensitivity to values/customs, living in a large metropolitan statistical area, and lack of medical information were associated with problems obtaining a specialist care referral. Findings revealed some similarities and differences with meeting the need for specialist care when comparing Texas results to other studies. In Texas, aspects of customer satisfaction variables, especially doctors' sensitivity to family values/customs and parents' not receiving enough information on medical problems, were significantly associated with problems obtaining specialist referrals. Findings indicate a need to further research relationships and communication among doctors, CSHCN, and their families.

Motivation and stimulation of employment specialists in the sphere of information technologies

Directory of Open Access Journals (Sweden)

S. Bazhenov

2015-01-01

Full Text Available The article discusses the concept of "Information and communication technologies." The characteristic of the labor specialists in the sphere of information technologies, namely the characteristics of the object, means and product of their labor. The author of the article deals with the specifics of specialists of the topic. We study the needs and motivations of IT professionals. A method for evaluating the effectiveness of labor specialists in the sphere of information technologies and offered rates for calculating the efficiency of workers, including factors: timeliness; the number of completed tasks; detected errors; the cost of bug fixes. Purpose of the article – to reveal the specifics of working IT professionals, and especially to justify the incentives and motivation of specialists in this field. The objectives of the article: to characterize the concept of "Information and communications technologies"; identify the main needs and motivations of IT professionals; develop a method for evaluating the effectiveness of specialists in this field.Methodology. In conducting this study the main sources of raw data served as the information contained in scientific, reference, periodical literature on the subject in question, including the sources of information and telecommunications network "Internet". The basis of methodological developments put the comparative methods of analysis and synthesis of existing data.Results. The characteristic of the concept of "Information and communication technologies." It is proved that the work of specialists in the sphere of information technologies is intellectual work, and that the subject, the means and the product of this kind of work – are special types of information in digital form. Emphasize that as part of the system of social production, work in the field of software development (software performs a task and a number of specific functions: creative, integration, stimulating, consumer

What are the roles of clinical nurses and midwife specialists?

Science.gov (United States)

Wickham, Sheelagh

Research shows the increasing part the Clinical Nurse Specialist (CNS) plays in healthcare today. But what does a CNS actually do in their day-to day-work? This study, set in the Republic of Ireland, aimed to explore the CNS and clinical midwife specialist (CMS) roles in practice. Quantitative methodology was used to explore the roles and activities of the CNS and CMS. Following ethics approval, a valid and reliable questionnaire was circulated to the total population of CNS/CMS in Ireland. The data were analysed using SPSS. This study articulates the individual role elements and activity level. The findings show the CNS/CMS to be active in the roles of researcher, educator, communicator, change agent, leader and clinical specialist, but the level of activity varies between different roles and individual role elements. The CNS/CMS is seen as a valuable resource in health care today and has potential to have a positive effect on patient care. The majority of CNS/CMSs are active in varying roles but the analysis shows lesser activity in some areas, such as research. The findings merit further study on role activity and possible variables that influence role activity.

A study on the social risk comparison for various power systems: focusing on the social acceptance

International Nuclear Information System (INIS)

Jung, Young Soo; Kim, Young Pyung; Lee, Jae Eun

2007-02-01

The objective of this study is to develop measurement indices for social risk acceptance of various power systems(nuclear, coal, oil, LNG, hydro, wind, solar) and compare them empirically. In order to measure social risk acceptance of various power systems, four measurement fields and twelve measurement indices were developed. Measurement areas contains rationality, emotion, trust, communication. Each measurement field has two or three measurement indices. Rationality field has indices of amount of knowledge, recognition of technological utility, risk controllability. Emotion field has indices of experiences, risk recognition. Trust field has indices of openness, sincerity, willingness of sharing knowledge and experiences. Communication field has indices of scientist's roll, media's roll, public relations. Based on these measurement field and indices, this study made questionnaire and surveyed citizens to compare deciding factors of social acceptance on risk of various power systems. Questionnaire respondents were sampled from six different groups, including power system specialists, highschool students, university students, general citizen, professors and environmental NGOs. The methodologies used to analyze the deciding factors of social acceptance on risk of various power systems were frequency analysis, cross-tab analysis, t-test and ANOVA analysis. AHP method was used to analyze power system specialists' perception on relative severance and priority among measurement fields and indices

A study on the social risk comparison for various power systems: focusing on the social acceptance

Energy Technology Data Exchange (ETDEWEB)

Jung, Young Soo [Myongji Univ., Seoul (Korea, Republic of); Kim, Young Pyung [Korea Univ, Seoul (Korea, Republic of); Lee, Jae Eun [Chungbuk Nat. Univ., Cheongju (Korea, Republic of)

2007-02-15

The objective of this study is to develop measurement indices for social risk acceptance of various power systems(nuclear, coal, oil, LNG, hydro, wind, solar) and compare them empirically. In order to measure social risk acceptance of various power systems, four measurement fields and twelve measurement indices were developed. Measurement areas contains rationality, emotion, trust, communication. Each measurement field has two or three measurement indices. Rationality field has indices of amount of knowledge, recognition of technological utility, risk controllability. Emotion field has indices of experiences, risk recognition. Trust field has indices of openness, sincerity, willingness of sharing knowledge and experiences. Communication field has indices of scientist's roll, media's roll, public relations. Based on these measurement field and indices, this study made questionnaire and surveyed citizens to compare deciding factors of social acceptance on risk of various power systems. Questionnaire respondents were sampled from six different groups, including power system specialists, highschool students, university students, general citizen, professors and environmental NGOs. The methodologies used to analyze the deciding factors of social acceptance on risk of various power systems were frequency analysis, cross-tab analysis, t-test and ANOVA analysis. AHP method was used to analyze power system specialists' perception on relative severance and priority among measurement fields and indices.

Unsharpness-risk analysis

International Nuclear Information System (INIS)

Preyssl, C.

1986-01-01

Safety analysis provides the only tool for evaluation and quantification of rare or hypothetical events leading to system failure. So far probability theory has been used for the fault- and event-tree methodology. The phenomenon of uncertainties constitutes an important aspect in risk analysis. Uncertainties can be classified as originating from 'randomness' or 'fuzziness'. Probability theory addresses randomness only. The use of 'fuzzy set theory' makes it possible to include both types of uncertainty in the mathematical model of risk analysis. Thus the 'fuzzy fault tree' is expressed in 'possibilistic' terms implying a range of simplifications and improvements. 'Human failure' and 'conditionality' can be treated correctly. Only minimum-maximum relations are used to combine the possibility distributions of events. Various event-classifications facilitate the interpretation of the results. The method is demonstrated by application to a TRIGA-research reactor. Uncertainty as an implicit part of 'fuzzy risk' can be quantified explicitly using an 'uncertainty measure'. Based on this the 'degree of relative compliance' with a quantizative safety goal can be defined for a particular risk. The introduction of 'weighting functionals' guarantees the consideration of the importances attached to different parts of the risk exceeding or complying with the standard. The comparison of two reference systems is demonstrated in a case study. It is concluded that any application of the 'fuzzy risk analysis' has to be free of any hypostatization when reducing subjective to objective information. (Author)

Specialist Physicians' Attitudes and Practice Patterns Regarding Disclosure of Pre-referral Medical Errors.

Science.gov (United States)

Dossett, Lesly A; Kauffmann, Rondi M; Lee, Jay S; Singh, Harkamal; Lee, M Catherine; Morris, Arden M; Jagsi, Reshma; Quinn, Gwendolyn P; Dimick, Justin B

2018-06-01

Our objective was to determine specialist physicians' attitudes and practices regarding disclosure of pre-referral errors. Physicians are encouraged to disclose their own errors to patients. However, no clear professional norms exist regarding disclosure when physicians discover errors in diagnosis or treatment that occurred at other institutions before referral. We conducted semistructured interviews of cancer specialists from 2 National Cancer Institute-designated Cancer Centers. We purposively sampled specialists by discipline, sex, and experience-level who self-described a >50% reliance on external referrals (n = 30). Thematic analysis of verbatim interview transcripts was performed to determine physician attitudes regarding disclosure of pre-referral medical errors; whether and how physicians disclose these errors; and barriers to providing full disclosure. Participants described their experiences identifying different types of pre-referral errors including errors of diagnosis, staging and treatment resulting in adverse events ranging from decreased quality of life to premature death. The majority of specialists expressed the belief that disclosure provided no benefit to patients, and might unnecessarily add to their anxiety about their diagnoses or prognoses. Specialists had varying practices of disclosure including none, non-verbal, partial, event-dependent, and full disclosure. They identified a number of barriers to disclosure, including medicolegal implications and damage to referral relationships, the profession's reputation, and to patient-physician relationships. Specialist physicians identify pre-referral errors but struggle with whether and how to provide disclosure, even when clinical circumstances force disclosure. Education- or communication-based interventions that overcome barriers to disclosing pre-referral errors warrant development.

School Library Media Specialist-Teacher Collaboration: Characteristics, Challenges, Opportunities

Science.gov (United States)

Cooper, O. P.; Bray, Marty

2011-01-01

The most successful school library media specialists are those who collaborate with teachers as full partners in the instructional process. Without assertive action by the school library media specialist, however, school administrators and teachers are likely to be more aware of the media specialist's administrative role than the roles of teacher,…

Patients' Experiences with Specialist Care via Video Consultation in Primary Healthcare in Rural Areas

Science.gov (United States)

Johansson, Annette M.; Lindberg, Inger; Söderberg, Siv

2014-01-01

Introduction. Video consultation (VC) can improve access to specialist care, especially for individuals who live in rural areas that are long distances from specialist clinics. Aim. The aim of this study was to describe patients' experiences with specialist care via VC encounters. Method. Interviews were conducted with 26 patients who had participated in a VC encounter. The data were analysed using thematic content analysis. Result. The analysis resulted in two themes. The theme “confident with the technology” was constructed from the categories “possibilities and obstacles in using VC encounters” and “advantages and disadvantages of the technology.” The theme “personal satisfaction with the VC encounters” was constructed from the categories “support from the healthcare personnel,” “perceived security,” and “satisfaction with the specialist consultation.” Conclusion. The patients who did not think that the VC was the best care still considered that the visit was adequate because they did not have to travel. An important finding was that the patients' perceived even short distances to specialty care as expensive journeys because many patients had low incomes. Among the patients who had more than one VC, the second encounter was perceived as safer. Additionally, good communication was essential for the patient's perception of security during the VC encounter. PMID:25243009

Patients’ Experiences with Specialist Care via Video Consultation in Primary Healthcare in Rural Areas

Directory of Open Access Journals (Sweden)

Annette M. Johansson

2014-01-01

Full Text Available Introduction. Video consultation (VC can improve access to specialist care, especially for individuals who live in rural areas that are long distances from specialist clinics. Aim. The aim of this study was to describe patients’ experiences with specialist care via VC encounters. Method. Interviews were conducted with 26 patients who had participated in a VC encounter. The data were analysed using thematic content analysis. Result. The analysis resulted in two themes. The theme “confident with the technology” was constructed from the categories “possibilities and obstacles in using VC encounters” and “advantages and disadvantages of the technology.” The theme “personal satisfaction with the VC encounters” was constructed from the categories “support from the healthcare personnel,” “perceived security,” and “satisfaction with the specialist consultation.” Conclusion. The patients who did not think that the VC was the best care still considered that the visit was adequate because they did not have to travel. An important finding was that the patients’ perceived even short distances to specialty care as expensive journeys because many patients had low incomes. Among the patients who had more than one VC, the second encounter was perceived as safer. Additionally, good communication was essential for the patient’s perception of security during the VC encounter.

RAMS (Risk Analysis - Modular System) methodology

Energy Technology Data Exchange (ETDEWEB)

Stenner, R.D.; Strenge, D.L.; Buck, J.W. [and others

1996-10-01

The Risk Analysis - Modular System (RAMS) was developed to serve as a broad scope risk analysis tool for the Risk Assessment of the Hanford Mission (RAHM) studies. The RAHM element provides risk analysis support for Hanford Strategic Analysis and Mission Planning activities. The RAHM also provides risk analysis support for the Hanford 10-Year Plan development activities. The RAMS tool draws from a collection of specifically designed databases and modular risk analysis methodologies and models. RAMS is a flexible modular system that can be focused on targeted risk analysis needs. It is specifically designed to address risks associated with overall strategy, technical alternative, and `what if` questions regarding the Hanford cleanup mission. RAMS is set up to address both near-term and long-term risk issues. Consistency is very important for any comparative risk analysis, and RAMS is designed to efficiently and consistently compare risks and produce risk reduction estimates. There is a wide range of output information that can be generated by RAMS. These outputs can be detailed by individual contaminants, waste forms, transport pathways, exposure scenarios, individuals, populations, etc. However, they can also be in rolled-up form to support high-level strategy decisions.

Risk analysis

International Nuclear Information System (INIS)

Baron, J.H.; Nunez McLeod, J.; Rivera, S.S.

1997-01-01

This book contains a selection of research works performed in the CEDIAC Institute (Cuyo National University) in the area of Risk Analysis, with specific orientations to the subjects of uncertainty and sensitivity studies, software reliability, severe accident modeling, etc. This volume presents important material for all those researches who want to have an insight in the risk analysis field, as a tool to solution several problems frequently found in the engineering and applied sciences field, as well as for the academic teachers who want to keep up to date, including the new developments and improvements continuously arising in this field [es

Evaluation of a diabetes nurse specialist prescribing project.

Science.gov (United States)

Wilkinson, Jill; Carryer, Jenny; Adams, Jeffery

2014-08-01

To evaluate the diabetes nurse specialist prescribing project with the aim of determining whether diabetes nurse specialist prescribing is safe and effective and to inform the implementation and extension of registered nurse prescribing. Registered nurses in many countries are able to prescribe medicines, but in New Zealand, prior to the diabetes nurse specialist project, nurse practitioners were the only nurses who could prescribe medicines. New regulations allowed the nurses to prescribe a limited number of prescription medicines. The study was a process and outcome clinical programme evaluation. The project took place between April-September 2011 and involved 12 diabetes nurse specialist in four localities. Quantitative data were collected from clinical records maintained by the diabetes nurse specialist for the project (1274 patients and 3402 prescribing events), from surveys with stakeholders (general practitioners, n = 30; team members, n = 19; and patients, n = 89) and audits from patient notes (n = 117) and prescriptions (n = 227), and qualitative data from interviews with project participants (n = 18) and patients (n = 19). All data were analysed descriptively. Diabetes nurse specialist prescribing was determined to be safe, of high quality and appropriate. It brought important benefits to the effectiveness of specialist diabetes services, was acceptable to patients and was supported by the wider healthcare team. These findings are consistent with the findings reported in the international literature about nurse prescribing in a range of different practice areas. Clarification of the education and competence requirements and resourcing for the ongoing supervision of nurses is recommended if the prescribing model is to be extended. Diabetes nurse specialist prescribing improved access to medicines by providing a more timely service. Nurses felt more satisfied with their work because they could independently provide a complete episode of care

A background risk analysis. Vol. 1

International Nuclear Information System (INIS)

Taylor, J.R.

1979-01-01

This 4-volumes report gives a background of ideas, principles, and examples which might be of use in developing practical methods for risk analysis. Some of the risk analysis techniques, described are somewhat experimental. The report is written in an introductory style, but where some point needs further justification or evaluation, this is given in the form of a chapter appendix. In this way, it is hoped that the report can serve two purposes, - as a basis for starting risk analysis work and as a basis for discussing effectiveness of risk analysis procedures. The report should be seen as a preliminary stage, prior to a program of industrial trials of risk analysis methods. Vol. 1 contains a short history of risk analysis, and chapters on risk, failures, errors and accidents, and general procedures for risk analysis. (BP)

The development of leadership outcome-indicators evaluating the contribution of clinical specialists and advanced practitioners to health care: a secondary analysis.

Science.gov (United States)

Elliott, Naomi; Begley, Cecily; Kleinpell, Ruth; Higgins, Agnes

2014-05-01

To report a secondary analysis of data collected from the case study phase of a national study of advanced practitioners and to develop leadership outcome-indicators appropriate for advanced practitioners. In many countries, advanced practitioners in nursing and midwifery have responsibility as leaders for health care development, but without having leadership outcome measures available they are unable to demonstrate the results of their activities. In Ireland, a sequential mixed method research study was used to develop a validated tool for the evaluation of clinical specialists and advanced practitioners. Despite strong evidence of leadership activities, few leadership-specific outcomes were generated from the primary analysis. Secondary analysis of a multiple case study data set. Data set comprised 23 case studies of advanced practitioner/clinical specialists from 13 sites across each region in Ireland from all divisions of the Nursing Board Register. Data were collected 2008-2010. Data sources included non-participant observation (n = 92 hours) of advanced practitioners in practice, interviews with clinicians (n = 21), patients (n = 20) and directors of nursing/midwifery (n = 13) and documents. Analysis focused on leadership outcome-indicator development in line with the National Health Service's Good Indicators Guide. The four categories of leadership outcomes for advanced practitioner developed were as follows: (i) capacity and capability building of multidisciplinary team; (ii) measure of esteem; (iii) new initiatives for clinical practice and healthcare delivery; and (iv) clinical practice based on evidence. The proposed set of leadership outcome-indicators derived from a secondary analysis captures the complexity of leadership in practice. They add to existing clinical outcomes measuring advanced practice. © 2013 John Wiley & Sons Ltd.

International Conference on Risk Analysis

CERN Document Server

Oliveira, Teresa; Rigas, Alexandros; Gulati, Sneh

2015-01-01

This book covers the latest results in the field of risk analysis. Presented topics include probabilistic models in cancer research, models and methods in longevity, epidemiology of cancer risk, engineering reliability and economical risk problems. The contributions of this volume originate from the 5th International Conference on Risk Analysis (ICRA 5). The conference brought together researchers and practitioners working in the field of risk analysis in order to present new theoretical and computational methods with applications in biology, environmental sciences, public health, economics and finance.

A decade in diabetes specialist services, 2000 to 2011, in England: the views of consultant diabetologists and diabetes specialist nurses amidst persistent healthcare delivery change.

Science.gov (United States)

Gosden, C A; Barnard, K; Williams, D R R; Tinati, T; Turner, B; Holt, R I G

2015-12-01

To assess the impact of continual major National Health Service reorganization on commissioning, organizational and delivery arrangements for secondary care diabetes services. To explore how consultant diabetologists and diabetes specialist nurses perceive the issues facing diabetes specialist services in 2011 and how these have changed in the preceding decade. We used a longitudinal case study approach that combined quantitative and qualitative methods. Five locations in England were purposively selected to represent the wider diabetes specialist community, and seven semi-structured interviews were conducted. Interviews were recorded, transcribed verbatim and analysed using Framework analysis. Findings were compared with and contrasted to results from national quantitative surveys of diabetes specialist services undertaken in 2000 and 2006. Clinicians viewed positively the expertise and commitment of multidisciplinary teams and their ability to adapt to new situations. Negative perceptions persisted throughout the decade, relating to the continual change that threatens to dismantle relationships and services which had taken many years to establish. Lack of resources, inadequate manpower planning and poor access to psychological support for people with diabetes remained constant themes from 2000 to 2011. A willingness to innovate and work differently to improve services was identified; however, clinicians must be supported through organizational changes to ensure people with diabetes receive high-quality care. The disruptive nature of organizational change was a recurrent theme throughout the decade. Periods of stability must exist within commissioning to allow relationships, which are key to integration, to be maintained and permit service improvements to develop. © 2015 The Authors. Diabetic Medicine © 2015 Diabetes UK.

Education of radiation safety specialists at Faculty of Medicine of Vilnius University

International Nuclear Information System (INIS)

Urbelis, A.; Surkiene, G.

2004-01-01

Vilnius University is the first institution of higher education in Lithuania that began to teach students on radiation safety. The special course of radiation hygiene was delivered to students in 1962-1992. In 1992 it was introduced residency of radiation hygiene and graduated students qualified for title of radiation hygiene specialist. The residency lasted one year and included six cycles: fundamentals of nuclear physics, statistics and noninfectious epidemiology, radiobiology, radiological research methods, controls of radiation safety and hygienic analysis of radiation safety. From 1994 Vilnius University has been educating and training professionals of public health. The specialists of radiation safety aren't been training as isolated branch. All courses is divided into two parts. The first one is included into bachelor, the second part - into master study. The bachelor study consists of 2 credits (16 hours for lectures and 32 hours for practical studies). The future bachelors study introduction of radiation safety, elements of nuclear physics, dose limit values, fundamentals of radiological protection, natural radiation. The master study consists of 2 credits (8 hours for lectures and 48 hours for practical studies). The future masters study specific problems of radiation safety in medicine and industry, the safety problems of nuclear power - stations, the problems of radioactive wastes, radiation biology, radiation risk. Radiation safety study model in Faculty of medicine of Vilnius University differs from study model in most European countries as it makes great play of radiation safety while usual model includes radiation safety as insignificant part of environmental health. (author)

Specialist training in pediatric anesthesia

DEFF Research Database (Denmark)

Hansen, Tom G

2009-01-01

There has been a great deal of focus on specialist training in pediatric anesthesia in the last decade or so. Internationally, however, there is still no uniform agreement as to how such a training program should be arranged and organized. Since September 2003, the Scandinavian Society of Anaesth......There has been a great deal of focus on specialist training in pediatric anesthesia in the last decade or so. Internationally, however, there is still no uniform agreement as to how such a training program should be arranged and organized. Since September 2003, the Scandinavian Society...... of Anaesthesiology and Intensive Care Medicine has coordinated an advanced Inter-Nordic educational program in pediatric anesthesia and intensive care. The training program is managed by a Steering Committee. This program is intended for physicians who recently have received their specialist degree in anesthesiology...... and intensive care. The training period is 12 months of which 9 months are dedicated to pediatric anesthesia and 3 months to pediatric intensive care. During the 1-year training period, the candidates are designated a Scandinavian host clinic (at a tertiary pediatric center in Scandinavia approved...

[Databases for surgical specialists in Cancún, Quintana Roo].

Science.gov (United States)

Contla-Hosking, Jorge Eduardo; Ceballos-Martínez, Zoila Inés; Peralta-Bahena, Mónica Esther

2004-01-01

Our aim was to identify the level of knowledge of surgical health-area specialists in Cancún, Quintana Roo, Mexico, from the personal productivity database. We carried out an investigation of 37 surgical specialists: 24 belonged to the Mexican Social Security Institute (IMSS), while 13 belonged to the Mexican Health Secretariat (SSA). In our research, we found that 61% of surgical health-area specialist physicians were familiar with some aspects of the institutional surgical registry, including the following: 54% knew of the existence of a personal registry of surgeries carried out, and 43% keep a record of their personal activities. From the latter percentage, 69% of surgical health-area specialist physicians mentioned keeping their records manually, while 44% used the computer. Results of the research suggest that these physicians would like to have some kind of record of the surgeries carried out by each. An important percentage of these specialists do not keep a personal record on a database; due to this lack of knowledge, we obtain incorrect information in institutional records of the reality of what is actually done. We consider it important to inform surgical specialists concerning the existence of personal institutional records in database form or even of record done manually, as well as correct terminology for the International Codification (CIE-9 & 10). We inform here of the need to encourage a culture in records and databases in the formative stage of surgeon specialists.

Contrasting effects of specialist and generalist herbivores on resistance evolution in invasive plants.

Science.gov (United States)

Zhang, Zhijie; Pan, Xiaoyun; Blumenthal, Dana; van Kleunen, Mark; Liu, Mu; Li, Bo

2018-04-01

Invasive alien plants are likely to be released from specialist herbivores and at the same time encounter biotic resistance from resident generalist herbivores in their new ranges. The Shifting Defense hypothesis predicts that this will result in evolution of decreased defense against specialist herbivores and increased defense against generalist herbivores. To test this, we performed a comprehensive meta-analysis of 61 common garden studies that provide data on resistance and/or tolerance for both introduced and native populations of 32 invasive plant species. We demonstrate that introduced populations, relative to native populations, decreased their resistance against specialists, and increased their resistance against generalists. These differences were significant when resistance was measured in terms of damage caused by the herbivore, but not in terms of performance of the herbivore. Furthermore, we found the first evidence that the magnitude of resistance differences between introduced and native populations depended significantly on herbivore origin (i.e., whether the test herbivore was collected from the native or non-native range of the invasive plant). Finally, tolerance to generalists was found to be higher in introduced populations, while neither tolerance to specialists nor that to simulated herbivory differed between introduced and native plant populations. We conclude that enemy release from specialist herbivores and biotic resistance from generalist herbivores have contrasting effects on resistance evolution in invasive plants. Our results thus provide strong support for the Shifting Defense hypothesis. © 2018 by the Ecological Society of America.

The evolution of resource adaptation: how generalist and specialist consumers evolve.

Science.gov (United States)

Ma, Junling; Levin, Simon A

2006-07-01

Why and how specialist and generalist strategies evolve are important questions in evolutionary ecology. In this paper, with the method of adaptive dynamics and evolutionary branching, we identify conditions that select for specialist and generalist strategies. Generally, generalist strategies evolve if there is a switching benefit; specialists evolve if there is a switching cost. If the switching cost is large, specialists always evolve. If the switching cost is small, even though the consumer will first evolve toward a generalist strategy, it will eventually branch into two specialists.

Does the specialist nurse enhance or deskill the general nurse?

Science.gov (United States)

Marshall, Z; Luffingham, N

Much conflict and confusion surrounds the title and role of the specialist nurse, leading in some instances to disharmony between general and specialist nurses. It has been suggested that too many highly specialized nurses in a general area may lead to a deskilled workforce and fragmented care. Attempts to define the key concepts of specialist practice as described by the UKCC has resulted in elitism, conflict and abuse of the title. One suggestion to eliminate this conflict is for specialist nurses to achieve key competencies that encompass the role of the clinical expert. These key competencies should be devised by specialist nurses, in the absence of national guidelines, and be agreed by employers. They should incorporate the key roles of: change agent, expert clinician, educator, researcher and coordinator. It is contended that if all concerned have a clearer definition of the title, role and what is expected from the specialist nurse then this will result in reduced conflict and improved quality of care.

Brazilian infectious diseases specialists: who and where are they?

Directory of Open Access Journals (Sweden)

Alex Jones Flores Cassenote

2016-03-01

Conclusion: Our study shows that Brazilian infectious diseases specialists are predominantly young and female doctors. Most have concluded a medical residency training program. The absolute majority practice in the Southeastern region. However, some states from the Northern, Northeastern and Southeastern regions exhibit specialist rates above the national average. In these areas, nonetheless, there is a strong concentration of infectious diseases specialists in state capitals and in metropolitan areas.

Educational programme on radiation protection for veterinary medicine specialists

International Nuclear Information System (INIS)

Djuric, G.; Popovic, D.

1992-01-01

The education of radiation protection for veterinary medicine specialists on the University of Belgrade is integrated both in regular graduate studies and in postgraduate studies. Within the graduate studies, students attend courses in physics and biophysics and in radiation hygiene. During postgraduate or specialistic veterinary medicine studies, veterinary medicine specialists expand their knowledge in radiation protection through a number of courses on radiation biophysics, radioecology, nuclear instrumentation and environmental protection. (author)

'The use of technical specialists in quality assurance audits'

International Nuclear Information System (INIS)

Higgins, T.J.; Diaz, M.R.

1993-01-01

This paper provides a nontechnical discussion of the use of Technical Specialists in quality assurance audits by the Office of Civilian Radioactive Waste Management's Office of Quality Assurance. The purpose is to describe one successful solution to the problem that arises when a quality assurance organization is responsible for conducting audits of many, diverse, highly technical activities. The solution is the conduct of audits that combine both horizontal and vertical sample selection strategies and which employ Technical Specialists in the vertical portion of the audit. The Technical Specialist is paired with a programmatic auditor who perform as a dedicated team in their conduct of the audit. This paper focuses on the Technical Specialist

Elder Specialists: Psychosocial Aspects of Medical Education in Geriatric Care

Science.gov (United States)

McCann-Stone, Nancy; Robinson, Sherry B.; Rull, Gary; Rosher, Richard B.

2009-01-01

This paper describes an Elder Specialist Program developed by one school of medicine to sensitize medical students to geriatric psychosocial issues. Elder Specialists participate in panel discussions as part of each geriatric session. As an alternative to traditional senior mentoring programs, the Elder Specialist Program provides all students a…

Conflict Management Strategies in the ICU Differ Between Palliative Care Specialists and Intensivists.

Science.gov (United States)

Chiarchiaro, Jared; White, Douglas B; Ernecoff, Natalie C; Buddadhumaruk, Praewpannarai; Schuster, Rachel A; Arnold, Robert M

2016-05-01

Conflict is common between physicians and surrogate decision makers around end-of-life care in ICU. Involving experts in conflict management improve outcomes, but little is known about what differences in conflict management styles may explain the benefit. We used simulation to examine potential differences in how palliative care specialists manage conflict with surrogates about end-of-life treatment decisions in ICUs compared with intensivists. Subjects participated in a high-fidelity simulation of conflict with a surrogate in an ICU. In this simulation, a medical actor portrayed a surrogate decision maker during an ICU family meeting who refuses to follow an advance directive that clearly declines advanced life-sustaining therapies. We audiorecorded the simulation encounters and applied a coding framework to quantify conflict management behaviors, which was organized into two categories: task-focused communication and relationship building. We used negative binomial modeling to determine whether there were differences between palliative care specialists' and intensivists' use of task-focused communication and relationship building. Single academic medical center ICU. Palliative care specialists and intensivists. None. We enrolled 11 palliative care specialists and 25 intensivists. The palliative care specialists were all attending physicians. The intensivist group consisted of 11 attending physicians, 9 pulmonary and critical care fellows, and 5 internal medicine residents rotating in the ICU. We excluded five residents from the primary analysis in order to reduce confounding due to training level. Physicians' mean age was 37 years with a mean of 8 years in practice. Palliative care specialists used 55% fewer task-focused communication statements (incidence rate ratio, 0.55; 95% CI, 0.36-0.83; p = 0.005) and 48% more relationship-building statements (incidence rate ratio, 1.48; 95% CI, 0.89-2.46; p = 0.13) compared with intensivists. We found that palliative care

Art Appreciation as a Learned Competence: A Museum-Based Qualitative Study of Adult Art Specialist and Art Non-Specialist Visitors

Science.gov (United States)

Bracun Sova, Rajka

2015-01-01

Since Bourdieu, it has been argued that art appreciation requires "knowledge". The focus of this qualitative study was to examine art appreciation as a learned competence by exploring two different groups of museum visitors: art specialists and art non-specialists. The research was conducted at Moderna galerija in Ljubljana. Twenty-three…

Risk analysis: opening the process

International Nuclear Information System (INIS)

Hubert, Ph.; Mays, C.

1998-01-01

This conference on risk analysis took place in Paris, 11-14 october 1999. Over 200 paper where presented in the seven following sessions: perception; environment and health; persuasive risks; objects and products; personal and collective involvement; assessment and valuation; management. A rational approach to risk analysis has been developed in the three last decades. Techniques for risk assessment have been thoroughly enhanced, risk management approaches have been developed, decision making processes have been clarified, the social dimensions of risk perception and management have been investigated. Nevertheless this construction is being challenged by recent events which reveal how deficits in stakeholder involvement, openness and democratic procedures can undermine risk management actions. Indeed, the global process most components of risk analysis may be radically called into question. Food safety has lately been a prominent issue, but now debates appear, or old debates are revisited in the domains of public health, consumer products safety, waste management, environmental risks, nuclear installations, automobile safety and pollution. To meet the growing pressures for efficiency, openness, accountability, and multi-partner communication in risk analysis, institutional changes are underway in many European countries. However, the need for stakeholders to develop better insight into the process may lead to an evolution of all the components of risks analysis, even in its most (technical' steps. For stakeholders of different professional background, political projects, and responsibilities, risk identification procedures must be rendered understandable, quantitative risk assessment must be intelligible and accommodated in action proposals, ranging from countermeasures to educational programs to insurance mechanisms. Management formats must be open to local and political input and other types of operational feedback. (authors)

Stress, satisfaction and burnout among Dutch medical specialists

NARCIS (Netherlands)

Visser, Mechteld R. M.; Smets, Ellen M. A.; Oort, Frans J.; de Haes, Hanneke C. J. M.

2003-01-01

Background: Stress and stress-related illnesses are increasing among medical specialists. This threatens the quality of patient care. in this study we investigated (a) levels of job stress and job satisfaction among medical specialists, (b) factors contributing to stress and satisfaction and (c) the

Adversarial risk analysis

CERN Document Server

Banks, David L; Rios Insua, David

2015-01-01

Flexible Models to Analyze Opponent Behavior A relatively new area of research, adversarial risk analysis (ARA) informs decision making when there are intelligent opponents and uncertain outcomes. Adversarial Risk Analysis develops methods for allocating defensive or offensive resources against intelligent adversaries. Many examples throughout illustrate the application of the ARA approach to a variety of games and strategic situations. The book shows decision makers how to build Bayesian models for the strategic calculation of their opponents, enabling decision makers to maximize their expected utility or minimize their expected loss. This new approach to risk analysis asserts that analysts should use Bayesian thinking to describe their beliefs about an opponent's goals, resources, optimism, and type of strategic calculation, such as minimax and level-k thinking. Within that framework, analysts then solve the problem from the perspective of the opponent while placing subjective probability distributions on a...

Understanding practice patterns of glaucoma sub-specialists in India

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Nikhil S. Choudhari

2017-10-01

Full Text Available AIM: To obtain information on the prevailing practice patterns of glaucoma specialists in India. METHODS: Glaucoma specialists attending the Annual Conference of the Glaucoma Society of India (GSI were surveyed. This survey, conducted in 2013, was based on an interactive audience response system. RESULTS: The information was obtained from 146 glaucoma specialists. Approximately half (n=83; 57% had ≥10y of experience in managing glaucoma and were in institutional practice (n=74, 51%. Goldmann applanation tonometry was preferred by 103 (72% specialists whilst n=25 (17.4% used non-contact tonometer. Indentation gonioscopy was favoured by two-thirds (n=90, 66% whereas stereoscopic optic disc examination and visual fields using Humphrey perimeter was performed by a majority of the specialists surveyed (n=115, 86% and n=114; 83% respectively. Nearly three quarter specialists (n=96; 72% preferred optical coherence tomography for imaging. The primary choice for treatment of angle closure disease and primary open angle glaucoma was laser (iridotomy, n=117; 93% and medical management (prostaglandin analogue, n=104; 78%, respectively. Approximately only a third of the specialists surveyed (n=37; 28% were performing both trabeculectomy and implantation of a glaucoma drainage device and about half (n=64; 47% were not operating on congenital glaucoma at all. CONCLUSION: This survey has found conformance with preferred practice patterns in several areas of diagnosis and management of glaucoma, but there was diversity in a few areas. The information is a significant step towards improvement of glaucoma care in India, including planning for future strategies.

Leadership capabilities of physiotherapy leaders in Ireland: Part 2. Clinical specialists and advanced physiotherapy practitioners.

Science.gov (United States)

McGowan, E; Elliott, N; Stokes, E

2018-05-07

Investigation of the leadership capabilities of physiotherapy managers found that they report predominantly demonstrating capabilities associated with the human resource and structural frames. However, little is known about the leadership capabilities of clinical specialists and advanced physiotherapy practitioners (APPs) who also are identified as having responsibility for leadership. To explore clinical specialists´ and APPs' perceptions of their leadership capabilities and compare them with the reported leadership capabilities of physiotherapy managers. Semi-structured interviews were conducted with a purposive sample of 17 physiotherapy clinical specialists and APPs from a range of practice settings across Ireland. The interviews were analyzed using template analysis and the coding template was based on the Bolman and Deal Leadership framework. The participants described demonstrating leadership capabilities associated with each of the four leadership frames. However, the language used by the clinical specialists/APPs suggested that they work predominantly through the human resource frame. Structural frame capabilities were reported by the clinical specialists/APPs and there were some differences to those reported by the managers. In keeping with the reported leadership capabilities of the physiotherapy managers, the employment of capabilities associated with the political frame varied between participants and symbolic frame capabilities were underused. There are many similarities in the self-reported leadership capabilities of managers and clinical specialists/APPs. However, differences were also noted. Both cohorts of physiotherapy leaders may benefit from specific development programs to develop leadership capabilities associated with the political and symbolic frames.

Exploring the situational motivation of medical specialists: a qualitative study.

Science.gov (United States)

van der Burgt, Stéphanie M E; Kusurkar, Rashmi A; Croiset, Gerda; Peerdeman, Saskia M

2018-02-26

The aim was to obtain insight into the factors in the work environment that motivate or demotivate a medical specialist during his/her working day. A qualitative ethnographic design was used, and a constructivist approach was adopted with the Self-Determination theory of motivation as a framework. Six medical specialists from VU University Medical Center in the Netherlands, recruited through convenience, snowball, and purposive sampling, were shadowed for one day each. Data were transcribed and open-coded. Themes were finalized through discussion and consensus. Sixty hours of observation data identified motivating and demotivating factors categorized into four themes that are important for specialists' motivation. Informational technology issues are demotivating factors. Working with colleagues can be both a motivating and demotivating factor, e.g., filling in for each other through feelings of relatedness was motivating. Being in control of one's planning through feelings of autonomy was motivating. Furthermore, patient care and teaching, especially in combination, stimulated specialists' motivation. Regarding the design of the study, we found that situational motivation is indeed observable. The basic psychological needs autonomy, competence, and relatedness are important for specialists' motivation. Investing in a more motivating, open, transparent, and basic-needs- supportive work environment for medical specialists is necessary. Keywords: Continuing professional development, motivation, medical specialists, self-determination theory, qualitative research.

Glaucoma Medication Preferences among Glaucoma Specialists in Mexico.

Science.gov (United States)

Lazcano-Gomez, Gabriel; Alvarez-Ascencio, Daniela; Haro-Zuno, Cindy; Turati-Acosta, Mauricio; Garcia-Huerta, Magdalena; Jimenez-Arroyo, Jesus; Castañeda-Diez, Rafael; Castillejos-Chevez, Armando; Gonzalez-Salinas, Roberto; Dominguez-Dueñas, Francisca; Jimenez-Roman, Jesus

2017-01-01

To determine the glaucoma specialists' preferences for the different brands of topical glaucoma medications available in Mexico. A web-based survey was sent to 150 board-certified glaucoma specialists in Mexico, with 14 questions related to brand preferences for all glaucoma medications available in Mexico. Participants were asked to select each glaucoma medication class by brand and to state the factors leading to their choice. Data from 111 (74%) glaucoma specialists were collected. Imot (timolol 0.5%; Sophia, Mexico) was the preferred brand for the beta-blockers (BB) class by 71% (n = 79) of the participants. Azopt (brinzolamide 1%; Alcon Lab, US) was the preferred carbonic anhydrase inhibitor (CAI) by 54% (n = 60) of the glaucoma specialists. Lumigan (bimatoprost 0.01% and 0.03%; Allergan Inc., U.S.) was the first choice for the prostaglandin analogues (PGAs) in 62% (n = 70) of the answers. The most frequently prescribed alpha-agonist (AA) was Agglad (brimonidine 0.2%; Sophia Lab, Mexico) in 44% (n = 49) of the answers. Medication accessibility (31%), cost (29%), and recommended dose (23%) were the three main factors influencing the glaucoma specialists' preferences. Medication cost and accessibility, as well as posology, remain the main factors influencing brand preferences among glaucoma doctors. In our professional opinion, the therapeutic effect must be the leading factor when prescribing topical medications in the daily practice, so that patients receive the best treatment option. This survey provides an understanding of the decision-making process when prescribing glaucoma medications by glaucoma specialists in a Latin American developing country. Ideally, patient treatment should be individualized and aimed to achieve the best results possible for their specific condition. How to cite this article: Lazcano-Gomez G, Alvarez-Ascencio D, Haro-Zuno C, Turati-Acosta M, Garcia-Huerta M, Jimenez-Arroyo J, Castañeda-Diez R, Castillejos-Chevez A, Gonzalez

A qualitative study of work-life balance amongst specialist orthodontists in the United Kingdom.

Science.gov (United States)

Bateman, Lindsey E; Collins, Joanne M; Cunningham, Susan J

2016-12-01

To identify factors affecting work-life balance amongst male and female orthodontists in the UK. A qualitative interview-based study with a cross-sectional design. Specialist orthodontists working in specialist practice and the hospital service in the UK were selected by purposive sampling. In-depth semi-structured interviews were conducted with 18 orthodontic specialists. Interview transcripts were analyzed using Framework Analysis. Four main themes pertaining to work-life balance in orthodontics were identified: work factors affecting work-life balance, life factors affecting work-life balance, perception and effects of work-life balance and suggestions for managing work-life balance within the profession. There was substantial variation in the work-life balance of the orthodontists interviewed in this study; however the majority reported high levels of career satisfaction despite difficulties maintaining a good work-life balance. Whilst there were some clear distinctions in the factors affecting work-life balance between the hospital environment and specialist practice (including additional professional commitments and teaching/training-related issues), there were also a number of similarities. These included, the lack of flexibility in the working day, managing patient expectations, taking time off work at short notice and the ability to work part-time.

Sudden Cardiac Arrest (SCA) Risk Assessment

Science.gov (United States)

... HRS Find a Specialist Share Twitter Facebook SCA Risk Assessment Sudden Cardiac Arrest (SCA) occurs abruptly and without ... people of all ages and health conditions. Start Risk Assessment The Sudden Cardiac Arrest (SCA) Risk Assessment Tool ...

Lack of consensus in the diagnosis and treatment for ocular tuberculosis among uveitis specialists.

Science.gov (United States)

Lou, Susan M; Larkin, Kelly L; Winthrop, Kevin; Rosenbaum, James T

2015-02-01

To assess the approach of specialists to ocular tuberculosis (TB). The American Uveitis Society (AUS) Listserv was surveyed using two clinical cases and general questions. Of 196 members, 87 responded (44.4%), of whom 64 were affiliated with practices in North America, while 23 were outside of North America. The survey provided normative data on how physicians evaluate patients with uveitis as well as opinions about ocular TB. Responses varied widely on such issues as (1) the pretest probability that a patient with granulomatous panuveitis had TB uveitis (range 1-75%) or that a patient with a risk factor for TB had ocular TB (range 0-90%); (2) the optimal duration of anti-TB therapy; and (3) whether therapy should be discontinued after 2 months in nonresponders. Consensus is lacking among uveitis specialists for the diagnosis or management of ocular TB.

STS-95 Mission Specialist Duque suits up during TCDT

Science.gov (United States)

1998-01-01

STS-95 Mission Specialist Pedro Duque of Spain, representing the European Space Agency, suits up in the Operations and Checkout Building prior to his trip to Launch Pad 39-B. Duque and the rest of the STS-95 crew are at KSC to participate in the Terminal Countdown Demonstration Test (TCDT) which includes mission familiarization activities, emergency egress training, and a simulated main engine cutoff. The other crew members are Payload Specialist Chiaki Mukai (M.D., Ph.D.), representing the National Space Development Agency of Japan (NASDA), Pilot Steven W. Lindsey, Mission Specialist Scott E. Parazynski, Mission Specialist Stephen K. Robinson, Payload Specialist John H. Glenn Jr., senator from Ohio, and Mission Commander Curtis L. Brown. The STS-95 mission, targeted for liftoff on Oct. 29, includes research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process. Following the TCDT, the crew will be returning to Houston for final flight preparations.

A descriptive study of employment patterns and work environment outcomes of specialist nurses in Canada.

Science.gov (United States)

Doran, Diane; Duffield, Christine; Rizk, Paul; Nahm, Sang; Chu, Charlene H

2014-01-01

The purpose was to describe the number, demographic characteristics, work patterns, exit rates, and work perceptions of nurses in Ontario, Canada, in 4 specialty classifications: advanced practice nurse (APN)-clinical nurse specialist (CNS), APN-other, primary healthcare nurse practitioner [RN(extended class [EC])], and registered nurse (RN) with specialty certification. The objectives were to (1) describe how many qualified nurses are available by specialty class; (2) create a demographic profile of specialist nurses; (3) determine the proportions of specialist and nonspecialist nurses who leave (a) direct patient care and (b) nursing practice annually; (4) determine whether specialist and nonspecialist nurses differ in their self-ratings of work environment, job satisfaction, and intention to remain in nursing. Employment patterns refer to nurses' employment status (eg, full-time, part-time, casual), work duration (ie, length of employment in nurses and in current role), and work transitions (ie, movement in and out of the nursing workforce, and movement out of current role). A longitudinal analysis of the Ontario nurses' registration database from 2005 to 2010 and a survey of specialist nurses in Canada was conducted. The setting was Canada. The database sample consisted of 3 specialist groups, consisting of RN(EC), CNS, and APN-other, as well as 1 nonspecialist RN staff nurse group. The survey sample involved 359 nurses who were classified into groups based on self-reported job title and RN specialty-certification status. Data sources included College of Nurses of Ontario registration database and survey data. The study measures were the Nursing Work Index, a 4-item measure of job satisfaction, and 1-item measure of intent to leave current job. Nurses registered with the College of Nurses of Ontario were tracked over the study period to identify changes in their employment status with comparisons made between nurses employed in specialist roles and those

Bridging the care continuum: patient information needs for specialist referrals

Directory of Open Access Journals (Sweden)

Steltenkamp Carol L

2009-09-01

Full Text Available Abstract Background Information transfer is critical in the primary care to specialist referral process and has been examined extensively in the US and other countries, yet there has been little attention to the patient's perspective of the information transfer process. This cross-sectional study examined the quality of the information received by patients with a chronic condition from the referring and specialist physician in the specialist referral process and the relationship of the quality of information received to trust in the physicians. Methods Structured telephone interviews were conducted with a random sample of 250 patients who had experienced a referral to a specialist for the first visit for a chronic condition within the prior six months. The sample was selected from the patients who visited specialist physicians at any of the 500 hospitals from the National Research Corporation client base. Results Most patients (85% received a good explanation about the reason for the specialist visit from the referring physician yet 26% felt unprepared about what to expect. Trust in the referring physician was highly associated with the preparatory information patients received. Specialists gave good explanations about diagnosis and treatment, but 26% of patients got no information about follow-up. Trust in the specialist correlated highly with good explanations of diagnosis, treatment, and self-management. Conclusion Preparatory information from referring physicians influences the quality of the referral process, the subsequent coordination of care, and trust in the physician. Changes in the health care system can improve the information transfer process and improve coordination of care for patients.

Specialist participation in healthcare delivery transformation: influence of patient self-referral.

Science.gov (United States)

Aliu, Oluseyi; Sun, Gordon; Burke, James; Chung, Kevin C; Davis, Matthew M

2014-01-01

Improving coordination of care and containing healthcare costs are prominent goals of healthcare reform. Specialist involvement in healthcare delivery transformation efforts like Accountable Care Organizations (ACOs) is necessary to achieve these goals. However, patients’ self-referrals to specialists may undermine care coordination and incur unnecessary costs if patients frequently receive care from specialists not engaged in such healthcare delivery transformation efforts. Additionally, frequent self-referrals may also diminish the incentive for specialist participation in reform endeavors like ACOs to get access to a referral base. To examine recent national trends in self-referred new visits to specialists. A descriptive cross-sectional study of new ambulatory visits to specialists from 2000 to 2009 using data from the National Ambulatory Medical Care Survey. We calculated nationally representative estimates of the proportion of new specialist visits through self-referrals among Medicare and private insurance beneficiaries. We also estimated the nationally representative absolute number of self-referred new specialist visits among both groups of beneficiaries. Among Medicare and private insurance beneficiaries, self-referred visits declined from 32.2% (95% confidence interval [CI], 24.0%-40.4%) to 19.6% (95% CI, 13.9%-23.3%) and from 32.4% (95% CI, 27.9%-36.8%) to 24.1% (95% CI,18.8%-29.4%), respectively. Hence, at least 1 in 5 and 1 in 4 new visits to specialists among Medicare and private insurance beneficiaries, respectively, are self-referred. The current considerable rate of self-referred new specialist visits among both Medicare and private insurance beneficiaries may have adverse implications for organizations attempting to transform healthcare delivery with improved care coordination.

Methodological bases of innovative training of specialists in nanotechnology field

Directory of Open Access Journals (Sweden)

FIGOVSKY Oleg Lvovich

2016-10-01

Full Text Available The performance of innovative training system aimed at highly intellectual specialists in the area of nanotechnologies for Kazakhstan’s economy demands establishment and development of nanotechnological market in the country, teaching of innovative engineering combined with consistent research, integration of trained specialists with latest technologies and sciences at the international level. Methodological aspects of training competitive specialists for nanotechnological field are specific. The paper presents methodological principles of innovative training of specialists for science-intensive industry that were realized according to grant given by the Ministry of Education and Science of the Republic of Kazakhstan.

National Target for South Asia Specialists. A Report.

Science.gov (United States)

National Council on Foreign Language and International Studies, New York, NY.

The South Asia Panel of the National Council on Foreign Languages and International Studies reports on the need for specialists in the languages and cultures of Afghanistan, Bangladesh, India, Nepal, Pakistan, Sri Lanka, Bhutan, and the Maldives. Two categories of specialists are discussed: (1) individuals in government, mission, etc., in…

The effect of medical malpractice liability on rate of referrals received by specialist physicians.

Science.gov (United States)

Xu, Xiao; Spurr, Stephen J; Nan, Bin; Fendrick, A Mark

2013-10-01

Using nationally representative data from the United States, this paper analyzed the effect of a state’s medical malpractice environment on referral visits received by specialist physicians. The analytic sample included 12,839 ambulatory visits to specialist care doctors in office-based settings in the United States during 2003–2007. Whether the patient was referred for the visit was examined for its association with the state’s malpractice environment, assessed by the frequency and severity of paid medical malpractice claims, medical malpractice insurance premiums and an indicator for whether the state had a cap on non-economic damages. After accounting for potential confounders such as economic or professional incentives within practices, the analysis showed that statutory caps on non-economic damages of $250,000 were significantly associated with lower likelihood of a specialist receiving referrals, suggesting a potential impact of a state’s medical malpractice environment on physicians’ referral behavior.

Optometry Specialist (AFSC 91255).

Science.gov (United States)

Kille, Michael O.

This four-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for optometry specialists. Covered in the individual volumes are optometry clinic administration (optometry career and field training, ethical relationships and professionalism, eligibility for optometric care and appointment…

Cost-efficiency of specialist inpatient rehabilitation for working-aged adults with complex neurological disabilities: a multicentre cohort analysis of a national clinical data set.

Science.gov (United States)

Turner-Stokes, Lynne; Williams, Heather; Bill, Alan; Bassett, Paul; Sephton, Keith

2016-02-24

To evaluate functional outcomes, care needs and cost-efficiency of specialist rehabilitation for a multicentre cohort of inpatients with complex neurological disability, comparing different diagnostic groups across 3 levels of dependency. A multicentre cohort analysis of prospectively collected clinical data from the UK Rehabilitation Outcomes Collaborative (UKROC) national clinical database, 2010-2015. All 62 specialist (levels 1 and 2) rehabilitation services in England. Working-aged adults (16-65 years) with complex neurological disability. all episodes with length of stay (LOS) 8-400 days and complete outcome measures recorded on admission and discharge. Total N=5739: acquired brain injury n=4182 (73%); spinal cord injury n=506 (9%); peripheral neurological conditions n=282 (5%); progressive conditions n=769 (13%). Specialist inpatient multidisciplinary rehabilitation. Dependency and care costs: Northwick Park Dependency Scale/Care Needs Assessment (NPDS/NPCNA). Functional independence: UK Functional Assessment Measure (UK Functional Independence Measure (FIM)+FAM). Cost-efficiency: (1) time taken to offset rehabilitation costs by savings in NPCNA-estimated costs of ongoing care, (2) FIM efficiency (FIM gain/LOS days), (3) FIM+FAM efficiency (FIM+FAM gain/LOS days). Patients were analysed in 3 groups of dependency. Mean LOS 90.1 (SD 66) days. All groups showed significant reduction in dependency between admission and discharge on all measures (paired t tests: pSpecialist rehabilitation can be highly cost-efficient for all neurological conditions, producing substantial savings in ongoing care costs, especially in high-dependency patients. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Management Matters: The Library Media Specialist's Management Toolbox

Science.gov (United States)

Pappas, Marjorie L.

2004-01-01

Library media specialists need tools to help them manage the school library media program. The Internet includes a vast array of tools that a library media specialist might find useful. The websites and electronic resources included in this article are only a representative sample and future columns may explore additional tools. All the tools are…

The clinical nurse specialist: leadership in quality improvement.

Science.gov (United States)

Finkelman, Anita

2013-01-01

Healthcare delivery is in a crisis, requiring improvement. How to improve and who should assume more leadership are not clear. At the same time, the nursing profession struggles with a weak education system, graduating students who require major support for an extended time. There is also confusion related to nursing roles, particularly with nurses who have a graduate degree. The Institute of Medicine has published a series of reports about the healthcare system and need for improvement and describes a structure for improvement. The clinical nurse specialist is particularly suited to assume a major role in nursing leadership to guide staff and the healthcare system to better ensure improved care. There is great need to communicate that the clinical nurse specialist can and should assume this role. This will require a review and development of more quality improvement content and experiences in clinical nurse specialist educational programs, but much of the content is already in programs. The clinical nurse specialist works in systems, impacts systems, works with staff, and can thus reach more patients with improvement approaches.

A background to risk analysis. Vol. 3

International Nuclear Information System (INIS)

Taylor, J.R.

1979-01-01

This 4-volumes report gives a background of ideas, principles, and examples which might be of use in developing practical methods for risk analysis. Some of the risk analysis techniques described are somewhat experimental. The report is written in an introductory style, but where some point needs further justifi- cation or evaluation, this is given in the form of a chapter appenix. In this way, it is hoped that the report can serve two purposes, - as a basis for starting risk analysis work and as a basis for discussing effectiveness of risk analysis procedures. The report should be seen as a preliminary stage, prior to a program of industrial trials of risk analysis methods. Vol. 3 contains chapters on quantification of risk, failure and accident probability, risk analysis and design, and examles of risk analysis for process plant. (BP)

Who teaches science in Alagoas? A quantitative analysis of non-specialist teaching at primary and secondary schools in Brazil

OpenAIRE

Fischer, Robert; Fireman, Elton; Gomes, Jose Renan

2013-01-01

While non-specialist teaching increasingly becomes an object of public interest, there is little data available on the actual educational background of teachers giving classes outside their specialisation. This work analyses the data collected by the Brazilian Ministry of Education from public and private schools in Alagoas (Brazil), with a special focus on science education at primary and secondary schools. We find that the phenomena of non-specialist teaching is highly subject specific. For...

Proceedings of a C.S.N.I. specialist meeting on instrumented pre-cracked Charpy testing

Energy Technology Data Exchange (ETDEWEB)

Wullaert, R A [Fracture Control Corp., 340 South Kellogg Avenue, Suite G, Goleta, California 93017 (United States)

1981-11-15

This report presents the status of the testing and data analysis procedures for the instrumented pre-cracked Charpy test with emphasis on the application of the test technique to the nuclear industry. The report (Proceedings) consist of invited technical papers by specialists in the field and a synopsis of the comments, conclusions, and recommendations reached in a workshop session. The CSNl-sponsored and EPRI-hosted meeting confirmed both the popularity of the test technique in the nuclear industry and the problems associated with the test technique due to the lack of a national or international consensus standard. Major emphasis in the meeting was devoted to evaluating the existing industry testing procedure (EPRI procedure) and proposed national standards (ASTM, ASK). The EPRI procedures were considered adequate by specialists concerned with engineering applications, but too restrictive by specialists concerned with research applications. As a result of the conference, a compilation of state-of-the-art papers is now available to code and standard committees. Specific comments concerning test and data analysis procedures, applications in the nuclear industry, and future research areas are also contained in the proceedings

Educational support for specialist international medical graduates in anaesthesia.

Science.gov (United States)

Higgins, Niall S; Taraporewalla, Kersi; Edirippulige, Sisira; Ware, Robert S; Steyn, Michael; Watson, Marcus O

2013-08-19

To measure specialist international medical graduates' (SIMGs) level of learning through participation in guided tutorials, face-to-face or through videoconferencing (VC), and the effect of tutorial attendance and quality of participation on success in specialist college examinations. Tutorials were conducted at the Royal Brisbane and Women's Hospital between 19 September 2007 and 23 August 2010, and delivered through VC to participants at other locations. Tutorials were recorded and transcribed, and speaker contributions were tagged and ranked using content analysis software. Summary examination results were obtained from the Australian and New Zealand College of Anaesthetists. Tutorial participation and attendance, and college examination pass and fail rates. Transcripts were obtained for 116 tutorials. The median participation percentage for those who subsequently failed the college examinations was 1% (interquartile range [IQR], 0%-1%), while for those who passed the exams it was 5% (IQR, 2%-8%; P technology was found to be a feasible method to assist SIMGs to become aware of the requirements of the exam and to prepare more effectively.

3rd CEAS Specialist Conference on Guidance, Navigation and Control

CERN Document Server

Drouin, Antoine; Roos, Clément

2015-01-01

The two first CEAS (Council of European Aerospace Societies) Specialist Conferences on Guidance, Navigation and Control (CEAS EuroGNC) were held in Munich, Germany in 2011 and in Delft, The Netherlands in 2013. ONERA The French Aerospace Lab, ISAE (Institut Supérieur de l’Aéronautique et de l’Espace) and ENAC (Ecole Nationale de l’Aviation Civile) accepted the challenge of jointly organizing the 3rd edition. The conference aims at promoting new advances in aerospace GNC theory and technologies for enhancing safety, survivability, efficiency, performance, autonomy and intelligence of aerospace systems. It represents a unique forum for communication and information exchange between specialists in the fields of GNC systems design and operation, including air traffic management. This book contains the forty best papers and gives an interesting snapshot of the latest advances over the following topics: l  Control theory, analysis, and design l  Novel navigation, estimation, and tracking methods l  Aircr...

Characteristics of Specialists' Adaptation to the Conditions of a Society in Transformation

Science.gov (United States)

Nizamova, A. E.

2012-01-01

The declining size of the Russian population means that labor resources need to be used more effectively, which is especially true of highly skilled workers. An analysis of data from the Russian Longitudinal Monitoring Survey (RLMS) shows that the social and workplace situations of specialists need to be improved significantly. (Contains 5 tables…

Proceedings of the OECD/CSNI specialists meeting on fuel-coolant interactions

Energy Technology Data Exchange (ETDEWEB)

Akiyama, Mamoru; Yamano, Norihiro; Sugimoto, Jun [eds.

1998-01-01

The OECD/CSNI Specialists Meeting on Fuel Coolant Interactions (FCI) was held at Tokai-mura in Japan on May 19 through 21, 1997, and attended by 80 participants from 14 countries and one international organizations. In the meeting 36 papers were presented followed by active discussions in six sessions on various aspects of FCI issues, such as reactor application, premixing, propagation/trigger, experiments and code/models. At the end of the Meeting, the participants have reached to the consensus on the summary and recommendations, which consists of the following items; (1) We find no new evidence that would change or violate the conclusion of SERG-2 (1996) that alpha-mode failure is not risk significant. (2) Significant progress has been made since the Santa Barbara meeting (1993). (3) Several areas have been identified, which need further investigations to understand the basic FCI phenomena, and to improve the modeling. (4) We recommend maximizing open communication between various research groups in order to accelerate the resolution of the remaining issues. (5) We recommend that the next specialist meeting be held within 3 to 5 years in order to synthesize the activities described above. (J.P.N.)

Host specialist clownfishes are environmental niche generalists

Science.gov (United States)

Litsios, Glenn; Kostikova, Anna; Salamin, Nicolas

2014-01-01

Why generalist and specialist species coexist in nature is a question that has interested evolutionary biologists for a long time. While the coexistence of specialists and generalists exploiting resources on a single ecological dimension has been theoretically and empirically explored, biological systems with multiple resource dimensions (e.g. trophic, ecological) are less well understood. Yet, such systems may provide an alternative to the classical theory of stable evolutionary coexistence of generalist and specialist species on a single resource dimension. We explore such systems and the potential trade-offs between different resource dimensions in clownfishes. All species of this iconic clade are obligate mutualists with sea anemones yet show interspecific variation in anemone host specificity. Moreover, clownfishes developed variable environmental specialization across their distribution. In this study, we test for the existence of a relationship between host-specificity (number of anemones associated with a clownfish species) and environmental-specificity (expressed as the size of the ecological niche breadth across climatic gradients). We find a negative correlation between host range and environmental specificities in temperature, salinity and pH, probably indicating a trade-off between both types of specialization forcing species to specialize only in a single direction. Trade-offs in a multi-dimensional resource space could be a novel way of explaining the coexistence of generalist and specialists. PMID:25274370

Find an Endocrinology - Thyroid Specialist

Science.gov (United States)

... History Resource Center Patients Thyroid Information Find an Endocrinology – Thyroid Specialist Patient Support Links Clinical Thyroidology for ... Access Thyroid Online Access Clinical Thyroidology Online Video Endocrinology Donate Give Online Research Accomplishments Ridgway Legacy Fund ...

Environmental risk analysis

International Nuclear Information System (INIS)

Lima-e-Silva, Pedro Paulo de

1996-01-01

The conventional Risk Analysis (RA) relates usually a certain undesired event frequency with its consequences. Such technique is used nowadays in Brazil to analyze accidents and their consequences strictly under the human approach, valuing loss of human equipment, human structures and human lives, without considering the damage caused to natural resources that keep life possible on Earth. This paradigm was developed primarily because of the Homo sapiens' lack of perception upon the natural web needed to sustain his own life. In reality, the Brazilian professionals responsible today for licensing, auditing and inspecting environmental aspects of human activities face huge difficulties in making technical specifications and procedures leading to acceptable levels of impact, furthermore considering the intrinsic difficulties to define those levels. Therefore, in Brazil the RA technique is a weak tool for licensing for many reasons, and of them are its short scope (only accident considerations) and wrong a paradigm (only human direct damages). A paper from the author about the former was already proposed to the 7th International Conference on Environmetrics, past July'96, USP-SP. This one discusses the extension of the risk analysis concept to take into account environmental consequences, transforming the conventional analysis into a broader methodology named here as Environmental Risk Analysis. (author)

Comparison of accident risks in different energy systems: Comments from Russian specialists

International Nuclear Information System (INIS)

2000-01-01

Many articles on accident risk analysis of different energy systems in comparison with nuclear power share certain stereotypical features. For example: When assessing the risks associated with the operation of such facilities, they ignore the effects of the upgrading of RBMK reactors which was carried out after the Chernobyl accident. In their integrated assessment of the radiological consequences of the Chernobyl accident they use numerous studies which frequently contain unreliable source data and unfounded predictions, and they ignore many socio-political factors which considerably increased the damage caused by the accident. Unfortunately, the study in question, despite its topicality and originality of approach, is also not without such shortcomings. After the Chernobyl accident, reconstruction and safety enhancement measures were implemented at nuclear power plants with RBMK reactors which were without precedent in world practice and have continued to this day. According to probabilistic safety assessments (PSA) carried out with the assistance of international experts, the probability of serious accidents at RBMKs has decreased by a factor of two or more thanks to the above mentioned measures. The mean weighted safety index for all operational RBMK reactors is 10 -4 l/year and is decreasing thanks to the ongoing and planned reconstruction of all units. All operational nuclear power plants with RBMK reactors are thus on a par with the successfully operating Soviet WWERs and western boiling water reactors (BWRs) and pressurized water reactors (PWRs), and satisfy the IAEA recommendations regarding the risk level of older generation nuclear power plants. The authors of the IAEA Bulletin article give estimates of the remote radiological consequences of the Chernobyl accident which range from an estimated 10,000 to 30,000 fatal cases of radiation-induced cancer, and the literature on the subject contains even more extreme estimates. However, our 14 years

Is travel-time to a specialist centre a risk factor for non-referral, non-attendance and loss to follow-up among patients with hepatitis C (HCV) infection?

Science.gov (United States)

Astell-Burt, Thomas; Flowerdew, Robin; Boyle, Paul; Dillon, John

2012-07-01

Little is known about why many people diagnosed with hepatitis C virus (HCV) infection fail to reach and stay within specialist care services. We used a Geographic Information System and logit regression to investigate whether travel-time to a specialist centre was associated with an increased likelihood of non-referral, non-attendance and loss to follow-up among persons diagnosed with HCV between 1991 and 2003 in Tayside, Scotland (UK). Information was available on referral to, and utilisation of, the single HCV specialist centre in Tayside between 1991 and 2006. Longer travel-time to a specialist centre was associated with an increased likelihood of non-referral to a specialist centre following diagnosis (Odds Ratio: 1.25, 95% Confidence Interval: 1.09, 1.44). Patients living further from an HCV specialist centre were less likely to be referred to it for treatment that could cure their HCV infection. Neither a history of intravenous drug use (IDU), nor area deprivation predicted non-referral. Subsequent to referral, travel-time to a specialist centre was not associated with either non-attendance (0.83 (0.56, 1.21)) or loss to follow-up (0.98 (0.78, 1.22)), although a history of IDU was a strong predictor of both non-attendance and loss to follow-up. Non-attendance was less likely among older patients, while loss to follow-up was more common among those living in deprived areas. Once referred, patients appear able to cope with stress and financial cost of long and frequent journeys to hospital. However, as rates of referral improve from more geographically remote areas, long travel-times to an HCV specialist centre may become an important factor determining future utilisation. Copyright © 2012 Elsevier Ltd. All rights reserved.

Component of the risk analysis

International Nuclear Information System (INIS)

Martinez, I.; Campon, G.

2013-01-01

The power point presentation reviews issues like analysis of risk (Codex), management risk, preliminary activities manager, relationship between government and industries, microbiological danger and communication of risk

Professional training of future specialists with the use of information technologies

Directory of Open Access Journals (Sweden)

Виктор Семенович Корнилов

2013-12-01

Full Text Available This paper deals with implementation of information technologies within different levels of professional training of the future specialists at A. Yassawi International Kazakh-Turkish University. Information technologies enable the future specialists to engage in online exchanges and it gives great good opportunity in learning the subject efficiently; thereby expanding their study and learning community during the classroom activity. The results obtained by the use of the information technologies show improvements in professional training of the future specialists in teaching foreign language. The use of information technology in teaching is increasing, which should lead to a significant improvement of the training quality of future specialists. Improvements also are observed in the experimental groups of higher levels, which indicates the efficiency of the use of information technologies in the professional training of future specialists.

Credit Risk Evaluation : Modeling - Analysis - Management

OpenAIRE

Wehrspohn, Uwe

2002-01-01

An analysis and further development of the building blocks of modern credit risk management: -Definitions of default -Estimation of default probabilities -Exposures -Recovery Rates -Pricing -Concepts of portfolio dependence -Time horizons for risk calculations -Quantification of portfolio risk -Estimation of risk measures -Portfolio analysis and portfolio improvement -Evaluation and comparison of credit risk models -Analytic portfolio loss distributions The thesis contributes to the evaluatio...

Interaction of a physician and a specialist on physical rehabilitation at violations of activity of the musculoskeletal system

Directory of Open Access Journals (Sweden)

Andrii Hertsyk

2016-08-01

Full Text Available Purpose: the improvement of cooperation and the interaction of an attending physician and a specialist on physical rehabilitation at violations of activity of musculoskeletal system. Material & Methods: physical rehabilitation is considered as a difficult system with the hierarchically-ordered structure. The analysis of references and the system analysis are applied. Results: the modern approaches to coordination of centers of decision-making and the management in hierarchical systems are analyzed. The ways of the interlevel coordination in organizational systems are revealed. The need of coordination of activity of an attending physician and a specialist on physical rehabilitation is proved. The content and the direction of coordination signals for the system of physical rehabilitation at violations of activity of the musculoskeletal system are determined. Conclusions: the coordination of activity of an attending physician and a specialist on physical rehabilitation at violations of activity of the musculoskeletal system has to occur in certain ways: on purposes, on restrictions, in time, on input and output parameters.

Redefining "Community" through Collaboration and Co-Teaching: A Case Study of an ESOL Specialist, a Literacy Specialist, and a Fifth-Grade Teacher

Science.gov (United States)

Ahmed Hersi, Afra; Horan, Deborah A.; Lewis, Mark A.

2016-01-01

This article explores the development of a professional learning community through a case study of three teachers--an ESOL specialist, a literacy specialist, and a fifth-grade teacher--who engaged in co-teaching and collaboration. The emerging community of practice offered these teachers a space to learn and problem-solve by utilizing their…

The School Librarian as Information Specialist: A Vibrant Species

Science.gov (United States)

Harris, Frances Jacobson

2011-01-01

In this article, the author talks about the school librarian as information specialist. She stresses that the school librarian's information specialist role is more important than ever. She offers her personal toolkit that consists of four strategies in helping and teaching students to use content responsibly.

The Role of Extension Specialists in Helping Entrepreneurs Develop Successful Food-Based Businesses.

Science.gov (United States)

Holcomb, Rodney; Muske, Glenn

2000-01-01

Three areas in which extension specialists can assist food industry entrepreneurs include (1) awareness of the components of a business plan, (2) pro forma financial analysis, and (3) legal issues affecting the food industry. In addition to specialized expertise, extension professionals can help with making contacts, objectively review business…

Risk Analysis in Road Tunnels – Most Important Risk Indicators

DEFF Research Database (Denmark)

Berchtold, Florian; Knaust, Christian; Thöns, Sebastian

2016-01-01

Methodologies on fire risk analysis in road tunnels consider numerous factors affecting risks (risk indicators) and express the results by risk measures. But only few comprehensive studies on effects of risk indicators on risk measures are available. For this reason, this study quantifies...... the effects and highlights the most important risk indicators with the aim to support further developments in risk analysis. Therefore, a system model of a road tunnel was developed to determine the risk measures. The system model can be divided into three parts: the fire part connected to the fire model Fire...... Dynamics Simulator (FDS); the evacuation part connected to the evacuation model FDS+Evac; and the frequency part connected to a model to calculate the frequency of fires. This study shows that the parts of the system model (and their most important risk indicators) affect the risk measures in the following...

Risk analysis in radiosurgery treatments using risk matrices

International Nuclear Information System (INIS)

Delgado, J. M.; Sanchez Cayela, C.; Ramirez, M. L.; Perez, A.

2011-01-01

The aim of this study is the risk analysis process stereotactic single-dose radiotherapy and evaluation of those initiating events that lead to increased risk and a possible solution in the design of barriers.

Chemical and behavioral integration of army ant-associated rove beetles - a comparison between specialists and generalists.

Science.gov (United States)

von Beeren, Christoph; Brückner, Adrian; Maruyama, Munetoshi; Burke, Griffin; Wieschollek, Jana; Kronauer, Daniel J C

2018-01-01

Host-symbiont interactions are embedded in ecological communities and range from unspecific to highly specific relationships. Army ants and their arthropod guests represent a fascinating example of species-rich host-symbiont associations where host specificity ranges across the entire generalist - specialist continuum. In the present study, we compared the behavioral and chemical integration mechanisms of two extremes of the generalist - specialist continuum: generalist ant-predators in the genus Tetradonia (Staphylinidae: Aleocharinae: Athetini), and specialist ant-mimics in the genera Ecitomorpha and Ecitophya (Staphylinidae: Aleocharinae: Ecitocharini). Similar to a previous study of Tetradonia beetles, we combined DNA barcoding with morphological studies to define species boundaries in ant-mimicking beetles. This approach found four ant-mimicking species at our study site at La Selva Biological Station in Costa Rica. Community sampling of Eciton army ant parasites revealed that ant-mimicking beetles were perfect host specialists, each beetle species being associated with a single Eciton species. These specialists were seamlessly integrated into the host colony, while generalists avoided physical contact to host ants in behavioral assays. Analysis of the ants' nestmate recognition cues, i.e. cuticular hydrocarbons (CHCs), showed close similarity in CHC composition and CHC concentration between specialists and Eciton burchellii foreli host ants. On the contrary, the chemical profiles of generalists matched host profiles less well, indicating that high accuracy in chemical host resemblance is only accomplished by socially integrated species. Considering the interplay between behavior, morphology, and cuticular chemistry, specialists but not generalists have cracked the ants' social code with respect to various sensory modalities. Our results support the long-standing idea that the evolution of host-specialization in parasites is a trade-off between the range of

An Overview Of Specialist Nurse Role In Patients With Stroke Caring And Their Care-Givers Support

Directory of Open Access Journals (Sweden)

Elham Navab

2017-02-01

Full Text Available Background: The practical difficulties for patients with stroke include lack of information about their condition, poor knowledge of the services and benefits available. Specialist Stroke nurses provide education and support services for people with Stroke  in many health care systems. A key goal is helping and empowering unable people to self-manage their stroke and supporting caregivers of these valnurable population, too. Objective: The objective of this review was to assess the role of specialist nurse in care for patients following a stroke and their caregivers support. Search methods: The databases CINAHL, PubMed, Science Direct and Synergy were searched from 1988 to 2017 using the keywords Stroke, Specialist Nurse, Care, Caregivers and support. Bibliographies of relevant papers were searched, and hand searching of relevant publications was undertaken to identify additional Studies. Selection criteria: All studies of the effects of a specialist nurse practitioner on short and long term stroke outcomes were included in the review. Data collection and analysis: Three investigators performed data extraction and quality scoring independently; any discrepancies were resolved by consensus. Findings:  Stroke, Specialist Nurse, Care, Caregivers concepts and labels are defined and measured in different and often contradictory ways by using 31 founded study. Conclusions: The findings indicate a dissonance in the views of different stakeholders within the care system. The division of labour associated with nursing care and specialist nurse requires further exploration. The contrasting paradigms of health care professionals and people with stroke regarding models of disability were highlighted.  Stroke, like other chronic illnesses, requires substantial nursing care. There is a growing number of specialist nurses in the workforce, however, little is known how their role interfaces with other nurses.

A specialist toxicity database (TRACE) is more effective than its larger, commercially available counterparts

NARCIS (Netherlands)

Anderson, C.A.; Copestake, P.T.; Robinson, L.

2000-01-01

The retrieval precision and recall of a specialist bibliographic toxicity database (TRACE) and a range of widely available bibliographic databases used to identify toxicity papers were compared. The analysis indicated that the larger size and resources of the major bibliographic databases did not,

Nuclear criticality safety specialist training and qualification programs

International Nuclear Information System (INIS)

Hopper, C.M.

1993-01-01

Since the beginning of the Nuclear Criticality Safety Division of the American Nuclear Society (ANS) in 1967, the nuclear criticality safety (NCS) community has sought to provide an exchange of information at a national level to facilitate the education and development of NCS specialists. In addition, individual criticality safety organizations within government contractor and licensed commercial nonreactor facilities have developed training and qualification programs for their NCS specialists. However, there has been substantial variability in the content and quality of these program requirements and personnel qualifications, at least as measured within the government contractor community. The purpose of this paper is to provide a brief, general history of staff training and to describe the current direction and focus of US DOE guidance for the content of training and qualification programs designed to develop NCS specialists

Becoming a Specialist Nurse in Psychiatric Mental Health Care

Science.gov (United States)

Södergren, Ulrika; Benjaminson, Carin; Mattsson, Janet

2017-01-01

Background: Specialist nurse students are upon graduation certified to have increased their professional competence to an advanced level. But how do specialist nurse students themselves experience and understand their professional competence and its development upon graduation? This is what this study aims at describing. Method: This study has a…

Doctors applying for Danish postgraduate medical specialist training are getting younger

DEFF Research Database (Denmark)

Kjaer, N. K.; Clausen, L. W.; Qvesel, D.

2012-01-01

was 58 months. 6% of the recruited doctors had a PhD. 61% of the doctors were graduates from the University of Southern Denmark. 14% graduated from the University of Copenhagen and 12% from Aarhus University. Finally, 13% graduated from a foreign university. CONCLUSION: Applicants accepted for specialist......INTRODUCTION: It was previously shown that applicants for postgraduate medical specialist training in Denmark were old. In order to prevent potential shortage of specialists, the Danish health authorities have passed legislation to speed up the output of new specialists. The aim of this study...... was to highlight the present characteristics of young doctors who entered specialist training. MATERIAL AND METHODS: Data include 443 doctors who were enrolled in a formalized postgraduate medical training programme in the Region of Southern Denmark from 2009 to 2011. RESULTS: 41% of the recruited young doctors...

The health abnormalities under the technogenic exposures risks analysis

Science.gov (United States)

Fedorova, E. V.; Malyshev, V. S.; Borovkova, A. M.

2017-11-01

A number of the medico-ecological orientation subjects are included in the curricula of the masters being trained in the teaching course 13.04.02 “Power industry and electrical equipment” and had elected the courses “Anthropogenic safety in power industry and electrical equipment” of the engineering ecology and labor safety department (EE and LS) of NRU “MPEI”. The anthropogenic safety specialist is to know all consequences suffers of such disciplines on account of the human person being influenced with the anthropogenic stress firstly. Energetic is to be obviously foreground in the environment pollution. Carbon, sulfurs, nitrogen oxides, heavy metals compounds, soot particles, benzapiren are arrived to the atmospheric air. The receipt of the harmful substances with an inhaled air leads to the respiratory organs pathology, organism adaptation properties tension and the population morbidity increase. The discipline “The Human physiology” developed on EE and LS chair and being taught of the first course of a magistracy first semester, helps to understand these above-mentioned processes. The general questions of human physiology being besides, all the students are gotten acquainted with ecological and production factors on a human body adverse impacts consequences and with the methods of its analysis, prevention and health risks studies. The most part of a course is presented with the practical trainings permitting the students to gain the basic skills of an organism functional condition main systems for analysis. The innovative “bronkhofonografiya” technique (with the CDC applications “Pattern-1” EE and LS chairs developed) is used for the respiratory organs conditions analysis along with the traditional spirometry methods.

The changing role of the subject specialist

Directory of Open Access Journals (Sweden)

Michael Cotta-Schønberg

2007-11-01

Full Text Available As we all know, libraries are these years rapidly undergoing change on unparalleled scale. Evidently, this applies to librarians, too, and not the least to that important category of library staff, the subject specialist. As recruiting and education of library workers differ from country to country it is difficult to give a detailed, generally valid description of the subject librarian in libraries, but I believe that you can describe an ideal model of subject librarianship as follows: Within each of the major subject disciplines covered by the library, the library should have a subject specialist preferably with a master degree or at least a bachelor degree in the particular subject discipline. The role of the subject specialist is to perform four basic functions where extensive subject knowledge is considered to be necessary: selecting and classifying books, assisting users with advanced subject inquiries, giving subject-specific courses in information retrieval, and maintaining liaison with relevant academic departments and centres. Personally, I know this system very well since I got employment in the Royal Library in Copenhagen as a subject specialist in psychology in the very month I finished my degree in psychology from the University of Copenhagen, back in 1973. The subject librarian system at the Royal Library in Copenhagen was patterned on the ideal model, as I just described it, and it was closely paralleled in the other academic libraries in Denmark, also the new university libraries which were founded in the seventies.

Polish Code of Ethics of a Medical Laboratory Specialist.

Science.gov (United States)

Elżbieta, Puacz; Waldemar, Glusiec; Barbara, Madej-Czerwonka

2014-09-01

Along with the development of medicine, increasingly significant role has been played by the laboratory diagnostics. For over ten years the profession of the medical laboratory specialist has been regarded in Poland as the autonomous medical profession and has enjoyed a status of one of public trust. The process of education of medical laboratory specialists consists of a five-year degree in laboratory medicine, offered at Medical Universities, and of a five-year Vocational Specialization in one of the fields of laboratory medicine such as clinical biochemistry, medical microbiology, medical laboratory toxicology, medical laboratory cytomorphology and medical laboratory transfusiology. An important component of medical laboratory specialists' identity is awareness of inherited ethos obtained from bygone generations of workers in this particular profession and the need to continue its further development. An expression of this awareness is among others Polish Code of Ethics of a Medical Laboratory Specialist (CEMLS) containing a set of values and a moral standpoint characteristic of this type of professional environment. Presenting the ethos of the medical laboratory specialist is a purpose of this article. Authors focus on the role CEMLS plays in areas of professional ethics and law. Next, they reconstruct the Polish model of ethos of medical diagnostic laboratory personnel. An overall picture consists of a presentation of the general moral principles concerning execution of this profession and rules of conduct in relations with the patient, own professional environment and the rest of the society. Polish model of ethical conduct, which is rooted in Hippocratic medical tradition, harmonizes with the ethos of medical laboratory specialists of other European countries and the world.

Certification of the instructional competence of nuclear training specialists

International Nuclear Information System (INIS)

Wollert, T.N.

1990-01-01

This study was designed to identify the qualification requirements and the means to assess the unique knowledge and skills necessary to perform the instructional activities needed by nuclear training specialist at Fort Saint Vrain Nuclear Generating Station. A survey questionnaire with 233 task statements categorized into eleven duty areas was distributed to twenty-three nuclear training specialists at Fort Saint Vrain Nuclear Generating Station. On the basis of the data accumulated for this study, the researcher identified the following findings. A list of 158 task statements were identified as being relevant; this list was considered a core knowledge, skills, and abilities needed as a nuclear training specialist. The list consisted of ten duty areas which were relevant to the effective performance of a nuclear training specialist. Thirty-three task statements were identified as being relevant for the duty area Conductive Training. These were considered the core of knowledge, skills, and abilities needed in the development of the initial test instrument and the instructor classroom skills observation checklist. The significant correlation between the results of these two instruments, using a rank-order correlation coefficient, was interpreted by the researcher as indicating that the initial test instrument possessed concurrent validity. The researcher interpreted the reliability value as a positive indicator that the initial test instrument demonstrated internal consistency. It was concluded that it could be determined whether personnel possessed the level of competence needed to perform the instructional duties of a nuclear training specialist by using a written test. Data from this research supported the use of the initial test developed for this study as a valid means to certify nuclear training specialists for the duty area Conducting Training

Risk analysis of Odelouca cofferdam

OpenAIRE

Pimenta, L.; Caldeira, L.; Maranha das Neves, E.

2009-01-01

In this paper we present the risk analysis of Odelouca Cofferdam, using an event tree analysis. The initializing events, failure modes and analysed limit states are discussed based on an influence diagram. The constructed event trees and their interpretation are presented. The obtained risk values are represented in an FN plot superimposed to the acceptability and tolerability risk limits proposed for Portuguese dams. Initially, particular emphasis is placed on the main characteristic...

Methodological basis for formation of uniterruptible education content for future specialists of atomic-nuclear complex

International Nuclear Information System (INIS)

Burtebayev, N.; Burtebayeva, J.T.; Basharuly, R.; Altynsarin, Y.

2009-01-01

Full text: For science-reliable determination of the content of uninterruptible education system, as a rule, the following levels of theoretical-methodological approach are used in complex: 1) science-wide methodological level based on the dialectical laws of knowledge theory; 2) science-wide methodological level based on the principles and the provisions of system analysis; 3) particular science methodological level based on the laws and the principles of any specific science [1]. Such holistic approach covering all levels of science methodology is required for determination of the content of uninterruptible education for future specialists of nuclear profile. Indeed, considering the problem related to the content of uninterruptible education from the point of the first science-wide methodological level we shall follow primary the requirements of dialectical 'Law of common, special and single unity', where firstly the universal values in science, culture and technology forming the united invariant of education content of the world education space is positioned as the 'common' component of uninterruptible education content; secondly, the theoretical-practical achievements gained in the countries of any region (for example Eurasian space) are positioned as the 'special' component of the content for the training of the specialists of nuclear profile; thirdly, the content elements determined in accordance with socio-economic order of the specific society introducing the national interests of the specific country (for example, Republic of Kazakhstan) are positioned as the 'single' component of the education content for the future specialists of atomic-nuclear complex. Inseparable unity of the above mentioned components of the education content which have been determined in accordance with the laws, principles and provisions of all three levels of science-methodological approach assures the high level competence and the functional mobility of nuclear profile specialist

Dynamics of a intraguild predation model with generalist or specialist predator.

Science.gov (United States)

Kang, Yun; Wedekin, Lauren

2013-11-01

Intraguild predation (IGP) is a combination of competition and predation which is the most basic system in food webs that contains three species where two species that are involved in a predator/prey relationship are also competing for a shared resource or prey. We formulate two intraguild predation (IGP: resource, IG prey and IG predator) models: one has generalist predator while the other one has specialist predator. Both models have Holling-Type I functional response between resource-IG prey and resource-IG predator; Holling-Type III functional response between IG prey and IG predator. We provide sufficient conditions of the persistence and extinction of all possible scenarios for these two models, which give us a complete picture on their global dynamics. In addition, we show that both IGP models can have multiple interior equilibria under certain parameters range. These analytical results indicate that IGP model with generalist predator has "top down" regulation by comparing to IGP model with specialist predator. Our analysis and numerical simulations suggest that: (1) Both IGP models can have multiple attractors with complicated dynamical patterns; (2) Only IGP model with specialist predator can have both boundary attractor and interior attractor, i.e., whether the system has the extinction of one species or the coexistence of three species depending on initial conditions; (3) IGP model with generalist predator is prone to have coexistence of three species.

Nurse specialists in adult congenital heart disease: The current status in Europe

NARCIS (Netherlands)

Moons, P.; Scholte op Reimer, W.; De Geest, S.; Fridlund, B.; Heikkila, J.; Jaarsma, Trijntje (Tiny); Martensson, J.; Smith, K; Stewart, S.; Stromberg, A; Thompson, D.R.

2006-01-01

Aim: Recommendations for the management of adults with congenital heart disease indicate that specialist referral centres should employ nurse specialists who are trained and educated in the care for these patients. We surveyed the involvement, education and activities of nurse specialists in the

Generalized indices for radiation risk analysis

International Nuclear Information System (INIS)

Bykov, A.A.; Demin, V.F.

1989-01-01

A new approach to ensuring nuclear safety has begun forming since the early eighties. The approach based on the probabilistic safety analysis, the principles of acceptable risk, the optimization of safety measures, etc. has forced a complex of adequate quantitative methods of assessment, safety analysis and risk management to be developed. The method of radiation risk assessment and analysis hold a prominent place in the complex. National and international research and regulatory organizations ICRP, IAEA, WHO, UNSCEAR, OECD/NEA have given much attention to the development of the conceptual and methodological basis of those methods. Some resolutions of the National Commission of Radiological Protection (NCRP) and the Problem Commission on Radiation Hygiene of the USSR Ministry of Health should be also noted. Both CBA (cost benefit analysis) and other methods of radiation risk analysis and safety management use a system of natural and socio-economic indices characterizing the radiation risk or damage. There exist a number of problems associated with the introduction, justification and use of these indices. For example, the price, a, of radiation damage, or collective dose unit, is a noteworthy index. The difficulties in its qualitative and quantitative determination are still an obstacle for a wide application of CBA to the radiation risk analysis and management. During recent 10-15 years these problems have been a subject of consideration for many authors. The present paper also considers the issues of the qualitative and quantitative justification of the indices of radiation risk analysis

22 CFR 62.26 - Specialists.

Science.gov (United States)

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Specialists. 62.26 Section 62.26 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES EXCHANGE VISITOR PROGRAM Specific Program... such areas, for example, as mass media communication, environmental science, youth leadership...

International Atomic Energy Agency specialist meeting on advances in structural analysis for LMFBR applications. Summary report

Energy Technology Data Exchange (ETDEWEB)

Perez, M A; Roche, R L [eds.

1983-05-01

After the first session on review of national positions in the subject field, the meeting was divided into five technical sections as follows: General methods of Structural Analysis for Elevated Temperatures; Inelastic Analysis Methods for Elevated Temperature; Effects of Cyclic loading; Design Codes and Criteria; Instability and Buckling - Piping Analysis in the Creep Range. The conclusions of the Meeting were summarised as follows. In view of the complexity of material behaviour and the variability of properties from cast to cast, continuing work is needed to develop simple constitutive relations which ensure an acceptable level of conservatism for design evaluations. It is recognized that simplified design methods require further development for the assessment of ratchetting and shakedown of high temperature structures. More development work is required in the areas of buckling elastic follow up weld factors and these developments should take account of the imperfections inherent in welded fabrications. There is a need for realistic tests on welded structural features to validate design methods. It is proposed that this subject would be the topic of a future specialists meeting. In several countries, organisations are now preparing Guides and Codes concerning Structural Assessment for LMFBR components. It seems that some of these Codes could be drafted within a few years. In order to make a more realistic assessment of LMFBR structures, defect assessment in elevated temperature range must be considered.

International Atomic Energy Agency specialist meeting on advances in structural analysis for LMFBR applications. Summary report

International Nuclear Information System (INIS)

Perez, M.A.; Roche, R.L.

1983-05-01

After the first session on review of national positions in the subject field, the meeting was divided into five technical sections as follows: General methods of Structural Analysis for Elevated Temperatures; Inelastic Analysis Methods for Elevated Temperature; Effects of Cyclic loading; Design Codes and Criteria; Instability and Buckling - Piping Analysis in the Creep Range. The conclusions of the Meeting were summarised as follows. In view of the complexity of material behaviour and the variability of properties from cast to cast, continuing work is needed to develop simple constitutive relations which ensure an acceptable level of conservatism for design evaluations. It is recognized that simplified design methods require further development for the assessment of ratchetting and shakedown of high temperature structures. More development work is required in the areas of buckling elastic follow up weld factors and these developments should take account of the imperfections inherent in welded fabrications. There is a need for realistic tests on welded structural features to validate design methods. It is proposed that this subject would be the topic of a future specialists meeting. In several countries, organisations are now preparing Guides and Codes concerning Structural Assessment for LMFBR components. It seems that some of these Codes could be drafted within a few years. In order to make a more realistic assessment of LMFBR structures, defect assessment in elevated temperature range must be considered

Reliability and validity of risk analysis

International Nuclear Information System (INIS)

Aven, Terje; Heide, Bjornar

2009-01-01

In this paper we investigate to what extent risk analysis meets the scientific quality requirements of reliability and validity. We distinguish between two types of approaches within risk analysis, relative frequency-based approaches and Bayesian approaches. The former category includes both traditional statistical inference methods and the so-called probability of frequency approach. Depending on the risk analysis approach, the aim of the analysis is different, the results are presented in different ways and consequently the meaning of the concepts reliability and validity are not the same.

Payload specialist Reinhard Furrer show evidence of previous blood sampling

Science.gov (United States)

1985-01-01

Payload specialist Reinhard Furrer shows evidence of previous blood sampling while Wubbo J. Ockels, Dutch payload specialist (only partially visible), extends his right arm after a sample has been taken. Both men show bruises on their arms.

Understanding Patients' Preferences for Referrals to Specialists for an Asymptomatic Condition.

Science.gov (United States)

Dunlea, Robert; Lenert, Leslie

2015-01-14

A specialty referral is a common but complex decision that often requires a primary care provider to balance his or her own interests with those of the patient. To examine the factors that influence a patient's choice of a specialist for consultation for an asymptomatic condition and better understand the tradeoffs that patients are and are not willing to make in this decision. Stratified cross-sectional convenience sample of subjects selected to parallel US population demographics. Members of an Internet survey panel who reported seeing a physician in the past year whose responses met objective quality metrics for attention. Respondents completed an adaptive conjoint analysis survey comparing specialists regarding eight attributes. The reliability of assessments and the predictive validity of models were measured using holdout samples. The relative importance (RI) of different attributes was computed using paired t tests. The implications of utility values were studied using market simulation methods. Five hundred and thirty subjects completed the survey and had responses that met quality criteria. The reliability of responses was high (86% agreement), and models were predictive of patients' preferences (82.6% agreement with holdout choices). The most important attribute for patients was out-of-pocket cost (RI of 19.5%, P communication" with the primary care provider was the most important attribute (RI of 13.1% P importance was whether the specialist practiced shared decision making (RI of 12.2% P well with their primary care provider and practiced shared decision making. Most patients prefer to wait for a doctor who practices shared decision making: Only one-third (32.3%) of patients preferred a paternalistic doctor who was available in 2 weeks over a doctor who practiced decision making but was available in 4 weeks. In the setting of a referral for an asymptomatic but serious condition, out-of-pocket costs are important to patients; however, they also value

Telemedicine in the acute health setting: A disruptive innovation for specialists (an example from stroke).

Science.gov (United States)

Bagot, Kathleen L; Cadilhac, Dominique A; Vu, Michelle; Moss, Karen; Bladin, Christopher F

2015-12-01

Telemedicine is a disruptive innovation within health care settings as consultations take place via audio-visual technology rather than traditional face-to-face. Specialist perceptions and experiences of providing audio-visual consultations in emergency situations, however, are not well understood. The aim of this exploratory study was to describe the experience of medical specialists providing acute stroke decision-making support via telemedicine. Data from the Victorian Stroke Telemedicine (VST) programme were used. The experiences of specialists providing an acute clinical telemedicine service to rural emergency departments were explored, drawing on disruptive innovation theory. Document analysis of programme consultation records, meeting minutes and in-depth individual interviews with three neurologists were analysed using triangulation. Since February 2014, 269 stroke telemedicine consultations with 12 neurologists have occurred. Retention on the roster has varied between 1 and >4 years. Overall, neurologists reported benefits of participation, as they were addressing health equity gaps for rural patients. Negative effects were the unpredictability of consultations impacting on their personal life, the mixed level of experience of colleagues initiating the consult and not knowing patient outcomes since follow-up communication was not routine. Insights into workforce experience and satisfaction were identified to inform strategies to support specialists to adapt to the disruptive innovation of telemedicine. © The Author(s) 2015.

The competences postulated as requirements for occupational medicine training in Europe as viewed by Polish specialists.

Science.gov (United States)

Boczkowski, A

2001-01-01

A questionnaire has been developed and disseminated in several European countries to determine common key competences required of occupational medicine specialists. The questionnaire contained 115 subjects relating to eight fields of activity of an occupational medicine physician (occupational hazards to health, assessment of disability and fitness for work, communications, research methods, management, environmental medicine, occupational health law and ethics, and health promotion). Items in each part were classified into three categories: knowledge, skills and experience. For each of the subjects respondents were asked to allocate a score from 0 (not necessary) to 5 (most important or essential). In Poland the questionnaire was distributed among two groups of specialists: (1) chief administrators of occupational health services, and (2) relatively young occupational medicine physicians attending a specialist training. A comprehensive analysis of the completed questionnaires had three dimensions: (a) substantive (classification of the importance of particular key competences, as perceived by Polish specialists in occupational medicine); (b) personal (differences in opinions among occupational medicine physicians and an attempt to explain these differences in sociological terms); and (c) comparative (evaluation and interpretation of similarities and differences between two groups).

Motivational Profiles and Motivation for Lifelong Learning of Medical Specialists.

Science.gov (United States)

van der Burgt, Stéphanie M E; Kusurkar, Rashmi A; Wilschut, Janneke A; Tjin A Tsoi, Sharon L N M; Croiset, Gerda; Peerdeman, Saskia M

2018-05-22

Medical specialists face the challenge of maintaining their knowledge and skills and continuing professional development, that is, lifelong learning. Motivation may play an integral role in many of the challenges facing the physician workforce today including maintenance of a high performance. The aim of this study was to determine whether medical specialists show different motivational profiles and if these profiles predict differences in motivation for lifelong learning. An online questionnaire was sent to every medical specialist working in five hospitals in the Netherlands. The questionnaire included the validated Multidimensional Work Motivation Scale and the Jefferson Scale of Physician Lifelong Learning together with background questions like age, gender, and type of hospital. Respondents were grouped into different motivational profiles by using a two-step clustering approach. Four motivational profiles were identified: (1) HAMC profile (for High Autonomous and Moderate Controlled motivation), (2) MAMC profile (for Moderate Autonomous and Moderate Controlled motivation), (3) MALC profile (for Moderate Autonomous and Low Controlled motivation), and (4) HALC profile (for High Autonomous and Low Controlled motivation). Most of the female specialists that work in an academic hospital and specialists with a surgical specialty were represented in the HALC profile. Four motivational profiles were found among medical specialists, differing in gender, experience and type of specialization. The profiles are based on the combination of autonomous motivation (AM) and controlled motivation (CM) in the specialists. The profiles that have a high score on autonomous motivation have a positive association with lifelong learning.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work

Safety analysis, risk assessment, and risk acceptance criteria

International Nuclear Information System (INIS)

Jamali, K.

1997-01-01

This paper discusses a number of topics that relate safety analysis as documented in the Department of Energy (DOE) safety analysis reports (SARs), probabilistic risk assessments (PRA) as characterized primarily in the context of the techniques that have assumed some level of formality in commercial nuclear power plant applications, and risk acceptance criteria as an outgrowth of PRA applications. DOE SARs of interest are those that are prepared for DOE facilities under DOE Order 5480.23 and the implementing guidance in DOE STD-3009-94. It must be noted that the primary area of application for DOE STD-3009 is existing DOE facilities and that certain modifications of the STD-3009 approach are necessary in SARs for new facilities. Moreover, it is the hazard analysis (HA) and accident analysis (AA) portions of these SARs that are relevant to the present discussions. Although PRAs can be qualitative in nature, PRA as used in this paper refers more generally to all quantitative risk assessments and their underlying methods. HA as used in this paper refers more generally to all qualitative risk assessments and their underlying methods that have been in use in hazardous facilities other than nuclear power plants. This discussion includes both quantitative and qualitative risk assessment methods. PRA has been used, improved, developed, and refined since the Reactor Safety Study (WASH-1400) was published in 1975 by the Nuclear Regulatory Commission (NRC). Much debate has ensued since WASH-1400 on exactly what the role of PRA should be in plant design, reactor licensing, 'ensuring' plant and process safety, and a large number of other decisions that must be made for potentially hazardous activities. Of particular interest in this area is whether the risks quantified using PRA should be compared with numerical risk acceptance criteria (RACs) to determine whether a facility is 'safe.' Use of RACs requires quantitative estimates of consequence frequency and magnitude

A background to risk analysis. Vol. 2

International Nuclear Information System (INIS)

Taylor, J.R.

1979-01-01

This 4-volumes report gives a background of ideas, principles and examples which might be of use in developing practical methods for risk analysis. Some of the risk analysis techniques described are somewhat experimental. The report is written in an introductory style, but where some point needs further justification or evaluation, this is given in the form of a chapter appendix. In this way, it is hoped that the report can serve two purposes, - as a basis for starting risk analysis work and as a basis for discussing effectiveness of risk analysis procedures. The report should be seen as a preliminary stage, prior to a program of industrial trials of risk analysis methods. Vol. 2 treats generic methods of qualitative failure analysis. (BP)

Addressing cultural diversity: the hepatitis B clinical specialist perspective.

Science.gov (United States)

Wallace, Jack; Smith, Elizabeth; Hajarizadeh, Behzad; Richmond, Jacqueline; Lucke, Jayne

2017-08-31

Hepatitis B is a viral infection primarily affecting people from culturally diverse communities in Australia. While vaccination prevents infection, there is increasing mortality resulting from liver damage associated with chronic infection. Deficits in the national policy and clinical response to hepatitis B result in a low diagnosis rate, inadequate testing and diagnosis processes, and poor access to hepatitis B treatment services. While research identifies inadequate hepatitis B knowledge among people with the virus and primary health care workers, this project sought to identify how specialist clinicians in Australia negotiate cultural diversity, and provide often complex clinical information to people with hepatitis B. A vignette was developed and presented to thirteen viral hepatitis specialist clinicians prior to an electronically recorded interview. Recruitment continued until saturation of themes was reached. Data were thematically coded into themes outlined in the interview schedule. Ethical approval for the research was provided by the La Trobe University Human Research Ethics Committee. Key messages provided to patients with hepatitis B by clinical specialists were identified. These messages were not consistently provided to all patients with hepatitis B, but were determined on perceptions of patient knowledge, age and highest educational level. While the vignette stated that English was not an issue for the patient, most specialists identified the need for an interpreter. Combating stigma related to hepatitis B was seen as important by the specialists and this was done through normalising the virus. Having an awareness of different cultural understandings about hepatitis B specifically, and health and well-being generally, was noted as a communication strategy. Key core competencies need to be developed to deliver educational messages to people with hepatitis B within clinical encounters. The provision of adequate resources to specialist clinics will

Study on the high level radioactive wastes geological isolation seen from the social acceptance of science and technology. (1) The explanation based on the principle of risk and benefit for another field specialist

International Nuclear Information System (INIS)

Wada, Ryutaro; Tanaka, Satoru; Nagasaki, Shinya

2009-01-01

Generally speaking, a vast, advanced and unfamiliar science and technology is unacceptable by public for the fear of its unknown nature. The siting problem for the disposal of high level radioactive wastes is one of the typical examples. This study examined the desirable research scheme for geological disposal of the high level radioactive wastes seen from social acceptance of science and technology in the deductive approach by the technical essence described in the first report. As the safety is the most prioritized concern in the research of radioactive waste disposal, the correlation between safety and cost has not been argued. Therefore, the argument has only turned in seeking for limitless safety without paying attention to an economic principle. In this report, as the examination evolving from a social acceptability, the author tries to explain the safety together with cost information in accordance with the principle of the risk benefit. As a result, it turned out that the relation between the existing Japanese default proposal (H12 report) and overseas examples can be figured out to explain their relative position by the safety and cost correlation diagram made in accordance with the risk benefit principle. The nuclear field specialist can discuss a relative location of the Japanese disposal concept by this correlation diagram with another field specialist. (author)

A qualitative study of barriers to the implementation of a rheumatoid arthritis guideline among generalist and specialist physical therapists.

Science.gov (United States)

van Bodegom-Vos, Leti; Verhoef, John; Dickmann, Margot; Kleijn, Marjon; van Vliet, Ingrid; Hurkmans, Emalie; van der Wees, Philip; Vliet Vlieland, Thea

2012-10-01

Although the increasing complexity and expansion of the body of knowledge in physical therapy have led to specialized practice areas to provide better patient care, the impact of specialization on guideline implementation has been scarcely studied. Objectives The objective of this study was to identify the similarities and differences in barriers to the implementation of a Dutch rheumatoid arthritis (RA) guideline by generalist and specialist physical therapists. Design This observational study consisted of 4 focus group interviews in which 24 physical therapists (13 generalist and 11 specialist physical therapists) participated. Physical therapists were asked to discuss barriers to the implementation of the RA guideline. Data were analyzed qualitatively using a directed approach to content analysis. Both the interviews and the interview analysis were informed by a previously developed conceptual framework. Besides a number of similarities (eg, lack of time), the present study showed important, although subtle, differences in barriers to the implementation of the RA guideline between generalist physical therapists and specialist physical therapists. Generalist physical therapists more frequently reported difficulties in interpreting the guideline (cognitive barriers) and had less favorable opinions about the guideline (affective barriers) than specialist physical therapists. Specialist physical therapists were hampered by external barriers that are outside the scope of generalist physical therapists, such as a lack of agreement about the roles and responsibilities of medical professionals involved in the care of the same patient. The identified differences in barriers to the implementation of the RA guideline indicated that the effectiveness of implementation strategies could be improved by tailoring them to the level of specialization of physical therapists. However, it is expected that tailoring implementation strategies to barriers that hamper both generalist

Information Security Risk Analysis

CERN Document Server

Peltier, Thomas R

2010-01-01

Offers readers with the knowledge and the skill-set needed to achieve a highly effective risk analysis assessment. This title demonstrates how to identify threats and then determine if those threats pose a real risk. It is suitable for industry and academia professionals.

[Development of HIV infection risk assessment tool for men who have sex with men based on Delphi method].

Science.gov (United States)

Li, L L; Jiang, Z; Song, W L; Ding, Y Y; Xu, J; He, N

2017-10-10

Objective: To develop a HIV infection risk assessment tool for men who have sex with men (MSM) based on Delphi method. Methods: After an exhaustive literature review, we used Delphi method to determine the specific items and relative risk scores of the assessment tool through two rounds of specialist consultation and overall consideration of the opinions and suggestions of 17 specialists. Results: The positivity coefficient through first and second round specialist consultation was 100.0 % and 94.1 % , respectively. The mean of authority coefficients ( Cr ) was 0.86. Kendall's W coefficient of the specialist consultation was 0.55 for the first round consultation (χ(2)=84.426, P risk assessment tool for MSM has 8 items. Conclusions: The HIV infection risk assessment tool for MSM, developed under the Delphi method, can be used in the evaluation of HIV infection risk in MSM and individualized prevention and intervention. However, the reliability and validity of this risk assessment tool need to be further evaluated.

Wildlife Private Lands Specialist Support Areas

Data.gov (United States)

Minnesota Department of Natural Resources — This layer represents the areas of Minnesota that MNDNR Wildlife Private Lands Specialists cover. These boundaries are provided for support mapping and to show...

Meanings and experiential outcomes of bodily care in a specialist palliative context.

Science.gov (United States)

Håkanson, Cecilia; Öhlén, Joakim

2015-06-01

The objective of this study was to enhance the depth of existing knowledge about meanings and experiential outcomes of bodily care in the context of an inpatient specialist palliative setting. Interpretative phenomenology was chosen as the study sought to explore individuals' lived experiences related to bodily care. Nine participants (five women, four men) of various ages and with various metastasized cancers and bodily-care needs, all from one specialist palliative care ward, participated. Data were collected with repeated narrative interviews and supplementary participating observations. Analysis was informed by van Manen's approach. The following meanings and experiential outcomes of bodily care were revealed by our study: maintaining and losing body capability, breaching borders of bodily integrity, being comforted and relieved in bodily-care situations, and being left in distress with unmet needs. These meanings overlap and shape the nature of each other and involve comforting and distressing experiences related to what can be described as conditional dimensions: the particular situation, one's own experiences of the body, and healthcare professionals' approaches. The results, based on specialist palliative care patients' experiences, outline the meanings and outcomes that relate to the quintessence and complexity of palliative care, deriving from dying persons' blend of both basic and symptom-oriented bodily-care needs. Moreover, the results outline how these two dimensions of care equally influence whether comfort and well-being are facilitated or not. Considering this, specialist palliative care may consider how to best integrate and acknowledge the value of skilled basic nursing care as part of and complementary to expertise in symptom relief during the trajectories of illness and dying.

Subject Specialist Mentors in the Lifelong Learning Sector: The Subject Specialist Mentor Model; is it working? A case study approach

Directory of Open Access Journals (Sweden)

Bailey, Wayne

2011-01-01

Full Text Available This short article explores whether using a mentoring model supports our Subject Specialist Mentors (SSMs with their role of mentoring trainees on Initial Teacher Training (ITT courses. Although there are many mentoring models to choose from, our model is based around mentoring within the Lifelong Learning Sector (LLS where trainees need support for their subject specialism as well as their generic teaching skills. The main focus is the use of coaching and mentoring skills taking into consideration guiding, supporting and challenging the trainee during the lifetime of the mentor/trainee relationship. The SSMs found that using our model as a tool helped to structure meetings and to ensure that the trainee had the necessary support to enable them to become proficient, competent subject specialist teachers. In conclusion, it was found that there is a need for the use of a model or a framework to help the Subject Specialist Mentor (SSM with such an important role.

Bias in risk-benefit analysis

International Nuclear Information System (INIS)

Mazur, A.

1985-01-01

Risk-benefit analysis has become popular in the past decade as a means of improving decision making, especially in the area of technology policy. Here risk-benefit analysis is compared to other (equally defensible) approaches to decision making, showing how it favors some political interests more than others, and suggesting why it has recently come to the fore as a tool of political analysis. A considerable portion of the discussion concerns nuclear power. 6 references

STS-9 payload specialists and backup in training session

Science.gov (United States)

1983-01-01

Two Spacelab 1 payload specialists and a backup for that flight prepare for a training session in the JSC mockup and integration laboratory. Fully decked out in the Shuttle constant wear garments (foreground) are Ulf Merbold, left, and Byron K. Licktenberg, prime crewmembers on the STS-9 team. In civilian clothes is payload specialist backup Michael L. Lampton.

Assessing the impact of heart failure specialist services on patient populations

Directory of Open Access Journals (Sweden)

Lyratzopoulos Georgios

2004-05-01

Full Text Available Abstract Background The assessment of the impact of healthcare interventions may help commissioners of healthcare services to make optimal decisions. This can be particularly the case if the impact assessment relates to specific patient populations and uses timely local data. We examined the potential impact on readmissions and mortality of specialist heart failure services capable of delivering treatments such as b-blockers and Nurse-Led Educational Intervention (N-LEI. Methods Statistical modelling of prevented or postponed events among previously hospitalised patients, using estimates of: treatment uptake and contraindications (based on local audit data; treatment effectiveness and intolerance (based on literature; and annual number of hospitalization per patient and annual risk of death (based on routine data. Results Optimal treatment uptake among eligible but untreated patients would over one year prevent or postpone 11% of all expected readmissions and 18% of all expected deaths for spironolactone, 13% of all expected readmisisons and 22% of all expected deaths for b-blockers (carvedilol and 20% of all expected readmissions and an uncertain number of deaths for N-LEI. Optimal combined treatment uptake for all three interventions during one year among all eligible but untreated patients would prevent or postpone 37% of all expected readmissions and a minimum of 36% of all expected deaths. Conclusion In a population of previously hospitalised patients with low previous uptake of b-blockers and no uptake of N-LEI, optimal combined uptake of interventions through specialist heart failure services can potentially help prevent or postpone approximately four times as many readmissions and a minimum of twice as many deaths compared with simply optimising uptake of spironolactone (not necessarily requiring specialist services. Examination of the impact of different heart failure interventions can inform rational planning of relevant healthcare

Assessing the impact of heart failure specialist services on patient populations.

Science.gov (United States)

Lyratzopoulos, Georgios; Cook, Gary A; McElduff, Patrick; Havely, Daniel; Edwards, Richard; Heller, Richard F

2004-05-24

The assessment of the impact of healthcare interventions may help commissioners of healthcare services to make optimal decisions. This can be particularly the case if the impact assessment relates to specific patient populations and uses timely local data. We examined the potential impact on readmissions and mortality of specialist heart failure services capable of delivering treatments such as b-blockers and Nurse-Led Educational Intervention (N-LEI). Statistical modelling of prevented or postponed events among previously hospitalised patients, using estimates of: treatment uptake and contraindications (based on local audit data); treatment effectiveness and intolerance (based on literature); and annual number of hospitalization per patient and annual risk of death (based on routine data). Optimal treatment uptake among eligible but untreated patients would over one year prevent or postpone 11% of all expected readmissions and 18% of all expected deaths for spironolactone, 13% of all expected readmisisons and 22% of all expected deaths for b-blockers (carvedilol) and 20% of all expected readmissions and an uncertain number of deaths for N-LEI. Optimal combined treatment uptake for all three interventions during one year among all eligible but untreated patients would prevent or postpone 37% of all expected readmissions and a minimum of 36% of all expected deaths. In a population of previously hospitalised patients with low previous uptake of b-blockers and no uptake of N-LEI, optimal combined uptake of interventions through specialist heart failure services can potentially help prevent or postpone approximately four times as many readmissions and a minimum of twice as many deaths compared with simply optimising uptake of spironolactone (not necessarily requiring specialist services). Examination of the impact of different heart failure interventions can inform rational planning of relevant healthcare services.

IMPROVEMENT OF INNOVATIVE TRAINING OF ROAD SPECIALISTS

Directory of Open Access Journals (Sweden)

I. I. Leonovich

2007-01-01

Full Text Available Complicated conditions, under which road enterprises of the Republic are forced to operate, put forward and reveal the necessity to innovative way of development. In order to fulfill this task it is necessary to have specialists who are capable and ready to realize this endeavour. The most acceptable variant is to train specialists who will be able to introduce innovations and who are presently involved in the production process. Such training should be carried out within the framework of post-graduate education. Authors have provide a number of reasons in favour of quick development of such education. 

The FORMATION of PERSONal and PROFESSIONAL competencies of STUDENTS – specialists-to-be IN PUBLIC AND MUNICIPAL ADMINISTRATION SPHERE

OpenAIRE

Bushueva Irina Petrovna

2013-01-01

The article considers the necessity and possibility of formation of personal and professional competencies of specialists in the sphere of Public and Municipal Administration (PMA) at the pre-service professional stage of development. Purpose: to justify the necessity and possibility of personal and professional skills formation of specialists-to-be in PMA sphere, as well as to determine the conditions of such activity. Methods and methodology of the research: analysis of educational standard...

Knowledge of the law about withholding or withdrawing life-sustaining treatment by intensivists and other specialists.

Science.gov (United States)

White, Ben; Willmott, Lindy; Cartwright, Colleen; Parker, Malcolm H; Williams, Gail

2016-06-01

Decisions about withholding or withdrawing life-sustaining treatment (WWLST) from adults who lack capacity are an integral part of intensive care (IC) practice. We compare the knowledge, attitudes and practice of intensivists in relation to the law about WWLST with six other specialties most often involved in end-of-life care. We used a cross-sectional postal survey of medical specialists in the three most populous Australian states, and analysed responses from 867 medical specialists from the seven specialties most likely to be involved in WWLST decisions in the acute-care setting (emergency, geriatric, palliative, renal and respiratory medicine, medical oncology and IC). Attitudes to, and knowledge and practice of, the law relating to end-of-life care. Of 2702 surveys sent to eligible practitioners, 867 completed questionnaires were returned. There was an overall response rate of 32% and an IC response rate also of 32% (125/388). Intensivists performed better than average in legal knowledge but important knowledge gaps remain. Intensivists had a more negative attitude to the role of law in this area than other specialty groups but reported being seen as a leading source of information about legal issues by other medical specialists and nurses. Intensivists also reported being the specialists most frequently making decisions about end-of-life treatment. Improved legal knowledge and open engagement with the law can help manage the risk of harm to patients and protect intensivists from liability. IC guidelines and continuing professional development are important strategies to address these issues.

Factors associated with differences in quit rates between "specialist" and "community" stop-smoking practitioners in the english stop-smoking services.

Science.gov (United States)

McDermott, Máirtín S; Beard, Emma; Brose, Leonie S; West, Robert; McEwen, Andy

2013-07-01

Behavioral support improves smokers' chances of quitting, but quit rates are typically lower for smokers supported by "community practitioners" for whom smoking cessation is a small part of their job than for those supported by "specialist practitioners" for whom it is the main role. This article examined the factors that might contribute to this. A total of 573 specialist practitioners and 466 community practitioners completed a 42-item online survey that covered demographic and employment information, current practices, levels of training, and 4-week CO-verified quit rates. Responses were compared for community and specialist practitioners. Mediation analysis was undertaken to assess how far "structural" and "modifiable" variables account for the difference in quit rates. Specialist practitioners reported higher 4-week CO-verified quit rates than community practitioners (63.6% versus 50.4%, p Specialist" practitioners in the English stop-smoking services report higher success rates than "community" practitioners and this is at least in part attributable to more extensive training and supervision and greater adherence to evidence-based practice including advising on medication usage and promoting abrupt rather than gradual quitting.

Comorbidities and medications of patients with chronic hepatitis C under specialist care in the UK

Science.gov (United States)

Hudson, Benjamin; Walker, Alex J.

2017-01-01

Designing services with the capacity and expertise to meet the needs of the chronic hepatitis C (CHC) population in the era of direct acting antivirals (DAAs), and widening access to such treatments, requires detailed understanding of the characteristics and healthcare needs of the existing patient population. In this retrospective analysis of data from the National HCV Research UK Biobank between March 2012 and October 2014, the characteristics of the CHC population currently under specialist care in the UK were evaluated—with specific focus upon use of medications, adverse lifestyle choices, and comorbidities. Demographic data, risk factors for CHC acquisition, HCV genotype, liver disease status, lifestyle factors, comorbidities, and medication classes were collected. Data were analyzed by history of injecting drug use (IDU), age, and severity of liver disease. A total of 6278 patients (70.5% white; median age, 52 years) from 59 UK specialist centres were included; 59.1% of patients had acquired HCV through IDU. The prevalence of adverse lifestyle factors was significantly lower in non‐IDU compared with previous IDU or recent IDU patients. Depression was common in the previous (50.8%) and recent IDU (68.1%) groups, compared with 27.6% in non‐IDU patients. Cirrhosis was common (23.6%), and prevalence increased with age. We describe a heterogeneous, polymorbid, and aging population of CHC patients in secondary care, and demonstrate underrepresentation of injecting drug users within the current system. The implications of this present significant challenges to physicians and healthcare commissioners in designing services which are fit for purpose inthe DAA era. PMID:28480974

Collaboration with general practitioners: preferences of medical specialists – a qualitative study

Directory of Open Access Journals (Sweden)

Slaets Joris PJ

2006-12-01

Full Text Available Abstract Background Collaboration between general practitioners (GPs and specialists has been the focus of many collaborative care projects during the past decade. Unfortunately, quite a number of these projects failed. This raises the question of what motivates medical specialists to initiate and continue participating with GPs in new collaborative care models. The following question is addressed in this study: What motivates medical specialists to initiate and sustain new models for collaborating with GPs? Methods We conducted semi-structured interviews with eighteen medical specialists in the province of Groningen, in the North of The Netherlands. The sampling criteria were age, gender, type of hospital in which they were practicing, and specialty. The interviews were recorded, fully transcribed, and analysed by three researchers working independently. The resulting motivational factors were grouped into categories. Results 'Teaching GPs' and 'regulating patient flow' (referrals appeared to dominate when the motivational factors were considered. In addition, specialists want to develop relationships with the GPs on a more personal level. Most specialists believe that there is not much they can learn from GPs. 'Lack of time', 'no financial compensation', and 'no support from colleagues' were considered to be the main concerns to establishing collaborative care practices. Additionally, projects were often experienced as too complex and time consuming whereas guidelines were experienced as too restrictive. Conclusion Specialists are particularly interested in collaborating because the GP is the gatekeeper for access to secondary health care resources. Specialists feel that they are able to teach the GPs something, but they do not feel that they have anything to learn from the GPs. With respect to professional expertise, therefore, specialists do not consider GPs as equals. Once personal relationships with the GPs have been established, an

The Perception of Teachers and School Library Media Specialist on ...

African Journals Online (AJOL)

The Perception of Teachers and School Library Media Specialist on the Role of School Library Media Specialists in Selected Secondary Schools in Ogun State. ... Journal Home > Vol 9, No 1 (2012) >. Log in or Register to get access to full text ...

Pharmacovigilance training for specialist oncology nurses-a two way evaluation

NARCIS (Netherlands)

Schutte, T.; Van Eekeren, R.; Richir, M.; Van Staveren, J.; Van Puijenbroek, E.P.; Tichelaar, J.; Van Agtmael, M.A.

2017-01-01

Background: In a new prescribing qualifcation course for specialist oncology nurses, we thought it important to emphasize pharma-covigilance and adverse drug reaction (ADR)-reporting. To this end, our aim was to develop and evaluate an ADR reporting assignment for specialist oncology nurses.

Professional development of specialists of preschool educational establishments to educationally-health activity on the basis of pedagogical management.

Directory of Open Access Journals (Sweden)

Makovetskaya N.V.

2011-01-01

Full Text Available Priority directions modernization of activity of preschool educational establishments are shown. The analysis of publications, devoted creation of terms for educationally-health activity, and also professional development of specialists on its organization is resulted. In this connection light up possibilities of the use of pedagogical management. The value of management of the first and second levels is certain in professional development of specialists of preschool educational establishments. The types of organizational structures of management preschool educational establishment are appraised.

A background to risk analysis. Vol. 4

International Nuclear Information System (INIS)

Taylor, J.R.

1979-01-01

This 4-volumes report gives a background of ideas, principles, and examples which might be of use in developing practical methods for risk analysis. Some of the risk analysis techniques described are somewhat experimental. The report is written in an introductory style, but where some point needs further justification or evaluation, this is given in the form of a chapter appendix. In this way, it is hoped that the report can serve two purposes, - as a basis for starting risk analysis work and as a basis for discussing effectiveness of risk analysis procedures. The report should be seen as a preliminary stage, prior to a program of industrial trials of risk analysis methods. Vol. 4 treats human error in plant operation. (BP)

The work setting of diabetes nursing specialists in the Netherlands: a questionnaire survey.

Science.gov (United States)

van den Berg, Tilja I J; Vrijhoef, Hubertus J M; Tummers, Gladys; Landeweerd, Jan A; van Merode, Godefridus G

2008-10-01

The aim of this study is to explore whether the work organisation of diabetes specialist nurses (DSNs) differs significantly from nurses working in hospital and nursing home and if so, does this difference result in positive or negative consequences regarding work and health. In traditional health care settings, nurses exhibit a high level of environmental uncertainty and low decision-making authority, which has a negative effect on psychological reactions towards work. In professional nursing, specialisation, e.g. diabetic nursing, is a current trend in many countries. Therefore, insight into the determinants of the work situation of nursing specialists is becoming increasingly relevant. Comparisons were made between 3 different samples: 1204 nurses employed by 15 hospitals, 1058 nurses employed by 14 nursing homes, and 350 diabetes nurses working in other health care settings throughout the Netherlands. Data concerning organisation, work aspects, and psychological reactions were measured via questionnaires. Variances between the groups were analysed with ANCOVA, besides hierarchical multiple regression analysis was applied. Environmental uncertainty scored lower amongst diabetes nurses when compared to nurses working in the other two types of health care settings. Social support and role conflict scored low for diabetes nursing specialists who simultaneously perceived autonomy and role ambiguity highest. Diabetes nursing specialists also scored highest on intrinsic work motivation and job satisfaction and lowest for psychosomatic health. Except for social support and role ambiguity, diabetic nurses rate their [work] organisation, [work] aspects and psychological [work] reactions more positively than nurses employed in other health care settings.

The professional practice and imaging specialist from the deontological perspective in Costa Rica

International Nuclear Information System (INIS)

Alfaro Vega, Albert; Alvarado Garcia, Danny; Amen Montero, Omar; Gonzalez Rodriguez, Jonnathan; Jimenez Alpizar, Ana Carolina; Solano Arguello, Mariana

2008-01-01

A vision of how to address the challenges facing, daily, the professional person imaging specialist has been raised with the use of new and emerging technologies. Issues to consider conflicts, ethical and moral dilemmas that may affect the way patient care, besides his family; and also, working relationship with colleagues and the institution in which he serves. This professional requires of development and training that will enable him to assess with sufficient objectivity, ethical-moral and conflicting situations to take decisions more convenient, from a critical and reflective practice. A rule of professional practice in diagnostic and therapy imaging has been missing in Costa Rica. Consequently, the need for a study, both theoretical and practical, which take into account ethical and moral guidelines, professional and regulatory was presented, with the objective to establish a possible course to comprehensive consolidation of the professional. The imaging specialist has a great responsibility in his practice, with society and with the patient attending the services in which he works. Different data collection techniques were used, to develop a proposal for guidelines for a possible rules of conduct for the professional person imaging specialist in Costa Rica; in this, have addressed the appropriate deontological topics for future implementation taking into account the professional profile, the academic level, professional practice and the requirements of society. This research has made evident the need and importance of establishing such guidelines as main result. A proposed improvement to the practice of professional person imaging specialist in diagnosis and therapy in Costa Rica is exposed from the qualitative data analysis. (author) [es

Climatic risks

International Nuclear Information System (INIS)

Lamarre, D.; Favier, R.; Bourg, D.; Marchand, J.P.

2005-04-01

The climatic risks are analyzed in this book under the cross-vision of specialists of different domains: philosophy, sociology, economic history, law, geography, climatology and hydrology. The prevention of risks and the precautionary principle are presented first. Then, the relations between climatic risk and geography are analyzed using the notion of territoriality. The territory aspect is in the core of the present day debates about the geography of risks, in particular when the links between climate change and public health are considered. Then the main climatic risks are presented. Droughts and floods are the most damaging ones and the difficulties of prevention-indemnification coupling remain important. (J.S.)

Specialist clinics in remote Australian Aboriginal communities: where rock art meets rocket science.

Science.gov (United States)

Gruen, Russell; Bailie, Ross

2004-10-01

People in remote Aboriginal communities in the Northern Territory have greater morbidity and mortality than other Australians, but face considerable barriers when accessing hospital-based specialist services. The Specialist Outreach Service, which began in 1997, was a novel policy initiative to improve access by providing a regular multidisciplinary visiting specialist services to remote communities. It led to two interesting juxtapositions: that of 'state of the art' specialist services alongside under-resourced primary care in remote and relatively traditional Aboriginal communities; and that of attempts to develop an evidence base for the effectiveness of outreach, while meeting the short-term evaluative requirements of policy-makers. In this essay, first we describe the development of the service in the Northern Territory and its initial process evaluation. Through a Cochrane systematic review we then summarise the published research on the effectiveness of specialist outreach in improving access to tertiary and hospital-based care. Finally we describe the findings of an observational population-based study of the use of specialist services and the impact of outreach to three remote communities over 11 years. Specialist outreach improves access to specialist care and may lessen the demand for both outpatient and inpatient hospital care. Specialist outreach is, however, dependent on well-functioning primary care. According to the way in which outreach is conducted and the service is organised, it can either support primary care or it can hinder primary care and, as a result, reduce its own effectiveness.

Pest Management Specialist (AFSC 56650).

Science.gov (United States)

Air Univ., Gunter AFS, Ala. Extension Course Inst.

This eight-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for pest management specialists. Covered in the individual volumes are civil engineering; pest management (entomology, pest management planning and coordination, and safety and protective equipment); pest management chemicals and…

Families' perceptions of the contribution of intellectual disability clinical nurse specialists in Ireland.

Science.gov (United States)

Doody, Owen; Slevin, Eamonn; Taggart, Laurence

2018-01-01

To explore families' perceptions of the contribution of clinical nurse specialists in intellectual disability nursing in Ireland. Clinical nurse specialists roles have developed over the years and are seen as complex and multifaceted, causing confusion, frustration and controversy. 2001 saw the formal introduction of clinical nurse specialists roles in Ireland across nursing including intellectual disability. A exploratory qualitative approach using semistructured one-to-one interviews with 10 family members regarding their perceptions of the clinical nurse specialists in intellectual disability. Data were audio-recorded, transcribed and analysed using Burnard's framework. Ethical approval was gained and access granted by service providers. The study highlights that intellectual disability clinical nurse specialists contribute and support care deliver across a range of areas, including personal caring, supporting and empowering families, liaison, education and leadership. Clinical nurse specialists have an important role and contribution in supporting families and clients, and Ireland is in a unique position to develop knowledge regarding specialist care for people with intellectual disability that can be shared nationally and internationally. Ireland is in a unique position to develop knowledge regarding specialist care for people with intellectual disability that can be shared and adapted by other healthcare professionals in other countries that do not have a specialised intellectual disability nurses. © 2017 John Wiley & Sons Ltd.

22 CFR 11.20 - Foreign Service specialist career candidate appointments.

Science.gov (United States)

2010-04-01

..., background investigation, and final review process required of career candidates, but normally they will not... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Foreign Service specialist career candidate... SERVICE OFFICERS § 11.20 Foreign Service specialist career candidate appointments. (a) General...

What's 'difficult'? A multi-stage qualitative analysis of secondary care specialists' experiences with medically unexplained symptoms.

Science.gov (United States)

Maatz, Anke; Wainwright, Megan; Russell, Andrew J; Macnaughton, Jane; Yiannakou, Yan

2016-11-01

The term 'difficult' is pervasively used in relation to medically unexplained symptoms (MUS) and patients with MUS. This article scrutinises the use of the term by analysing interview data from a study of secondary care specialists' experiences with and attitudes towards patients suffering from MUS. Qualitative design employing semi-structured open-ended interviews systematically analysed in three stages: first, data were analysed according to the principles of content analysis. The analysis subsequently focused on the use of the term 'difficult'. Iterations of the term were extracted by summative analysis and thematic coding revealed its different meanings. Finally, alternative expressions were explored. Three NHS trust secondary care hospitals in North-East England. 17 senior clinicians from seven medical and two surgical specialities. Unsolicited use of the term 'difficult' was common. 'Difficult' was rarely used as a patient characteristic or to describe the therapeutic relationship. Participants used 'difficult' to describe their experience of diagnosing, explaining, communicating and managing these conditions and their own emotional reactions. Health care system deficits and the conceptual basis for MUS were other facets of 'difficult'. Participants also reported experiences that were rewarding and positive. This study shows that blanket statements such as 'difficult patients' mask the complexity of doctors' experiences in the context of MUS. Our nuanced analysis of the use of 'difficult' challenges preconceived attitudes. This can help counter the unreflexive perpetuation of negative evaluations that stigmatize patients with MUS, encourage greater acknowledgement of doctors' emotions, and lead to more appropriate conceptualizations and management of MUS. Copyright © 2016 Elsevier Inc. All rights reserved.

POSTGRADUATE EDUCATION FUNCTIONING PATTERNS OF TOURISM SPHERE SPECIALISTS IN SWITZERLAND

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Наталія Закордонець

2014-04-01

Full Text Available Functioning patterns of postgraduate education of tourism sphere specialists in Switzerland have been established. The competences of tourism sphere specialist, the formation of which programs of postgraduate education are focused on have been considered. The benefits of educational qualification of Masters in Business Administration with a major specialization in tourism have been outlined. The characteristics of the core curriculum of the Doctor of Management of leading universities in the field of tourism education have been determined. The performance criteria of postgraduate education system functioning of tourism sphere specialists in Switzerland have been revealed.

Caught in the Balance: An Organizational Analysis of Science Teaching in Schools with Elementary Science Specialists

Science.gov (United States)

Marco-Bujosa, Lisa M.; Levy, Abigail Jurist

2016-01-01

Elementary schools are under increasing pressure to teach science and teach it well; yet, research documents that classroom teachers must overcome numerous personal and school-based challenges to teach science effectively at this level, such as access to materials and inadequate instructional time. The elementary science specialist model…

Establishing a Research Agenda for Understanding the Role and Impact of Mental Health Peer Specialists.

Science.gov (United States)

Chinman, Matthew; McInnes, D Keith; Eisen, Susan; Ellison, Marsha; Farkas, Marianne; Armstrong, Moe; Resnick, Sandra G

2017-09-01

Mental health peer specialists are individuals with serious mental illnesses who receive training to use their lived experiences to help others with serious mental illnesses in clinical settings. This Open Forum discusses the state of the research for mental health peer specialists and suggests a research agenda to advance the field. Studies have suggested that peer specialists vary widely in their roles, settings, and theoretical orientations. Theories of action have been proposed, but none have been tested. Outcome studies have shown benefits of peer specialists; however, many studies have methodological shortcomings. Qualitative descriptions of peer specialists are plentiful but lack grounding in implementation science frameworks. A research agenda advancing the field could include empirically testing theoretical mechanisms of peer specialists, developing a measure of peer specialist fidelity, conducting more rigorous outcomes studies, involving peer specialists in executing the research, and assessing various factors that influence implementing peer specialist services and testing strategies that could address those factors.

Establishment of an innovative specialist cardiac indigenous outreach service in rural and remote Queensland.

Science.gov (United States)

Tibby, David; Corpus, Rohan; Walters, Darren L

2010-01-01

Cardiovascular diseases are the leading cause of mortality in Indigenous Australians. Indigneous Australians present at a younger age and have a greater incidence of cardiac risk including smoking and diabetes than non-Indigenous Australians. Access to specialist health services is an important determinant of health care outcomes for these patients. We describe an innovative and successful for model for providing Outreach Cardiac Specialist services to Indigenous communities in rural and remote locations. The approach involves a step-wise process of a) community engagement, b) delivering recovery interventions to improve health outcomes, c) building community capacity to self manage chronic illness and promoting health and well being with the aim of d) community self governance of chronic disease and health promotion. Key elements to this process are community participation in the program, disease self-management led by local health care workers, open access that is all-inclusive utilising community-generated referral, and the translation of scientific knowledge of disease processes into community understanding and making culturally relevant connections. Specialist cardiac services and point of care diagnostics have been provided to 18 sites across rural and remote Queensland. More than 1400 episodes of care have been provided to Indigenous Australians with rheumatic heart disease, ischaemic heart disease and congenital heart conditions. Traditional values can work harmoniously with an inclusive medical approach in this relational model. Crown Copyright 2010. Published by Elsevier B.V. All rights reserved.

Advances in probabilistic risk analysis

International Nuclear Information System (INIS)

Hardung von Hardung, H.

1982-01-01

Probabilistic risk analysis can now look back upon almost a quarter century of intensive development. The early studies, whose methods and results are still referred to occasionally, however, only permitted rough estimates to be made of the probabilities of recognizable accident scenarios, failing to provide a method which could have served as a reference base in calculating the overall risk associated with nuclear power plants. The first truly solid attempt was the Rasmussen Study and, partly based on it, the German Risk Study. In those studies, probabilistic risk analysis has been given a much more precise basis. However, new methodologies have been developed in the meantime, which allow much more informative risk studies to be carried out. They have been found to be valuable tools for management decisions with respect to backfitting, reinforcement and risk limitation. Today they are mainly applied by specialized private consultants and have already found widespread application especially in the USA. (orig.) [de

The role of the internal medicine specialist in the management of infective complications in general surgical wards

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Patrizia Zoboli

2013-05-01

Full Text Available BACKGROUND Internal medicine specialists are often asked to evaluate a patient before surgery. Perioperative risk evaluation for elderly patients is important, because complications increase with age. The increasing age of the general population increases the probabilities of surgery in the older patients. The manifestation of a surgical problem, is more likely to be severe and complicated in the elderly patients. In fact, emergency surgery treatment occurs more frequently in the elderly (e.g., it is much more common to see intestinal obstruction complicating colorectal cancer in the elderly compared with a younger population. Old age is an independent factor for long hospital stay after surgery. The role of the preoperative medical consultant is to identify and evaluate a patient’s current medical status and provide a clinical risk profile, in order to decide whether further tests are indicated prior to surgery, and to optimise the patient’s medical condition in the attempt of reducing the risk of complications. The medical consultant must know which medical condition could eventually influence the surgery, achieve a good contact and communication between the medical and surgical team, in order to obtain the best management planning. AIM OF THE STUDY This paper focuses on the rational use of antibiotic prophylaxis and on the treatment of the complications of post-surgery infections (e.g., pulmonary complication, peritonitis, intra-abdominal infection. Specific aspects of pre-operative risk evaluation and peri and post-operative management are discussed. CONCLUSIONS The internal medicin specialist in collaboration with the surgical team is necessary in the peri and post-surgery management.

Neurofibromatosis and the role of the specialist adviser.

Science.gov (United States)

Redman, Carolyn

2017-09-11

Neurofibromatosis (NF) is a genetic condition that mainly involves the nervous system. There are two types: NF1 affects about one in 2,500 of the population worldwide and NF2 affects one in 35,000. Both types result in complex health problems for patients and can pose significant challenges for all those involved in their management. Established in 1981, The Neuro Foundation is a patient-focused charity that funds a network of specialist advisers who work in partnership with the NHS to offer support and advice for families affected by NF and the professionals who care for them. With a significant level of autonomy, the specialist adviser role is flexible in matching the needs of those affected while working cooperatively alongside the national specialist services for NF1 and NF2. ©2012 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.

One Point of View: Elementary School Mathematics Specialists: Where Are They?

Science.gov (United States)

Dossey, John A.

1984-01-01

A plea is made for the mathematics education community to support the need for elementary school mathematics specialists. Roles of such specialists in primary as well as intermediate grades are listed. (MNS)

WIPP fire hazards and risk analysis

International Nuclear Information System (INIS)

1991-05-01

The purpose of this analysis was to conduct a fire hazards risk analysis of the Transuranic (TRU) contact-handled waste receipt, emplacement, and disposal activities at the Waste Isolation Pilot Plant (WIPP). The technical bases and safety envelope for these operations are defined in the approved WIPP Final Safety Analysis Report (FSAR). Although the safety documentation for the initial phase of the Test Program, the dry bin scale tests, has not yet been approved by the Department of Energy (DOE), reviews of the draft to date, including those by the Advisory Committee on Nuclear Facility Safety (ACNFS), have concluded that the dry bin scale tests present no significant risks in excess of those estimated in the approved WIPP FSAR. It is the opinion of the authors and reviewers of this analysis, based on sound engineering judgment and knowledge of the WIPP operations, that a Fire Hazards and Risk Analysis specific to the dry bin scale test program is not warranted prior to first waste receipt. This conclusion is further supported by the risk analysis presented in this document which demonstrates the level of risk to WIPP operations posed by fire to be extremely low. 15 refs., 41 figs., 48 tabs

Trends and quality of care in outpatient visits to generalist and specialist physicians delivering primary care in the United States, 1997-2010.

Science.gov (United States)

Edwards, Samuel T; Mafi, John N; Landon, Bruce E

2014-06-01

Although many specialists serve as primary care physicians (PCPs), the type of patients they serve, the range of services they provide, and the quality of care they deliver is uncertain. To describe trends in patient, physician, and visit characteristics, and compare visit-based quality for visits to generalists and specialists self-identified as PCPs. Cross-sectional study and time trend analysis. Nationally representative sample of visits to office-based physicians from the National Ambulatory Medical Care Survey, 1997-2010. Proportions of primary care visits to generalist and specialists, patient characteristics, principal diagnoses, and quality. Among 84,041 visits to self-identified PCPs representing an estimated 4.0 billion visits, 91.5 % were to generalists, 5.9 % were to medical specialists and 2.6 % were to obstetrician/gynecologists. The proportion of PCP visits to generalists increased from 88.4 % in 1997 to 92.4 % in 2010, but decreased for medical specialists from 8.0 % to 4.8 %, p = 0.04). The proportion of medical specialist visits in which the physician self-identified as the patient's PCP decreased from 30.6 % in 1997 to 9.8 % in 2010 (p specialist PCPs take care of older patients (mean age 61 years), and dedicate most of their visits to chronic disease management (51.0 %), while generalist PCPs see younger patients (mean age 55.4 years) most commonly for new problems (40.5 %). Obstetrician/gynecologists self-identified as PCPs see younger patients (mean age 38.3 p specialists. Medical specialists are less frequently serving as PCPs for their patients over time. Generalist, medical specialist, and obstetrician/gynecologist PCPs serve different primary care roles for different populations. Delivery redesign efforts must account for the evolving role of generalist and specialist PCPs in the delivery of primary care.

Cooperation between law enforcement officers and forensic specialists. Diagnosis and possible improvements - a Lithuanian experience.

Science.gov (United States)

Malewski, Henryk; Kurapka, Vidmantas Egidijus; Matulienė, Snieguolnė; Navickienė, Žaneta

The article investigates the characteristics and forms of cooperation between criminal investigation officers* and forensic laboratory specialists in pre-trial proceedings, as well as practical problems in such cooperation. Recently there have been a number of particularly heated debates about the relationship between determining a person possessing special knowledge and his/her status in pre-trial proceedings. Other discussed aspects include cooperation between entities involved in pre-trial proceedings in international contexts. A less intensive (albeit equally important) discussion relates to the form and characteristics of cooperation between criminal investigation officers on the one hand and specialists and experts on the other in investigating criminal acts. Bearing in mind the high practical importance and the existing differences in scholarly approaches to these issues, the current study concentrates on the forms and content of cooperation between law enforcement officers and specialists (experts) from forensic laboratories, as well as on problems resulting from such cooperation and directions for improvement. The first part of the article presents selected views on the definition of a person possessing special knowledge currently used in Lithuania** and in a number of other states. In the authors' opinion, unification (harmonization) of various notions (definitions), terms and statuses of an expert, a specialist and special knowledge should be one of the objectives in implementing the vision of the joint European forensic science area 2020. Achieving this objective requires a comprehensive analysis of standards in law and management in using special knowledge of each state***. The second part, supported by empirical study results, discusses practical problems of cooperation between a law enforcement officer and a specialist (expert), analyzes three basic forms of their cooperation and presents the content of those forms: activities at the crime scene

Individual prey choices of octopuses: Are they generalist or specialist?

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Jennifer A. MATHER, Tatiana S. LEITE, Allan T. BATISTA

2012-08-01

Full Text Available Prey choice is often evaluated at the species or population level. Here, we analyzed the diet of octopuses of different populations with the aim to assess the importance of individual feeding habits as a factor affecting prey choice. Two methods were used, an assessment of the extent to which an individual octopus made choices of species representative of those population (PSi and IS and 25% cutoff values for number of choices and percentage intake of individual on their prey. In one population of Octopus cf vulgaris in Bermuda individuals were generalist by IS=0.77, but most chose many prey of the same species, and were specialists on it by >75% intake. Another population had a wider prey selection, still generalist with PSi=0.66, but two individuals specialized by choices. In Bonaire, there was a wide range of prey species chosen, and the population was specialists by IS= 0.42. Individual choices revealed seven specialists and four generalists. A population of Octopus cyanea in Hawaii all had similar choices of crustaceans, so the population was generalist by IS with 0.74. But by individual choices, three were considered a specialist. A population of Enteroctopus dofleini from Puget Sound had a wide range of preferences, in which seven were also specialists, IS=0.53. By individual choices, thirteen were also specialists. Given the octopus specialty of learning during foraging, we hypothesize that both localized prey availability and individual personality differences could influence the exploration for prey and this translates into different prey choices across individuals and populations showed in this study [Current Zoology 58 (4: 597-603, 2012].

Risk Characterization uncertainties associated description, sensitivity analysis

International Nuclear Information System (INIS)

Carrillo, M.; Tovar, M.; Alvarez, J.; Arraez, M.; Hordziejewicz, I.; Loreto, I.

2013-01-01

The power point presentation is about risks to the estimated levels of exposure, uncertainty and variability in the analysis, sensitivity analysis, risks from exposure to multiple substances, formulation of guidelines for carcinogenic and genotoxic compounds and risk subpopulations

Risk and society

International Nuclear Information System (INIS)

Tubiana, M.; Vrousos, C.; Pages, J.P.; Carde, C.

1999-01-01

This book brings together the communications presented at the colloquium 'risk and society' held in Paris (France) on November 1998. During this colloquium, the various aspects of risk and of its management were discussed by medical specialists, historians, industrialists, engineers, philosophers, lawyers, politicians and administration representatives. The first theme concerns the controversies generated by the development of some activities (genetics, bio-technologies, nuclear and radiations use). The second theme concerns the management of risks and the way to conciliate the point of view of authorities and citizens (confidence of the public with respect to experts, scientists, industrialists, government and administrative representatives, role played by the media). The debates that took place during the colloquium have shown that the public opinion concerning the nuclear activities or the new technologies greatly depends on the ideological attitudes and on the public's likes and dislikes with respect to some categories of actors (distrust with respect to public decisions, fears with respect to changes and future, nostalgia of the past). The following aspects are reviewed: Notions of risk and hazard (risk and health, risk in today's society, medicine and society, the point of view of the industrialists and of the scientific and technical specialists); from the psychological aspects of the risk to its social aspects (survey of the risk assessment battlefield, social attenuation and amplification of risk, the feeling of risks in Europe, insecurity and delinquency, controversies around radioactivity and health); the negotiation and communication about risks (risk and public health, negotiation around risks, risks and information dissemination about the public debate, communication and crisis, evolution of risk communication, comparison between American and European approaches, the Seveso directive); the public debate and the evolution of risks management (the

Advances in Risk Analysis with Big Data.

Science.gov (United States)

Choi, Tsan-Ming; Lambert, James H

2017-08-01

With cloud computing, Internet-of-things, wireless sensors, social media, fast storage and retrieval, etc., organizations and enterprises have access to unprecedented amounts and varieties of data. Current risk analysis methodology and applications are experiencing related advances and breakthroughs. For example, highway operations data are readily available, and making use of them reduces risks of traffic crashes and travel delays. Massive data of financial and enterprise systems support decision making under risk by individuals, industries, regulators, etc. In this introductory article, we first discuss the meaning of big data for risk analysis. We then examine recent advances in risk analysis with big data in several topic areas. For each area, we identify and introduce the relevant articles that are featured in the special issue. We conclude with a discussion on future research opportunities. © 2017 Society for Risk Analysis.

Clinical Features and Correlates of Outcomes for High-Risk, Marginalized Mothers and Newborn Infants Engaged with a Specialist Perinatal and Family Drug Health Service

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Lee Taylor

2012-01-01

Full Text Available Background. There is a paucity of research in Australia on the characteristics of women in treatment for illicit substance use in pregnancy and the health outcomes of their neonates. Aims. To determine the clinical features and outcomes of high-risk, marginalized women seeking treatment for illicit substance use in pregnancy and their neonates. Methods. 139 women with a history of substance abuse/dependence engaged with a perinatal drug health service in Sydney, Australia. Maternal (demographic, drug use, psychological, physical, obstetric, and antenatal care and neonatal characteristics (delivery, early health outcomes were examined. Results. Compared to national figures, pregnant women attending a specialist perinatal and family drug health service were more likely to report being Australian born, Aboriginal or Torres Strait Islander, younger, unemployed, and multiparous. Opiates were the primary drug of concern (81.3%. Pregnancy complications were common (61.9%. Neonates were more likely to be preterm, have low birth weight, and be admitted to special care nursery. NAS was the most prevalent birth complication (69.8% and almost half required pharmacotherapy. Conclusion. Mother-infant dyads affected by substance use in pregnancy are at significant risk. There is a need to review clinical models of care and examine the longer-term impacts on infant development.

Overcoming barriers to integrating economic analysis into risk assessment.

Science.gov (United States)

Hoffmann, Sandra

2011-09-01

Regulatory risk analysis is designed to provide decisionmakers with a clearer understanding of how policies are likely to affect risk. The systems that produce risk are biological, physical, and social and economic. As a result, risk analysis is an inherently interdisciplinary task. Yet in practice, risk analysis has been interdisciplinary in only limited ways. Risk analysis could provide more accurate assessments of risk if there were better integration of economics and other social sciences into risk assessment itself. This essay examines how discussions about risk analysis policy have influenced the roles of various disciplines in risk analysis. It explores ways in which integrated bio/physical-economic modeling could contribute to more accurate assessments of risk. It reviews examples of the kind of integrated economics-bio/physical modeling that could be used to enhance risk assessment. The essay ends with a discussion of institutional barriers to greater integration of economic modeling into risk assessment and provides suggestions on how these might be overcome. © 2011 Society for Risk Analysis.

Evaluation of infectious diseases and clinical microbiology specialists' preferences for hand hygiene: analysis using the multi-attribute utility theory and the analytic hierarchy process methods.

Science.gov (United States)

Suner, Aslı; Oruc, Ozlem Ege; Buke, Cagri; Ozkaya, Hacer Deniz; Kitapcioglu, Gul

2017-08-31

Hand hygiene is one of the most effective attempts to control nosocomial infections, and it is an important measure to avoid the transmission of pathogens. However, the compliance of healthcare workers (HCWs) with hand washing is still poor worldwide. Herein, we aimed to determine the best hand hygiene preference of the infectious diseases and clinical microbiology (IDCM) specialists to prevent transmission of microorganisms from one patient to another. Expert opinions regarding the criteria that influence the best hand hygiene preference were collected through a questionnaire via face-to-face interviews. Afterwards, these opinions were examined with two widely used multi-criteria decision analysis (MCDA) methods, the Multi-Attribute Utility Theory (MAUT) and the Analytic Hierarchy Process (AHP). A total of 15 IDCM specialist opinions were collected from diverse private and public hospitals located in İzmir, Turkey. The mean age of the participants was 49.73 ± 8.46, and the mean experience year of the participants in their fields was 17.67 ± 11.98. The findings that we obtained through two distinct decision making methods, the MAUT and the AHP, suggest that alcohol-based antiseptic solution (ABAS) has the highest utility (0.86) and priority (0.69) among the experts' choices. In conclusion, the MAUT and the AHP, decision models developed here indicate that rubbing the hands with ABAS is the most favorable choice for IDCM specialists to prevent nosocomial infection.

RISKS MANAGEMENT. A PROPENSITY SCORE APPLICATION

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Constangioara Alexandru

2008-05-01

Full Text Available Risk management is relatively unexplored in Romania. Although Romanian specialists dwell on theoretical aspects such as the risks classification and the important distinction between risks and uncertainty the practical relevance of the matter is outside existing studies. Present paper uses a dataset of consumer data to build a propensity scorecard based on relevant quantitative modeling.

The Changing Role of the Reading Specialist: A Case Study

Science.gov (United States)

Ginsburg, Victoria Elaine

2012-01-01

This descriptive qualitative case study explored the changing role of the reading specialist through various perceptions of professionals in the Neon Shadow School District. The purpose of the study was to explore what, how, and why the duties and responsibilities of the reading specialist have changed since first employed as an…

Maritime transportation risk analysis: Review and analysis in light of some foundational issues

International Nuclear Information System (INIS)

Goerlandt, Floris; Montewka, Jakub

2015-01-01

Many methods and applications for maritime transportation risk analysis have been presented in the literature. In parallel, there is a recent focus on foundational issues in risk analysis, with calls for intensified research on fundamental concepts and principles underlying the scientific field. This paper presents a review and analysis of risk definitions, perspectives and scientific approaches to risk analysis found in the maritime transportation application area, focusing on applications addressing accidental risk of shipping in a sea area. For this purpose, a classification of risk definitions, an overview of elements in risk perspectives and a classification of approaches to risk analysis science are applied. Results reveal that in the application area, risk is strongly tied to probability, both in definitions and perspectives, while alternative views exist. A diffuse situation is also found concerning the scientific approach to risk analysis, with realist, proceduralist and constructivist foundations co-existing. Realist approaches dominate the application area. Very few applications systematically account for uncertainty, neither concerning the evidence base nor in relation to the limitations of the risk model in relation to the space of possible outcomes. Some suggestions are made to improve the current situation, aiming to strengthen the scientific basis for risk analysis. - Highlights: • Risk analyses in maritime transportation analysed in light of foundational issues. • Focus on definitions, perspectives and scientific approaches to risk analysis. • Probability-based definitions and realist approaches dominate the field. • Findings support calls for increased focus on foundational issues in risk research. • Some suggestions are made to improve the current situation

STOCHASTIC METHODS IN RISK ANALYSIS

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Vladimíra OSADSKÁ

2017-06-01

Full Text Available In this paper, we review basic stochastic methods which can be used to extend state-of-the-art deterministic analytical methods for risk analysis. We can conclude that the standard deterministic analytical methods highly depend on the practical experience and knowledge of the evaluator and therefore, the stochastic methods should be introduced. The new risk analysis methods should consider the uncertainties in input values. We present how large is the impact on the results of the analysis solving practical example of FMECA with uncertainties modelled using Monte Carlo sampling.

Risk Analysis of Telecom Enterprise Financing

Institute of Scientific and Technical Information of China (English)

YU Hua; SHU Hua-ying

2005-01-01

The main research objects in this paper are the causes searching and risk estimating method for telecom enterprises' financial risks. The multi-mode financing for telecom enterprises makes it flexible to induce the capital and obtain the profit by corresponding projects. But there are also potential risks going with these financing modes. After making analysis of categories and causes of telecom enterprises' financing risk, a method by Analytic Hierarchy Process (AHP) is put forward to estimating the financing risk. And the author makes her suggestion and opinion by example analysis, in order to provide some ideas and basis for telecom enterprise's financing decision-making.

Risk determination after an acute myocardial infarction: review of 3 clinical risk prediction tools.

Science.gov (United States)

Scruth, Elizabeth Ann; Page, Karen; Cheng, Eugene; Campbell, Michelle; Worrall-Carter, Linda

2012-01-01

The objective of the study was to provide comprehensive information for the clinical nurse specialist (CNS) on commonly used clinical prediction (risk assessment) tools used to estimate risk of a secondary cardiac or noncardiac event and mortality in patients undergoing primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI). The evolution and widespread adoption of primary PCI represent major advances in the treatment of acute myocardial infarction, specifically STEMI. The American College of Cardiology and the American Heart Association have recommended early risk stratification for patients presenting with acute coronary syndromes using several clinical risk scores to identify patients' mortality and secondary event risk after PCI. Clinical nurse specialists are integral to any performance improvement strategy. Their knowledge and understandings of clinical prediction tools will be essential in carrying out important assessment, identifying and managing risk in patients who have sustained a STEMI, and enhancing discharge education including counseling on medications and lifestyle changes. Over the past 2 decades, risk scores have been developed from clinical trials to facilitate risk assessment. There are several risk scores that can be used to determine in-hospital and short-term survival. This article critiques the most common tools: the Thrombolytic in Myocardial Infarction risk score, the Global Registry of Acute Coronary Events risk score, and the Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications risk score. The importance of incorporating risk screening assessment tools (that are important for clinical prediction models) to guide therapeutic management of patients cannot be underestimated. The ability to forecast secondary risk after a STEMI will assist in determining which patients would require the most aggressive level of treatment and monitoring postintervention including

Seismic analysis of liquid metal fast breeder reactors

International Nuclear Information System (INIS)

Gilbert, R.J.; Martelli, A.

1989-06-01

This report is a general survey of the recent methods to predict the seismic structural behaviour of LMFBRs. It shall put into evidence the impact of seismic analysis on the design of the different structures of the reactor. This report is addressed to specialists and institutions of governmental organizations in industrialized and developing countries responsible for the design and operation of LMFBRs. The information presented should enable specialists in the R and D institutions and industries likely to be involved, to establish the correct course of the design and operation of LMFBRs. Also, the safety aspect of seismic risk are emphasized in the report. Refs and figs

CAUSES FOR INEFFECTIVE COMMUNICATION BETWEEN MEDICAL SPECIALISTS

Directory of Open Access Journals (Sweden)

Stayko I. Spiridonov

2017-07-01

Full Text Available Purpose: In the resent years the healthcare system has moved to inter-professional, cross-disciplinary, multi-person approach where the communications are very important for ensuring patient safety. Communication in health organisations needs to be studied and analysed deeply and comprehensively because the future of an organisation often depends on good communication. The purpose of this study is to investigate and analyse the reasons for ineffective communication between medical specialists in the teams they work in. Materials and Methods: A questionnaire method is used. Through a survey over a period of 12 months (from 01. 12. 2014 to 01. 12. 2015 at the Escullap Hospital in Pazardzhik, DCC 18 - Sofia, St. Mina Hospital in Plovdiv, MHAT – Plovdiv, DCC 1 in Haskovo, UMHAT in Stara Zagora, DCC 3 in Varna and MHAT – Parvomay, was studied and analyzed the opinion of medical specialists on the effectiveness of communication within the team they work in. The survey includes 477 medical specialists. Results and conclusions: According to 41.1% of the respondents, the communication in the team they work in is insufficiently effective. Most of the respondents (39.8% find their colleagues responsible for the ineffective communication, followed by those who seek the cause for poor communication in the management of the health care facility (27.6%. The leading cause of poor communication in the team according to the study participants is the inequality between the characters of the colleagues (41.9%. According to the majority of respondents (28.3%, improvements in facilities and wage increases (27.3% would be essential to improve communication within the team they work in. Recommendations have been formulated to improve communication among medical specialists.

Web-Based Specialist Support for Spinal Cord Injury Person’s Care: Lessons Learned

Directory of Open Access Journals (Sweden)

Vincenzo Della Mea

2012-01-01

Full Text Available Persons with disability from spinal cord injury (SCI are subject to high risk of pathological events and need a regular followup even after discharge from the rehabilitation hospital. To help in followup, we developed a web portal for providing online specialist as well as GP support to SCI persons. After a feasibility study with 13 subjects, the portal has been introduced in the regional healthcare network in order to make it compliant with current legal regulations on data protection, including smartcard authentication. Although a number of training courses have been made to introduce SCI persons to portal use (up to 50 users, the number of accesses remained very low. Reasons for that have been investigated by means of a questionnaire submitted to the initial feasibility study subjects and included the still easier use of telephone versus our web-based smartcard-authenticated portal, in particular, because online communications are still perceived as an unusual way of interacting with the doctor. To summarize, the overall project has been appreciated by the users, but when it is time to ask for help to, the specialist, it is still much easier to make a phone call.

Is there a need for placement evaluations for specialist practice students? A proposal.

Science.gov (United States)

Sturge, Sally Anne

2014-10-01

This paper outlines a recent proposal justifying the initiation of standardised placement evaluations across specialist community public health nursing and specialist community nursing students while they undertake their educational programme. Within one approved education institute (AEI) it was identified that there was no standardised tool currently being used across the West Midlands, making the process of quality assurance extremely difficult. A clear rationale is provided for the use of such a tool, including supporting evidence from professional, statutory and regulatory bodies, health and education policies and quality assurance agencies. Placement evaluations are critical to students' learning, ensuring a safe and conducive environment, while providing a continuous cyclical process in conjunction with educational audits to allow the opportunity of regular assessment of the learning environment conforming to the Nursing Midwifery Council's risk-based approach. In light of the recent recommendations from the Francis report, it is pivotal that organisations such as the NHS and AEIs engage proactively together, fostering an open and transparent relationship to ensure standards of care are of the highest quality. Aspects of leadership theory are also discussed to enable the planned change to be successful.

Probabilistic risk analysis for nuclear power plants

International Nuclear Information System (INIS)

Hauptmanns, U.

1988-01-01

Risk analysis is applied if the calculation of risk from observed failures is not possible, because events contributing substantially to risk are too seldom, as in the case of nuclear reactors. The process of analysis provides a number of benefits. Some of them are listed. After this by no means complete enumeration of possible benefits to be derived from a risk analysis. An outline of risk studiesd for PWR's with some comments on the models used are given. The presentation is indebted to the detailed treatment of the subject given in the PRA Procedures Guide. Thereafter some results of the German Risk Study, Phase B, which is under way are communicated. The paper concludes with some remarks on probabilistic considerations in licensing procedures. (orig./DG)

Single-shell tank interim stabilization risk analysis

International Nuclear Information System (INIS)

Basche, A.D.

1998-01-01

The purpose of the Single-Shell Tank (SST) Interim Stabilization Risk Analysis is to provide a cost and schedule risk analysis of HNF-2358, Rev. 1, Single-Shell Tank Interim Stabilization Project Plan (Project Plan) (Ross et al. 1998). The analysis compares the required cost profile by fiscal year (Section 4.2) and revised schedule completion date (Section 4.5) to the Project Plan. The analysis also evaluates the executability of the Project Plan and recommends a path forward for risk mitigation

Contracting in specialists for emergency obstetric care- does it work in rural India?

Directory of Open Access Journals (Sweden)

Randive Bharat

2012-12-01

Full Text Available Abstract Background Contracting in private sector is promoted in developing countries facing human resources shortages as a challenge to reduce maternal mortality. This study explored provision, practice, performance, barriers to execution and views about contracting in specialists for emergency obstetric care (EmOC in rural India. Methods Facility survey was conducted in all secondary and tertiary public health facilities (44 in three heterogeneous districts in Maharashtra state of India. Interviews (42 were conducted with programme managers and district and block level officials and with public and private EmOC specialists. Locations of private obstetricians in the study districts were identified and mapped. Results Two schemes, namely Janani Suraksha Yojana and Indian Public Health standards (IPHS provided for contracting in EmOC specialists. The IPHS provision was chosen for use mainly due to greater sum for contracting in (US $ 30/service episode vs.300 US$/month. The positions of EmOC specialists were vacant in 83% of all facilities that hence had a potential for contracting in EmOC specialists. Private specialists were contracted in at 20% such facilities. The contracting in of specialists did not greatly increase EmOC service outputs at facilities, except in facilities with determined leadership. Contracting in specialists was useful for non emergency conditions, but not for obstetric emergencies. The contracts were more of a relational nature with poor monitoring structures. Inadequate infrastructure, longer distance to private specialists, insufficient financial provision for contracting in, and poor management capacities were barriers to effective implementation of contracting in. Dependency on the private sector was a concern among public partners while the private partners viewed contracting in as an opportunity to gain experience and credibility. Conclusions Density and geographic distribution of private specialists are important

Contracting in specialists for emergency obstetric care- does it work in rural India?

Science.gov (United States)

Randive, Bharat; Chaturvedi, Sarika; Mistry, Nerges

2012-12-31

Contracting in private sector is promoted in developing countries facing human resources shortages as a challenge to reduce maternal mortality. This study explored provision, practice, performance, barriers to execution and views about contracting in specialists for emergency obstetric care (EmOC) in rural India. Facility survey was conducted in all secondary and tertiary public health facilities (44) in three heterogeneous districts in Maharashtra state of India. Interviews (42) were conducted with programme managers and district and block level officials and with public and private EmOC specialists. Locations of private obstetricians in the study districts were identified and mapped. Two schemes, namely Janani Suraksha Yojana and Indian Public Health standards (IPHS) provided for contracting in EmOC specialists. The IPHS provision was chosen for use mainly due to greater sum for contracting in (US $ 30/service episode vs.300 US$/month). The positions of EmOC specialists were vacant in 83% of all facilities that hence had a potential for contracting in EmOC specialists. Private specialists were contracted in at 20% such facilities. The contracting in of specialists did not greatly increase EmOC service outputs at facilities, except in facilities with determined leadership. Contracting in specialists was useful for non emergency conditions, but not for obstetric emergencies. The contracts were more of a relational nature with poor monitoring structures. Inadequate infrastructure, longer distance to private specialists, insufficient financial provision for contracting in, and poor management capacities were barriers to effective implementation of contracting in. Dependency on the private sector was a concern among public partners while the private partners viewed contracting in as an opportunity to gain experience and credibility. Density and geographic distribution of private specialists are important influencing factors in determining feasibility and use of

Integrating HCI Specialists into Open Source Software Development Projects

Science.gov (United States)

Hedberg, Henrik; Iivari, Netta

Typical open source software (OSS) development projects are organized around technically talented developers, whose communication is based on technical aspects and source code. Decision-making power is gained through proven competence and activity in the project, and non-technical end-user opinions are too many times neglected. In addition, also human-computer interaction (HCI) specialists have encountered difficulties in trying to participate in OSS projects, because there seems to be no clear authority and responsibility for them. In this paper, based on HCI and OSS literature, we introduce an extended OSS development project organization model that adds a new level of communication and roles for attending human aspects of software. The proposed model makes the existence of HCI specialists visible in the projects, and promotes interaction between developers and the HCI specialists in the course of a project.

Struggling doctors in specialist training: a case control study

DEFF Research Database (Denmark)

O'Neill, Lotte; Norberg, Karen; Thomsen, Maria

), or transferred (i.e. had unplanned changes in place of training/ward due to failure to thrive or due to inadequate development of competences), or dropped out (i.e. were dismissed from, had resigned from, or changed their speciality). Controls were a random sample of doctors in the source population, who were......Abstract summary The aim of this cummulative incidence case-control study was to examine: if struggling trainees in medical specialist training (cases) tended to struggle already in medical school or not compared to non-struggling controls, and which performance indicators during medical school...... seemed to predict struggling in postgraduate education if any. The study design is rooted in epidemiological methodology. Struggling doctors in specialist training: a case-control study. It has been reported in the international literature, that around 3-10% of doctors in post-garduate specialist...

Multiple Sclerosis Increases Fracture Risk: A Meta-Analysis

Directory of Open Access Journals (Sweden)

Guixian Dong

2015-01-01

Full Text Available Purpose. The association between multiple sclerosis (MS and fracture risk has been reported, but results of previous studies remain controversial and ambiguous. To assess the association between MS and fracture risk, a meta-analysis was performed. Method. Based on comprehensive searches of the PubMed, Embase, and Web of Science, we identified outcome data from all articles estimating the association between MS and fracture risk. The pooled risk ratios (RRs with 95% confidence intervals (CIs were calculated. Results. A significant association between MS and fracture risk was found. This result remained statistically significant when the adjusted RRs were combined. Subgroup analysis stratified by the site of fracture suggested significant associations between MS and tibia fracture risk, femur fracture risk, hip fracture risk, pelvis fracture risk, vertebrae fracture risk, and humerus fracture risk. In the subgroup analysis by gender, female MS patients had increased fracture risk. When stratified by history of drug use, use of antidepressants, hypnotics/anxiolytics, anticonvulsants, and glucocorticoids increased the risk of fracture risk in MS patients. Conclusions. This meta-analysis demonstrated that MS was significantly associated with fracture risk.

ISD Designed Medical Specialist Training.

Science.gov (United States)

Rock, Samuel K., Jr.; Chagalis, George P.

The Basic Medical Specialist course has one of the largest enrollments of the U.S. Army's Academy of Health Sciences; 11,000 soldiers were trained in this course in 1977 and 1978. Training encompasses both emergency first aid (for field medics) and basic nursing skills. A task force working to improve Army training developed this course, in…

Risk watershed analysis: a new approach to manage torrent control structures

Science.gov (United States)

Quefféléan, Yann; Carladous, Simon; Deymier, Christian; Marco, Olivier

2017-04-01

and forestry works that have been implemented within the watershed, including their cost ; - decide on current protective works to implement (maintenance and new investment). For each EBR, a multidisciplinary team is involved with specialists in geomorphology, hydrology, hydraulics, geology, civil engineering and forestry. Approximatively 1 100 EBRs should be implemented at the national scale, including other natural phenomena such as snow avalanches and rock falls. Since 2012, approximatively 10 % have been realized in areas with the most significant elements at risk. From a practical point of view, these studies have helped a better understanding of torrential watershed conditions and of torrent control expected effect over years. An analysis of these studies will be performed soon to have a first overview of torrent control effect. We claim that these EBRs could be a significant source of information to help a comprehensive evaluation of long-term effectiveness of torrent control.

Caring for cancer patients on non-specialist wards.

LENUS (Irish Health Repository)

Gill, Finola

2012-02-01

As cancer is the leading cause of death worldwide, every nurse will be required to care for patients with the condition at some point in his\\/her career. However, non-specialized oncology nurses are often ill-prepared to nurse patients suffering from cancer. This literature review aims to provide an overview of current trends and developments in cancer care nursing in an attempt to identify the range of previous research pertaining to caring for patients with cancer on non-specialist wards. The review finds that non-specialized cancer nurses report a lack of education and training with regard to cancer care and cancer treatments, which acts as a barrier to providing quality nursing care. Emotional and communication issues with patients and their families can also cause non-specialist nurses significant distress. International research has shown that specialist oncology nurses make a considerable difference to physical and psychosocial patient care. It is therefore paramount that non-speciality nurses\\' educational needs are met to develop clinical competence and to provide supportive holistic care for both patients and their families.

Inequalities in utilisation of general practitioner and specialist services in 9 European countries

Directory of Open Access Journals (Sweden)

Mielck Andreas

2011-10-01

Full Text Available Abstract Background The aim of this study is to describe the magnitude of educational inequalities in utilisation of general practitioner (GP and specialist services in 9 European countries. In addition to West European countries, we have included 3 Eastern European countries: Hungary, Estonia and Latvia. To cover the gap in knowledge we pay a special attention to the magnitude of inequalities among patients with chronic conditions. Methods Data on the use of GP and specialist services were derived from national health surveys of Belgium, Estonia, France, Germany, Hungary, Ireland, Latvia, the Netherlands and Norway. For each country and education level we calculated the absolute prevalence and relative inequalities in utilisation of GP and specialist services. In order to account for the need for care, the results were adjusted by the measure of self-assessed health. Results People with lower education used GP services equally often in most countries (except Belgium and Germany compared with those with a higher level of education. At the same time people with a higher education used specialist care services significantly more often in all countries, except in the Netherlands. The general pattern of educational inequalities in utilisation of specialist care was similar for both men and women. Inequalities in utilisation of specialist care were equally large in Eastern European and in Western European countries, except for Latvia where the inequalities were somewhat larger. Similarly, large inequalities were found in the utilisation of specialist care among patients with chronic diseases, diabetes, and hypertension. Conclusions We found large inequalities in the utilisation of specialist care. These inequalities were not compensated by utilisation of GP services. Of particular concern is the presence of inequalities among patients with a high need for specialist care, such as those with chronic diseases.

Inequalities in utilisation of general practitioner and specialist services in 9 European countries.

Science.gov (United States)

Stirbu, Irina; Kunst, Anton E; Mielck, Andreas; Mackenbach, Johan P

2011-10-31

The aim of this study is to describe the magnitude of educational inequalities in utilisation of general practitioner (GP) and specialist services in 9 European countries. In addition to West European countries, we have included 3 Eastern European countries: Hungary, Estonia and Latvia. To cover the gap in knowledge we pay a special attention to the magnitude of inequalities among patients with chronic conditions. Data on the use of GP and specialist services were derived from national health surveys of Belgium, Estonia, France, Germany, Hungary, Ireland, Latvia, the Netherlands and Norway. For each country and education level we calculated the absolute prevalence and relative inequalities in utilisation of GP and specialist services. In order to account for the need for care, the results were adjusted by the measure of self-assessed health. People with lower education used GP services equally often in most countries (except Belgium and Germany) compared with those with a higher level of education. At the same time people with a higher education used specialist care services significantly more often in all countries, except in the Netherlands. The general pattern of educational inequalities in utilisation of specialist care was similar for both men and women. Inequalities in utilisation of specialist care were equally large in Eastern European and in Western European countries, except for Latvia where the inequalities were somewhat larger. Similarly, large inequalities were found in the utilisation of specialist care among patients with chronic diseases, diabetes, and hypertension. We found large inequalities in the utilisation of specialist care. These inequalities were not compensated by utilisation of GP services. Of particular concern is the presence of inequalities among patients with a high need for specialist care, such as those with chronic diseases. © 2011 Stirbu et al; licensee BioMed Central Ltd.

Work-based assessment within Malta’s specialist training programme in family medicine

OpenAIRE

Sammut, Mario R.; Abela, Gunther

2014-01-01

The Specialist Training Programme in Family Medicine (STPFM) – Malta was drawn up by the Malta College of Family Doctors in 2006, approved by Malta’s Specialist Accreditation Committee, and launched in 2007 by the Primary Health Care Department and the Malta College of Family Doctors. This article regarding the work-based assessment of specialist training in family medicine in Malta was prepared by consulting various local / international documents and publications tha...

Collaboration with general practitioners : preferences of medical specialists - a qualitative study

NARCIS (Netherlands)

Berendsen, Annette J.; Benneker, Wim H. G. M.; Schuling, Jan; Rijkers-Koorn, Nienke; Slaets, Joris P. J.; Meyboom-de Jong, Betty

2006-01-01

Background: Collaboration between general practitioners (GPs) and specialists has been the focus of many collaborative care projects during the past decade. Unfortunately, quite a number of these projects failed. This raises the question of what motivates medical specialists to initiate and continue

Anxiety in women "at risk' of developing breast cancer.

Science.gov (United States)

Thirlaway, K.; Fallowfield, L.; Nunnerley, H.; Powles, T.

1996-01-01

Do family history clinics offering counselling, surveillance and preventative programmes alleviate or exacerbate anxiety in women at a high risk of developing breast cancer? In this study risk perceptions and anxiety of 99 'at risk' women participating in the Tamoxifen Prevention Trial were compared with those of 87 'at risk' women not attending any specialist clinic who were recruited from the National Breast Screening Programme (NBSP). Most anxiety was found in NBSP women with a family history. Women attending the family history clinic and participating in the trial had anxiety scores comparable with 86 women recruited from the NBSP who did not have a family history. We conclude that such specialist clinics do not see a selected group of the most anxious 'at risk' women nor does participation in tamoxifen prevention programmes appear to increase anxiety. PMID:8645590

Mountain Warfare: The Need for Specialist Training

National Research Council Canada - National Science Library

Malik, Muhammad

2003-01-01

This study focuses on the need for specialist training for mountain warfare. It analyzes the special characteristics of mountain and high altitude terrain which affect conduct of military operations...

Public or private care: where do specialists spend their time?

Science.gov (United States)

Freed, Gary L; Turbitt, Erin; Allen, Amy

2017-10-01

Objectives The aim of the present study was to provide data to help clarify the public-private division of clinical care provision by doctors in Australia. Methods A secondary analysis was performed of data from the workforce survey administered by the Australian Health Practitioner Regulation Agency. The questionnaire included demographic and employment questions. Analysis included frequency distributions of demographic variables and mean and median calculations of employment data. Data were analysed from those currently employed in eight adult specialities chosen to provide a mix of surgical and medical fields. The specialties were orthopaedic surgery, otolaryngology, ophthalmology, cardiology, neurology, nephrology, gastroenterology and rheumatology. Results For the specialities analysed in the present study, a large majority of the time spent in patient care was provided in the private sector. For the surgical specialties studied, on average less than 30% of clinical time was spent in the public sector. There was considerable variation among specialties in whether a greater proportion of time was spent in out-patient versus in-patient care and how that was divided between the public and private sectors. Conclusions Ensuring Australians have a medical workforce that meets the needs of the population will require assessments of the public and private medical markets, the needs of each market and the adequacy with which current physician clinical time allocation meets those requirements. By appreciating this nuance, Australia can develop policies and strategies for the current and future speciality workforce to meet the nation's needs. What is known about the topic? Australian medical specialists can split their clinical practice time between the public (e.g. public hospitals, public clinics) and private (e.g. private hospitals, private consulting rooms) sectors. For all medical specialists combined, working hours have been reported to be similar in the public and

The Peer Specialist : Opportunities for the Recovery of Suicidal Care Consumers

NARCIS (Netherlands)

van Bergen, Diana; Huisman, Annemiek

2017-01-01

The emergence of peer specialists with a history of suicidality who work with suicidal care consumers is a recent phenomenon that increasingly receives attention in the field of suicide prevention. Peer specialists aim at: 1) Establishing a more open discussion of suicidality; 2) Enabling attempt

Modeling fraud detection and the incorporation of forensic specialists in the audit process

DEFF Research Database (Denmark)

Sakalauskaite, Dominyka

Financial statement audits are still comparatively poor in fraud detection. Forensic specialists can play a significant role in increasing audit quality. In this paper, based on prior academic research, I develop a model of fraud detection and the incorporation of forensic specialists in the audit...... process. The intention of the model is to identify the reasons why the audit is weak in fraud detection and to provide the analytical framework to assess whether the incorporation of forensic specialists can help to improve it. The results show that such specialists can potentially improve the fraud...... detection in the audit, but might also cause some negative implications. Overall, even though fraud detection is one of the main topics in research there are very few studies done on the subject of how auditors co-operate with forensic specialists. Thus, the paper concludes with suggestions for further...

Methicillin-resistant Staphylococcus aureus: Prevalence, incidence, risk factors, and effects on survival of patients in a specialist palliative care unit: A prospective observational study.

Science.gov (United States)

Gleeson, Aoife; Larkin, Philip; Walsh, Cathal; O'Sullivan, Niamh

2016-04-01

Little is known about the impact of methicillin-resistant Staphylococcus aureus in palliative care settings. To date, the clinical impact of methicillin-resistant Staphylococcus aureus in palliative care is unknown. To determine prevalence and incidence of methicillin-resistant Staphylococcus aureus colonisation in a specialist palliative care setting, to identify risk factors for methicillin-resistant Staphylococcus aureus colonisation, to determine the eradication success rate and to determine the impact of methicillin-resistant Staphylococcus aureus on survival. Prospective cohort study. Data were collected for consecutive admissions to an inpatient palliative care service. Patients were screened for methicillin-resistant Staphylococcus aureus colonisation on admission and 1 week post admission. Methicillin-resistant Staphylococcus aureus eradication was attempted in methicillin-resistant Staphylococcus aureus positive patients. Data were collected from 609 admissions for 466 individual patients. Admission screening data were available in 95.5%. Prevalence of methicillin-resistant Staphylococcus aureus colonisation was 11.59% (54 patients). One week incidence of methicillin-resistant Staphylococcus aureus colonisation was 1.2%. Risk factors for methicillin-resistant Staphylococcus aureus colonisation were determined using Chi-Squared test and included high Waterlow score (p resistant Staphylococcus aureus status prior to admission (p resistant Staphylococcus aureus was eradicated in 8.1% of admissions, while 46 patients commenced on the protocol (62.2%) died before completing it. Methicillin-resistant Staphylococcus aureus did not significantly impact survival but was significantly associated with having infection episodes and longer length of stay. This study identified risk factors for methicillin-resistant Staphylococcus aureus colonisation in palliative care patients. Methicillin-resistant Staphylococcus aureus was eradicated in 8.1% of patients. Hence

Cancer risk analysis among medical diagnostic X-ray workers in China

International Nuclear Information System (INIS)

Wang Jixian; Li Benxiao; Gao Zhiwei; Xu Jun; Zhang Jingyuan; Aoyama, Takashi; Sugahara, Tsutomu

1997-01-01

To provide the evidence and related rules of human malignant tumors produced by prolonged exposure to low level ionizing radiation. The cancer incidence (1950-1990) among 27011 medical diagnostic X-ray workers was compared with that among 25782 other medical specialists employed between 1950 and 1980 in China by means of O/E system. A significantly elevated risk of cancer was seen among diagnostic x-ray workers (RR = 1.1,95%Cl:1.0-1.2,P <0.05). Significantly elevated risks were seen for leukemia and cancers of skin, female breast, liver and esophagus, the RR being 2.3, 5.0, 1.6, 1.3 and 4.4 respectively. The RR for leukemia was higher for X-ray workers who began employment before 1970 and also for those who were young when employment began. The patterns of risk associated with length of service and with age and calendar year of initial employment suggest that the excesses of leukemia, skin cancer and female breast cancer were due to occupational exposure to X-rays. The ERR and EAR for leukemia and solid cancer were calculated roughly. (author)

38 CFR 75.115 - Risk analysis.

Science.gov (United States)

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Risk analysis. 75.115 Section 75.115 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) INFORMATION SECURITY MATTERS Data Breaches § 75.115 Risk analysis. If a data breach involving sensitive personal information that is processed or...

The specialist physician's approach to rheumatoid arthritis in South Africa.

Science.gov (United States)

Bester, Frederik C J; Bosch, Fredricka J; van Rensburg, Barend J Jansen

2016-03-01

Rheumatoid arthritis (RA) is expected to increase in Africa and South Africa. Due to the low numbers of rheumatologists in South Africa, specialist physicians also have to care for patients with RA. Furthermore several new developments have taken place in recent years which improved the management and outcome of RA. Classification criteria were updated, assessment follow-up tools were refined and above all, several new biological disease-modifying anti-rheumatic drugs were developed. Therefore it is imperative for specialist physicians to update themselves with the newest developments in the management of RA. This article provides an overview of the newest developments in the management of RA in the South African context. This approach may well apply to countries with similar specialist to patient ratios and disease profiles.

Training Nuclear Power Specialists

International Nuclear Information System (INIS)

Paulikas, V.

2003-01-01

Situation of preparation of nuclear energy specialists in Lithuania is presented. Nuclear engineers are being prepared at Kaunas University of Technology. In view with decision to decommission Unit 1, the Ignalina NPP is limiting the number of new personnel to fill in vacancies. The main attention is given to the training courses for improvement skills of existing Ignalina NPP, VATESI personnel. Main topics of the training courses are listed. Comparison with previous years on personnel hired and dismissed in Ignalina NPP is made

Thermonuclear generation program: risks and safety

International Nuclear Information System (INIS)

Goes, Alexandre Gromann de Araujo

1999-01-01

This work deals with the fundamental concepts of risk and safety related to nuclear power generation. In the first chapter, a general evaluation of the various systems for energy generation and their environmental impacts is made. Some definitions for safety and risk are suggested, based on the already existing regulatory processes and also on the current tendencies of risk management. Aspects regarding the safety culture are commented. The International Nuclear Event Scale (INES), a coherent and clear mechanism of communication between nuclear specialists and the general public, is analyzed. The second chapter examines the thermonuclear generation program in Brazil and the role of the National Nuclear Energy Commission. The third chapter presents national and international scenarios in terms of safety and risks, available policies and the main obstacles for future development of nuclear energy and nuclear engineering, and strategies are proposed. In the last chapter, comments about possible trends and recommendations related to practical risk management procedures, taking into account rational criteria for resources distribution and risk reduction are made, envisaging a closer integration between nuclear specialists and the society as a whole, thus decreasing the conflicts in a democratic decision-making process

Common approach of risks analysis

International Nuclear Information System (INIS)

Noviello, L.; Naviglio, A.

1996-01-01

Although, following the resolutions of the High German Court, the protection level of the human beings is an objective which can change in time, it is obvious that it is an important point when there is a risk for the population. This is true more particularly for the industrial plants whose possible accidents could affect the population. The accidents risk analysis indicates that there is no conceptual difference between the risks of a nuclear power plant and those of the other industrial plants as chemical plants, the gas distribution system and the hydraulic dams. A legislation analysis induced by the Seveso Directive for the industrial risks give some important indications which should always be followed. This work analyses more particularly the legislative situation in different European countries and identifies some of the most important characteristics. Indeed, for most of the countries, the situation is different and it is a later difficulties source for nuclear power plants. In order to strengthen this reasoning, this paper presents some preliminary results of an analysis of a nuclear power plant following the approach of other industrial plants. In conclusion, it will be necessary to analyse again the risks assessment approach for nuclear power plants because the real protection level of human beings in a country is determined by the less regulated of the dangerous industrial plants existing at the surroundings. (O.M.)

Standardised risk analysis as a communication tool

International Nuclear Information System (INIS)

Pluess, Ch.; Montanarini, M.; Bernauer, M.

1998-01-01

Full text of publication follows: several European countries require a risk analysis for the production, storage or transport a dangerous goods. This requirement imposes considerable administrative effort for some sectors of the industry. In order to minimize the effort of such studies, a generic risk analysis for an industrial sector proved to help. Standardised procedures can consequently be derived for efficient performance of the risk investigations. This procedure was successfully established in Switzerland for natural gas transmission lines and fossil fuel storage plants. The development process of the generic risk analysis involved an intense discussion between industry and authorities about methodology of assessment and the criteria of acceptance. This process finally led to scientific consistent modelling tools for risk analysis and to an improved communication from the industry to the authorities and the public. As a recent example, the Holland-Italy natural gas transmission pipeline is demonstrated, where this method was successfully employed. Although this pipeline traverses densely populated areas in Switzerland, using this established communication method, the risk problems could be solved without delaying the planning process. (authors)

Introduction of the risk analysis

International Nuclear Information System (INIS)

Campon, G.; Martinez, I.

2013-01-01

An introduction of risks analysis was given in the exposition which main issues were: food innocuousness, world, regional and national food context,change of paradigms, health definition, risk, codex, standardization, food chain role, trade agreement, codex alimentarius, food transmission diseases cost impact

The role of rehabilitation specialists in Canadian NICUs: a national survey.

Science.gov (United States)

Limperopoulos, Catherine; Majnemer, Annette

2002-01-01

Rehabilitation specialists are an integral part of the team in the neonatal intensive care unit (NICU). A national survey was conducted to elucidate the current roles of rehabilitation specialists. Occupational therapy (OT), physical therapy (PT), and speech and language pathology (SLP) departments in all Canadian health care institutions with tertiary level NICUs (n = 38) were surveyed by telephone. Results indicate that 16% have no rehabilitation coverage, while 11% receive very limited external services (< 1/month). Over half of the OT and PT departments provide weekly services whereas only 5/38 provide SLP coverage. Service delivery includes assessment and a number of therapeutic interventions. Splinting and feeding are predominantly performed by OT, whereas chest physiotherapy and ROM are carried out primarily by PT. Rehabilitation specialists are actively involved in education and case management. The extent of involvement of rehabilitation specialists was discrepant, and highly associated with the type of facility. Rehabilitation services, when provided, are comprehensive and include evaluation, treatment, teaching, decision-making, and family support.

Resource specialists lead local insect community turnover associated with temperature - analysis of an 18-year full-seasonal record of moths and beetles.

Science.gov (United States)

Thomsen, Philip Francis; Jørgensen, Peter Søgaard; Bruun, Hans Henrik; Pedersen, Jan; Riis-Nielsen, Torben; Jonko, Krzysztof; Słowińska, Iwona; Rahbek, Carsten; Karsholt, Ole

2016-01-01

Insect responses to recent climate change are well documented, but the role of resource specialization in determining species vulnerability remains poorly understood. Uncovering local ecological effects of temperature change with high-quality, standardized data provides an important first opportunity for predictions about responses of resource specialists, and long-term time series are essential in revealing these responses. Here, we investigate temperature-related changes in local insect communities, using a sampling site with more than a quarter-million records from two decades (1992-2009) of full-season, quantitative light trapping of 1543 species of moths and beetles. We investigated annual as well as long-term changes in fauna composition, abundance and phenology in a climate-related context using species temperature affinities and local temperature data. Finally, we explored these local changes in the context of dietary specialization. Across both moths and beetles, temperature affinity of specialists increased through net gain of hot-dwelling species and net loss of cold-dwelling species. The climate-related composition of generalists remained constant over time. We observed an increase in species richness of both groups. Furthermore, we observed divergent phenological responses between cold- and hot-dwelling species, advancing and delaying their relative abundance, respectively. Phenological advances were particularly pronounced in cold-adapted specialists. Our results suggest an important role of resource specialization in explaining the compositional and phenological responses of insect communities to local temperature increases. We propose that resource specialists in particular are affected by local temperature increase, leading to the distinct temperature-mediated turnover seen for this group. We suggest that the observed increase in species number could have been facilitated by dissimilar utilization of an expanded growing season by cold- and hot

Risk Analysis Group annual progress report 1984

International Nuclear Information System (INIS)

1985-06-01

The activities of the Risk Analysis Group at Risoe during 1984 are presented. These include descriptions in some detail of work on general development topics and risk analysis performed as contractor. (author)

Association of State Access Standards With Accessibility to Specialists for Medicaid Managed Care Enrollees.

Science.gov (United States)

Ndumele, Chima D; Cohen, Michael S; Cleary, Paul D

2017-10-01

Medicaid recipients have consistently reported less timely access to specialists than patients with other types of coverage. By 2018, state Medicaid agencies will be required by the Center for Medicare and Medicaid Services (CMS) to enact time and distance standards for managed care organizations to ensure an adequate supply of specialist physicians for enrollees; however, there have been no published studies of whether these policies have significant effects on access to specialty care. To compare ratings of access to specialists for adult Medicaid and commercial enrollees before and after the implementation of specialty access standards. We used Consumer Assessment of Healthcare Providers and Systems survey data to conduct a quasiexperimental difference-in-differences (DID) analysis of 20 163 nonelderly adult Medicaid managed care (MMC) enrollees and 54 465 commercially insured enrollees in 5 states adopting access standards, and 37 290 MMC enrollees in 5 matched states that previously adopted access standards. Reported access to specialty care in the previous 6 months. Seven thousand six hundred ninety-eight (69%) Medicaid enrollees and 28 423 (75%) commercial enrollees reported that it was always or usually easy to get an appointment with a specialist before the policy implementation (or at baseline) compared with 11 889 (67%) of Medicaid enrollees in states that had previously implemented access standards. Overall, there was no significant improvement in timely access to specialty services for MMC enrollees in the period following implementation of standard(s) (adjusted difference-in-differences, -1.2 percentage points; 95% CI, -2.7 to 0.1), nor was there any impact of access standards on insurance-based disparities in access (0.6 percentage points; 95% CI, -4.3 to 5.4). There was heterogeneity across states, with 1 state that implemented both time and distance standards demonstrating significant improvements in access and reductions in disparities

Communication Capacity Research in the Majority World: Supporting the human right to communication specialist services.

Science.gov (United States)

Hopf, Suzanne C

2018-02-01

Receipt of accessible and appropriate specialist services and resources by all people with communication and/or swallowing disability is a human right; however, it is a right rarely achieved in either Minority or Majority World contexts. This paper considers communication specialists' efforts to provide sustainable services for people with communication difficulties living in Majority World countries. The commentary draws on human rights literature, particularly Article 19 of the Universal Declaration of Human Rights and the Communication Capacity Research program that includes: (1) gathering knowledge from policy and literature; (2) gathering knowledge from the community; (3) understanding speech, language and literacy use and proficiency; and (4) developing culturally and linguistically appropriate resources and assessments. To inform the development of resources and assessments that could be used by speech-language pathologists as well as other communication specialists in Fiji, the Communication Capacity Research program involved collection and analysis of data from multiple sources including 144 community members, 75 school students and their families, and 25 teachers. The Communication Capacity Research program may be applicable for achieving the development of evidence-based, culturally and linguistically sustainable SLP services in similar contexts.

A Survey of Headache Medicine Specialists on Career Satisfaction and Burnout.

Science.gov (United States)

Evans, Randolph W; Ghosh, Kamalika

2015-01-01

Physicians report increasing rates of career dissatisfaction and professional burnout, which may be related to the practice environment and subspecialty. There has never been a survey of professional burnout among headache medicine specialists. The aim of the present survey was to learn more about how headache medicine physicians are affected by these issues. An email survey was sent to 749 physician members of the American Headache Society with questions or statements about demographics, professional quality of life and satisfaction, future practice plans, and professional burnout using the Maslach Burnout Inventory. In a sample of 127 headache medicine specialists, 66 (57.4%) physicians reported symptoms of professional burnout reflected by high Emotional Exhaustion and/or high Depersonalization. There is widespread dissatisfaction with work schedules, government regulations, implementation of the Affordable Care Act, insurance company policies, malpractice concerns, patient telephone calls, and compensation. Sixty-two percent of respondents concur that headache medicine is becoming more complicated without patient benefit, 14% concur that headache medicine specialists are fairly compensated, and 59% would go into headache medicine again if they were fourth year medical students. In the next 1 to 3 years, 21.3% plan to cut back on hours, 14.2% plan to cut back on patients seen, and 12.6% plan to switch to a cash practice. Medicine and healthcare are changing in such a way that 33.9% concur that they will accelerate their retirement plans. Headache medicine specialists have one of the highest rates of burnout compared to other physician specialists, which is twice the rate of working adults. Physicians' age and practice environment and experience are related with their career satisfaction and professional burnout. Some attributes of career satisfaction can decrease burnout by reducing emotional exhaustion and depersonalization and by enhancing personal

Sources of satisfaction and dissatisfaction among specialists within the public and private health sectors

DEFF Research Database (Denmark)

Ashton, Toni; Brown, Paul M.; Sopina, Elizaveta (Liza)

2013-01-01

and professional development, key sources of dissatisfaction are workload pressures, mentally demanding work and managerial interference. In the private sector specialists value the opportunity to work independently and apply their own ideas in the workplace. Conclusion Sources of job satisfaction...... and dissatisfaction amongst specialists are different for the public and private sectors. Allowing specialists more freedom to work independently and to apply their own ideas in the workplace may enhance recruitment and retention of specialists in the public health system....

Payload specialist Ronald Parise using SAREX

Science.gov (United States)

1995-01-01

ASTRO-2 payload specialist Ronald A. Parise reminisces on his inspace amateur radio experience of five years ago in the ASTRO-1 mission. Using the Shuttle Amateur Radio Experiment (SAREX), Parise talks to students on Earth from the flight deck of the Earth orbiting Space Shuttle Endeavour.

Administrative Perceptions on the Role of the School Library Media Specialist

Science.gov (United States)

Page, Kayla

2013-01-01

Despite the efforts of local school library media specialists to promote their programming, many administrators do not understand the roles and responsibilities of the school library media specialist. Using a constructivist theoretical framework, this study was designed to examine the local school administrators' perceptions of the role of the…

Rural specialists: The nature of their work and professional satisfaction by geographical location of work.

Science.gov (United States)

O'Sullivan, Belinda; McGrail, Matthew; Russell, Deborah

2017-12-01

Systematically describe the characteristics of rural specialists, their work and job satisfaction by geographical location of work. Cross-sectional. Three thousand, four hundred and seventy-nine medical specialists participating in the 2014 Medicine in Australia: Balancing Employment and Life (MABEL) survey of doctors. Location of practice, whether metropolitan, large (>50 000 population) or small regional centres (Rural specialists had more on-call requirements and poorer professional development opportunities. However, satisfaction with work hours, remuneration, variety of work, level of responsibility, opportunities to use abilities and overall satisfaction did not differ. Specialists in general medicine and general surgery were significantly more likely to work rurally compared with anaesthetists, particularly in small regional centres, whereas a range of other relevant specialists had lower than the average rural distribution and paediatricians and endocrinologists were significantly less likely to work in large regional centres. Rural specialists are just as satisfied as metropolitan counterparts reporting equivalent variety and responsibility at work. Better support for on-call demands and access to professional development could attract more specialists to rural practice. Increased rural training opportunities and regional workforce planning is needed to develop and recruit relevant specialties. Specifically, targeted support is warranted for training and development of specialists in general medicine and general surgery and overseas-trained specialists, who provide essential services in smaller regional centres. © 2017 National Rural Health Alliance Inc.

Status of Ignalina's safety analysis reports

International Nuclear Information System (INIS)

Uspuras, E.

1999-01-01

Ignalina NPP is unique among RBMK type reactors in the scope and comprehensiveness of international studies which have been performed to verify its design parameters and analyze risk levels. International assistance took several forms, a very valuable mod of assistance utilized the knowledge of international experts in extensive international studies whose purpose was: collection, systematization and verification of plant design data; analysis of risk levels; recommendations leading to improvements in the safety lave; transfer of state of the art analytical methodology to Lithuanian specialists. The major large scale international studies include: probabilistic risk analysis; extensive international study meant to provide comprehensive overview of plant status with special emphasis on safety aspects; an extensive review of the Safety Analysis Report by an independent group of international experts. In spite of the safety improvements and analyses which have been performed at the Ignalina NPP, much remains to be done in the nearest future

Risk-based decision analysis for groundwater operable units

International Nuclear Information System (INIS)

Chiaramonte, G.R.

1995-01-01

This document proposes a streamlined approach and methodology for performing risk assessment in support of interim remedial measure (IRM) decisions involving the remediation of contaminated groundwater on the Hanford Site. This methodology, referred to as ''risk-based decision analysis,'' also supports the specification of target cleanup volumes and provides a basis for design and operation of the groundwater remedies. The risk-based decision analysis can be completed within a short time frame and concisely documented. The risk-based decision analysis is more versatile than the qualitative risk assessment (QRA), because it not only supports the need for IRMs, but also provides criteria for defining the success of the IRMs and provides the risk-basis for decisions on final remedies. For these reasons, it is proposed that, for groundwater operable units, the risk-based decision analysis should replace the more elaborate, costly, and time-consuming QRA

Think Stoma Nurse: a tool to trigger referral to specialist care.

Science.gov (United States)

Hanley, Judy; Adams, Jane

This article describes the initial development and subsequent evolution of a simple referral assessment tool for stoma care. The first author's personal experience identified that there was widespread inconsistency in perceptions of local multidisciplinary teams as to when it was appropriate to refer to specific specialist nursing teams. This resulted in both inappropriate and delayed referrals. A 'Think Specialist Nurse' initiative was developed across the author's trust, building on the traffic light template from the 'ThinkGlucose' tool, to facilitate referrals to clinical nurse specialists. The stoma-care specific tool, 'Think Stoma Nurse', has subsequently evolved beyond its initial audience, and has been adapted into materials aimed at patients and carers.

The Specialist Court for Kosovo: continuity or departure from the hybrid courts model?

Directory of Open Access Journals (Sweden)

Shkёlzen Selimi

2016-01-01

Full Text Available The issue of whether to establish Specialist Chambers within the Kosovo justice system for alleged war crimes committed in Kosovo has been, arguably, one of the most heated debates not only from a political and social point of view, but also from a legal one. While the required amendments in the Constitution and several laws of Kosovo necessary to establish the Specialist Chambers in furtherance of the agreement dated 14 April 2014 between the Republic of Kosovo and the European Union on the Mission of the European Union Rule of Law Mission in Kosovo (“EULEX” will certainly create heated debates in the political level, one may argue that the legal issues that are expected to be encountered when the Specialist Chambers will be operational, may be even more pressing. This is in consideration of the peculiar nature of the Specialist Chambers, which are meant to have their basis within the laws of Kosovo, but at the same time, be independent from them and from control of Kosovo authorities. The purpose of this article is to delineate the possible legal issues that might confront the Specialist Chambers of Kosovo. Its main argument is that, while the Specialist Chambers seem to follow the experience of other hybrid internationalised courts, it still differs from them in some aspects. The challenges that the new Specialist Chambers may need to tackle deal with its jurisdiction and position within the Kosovo Judicial system, and its legitimacy and legal basis.

Resource specialists lead local insect community turnover associated with temperature - analysis of an 18-year full-seasonal record of moths and beetles

DEFF Research Database (Denmark)

Thomsen, Philip Francis; Jørgensen, Peter Søgaard; Bruun, Hans Henrik

2016-01-01

role of resource specialization in explaining the compositional and phenological responses of insect communities to local temperature increases. We propose that resource specialists in particular are affected by local temperature increase, leading to the distinct temperature-mediated turnover seen...... opportunity for predictions about responses of resource specialists, and long-term time series are essential in revealing these responses. Here, we investigate temperature-related changes in local insect communities, using a sampling site with more than a quarter-million records from two decades (1992...

PROBLEMS OF FORMATION OF HIGHLY QUALIFIED SPECIALIST IN ACCORDANCE WITH FUNDAMENTALLY NEW CHALLENGES OF MODERNITY

Directory of Open Access Journals (Sweden)

Vladimir Shostka

2015-09-01

Full Text Available Some aspects of education of specialists are reflected in the article. Methods and problems of organization of improvement of quality and efficiency of learning process are considered. The paper conducts a comparative analysis of the competencies that are formed at different levels of education according to Russian and European educational standards.

How to Perform an Ethical Risk Analysis (eRA).

Science.gov (United States)

Hansson, Sven Ove

2018-02-26

Ethical analysis is often needed in the preparation of policy decisions on risk. A three-step method is proposed for performing an ethical risk analysis (eRA). In the first step, the people concerned are identified and categorized in terms of the distinct but compatible roles of being risk-exposed, a beneficiary, or a decisionmaker. In the second step, a more detailed classification of roles and role combinations is performed, and ethically problematic role combinations are identified. In the third step, further ethical deliberation takes place, with an emphasis on individual risk-benefit weighing, distributional analysis, rights analysis, and power analysis. Ethical issues pertaining to subsidiary risk roles, such as those of experts and journalists, are also treated in this phase. An eRA should supplement, not replace, a traditional risk analysis that puts emphasis on the probabilities and severities of undesirable events but does not cover ethical issues such as agency, interpersonal relationships, and justice. © 2018 Society for Risk Analysis.

Proceedings of the specialists' meeting on delayed neutron nuclear data

International Nuclear Information System (INIS)

Katakura, Jun-ichi

1999-07-01

This report is the Proceedings of the Specialists' Meeting on Delayed Neutron Nuclear Data. The meeting was held on January 28-29, 1999, at the Tokai Research Establishment of Japan Atomic Energy Research Institute with the participation of thirty specialists, who are evaluators, theorist, experimentalists. Although the fraction of the delayed neutron is no more than 1% in the total neutrons emitted in the fission process, it plays an important roll in the control of fission reactor. In the meeting, the following topics were reported: the present status of delayed neutron data in the major evaluated data libraries, measurements of effective delayed neutron fraction using FCA (Fast Critical Assembly) and TCA (Tank-type Critical Assembly) and their analyses, sensitivity analysis for fast reactor, measurements of delayed neutron emission from actinides and so on. As another topics, delayed neutron in transmutation system and fission yield data were also presented. Free discussion was held on the future activity of delayed neutron data evaluation. The discussion was helpful for the future activity of the delayed neutron working group of JNDC aiming to the evaluation of delayed neutron data for JENDL-3.3. The 15 of the presented papers are indexed individually. (J.P.N.)

Second Specialist Meeting on operator aids for severe accident management: summary and conclusions

International Nuclear Information System (INIS)

1997-01-01

The second OECD Specialist Meeting on operator aids for severe accident management (SAMOA-2) was held in Lyon, France (1997), and was attended by 33 specialists representing ten OECD member countries. As for SAMOA-1, the scope of SAMOA-2 was limited to operator aids for accident management which were in operation or could be soon. The meeting concentrated on the management of accidents beyond the design basis, including tools which might be extended from the design basis range into the severe accident area. Relevant simulation tools for operator training were also part of the scope of the meeting. 20 papers were presented; there were two demonstrations of computerized systems (the ATLAS analysis simulator developed by GRS, and EDF's 'Simulateur Post Accidentels' (SIPA). The three sessions dealt with operator aids for control rooms, operator aids for technical support centres, and simulation tools for operator training. The various papers for each session are summarized

A Business Case Framework for Planning Clinical Nurse Specialist-Led Interventions.

Science.gov (United States)

Bartlett Ellis, Rebecca J; Embree, Jennifer L; Ellis, Kurt G

2015-01-01

The purpose of this article is to describe a business case framework that can guide clinical nurse specialists (CNS) in clinical intervention development. Increased emphasis on cost-effective interventions in healthcare requires skills in analyzing the need to make the business case, especially for resource-intensive interventions. This framework assists the CNS to anticipate resource use and then consider if the intervention makes good business sense. We describe a business case framework that can assist the CNS to fully explore the problem and determine if developing an intervention is a good investment. We describe several analyses that facilitate making the business case to include the following: problem identification and alignment with strategic priorities, needs assessment, stakeholder analysis, market analysis, intervention implementation planning, financial analysis, and outcome evaluation. The findings from these analyses can be used to develop a formal proposal to present to hospital leaders in a position to make decisions. By aligning intervention planning with organizational priorities and engaging patients in the process, interventions will be more likely to be implemented in practice and produce robust outcomes. The business case framework can be used to justify to organization decision makers the need to invest resources in new interventions that will make a difference for quality outcomes as well as the financial bottom line. This framework can be used to plan interventions that align with organizational strategic priorities, plan for associated costs and benefits, and outcome evaluation. Clinical nurse specialists are well positioned to lead clinical intervention projects that will improve the quality of patient care and be cost-effective. To do so requires skill development in making the business case.

Part-time and full-time medical specialists, are there differences in allocation of time?

Directory of Open Access Journals (Sweden)

Groenewegen Peter P

2006-03-01

Full Text Available Abstract Background An increasing number of medical specialists prefer to work part-time. This development can be found worldwide. Problems to be faced in the realization of part-time work in medicine include the division of night and weekend shifts, as well as communication between physicians and continuity of care. People tend to think that physicians working part-time are less devoted to their work, implying that full-time physicians complete a greater number of tasks. The central question in this article is whether part-time medical specialists allocate their time differently to their tasks than full-time medical specialists. Methods A questionnaire was sent by mail to all internists (N = 817, surgeons (N = 693 and radiologists (N = 621 working in general hospitals in the Netherlands. Questions were asked about the actual situation, such as hours worked and night and weekend shifts. The response was 53% (n = 411 for internists, 52% (n = 359 for surgeons, and 36% (n = 213 for radiologists. Due to non-response on specific questions there were 367 internists, 316 surgeons, and 71 radiologists included in the analyses. Multilevel analyses were used to analyze the data. Results Part-time medical specialists do not spend proportionally more time on direct patient care. With respect to night and weekend shifts, part-time medical specialists account for proportionally more or an equal share of these shifts. The number of hours worked per FTE is higher for part-time than for full-time medical specialists, although this difference is only significant for surgeons. Conclusion In general, part-time medical specialists do their share of the job. However, we focussed on input only. Besides input, output like the numbers of services provided deserves attention as well. The trend in medicine towards more part-time work has an important consequence: more medical specialists are needed to get the work done. Therefore, a greater number of medical specialists

RISK ANALYSIS IN INFORMATION TECHNOLOGY AND COMMUNICATION OUTSOURCING

Directory of Open Access Journals (Sweden)

Edmir Parada Vasques Prado

2011-12-01

Full Text Available This research aims at evaluating the risk analysis process in Information Technology and Communication (ICT outsourcing conducted by organizations of the private sector. The research is characterized by being a descriptive, quantitative and transversal type study, which was used the survey method. Data were collected through questionnaire, the sample is not random and we used a convenience sampling process. The research made contributions to understanding the risk analysis process in ICT services outsourcing, and identified statistically significant relationships between risk analysis, organization's size and its industry, and between risk analysis and diversity of outsourced services

Operative training in otolaryngology in the United Kingdom: a specialist registrar survey

NARCIS (Netherlands)

Georgalas, Christos; Hadjihannas, Edward; Ghufoor, Khalid; Pracy, Paul; Papesch, Michael

2005-01-01

OBJECTIVE: To assess the current status of operative training for otolaryngology specialist registrars in the United Kingdom. DESIGN: Web-based questionnaire survey. PARTICIPANTS: All otolaryngology specialist registrars in the United Kingdom. MAIN OUTCOME MEASURES: The overall satisfaction with

What influences the job satisfaction of staff and associate specialist hospital doctors?

Science.gov (United States)

French, Fiona; Ikenwilo, Divine; Scott, Anthony

2007-08-01

Despite their rising numbers in the National Health Service (NHS), the recruitment, retention, morale and educational needs of staff and associate specialist hospital doctors have traditionally not been the focus of attention. A postal survey of all staff grades and associate specialists in NHS Scotland was conducted to investigate the determinants of their job satisfaction. Doctors in both grades were least satisfied with their pay. They were more satisfied if they were treated as equal members of the clinical team, but less satisfied if their workload adversely affected the quality of patient care. With the exception of female associate specialists, respondents who wished to become a consultant were less satisfied with all aspects of their jobs. Associate specialists who worked more sessions also had lower job satisfaction. Non-white staff grades were less satisfied with their job compared with their white counterparts. It is important that associate specialists and staff grades are promoted to consultant posts, where this is desired. It is also important that job satisfaction is enhanced for doctors who do not desire promotion, thereby improving retention. This could be achieved through improved pay, additional clinical training, more flexible working hours and improved status.

Risk-benefit analysis and public policy: a bibliography

Energy Technology Data Exchange (ETDEWEB)

Clark, E.M.; Van Horn, A.J.

1976-11-01

Risk-benefit analysis has been implicitly practiced whenever decision-makers are confronted with decisions involving risks to life, health, or to the environment. Various methodologies have been developed to evaluate relevant criteria and to aid in assessing the impacts of alternative projects. Among these have been cost-benefit analysis, which has been widely used for project evaluation. However, in many cases it has been difficult to assign dollar costs to those criteria involving risks and benefits which are not now assigned explicit monetary values in our economic system. Hence, risk-benefit analysis has evolved to become more than merely an extension of cost-benefit analysis, and many methods have been applied to examine the trade-offs between risks and benefits. In addition, new scientific and statistical techniques have been developed for assessing current and future risks. The 950 references included in this bibliography are meant to suggest the breadth of those methodologies which have been applied to decisions involving risk.

Risk-benefit analysis and public policy: a bibliography

International Nuclear Information System (INIS)

Clark, E.M.; Van Horn, A.J.

1976-11-01

Risk-benefit analysis has been implicitly practiced whenever decision-makers are confronted with decisions involving risks to life, health, or to the environment. Various methodologies have been developed to evaluate relevant criteria and to aid in assessing the impacts of alternative projects. Among these have been cost-benefit analysis, which has been widely used for project evaluation. However, in many cases it has been difficult to assign dollar costs to those criteria involving risks and benefits which are not now assigned explicit monetary values in our economic system. Hence, risk-benefit analysis has evolved to become more than merely an extension of cost-benefit analysis, and many methods have been applied to examine the trade-offs between risks and benefits. In addition, new scientific and statistical techniques have been developed for assessing current and future risks. The 950 references included in this bibliography are meant to suggest the breadth of those methodologies which have been applied to decisions involving risk

OECD/CSNI specialist meeting on nuclear aerosols in reactor safety - Summary and Conclusions

International Nuclear Information System (INIS)

Allelein, Hans-Josef; Boulaud, Denis; Guentay, Salih; Dehbi, Abdelouahab; Hontanon, Esther; Jokiniemi, Jorma; Jones, Alan V.; Koroll, Grant W.; Tinkler, Charles G.; Schaperow, J.; Royen, Jacques

1999-01-01

The Third OECD Specialist Meeting on Nuclear Aerosols in Reactor Safety was organised in Cologne, Germany, from 15-18 June 1998, in collaboration with the Gesellschaft fuer Anlagen- und Reaktorsicherheit (GRS) mbH. It was attended by sixty-five specialists representing thirteen OECD Member countries and the Commission of the European Communities. Thirty-nine papers were presented, in eight sessions. The meeting was concluded by a general discussion devoted to the following topics: - What has been solved up to the level of plant applications and accident management? - Where is more work needed for plant applications? Over the last eight years significant progress has been made in source term modelling and code development. Results have been consolidated in codes which are being used for plant calculations to address safety issues. For example, two countries used their source term codes last year to assess the impact of heating from deposited fission products on the potential for steam generator tube rupture. Also, another source term code was used to assess the need of sprays for fission product removal in the proposed design of a new type of reactor. Over the next few years, experiments and model development will continue, with more emphasis on application to risk-important severe accident scenarios

Evaluating the mathematical models to Solve Job Shop Problem with the Use of human resources specialists in projects

Directory of Open Access Journals (Sweden)

Renato Penha

2012-10-01

Full Text Available A project can be defined as a complex system. This requires the use of resources (human, material, technology, etc., allocated among alternative uses, as a means to achieve specific goals by the presence of constraints of different orders. The planning, allocation and prioritization of resources, including human resource specialists (HRE, is performed by means of single project management.This treatment can cause internal strife by using the same resource or even its underuse, and may worsen in software development environments due to the high degree of interdependence, uncertainty and risk of each project. This need is related to the so called Job Shop Problem (JSP. In this context, the objective of this study is to evaluate the mathematical models of genetic algorithm and optimization and their contributions to solve Job Shop Problem in software development projects with the use of human resources specialists.

Specialist Teams Needed to Support Youth.

Science.gov (United States)

Mellin, Laurel M.

1991-01-01

Presents seven reasons why it is important for health specialist teams to take action supporting the prevention and treatment of childhood obesity. The article offers guidelines to help parents assist their children in maintaining positive eating, exercise, and self-esteem patterns, noting sensitive intervention is preferable to imposed diets. (SM)

Methods for Risk Analysis

International Nuclear Information System (INIS)

Alverbro, Karin

2010-01-01

Many decision-making situations today affect humans and the environment. In practice, many such decisions are made without an overall view and prioritise one or other of the two areas. Now and then these two areas of regulation come into conflict, e.g. the best alternative as regards environmental considerations is not always the best from a human safety perspective and vice versa. This report was prepared within a major project with the aim of developing a framework in which both the environmental aspects and the human safety aspects are integrated, and decisions can be made taking both fields into consideration. The safety risks have to be analysed in order to be successfully avoided and one way of doing this is to use different kinds of risk analysis methods. There is an abundance of existing methods to choose from and new methods are constantly being developed. This report describes some of the risk analysis methods currently available for analysing safety and examines the relationships between them. The focus here is mainly on human safety aspects

Clinical Nurse Specialists Guide Staff Nurses to Promote Practice Accountability Through Peer Review.

Science.gov (United States)

Semper, Julie; Halvorson, Betty; Hersh, Mary; Torres, Clare; Lillington, Linda

2016-01-01

The aim of the study was to describe the clinical nurse specialist role in developing and implementing a staff nurse education program to promote practice accountability using peer review principles. Peer review is essential for professional nursing practice demanding a significant culture change. Clinical nurse specialists in a Magnet-designated community hospital were charged with developing a staff nurse peer review education program. Peer review is a recognized mechanism of professional self-regulation to ensure delivery of quality care. The American Nurses Association strongly urges incorporating peer review in professional nursing practice models. Clinical nurse specialists play a critical role in educating staff nurses about practice accountability. Clinical nurse specialists developed an education program guided by the American Nurses Association's principles of peer review. A baseline needs assessment identified potential barriers and learning needs. Content incorporated tools and strategies to build communication skills, collaboration, practice change, and peer accountability. The education program resulted in increased staff nurse knowledge about peer review and application of peer review principles in practice. Clinical nurse specialists played a critical role in helping staff nurses understand peer review and its application to practice. The clinical nurse specialist role will continue to be important in sustaining the application of peer review principles in practice.

The Path to Advanced Practice Licensure for Clinical Nurse Specialists in Washington State.

Science.gov (United States)

Schoonover, Heather

The aim of this study was to provide a review of the history and process to obtaining advanced practice licensure for clinical nurse specialists in Washington State. Before 2016, Washington State licensed certified nurse practitioners, certified nurse midwives, and certified nurse anesthetists under the designation of an advanced registered nurse practitioner; however, the state did not recognize clinical nurse specialists as advanced practice nurses. The work to drive the rule change began in 2007. The Washington Affiliate of the National Association of Clinical Nurse Specialists used the Power Elite Theory to guide advocacy activities, building coalitions and support for the desired rule changes. On January 8, 2016, the Washington State Nursing Care Quality Assurance Commission voted to amend the state's advanced practice rules, including clinical nurse specialists in the designation of an advanced practice nurse. Since the rule revision, clinical nurse specialists in Washington State have been granted advanced registered nurse practitioner licenses. Driving changes in state regulatory rules requires diligent advocacy, partnership, and a deep understanding of the state's rule-making processes. To be successful in changing rules, clinical nurse specialists must build strong partnerships with key influencers and understand the steps in practice required to make the desired changes.

Management of Nonceliac Gluten Sensitivity by Gastroenterology Specialists: Data from an Italian Survey

Directory of Open Access Journals (Sweden)

Federica Branchi

2015-01-01

Full Text Available Background and Aim. Nonceliac gluten sensitivity is syndrome characterized by symptoms disappearing after a gluten-free diet. Its existence is still argument of discussion among specialists. Our aim was to evaluate the knowledge about nonceliac gluten sensitivity among gastroenterology specialists. Methods. During October 2013 a questionnaire was sent through a medical newsletter to Italian gastroenterologists. Twelve questions investigated their knowledge on nonceliac gluten sensitivity, including their diagnostic and therapeutic approach. Results. A total of 212 gastroenterologists filled in the questionnaire. The 98.6% were aware of the existence of a syndrome called “nonceliac gluten sensitivity” and 77% believe in its existence. However, only 56% gave a correct definition of the term. The majority of specialists diagnosed gluten sensitive patients and the number of diagnoses was not statistically different from that of celiac disease. Moreover, a gluten-free diet was prescribed by 64% of the specialists and among them the 73% noted an increase of gluten sensitive patients attending their outpatient services. Conclusions. Our study indicated that most of the specialists recognize nonceliac gluten sensitivity and prescribe gluten-free diet, although 44% of the specialists are not able to give its correct definition; underlining the necessity of medical education on this topic is needed.

The impact of economic factors on migration considerations among Icelandic specialist doctors: a cross-sectional study.

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Solberg, Ingunn Bjarnadóttir; Tómasson, Kristinn; Aasland, Olaf; Tyssen, Reidar

2013-12-18

Globalization has facilitated the employability of doctors almost anywhere in the world. In recent years, the migration of doctors seems to have increased. However, we lack studies on doctors' migration from developed countries. Because the economic recession experienced by many countries might have affected the migration of doctors, research on this topic is important for the retention of doctors. Iceland was hit hard by the economic recession in 2008. Therefore, we want to explore how many specialist doctors in Iceland have considered migrating and whether economic factors at work and in private life, such as extensive cost-containment initiatives at work and worries about personal finances, are related to doctors' migration considerations. In 2010, all doctors in Iceland registered with the Icelandic Medical Association were sent an electronic cross-sectional survey by email. The 467 specialists who participated in this study represent 55% of all specialist doctors working in Iceland. Information on doctors' contemplation of migration was available from responses to the question: "Have you considered moving and working abroad?" The predictor variables in our logistic regression model are perceived cost-containment initiatives at work, stress related to personal finances, experience of working abroad during vacations, job dissatisfaction, job position, age, and gender. Sixty-three per cent of Iceland's specialist doctors had considered relocation abroad, 4% were moving in the next year or two, and 33% had not considered relocating. Logistic regression analysis shows that, controlling for age, gender, job position, job satisfaction, and experience of working abroad during vacations, doctors' migration considerations were significantly affected by their experiences of cost-containment initiatives at work (odds ratio (OR) = 2.0, p Economic factors affect whether specialist doctors in Iceland consider migration. More studies on the effect of economic recession

IT Security Specialist | IDRC - International Development Research ...

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

The IT Security Specialist takes a strategic role in the delivery of Infrastructure ... on IT Security to project managers, business clients and senior management. ... as a team member or a team leader by undertaking research, investigations, ...

Racial Disparities in Asthma Morbidity Among Pediatric Patients Seeking Asthma Specialist Care.

Science.gov (United States)

Mitchell, Stephanie J; Bilderback, Andrew L; Okelo, Sande O

2016-01-01

To elucidate whether there may be a higher morbidity threshold for African American versus white children to be referred to or seek asthma specialist care. Secondary analysis of registry data captured from children presenting for an initial routine outpatient asthma consultation. Parents completed standard survey instruments, and spirometry was conducted when deemed appropriate by the provider. Wilcoxon rank sum tests revealed that African American patients had been hospitalized twice as often and admitted to the intensive care unit or intubated significantly more than 1½ times more frequently than their white patient counterparts. t tests indicated African American patients' forced expiratory volume in 1 second (FEV1) percentage predicted was significantly worse than that of whites, but there was no significant difference for FEV1/forced vital capacity ratio. t tests suggested that African American patients had statistically worse asthma control than did white patients at the time of initial presentation to the pulmonologist, but there was no difference in the distribution of asthma severity categories. Multivariate regression models indicated that racial differences in parent education did not explain the disparities in asthma morbidity. African American patients had significantly worse asthma morbidity than their white counterparts, including higher rates of hospitalization and intensive care unit admission and poorer lung functioning. Given that receipt of asthma specialist care can improve those outcomes that are disparately experienced by African American children, methods of increasing their access to and use of asthma specialist care need to be developed. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Flood Risk Assessment Based On Security Deficit Analysis

Science.gov (United States)

Beck, J.; Metzger, R.; Hingray, B.; Musy, A.

Risk is a human perception: a given risk may be considered as acceptable or unac- ceptable depending on the group that has to face that risk. Flood risk analysis of- ten estimates economic losses from damages, but neglects the question of accept- able/unacceptable risk. With input from land use managers, politicians and other stakeholders, risk assessment based on security deficit analysis determines objects with unacceptable risk and their degree of security deficit. Such a risk assessment methodology, initially developed by the Swiss federal authorities, is illustrated by its application on a reach of the Alzette River (Luxembourg) in the framework of the IRMA-SPONGE FRHYMAP project. Flood risk assessment always involves a flood hazard analysis, an exposed object vulnerability analysis, and an analysis combing the results of these two previous analyses. The flood hazard analysis was done with the quasi-2D hydraulic model FldPln to produce flood intensity maps. Flood intensity was determined by the water height and velocity. Object data for the vulnerability analysis, provided by the Luxembourg government, were classified according to their potential damage. Potential damage is expressed in terms of direct, human life and secondary losses. A thematic map was produced to show the object classification. Protection goals were then attributed to the object classes. Protection goals are assigned in terms of an acceptable flood intensity for a certain flood frequency. This is where input from land use managers and politicians comes into play. The perception of risk in the re- gion or country influences the protection goal assignment. Protection goals as used in Switzerland were used in this project. Thematic maps showing the protection goals of each object in the case study area for a given flood frequency were produced. Com- parison between an object's protection goal and the intensity of the flood that touched the object determine the acceptability of the risk and the

A novel statistical method for classifying habitat generalists and specialists

DEFF Research Database (Denmark)

Chazdon, Robin L; Chao, Anne; Colwell, Robert K

2011-01-01

in second-growth (SG) and old-growth (OG) rain forests in the Caribbean lowlands of northeastern Costa Rica. We evaluate the multinomial model in detail for the tree data set. Our results for birds were highly concordant with a previous nonstatistical classification, but our method classified a higher......: (1) generalist; (2) habitat A specialist; (3) habitat B specialist; and (4) too rare to classify with confidence. We illustrate our multinomial classification method using two contrasting data sets: (1) bird abundance in woodland and heath habitats in southeastern Australia and (2) tree abundance...... fraction (57.7%) of bird species with statistical confidence. Based on a conservative specialization threshold and adjustment for multiple comparisons, 64.4% of tree species in the full sample were too rare to classify with confidence. Among the species classified, OG specialists constituted the largest...

Sources of satisfaction and dissatisfaction among specialists within the public and private health sectors.

Science.gov (United States)

Ashton, Toni; Brown, Paul; Sopina, Elizaveta; Cameron, Linda; Tenbensel, Timothy; Windsor, John

2013-09-27

As in many countries, medical and surgical specialists in New Zealand have the opportunity of working in the public sector, the private sector or both. This study aimed to explore the level and sources of satisfaction and dissatisfaction of specialists in New Zealand with working in the two sectors. Such information can assist workforce planning, management and policy and may inform the wider debate about the relationship between the two sectors. A postal survey was conducted of 1983 registered specialists throughout New Zealand. Respondents were asked to assess 14 sources of satisfaction and 9 sources of dissatisfaction according to a 5-point Likert scale. Means and standard deviations were calculated for the total sample, and for procedural and non-procedural specialties. Differences between the means of each source of satisfaction and dissatisfaction were also calculated. Completed surveys were received from 943 specialists (47% response rate). Overall mean levels of satisfaction were higher in the private sector than the public sector while levels of dissatisfaction were lower. While the public system is valued for its opportunities for further education and professional development, key sources of dissatisfaction are workload pressures, mentally demanding work and managerial interference. In the private sector specialists value the opportunity to work independently and apply their own ideas in the workplace. Sources of job satisfaction and dissatisfaction amongst specialists are different for the public and private sectors. Allowing specialists more freedom to work independently and to apply their own ideas in the workplace may enhance recruitment and retention of specialists in the public health system.

Commissioning of specialist palliative care services in England.

Science.gov (United States)

Lancaster, Harriet; Finlay, Ilora; Downman, Maxwell; Dumas, James

2018-03-01

Some failures in end-of-life care have been attributed to inconsistent provision of palliative care across England. We aimed to explore the variation in commissioning of services by Clinical Commissioning Groups (CCGs) using a data collection exercise. We sent a Freedom of Information request in the form of an open questionnaire to all 209 CCGs in England to assess their commissioning of palliative and end-of-life care services, mainly focused on the provision of specialist palliative care services. 29 CCGs provided information about the number of patients with some form of palliative care needs in their population. For specialist palliative care services, CCGs allocated budgets ranging from £51.83 to £2329.19 per patient per annum. 163 CCGs (77.90%) currently commission 7-day admission to their specialist palliative care beds. 82.84% of CCGs commission 7-day specialist palliative care services in patients' own homes and out-of-hours services rely heavily on hospice provision. 64 CCGs (31.37%) commission pain control teams, the majority of whom only operate in regular working hours. 68.14% of CCGs reported commissioning palliative care education of any sort for healthcare professionals and 44.85% of CCGs had no plans to update or review their palliative care services. The most important finding from this exercise is that the information CCGs hold about their population and services is not standardised. However, information based on data that are more objective, for example, population and total budget for palliative care, demonstrate wide variations in commissioning. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

[Changing to a career in general practice - a qualitative study reveals motives of specialists].

Science.gov (United States)

Schwill, Simon; Magez, Julia; Jäger, Cornelia; von Meißner, Wolfgang Cg; Szecsenyi, Joachim; Flum, Elisabeth

2016-12-01

In 2011, the national German Medical Association (Bundesärztekammer) published guidelines for a slim-lined training program in general practice (Quereinstieg) for qualified medical specialists in other fields (e. g., surgeons, internists or anesthesiologists). This step is part of a strategy to prevent further shortages of general practitioners in Germany. In the state of Baden-Wuerttemberg, qualified medical specialists are allowed to complete their general practice training in approximately two years instead of five. The aim of this study was to understand the reasons of specialists for changing to a career in general practice. The postgraduate training program Verbundweiterbildung plus Baden-Württemberg had 597 trainees at the time of the study in December 2015. Previously qualified specialists in another medical discipline were identified and invited to participate in this study. Qualitative data was gathered using semi-structured interviews with content analysis of the interviews performed by three independent members of the research team. In total, 36 out of 597 trainees were identified as previously qualified specialists in another medical discipline. All 36 were invited to take part and 15 agreed to participate in this study. Overall, 15 interviews were performed, with a mean time of 24.19minutes. Participants with a median age of 40 years (33-59 years) - mainly anesthesiologists (n=7), surgeons (n=3) and internists (n=3) - presented with an average of 6.5 years of professional experience in their specialty. First, the participants' motivation to switch career arose from the wish to intensify the quality of patient contacts with a holistic approach including family and social background and from the infinite variety of general practice. Another reason given for a career change was self-employment opportunities. Finally, feelings of frustration over poor working conditions in hospitals resulted in a job search elsewhere in medicine, taking account of

Analysis and management of risks experienced in tunnel construction

Directory of Open Access Journals (Sweden)

Cagatay Pamukcu

2015-12-01

Full Text Available In this study, first of all, the definitions of "risk", "risk analysis", "risk assessment" and "risk management" were made to avoid any confusions about these terms and significance of risk analysis and management in engineering projects was emphasized. Then, both qualitative and quantitative risk analysis techniques were mentioned and within the scope of the study, Event Tree Analysis method was selected in order to analyze the risks regarding TBM (Tunnel Boring Machine operations in tunnel construction. After all hazards that would be encountered during tunnel construction by TBM method had been investigated, those hazards were undergoing a Preliminary Hazard Analysis to sort out and prioritize the risks with high scores. When the risk scores were taken into consideration, it was seen that the hazards with high risk scores could be classified into 4 groups which are excavation + support induced accidents, accidents stemming from geologic conditions, auxiliary works, and project contract. According to these four classified groups of initiating events, Event Tree Analysis was conducted by taking into care 4 countermeasures apart from each other. Finally, the quantitative and qualitative consequences of Event Tree Analyses, which were undertaken for all initiating events, were investigated and interpreted together by making comparisons and referring to previous studies.

Personalizing protocol-driven care: the case of specialist heart failure nurses.

Science.gov (United States)

Sanders, Tom; Harrison, Stephen; Checkland, Katherine

2010-09-01

This paper is a report of a study conducted to explore how specialist heart failure nurses negotiate treatment advice with patients, in the context of an increasing expectation that clinical staff in the National Health Services will follow guidelines in their daily work. The development of specialist nurse roles has given rise to questions about their compatibility with patient-centred care. However, research has revealed little about how specialist nurses balance clinical guidelines with traditional caring tasks. Semi-structured interviews (n = 10) were conducted with specialist heart failure nurses in northern England recruited from a heart failure specialist nursing contact list. In addition, non-participant observations were carried out on nurse-patient consultations (n = 16) in one regional nurse-led heart failure clinic. Data were collected between 2003 and 2005, and analysed using a variation of grounded theory. Heart failure nurses sought to combine traditional caring work with the wider goal of improving patient outcomes by 'personalizing' their advice to patients and presenting their heart failure as 'typical'. They accommodated protocol-driven care into their daily routines, and perceived no disjuncture between evidence-based practice and patient-centredness. However, their approach allowed little space for the exploration of each patient's own priorities about their illness. There is a need both to re-examine the appropriateness of traditional caring concepts, and to reflect on the need to incorporate patients' own values into the consultation process.

Doing HOF work in NPP - an internal specialist point of view

International Nuclear Information System (INIS)

Koistinen, Petri

2011-01-01

Organisational learning has been identified as one success factor both in general business literature and also in nuclear industry. One part of organisational learning is routines that support organisational learning. In nuclear industry learning from events is an important process of organisational learning. The other building blocks of learning organisation are climate that supports learning and leadership that encourages learning. These have also been identified in nuclear industry as being important issues. Learning from events relies on the validity of the investigation process. Investigation process and report has simply three parts: what happened (facts), why it happened (analysis) and how to prevent reoccurrence (corrective actions, CA). In RCA analysis part is highlighted, however it cannot be done correctly unless the facts have not been collected well. In a good learning process there must also be a follow up and feedback system for CA's. The following are the key points from this presentation: - Koistinen has been an internal HOF specialist since 2004; still the only HOF specialist at TVO. - Main duties are event investigations (including RCA), operating experience, safety culture improvement, human performance and organisational development issues. - Human error is typically the end point of an investigation - Koistinen's job is to find out what has led a good professional to make an error (organisational factors). - A blame-free or just culture is required to identify the organisational issues in an event. - RCA is used for the most serious events - about 5 RCA like investigations are conducted at the two TVO units per year. - Finland does not have RCA training available and so staff must go elsewhere. Those working in event investigations are usually new in the nuclear business and therefore lack experience. - The author presents a number of guidelines from STUK, the Finnish regulatory body. There are requirements for competence of investigators

The role of specialist nurses in multiple sclerosis: a rapid and systematic review.

Science.gov (United States)

De Broe, S; Christopher, F; Waugh, N

2001-01-01

Multiple sclerosis (MS) is a disease of the central nervous system. The cause is unknown. There are about 80-160 people with MS per 100,000 population, with twice as many women affected as men. The management of individuals with MS includes treatment of acute relapses and chronic symptoms. The care of MS patients is provided by various healthcare professionals, such as general practitioners (GPs), neurologists, physiotherapists, occupational therapists and nurses. Some MS patients have access to an MS specialist nurse, although this provision varies geographically. The aim of this report is to assess the effectiveness and relative cost-effectiveness of MS specialist nurses in improving care and outcomes for patients with MS. A systematic review of the literature, involving a range of databases, was performed. Full details are described in the main report. Only one study was identified that tried to evaluate the benefit of MS specialist nurses. The study concluded that MS patients and their carers found the MS specialist nurse to be helpful, particularly in improving their knowledge of MS, ability to cope, mood and confidence about the future. GPs also reported finding the nurse to be helpful with their MS patients, and 40% of the GPs stated they would purchase the services of an MS specialist nurse if their practices became fundholding. However, there were considerable methodological weaknesses inherent in the study design, and it was unclear whether the results of the study could be extrapolated to other settings or to other MS patient groups. RESULTS - ONGOING RESEARCH: There are two ongoing research studies regarding MS specialist nurses. One of these studies involves the provision of MS nurses to several areas, but also has two control populations to allow evaluation of the health benefits of the nurses to MS patients and their carers. This study will help to fill the evidence gap. RESULTS - COSTS: The costs of providing MS specialist nurses consist of their

49 CFR 260.17 - Credit risk premium analysis.

Science.gov (United States)

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Credit risk premium analysis. 260.17 Section 260... Financial Assistance § 260.17 Credit risk premium analysis. (a) When Federal appropriations are not available to cover the total subsidy cost, the Administrator will determine the Credit Risk Premium...

Career preferences and the work-family balance in medicine: gender differences among medical specialists.

Science.gov (United States)

Heiliger, P J; Hingstman, L

2000-05-01

In this article career preferences of medical specialists in the Netherlands are analysed, based on a survey among the members of medical associations of five specialties. Four different career preferences were offered, each of which implied a possible variation in working hours. A questionnaire was sent to a random selected group of working specialists in general practice, internal medicine, anaesthesiology, ophthalmology and psychiatry. Logistic regressions were used to predict career preferences. Besides individual characteristics, work and home domain characteristics were taken into the analysis. Not surprisingly, the preference for career change in respect of working hours is higher among full-time MDs, especially women, than among part-time workers. In contradiction to what was expected, home domain characteristics did not predict a part-time preference for female, but for male MDs. One home domain characteristic, children's age, did predict the male part-time preference. Further gender differences were found in respect of the fit between actual and preferred working hours (A/P-fit). The majority of male MDs with a full-time preference had achieved an A/P-fit, whereas significantly less female MDs achieved their preferences. It was found that hospital-bound specialists are less positive towards part-time careers than other specialists. Furthermore, the change of working hours would imply a reduction in FTE for all specialties, if all preferences were met. Especially in hospital-bound specialisms it was not confirmed that the reduction in FTE would be low; this was found only in respect of interns. It may be concluded that individual preferences in career paths are very diverse. Personnel policy in medical specialties, especially in hospitals, will have to cope with changes in traditional vertical and age-related career paths. Flexible careers related to home domain determinants or other activities will reinforce a life cycle approach, in which the centrality

[Supply and demand of medical specialists in the health facilities of the Ministry of Health: national, regional and by type of specialty gaps].

Science.gov (United States)

Zevallos, Leslie; Pastor, Reyna; Moscoso, Betsy

2011-06-01

To characterize the supply, demand and the gap of medical specialists in facilities of the Ministry of Health of Peru (MINSA) at the national, regional and specialty type levels. Observational, descriptive study through which we calculated the supply of medical specialists using secondary sources of MINSA. The analysis of the demand for medical specialists was based on two methodologies: the need for specialists according to the guidelines of classification of the health facilities and according to the epidemiological and demographic profile. The arithmetic difference between the estimated demand and the supply was the procedure used to calculate the gap of medical specialists. The Ministry of Health has a total supply at the national level of 6,074 medical specialists of which 61.5% belong to the clinical specialties, 33.2% to the surgical specialties, 4.9% specialities related to aid to diagnosis and treatment and 0.4% to public health specialties. According to the categorization guideline there is a total demand of 11,176 medical specialists and according to the epidemiological and demographic profile of 11,738. The national estimated gaps found are similar in both methods, although they differ widely across regions and by type of specialty. At the regional level, the gaps are greater in Loreto, Piura, Puno and Madre de Dios when estimating the defficit in relation to the supply. Regarding the speciality, the gap is greater in the four basic specialties: gynecology and obstetrics, pediatrics, internal medicine and general surgery. There is a waid gap between supply and demand of medical specialists at the national and regional levels, as a whole representing approximately 45% of the current offer, regardless of the estimation method.

Adult orthodontics in the Republic of Ireland: specialist orthodontists' opinions.

Science.gov (United States)

McMorrow, Siobhán Mary; Millett, Declan T

2017-12-01

To report the opinions of specialist orthodontists regarding the profile, characteristics and treatment of adults currently undergoing orthodontic treatment in the Republic of Ireland (ROI) Design/setting: A national cross-sectional questionnaire study in the ROI. A pilot-tested questionnaire was distributed to 122 specialist orthodontists in the ROI. Questions addressed general and treatment information for current adult orthodontic patients. Those whose treatment involved orthognathic surgery were not excluded. A response of 83% was obtained. Ninety-five per cent of specialists reported treating adults, most of whom were self-referred and were typically professional, female and aged 25-35 years. The overall ratio quoted of professionals to non-professionals was almost 3:2. For 50% of specialists, males were estimated to account for 20-40% of their adult cases and for 23%, this increased to an estimated 40-60%. Class II division 1 malocclusion and skeletal II were considered the most common dentofacial characteristics. Occlusal features encountered in decreasing frequency were generalised crowding, increased overjet, deep overbite, late lower incisor crowding, spacing and impacted teeth. Fifteen per cent reported that at least 10% of their adult cases required orthodontics with maxillofacial surgery but 8% reported that this was at least 50%. Treatment challenges commonly acknowledged were overbite reduction, anchorage management, 'black triangles' and overjet reduction. Tooth whitening was reckoned to be used by 19% of specialists. Aesthetic upper and stainless steel lower brackets were indicated to be used most often whereas only 19% used clear aligners and 10% used lingual appliances often. The profile and characteristics of adults currently undergoing orthodontic treatment in the ROI were diverse. Higher estimates were quoted for self- than for general dental practitioner-referral. A high percentage of treatment was reported to be undertaken for non

Entomology Specialist 1-1. Military Curriculum Materials for Vocational and Technical Education.

Science.gov (United States)

Jones, Jimmie L.

This individualized, self-paced course for training an entomology specialist was adapted from military curriculum materials for use in vocational and technical education. Completion of the course should provide students with basic information needed to accomplish the following duties of an entomology specialist: perform entomological work, apply…

The Association for Educational Communications and Technology: Division of School Media Specialists.

Science.gov (United States)

Miller, Mary Mock

1993-01-01

Reports on the Division of School Media Specialists of the Association for Educational Communications and Technology (AECT). Highlights include the mission statement; publications; board members and committee chairs; activities at the AECT conferences; and future concerns, including public relations and marketing plans for media specialists and…

Effectiveness and Persistence of Liraglutide Treatment Among Patients with Type 2 Diabetes Treated in Primary Care and Specialist Settings: A Subgroup Analysis from the EVIDENCE Study, a Prospective, 2-Year Follow-up, Observational, Post-Marketing Study.

Science.gov (United States)

Martinez, Luc; Penfornis, Alfred; Gautier, Jean-Francois; Eschwège, Eveline; Charpentier, Guillaume; Bouzidi, Amira; Gourdy, Pierre

2017-03-01

The objective of this subgroup analysis is to investigate the effectiveness of liraglutide in people with type 2 diabetes (T2D) treated within the primary care physician (PCP) and specialist care settings. EVIDENCE is a prospective, observational study of 3152 adults with T2D recently starting or about to start liraglutide treatment in France. We followed patients in the PCP and specialist settings for 2 years to evaluate the effectiveness of liraglutide in glycemic control and body weight reduction. Furthermore, we evaluated the changes in combined antihyperglycemic treatments, the reasons for prescribing liraglutide, patient satisfaction, and safety of liraglutide in these two treatment settings. After 2 years of follow-up, 477 out of 1209 (39.0%) of PCP and 297 out of 1398 (21.2%) of specialist-treated patients still used liraglutide and maintained the glycated hemoglobin (HbA 1c ) target of <7.0%. Significant reductions from baseline were observed in both PCP- and specialist-treated cohorts in mean HbA 1c (-1.22% and -0.8%, respectively), fasting plasma glucose (FPG) concentration (-39 and -23 mg/dL), body weight (-4.4 and -3.8 kg), and body mass index (BMI) (-1.5 and -1.4 kg/m 2 ), all p < 0.0001. Reductions in HbA 1c and FPG were significantly greater among PCP- compared with specialist-treated patients, p < 0.0001 for both. Patient treatment satisfaction was also significantly increased in both cohorts. Reported gastrointestinal adverse events were less frequent among PCP-treated patients compared with specialist-treated patients (4.5% vs. 16.1%). Despite differences in demography and clinical characteristics of patients treated for T2D in PCP and specialty care, greater reduction in HbA 1c and increased glycemic control durability were observed with liraglutide in primary care, compared with specialist care. These data suggest that liraglutide treatment could benefit patients in primary care by delaying the need for further treatment

Asthma management in a specialist setting: Results of an Italian Respiratory Society survey.

Science.gov (United States)

Braido, Fulvio; Baiardini, Ilaria; Alleri, Pietro; Bacci, Elena; Barbetta, Carlo; Bellocchia, Michela; Benfante, Alida; Blasi, Francesco; Bucca, Caterina; Busceti, Maria Teresa; Centanni, Stefano; Colanardi, Maria Cristina; Contoli, Marco; Corsico, Angelo; D'Amato, Maria; Di Marco, Fabiano; Marco, Dottorini; Ferrari, Marta; Florio, Giovanni; Fois, Alessandro Giuseppe; Foschino Barbaro, Maria Pia; Silvia, Garuti; Girbino, Giuseppe; Grosso, Amelia; Latorre, Manuela; Maniscalco, Sara; Mazza, Francesco; Mereu, Carlo; Molinengo, Giorgia; Ora, Josuel; Paggiaro, Pierluigi; Patella, Vincenzo; Pelaia, Girolamo; Pirina, Pietro; Proietto, Alfio; Rogliani, Paola; Santus, Pierachille; Scichilone, Nicola; Simioli, Francesca; Solidoro, Paolo; Terraneo, Silvia; Zuccon, Umberto; Canonica, Giorgio Walter

2017-06-01

Asthma considerably impairs patients' quality of life and increases healthcare costs. Severity, morbidity, and degree of disease control are the major drivers of its clinical and economic impact. National scientific societies are required to monitor the application of international guidelines and to adopt strategies to improve disease control and better allocate resources. to provide a detailed picture of the characteristics of asthma patients and modalities of asthma management by specialists in Italy and to develop recommendations for the daily management of asthma in a specialist setting. A quantitative research program was implemented. Data were collected using an ad hoc questionnaire developed by a group of specialists selected by the Italian Pneumology Society/Italian Respiratory Society. The records of 557 patients were analyzed. In the next few years, specialists are expected to focus their activity patients with more severe disease and will be responsible for selection of patients for personalized biological therapy; however, only 20% of patients attending Italian specialist surgery can be considered severe. In 84.4% of cases, the visit was a follow-up visit requested in 82.2% of cases by the specialist him/herself. The Asthma Control Test is used only in 65% of patients. When available, a significant association has been observed between the test score and asthma control as judged by the physician, although concordance was only moderate (κ = 0.68). Asthma was considered uncontrolled by the specialist managing the case in 29.1% of patients; nevertheless, treatment was not stepped up in uncontrolled or partly controlled patients (modified in only 37.2% of patients). The results of this survey support re-evaluation of asthma management by Italian specialists. More resources should be made available for the initial visit and for more severely ill patients. In addition, more extensive use should be made of validated tools, and available drugs should be used

STRUCTURAL-FUNCTIONAL MODEL OF PROFESSIONAL BUSINESS COMMUNICATION DEVELOPMENT OF FUTURE ECONOMIC SPECIALISTS

Directory of Open Access Journals (Sweden)

Zotova-Sadylo Yelena Yurievna

2013-05-01

Full Text Available Purpose The structural-functional model of professional business communication development of future economic specialists is presented by the author. Its basic components, purpose, function, principles, methods of its practical realization are characterized in the article. Methodology The considered model is aimed at providing advanced and competent levels of professional business communication / cross-cultural business communication of future specialists in economics by means of relevant to the problem special course within a system of humanitarian cycle disciplines, and integrated class hours and extracurricular activity. The main feature of the special course is its integrated character determined by the necessity to synthesize contents of humanitarian cycle disciplines for the purpose of training material comprehensive awareness. Results In this context focused professional extracurricular activity carried out in strict accordance with an overall objective of young specialist training is effective. Successful implementation of structural functional model is possible providing that integrated approach to creative specialists training by means of entire educational and extracurricular activity system.

Treatment Algorithm of a Hypertension Specialist

Czech Academy of Sciences Publication Activity Database

Peleška, Jan; Anger, Z.; Buchtela, David; Tomečková, Marie; Veselý, Arnošt; Zvárová, Jana

2007-01-01

Roč. 25, Suppl. 2 (2007), S 383-S 383 ISSN 0952-1178. [European Meeting on Hypertension /17./. 15.06.2007-19.06.2007, Milan] R&D Projects: GA AV ČR 1ET200300413 Institutional research plan: CEZ:AV0Z10300504 Keywords : treatment algorithm for hypertension * hypertension specialist Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery

STS-87 Mission Specialist Winston E. Scott suits up

Science.gov (United States)

1997-01-01

STS-87 Mission Specialist Winston Scott dons his launch and entry suit with the assistance of a suit technician in the Operations and Checkout Building. This is Scotts second space flight. He and the five other crew members will depart shortly for Launch Pad 39B, where the Space Shuttle Columbia awaits liftoff on a 16-day mission to perform microgravity and solar research. Scott is scheduled to perform an extravehicular activity spacewalk with Mission Specialist Takao Doi, Ph.D., of the National Space Development Agency of Japan, during STS-87. He also performed a spacewalk on STS-72.

Computational Aspects of Dam Risk Analysis: Findings and Challenges

Directory of Open Access Journals (Sweden)

Ignacio Escuder-Bueno

2016-09-01

Full Text Available In recent years, risk analysis techniques have proved to be a useful tool to inform dam safety management. This paper summarizes the outcomes of three themes related to dam risk analysis discussed in the Benchmark Workshops organized by the International Commission on Large Dams Technical Committee on “Computational Aspects of Analysis and Design of Dams.” In the 2011 Benchmark Workshop, estimation of the probability of failure of a gravity dam for the sliding failure mode was discussed. Next, in 2013, the discussion focused on the computational challenges of the estimation of consequences in dam risk analysis. Finally, in 2015, the probability of sliding and overtopping in an embankment was analyzed. These Benchmark Workshops have allowed a complete review of numerical aspects for dam risk analysis, showing that risk analysis methods are a very useful tool to analyze the risk of dam systems, including downstream consequence assessments and the uncertainty of structural models.

Integrating Household Risk Mitigation Behavior in Flood Risk Analysis: An Agent-Based Model Approach.

Science.gov (United States)

Haer, Toon; Botzen, W J Wouter; de Moel, Hans; Aerts, Jeroen C J H

2017-10-01

Recent studies showed that climate change and socioeconomic trends are expected to increase flood risks in many regions. However, in these studies, human behavior is commonly assumed to be constant, which neglects interaction and feedback loops between human and environmental systems. This neglect of human adaptation leads to a misrepresentation of flood risk. This article presents an agent-based model that incorporates human decision making in flood risk analysis. In particular, household investments in loss-reducing measures are examined under three economic decision models: (1) expected utility theory, which is the traditional economic model of rational agents; (2) prospect theory, which takes account of bounded rationality; and (3) a prospect theory model, which accounts for changing risk perceptions and social interactions through a process of Bayesian updating. We show that neglecting human behavior in flood risk assessment studies can result in a considerable misestimation of future flood risk, which is in our case study an overestimation of a factor two. Furthermore, we show how behavior models can support flood risk analysis under different behavioral assumptions, illustrating the need to include the dynamic adaptive human behavior of, for instance, households, insurers, and governments. The method presented here provides a solid basis for exploring human behavior and the resulting flood risk with respect to low-probability/high-impact risks. © 2016 The Authors Risk Analysis published by Wiley Periodicals, Inc. on behalf of Society for Risk Analysis.

A qualitative study of work-life balance amongst specialist orthodontists in the United Kingdom

OpenAIRE

Cunningham, S. J.; Bateman, L. E.; Collins, J. M.

2016-01-01

Objective: To identify factors affecting work-life balance amongst male and female orthodontists in the United Kingdom. Design: A qualitative interview-based study with a cross-sectional design. Subjects: Specialist orthodontists working in specialist practice and the hospital service in the United Kingdom were selected by purposive sampling. Methods: In-depth semi-structured interviews were conducted with eighteen orthodontic specialists. Interview transcripts were analysed using Framework A...

Evaluation of specialist referrals at a rural health care clinic.

Science.gov (United States)

Biggerstaff, Mary Ellen; Short, Nancy

2017-07-01

Transition to a value-based care system involves reducing costs improving population health and enhancing the patient experience. Many rural hospitals must rely on specialist referrals because of a lack of an internal system of specialists on staff. This evaluation of the existing specialist referrals from primary care was conducted to better understand and improve the referral process and address costs, population health, and the patient experience. A 6-month retrospective chart review was conducted to evaluate quality and outcomes of specialty referrals submitted by 10 primary care providers. During a 6-month period in 2015, there was a total of 13,601 primary care patient visits and 3814 referrals, a referral rate of approximately 27%. The most striking result of this review was that nearly 50% of referred patients were not making the prescribed specialist appointment. Rather than finding a large number of unnecessary referrals, we found overall referral rates higher than expected, and a large percentage of our patients were not completing their referrals. The data and patterns emerging from this investigation would guide the development of referral protocols for a newly formed accountable care organization and lead to further quality improvement projects: a LEAN effort, dissemination of results to clinical and executive staff, protocols for orthopedic and neurosurgical referrals, and recommendations for future process improvements. ©2017 American Association of Nurse Practitioners.

Trying To Reduce Your Technostress?: Helpful Activities for Teachers and Library Media Specialists.

Science.gov (United States)

McKenzie, Barbara K.; And Others

1997-01-01

As pressure increases to integrate technology into instruction, many teachers and library media specialists are having difficulty coping with "technostress." Presents suggestions and activities for teachers and library media specialists designed to reduce "technostress." (PEN)

Development of the Role Scenario of the Personnel Management Specialist Activity

Directory of Open Access Journals (Sweden)

Stolyaruk Khrystyna S.

2013-12-01

Full Text Available The article is devoted of the issues of development of classification and content of role, which are performed by personnel management specialists in their professional activity. It proves a necessity of development of role scenarios under conditions of application of the competence approach in training and practical activity. Thus, the author offers five key roles in activity of a personnel management specialist, which reflect different vectors of directions of the scenario of professional activity regardless of the performed function and position. The article specifies the following roles in the offered classification: partner, expert, communicator, consultant and curator. It presents results of a sociological study, which demonstrate the degree of co-ordination of opinions of employers and practicing personnel managers with respect to performance of roles in the sphere by their professional activity by the latter. This helps to identify a number of problems, which include the problem of availability of reserves of increase of the level of competence of personnel management specialists. This issue, in its turn, closely deals with main aspects of formation of competitiveness of the said specialists, since the degree of formation of competences is the key condition of formation of competitive advantages.

The Generalist versus the Specialist: The New Oxford Dictionary Reveals a Gap.

Science.gov (United States)

Levine, Martin Lyon

1981-01-01

There is a gap, it is suggested, separating the generally cultured person, not just from the scientist, but from specialists in many fields. Dictionary definitions are seen as one means of seeing the extent to which specialists and those in the general culture speak the same language. (MLW)

Proceedings of fuel safety research specialists' meeting

International Nuclear Information System (INIS)

Suzuki, Motoe

2002-08-01

Fuel Safety Research Specialists' Meeting, which was organized by Japan Atomic Energy Research Institute, was held on March 4-5, 2002 at JAERI in Tokai Establishment. Purposes of the Meeting are to exchange information and views on LWR fuel safety topics among the specialist participants from domestic and foreign organizations, and to discuss the recent and future fuel research activities in JAERI. In the Meeting, presentations were given and discussions were made on general report of fuel safety research activities, fuel behaviors in normal operation and accident conditions, FP release behaviors in severe accident conditions, and JAERI's ''Advanced LWR Fuel Performance and Safety Research Program''. A poster exhibition was also carried out. The Meeting significantly contributed to planning future program and cooperation in fuel research. This proceeding integrates all the pictures and papers presented in the Meeting. The 10 of the presented papers are indexed individually. (J.P.N.)

Putting problem formulation at the forefront of GMO risk analysis.

Science.gov (United States)

Tepfer, Mark; Racovita, Monica; Craig, Wendy

2013-01-01

When applying risk assessment and the broader process of risk analysis to decisions regarding the dissemination of genetically modified organisms (GMOs), the process has a tendency to become remarkably complex. Further, as greater numbers of countries consider authorising the large-scale dissemination of GMOs, and as GMOs with more complex traits reach late stages of development, there has been increasing concern about the burden posed by the complexity of risk analysis. We present here an improved approach for GMO risk analysis that gives a central role to problem formulation. Further, the risk analysis strategy has been clarified and simplified in order to make rigorously scientific risk assessment and risk analysis more broadly accessible to diverse stakeholder groups.

Streamlining project delivery through risk analysis.

Science.gov (United States)

2015-08-01

Project delivery is a significant area of concern and is subject to several risks throughout Plan Development : Process (PDP). These risks are attributed to major areas of project development, such as environmental : analysis, right-of-way (ROW) acqu...

Monitoring stream temperatures—A guide for non-specialists

Science.gov (United States)

Heck, Michael P.; Schultz, Luke D.; Hockman-Wert, David; Dinger, Eric C.; Dunham, Jason B.

2018-04-19

Executive SummaryWater temperature influences most physical and biological processes in streams, and along with streamflows is a major driver of ecosystem processes. Collecting data to measure water temperature is therefore imperative, and relatively straightforward. Several protocols exist for collecting stream temperature data, but these are frequently directed towards specialists. This document was developed to address the need for a protocol intended for non-specialists (non-aquatic) staff. It provides specific step-by-step procedures on (1) how to launch data loggers, (2) check the factory calibration of data loggers prior to field use, (3) how to install data loggers in streams for year-round monitoring, (4) how to download and retrieve data loggers from the field, and (5) how to input project data into organizational databases.

Reliability and risk analysis methods research plan

International Nuclear Information System (INIS)

1984-10-01

This document presents a plan for reliability and risk analysis methods research to be performed mainly by the Reactor Risk Branch (RRB), Division of Risk Analysis and Operations (DRAO), Office of Nuclear Regulatory Research. It includes those activities of other DRAO branches which are very closely related to those of the RRB. Related or interfacing programs of other divisions, offices and organizations are merely indicated. The primary use of this document is envisioned as an NRC working document, covering about a 3-year period, to foster better coordination in reliability and risk analysis methods development between the offices of Nuclear Regulatory Research and Nuclear Reactor Regulation. It will also serve as an information source for contractors and others to more clearly understand the objectives, needs, programmatic activities and interfaces together with the overall logical structure of the program

American specialists and SAP project

International Nuclear Information System (INIS)

Andrlova, Z.

2008-01-01

Within the past days of November the project teams of SAP Nuclear in Slovenske elektrarne, a. s. incorporated the specialists from PSEG from New Jersey, U.S.A. The goal of their stay here was to pass on the professional experience and good practice from the implementation of quite demanding project in the nuclear power plants. We have learned more about the company and the objectives from an interview with Clay Warren, SAP Nuclear Project Manager in SE. (author)

Ensemble modeling to predict habitat suitability for a large-scale disturbance specialist

Science.gov (United States)

Quresh S. Latif; Victoria A. Saab; Jonathan G. Dudley; Jeff P. Hollenbeck

2013-01-01

To conserve habitat for disturbance specialist species, ecologists must identify where individuals will likely settle in newly disturbed areas. Habitat suitability models can predict which sites at new disturbances will most likely attract specialists. Without validation data from newly disturbed areas, however, the best approach for maximizing predictive accuracy can...

Multi-hazard risk analysis for management strategies

Science.gov (United States)

Kappes, M.; Keiler, M.; Bell, R.; Glade, T.

2009-04-01

Risk management is very often operating in a reactive way, responding to an event, instead of proactive starting with risk analysis and building up the whole process of risk evaluation, prevention, event management and regeneration. Since damage and losses from natural hazards raise continuously more and more studies, concepts (e.g. Switzerland or South Tyrol-Bolozano) and software packages (e.g. ARMAGEDOM, HAZUS or RiskScape) are developed to guide, standardize and facilitate the risk analysis. But these approaches focus on different aspects and are mostly closely adapted to the situation (legislation, organization of the administration, specific processes etc.) of the specific country or region. We propose in this study the development of a flexible methodology for multi-hazard risk analysis, identifying the stakeholders and their needs, processes and their characteristics, modeling approaches as well as incoherencies occurring by combining all these different aspects. Based on this concept a flexible software package will be established consisting of ArcGIS as central base and being complemented by various modules for hazard modeling, vulnerability assessment and risk calculation. Not all modules will be developed newly but taken from the current state-of-the-art and connected or integrated into ArcGIS. For this purpose two study sites, Valtellina in Italy and Bacelonnette in France, were chosen and the hazards types debris flows, rockfalls, landslides, avalanches and floods are planned to be included in the tool for a regional multi-hazard risk analysis. Since the central idea of this tool is its flexibility this will only be a first step, in the future further processes and scales can be included and the instrument thus adapted to any study site.

Variation of fee-for-service specialist direct care work effort with patient overall illness burden.

Science.gov (United States)

Goodman, Robert

2011-08-01

To explore whether a common industry measure of overall patient illness burden, used to assess the total costs of members in a health plan, would be suitable to describe variation in a summary metric of utilization that assesses specialist physician direct patient care services not grouped into clinical episodes, but with exclusion criteria applied to reduce any bias in the data. Data sources/study setting Calendar year 2006 administrative data on 153,557 commercial members enrolled in a non-profit single-state statewide Health Maintenance Organization (HMO) and treated by 4356 specialists in 11 specialties. The health plan's global referral process and specialist fee-for-service reimbursement likely makes these results applicable to the non-managed care setting, as once a global referral was authorized there was no required intervention by the HMO or referring primary care provider for the majority of any subsequent specialist direct clinical care. Study design Specialty-specific correlations and ordinary least-squares regression models to assess variations in specialist direct patient care work effort with patient overall illness burden, after the application of exclusion criteria to reduce potential bias in the data. Principle findings Statistically significant positive correlations exist between specialist direct patient care work effort and patient overall illness burden for all studied specialties. Regression models revealed a generally monotonic increasing relationship between illness burden categories and aggregate specialist direct patient care work effort. Almost all regression model differences from the reference category across specialties are statistically significant (P ≤ 0.012). Assessment of additional results demonstrates the relationship has more substantive significance in some specialties and less in others. The most substantive relationships in this study were found in the specialties of orthopaedic surgery, general surgery and interventional

Subsidies to target specialist outreach services into more remote locations: a national cross-sectional study.

Science.gov (United States)

O'Sullivan, Belinda G; McGrail, Matthew R; Stoelwinder, Johannes U

2017-07-01

Objective Targeting rural outreach services to areas of highest relative need is challenging because of the higher costs it imposes on health workers to travel longer distances. This paper studied whether subsidies have the potential to support the provision of specialist outreach services into more remote locations. Methods National data about subsidies for medical specialist outreach providers as part of the Wave 7 Medicine in Australia: Balancing Employment and Life (MABEL) Survey in 2014. Results Nearly half received subsidies: 19% (n=110) from a formal policy, namely the Australian Government Rural Health Outreach Fund (RHOF), and 27% (n=154) from other sources. Subsidised specialists travelled for longer and visited more remote locations relative to the non-subsidised group. In addition, compared with non-subsidised specialists, RHOF-subsidised specialists worked in priority areas and provided equally regular services they intended to continue, despite visiting more remote locations. Conclusion This suggests the RHOF, although limited to one in five specialist outreach providers, is important to increase targeted and stable outreach services in areas of highest relative need. Other subsidies also play a role in facilitating remote service distribution, but may need to be more structured to promote regular, sustained outreach practice. What is known about this topic? There are no studies describing subsidies for specialist doctors to undertake rural outreach work and whether subsidies, including formal and structured subsidies via the Australian Government RHOF, support targeted outreach services compared with no financial support. What does this paper add? Using national data from Australia, we describe subsidisation among specialist outreach providers and show that specialists subsidised via the RHOF or another source are more likely to provide remote outreach services. What are the implications for practitioners? Subsidised specialist outreach providers are

Orienting and Onboarding Clinical Nurse Specialists: A Process Improvement Project.

Science.gov (United States)

Garcia, Mayra G; Watt, Jennifer L; Falder-Saeed, Karie; Lewis, Brennan; Patton, Lindsey

Clinical nurse specialists (CNSs) have a unique advanced practice role. This article describes a process useful in establishing a comprehensive orientation and onboarding program for a newly hired CNS. The project team used the National Association of Clinical Nurse Specialists core competencies as a guide to construct a process for effectively onboarding and orienting newly hired CNSs. Standardized documents were created for the orientation process including a competency checklist, needs assessment template, and professional evaluation goals. In addition, other documents were revised to streamline the orientation process. Standardizing the onboarding and orientation process has demonstrated favorable results. As of 2016, 3 CNSs have successfully been oriented and onboarded using the new process. Unique healthcare roles require special focus when onboarding and orienting into a healthcare system. The use of the National Association of Clinical Nurse Specialists core competencies guided the project in establishing a successful orientation and onboarding process for newly hired CNSs.

ICT SPECIALIST SKILLS AND KNOWLEDGE – BUSINESS REQUIREMENTS AND EDUCATION

Directory of Open Access Journals (Sweden)

Miloš Maryška

2012-09-01

Full Text Available This paper describes partial results of surveys realized amongCzech universities and business units which aim has been to analyzecurrent situation in demand and supply side of ICT (Informationand Communication Technologies specialists at the labor marketin the Czech Republic. The demand and supply side are comparedthrough their requirements on knowledge of ICT specialists. Theresults present typical “product” of Czech education system inICT competencies. General conclusions show that majority ofundergraduates do not have appropriate knowledge profile to enterICT corporate business as qualified employees - ICT specialist -without further additional training. The same fact is valid for a littleless than a half of graduates at master level. During quantitativeanalysis, we have identified that at about 60 per cent of ICTspecialists did not pass a formal ICT education. These facts showlacks in ICT oriented study programs and provoke requirementon further development of ICT oriented curricula in accordance tobusiness requirements and needs.

PERFORMANCE IN INTERNAL CONTROL AND RISK MANAGEMENT

OpenAIRE

JELER (POPA) IOANA; FOCŞAN ELEONORA IONELA; CORICI MARIAN CĂTĂLIN

2017-01-01

The purpose of this article is to highlight the importance of internal control and risk management. In practice, economic entities meet a variety of risks that have the origins from the internal environment or the external one. Although there are different of views on addressing the concept of risk - threats or opportunities, event or action, accordingly uncertain, proposed by specialists in risk management in this article we try to present these issues and identify techniques to ...

Environmental risk analysis of hazardous material rail transportation

Energy Technology Data Exchange (ETDEWEB)

Saat, Mohd Rapik, E-mail: mohdsaat@illinois.edu [Department of Civil and Environmental Engineering, University of Illinois at Urbana-Champaign, 1243 Newmark Civil Engineering Laboratory, 205 North Mathews Avenue, Urbana, IL 61801 (United States); Werth, Charles J.; Schaeffer, David [Department of Civil and Environmental Engineering, University of Illinois at Urbana-Champaign, 1243 Newmark Civil Engineering Laboratory, 205 North Mathews Avenue, Urbana, IL 61801 (United States); Yoon, Hongkyu [Sandia National Laboratories, Albuquerque, NM 87123 (United States); Barkan, Christopher P.L. [Department of Civil and Environmental Engineering, University of Illinois at Urbana-Champaign, 1243 Newmark Civil Engineering Laboratory, 205 North Mathews Avenue, Urbana, IL 61801 (United States)

2014-01-15

Highlights: • Comprehensive, nationwide risk assessment of hazardous material rail transportation. • Application of a novel environmental (i.e. soil and groundwater) consequence model. • Cleanup cost and total shipment distance are the most significant risk factors. • Annual risk varies from $20,000 to $560,000 for different products. • Provides information on the risk cost associated with specific product shipments. -- Abstract: An important aspect of railroad environmental risk management involves tank car transportation of hazardous materials. This paper describes a quantitative, environmental risk analysis of rail transportation of a group of light, non-aqueous-phase liquid (LNAPL) chemicals commonly transported by rail in North America. The Hazardous Materials Transportation Environmental Consequence Model (HMTECM) was used in conjunction with a geographic information system (GIS) analysis of environmental characteristics to develop probabilistic estimates of exposure to different spill scenarios along the North American rail network. The risk analysis incorporated the estimated clean-up cost developed using the HMTECM, route-specific probability distributions of soil type and depth to groundwater, annual traffic volume, railcar accident rate, and tank car safety features, to estimate the nationwide annual risk of transporting each product. The annual risk per car-mile (car-km) and per ton-mile (ton-km) was also calculated to enable comparison between chemicals and to provide information on the risk cost associated with shipments of these products. The analysis and the methodology provide a quantitative approach that will enable more effective management of the environmental risk of transporting hazardous materials.

Environmental risk analysis of hazardous material rail transportation

International Nuclear Information System (INIS)

Saat, Mohd Rapik; Werth, Charles J.; Schaeffer, David; Yoon, Hongkyu; Barkan, Christopher P.L.

2014-01-01

Highlights: • Comprehensive, nationwide risk assessment of hazardous material rail transportation. • Application of a novel environmental (i.e. soil and groundwater) consequence model. • Cleanup cost and total shipment distance are the most significant risk factors. • Annual risk varies from $20,000 to $560,000 for different products. • Provides information on the risk cost associated with specific product shipments. -- Abstract: An important aspect of railroad environmental risk management involves tank car transportation of hazardous materials. This paper describes a quantitative, environmental risk analysis of rail transportation of a group of light, non-aqueous-phase liquid (LNAPL) chemicals commonly transported by rail in North America. The Hazardous Materials Transportation Environmental Consequence Model (HMTECM) was used in conjunction with a geographic information system (GIS) analysis of environmental characteristics to develop probabilistic estimates of exposure to different spill scenarios along the North American rail network. The risk analysis incorporated the estimated clean-up cost developed using the HMTECM, route-specific probability distributions of soil type and depth to groundwater, annual traffic volume, railcar accident rate, and tank car safety features, to estimate the nationwide annual risk of transporting each product. The annual risk per car-mile (car-km) and per ton-mile (ton-km) was also calculated to enable comparison between chemicals and to provide information on the risk cost associated with shipments of these products. The analysis and the methodology provide a quantitative approach that will enable more effective management of the environmental risk of transporting hazardous materials

Tests and measures used by specialist physical therapists when examining patients with stroke.

Science.gov (United States)

Andrews, A Williams; Folger, Stephen E; Norbet, Shannon E; Swift, Lindsay C

2008-09-01

Examination procedures preferred by physical therapists have not been documented either specifically or comprehensively. The purpose of this study was to determine which tests and measures are used most frequently by specialists in the examination of adults with stroke. Physical therapy specialists were identified as having geriatric or neurologic certification through the American Board of Physical Therapy Specialties. A request to participate in a Web-based survey was sent to 471 individuals in the American Physical Therapy Association's Directory of Certified Specialists. A comprehensive list of tests and measures was first derived from the Interactive Guide to Physical Therapist Practice. The list was finalized based on several exclusion criteria and the results of a pilot study. Subjects rated the frequency of use of 294 tests and measures with patients post-stroke on a Likert scale. The survey response rate was 31.7% (n = 128). The 50 most frequently used tests and measures were identified. The results of this study do not identify the tests and measures that clinicians should use, only those that the specialists use. Nevertheless, clinicians may want to consider tests and measurements frequently used by specialists when examining adults with stroke.

78 FR 14359 - Verizon Business Networks Services, Inc., Specialist-Tech Customer Service, Philadelphia, PA...

Science.gov (United States)

2013-03-05

... Business Networks Services, Inc., Specialist-Tech Customer Service, Philadelphia, PA; Verizon Business Networks Services, Inc., Specialist-Tech Customer Service, Tampa, Florida; Amended Certification Regarding... should [[Page 14360

Proceedings of the specialists' meeting on delayed neutron nuclear data

Energy Technology Data Exchange (ETDEWEB)

Katakura, Jun-ichi [ed.] [Japanese Nuclear Data Committee, Tokai, Ibaraki (Japan)

1999-07-01

This report is the Proceedings of the Specialists' Meeting on Delayed Neutron Nuclear Data. The meeting was held on January 28-29, 1999, at the Tokai Research Establishment of Japan Atomic Energy Research Institute with the participation of thirty specialists, who are evaluators, theorist, experimentalists. Although the fraction of the delayed neutron is no more than 1% in the total neutrons emitted in the fission process, it plays an important roll in the control of fission reactor. In the meeting, the following topics were reported: the present status of delayed neutron data in the major evaluated data libraries, measurements of effective delayed neutron fraction using FCA (Fast Critical Assembly) and TCA (Tank-type Critical Assembly) and their analyses, sensitivity analysis for fast reactor, measurements of delayed neutron emission from actinides and so on. As another topics, delayed neutron in transmutation system and fission yield data were also presented. Free discussion was held on the future activity of delayed neutron data evaluation. The discussion was helpful for the future activity of the delayed neutron working group of JNDC aiming to the evaluation of delayed neutron data for JENDL-3.3. The 15 of the presented papers are indexed individually. (J.P.N.)

Clinical nurse specialist education: actualizing the systems leadership competency.

Science.gov (United States)

Thompson, Cathy J; Nelson-Marten, Paula

2011-01-01

The purpose of this article was to show how sequenced educational strategies aid in the acquisition of systems leadership and change agent skills, as well as other essential skills for professional clinical nurse specialist (CNS) practice. Clinical nurse specialist education offers the graduate student both didactic and clinical experiences to help the student transition into the CNS role. Clinical nurse specialist faculty have a responsibility to prepare students for the realities of advanced practice. Systems leadership is an integral competency of CNS practice. The contemporary CNS is to be a leader in the translation of evidence into practice. To assist students to acquire this competency, all CNS students are expected to use research and other sources of evidence to identify, design, implement, and evaluate a specific practice change. Anecdotal comments from students completing the projects are offered. Student projects have been focused in acute and critical care, palliative care, and adult/gerontologic health clinical settings; community outreach has been the focus of a few change projects. Examples of student projects related to the systems leadership competency and correlated to the spheres of influence impacted are presented.

Entrustable professional activity (EPA) reshapes the practice of specialist training.

Science.gov (United States)

Niemi-Murola, Leila

In addition to medical expertise, competence-based medical training comprises communication and collaboration skills, professionalism, and leadership skills. Continuous feedback is essential for learning and development, and feedback only from the medical specialist examination taken in the end of training does not ensure thorough specialist training. Entrustable professional activity (EPA) is a unit of professional practice, defined as tasks or responsibilities typical of the specialty. EPA translates competence-based training into manageable and meaningful entities and provides tools for the evaluation of medical competence.

38 CFR 17.142 - Authority to approve sharing agreements, contracts for scarce medical specialist services and...

Science.gov (United States)

2010-07-01

... sharing agreements, contracts for scarce medical specialist services and contracts for other medical... medical specialist services and contracts for other medical services. The Under Secretary for Health is... specialist services at Department of Veterans Affairs health care facilities (including, but not limited to...

RISK ANALYSIS APPLIED IN OIL EXPLORATION AND PRODUCTION

African Journals Online (AJOL)

ES Obe

aDepartment of Civil Engineering, University of Nigeria, Nsukka, Enugu State, Nigeria. ... The analysis in this work is ... risk analysis, oil field, risk management, projects, investment opportunity. 1. .... own merit but since the company has limited.

Physical perfection of future specialists to the management.

Directory of Open Access Journals (Sweden)

Dolinnyj U.A.

2012-12-01

Full Text Available The process of leadthrough of practical employments is considered on physical education on an experimental model, which are directed on the increase of reserve possibilities of organism of future specialists of management. In an experiment took part 30 students of 2 and 3 courses. It is set that management specialists for high-quality implementation of work need a high mental capacity, enhanceable psychoemotional firmness, general endurance. Directions of prophylaxis of emotional and physical overstrain are recommended, increases of level of positive motivation to systematic employments by physical exercises. It is marked that an experimental model in combination with the fixed form of leadthrough of employments on a body-conditioning and employments on specialization of the chosen type of sport is one the stages of alteration organizationally of methodical aspects of physical culture.

The consent process in interventional radiology: the role of specialist nurses

International Nuclear Information System (INIS)

Davies, L.; Laasch, H.-U.; Wilbraham, L.; Marriott, A.; England, R.E.; Martin, D.F.

2004-01-01

AIMS: To evaluate the impact of patient education by specialist nurses on patients' understanding of interventional procedures, their anxiety levels and satisfaction with the given information. MATERIALS AND METHODS: Sixty patients attending the radiology department for gastrointestinal interventional procedures were interviewed. Patients were assessed using a combination of categorical and visual analogue scales. Parameters were assessed on admission and after additional information had been given by specialist nurses. After the procedure patients were asked to rate the quality of information given and their overall satisfaction. RESULTS: Four of the 60 patients were excluded due to a Mini Mental Test score of <7. Only 35 (62.5%) claimed to have been given information by the referring consultant. Fifty-three patients received additional information before formally giving consent, 50 (96.2%) from the specialist nurses. Patient anxiety before and after information did not significantly change (p=0.52), but there was significant improvement in levels of satisfaction (p=0.001) and perceived understanding (p<0.001). Patients rated overall quality of information at an average of 9.2/10 and overall satisfaction was high (median=9.1/10). CONCLUSION: The use of specialist nurses to educate patients greatly increases patient understanding. The process of informed consent is improved and patient satisfaction is increased

The consent process in interventional radiology: the role of specialist nurses

Energy Technology Data Exchange (ETDEWEB)

Davies, L.; Laasch, H.-U.; Wilbraham, L.; Marriott, A.; England, R.E.; Martin, D.F. E-mail: derrick.martin@smtr.nhs.uk

2004-03-01

AIMS: To evaluate the impact of patient education by specialist nurses on patients' understanding of interventional procedures, their anxiety levels and satisfaction with the given information. MATERIALS AND METHODS: Sixty patients attending the radiology department for gastrointestinal interventional procedures were interviewed. Patients were assessed using a combination of categorical and visual analogue scales. Parameters were assessed on admission and after additional information had been given by specialist nurses. After the procedure patients were asked to rate the quality of information given and their overall satisfaction. RESULTS: Four of the 60 patients were excluded due to a Mini Mental Test score of <7. Only 35 (62.5%) claimed to have been given information by the referring consultant. Fifty-three patients received additional information before formally giving consent, 50 (96.2%) from the specialist nurses. Patient anxiety before and after information did not significantly change (p=0.52), but there was significant improvement in levels of satisfaction (p=0.001) and perceived understanding (p<0.001). Patients rated overall quality of information at an average of 9.2/10 and overall satisfaction was high (median=9.1/10). CONCLUSION: The use of specialist nurses to educate patients greatly increases patient understanding. The process of informed consent is improved and patient satisfaction is increased.

Ophthalmic requirements and considerations for the en route air traffic control specialist : an ergonomic analysis of the visual work environment.

Science.gov (United States)

1996-04-01

The Federal Air Surgeon requested continued investigation of visual disorders and vision corrective devices as to their relevance to the medical certification of airmen and controllers. The en route Air Traffic Control Specialist (ATCS) works with a ...

Cyber Risk Management for Critical Infrastructure: A Risk Analysis Model and Three Case Studies.

Science.gov (United States)

Paté-Cornell, M-Elisabeth; Kuypers, Marshall; Smith, Matthew; Keller, Philip

2018-02-01

Managing cyber security in an organization involves allocating the protection budget across a spectrum of possible options. This requires assessing the benefits and the costs of these options. The risk analyses presented here are statistical when relevant data are available, and system-based for high-consequence events that have not happened yet. This article presents, first, a general probabilistic risk analysis framework for cyber security in an organization to be specified. It then describes three examples of forward-looking analyses motivated by recent cyber attacks. The first one is the statistical analysis of an actual database, extended at the upper end of the loss distribution by a Bayesian analysis of possible, high-consequence attack scenarios that may happen in the future. The second is a systems analysis of cyber risks for a smart, connected electric grid, showing that there is an optimal level of connectivity. The third is an analysis of sequential decisions to upgrade the software of an existing cyber security system or to adopt a new one to stay ahead of adversaries trying to find their way in. The results are distributions of losses to cyber attacks, with and without some considered countermeasures in support of risk management decisions based both on past data and anticipated incidents. © 2017 Society for Risk Analysis.

Brakes Specialist. Teacher Edition. Automotive Service Series.

Science.gov (United States)

Oklahoma State Dept. of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.

This document contains teacher's materials for a course on becoming an automotive brakes specialist, based on the National Institute of Automotive Service Excellence task lists. The course consists of three instructional units: service brake hydraulic system and wheel bearings, service drum brakes, and service disc brakes. Depending on the…

Learning Mathematics for Teaching Mathematics: Non-Specialist Teachers' Mathematics Teacher Identity

Science.gov (United States)

Crisan, Cosette; Rodd, Melissa

2017-01-01

A non-specialist teacher of mathematics is a school teacher who qualified to teach in a subject other than mathematics yet teaches mathematics to students in secondary school. There is an emerging interest internationally in this population, a brief report of which is given in the paper. Because of concerns about the quality of non-specialists'…

Insideness and Outsideness: An Autoethnography of a Primary Physical Education Specialist Teacher

Science.gov (United States)

Brooks, Caroline; Thompson, Maree Dinan

2015-01-01

The purpose of this study is to provide an authentic and legitimate voice to the physical education (PE) specialist teacher in the primary school and to give an insight into professional knowledge. An autoethnographic approach has been used to invite readers to enter my world of the primary PE specialist teacher and observe and respond to its…

Active methods of teaching in the system of preparation of specialists on physical education

Directory of Open Access Journals (Sweden)

Pechko O.M.

2010-03-01

Full Text Available The uses of simulation games given about directions are resulted in pedagogical practice. Practice is conducted during the increase of professional qualification of specialists. Possibilities of the use of pedagogical situations are considered in the system of preparation of specialist. Pedagogical situations are an aggregate of facilities and methods of becoming of professional specialist. The prospects of the use of simulation games are indicated in an educational process. Acquisition of the proper qualities options are rotined.

Survey of the labour market for information specialists in Lithuania

Directory of Open Access Journals (Sweden)

Elena Maceviciute

1998-01-01

Full Text Available This paper reports on the results of surveys carried out in Lithuania and Estonia in 1995 and 1996, the main aim of which was to provide a basis for planning the development of information management courses in the Baltic States. In the course of the project it was necessary to resolve certain methodological difficulties in the identification of the concept 'information specialist' and in the process of data collection. The results show the recruitment rates needed over the next three years and the qualities and skills needed by information specialists.

A qualitative exploration of psychosocial specialists' experiences of providing support in UK burn care services.

Science.gov (United States)

Guest, Ella; Griffiths, Catrin; Harcourt, Diana

2018-01-01

A burn can have a significant and long-lasting psychosocial impact on a patient and their family. The National Burn Care Standards (2013) recommend psychosocial support should be available in all UK burn services; however, little is known about how it is provided. The current study aimed to explore experiences of psychosocial specialists working in UK burn care, with a focus on the challenges they experience in their role. Semi-structured telephone interviews with eight psychosocial specialists (two psychotherapists and six clinical psychologists) who worked within UK burn care explored their experiences of providing support to patients and their families. Thematic analysis revealed two main themes: burn service-related experiences and challenges reflected health professionals having little time and resources to support all patients; reduced patient attendance due to them living large distances from service; psychosocial appointments being prioritised below wound-related treatments; and difficulties detecting patient needs with current outcome measures. Therapy-related experiences and challenges outlined the sociocultural and familial factors affecting engagement with support, difficulties treating patients with pre-existing mental health conditions within the burn service and individual differences in the stage at which patients are amenable to support. Findings provide an insight into the experiences of psychosocial specialists working in UK burn care and suggest a number of ways in which psychosocial provision in the NHS burn service could be developed.

Exploring challenges to telehealth communication by specialists in poison information.

Science.gov (United States)

Rothwell, Erin; Ellington, Lee; Planalp, Sally; Crouch, Barbara

2012-01-01

The use of the telephone for providing health care is growing. A significant amount of social meaning is derived from visual information, and the absence of visual stimuli provides unique barriers to communication and increases the risks for misunderstandings and distractions. Understanding challenges to telephone communication can provide insight into training opportunities for overcoming these difficulties and improving patient care. The purpose of this research was to explore through focus groups the challenges of phone communication perceived by specialists in poison information. General types of challenges to effective phone communication included developing new communication skills to compensate for lack of visual information, difficulty assessing caller understanding, difficulty managing caller misunderstandings, maintaining distinctive assessments for routine calls, and managing the multifaceted aspects of job stress. The desire for training to enhance telehealth and cultural competency skills was also mentioned, and these findings might provide guidance for the development of training opportunities for telehealth professionals.

STS-95 Payload Specialist Glenn participates in a media briefing before returning to JSC

Science.gov (United States)

1998-01-01

STS-95 Payload Specialist John H. Glenn Jr., a senator from Ohio and one of the original seven Project Mercury astronauts, participates in a media briefing at the Kennedy Space Center Press Site Auditorium before returning to the Johnson Space Center in Houston, Texas. The STS-95 mission ended with landing at Kennedy Space Center's Shuttle Landing Facility at 12:04 p.m. EST on Nov. 7. Also participating in the briefing were the other STS-95 crew members: Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist and Payload Commander Stephen K. Robinson; Mission Specialist Scott E. Parazynski; Mission Specialist Pedro Duque, with the European Space Agency (ESA); and Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA). The mission included research payloads such as the Spartan-201 solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as a SPACEHAB single module with experiments on space flight and the aging process.

Development of the Role Scenario of the Personnel Management Specialist Activity

OpenAIRE

Stolyaruk Khrystyna S.

2013-01-01

The article is devoted of the issues of development of classification and content of role, which are performed by personnel management specialists in their professional activity. It proves a necessity of development of role scenarios under conditions of application of the competence approach in training and practical activity. Thus, the author offers five key roles in activity of a personnel management specialist, which reflect different vectors of directions of the scenario of professional a...

Urban flooding and health risk analysis by use of quantitative microbial risk assessment

DEFF Research Database (Denmark)

Andersen, Signe Tanja

D thesis is to identify the limitations and possibilities for optimising microbial risk assessments of urban flooding through more evidence-based solutions, including quantitative microbial data and hydrodynamic water quality models. The focus falls especially on the problem of data needs and the causes......, but also when wading through a flooded area. The results in this thesis have brought microbial risk assessments one step closer to more uniform and repeatable risk analysis by using actual and relevant measured data and hydrodynamic water quality models to estimate the risk from flooding caused...... are expected to increase in the future. To ensure public health during extreme rainfall, solutions are needed, but limited knowledge on microbial water quality, and related health risks, makes it difficult to implement microbial risk analysis as a part of the basis for decision making. The main aim of this Ph...

Specialist services: the need for multi-agency partnership.

Science.gov (United States)

Christian, J; Gilvarry, E

1999-07-01

In the UK the broad trend noted in prevalence surveys is towards increased availability, exposure, and use of illicit drugs across all social strata. There is a developing consensus regarding those groups of young people who are at particular risk. They may be homeless, pregnant, leaving local authority or foster care, engaged in prostitution or involved with the criminal justice system. These young people are likely to require intervention from a variety of agencies and professionals to respond to their multiple needs, yet they are faced with a dearth of specialist substance misuse services. Consequently there is a need to develop a range of partnership approaches amongst both providers and commissioners of services. The importance of partnership has been stressed in a succession of professional guidance documents, but there remain considerable bureaucratic, organisational, and historical barriers that must be overcome. Effective service models that exist in the UK and elsewhere are a source of ideas to stimulate appropriate, child-centred developments. Overall the need for a fresh impetus is emphasised, in which new partnerships are formed, and collaborative services are developed and evaluated. In this way future initiatives can be based upon evidence of clinical and cost effectiveness.

Impact of the Pharmacy Practice Model Initiative on Clinical Pharmacy Specialist Practice.

Science.gov (United States)

Jacobi, Judith; Ray, Shaunta'; Danelich, Ilya; Dodds Ashley, Elizabeth; Eckel, Stephen; Guharoy, Roy; Militello, Michael; O'Donnell, Paul; Sam, Teena; Crist, Stephanie M; Smidt, Danielle

2016-05-01

This paper describes the goals of the American Society of Health-System Pharmacists' Pharmacy Practice Model Initiative (PPMI) and its recommendations for health-system pharmacy practice transformation to meet future patient care needs and elevate the role of pharmacists as patient care providers. PPMI envisions a future in which pharmacists have greater responsibility for medication-related outcomes and technicians assume greater responsibility for product-related activities. Although the PPMI recommendations have elevated the level of practice in many settings, they also potentially affect existing clinical pharmacists, in general, and clinical pharmacy specialists, in particular. Moreover, although more consistent patient care can be achieved with an expanded team of pharmacist providers, the role of clinical pharmacy specialists must not be diminished, especially in the care of complex patients and populations. Specialist practitioners with advanced training and credentials must be available to model and train pharmacists in generalist positions, residents, and students. Indeed, specialist practitioners are often the innovators and practice leaders. Negotiation between hospitals and pharmacy schools is needed to ensure a continuing role for academic clinical pharmacists and their contributions as educators and researchers. Lessons can be applied from disciplines such as nursing and medicine, which have developed new models of care involving effective collaboration between generalists and specialists. Several different pharmacy practice models have been described to meet the PPMI goals, based on available personnel and local goals. Studies measuring the impact of these new practice models are needed. © 2016 Pharmacotherapy Publications, Inc.

Risk and society; Risque et societe

Energy Technology Data Exchange (ETDEWEB)

Tubiana, M. [Academie des Sciences, 75 - Paris (France)]|[Centre Antoine Beclere, Faculte de medecine, 75 - Paris (France); Vrousos, C.; Pages, J.P. [Centre Hospitalier Universitaire, 38 - Grenoble (France); Carde, C.

1999-07-01

This book brings together the communications presented at the colloquium 'risk and society' held in Paris (France) on November 1998. During this colloquium, the various aspects of risk and of its management were discussed by medical specialists, historians, industrialists, engineers, philosophers, lawyers, politicians and administration representatives. The first theme concerns the controversies generated by the development of some activities (genetics, bio-technologies, nuclear and radiations use). The second theme concerns the management of risks and the way to conciliate the point of view of authorities and citizens (confidence of the public with respect to experts, scientists, industrialists, government and administrative representatives, role played by the media). The debates that took place during the colloquium have shown that the public opinion concerning the nuclear activities or the new technologies greatly depends on the ideological attitudes and on the public's likes and dislikes with respect to some categories of actors (distrust with respect to public decisions, fears with respect to changes and future, nostalgia of the past). The following aspects are reviewed: Notions of risk and hazard (risk and health, risk in today's society, medicine and society, the point of view of the industrialists and of the scientific and technical specialists); from the psychological aspects of the risk to its social aspects (survey of the risk assessment battlefield, social attenuation and amplification of risk, the feeling of risks in Europe, insecurity and delinquency, controversies around radioactivity and health); the negotiation and communication about risks (risk and public health, negotiation around risks, risks and information dissemination about the public debate, communication and crisis, evolution of risk communication, comparison between American and European approaches, the Seveso directive); the public debate and the evolution of risks

Risk and society; Risque et societe

Energy Technology Data Exchange (ETDEWEB)

Tubiana, M [Academie des Sciences, 75 - Paris (France); [Centre Antoine Beclere, Faculte de medecine, 75 - Paris (France); Vrousos, C; Pages, J P [Centre Hospitalier Universitaire, 38 - Grenoble (France); Carde, C

1999-07-01

This book brings together the communications presented at the colloquium 'risk and society' held in Paris (France) on November 1998. During this colloquium, the various aspects of risk and of its management were discussed by medical specialists, historians, industrialists, engineers, philosophers, lawyers, politicians and administration representatives. The first theme concerns the controversies generated by the development of some activities (genetics, bio-technologies, nuclear and radiations use). The second theme concerns the management of risks and the way to conciliate the point of view of authorities and citizens (confidence of the public with respect to experts, scientists, industrialists, government and administrative representatives, role played by the media). The debates that took place during the colloquium have shown that the public opinion concerning the nuclear activities or the new technologies greatly depends on the ideological attitudes and on the public's likes and dislikes with respect to some categories of actors (distrust with respect to public decisions, fears with respect to changes and future, nostalgia of the past). The following aspects are reviewed: Notions of risk and hazard (risk and health, risk in today's society, medicine and society, the point of view of the industrialists and of the scientific and technical specialists); from the psychological aspects of the risk to its social aspects (survey of the risk assessment battlefield, social attenuation and amplification of risk, the feeling of risks in Europe, insecurity and delinquency, controversies around radioactivity and health); the negotiation and communication about risks (risk and public health, negotiation around risks, risks and information dissemination about the public debate, communication and crisis, evolution of risk communication, comparison between American and European approaches, the Seveso directive); the public debate and the evolution of risks management (the

Probabilistic risk analysis in chemical engineering

International Nuclear Information System (INIS)

Schmalz, F.

1991-01-01

In risk analysis in the chemical industry, recognising potential risks is considered more important than assessing their quantitative extent. Even in assessing risks, emphasis is not on the probability involved but on the possible extent. Qualitative assessment has proved valuable here. Probabilistic methods are used in individual cases where the wide implications make it essential to be able to assess the reliability of safety precautions. In this case, assessment therefore centres on the reliability of technical systems and not on the extent of a chemical risk. 7 figs

Method for environmental risk analysis (MIRA) revision 2007

International Nuclear Information System (INIS)

2007-04-01

OLF's instruction manual for carrying out environmental risk analyses provides a united approach and a common framework for environmental risk assessments. This is based on the best information available. The manual implies standardizations of a series of parameters, input data and partial analyses that are included in the environmental risk analysis. Environmental risk analyses carried out according to the MIRA method will thus be comparable between fields and between companies. In this revision an update of the text in accordance with today's practice for environmental risk analyses and prevailing regulations is emphasized. Moreover, method adjustments for especially protected beach habitats have been introduced, as well as a general method for estimating environmental risk concerning fish. Emphasis has also been put on improving environmental risk analysis' possibilities to contribute to a better management of environmental risk in the companies (ml)

Focus group interviews examining the contribution of intellectual disability clinical nurse specialists in Ireland.

Science.gov (United States)

Doody, Owen; Slevin, Eamonn; Taggart, Laurence

2017-10-01

To explore the contribution of clinical nurse specialists in intellectual disability nursing in Ireland. While clinical nurse specialists exist since the 1940s, they have only been a reality in Ireland since 2001. While the role of clinical nurse specialist has developed over the years, it still however is often seen as a complex multifaceted role that causes confusion, frustration and controversy. A exploratory qualitative approach using focus groups with Irish intellectual disability clinical nurse specialists (n = 31). Five focus group interviews were conducted to gather qualitative data to gain insight into the attitudes, perceptions and opinions of the participants. Data were audio-recorded, transcribed and analysed using Burnard's (Vital Notes for Nurses: Research for Evidence-Based Practice in Healthcare, 2011, Blackwell Publishing, Oxford) framework. Ethical approval was gained from the researcher's university and access granted by the national council for the professional development of nursing/midwifery in Ireland. The study highlights that intellectual disability clinical nurse specialists contribute to and support care delivery across a range of areas including client-focused and family-centred care, staff support, organisation support, community support and supporting other agencies. Overall, the study shows the importance of intellectual disability clinical nurse specialists and their contribution across a range of services, care environments and the support they offer to clients/families/staff/multidisciplinary team members and outside agencies. Ireland is in a unique position to develop knowledge regarding specialist care for people with intellectual disability that can be shared and adapted by other healthcare professionals in other countries that do not have specialised intellectual disability nurses. © 2016 John Wiley & Sons Ltd.

CONCEPTUAL BASES OF TRAINING OF TOURISM SPECIALISTS IN UKRAINE (BY THE EXAMPLE OF KRYVYI RIH

Directory of Open Access Journals (Sweden)

Вікторія Пацюк

2015-05-01

Full Text Available Relevance and importance of training of tourism specialists on the regional level have been revealed.  General principles of training of tourism services specialists in Ukraine have been found out. The structure and professional specialization of Ukrainian universities, where the “Tourism” specialists are trained have been analyzed. Pofessional requirements for future employees of tourism industry have been defined. Relevance of training of tourism specialists in Kryvyi Rih in the context of the implementation of the Program of Industrial Tourism Development has been revealed. Potential scope of employment of tourism graduates has been defined. Main tasks  of tourism education in Ukraine have been generalized.

Evaluating the risks of clinical research: direct comparative analysis.

Science.gov (United States)

Rid, Annette; Abdoler, Emily; Roberson-Nay, Roxann; Pine, Daniel S; Wendler, David

2014-09-01

Many guidelines and regulations allow children and adolescents to be enrolled in research without the prospect of clinical benefit when it poses minimal risk. However, few systematic methods exist to determine when research risks are minimal. This situation has led to significant variation in minimal risk judgments, raising concern that some children are not being adequately protected. To address this concern, we describe a new method for implementing the widely endorsed "risks of daily life" standard for minimal risk. This standard defines research risks as minimal when they do not exceed the risks posed by daily life activities or routine examinations. This study employed a conceptual and normative analysis, and use of an illustrative example. Different risks are composed of the same basic elements: Type, likelihood, and magnitude of harm. Hence, one can compare the risks of research and the risks of daily life by comparing the respective basic elements with each other. We use this insight to develop a systematic method, direct comparative analysis, for implementing the "risks of daily life" standard for minimal risk. The method offers a way of evaluating research procedures that pose the same types of risk as daily life activities, such as the risk of experiencing anxiety, stress, or other psychological harm. We thus illustrate how direct comparative analysis can be applied in practice by using it to evaluate whether the anxiety induced by a respiratory CO2 challenge poses minimal or greater than minimal risks in children and adolescents. Direct comparative analysis is a systematic method for applying the "risks of daily life" standard for minimal risk to research procedures that pose the same types of risk as daily life activities. It thereby offers a method to protect children and adolescents in research, while ensuring that important studies are not blocked because of unwarranted concerns about research risks.

Use of an integrated human health/ecological risk assessment to develop a long-term groundwater/site management plan for a sour gas facility

International Nuclear Information System (INIS)

Swanson, S.M.; Shaw, R.D.; McClymont, G.; Nadeau, S.

1995-01-01

An integrated human health and ecological risk assessment was used to quantify the level of risk associated with the off-site movement of contaminants via groundwater and soils at a medium-sized gas processing facility in southern Alberta. The study incorporated three key aspects: (1) integration; (2) consultation; and, (3) pro-active remedial actions. Integration was complete, beginning with the Problem Formulation stage and progressing through Risk Characterization and Risk Management. This integration was reflected in a multidisciplinary team of hydrogeologists, biologists and human health specialists. Several lessons emerged from the integrated approach: (1) spending 2/3 of the time and resources on Problem Formulation prevented later problems; (2) the different perspectives provided by the various specialists helped reveal the relative importance of pathways and ecological receptors (3) clear, consistent screening procedures for contaminants of concern and receptors were very effective with stakeholders; (4) exposure scenarios that incorporated common-sense situations (although still conservative) contributed to the credibility of the risk analysis; and, (5) an innovative combination of toxicity testing and chemical analysis helped delineate the boundaries of the potentially contaminated area for both human and ecological receptors in a cost effective manner. Consultation included directly affected parties, regulatory personnel and community members. The consultation extended through the project, with key ''buy-in'' points during Problem Formulation and Risk Characterization/Management. Pro-active remedial action included the removal of contaminant sources in the 1980's, a pump-and-treat system and extensive monitoring. These actions showed commitment and set the stage for credible risk-based mitigation and long-term monitoring

Analysis of Hepatitis B Transmission Risk Factors in HIV Patients

Directory of Open Access Journals (Sweden)

Iman Ghasemzadeh

2016-09-01

Full Text Available Co-infection with Hepatitis B (HBV virus and HIV is common due to similarity of their transmission methods. However, the prevalence of concurrent infection in different societies, shows the crucial role of various risk factors in different populations. Therefore, the present study was performed to examine risk factors of transmission of HBV in patients with HIV in a care center for AIDS patients in Rasht City. This case-control study was carried out on 60 HIV positive patients, who visited the Infectious Diseases Center of Razi Hospital of Rasht from November, 2015 to March, 2016. Participants were assigned to two 30-member experiment and control groups. They were adjusted in terms of age group (18-30, 30-40, 40-50, and 50-60, gender (male and female, and marital status (married, single, divorced, and widowed and visited by an infectious diseases specialist according to routine examinations. Data was recorded in a questionnaire for each subject. The mean age for the experimental group was 35±6.1, and for control group was 36.6± 5.7 years. Both univariate and multivariate analyses of development of HBV infection and variables including Illegitimate sexual intercourse, use of intravenous injection drugs, positive history of imprisonment, and tattooing (p value < 0.05 showed existence of significant relationships. Injection of illegal intravenous drugs, history of imprisonment, illegitimate sexual intercourse, and tattooing are four important risk factors for transmission of HBV infection to HIV patients. In addition, the master risk reduction program may include provision of clean disposable tools for intravenous injection of drugs and tattooing.

Risk Analysis for Unintentional Slide Deployment During Airline Operations.

Science.gov (United States)

Ayra, Eduardo S; Insua, David Ríos; Castellanos, María Eugenia; Larbi, Lydia

2015-09-01

We present a risk analysis undertaken to mitigate problems in relation to the unintended deployment of slides under normal operations within a commercial airline. This type of incident entails relevant costs for the airline industry. After assessing the likelihood and severity of its consequences, we conclude that such risks need to be managed. We then evaluate the effectiveness of various countermeasures, describing and justifying the chosen ones. We also discuss several issues faced when implementing and communicating the proposed measures, thus fully illustrating the risk analysis process. © 2015 Society for Risk Analysis.

[Effect of psychosocial work environment and job satisfaction on burnout syndrome among specialist physicians].

Science.gov (United States)

Escribà-Agüir, Vicenta; Artazcoz, Lucía; Pérez-Hoyos, Santiago

2008-01-01

To describe the prevalence of burnout syndrome according to medical specialty and to examine the impact of work psychosocial risk factors, job satisfaction and professional characteristics on burnout syndrome among specialist physicians throughout Spain. A cross-sectional survey was carried out among 1,021 Spanish physicians. The outcome variables were the 3 dimensions of burnout syndrome: emotional exhaustion, depersonalization, and personal accomplishment. The explanatory variables were work psychosocial risk factors and job satisfaction evaluated by a stress scale specifically designed for physicians. Adjusted odds ratios and their 95% confidence intervals were calculated by logistic regression. The probability of high emotional exhaustion and depersonalization were greater in physicians exposed to a high level of contact with suffering and death and to a negative impact of work on home life. The probability of high emotional exhaustion was greater among physicians with a high work overload. The risk of low personal accomplishment was higher among physicians with low professional satisfaction and those without training activities. Dissatisfaction with relationships with patients and relatives had a negative effect on the 3 dimensions of burnout. Psychosocial work environment and job satisfaction have a negative effect on burnout syndrome, especially on emotional exhaustion and depersonalization.

Specialist services for older people : issues of negative and positive ageism

OpenAIRE

Reed, Jan; Cook, Glenda; Cook, Margaret; Inglis, Pamela; Clarke, Charlotte

2006-01-01

This paper reports findings of a study in 2004 of the development of specialist services for older people in the National Health Service (NHS) in England, as recommended in the Department of Health's National Service Framework for Older People (NSF-OP). The study was funded by the Department of Health as part of a programme of research to explore the Framework's implementation. Information was collected through a questionnaire survey about the nature of specialist developments at three levels...

Mare Risk Analysis monitor

International Nuclear Information System (INIS)

Fuente Prieto, I.; Alonso, P.; Carretero Fernandino, J. A.

2000-01-01

The Nuclear Safety Council's requirement that Spanish power plants comply with the requirements of the Maintenance Rule associated with plant risk assessment during power operation, arising from the partial unavailability of systems due to the maintenance activities, has led to need for additional tools to facilitate compliance with said requirements. While the impact on risk produced by individual equipment unavailabilities can easily be evaluated, either qualitatively or quantitatively, the process becomes more complicated when un programmed unavailabilities simultaneously occur in various systems, making it necessary to evaluate their functional impact. It is especially complex in the case of support systems that can affect the functionality of multiple systems. In view of the above, a computer application has been developed that is capable of providing the operator with quick answers based on the specific plant model in order to allow fast risk assessment using the information compiled as part of the Probabilistic Safety Analysis. The paper describes the most important characteristics of this application and the basic design requirements of the MARE Risk Monitor. (Author)

Diversifying Schools and Leveraging School Improvement: A Comparative Analysis of the English Radical, and Singapore Conservative, Specialist Schools' Policies

Science.gov (United States)

Dimmock, Clive

2011-01-01

Within the context of fierce global economic competition, school diversification and specialist schools have been seen by governments as cornerstones of education policy to engineer school improvement in both England and Singapore for more than a decade. In both systems, the policy has manifested in different school types, school names and…

How working on mathematics impacts primary teaching: Mathematics Specialist Teachers make the connections

OpenAIRE

Hilton, C.; Houssart, J.

2014-01-01

We draw on analysis of assignments by primary teachers as part of the assessment for the Mathematics Specialist Teachers programme (MaST). In the assignment teachers are asked to work on some mathematics themselves, write up the mathematical part of their work then write about how this experience has impacted on their practice as a primary teacher. We focus first on case studies of teachers who included algebraic work in the first part of their assignments and look at what they say about the ...

Scholarly Productivity of School Psychology Faculty Members in Specialist-Level Programs: 2002-2011

Science.gov (United States)

Laurent, Jeff; Runia, Elizabeth

2016-01-01

The scholarly productivity of school psychology faculty members in specialist-level only programs was examined. Information was gathered from the School Psychology Program Information portion of the website for the National Association of School Psychologists. A total of 137 specialist-level only school psychology programs were identified.…

Bayesian-network-based safety risk analysis in construction projects

International Nuclear Information System (INIS)

Zhang, Limao; Wu, Xianguo; Skibniewski, Miroslaw J.; Zhong, Jingbing; Lu, Yujie

2014-01-01

This paper presents a systemic decision support approach for safety risk analysis under uncertainty in tunnel construction. Fuzzy Bayesian Networks (FBN) is used to investigate causal relationships between tunnel-induced damage and its influential variables based upon the risk/hazard mechanism analysis. Aiming to overcome limitations on the current probability estimation, an expert confidence indicator is proposed to ensure the reliability of the surveyed data for fuzzy probability assessment of basic risk factors. A detailed fuzzy-based inference procedure is developed, which has a capacity of implementing deductive reasoning, sensitivity analysis and abductive reasoning. The “3σ criterion” is adopted to calculate the characteristic values of a triangular fuzzy number in the probability fuzzification process, and the α-weighted valuation method is adopted for defuzzification. The construction safety analysis progress is extended to the entire life cycle of risk-prone events, including the pre-accident, during-construction continuous and post-accident control. A typical hazard concerning the tunnel leakage in the construction of Wuhan Yangtze Metro Tunnel in China is presented as a case study, in order to verify the applicability of the proposed approach. The results demonstrate the feasibility of the proposed approach and its application potential. A comparison of advantages and disadvantages between FBN and fuzzy fault tree analysis (FFTA) as risk analysis tools is also conducted. The proposed approach can be used to provide guidelines for safety analysis and management in construction projects, and thus increase the likelihood of a successful project in a complex environment. - Highlights: • A systemic Bayesian network based approach for safety risk analysis is developed. • An expert confidence indicator for probability fuzzification is proposed. • Safety risk analysis progress is extended to entire life cycle of risk-prone events. • A typical

On the validation of risk analysis-A commentary

International Nuclear Information System (INIS)

Rosqvist, Tony

2010-01-01

Aven and Heide (2009) [1] provided interesting views on the reliability and validation of risk analysis. The four validation criteria presented are contrasted with modelling features related to the relative frequency-based and Bayesian approaches to risk analysis. In this commentary I would like to bring forth some issues on validation that partly confirm and partly suggest changes in the interpretation of the introduced validation criteria-especially, in the context of low probability-high consequence systems. The mental model of an expert in assessing probabilities is argued to be a key notion in understanding the validation of a risk analysis.

Quantitative risk assessment using the capacity-demand analysis

International Nuclear Information System (INIS)

Morgenroth, M.; Donnelly, C.R.; Westermann, G.D.; Huang, J.H.S.; Lam, T.M.

1999-01-01

The hydroelectric industry's recognition of the importance of avoiding unexpected failure, or forced outages, led to the development of probabilistic, or risk-based, methods in order to attempt to quantify exposures. Traditionally, such analysis has been carried out by qualitative assessments, relying on experience and sound engineering judgment to determine the optimum time to maintain, repair or replace a part or system. Depending on the nature of the problem, however, and the level of experience of those included in the decision making process, it is difficult to find a balance between acting proactively and accepting some amount of risk. The development of a practical means for establishing the probability of failure of any part or system, based on the determination of the statistical distribution of engineering properties such as acting stresses, is discussed. The capacity-demand analysis methodology, coupled with probablistic, risk-based analysis, permits all the factors associated with a decision to rehabilitate or replace a part, including the risks associated with the timing of the decision, to be assessed in a transparent and defendable manner. The methodology does not eliminate judgment altogether, but does move it from the level of estimating the risk of failure to the lower level of estimating variability in material properties, uncertainty in loading, and the uncertainties inherent in any engineering analysis. The method was successfully used in 1998 to carry out a comprehensive, economic risk analysis for the entire water conveyance system of a 90 year old hydropower station. The analysis included a number of diverse parts ranging from rock slopes and aging steel and concrete conduits, and the method allowed a rational assessment of the risks associated with reach of these varied parts to be determined, permitting the essential remedial works to be prioritized. 14 refs., 4 figs

STS-95 Payload Specialist Glenn and his wife pose before their return flight to JSC

Science.gov (United States)

1998-01-01

At the Skid Strip at Cape Canaveral Air Station, STS-95 Payload Specialist John H. Glenn Jr., a senator from Ohio and one of the original seven Project Mercury astronauts, poses with his wife Annie before their return flight to the Johnson Space Center in Houston, Texas. The STS-95 mission ended with landing at Kennedy Space Center's Shuttle Landing Facility at 12:04 p.m. EST on Nov. 7. The STS-95 crew also includes Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist Scott E. Parazynski; Mission Specialist Stephen K. Robinson; Mission Specialist Pedro Duque, with the European Space Agency (ESA); and Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA). The mission included research payloads such as the Spartan-201 solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as a SPACEHAB single module with experiments on space flight and the aging process.

Host plant invests in growth rather than chemical defense when attacked by a specialist herbivore.

Science.gov (United States)

Arab, Alberto; Trigo, José Roberto

2011-05-01

Plant defensive compounds may be a cost rather than a benefit when plants are attacked by specialist insects that may overcome chemical barriers by strategies such as sequestering plant compounds. Plants may respond to specialist herbivores by compensatory growth rather than chemical defense. To explore the use of defensive chemistry vs. compensatory growth we studied Brugmansia suaveolens (Solanaceae) and the specialist larvae of the ithomiine butterfly Placidina euryanassa, which sequester defensive tropane alkaloids (TAs) from this host plant. We investigated whether the concentration of TAs in B. suaveolens was changed by P. euryanassa damage, and whether plants invest in growth, when damaged by the specialist. Larvae feeding during 24 hr significantly decreased TAs in damaged plants, but they returned to control levels after 15 days without damage. Damaged and undamaged plants did not differ significantly in leaf area after 15 days, indicating compensatory growth. Our results suggest that B. suaveolens responds to herbivory by the specialist P. euryanassa by investing in growth rather than chemical defense.

Education of specialists-cartographers in Lviv Polytechnic National University

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Наталія Ярема

2017-09-01

Full Text Available This paper describes the system of future specialists-cartographers education in Lviv polytechnic national university. Main targets of the department of cartography and geospatial modelling are listed. Key research areas of the department, the educational specifics of students at «Bachelor» and «Master‘s» levels are described. At present, the main task of the department is to train specialists with good knowledge of cartographic investigation method, GIS technologies, because digital cartography, web-mapping, web-portal are things of the future. Cartography specialists must know how to create traditional maps (topographic, thematic, tourist using computer technologies and electronic maps that can be used in the creation of GIS systems, informational resources in navigation, military affairs and so on. The main scientific direction of the department is general geographic and thematic mapping, GIS mapping and development of GIS, history of the cartography, mathematic modelling in geodesy, astronomy and geophysics. The department trains bachelors on specialty 103 «Earth sciences», specialization 103.02 «Cartography». The feature of master’s education is maximum approach to education content for future employment. Master degree students are improving their professional knowledge and skills received during their study for the bachelor’s degree. They are deeply studying modern methods of cartographic digital terrain models with GIS technologies, combining their work with development of cartographic databases. They get acquainted with the principles of base sets of geospatial data, conduct thematic evaluation and forecast maps, using GIS. The students also study methods and order of design, edition, and maps development in detail. Modern mapping needs to be more efficient in the use of both natural and human resources, reflect a complex system man - society - environment. Such problem can be solved using various modeling techniques with

FORMATION OF PROFESSIONAL MOBILITY SPECIALIST WITHIN THE COMPETENCE APPROACH

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M. L. Gruzdeva

2013-01-01

Full Text Available In the article discussed the question of formation of professional mobility specialist through the formation of professional competencies within the educational process in high school.

On the news string: Irradiation diseases and risks

Energy Technology Data Exchange (ETDEWEB)

Lazzarini, E

1986-01-01

This article, suggested by Chernobyl incident, has the purpose to show to non specialists some basic informations about the risks of a radioactive contamination produced by radionuclides released to the environment by nuclear installations.

Approach of fuzzy logic in the preliminary risk analysis of the upstream and downstream lines of an offshore petroleum production unit

Energy Technology Data Exchange (ETDEWEB)

Garcia, Claudio B. [PETROBRAS Transporte S.A. (TRANSPETRO), Rio de Janeiro, RJ (Brazil); Pinho, Edson [Universidade Federal Rural do Rio de Janeiro (UFRRJ), Seropedica, RJ (Brazil); Maia Neto, Luiz

2009-07-01

This work consists of the application of a model of qualitative risk assessment based in fuzzy logic for the judgment of criticality of the scenarios of accident identified through the technique of preliminary hazard analysis in the upstream and downstream of an offshore oil production unit already in operation. The model based on fuzzy logic acts as substitute to the traditional Risks Matrix that uses subjective concepts for the categories of expected severity and frequency of the accidents. The structure of the employed model consists of 7 input variables, an internal variable and an output variable, all linked in accordance with the modules of analysis for each type of accident. The developed base of knowledge, that complete the expert system consists of membership functions developed for each one of the variables and a set of 219 distributed inference rules in the 7 different modules. The developed knowledge base, which incorporates the mechanisms of logical reasoning of specialists, assists and guides, with efficiency, the teams that carry through the preliminary hazard analyses with the use of a computer program having previously inserted routines. The employed model incorporates in the knowledge base of the program the existing concepts in the categories of frequency and severity, under the form of membership functions of the linguistic variable and the set of rules. With this, scales subdivided in ranges, defined on the basis of the existing direction present in the risks matrices are used to define the actions to be taken for the analyzed accident scenarios. (author)

Paediatric conscious sedation: views and experience of specialists in paediatric dentistry.

Science.gov (United States)

Woolley, S M; Hingston, E J; Shah, J; Chadwick, B L

2009-09-26

The objectives were three-fold: to investigate the level of conscious sedation training received prior to and during specialist training in paediatric dentistry; to establish the use of conscious sedation during and following specialisation; and to determine the attitudes of specialists in paediatric dentistry to conscious sedation. A self-administered postal questionnaire was sent to all specialists in paediatric dentistry registered with the General Dental Council in January 2008. Non-responders were contacted again after a four-week period. A response rate of 60% was achieved. Of the 122 respondents, 67 (55%) had received sedation training as an undergraduate; 89 (75%) had been trained during specialisation. All respondents performed dental treatment under sedation as a trainee and the majority used nitrous oxide inhalation sedation (NOIS). Over 90% of respondents felt that NOIS should be available to all children, both in appropriate primary care settings and in hospitals. One hundred and twenty-one (99%) respondents thought that all trainees in paediatric dentistry should have sedation training. The most popular form of sedation amongst specialists in paediatric dentistry was NOIS. However, some of the respondents felt that children should have access to other forms of sedation in both the primary care and hospital settings. Additional research on other forms of sedation is required to evaluate their effectiveness and safety.

System risk evolution analysis and risk critical event identification based on event sequence diagram

International Nuclear Information System (INIS)

Luo, Pengcheng; Hu, Yang

2013-01-01

During system operation, the environmental, operational and usage conditions are time-varying, which causes the fluctuations of the system state variables (SSVs). These fluctuations change the accidents’ probabilities and then result in the system risk evolution (SRE). This inherent relation makes it feasible to realize risk control by monitoring the SSVs in real time, herein, the quantitative analysis of SRE is essential. Besides, some events in the process of SRE are critical to system risk, because they act like the “demarcative points” of safety and accident, and this characteristic makes each of them a key point of risk control. Therefore, analysis of SRE and identification of risk critical events (RCEs) are remarkably meaningful to ensure the system to operate safely. In this context, an event sequence diagram (ESD) based method of SRE analysis and the related Monte Carlo solution are presented; RCE and risk sensitive variable (RSV) are defined, and the corresponding identification methods are also proposed. Finally, the proposed approaches are exemplified with an accident scenario of an aircraft getting into the icing region

Instability risk analysis and risk assessment system establishment of underground storage caverns in bedded salt rock

Science.gov (United States)

Jing, Wenjun; Zhao, Yan

2018-02-01

Stability is an important part of geotechnical engineering research. The operating experiences of underground storage caverns in salt rock all around the world show that the stability of the caverns is the key problem of safe operation. Currently, the combination of theoretical analysis and numerical simulation are the mainly adopts method of reserve stability analysis. This paper introduces the concept of risk into the stability analysis of underground geotechnical structure, and studies the instability of underground storage cavern in salt rock from the perspective of risk analysis. Firstly, the definition and classification of cavern instability risk is proposed, and the damage mechanism is analyzed from the mechanical angle. Then the main stability evaluating indicators of cavern instability risk are proposed, and an evaluation method of cavern instability risk is put forward. Finally, the established cavern instability risk assessment system is applied to the analysis and prediction of cavern instability risk after 30 years of operation in a proposed storage cavern group in the Huai’an salt mine. This research can provide a useful theoretical base for the safe operation and management of underground storage caverns in salt rock.

BUSINESS GAMES IN PROFESSIONAL TRAINING OF FUTURE FIRE SAFETY SPECIALISTS

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Лариса Маладика

2014-12-01

Full Text Available Special features of professional training of future specialists in extraordinary (emergency situations, increasing its quality with the use of interactive technologies have been considered in this article. The paper presents a research of modern interactive educational technologies, most widely used at higher educational institutions, promoting modernization of education as well as training of competitive future specialists. The article grounds possibility of formation and development of the culture of professional communication by interactive methods of learning, and business games, in particular. The research deals with kinds of business games as active methods of learning, their structural levels and features of use.

Economic evaluation of nurse practitioner and clinical nurse specialist roles: A methodological review.

Science.gov (United States)

Lopatina, Elena; Donald, Faith; DiCenso, Alba; Martin-Misener, Ruth; Kilpatrick, Kelley; Bryant-Lukosius, Denise; Carter, Nancy; Reid, Kim; Marshall, Deborah A

2017-07-01

Advanced practice nurses (e.g., nurse practitioners and clinical nurse specialists) have been introduced internationally to increase access to high quality care and to tackle increasing health care expenditures. While randomised controlled trials and systematic reviews have demonstrated the effectiveness of nurse practitioner and clinical nurse specialist roles, their cost-effectiveness has been challenged. The poor quality of economic evaluations of these roles to date raises the question of whether current economic evaluation guidelines are adequate when examining their cost-effectiveness. To examine whether current guidelines for economic evaluation are appropriate for economic evaluations of nurse practitioner and clinical nurse specialist roles. Our methodological review was informed by a qualitative synthesis of four sources of information: 1) narrative review of literature reviews and discussion papers on economic evaluation of advanced practice nursing roles; 2) quality assessment of economic evaluations of nurse practitioner and clinical nurse specialist roles alongside randomised controlled trials; 3) review of guidelines for economic evaluation; and, 4) input from an expert panel. The narrative literature review revealed several challenges in economic evaluations of advanced practice nursing roles (e.g., complexity of the roles, variability in models and practice settings where the roles are implemented, and impact on outcomes that are difficult to measure). The quality assessment of economic evaluations of nurse practitioner and clinical nurse specialist roles alongside randomised controlled trials identified methodological limitations of these studies. When we applied the Guidelines for the Economic Evaluation of Health Technologies: Canada to the identified challenges and limitations, discussed those with experts and qualitatively synthesized all findings, we concluded that standard guidelines for economic evaluation are appropriate for economic

Analysis of risk factors and risk assessment for ischemic stroke recurrence

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Xiu-ying LONG

2016-08-01

Full Text Available Objective To screen the risk factors for recurrence of ischemic stroke and to assess the risk of recurrence. Methods Essen Stroke Risk Score (ESRS was used to evaluate the risk of recurrence in 176 patients with ischemic stroke (96 cases of first onset and 80 cases of recurrence. Univariate and multivariate stepwise Logistic regression analysis was used to screen risk factors for recurrence of ischemic stroke.  Results There were significant differences between first onset group and recurrence group on age, the proportion of > 75 years old, hypertension, diabetes, coronary heart disease, peripheral angiopathy, transient ischemic attack (TIA or ischemic stroke, drinking and ESRS score (P < 0.05, for all. First onset group included one case of ESRS 0 (1.04%, 8 cases of 1 (8.33%, 39 cases of 2 (40.63%, 44 cases of 3 (45.83%, 4 cases of 4 (4.17%. Recurrence group included 2 cases of ESRS 3 (2.50%, 20 cases of 4 (25% , 37 cases of 5 (46.25% , 18 cases of 6 (22.50% , 3 cases of 7 (3.75% . There was significant difference between 2 groups (Z = -11.376, P = 0.000. Logistic regression analysis showed ESRS > 3 score was independent risk factor for recurrence of ischemic stroke (OR = 31.324, 95%CI: 3.934-249.430; P = 0.001.  Conclusions ESRS > 3 score is the independent risk factor for recurrence of ischemic stroke. It is important to strengthen risk assessment of recurrence of ischemic stroke. To screen and control risk factors is the key to secondary prevention of ischemic stroke. DOI: 10.3969/j.issn.1672-6731.2016.07.011

Elementary School Math Instruction: Can Reading Specialists Assist?

Science.gov (United States)

Heinrichs, Audrey S.

1987-01-01

Discusses the contradictions found in recommendations for direction instruction or informal math language development, and some suggestions for practical resolution of disagreements, to enable school reading specialists to provide both background and practical help to classroom instructors teaching math. (HTH)

Communicating Radiation Risk to the Population of Fukushima

International Nuclear Information System (INIS)

Takamura, N.; Taira, Y.; Yoshida, K.; Nakashima-Hashiguchi, K.; Orita, M.; Yamashita, S.

2016-01-01

Radiological specialists from Nagasaki University have served on the medical relief team organized at Fukushima Medical University Hospital (Fukushima City) ever since the accident at the Fukushima Dai-ichi nuclear power plant. Furthermore, we have conducted the radiation crisis communication efforts by spreading correct information on the health effects of radiation as 'advisors on radiation health risk control'. Nagasaki University has been assisting the reconstruction efforts of Kawauchi Village in Fukushima Prefecture, which was the first village to declare that residents could safely return to their homes because radiation doses were found to be at comparatively low levels. In April 2013, Nagasaki University and the Kawauchi government office concluded an agreement concerning comprehensive cooperation toward reconstruction of the village. As a result, we established a satellite facility of the university in the village. In conclusion, training of specialists who can take responsibility for long-term risk communication regarding the health effects of radiation as well as crisis communication in the initial phase of the accident is an essential component of all such recovery efforts. Establishment of a training system for such specialists will be very important both for Japan and other countries worldwide. (authors)

Why are some medical specialists working part-time, while others work full-time?

NARCIS (Netherlands)

Jong, Judith D. de; Heiligers, Phil; Groenewegen, Peter P.; Hingstman, Lammert

2006-01-01

Although medical specialists primarily work full-time, part-time work is on the increase, a trend that can be found worldwide. This article seeks to answer the question why some medical specialists work part-time, while others do not although they are willing to work part-time. Two approaches are

Risk analysis of industrial plants operation

International Nuclear Information System (INIS)

Hubert, Philippe

1989-12-01

This study examines the possibilities of systematic technology risk analysis in view of territorial management (city, urban community, region), including chronic and accidental risks. The objective was to relate this evaluation with those done for permanent water and air pollution. Risk management for pollution are done for a long time. A number of studies were done in urban communities and regions both for air and water pollution. The second objective is related to management of industrial risks: nuclear, petrochemical, transport of hazardous material, pipelines, etc. At the beginning, three possibilities of effects are taken into account: human health, economic aspect and water, and possibilities of evaluation are identified. Elements of risk identification are presented for quantification of results [fr

[Survival analysis with competing risks: estimating failure probability].

Science.gov (United States)

Llorca, Javier; Delgado-Rodríguez, Miguel

2004-01-01

To show the impact of competing risks of death on survival analysis. We provide an example of survival time without chronic rejection after heart transplantation, where death before rejection acts as a competing risk. Using a computer simulation, we compare the Kaplan-Meier estimator and the multiple decrement model. The Kaplan-Meier method overestimated the probability of rejection. Next, we illustrate the use of the multiple decrement model to analyze secondary end points (in our example: death after rejection). Finally, we discuss Kaplan-Meier assumptions and why they fail in the presence of competing risks. Survival analysis should be adjusted for competing risks of death to avoid overestimation of the risk of rejection produced with the Kaplan-Meier method.

Bird communities of the arctic shrub tundra of Yamal: habitat specialists and generalists.

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Vasiliy Sokolov

Full Text Available BACKGROUND: The ratio of habitat generalists to specialists in birds has been suggested as a good indicator of ecosystem changes due to e.g. climate change and other anthropogenic perturbations. Most studies focusing on this functional component of biodiversity originate, however, from temperate regions. The Eurasian Arctic tundra is currently experiencing an unprecedented combination of climate change, change in grazing pressure by domestic reindeer and growing human activity. METHODOLOGY/PRINCIPAL FINDINGS: Here we monitored bird communities in a tundra landscape harbouring shrub and open habitats in order to analyse bird habitat relationships and quantify habitat specialization. We used ordination methods to analyse habitat associations and estimated the proportions of specialists in each of the main habitats. Correspondence Analysis identified three main bird communities, inhabiting upland, lowland and dense willow shrubs. We documented a stable structure of communities despite large multiannual variations of bird density (from 90 to 175 pairs/km(2. Willow shrub thickets were a hotspot for bird density, but not for species richness. The thickets hosted many specialized species whose main distribution area was south of the tundra. CONCLUSION/SIGNIFICANCE: If current arctic changes result in a shrubification of the landscape as many studies suggested, we would expect an increase in the overall bird abundance together with an increase of local specialists, since they are associated with willow thickets. The majority of these species have a southern origin and their increase in abundance would represent a strengthening of the boreal component in the southern tundra, perhaps at the expense of species typical of the subarctic zone, which appear to be generalists within this zone.

Preparation, Endorsement, and Employment of Mathematics Specialists

Science.gov (United States)

Cicmanec, Karen B. Mauck

2008-01-01

For over 30 years, educators have recommended that mathematics specialists be placed in schools to provide teachers with the resources they need to assist their students. To assess whether these recommendations have been realized, a survey was used to gather data from large school districts, the 50 states, and District of Columbia. The outcome of…

Quantitative risk analysis of a space shuttle subsystem

International Nuclear Information System (INIS)

Frank, M.V.

1989-01-01

This paper reports that in an attempt to investigate methods for risk management other than qualitative analysis techniques, NASA has funded pilot study quantitative risk analyses for space shuttle subsystems. The authors performed one such study of two shuttle subsystems with McDonnell Douglas Astronautics Company. The subsystems were the auxiliary power units (APU) on the orbiter, and the hydraulic power units on the solid rocket booster. The technology and results of the APU study are presented in this paper. Drawing from a rich in-flight database as well as from a wealth of tests and analyses, the study quantitatively assessed the risk of APU-initiated scenarios on the shuttle during all phases of a flight mission. Damage states of interest were loss of crew/vehicle, aborted mission, and launch scrub. A quantitative risk analysis approach to deciding on important items for risk management was contrasted with the current NASA failure mode and effects analysis/critical item list approach

About a competence and professional trade of specialists in the field of physical culture

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F.I. Sobyanin

2013-02-01

Full Text Available Correlation of concepts «competence» and «professional trade» is examined. More than 200 sources are studied. The necessity of account for training of athletic personnels of professional fitness and value of professional trade becomes firmly established as to the ultimate goal of forming of specialist in the field of physical culture. Negative tendencies are exposed in maintenance of preparation of specialists and higher professional athletic education in the higher institutes. Culturological and acmeological approach is offered for further strategy of perfection of professional pedagogical preparation of specialists. The stages of forming of specialist are presented on the basis of application of this approach. A necessity is marked at training of personnels oriented on the exposure of features of professional fitness of young people to the professions in the field of physical culture, its initial state and dynamics.

New algorithm for risk analysis in radiotherapy

International Nuclear Information System (INIS)

Torres, Antonio; Montes de Oca, Joe

2015-01-01

Risk analyses applied to radiotherapy treatments have become an undeniable necessity, considering the dangers generated by the combination of using powerful radiation fields on patients and the occurrence of human errors and equipment failures during these treatments. The technique par excellence to execute these analyses has been the risk matrix. This paper presents the development of a new algorithm to execute the task with wide graphic and analytic potentialities, thus transforming it into a very useful option for risk monitoring and the optimization of quality assurance. The system SECURE- MR, which is the basic software of this algorithm, has been successfully used in risk analysis regarding different kinds of radiotherapies. Compared to previous methods, It offers new possibilities of analysis considering risk controlling factors as the robustness of reducers of initiators frequency and its consequences. Their analytic capacities and graphs allow novel developments to classify risk contributing factors, to represent information processes as well as accidental sequences. The paper shows the application of the proposed system to a generic process of radiotherapy treatment using a lineal accelerator. (author)

Modeling issues in nuclear plant fire risk analysis

International Nuclear Information System (INIS)

Siu, N.

1989-01-01

This paper discusses various issues associated with current models for analyzing the risk due to fires in nuclear power plants. Particular emphasis is placed on the fire growth and suppression models, these being unique to the fire portion of the overall risk analysis. Potentially significant modeling improvements are identified; also discussed are a variety of modeling issues where improvements will help the credibility of the analysis, without necessarily changing the computed risk significantly. The mechanistic modeling of fire initiation is identified as a particularly promising improvement for reducing the uncertainties in the predicted risk. 17 refs., 5 figs. 2 tabs

Key challenges for the creation and maintenance of specialist protein resources

Science.gov (United States)

Holliday, Gemma L; Bairoch, Amos; Bagos, Pantelis G; Chatonnet, Arnaud; Craik, David J; Finn, Robert D; Henrissat, Bernard; Landsman, David; Manning, Gerard; Nagano, Nozomi; O’Donovan, Claire; Pruitt, Kim D; Rawlings, Neil D; Saier, Milton; Sowdhamini, Ramanathan; Spedding, Michael; Srinivasan, Narayanaswamy; Vriend, Gert; Babbitt, Patricia C; Bateman, Alex

2015-01-01

As the volume of data relating to proteins increases, researchers rely more and more on the analysis of published data, thus increasing the importance of good access to these data that vary from the supplemental material of individual articles, all the way to major reference databases with professional staff and long-term funding. Specialist protein resources fill an important middle ground, providing interactive web interfaces to their databases for a focused topic or family of proteins, using specialized approaches that are not feasible in the major reference databases. Many are labors of love, run by a single lab with little or no dedicated funding and there are many challenges to building and maintaining them. This perspective arose from a meeting of several specialist protein resources and major reference databases held at the Wellcome Trust Genome Campus (Cambridge, UK) on August 11 and 12, 2014. During this meeting some common key challenges involved in creating and maintaining such resources were discussed, along with various approaches to address them. In laying out these challenges, we aim to inform users about how these issues impact our resources and illustrate ways in which our working together could enhance their accuracy, currency, and overall value. Proteins 2015; 83:1005–1013. © 2015 The Authors. Proteins: Structure, Function, and Bioinformatics Published by Wiley Periodicals, Inc. PMID:25820941

Comparative risk analysis for the Rocky Flats Plant integrated project planning

International Nuclear Information System (INIS)

Jones, M.E.; Shain, D.I.

1994-01-01

The Rocky Flats Plant is developing, with active stakeholder participation, a comprehensive planning strategy that will support transition of the Rocky Flats Plant from a nuclear weapons production facility to site cleanup and final disposition. Consideration of the interrelated nature of sitewide problems, such as material movement and disposition, facility and land use endstates, costs, relative risks to workers and the public, and waste disposition are all needed. Comparative Risk Analysis employs both incremental risk and cumulative risk evaluations to compare risks from postulated options or endstates and is an analytical tool for the Rocky Flats Plant Integrated Project Planning which can assist a decision-maker in evaluating relative risks among proposed remediation activity. However, risks from all of the remediation activities, decontamination and decommissioning activities, and normal ongoing operations are imposed upon the Rocky Flats workers, the surrounding public, and the environment. Comparative Risk Analysis will provide risk information, both human health and ecological, to aid in reducing unnecessary resource and monetary expenditures by focusing these resources on the largest risks first. Comparative Risk Analysis has been developed to aggregate various incremental risk estimates to develop a site cumulative risk estimate. The Comparative Risk Analysis methodology Group, consisting of community stakeholders, was established. Early stakeholder involvement in the risk analysis methodology development provides an opportunity for stakeholders to influence the risk information delivered to a decision-maker. This paper discusses development of the Comparative Risk Analysis methodology, stakeholder participation and lessons learned from these challenges