WorldWideScience

Sample records for solutions practical implications

  1. Implications of Risk Management Practices on Financial ...

    African Journals Online (AJOL)

    Implications of Risk Management Practices on Financial Performance of Sugar ... The respondents were functional heads of the companies under the survey. ... of downside losses in order to minimize the negative impact of risk on returns.

  2. Using the Delphi Method for Selecting Effective Rehabilitation Practices for Case Study Research: Methods, Challenges, and Solutions and Implications for Future Research

    Science.gov (United States)

    Fleming, Allison R.; Boeltzig-Brown, Heike; Foley, Susan M.

    2015-01-01

    Purpose: We describe a modified Delphi method used to select effective state vocational rehabilitation agency practices to prioritize rehabilitation services for individuals with most significant disabilities within the context of Order of Selection, an area where there is little known and published. Specifically, we describe how we applied the…

  3. Modern Urban Naming Practices: Strategic Approaches and Practical Solutions

    Directory of Open Access Journals (Sweden)

    Marina V. Golomidova

    2017-11-01

    Full Text Available The article looks at the problems of the naming of municipal facilities. The author analyzes the existing policy in assigning new names and renaming urban sites, describes the current strategic approaches to urban naming and proposes a new strategy based on congruity with the holistic image of the city. The current approaches to urban naming mark the predominating interest in the historical and cultural heritage of cities as a valuable source for the toponymic nomination shared both by native and foreign experts. However, this commitment to the past may run counter to the modern arrangement and perception of the urban space, as well as impede the city development prospects. From the standpoint of modern area marketing, names of urban sites are regarded as an information and communication resource highly relevant to the city image formation and promotion. In the author’s view, the benefits of adopting a new strategy may also resonate with the concept of “urbanonymic construction,” which is understood as sustainable and streamlined management policy aimed at the progressive implementation of long-term programs for individual urban site names consistency. The urbanonymic construction involves a normative, regulatory aspect; formation of the holistic city image that builds on its resource base, the symbolic capital, and the development strategy; definition of key characteristics of the city image which are most relevant to its positioning; identification of principal nominative themes for verbal representation of the city image; use of naming technologies to ensure the relevance of the name’s implications; testing and expert evaluation of new names. Drawing on domestic and foreign expertise in the same study field, a number of practical solutions for the creation of new urbanonyms are described.

  4. Practical implications of 'postmodern philosophy'

    Directory of Open Access Journals (Sweden)

    Savić Mile V.

    2002-01-01

    Full Text Available The article examines the implications of the discourse about postmodernity. Postmodernity is analyzed as a complex discursive figure. Within the discourse about postmodernity three levels are distinguished: the postmodern condition, postmodernism, and reflection of the postmodern condition. Special attention is paid to globalization and the problem of the enforcement of modern projects in East-European societies, particularly Serbia. These societies are termed object-societies, while their modification of modernity is called eastmodernity. The author's answer to the complexity of the postmodern condition is a conception of the politics of subsistence.

  5. Relative age effect: implications for effective practice.

    Science.gov (United States)

    Andronikos, Georgios; Elumaro, Adeboye Israel; Westbury, Tony; Martindale, Russell J J

    2016-01-01

    Physical and psychological differences related to birthdate amongst athletes of the same selection year have been characterised as the "relative age effects" (RAEs). RAEs have been identified in a variety of sports, both at youth and adult level, and are linked with dropout of athletes and a reduction of the talent pool. This study examined the existence, mechanisms and possible solutions to RAEs using qualitative methodology. Seven experts in the field of talent identification and development were interviewed. Inductive analysis of the data showed that, while there was mixed evidence for the existence of RAEs across sports, the eradication of RAEs was attributed to controllable features of the development environment. The factors reported included the structure of "categories" used to group athletes within the sport (e.g. age, weight, size, skills), recognition and prioritisation of long-term development over "short term win focus." Education of relevant parties (e.g. coaches, scouts, clubs) about RAEs and the nature of "talent" within a long-term context was suggested, along with careful consideration of the structure of the development environment (e.g. delayed selection, provision for late developers, focus on skills not results, use of challenge). Implications for research and practice are discussed.

  6. Reflective practice and its implications for pharmacy education.

    Science.gov (United States)

    Tsingos, Cherie; Bosnic-Anticevich, Sinthia; Smith, Lorraine

    2014-02-12

    Pharmacy students require critical-thinking and problem-solving skills to integrate theory learned in the classroom with the complexities of practice, yet many pharmacy students fall short of acquiring these skills.(1-2) Reflective practice activities encourage learning from the student's own experiences and those of others, and offer a possible solution for the integration of knowledge-based curricula with the ambiguities of practice, as well as enhance communication and collaboration within a multidisciplinary team. Although reflective practices have been embraced elsewhere in health professions education, their strengths and shortcomings need to be considered when implementing such practices into pharmacy curricula. This review provides an overview of the evolution of theories related to reflective practice, critically examines the use of reflective tools (such as portfolios and blogs), and discusses the implications of implementing reflective practices in pharmacy education.

  7. Teacher's experiences in PBL: implications for practice

    Science.gov (United States)

    Alves, Anabela C.; Sousa, Rui M.; Fernandes, Sandra; Cardoso, Elisabete; Carvalho, Maria Alice; Figueiredo, Jorge; Pereira, Rui M. S.

    2016-03-01

    Project-Based Learning (PBL) has been implemented in the first year of the Industrial Engineering and Management programme at the University of Minho, Portugal, since 2004/2005. The purpose of this paper is to analyse and discuss teachers' experiences in PBL in this programme and to explore its implications for student learning and for teaching practices in higher education. For data collection, the research method used was written narratives to these teachers, at the end of the PBL semester. Findings suggest that teachers express a positive view of PBL as a learning approach. They identify student motivation and engagement, along with a better understanding of the application of concepts in real-life situations, as important outcomes of the project for students. Besides this, teachers also highlight the importance of the development of transversal skills by students throughout the project. Recommendations for future work and implications for practice will also be discussed.

  8. Emergency department surge: models and practical implications.

    Science.gov (United States)

    Nager, Alan L; Khanna, Kajal

    2009-08-01

    Emergency Department crowding has long been described. Despite the daily challenges of managing emergency department volume and acuity; a surge response during a disaster entails even greater challenges including collaboration, intervention, and resourcefulness to effectively carry out pediatric disaster management. Understanding surge and how to respond with appropriate planning will lead to success. To achieve this, we sought to analyze models of surge; review regional and national data outlining surge challenges and factors that impact surge; and to outline potential solutions. We conducted a systemic review and included articles and documents that best described the theoretical and practical basis of surge response. We organized the systematic review according to the following questions: What are the elements and models that are delineated by the concept of surge? What is the basis for surge response based on regional and national published sources? What are the broad global solutions? What are the major lessons observed that will impact effective surge capacity? Multiple models of surge are described including public health, facility-based and community-based; a 6-tiered response system; and intrinsic or extrinsic surge capacity. In addition, essential components (4 S's of surge response) are described along with regional and national data outlining surge challenges, impacting factors, global solutions, and lesions observed. There are numerous shortcomings regionally and nationally affecting our ability to provide an effective and coordinated surge response. Planning, education, and training will lead to an effective pediatric disaster management response.

  9. Language practice as games: Implications for sociology of ...

    African Journals Online (AJOL)

    Language practice as games: Implications for sociology of translation in development contexts in Africa. ... Abstract. Drawing from Game Theory, the article conceptualises language practice as games, that is ... AJOL African Journals Online.

  10. Child Rearing Practices in Nigeria: Implications for Mental Health ...

    African Journals Online (AJOL)

    Child Rearing Practices in Nigeria: Implications for Mental Health. ... over time are important, especially as this region is undergoing rapid transformation. ... Through policy and aggressive health education, traditional child rearing practices in ...

  11. Practical solutions in African agriculture | IDRC - International ...

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

    2016-11-25

    Nov 25, 2016 ... These include technologies, models, and management practices, among them: ... by three meals a week once the products are available in the market. ... been trained on business plan development and entrepreneurship.

  12. Tacit Knowledge Barriers in Franchising: Practical Solutions

    Science.gov (United States)

    Cumberland, Denise; Githens, Rod

    2012-01-01

    Purpose: The purpose of this paper is to identify barriers that hinder tacit knowledge transfer in a franchise environment and offer a compendium of solutions that encourage franchisees and franchisors to leverage tacit knowledge as a resource for competitive advantage. Design/methodology/approach: Drawing from the research on franchise…

  13. Education System Reform in China after 1978: Some Practical Implications

    Science.gov (United States)

    Sun, Miantao

    2010-01-01

    Purpose: This paper aims to provide an overview of education system reform in China since 1978, and its practical implications. Design/methodology/approach: Data were collected from literature review and interview. An overview of education system reform and its practical implications was found through data analysis. Findings: There has been two…

  14. Some practical implications of source term reassessment

    International Nuclear Information System (INIS)

    1988-03-01

    This report provides a brief summary of the current knowledge of severe accident source terms and suggests how this knowledge might be applied to a number of specific aspects of reactor safety. In preparing the report, consideration has been restricted to source term issues relating to light water reactors (LWRs). Consideration has also generally been restricted to the consequences of hypothetical severe accidents rather than their probability of occurrence, although it is recognized that, in the practical application of source term research, it is necessary to take account of probability as well as consequences. The specific areas identified were as follows: Exploration of the new insights that are available into the management of severe accidents; Investigating the impact of source term research on emergency planning and response; Assessing the possibilities which exist in present reactor designs for preventing or mitigating the consequences of severe accidents and how these might be used effectively; Exploring the need for backfitting and assessing the implications of source term research for future designs; and Improving the quantification of the radiological consequences of hypothetical severe accidents for probabilistic safety assessments (PSAs) and informing the public about the realistic risks associated with nuclear power plants. 7 refs

  15. Practical implications of neutron survey instrument performance

    International Nuclear Information System (INIS)

    Tanner, R. J.; Bartlett, D. T.; Hager, I. G.; Jones, I. N.; Molinos, C.; Roberts, N. J.; Taylor, G. C.; Thomas, D. J.

    2004-01-01

    Improvements have been made to the Monte Carlo modelling used to calculate the response of the neutron survey instruments most commonly used in the UK, for neutron energies up to 20 MeV. The improved modelling of the devices includes the electronics and battery pack, allowing better calculations of both the energy and angle dependence of response. These data are used to calculate the response of the instruments in rotationally and fully isotropic, as well as unidirectional fields. Experimental measurements with radionuclide sources and monoenergetic neutron fields have been, and continue to be made, to test the calculated response characteristics. The enhancements to the calculations have involved simulation of the sensitivity of the response to variations in instrument manufacture, and will include the influence of the user and floor during measurements. The practical implications of the energy and angle dependence of response, variations in manufacture, and the influence of the user are assessed by folding the response characteristics with workplace energy and direction distributions. (authors)

  16. Practical implications of the new risk perspectives

    International Nuclear Information System (INIS)

    Aven, Terje

    2013-01-01

    In recent years several authors have argued for the adoption of certain new types of risk perspectives which highlight uncertainties rather than probabilities in the way risk is understood and measured. The theoretical rationale for these new perspectives is well established, but the practical implications have not been so clearly demonstrated. There is a need to show how the new perspectives change the way risk is described and communicated in real-life situations and in its turn the effects on risk management and decision making. The present paper aims at contributing to this end by considering two cases, related to a national risk level, and a specific analysis concerning an LNG plant. The paper concludes that the new risk perspectives influence the current regime in many ways, in particular the manner in which the knowledge dimension is described and dealt with. Two methods for characterising the strength of knowledge are presented, one of them based on a new concept, the “assumption deviation risk”, reflecting risks related to the deviations from the conditions/states defined by the assumption made

  17. Lectures on the practical solution of differential equations

    International Nuclear Information System (INIS)

    Dresner, L.

    1979-11-01

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

  18. Finding practical solutions to complex problems: IDRC's fifth annual ...

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

    2016-04-15

    Apr 15, 2016 ... English · Français ... Finding practical solutions to complex problems: IDRC's fifth annual ... “IDRC staff share a common goal with the researchers they work with – to find low-cost, down-to-earth solutions to complex problems ...

  19. Quality factor: conceptual problems and practical solutions

    International Nuclear Information System (INIS)

    Dennis, J.A.

    1988-01-01

    In the past ten years a growing divide has become apparent between the dosimetric concepts designed to provide measures of stochastic risks and those designed for the measurement and control of exposures to radiation. Those designed to provide estimates of risk, e.g. effective dose equivalent, might need to be further refined to incorporate the latest scientific beliefs and evidence about the dependence on radiation quality and dose rate as well as on age and sex. Both animal and human evidence strongly supports a belief that different tissues and different types of neoplasm will have different dependencies on radiation quality and dose rate. For practical purposes of risk estimation it is necessary to select the same values for all human neoplasms. There are reasons for using life shortening in animals as a basis for this purpose, but the data for the dependence on the whole range of radiation qualities is meagre. To provide some stability for the new concepts of measurement and calibration it may be better to accommodate changing perceptions on radiation risks by specifying different levels of exposure for different types of radiation without changing the current quality factors for the measurement quantities. (author)

  20. Teacher's reading comprehension: Implication for teaching practices

    Directory of Open Access Journals (Sweden)

    Adriana Benevides Soares

    2010-11-01

    Full Text Available A question of interest for educational workers is the reading comprehension process, a fundamental ability for progress in more advanced years of schooling, and its effect on pedagogical practices. This is a study that explores this question. A reading comprehension instrument composed by four structural levels of text and a scale of pedagogical practice composed by four sub-scales involving: cognitive practices with linguistic focus, cognitive practices, affective and motor practices, continuous education, was used. The results of 53 children suggest a slight tendency of teacher to prioritize cognitive practices independently of their reading comprehension level.

  1. Implementing Comprehensive Reform: Implications for Practice

    Science.gov (United States)

    Stout, Karen A.

    2016-01-01

    This chapter describes the challenges and practical barriers community colleges face when implementing comprehensive reform, exploring how reforms are leading to some improvements but not often scaled improvements.

  2. Privacy Threats and Practical Solutions for Genetic Risk Tests

    OpenAIRE

    Barman, Ludovic; El Graini, Mohammed-Taha; Raisaro, Jean Louis; Ayday, Erman; Hubaux, Jean-Pierre

    2015-01-01

    Recently, several solutions have been proposed to address the complex challenge of protecting individuals’ genetic data during personalized medicine tests. In this short paper, we analyze different privacy threats and propose simple countermeasures for the generic architecture mainly used in the literature. In particular, we present and evaluate a new practical solution against a critical attack of a malicious medical center trying to actively infer raw genetic information of patients.

  3. Democratic Schooling in Norway: Implications for Leadership in Practice

    Science.gov (United States)

    Moller, Jorunn

    2006-01-01

    This article explores the meaning of an education based on democratic values and the implications for school leadership in practice. Based on findings from a case study in a Norwegian upper secondary school, the study describes democratic school leadership in practice, with particular attention to the distribution of power and leadership in the…

  4. Emerging solutions in reference services implications for libraries in the new millennium

    CERN Document Server

    Edwards, John D

    2013-01-01

    How can you enhance reference services without adding staff?Modern law librarians are under growing pressure to keep up with new technologies, deal instantly with the demands of patrons, keep the library safe and user-friendly, and generally offer the best possible service while keeping costs down. Emerging Solutions in Reference Services: Implications for Libraries in the New Millennium is a very practical guide for coping with rapidly changing technology and increasing demands for services. Its sane, well-researched advice and suggestions can help you deal with the hectic days and

  5. TECHNICAL AND PRACTICAL IMPLICATIONS OF SHORT SELLING

    Directory of Open Access Journals (Sweden)

    Radu BORES

    2016-07-01

    Full Text Available This paper aims at providing insight into some of the implication of short selling for markets, investors as well as regulators. Findings show that capital flows are adversely affected by strict regulation and bans of short sales, while market liquidity, and bid-ask spread can be improved by allowing short selling. Additionally portfolios that incorporate short selling strategies can have lower volatility in returns. The informational content of short sales can provide important feedback for informed investors and lead to better price discovery.

  6. Medical Malpractice Implications of Clinical Practice Guidelines.

    Science.gov (United States)

    Ruhl, Douglas S; Siegal, Gil

    2017-08-01

    Clinical practice guidelines aim to improve medical care by clarifying and making useful recommendations to providers. Although providers should account for patients' unique characteristics when determining a treatment plan, it is generally perceived as good practice to follow guidelines when applicable. This is of interest in malpractice litigation, where it is essential to establish a standard of care to evaluate the performances of providers. Although the opinions of expert witnesses are used to determine standards of care, guidelines are expected to play a leading role. Guidelines alone should not establish a legal standard but may help inform this discussion in the courtroom. Therefore, it is incumbent that excellent, practical, and timely guidelines are continually created and updated in a transparent way. These guidelines must be very clear and underscore the various strengths of recommendation based on the quality of available evidence.

  7. Stem cell terminology: practical, theological and ethical implications.

    Science.gov (United States)

    Shanner, Laura

    2002-01-01

    Stem cell policy discussions frequently confuse embryonic and fetal sources of stem cells, and label untested, non-reproductive cloning as "therapeutic." Such misnomers distract attention from significant practical and ethical implications: accelerated research agendas tend to be supported at the expense of physical risks to women, theological implications in a multi-faith community, informed consent for participation in research, and treatment decisions altered by unrealistic expectations.

  8. Contemporary marketing practice : theoretical propositions and practical implications

    NARCIS (Netherlands)

    Lindgreen, A.; Palmer, R.; Vanhamme, J.

    2004-01-01

    Marketing has changed significantly since it first emerged as a distinct business and management phenomenon. We identify some of the major factors causing the observed change in marketing practice. We then describe a classification scheme that is based on transaction marketing and relationship

  9. PRACTICAL IMPLICATIONS OF LOCATION-BASED SCHEDULING

    DEFF Research Database (Denmark)

    Andersson, Niclas; Christensen, Knud

    2007-01-01

    The traditional method for planning, scheduling and controlling activities and resources in construction projects is the CPM-scheduling, which has been the predominant scheduling method since its introduction in the late 1950s. Over the years, CPM has proven to be a very powerful technique...... that will be used in this study. LBS is a scheduling method that rests upon the theories of line-of-balance and which uses the graphic representation of a flowline chart. As such, LBS is adapted for planning and management of workflows and, thus, may provide a solution to the identified shortcomings of CPM. Even...

  10. Implications of radiation risk for practical dosimetry

    International Nuclear Information System (INIS)

    Dennis, J.A.

    1984-01-01

    Radiobiological experiments with animals and cells have led to an expectation that the risks of cancer and hereditary effects are reduced at low doses and low dose rates of low LET radiation. Risk estimates derived from human exposures at high doses and dose rates usually contain an allowance for low dose effects in comparison with high dose effects, but no allowance may have been made for low dose rate effects. Although there are reasons for thinking that leukaemia risks may possibly have been underestimated, the total cancer risk assumed by ICRP for occupational exposures is reasonably realistic. For practical dosimetry the primary dose concepts and limits have to be translated into secondary quantities that are capable of practical realisation and measurement, and which will provide a stable and robust system of metrology. If the ICRP risk assumptions are approximately correct, it is extremely unlikely that epidemiological studies of occupational exposures will detect the influence of radiation. Elaboration of dosimetry and dose recording for epidemiological purposes is therefore unjustified except possibly in relation to differences between high and low LET radiations. (author)

  11. Computed tomographic practice and dosimetry: implications for nuclear medicine: editorial

    International Nuclear Information System (INIS)

    Mountford, P.J.; Harding, L.K.

    1992-01-01

    This editorial briefly discusses the results of an NRPB survey of x-ray computed tomography practice and dosimetry in the UK. A wide variation in practice and patient doses was revealed. The implications for nuclear medicine are considered. The NRPB is to issue formal guidance on protection of the patient undergoing a CT investigation with the aim of achieving a more systematic approach to the justification and optimization of such exposures. (UK)

  12. Analysis of Current Supplier Relationship Management Practices: A Solution Proposal

    OpenAIRE

    Gomes Campelo Filho, Eulalio

    2009-01-01

    The work contributes with the existing literature by investigating current SRM practices. Based on the research, the author has designed an information system framework, which provides companies with an innovative SRM solution to manage their indirect material purchasing process through an environment that supports companies entire plan-to-order activities, including functionalities such as central data management, spend data management, e-sourcing and the usual e-procurement features.

  13. Safeguarding and Protecting Children in Maternity Services: Implications for Practice

    Science.gov (United States)

    Lazenbatt, Anne; Greer, Jean

    2009-01-01

    This article debates the issues involved in safeguarding and protecting children in maternity services and offers implications for professional practice. Midwives and other staff who work as members of the maternity team have a safeguarding role to play in the identification of babies and children who have been abused, or are at risk of abuse, and…

  14. Implications of teacher educators' practices in assessment for ...

    African Journals Online (AJOL)

    This study presents findings on teacher educators' practices in assessment and their implications for student learning in Tanzania. Research on classroom assessment has been dichotomizing assessment and teaching-learning processes instead of viewing assessment as an integral part of the teachinglearning process.

  15. Global megatrends and their implications for environmental assessment practice

    Energy Technology Data Exchange (ETDEWEB)

    Retief, Francois, E-mail: francois.retief@nwu.ac.za [Research Unit for Environmental Sciences and Management, North-West University (South Africa); Bond, Alan [School of Environmental Sciences, University of East Anglia (United Kingdom); Research Unit for Environmental Sciences and Management, North-West University (South Africa); Pope, Jenny [Integral Sustainability (Australia); Research Unit for Environmental Sciences and Management, North-West University (South Africa); Morrison-Saunders, Angus [Murdoch University (Australia); Research Unit for Environmental, Sciences and Management, North-West University (South Africa); King, Nicholas [Research Unit for Environmental Sciences and Management, North-West University (South Africa)

    2016-11-15

    This paper addresses the future of environmental assessment (EA) practice in light of a rapidly changing world. We apply a literature review-based methodology to firstly identify key global megatrends and then reflect upon the implications for EA practice based on some known challenges. The key megatrends identified are synthesised into six categories: i) demographics, ii) urbanization, iii) technological innovation, iv) power shifts, v) resource scarcity and vi) climate change. We then discuss the implications of these megatrends for EA practice against four known EA challenges namely: dealing with i) complexity and uncertainty, ii) efficiency, iii) significance and iv) communication and participation. Our analysis suggests important implications for EA practice such as: increased difficulties with accuracy of prediction; the need for facilitative adaptation; an increase in the occurrence of unexpected events; higher expectations for procedural efficiency; challenges with information and communication management; dealing with significance judgements; and mitigation amidst resource scarcity and increasing pressures on earth systems. The megatrends underscore the need for continued evolution of EA thinking and practice, especially moving away from seeking a predictable single future or outcome towards the possibility of multiple scenarios with associated adaptability and enhanced system resilience capable of responding to rapid change.

  16. Global megatrends and their implications for environmental assessment practice

    International Nuclear Information System (INIS)

    Retief, Francois; Bond, Alan; Pope, Jenny; Morrison-Saunders, Angus; King, Nicholas

    2016-01-01

    This paper addresses the future of environmental assessment (EA) practice in light of a rapidly changing world. We apply a literature review-based methodology to firstly identify key global megatrends and then reflect upon the implications for EA practice based on some known challenges. The key megatrends identified are synthesised into six categories: i) demographics, ii) urbanization, iii) technological innovation, iv) power shifts, v) resource scarcity and vi) climate change. We then discuss the implications of these megatrends for EA practice against four known EA challenges namely: dealing with i) complexity and uncertainty, ii) efficiency, iii) significance and iv) communication and participation. Our analysis suggests important implications for EA practice such as: increased difficulties with accuracy of prediction; the need for facilitative adaptation; an increase in the occurrence of unexpected events; higher expectations for procedural efficiency; challenges with information and communication management; dealing with significance judgements; and mitigation amidst resource scarcity and increasing pressures on earth systems. The megatrends underscore the need for continued evolution of EA thinking and practice, especially moving away from seeking a predictable single future or outcome towards the possibility of multiple scenarios with associated adaptability and enhanced system resilience capable of responding to rapid change.

  17. Fast food in the diet: Implications and solutions for families.

    Science.gov (United States)

    Fulkerson, Jayne A

    2018-04-06

    Fast food is omnipresent in the United States (U.S.) and contributes to poor dietary quality and poor health among youth and adults alike. Children need adults to teach them good eating habits to attain and maintain good health by introducing them to healthful foods and being good role models. The fast food industry, through vast funds and advertising, contribute to challenges parents face to provide healthful foods for their families and thwart our best efforts to meet health goals. Research shows fast food consumption is influenced by lack of cooking confidence, time pressures, and perceptions of ease and convenience. We need practical strategies to help parents and children make healthier food choices. As a product of conference proceedings, this paper provides a non-exhaustive narrative summary of the fast food marketplace and marketing, the contributions of fast food to diet and health, struggles with healthful eating among families, and possible solutions of how we can help children and parents empower themselves to have healthier lives. Copyright © 2018. Published by Elsevier Inc.

  18. A Practical Solution for Time Synchronization in Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    COCA, E.

    2012-11-01

    Full Text Available Time synchronization in wireless sensor node networks is a hot topic. Many papers present various software algorithms and hardware solutions to keep accurate time information on mobile nodes. In terms of real life applications wireless sensor nodes are preferred in many domains, starting with simple room monitoring and finishing with pipeline surveillance projects. Positioning applications are far more restrictive on timekeeping accuracy, as for the velocity of nodes calculations precise time or time difference values are needed. The accuracy of time information on nodes has to be always correlated with the application requirements. In this paper, we present some considerations regarding time synchronization linked with specific needs for individual practical applications. A practical low energy method of time keeping at node level is proposed and tested. The performances of the proposed solution in terms of short and long term stability and energy requirements are analyzed and compared with existing solutions. Simulation and experimental results, some advantages and disadvantages of the method are presented at the end of the paper.

  19. Resource depletion promotes automatic processing: implications for distribution of practice.

    Science.gov (United States)

    Scheel, Matthew H

    2010-12-01

    Recent models of cognition include two processing systems: an automatic system that relies on associative learning, intuition, and heuristics, and a controlled system that relies on deliberate consideration. Automatic processing requires fewer resources and is more likely when resources are depleted. This study showed that prolonged practice on a resource-depleting mental arithmetic task promoted automatic processing on a subsequent problem-solving task, as evidenced by faster responding and more errors. Distribution of practice effects (0, 60, 120, or 180 sec. between problems) on rigidity also disappeared when groups had equal time on resource-depleting tasks. These results suggest that distribution of practice effects is reducible to resource availability. The discussion includes implications for interpreting discrepancies in the traditional distribution of practice effect.

  20. Exploring accountability of clinical ethics consultants: practice and training implications.

    Science.gov (United States)

    Weise, Kathryn L; Daly, Barbara J

    2014-01-01

    Clinical ethics consultants represent a multidisciplinary group of scholars and practitioners with varied training backgrounds, who are integrated into a medical environment to assist in the provision of ethically supportable care. Little has been written about the degree to which such consultants are accountable for the patient care outcome of the advice given. We propose a model for examining degrees of internally motivated accountability that range from restricted to unbounded accountability, and support balanced accountability as a goal for practice. Finally, we explore implications of this model for training of clinical ethics consultants from diverse academic backgrounds, including those disciplines that do not have a formal code of ethics relating to clinical practice.

  1. Practical implications of incentive systems are utilized by dental franchises.

    Science.gov (United States)

    Yavner, S B

    1989-01-01

    The success of any dental practice depends, among other factors, on the critical role of staff employees. In order to encourage desired staff behaviors, incentive systems can be designed for employee dentists, assistants/hygienists and managers. A survey of dental franchises was conducted in 1987 for the purpose of examining their incentive control systems. The specific incentives employed by these dental franchises for their employees are analyzed. The implications of these incentive systems used by dental franchise organizations for all dental practices are then discussed.

  2. Significance chasing in research practice: causes, consequences and possible solutions.

    Science.gov (United States)

    Ware, Jennifer J; Munafò, Marcus R

    2015-01-01

    The low reproducibility of findings within the scientific literature is a growing concern. This may be due to many findings being false positives which, in turn, can misdirect research effort and waste money. We review factors that may contribute to poor study reproducibility and an excess of 'significant' findings within the published literature. Specifically, we consider the influence of current incentive structures and the impact of these on research practices. The prevalence of false positives within the literature may be attributable to a number of questionable research practices, ranging from the relatively innocent and minor (e.g. unplanned post-hoc tests) to the calculated and serious (e.g. fabrication of data). These practices may be driven by current incentive structures (e.g. pressure to publish), alongside the preferential emphasis placed by journals on novelty over veracity. There are a number of potential solutions to poor reproducibility, such as new publishing formats that emphasize the research question and study design, rather than the results obtained. This has the potential to minimize significance chasing and non-publication of null findings. Significance chasing, questionable research practices and poor study reproducibility are the unfortunate consequence of a 'publish or perish' culture and a preference among journals for novel findings. It is likely that top-down change implemented by those with the ability to modify current incentive structure (e.g. funders and journals) will be required to address problems of poor reproducibility. © 2014 Society for the Study of Addiction.

  3. Practice implications and recommendations for managing codeine misuse and dependence

    Directory of Open Access Journals (Sweden)

    Bergin Michael

    2015-12-01

    Full Text Available Codeine, a weak opiate, requires increased pharmacovigilance relating to availability, heterogeneous nature of misuse, dependence and associated harm. A scoping review of literature on codeine was conducted using Arksey & O’Malley’s framework (1. Databases searched included PubMed, EBSCO Host, Science Direct, EMBASE, PsycINFO, Cochrane library and Medline from 1994 to 2014. Follow-up search strategies involved hand searching and searching of pharmaceutical, health, medical and drug related websites. Initial zscreening identified 3,105 articles with 475 meeting the inclusion criteria. Eight broad categories organised the literature, data charting and qualitative synthesis. This paper presents implications for practice and makes recommendations to address these issues. Themes identified relate to raising public and practitioner awareness, risk management, dispensing practices and monitoring and surveillance of codeine. Evidence to inform law enforcement, drug surveillance, public health initiatives, harm reduction approaches, pharmacy, clinical and treatment practices is warranted.

  4. Ideology and community social psychology: theoretical considerations and practical implications.

    Science.gov (United States)

    Montenegro, Marisela

    2002-08-01

    This paper addresses the importance of the concept of ideology in community work. The implications of a Marxist approach to ideology in community practice are analyzed in terms of the concepts of problematization (P. Freire, 1979) and consciousness-raising (J. Barreiro, 1976), illustrating the point with some examples. The traditional Marxist perspective is also examined in relation to the perspectives of social constructionism (I. Ibáñez, 1996), cultural studies (A. McRobbie, 1992), post-Marxism (E. Laclau & C. Mouffe, 1985), and feminism (D. Haraway, 1991). It is argued that the concepts of hegemony and habitus (P. Bourdieu, 1985) can be useful to community social psychology theory and practice. A "situated perspective"--in which it is possible to dialogue from different "subject positions," and articulate transformation and political action--is argued. The implications of this shifting in the concept of ideology by means of theoretical developments outside social communitypsychology can help to define the external (outside) agent's position in community practice.

  5. TEHORIES OF CONNECTIONS – PRACTICAL IMPLICATIONS IN ACQUIRING MOTOR SKILLS

    Directory of Open Access Journals (Sweden)

    Zoran Milošević

    2010-09-01

    Full Text Available Theories of learning which are classified in two broad schools as theories of connections and cognitive theories, differ among themselves according to specific interaction relationships between external stimulus (S, reaction and behavior and organism (R, i.e. particular learner (O. In relation to pedagogical practices, predominance of a certain school is not rare, often without any objective insight into their potentials related to age, sex, learning contents and other determinants. Well-known approaches within the theories of relations include classical Pavlov reflex, Guthry’s close conditioning, associating of Thorndyke, and Skinner’s efficient conditioning. Practical implications of these theories in acquiring motor skills are related to an active learner’s approach, significance of repetition – exercising, supporting, and rewarding correct answers, as well as strengthening a new behavior by imitation of a sample – modeling.

  6. Integrated Practice Improvement Solutions-Practical Steps to Operating Room Management.

    Science.gov (United States)

    Chernov, Mikhail; Pullockaran, Janet; Vick, Angela; Leyvi, Galina; Delphin, Ellise

    2016-10-01

    Perioperative productivity is a vital concern for surgeons, anesthesiologists, and administrators as the OR is a major source of hospital elective admissions and revenue. Based on elements of existing Practice Improvement Methodologies (PIMs), "Integrated Practice Improvement Solutions" (IPIS) is a practical and simple solution incorporating aspects of multiple management approaches into a single open source framework to increase OR efficiency and productivity by better utilization of existing resources. OR efficiency was measured both before and after IPIS implementation using the total number of cases versus room utilization, OR/anesthesia revenue and staff overtime (OT) costs. Other parameters of efficiency, such as the first case on-time start and the turnover time (TOT) were measured in parallel. IPIS implementation resulted in increased numbers of surgical procedures performed by an average of 10.7%, and OR and anesthesia revenue increases of 18.5% and 6.9%, respectively, with a simultaneous decrease in TOT (15%) and OT for anesthesia staff (26%). The number of perioperative adverse events was stable during the two-year study period which involved a total of 20,378 patients. IPIS, an effective and flexible practice improvement model, was designed to quickly, significantly, and sustainably improve OR efficiency by better utilization of existing resources. Success of its implementation directly correlates with the involvement of and acceptance by the entire OR team and hospital administration.

  7. Evolutionary adaptations: theoretical and practical implications for visual ergonomics.

    Science.gov (United States)

    Fostervold, Knut Inge; Watten, Reidulf G; Volden, Frode

    2014-01-01

    The literature discussing visual ergonomics often mention that human vision is adapted to light emitted by the sun. However, theoretical and practical implications of this viewpoint is seldom discussed or taken into account. The paper discusses some of the main theoretical implications of an evolutionary approach to visual ergonomics. Based on interactional theory and ideas from ecological psychology an evolutionary stress model is proposed as a theoretical framework for future research in ergonomics and human factors. The model stresses the importance of developing work environments that fits with our evolutionary adaptations. In accordance with evolutionary psychology, the environment of evolutionary adaptedness (EEA) and evolutionarily-novel environments (EN) are used as key concepts. Using work with visual display units (VDU) as an example, the paper discusses how this knowledge can be utilized in an ergonomic analysis of risk factors in the work environment. The paper emphasises the importance of incorporating evolutionary theory in the field of ergonomics. Further, the paper encourages scientific practices that further our understanding of any phenomena beyond the borders of traditional proximal explanations.

  8. Kees: a Practical Ict Solution for Rural Areas

    Science.gov (United States)

    Dai, Xiaoye; Tabirca, Sabin; Lenihan, Eamon

    This paper introduces a practical e-learning system, identified as Knowledge Exchange E-learning System (abbr. KEES), for knowledge distribution in rural areas. Particularly, this paper is about providing a virtual teaching and learning environment for small holders in agriculture in those rural areas. E-learning is increasingly influencing the agricultural education (information and knowledge learning) in all forms and the current e-learning in agricultural education appears in informal and formal methods in many developed countries and some developing areas such as Asian Pacific regions. KEES is a solution to provide education services including other services of information distribution and knowledge sharing to local farmers, local institutes or local collection of farmers. The design of KEES is made to meet the needs of knowledge capacity building, experience sharing, skill upgrading, and information exchanging in agriculture for different conditions in rural areas. The system allows the online lecture/training materials to be distributed simultaneously with all multimedia resources through different file formats across different platforms. The teaching/training content can be contextless and broad, allowing for greater participation by more small holders, commercial farmers, extension workers, agriculturists, educators, and other agriculture-related experts. The relative inconsistency in content gives farmers more localised and useful knowledge. The framework of KEES has been designed to be a three-tier architecture logic workflow, which can configure the progressive approach for KEES to pass on and respond to different requests/communications between the client side and the server.

  9. Practical solutions to implementing "Born Semantic" data systems

    Science.gov (United States)

    Leadbetter, A.; Buck, J. J. H.; Stacey, P.

    2015-12-01

    The concept of data being "Born Semantic" has been proposed in recent years as a Semantic Web analogue to the idea of data being "born digital"[1], [2]. Within the "Born Semantic" concept, data are captured digitally and at a point close to the time of creation are annotated with markup terms from semantic web resources (controlled vocabularies, thesauri or ontologies). This allows heterogeneous data to be more easily ingested and amalgamated in near real-time due to the standards compliant annotation of the data. In taking the "Born Semantic" proposal from concept to operation, a number of difficulties have been encountered. For example, although there are recognised methods such as Header, Dictionary, Triples [3] for the compression, publication and dissemination of large volumes of triples these systems are not practical to deploy in the field on low-powered (both electrically and computationally) devices. Similarly, it is not practical for instruments to output fully formed semantically annotated data files if they are designed to be plugged into a modular system and the data to be centrally logged in the field as is the case on Argo floats and oceanographic gliders where internal bandwidth becomes an issue [2]. In light of these issues, this presentation will concentrate on pragmatic solutions being developed to the problem of generating Linked Data in near real-time systems. Specific examples from the European Commission SenseOCEAN project where Linked Data systems are being developed for autonomous underwater platforms, and from work being undertaken in the streaming of data from the Irish Galway Bay Cable Observatory initiative will be highlighted. Further, developments of a set of tools for the LogStash-ElasticSearch software ecosystem to allow the storing and retrieval of Linked Data will be introduced. References[1] A. Leadbetter & J. Fredericks, We have "born digital" - now what about "born semantic"?, European Geophysical Union General Assembly, 2014

  10. Nursing intellectual capital theory: implications for research and practice.

    Science.gov (United States)

    Covell, Christine L; Sidani, Souraya

    2013-05-31

    Due to rising costs of healthcare, determining how registered nurses and knowledge resources influence the quality of patient care is critical. Studies that have investigated the relationship between nursing knowledge and outcomes have been plagued with conceptual and methodological issues. This has resulted in limited empirical evidence of the impact of nursing knowledge on patient or organizational outcomes. The nursing intellectual capital theory was developed to assist with this area of inquiry. Nursing intellectual capital theory conceptualizes the sources of nursing knowledge available within an organization and delineates its relationship to patient and organizational outcomes. In this article, we review the nursing intellectual capital theory and discuss its implications for research and practice. We explain why the theory shows promise for guiding research on quality work environments and how it may assist with administrative decision-making related to nursing human resource management and continuing professional development.

  11. Continuing Developments in PV Risk Management: Strategies, Solutions, and Implications

    Energy Technology Data Exchange (ETDEWEB)

    Lowder, T.; Mendelsohn, M.; Speer, B.; Hill, R.

    2013-02-01

    As the PV industry matures, successful risk management practices will become more imperative to ensure investor confidence, control costs, and facilitate further growth. This report discusses several key aspects of risk management during the commercial- and utility-scale project life cycle, from identification of risks, to the process of mitigating and allocating those risks among project parties, to transferring those risks through insurance. The report also explores novel techniques in PV risk management, options to offload risks onto the capital markets, and innovative insurance policies (namely warranty policies) that address risks unique to the PV sector. One of the major justifications for robust risk management in the PV industry is the cost-reduction opportunities it affords. If the PV industry can demonstrate the capability to successfully manage its risks, thereby inspiring confidence in financiers, it may be able to obtain a lower cost of capital in future transactions. A lower cost of capital translates to a lower cost of energy, which will in turn enhance PV?s competitiveness at a time when it will have to rely less on subsidies to support its market penetration.

  12. A Practical Solution Using A New Approach To Robot Vision

    Science.gov (United States)

    Hudson, David L.

    1984-01-01

    Up to now, robot vision systems have been designed to serve both application development and operational needs in inspection, assembly and material handling. This universal approach to robot vision is too costly for many practical applications. A new industrial vision system separates the function of application program development from on-line operation. A Vision Development System (VDS) is equipped with facilities designed to simplify and accelerate the application program development process. A complimentary but lower cost Target Application System (TASK) runs the application program developed with the VDS. This concept is presented in the context of an actual robot vision application that improves inspection and assembly for a manufacturer of electronic terminal keyboards. Applications developed with a VDS experience lower development cost when compared with conventional vision systems. Since the TASK processor is not burdened with development tools, it can be installed at a lower cost than comparable "universal" vision systems that are intended to be used for both development and on-line operation. The VDS/TASK approach opens more industrial applications to robot vision that previously were not practical because of the high cost of vision systems. Although robot vision is a new technology, it has been applied successfully to a variety of industrial needs in inspection, manufacturing, and material handling. New developments in robot vision technology are creating practical, cost effective solutions for a variety of industrial needs. A year or two ago, researchers and robot manufacturers interested in implementing a robot vision application could take one of two approaches. The first approach was to purchase all the necessary vision components from various sources. That meant buying an image processor from one company, a camera from another and lens and light sources from yet others. The user then had to assemble the pieces, and in most instances he had to write

  13. Employment of people with disabilities: Implications for HR management practices

    Directory of Open Access Journals (Sweden)

    P. Gida

    2007-12-01

    Full Text Available Purpose: The purpose of this paper is to, firstly, present the findings of an empirical study in which the human resource management practices associated with the employment of people with disabilities were investigated. The human resource management challenges related to employment of people with disabilities were also identified in the empirical study and are presented in this paper. A further purpose of this paper is to propose a number of recommendations focused on human resource management practices and principles aimed at assisting managers and human resource management specialists in their endeavours to effectively deal with the employment of people with disabilities. Design/Methodology/Approach: This paper is based on an empirical study in which interviews were conducted with respondents from 19 different organisations identified in the Financial Mail's 'Top 100 Organisations in South Africa' list. Findings: The findings from the empirical study suggest that very few organisations are dealing with the employment of people with disabilities as a priority in their equity strategies. Where attention is being given to this issue, respondents seem to either address it as a legal compliance issue or a social responsibility 'project'. Furthermore, very little has been done to review current human resource management practices to determine whether they are discriminatory towards people with disabilities. Based on the insights gained from these findings and in line with best practice principles identified in the relevant literature, a number of recommendations focusing on human resource management practices and principles in relation to the employment of people with disabilities are proposed. Implications: This paper provides a number of practical steps to consider as part of an organisation's response to equity strategies related to the employment of people with disabilities. Originality/Value: In the Employment Equity Commission's Annual Report

  14. TEHORIES OF CONNECTIONS – PRACTICAL IMPLICATIONS IN ACQUIRING MOTOR SKILLS

    Directory of Open Access Journals (Sweden)

    Zoran Milošević

    2010-03-01

    Full Text Available Theories of learning which are classified in two broad schools as theories of connections and cognitive theories, differ among themselves according to specific interaction relationships between external stimulus (S, reaction and behavior and organism (R, i.e. particular learner (O. In relation to pedagogical practices, predominance of a certain school is not rare, often without any objective insight into their potentials related to age, sex, learning contents and other determinants. Supporters of the theories of connections treat behavior as a result of relations or associations, whereas learning occurs when these relations are strengthened by repetition or when new relations are formed. These theories are usually classified as theories of stimulus-reaction (S-R, whereas associating in this sense is used to stress the concept most theories usually agree upon: that learning consists of relations and link between stimuli (S-S, between stimuli and reactions (S-R, or between reaction and impulse (R-P. Well-known approaches within the theories of relations include classical Pavlov reflex, Guthry’s close conditioning, associating of Thorndyke, and Skinner’s efficient conditioning. Practical implications of these theories in acquiring motor skills are related to an active learner’s approach, significance of repetition – exercising, supporting, and rewarding correct answers, as well as strengthening a new behavior by imitation of a sample – modeling.

  15. Online Learning Integrity Approaches: Current Practices and Future Solutions

    Science.gov (United States)

    Lee-Post, Anita; Hapke, Holly

    2017-01-01

    The primary objective of this paper is to help institutions respond to the stipulation of the Higher Education Opportunity Act of 2008 by adopting cost-effective academic integrity solutions without compromising the convenience and flexibility of online learning. Current user authentication solutions such as user ID and password, security…

  16. Current knowledge on radon risk. Implications for practical radiation protection?

    International Nuclear Information System (INIS)

    Mueller, Wolfgang-Ulrich; Giussani, Augusto; Kreuzer, Michaela; Sobotzki, Christina; Ruehm, Werner; Lecomte, Jean-Francois; Harrison, John; Breckow, Joachim

    2016-01-01

    ICRP suggested a strategy based on the distinction between a protection approach for dwellings and one for workplaces in the previous recommendations on radon. Now, the Commission recommends an integrated approach for the protection against radon exposure in all buildings irrespective of their purpose and the status of their occupants. The strategy of protection in buildings, implemented through a national action plan, is based on the application of the optimisation principle below a derived reference level in concentration (maximum 300 Bq m -3 ). A problem, however, arises that due to new epidemiological findings and application of dosimetric models, ICRP 115 (Ann ICRP 40, 2010) presents nominal probability coefficients for radon exposure that are approximately by a factor of 2 larger than in the former recommendations of ICRP 65 (Ann ICRP 23, 1993). On the basis of the so-called epidemiological approach and the dosimetric approach, the doubling of risk per unit exposure is represented by a doubling of the dose coefficients, while the risk coefficient of ICRP 103 (2007) remains unchanged. Thus, an identical given radon exposure situation with the new dose coefficients would result in a doubling of dose compared with the former values. This is of serious conceptual implications. A possible solution of this problem was presented during the workshop. (orig.)

  17. Current knowledge on radon risk. Implications for practical radiation protection?

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, Wolfgang-Ulrich [Universitaetsklinikum Essen, Institut fuer Medizinische Strahlenbiologie, Essen (Germany); Giussani, Augusto; Kreuzer, Michaela; Sobotzki, Christina [Federal Office for Radiation Protection, Oberschleissheim (Germany); Ruehm, Werner [German Research Center for Environmental Health, Institute of Radiation Protection, Helmholtz Zentrum Muenchen, Neuherberg (Germany); Lecomte, Jean-Francois [International Affaires Directorate, Institut de Radioprotection et de Surete Nucleaire, P.O. Box 17, Fontenay-aux-Roses (France); Harrison, John [Oxford Brookes University, Faculty of Health and Life Sciences, Oxford (United Kingdom); Breckow, Joachim [THM University of Applied Sciences, Institute of Medical Physics and Radiation Protection, Giessen (Germany)

    2016-08-15

    ICRP suggested a strategy based on the distinction between a protection approach for dwellings and one for workplaces in the previous recommendations on radon. Now, the Commission recommends an integrated approach for the protection against radon exposure in all buildings irrespective of their purpose and the status of their occupants. The strategy of protection in buildings, implemented through a national action plan, is based on the application of the optimisation principle below a derived reference level in concentration (maximum 300 Bq m{sup -3}). A problem, however, arises that due to new epidemiological findings and application of dosimetric models, ICRP 115 (Ann ICRP 40, 2010) presents nominal probability coefficients for radon exposure that are approximately by a factor of 2 larger than in the former recommendations of ICRP 65 (Ann ICRP 23, 1993). On the basis of the so-called epidemiological approach and the dosimetric approach, the doubling of risk per unit exposure is represented by a doubling of the dose coefficients, while the risk coefficient of ICRP 103 (2007) remains unchanged. Thus, an identical given radon exposure situation with the new dose coefficients would result in a doubling of dose compared with the former values. This is of serious conceptual implications. A possible solution of this problem was presented during the workshop. (orig.)

  18. The science, policy and practice of nature-based solutions: An interdisciplinary perspective.

    Science.gov (United States)

    Nesshöver, Carsten; Assmuth, Timo; Irvine, Katherine N; Rusch, Graciela M; Waylen, Kerry A; Delbaere, Ben; Haase, Dagmar; Jones-Walters, Lawrence; Keune, Hans; Kovacs, Eszter; Krauze, Kinga; Külvik, Mart; Rey, Freddy; van Dijk, Jiska; Vistad, Odd Inge; Wilkinson, Mark E; Wittmer, Heidi

    2017-02-01

    In this paper, we reflect on the implications for science, policy and practice of the recently introduced concept of Nature-Based Solutions (NBS), with a focus on the European context. First, we analyse NBS in relation to similar concepts, and reflect on its relationship to sustainability as an overarching framework. From this, we derive a set of questions to be addressed and propose a general framework for how these might be addressed in NBS projects by funders, researchers, policy-makers and practitioners. We conclude that: To realise their full potential, NBS must be developed by including the experience of all relevant stakeholders such that 'solutions' contribute to achieving all dimensions of sustainability. As NBS are developed, we must also moderate the expectations placed on them since the precedent provided by other initiatives whose aim was to manage nature sustainably demonstrates that we should not expect NBS to be cheap and easy, at least not in the short-term. Copyright © 2016 British Geological Survey, NERC. Published by Elsevier B.V. All rights reserved.

  19. A practical evaluation of detergent and disinfectant solutions on ...

    African Journals Online (AJOL)

    Student01

    2012-01-06

    Jan 6, 2012 ... Nine sanitation chemical solutions: benzalkonium chloride, sodium hypochlorite, nitric ... cleaning and disinfection in reducing selected bacteria levels as required by ..... bacteria targeted during disinfection are attached to a.

  20. Contracting for safety with patients: clinical practice and forensic implications.

    Science.gov (United States)

    Garvey, Keelin A; Penn, Joseph V; Campbell, Angela L; Esposito-Smythers, Christianne; Spirito, Anthony

    2009-01-01

    The contract for safety is a procedure used in the management of suicidal patients and has significant patient care, risk management, and medicolegal implications. We conducted a literature review to assess empirical support for this procedure and reviewed legal cases in which this practice was employed, to examine its effect on outcome. Studies obtained from a PubMed search were reviewed and consisted mainly of opinion-based surveys of clinicians and patients and retrospective reviews. Overall, empirically based evidence to support the use of the contract for safety in any population is very limited, particularly in adolescent populations. A legal review revealed that contracting for safety is never enough to protect against legal liability and may lead to adverse consequences for the clinician and the patient. Contracts should be considered for use only in patients who are deemed capable of giving informed consent and, even in these circumstances, should be used with caution. A contract should never replace a thorough assessment of a patient's suicide risk factors. Further empirical research is needed to determine whether contracting for safety merits consideration as a future component of the suicide risk assessment.

  1. Interactions In Online Education Implications For Theory & Practice

    Directory of Open Access Journals (Sweden)

    Askim KURT

    2007-04-01

    Full Text Available This book was edited by, Charles Juwah, Senior EducationDevelopment Officer at Robert Gordon University, where heruns the postgraduate learning and teaching qualificationcourse. It was published by Routledge in 2006.Interaction is very important in open and flexible learning,and apparent at all levels of engagement, whether betweenstudents, students and tutors, online learning materials orinterfacing with the learning environment. A student whoactively engages with learning materials, interactions helpto improve learning by fortifying knowledge and providingcontext, encouraging reflection, questioning and deeplyunderstanding of a subject.This book provides international perspectives on key topics including analyzing and designing e-learning interactions, social and conceptual dimensions of learning, interactions in online discussions, interactions in pair learning, and professional development of online facilitators. In this book a collection of research and innovative case material drawn from practitioners and academicians and it covers the theory and the practical implications of related issues. It is essential reading for all those involved in the design,implementation, management and use of open and flexible learning.

  2. Cognitive load theory: Practical implications and an important challenge

    Directory of Open Access Journals (Sweden)

    Jimmie Leppink, Ph.D.

    2017-10-01

    Full Text Available The field of medical education has adopted a wide variety of theories from other fields. A fairly recent example is cognitive load theory, which originated in educational psychology. Several empirical studies inspired by cognitive load theory and reviews of practical implications of cognitive load theory have contributed to guidelines for the design of medical education. Simultaneously, several research groups have developed instruments for the measurement of cognitive load in a medical education context. These developments notwithstanding, obtaining evidence for different types of cognitive load remains an important challenge. Therefore, the aim of this article is twofold: to provide medical educators with three key guidelines for the design of instruction and assessment and to discuss several fundamental issues in the remaining challenges presented by different types of cognitive load. The guidelines revolve around minimizing cognitive activity that does not contribute to learning, working with specific learning goals in mind, and appreciating the multifaceted relation between learning and assessment. Key issues around the types of cognitive load include the context in which learning occurs, the continued use of single-item mental effort ratings, and the timing of cognitive load and learning outcome measurements.

  3. Practical implications of pre-employment nurse assessments.

    Science.gov (United States)

    Kuthy, James E; Ramon, Cheree; Gonzalez, Ronald; Biddle, Dan A

    2013-01-01

    Hiring nurses is a difficult task that can have serious repercussions for medical facilities. If nurses without proper skills are hired, patients can suffer from insufficient quality of care and potentially life-threatening conditions. Nurse applicants' technical knowledge is extremely important to avoid negative outcomes; however, there are soft skills that factor into their success, such as bedside manner, personality, communication, and decision making. In order for medical facilities to select and maintain high-performing nurse staff, hiring managers must incorporate evaluations for these types of skills in their hiring process. The current study focused on using content/criterion-related validation design to create assessments by which nurse applicants can be evaluated for both technical knowledge/skills and soft skills. The study included participation of more than 876 nursing staff members. To rank applicants on divergent skills, 3 assessment types were investigated, resulting in the creation of an assessment with 3 components. The clinical, situational, and behavioral components that were created measure applicants' job knowledge, interpersonal competency in medical facility-related situations, and aspects of personality and behavior, respectively. Results indicate that using the assessment can predict 45% of a nurse applicant's future job performance. Practical implications include hiring and maintaining a higher quality of nurses and decreased hiring costs.

  4. A practice-driven systematic review of dependency analysis solutions

    NARCIS (Netherlands)

    Callo Arias, Trosky B.; Spek, Pieter van der; Avgeriou, Paris

    2011-01-01

    When following architecture-driven strategies to develop large software-intensive systems, the analysis of the dependencies is not an easy task. In this paper, we report a systematic literature review on dependency analysis solutions. Dependency analysis concerns making dependencies due to

  5. Variability of CSF Alzheimer's disease biomarkers: implications for clinical practice.

    Directory of Open Access Journals (Sweden)

    Stephanie J B Vos

    Full Text Available BACKGROUND: Cerebrospinal fluid (CSF biomarkers are increasingly being used for diagnosis of Alzheimer's disease (AD. OBJECTIVE: We investigated the influence of CSF intralaboratory and interlaboratory variability on diagnostic CSF-based AD classification of subjects and identified causes of this variation. METHODS: We measured CSF amyloid-β (Aβ 1-42, total tau (t-tau, and phosphorylated tau (p-tau by INNOTEST enzyme-linked-immunosorbent assays (ELISA in a memory clinic population (n = 126. Samples were measured twice in a single or two laboratories that served as reference labs for CSF analyses in the Netherlands. Predefined cut-offs were used to classify CSF biomarkers as normal or abnormal/AD pattern. RESULTS: CSF intralaboratory variability was higher for Aβ1-42 than for t-tau and p-tau. Reanalysis led to a change in biomarker classification (normal vs. abnormal of 26% of the subjects based on Aβ1-42, 10% based on t-tau, and 29% based on p-tau. The changes in absolute biomarker concentrations were paralleled by a similar change in levels of internal control samples between different assay lots. CSF interlaboratory variability was higher for p-tau than for Aβ1-42 and t-tau, and reanalysis led to a change in biomarker classification of 12% of the subjects based on Aβ1-42, 1% based on t-tau, and 22% based on p-tau. CONCLUSIONS: Intralaboratory and interlaboratory CSF variability frequently led to change in diagnostic CSF-based AD classification for Aβ1-42 and p-tau. Lot-to-lot variation was a major cause of intralaboratory variability. This will have implications for the use of these biomarkers in clinical practice.

  6. Generalist solutions to complex problems: generating practice-based evidence--the example of managing multi-morbidity.

    Science.gov (United States)

    Reeve, Joanne; Blakeman, Tom; Freeman, George K; Green, Larry A; James, Paul A; Lucassen, Peter; Martin, Carmel M; Sturmberg, Joachim P; van Weel, Chris

    2013-08-07

    A growing proportion of people are living with long term conditions. The majority have more than one. Dealing with multi-morbidity is a complex problem for health systems: for those designing and implementing healthcare as well as for those providing the evidence informing practice. Yet the concept of multi-morbidity (the presence of >2 diseases) is a product of the design of health care systems which define health care need on the basis of disease status. So does the solution lie in an alternative model of healthcare? Strengthening generalist practice has been proposed as part of the solution to tackling multi-morbidity. Generalism is a professional philosophy of practice, deeply known to many practitioners, and described as expertise in whole person medicine. But generalism lacks the evidence base needed by policy makers and planners to support service redesign. The challenge is to fill this practice-research gap in order to critically explore if and when generalist care offers a robust alternative to management of this complex problem. We need practice-based evidence to fill this gap. By recognising generalist practice as a 'complex intervention' (intervening in a complex system), we outline an approach to evaluate impact using action-research principles. We highlight the implications for those who both commission and undertake research in order to tackle this problem. Answers to the complex problem of multi-morbidity won't come from doing more of the same. We need to change systems of care, and so the systems for generating evidence to support that care. This paper contributes to that work through outlining a process for generating practice-based evidence of generalist solutions to the complex problem of person-centred care for people with multi-morbidity.

  7. Exploring Privilege in the Digital Divide: Implications for Theory, Policy, and Practice.

    Science.gov (United States)

    Fang, Mei Lan; Canham, Sarah L; Battersby, Lupin; Sixsmith, Judith; Wada, Mineko; Sixsmith, Andrew

    2018-05-10

    The digital revolution has resulted in innovative solutions and technologies that can support the well-being, independence, and health of seniors. Yet, the notion of the "digital divide" presents significant inequities in terms of who accesses and benefits from the digital landscape. To better understand the social and structural inequities of the digital divide, a realist synthesis was conducted to inform theoretical understandings of information and communication technologies (ICTs); to understand the practicalities of access and use inequities; to uncover practices that facilitate digital literacy and participation; and to recommend policies to mitigate the digital divide. A systematic search yielded 55 articles published between 2006 and 2016. Synthesis of existing knowledge, combined with user-experience elicited through a deliberative dialogue session with community stakeholders (n = 35), made visible a pattern of privilege that determined individual agency in ICT access and use. Though age is consistently centralized as the key determinant of the digital divide, our analyses, which encompassed both van Dijk's resources and appropriation theory and intersectionality, appraised this notion and revealed that age is not the sole determinant. Findings highlight the role of other factors that contribute to digital inequity among community-dwelling middle-aged (45-64) and older (65+) adults, including education, income, gender, and generational status. Informed by results of a realist synthesis that was guided by intersectional perspectives, a conceptual framework was developed outlining implications for theory, policy, and practice to address the wicked problem that is the digital divide.

  8. Enterprise security IT security solutions : concepts, practical experiences, technologies

    CERN Document Server

    Fumy, Walter

    2013-01-01

    Addressing IT managers and staff, as well as CIOs and other executives dealing with corporate IT security, this book provides a broad knowledge on the major security issues affecting today's corporations and organizations, and presents state-of-the-art concepts and current trends for securing an enterprise.Areas covered include information security management, network and system security, identity and access management (IAM), authentication (including smart card based solutions and biometrics), and security certification. In-depth discussion of relevant technologies and standards (including cr

  9. Transfer Pricing Profit Split Methods : A Practical Solution?

    OpenAIRE

    Quttineh, Yousef

    2009-01-01

    The purpose of this master’s thesis is to explain and analyze whether today’s existing regulations provide sufficient guidance on how to apply the Profit Split Method (PSM) in practice. Since the enterprises’ profits arising from intra-group transactions increases, the tax base for any government also becomes larger and more important. This issue will likely become even more problematic as the globalization branches out and the majority of the global trade is undertaken between associated ent...

  10. The tangential breast match plane: Practical problems and solutions

    International Nuclear Information System (INIS)

    Norris, M.

    1989-01-01

    The three-field breast set-up, in which tangential oblique opposed fields are joined to an anterior supraclavicular field, has been the method of choice for treatment of breast cancer for many years. In the last several years many authors have suggested refinements to the technique that improve the accuracy with which fields join at a match plane. The three-field breast set-up, using a rotatable half-beam block is the technique used at our institution. In instituting this procedure, several practical problems were encountered. Due to the small collimator rotation angles used it is possible to clinically reverse the collimator angle without observing an error noticeable on fluoroscopy. A second error can occur when the table base angle is used to compensate for the incorrect collimator rotation. These potential sources of error can be avoided if a programmable calculator or computer program is used to assist the dosimetrist during the simulation. Utilization of fluoroscopy, digital table position displays and a caliper provide accurate input for the computer program. This paper will present a hybrid procedure that combines practical set-up procedures with the mathematical calculation of ideal angles to result in an accurate and practical approach to breast simulation

  11. Practical Solutions for Pesticide Safety: A Farm and Research Team Participatory Model.

    Science.gov (United States)

    Galvin, Kit; Krenz, Jen; Harrington, Marcy; Palmández, Pablo; Fenske, Richard A

    2016-01-01

    Development of the Practical Solutions for Pesticide Safety guide used participatory research strategies to identify and evaluate solutions that reduce pesticide exposures for workers and their families and to disseminate these solutions. Project principles were (1) workplace chemicals belong in the workplace, and (2) pesticide handlers and farm managers are experts, with direct knowledge of production practices. The project's participatory methods were grounded in self-determination theory. Practical solutions were identified and evaluated based on five criteria: practicality, adaptability, health and safety, novelty, and regulatory compliance. Research activities that had more personal contact provided better outcomes. The Expert Working Group, composed of farm managers and pesticide handlers, was key to the identification of solutions, as were farm site visits. Audience participation, hands-on testing, and orchard field trials were particularly effective in the evaluation of potential solutions. Small work groups in a Regional Advisory Committee provided the best direction and guidance for a "user-friendly" translational document that provided evidence-based practical solutions. The "farmer to farmer" format of the guide was endorsed by both the Expert Working Group and the Regional Advisory Committee. Managers and pesticide handlers wanted to share their solutions in order to "help others stay safe," and they appreciated attribution in the guide. The guide is now being used in educational programs across the region. The fundamental concept that farmers and farmworkers are innovators and experts in agricultural production was affirmed by this study. The success of this process demonstrates the value of participatory industrial hygiene in agriculture.

  12. Obstacles on the Practice of the Ethical Principles in Journalism and Some Solutions

    OpenAIRE

    ERİMLİ, Buşra

    2014-01-01

    Professional ethical principles of journalism are discussed in the article. Scope and limits of the ethical principles are examined. In this regard, the factors that prevent the practice of the professional ethical principles are analyzed and some solutions are reconsidered.

  13. Uav Photogrammetry: a Practical Solution for Challenging Mapping Projects

    Science.gov (United States)

    Saadatseresht, M.; Hashempour, A. H.; Hasanlou, M.

    2015-12-01

    We have observed huge attentions to application of unmanned aerial vehicle (UAV) in aerial mapping since a decade ago. Though, it has several advantages for handling time/cost/quality issues, there are a dozen of challenges in working with UAVs. In this paper, we; as the Robotic Photogrammetry Research Group (RPRG), will firstly review these challenges then show its advantages in three special practical projects. For each project, we will share our experiences through description of the UAV specifications, flight settings and processing steps. At the end, we will illustrate final result of each project and show how this technology could make unbelievable benefits to clients including 3D city realistic model in decimetre level, ultra high quality map production in several centimetre level, and accessing to a high risk and rough relief area for mapping aims.

  14. PRACTICAL SOLUTIONS FOR ECOLOGICAL RECONSTRUCTION OF GERAI POND

    Directory of Open Access Journals (Sweden)

    Alexandru Dimache

    2012-06-01

    Full Text Available Gerai Pond is one of the last natural wetlands along the Danube, being connected to natural flooding regime of the Danube and is situated at the confluence of the Danube River, between Gârcov and Islaz localities, in Olt County. Aquatic vegetation characteristic is a favorable habitat for two species of conservation concern that nest along the Danube: red duck and pygmy cormorant. During 1961-1970, Gerai Pond has changed radically due to impoundment and draining under the program of drainage and flood meadow regulate of the Danube. These works of land reclamation for decreasing surface lakes and wetlands and water stagnation period, had reduced the breeding areas of the two species mentioned above. Ecological reconstruction of Gerai Pond project was conducted by Technical University of Civil Engineering of Bucharest in collaboration with E.P.A. Olt and W.W.F.-Romania. The project was based on a hydrological study (which included a component related to flooding for the area analyzed, study in which were highlighted the areas which have water access to and from the Pond, surfaces and volumes of water corresponding to different rates, the optimal level of water for restoration of the nesting area. Based on this study were identified the areas of artificial feed-water discharge to and from the Danube. This paper presents the possible solutions for ecological reconstruction of Gerai Pond, identified in the project.

  15. SLT Beliefs about Collaborative Practice: Implications for Education and Learning

    Science.gov (United States)

    Jago, Suzanne; Radford, Julie

    2017-01-01

    Effective collaborative practice is expected of newly qualified speech and language therapists (SLTs) in order to achieve the best outcomes for clients. Research into collaborative practice has identified a number of barriers to and facilitators of collaborative practice, but there has been limited research into how well prepared newly qualified…

  16. Public health implications of post-harvest fish handling practices in ...

    African Journals Online (AJOL)

    A wide range of handling practices for harvested fish exists and they have economic as well as public health implications. This paper is a review of the existing problems in fish handling technologies at post-harvest in Nigeria. The public health aspects with the associated implications are highlighted. Status of policy on fish ...

  17. Blended learning as a solution to practice-related problems in vocational schools

    DEFF Research Database (Denmark)

    Kjærgaard, Hanne Wacher; Duch, Henriette Skjærbæk; Mark, Lene

    Four different types of vocational schools have experimented with blended learning as a way of dealing with problems faced in their students’ theoretical and practical training and the interplay between these. A large part of this has involved the need for differentiated teaching...... as will be illustrated through selected cases. The foci of the cases are: •How can students be part of school-based teaching and learning during periods of practical training? •How can authentic practice be brought into school-based practical training? •How may blended learning assist and support students who...... are otherwise challenged in terms of meeting the prescribed competence goals? Methodologically, scenarios have been employed as a tool for defining the practice-related problems teachers meet in their practice and describing ways in which blended learning may present solutions. Subsequently, the solutions have...

  18. The Basketball warms-ups - theoretical assumptions and practical solutions

    Directory of Open Access Journals (Sweden)

    Sebastian Łubiński

    2017-06-01

    , and technical-tactical activities, and activities with the ball or without it. The cognitive purpose of the paper: was to find and develop the best possible pre-match warm-up structures based on current literature. These data were used to determine a "model" (pattern of optimal warm-up. The practical aim was to formulate guidelines for basketball coaches to develop the warm-up structures, taking into account the duration and proportion of dynamic and static exercises that prepare the body for play. The research material was 12 male players from the basketball team playing in the top tournaments in Poland and in the Tauron Basket League. 11 players were included in the play reliability study, because one of them did not participate in the play and it was impossible to determine his play effectiveness. The team was ranked in the top five of the 2014/2015 league table. The standardized observation method was used in the study. The method consisted in observing people with respect to the purpose of observation, taking into account strictly defined behavioral (reactions categories the researchers were interested in. To evaluate the players’ effectiveness during the match, the original result sheet of the players’ performance based on the Superlak project was used. As a result of the research, no correlation between the type of warm-up performed by the respondents and the player’s reliability during the match was observed. According to authors, the results allow formulating the following conclusions: •    In the Extra-class team, many of the competitors skip the general phase and performed only the specialist phase. There is a division based on the type of exercises (dynamic, static, ball. •    Based on the observation made, the warm-up performed by the Extra-class basketball players did not match the warm-up model resulting from the literature recommendations and it did not affect the player's reliability and performance during the match. •    As a

  19. Relational Aggression, Victimization, and Language Development: Implications for Practice

    Science.gov (United States)

    Ostrov, Jamie M.; Godleski, Stephanie A.

    2007-01-01

    This review explores the development of relational aggression and relational victimization among peers, with specific emphasis on clinical implications for speech-language pathologists. Developmental manifestations of relational aggression and victimization are reviewed from early childhood through emerging adulthood. The concurrent and…

  20. Pumps vs. airlifts: Theoretical and practical energy implications

    Science.gov (United States)

    In the design of a recirculating aquaculture system five life-supporting issues should be considered which include aeration, degasification, circulation, biofiltration, and clarification. The implications associated with choosing a pumped system versus an airlift system to address these issues was e...

  1. Recapitalization, Implications for Educational Policy and Practice and Future Research

    NARCIS (Netherlands)

    Scheerens, Jaap; Scheerens, Jaap

    2017-01-01

    In this concluding chapter conclusions are drawn, and the relevance of the results for educational science and policy and practice are discussed. Illustrations are provided that were drawn from the exploration of policy and practices in the Netherlands. Synthetic answers to the three research

  2. Practical implications of empirically studying moral decision making

    NARCIS (Netherlands)

    Heinzelmann, N.; Ugazio, G.; Tobler, P.N.

    2012-01-01

    This paper considers the practical question of why people do not behave in the way they ought to behave. This question is a practical one, reaching both into the normative and descriptive domains of morality. That is, it concerns moral norms as well as empirical facts. We argue that two main

  3. Integrating Practice Guidelines into Professional Training: Implications for Diversity Competence

    Science.gov (United States)

    Miville, Marie L.; Duan, Changming; Nutt, Roberta L.; Waehler, Charles A.; Suzuki, Lisa; Pistole, M. Carole; Arredondo, Patricia; Duffy, Michael; Mejia, Brenda X.; Corpus, Melissa

    2009-01-01

    The authors present the findings of a special task group (STG) organized to explore effective training strategies for the practice guidelines focused on diverse populations. They provide a brief literature review and summarize survey data from academic training directors regarding current use of practice guidelines. The authors then describe the…

  4. Trends in dermatology practices and the implications for the workforce.

    Science.gov (United States)

    Ehrlich, Alison; Kostecki, James; Olkaba, Helen

    2017-10-01

    The American Academy of Dermatology (AAD) practice profile surveys have been conducted for more than a decade to gauge trends in our workforce supply and demand. To update the trends and current workforce issues for the field of dermatology. The AAD Practice Profile Survey is sent by both e-mail and postal mail to a random sample of practicing dermatologists who are AAD members. Shifts are noted in the primary practice setting; fewer dermatologists are in solo practice and more are in group practices than in previous years. Teledermatology use trended upward from 7% to 11% between 2012 and 2014. The implementation of electronic health records increased from 51% in 2011 to 70% in 2014. There is potential for response bias and inaccurate self-reporting. Survey responses collected may not be representative of all geographic areas. The demand for dermatology services remains strong. Shifts in the practice setting may be related to increases in overhead costs that are partially associated with the implementation of technology-based medical records. Integration of electronic health records and utilization of telemedicine are increasing. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  5. Medicine as a Community of Practice: Implications for Medical Education.

    Science.gov (United States)

    Cruess, Richard L; Cruess, Sylvia R; Steinert, Yvonne

    2018-02-01

    The presence of a variety of independent learning theories makes it difficult for medical educators to construct a comprehensive theoretical framework for medical education, resulting in numerous and often unrelated curricular, instructional, and assessment practices. Linked with an understanding of identity formation, the concept of communities of practice could provide such a framework, emphasizing the social nature of learning. Individuals wish to join the community, moving from legitimate peripheral to full participation, acquiring the identity of community members and accepting the community's norms.Having communities of practice as the theoretical basis of medical education does not diminish the value of other learning theories. Communities of practice can serve as the foundational theory, and other theories can provide a theoretical basis for the multiple educational activities that take place within the community, thus helping create an integrated theoretical approach.Communities of practice can guide the development of interventions to make medical education more effective and can help both learners and educators better cope with medical education's complexity. An initial step is to acknowledge the potential of communities of practice as the foundational theory. Educational initiatives that could result from this approach include adding communities of practice to the cognitive base; actively engaging students in joining the community; creating a welcoming community; expanding the emphasis on explicitly addressing role modeling, mentoring, experiential learning, and reflection; providing faculty development to support the program; and recognizing the necessity to chart progress toward membership in the community.

  6. Cultural relativism and cultural diversity: implications for nursing practice.

    Science.gov (United States)

    Baker, C

    1997-09-01

    This article examines the doctrine of cultural relativism in nursing practice. To introduce the issue, an overview of the intellectual history of cultural relativism is presented. The academic themes of the debate surrounding cultural relativism are illustrated with an example of the social controversy in France involving cultural relativism as used to defend the practice of female genital excision among immigrant communities. The dilemma faced by nursing in making cross-cultural judgments is then examined in the light of the academic and social debates. The article concludes with a theoretical resolution of the issue of cultural relativism for nursing practice that is based on hermeneutic philosophy.

  7. Knowledge, Attitudes and Behaviors Related to AIDS among Prisoners: Implications for Social Work Practice.

    Science.gov (United States)

    Miah, M. Mizanur Rahman; Olivero, J. Michael

    1995-01-01

    A survey of 33 male and 5 female prisoners examined their knowledge of AIDS and HIV transmission modes, current sexual behavior and safe sex practices, and sources of AIDS information and degree of trust in these sources. Discusses implications for social work practices and development of AIDS education for prisoners. (SV)

  8. Analytical Implications of Using Practice Theory in Workplace Information Literacy Research

    Science.gov (United States)

    Moring, Camilla; Lloyd, Annemaree

    2013-01-01

    Introduction: This paper considers practice theory and the analytical implications of using this theoretical approach in information literacy research. More precisely the aim of the paper is to discuss the translation of practice theoretical assumptions into strategies that frame the analytical focus and interest when researching workplace…

  9. Parents' perceptions of causes of and solutions for school violence: implications for policy.

    Science.gov (United States)

    Bliss, Melanie J; Emshoff, James; Buck, Chad A; Cook, Sarah L

    2006-05-01

    This study explores perceptions of causes of and solutions for school violence in a sample of 202 parents interviewed in the wake of nationally publicized school shootings. We also investigate the effects the school shootings had on children, parents' perceptions regarding firearms, and changes in parenting behavior. Parents exhibited strong support for almost all proposed causes and solutions, and we address their desire for immediate and often invasive interventions to prevent future violence. We contrast parents' perceptions with their own parenting behaviors and with literature on effective interventions. Results are discussed within the context of policy implications.Editors' Strategic Implications: Parents' perceptions and behaviors are frequently influenced by history effects. The national attention received by school shootings provided an opportunity for exploration of those perceptions and self-reported behaviors. The authors provide evidence from timely surveys that parents struggle with identifying causal factors that may contribute to school violence and consequently support a myriad of strategies for intervention including very invasive environmental preventive strategies. The findings suggest that social scientists should play a proactive role in translating research-supported preventive strategies to effective replications in the community and make research available in formats that are available and comprehensible by the lay public.

  10. Nursing practice implications of the year of ethics.

    Science.gov (United States)

    Harris, Karen T

    2015-01-01

    e 2015 ANA Code of Ethics is foundational to professional nursing practice and is aligned with AWHONN’s core values, standards of care and position statement on ethical decision-making in the clinical setting. Understanding the roles and responsibilities of nurses to ensure an ethical practice environment is critical to perinatal health outcomes and sta engagement and to the prevention of moral distress.

  11. Improving statistical reasoning theoretical models and practical implications

    CERN Document Server

    Sedlmeier, Peter

    1999-01-01

    This book focuses on how statistical reasoning works and on training programs that can exploit people''s natural cognitive capabilities to improve their statistical reasoning. Training programs that take into account findings from evolutionary psychology and instructional theory are shown to have substantially larger effects that are more stable over time than previous training regimens. The theoretical implications are traced in a neural network model of human performance on statistical reasoning problems. This book apppeals to judgment and decision making researchers and other cognitive scientists, as well as to teachers of statistics and probabilistic reasoning.

  12. Exploring Principals' Instructional Leadership Practices in Malaysia: Insights and Implications

    Science.gov (United States)

    Harris, Alma; Jones, Michelle; Cheah, Kenny Soon Lee; Devadason, Edward; Adams, Donnie

    2017-01-01

    Purpose: The purpose of this paper is to outline the findings from a small-scale, exploratory, study of principals' instructional leadership practice in Malaysian primary schools. The dimensions and functions of instructional leadership, explicitly explored in this study, are those outlined in the Hallinger and Murphy's (1985) model.…

  13. Miscommunication between patients and general practitioners: implications for clinical practice

    Directory of Open Access Journals (Sweden)

    Morgan S

    2013-06-01

    Full Text Available INTRODUCTION: Effective communication is integral to the general practice consultation, yet it is acknowledged that problems commonly occur. Previous research has shown that misunderstandings with potentially significant consequences occur frequently, but does not provide a clear picture of how and why miscommunication occurs, or how such problems can be prevented or resolved. This study explored the occurrence and management of specific examples of miscommunication in two routine general practice consultations. METHODS: A multi-method case study approach was used. The primary data collected for each case included a video-recorded consultation and post-consultation interviews with each general practitioner (GP and patient. Instances of communication mismatch were examined using in-depth interaction analysis techniques. FINDINGS: GPs and patients may not be aware when misunderstandings have occurred. In-depth analysis of the case studies revealed the complexity of miscommunication: it was not a straightforward matter to locate when or why instances of communication mismatch had occurred, and each of the mismatches was quite distinctive: (1 they were identified in different ways; (2 they occurred at different points in the communication process; (3 they arose because of problems occurring at different levels of the communication, and (4 they had different consequences. CONCLUSION: Given the frequency and complexity of miscommunication in general practice consultations, GPs need to consider adopting various strategies, at both the practice/systems level and the level of the consultation interaction to minimise the risk of communication problems.

  14. Critical Theory: Implications for School Leadership Theory and Practice.

    Science.gov (United States)

    Peca, Kathy

    The school leader's behaviors are inspired by theories, and theories are intrinsic to practice. This paper provides an overview of an emerging perspective in educational administration, critical theory. The paper first highlights the philosophies of Immanuel Kant, Fichte, Hegel, Marx, and the Frankfurt School. It then discusses critical theory…

  15. Typologies of Cohabitation: Implications for Clinical Practice and Research

    Science.gov (United States)

    Gold, Joshua M.

    2012-01-01

    This article will explore the current evolution in the practice of cohabitation. The intent of this literature- and web-based article is to acquaint counselors with three typologies of cohabitation. These categories can be utilized in the development of psychoeducational and remedial interventions and in the identification of areas of future…

  16. Integrating Social Class into Vocational Psychology: Theory and Practice Implications

    Science.gov (United States)

    Diemer, Matthew A.; Ali, Saba Rasheed

    2009-01-01

    Although social class plays a salient and significant role in career development and occupational attainment, social class is underrepresented in vocational psychology theory, scholarship, and practice. Vocational psychologists are in a unique position to meet the career development needs of persons from all social classes by integrating a fuller…

  17. Freudian Notion of Psychoanalysis: Its Implications in Contemporary Teaching Practices

    Science.gov (United States)

    Awan, Muhammad Afzal

    2017-01-01

    The author has engaged in a critical review of Frued's notion of psychoanalysis and its vitality in teaching. Illustrating from Freud's own assertions and through the interpretations of the later critics, the author has pointed out certain noticeable pitfalls and, or incapacities of contemporary teaching practices. The forces of aggression and sex…

  18. Implications of the law on video recording in clinical practice.

    Science.gov (United States)

    Henken, Kirsten R; Jansen, Frank Willem; Klein, Jan; Stassen, Laurents P S; Dankelman, Jenny; van den Dobbelsteen, John J

    2012-10-01

    Technological developments allow for a variety of applications of video recording in health care, including endoscopic procedures. Although the value of video registration is recognized, medicolegal concerns regarding the privacy of patients and professionals are growing. A clear understanding of the legal framework is lacking. Therefore, this research aims to provide insight into the juridical position of patients and professionals regarding video recording in health care practice. Jurisprudence was searched to exemplify legislation on video recording in health care. In addition, legislation was translated for different applications of video in health care found in the literature. Three principles in Western law are relevant for video recording in health care practice: (1) regulations on privacy regarding personal data, which apply to the gathering and processing of video data in health care settings; (2) the patient record, in which video data can be stored; and (3) professional secrecy, which protects the privacy of patients including video data. Practical implementation of these principles in video recording in health care does not exist. Practical regulations on video recording in health care for different specifically defined purposes are needed. Innovations in video capture technology that enable video data to be made anonymous automatically can contribute to protection for the privacy of all the people involved.

  19. Beauty: A Concept with Practical Implications for Teacher Researchers

    Science.gov (United States)

    Winston, Joe

    2011-01-01

    Hillman's (2001) simple affirmation that "an idea of beauty is useful, functional, practical" is one this article attempts to pursue with teacher researchers in mind, based on the belief that to move from the "re"pression of beauty to its "ex"pression--or, at the very least, to its articulation--will enlighten rather than distract individuals. The…

  20. Automated external defibrillation as part BLS: implications for education and practice.

    Science.gov (United States)

    Moule, Pam; Albarran, John W

    2002-09-01

    The latest Adult Basic Life Support (BLS) guidelines support the inclusion of the use of the automated external defibrillator (AED), as part of basic life support (BLS). Emphasis on the provision of early defibrillation as part of BLS acknowledges the importance of this manoeuvre in the successful termination of ventricular fibrillation. The ramifications of such changes for both first responders and organisations implementing the guidelines should not be underestimated. Issues relating to resourcing, content and duration of training and retraining, auditing and evaluation require further exploration. To consider these issues now seems particularly pertinent, given the recent launch of the UK Government's paper on public health, 'Saving Lives-Our Healthier Nation' which seeks to deploy AEDs in busy public places for use by trained members of the lay public. Additionally, defibrillation has been identified as one of the key competencies that all trained nurses and other health care providers should be able to undertake. This paper will consider the background to the current guideline changes, analyse the wider implications of translating the recommendations into practice, and offer possible solutions to address the issues raised. Whilst the analysis is particularly pertinent to the United Kingdom, many of the issues raised have international importance.

  1. Virtual reality solutions for the design of machine tools in practice

    OpenAIRE

    Zickner, H.; Neugebauer, Reimund; Weidlich, D.

    2006-01-01

    At the Virtual Reality Centre Production Engineering (VRCP) the Institute for Machine Tools and Production Processes (IWP) of the Chemnitz University of Technology and the Fraunhofer Institute for Machine Tools and Forming Technology (IWU) have developed several practical Virtual Reality (VR) based solutions for the industry. Some practical examples will show the benefits gained by the application of Virtual Reality techniques in the design process of machine tools and assembly lines.

  2. Problems and their solutions in practical application of Eurocodes in seismic design of RC structures

    Directory of Open Access Journals (Sweden)

    Milev Jordan

    2016-01-01

    Full Text Available The main purpose of the paper is to present practical application of Eurocodes in the field of RC structures design. The selected examples represent the main problems in practical application of Eurocodes for seismic analysis and design of RC Structures in Bulgarian construction practice. The analysis is focused on some structural and economic problems as well as on some contradictions in Eurocode 8 itself. Special attention is paid to the practical solution of the following problems: recognition of torsionally flexible systems, stiffness reduction of RC elements for linear analysis dimensions and detailing of confined boundary areas of shear walls, detailing of wall structures, etc. Those problems appear during the practical design of some buildings in Bulgaria. Several proposals for solving some problems defined in the paper are presented through some practical examples. Some conclusions are made for further application of Eurocode 8 in the design and construction practice. The importance of some rules and procedures in Eurocode 8 is supported by the examples of damaged RC members during the past earthquakes. The problems of Eurocode 8 and their solutions are illustrated through the experience of Bulgarian construction practice.

  3. Commercial property loan valuations in the UK : implications of current trends in practice and liability

    OpenAIRE

    Crosby, Neil; Lavers, Anthony; Foster , Henry

    1997-01-01

    This paper is the second of two papers which aim to examine the major legal liability implications of changes to the commercial property loan valuation process caused by the recession in the UK property market and to make recommendations to valuers and their professional institutions to improve the quality of the process and the result. The objectives of this paper are to address a number of the practical implications of changes to the loan valuation process within the context of legal liabil...

  4. Understanding implementation in complex public organizations – implication for practice

    Directory of Open Access Journals (Sweden)

    Gry Cecilie Høiland

    2016-10-01

    Full Text Available The effective implementation of politically initiated public service innovations to the front-lines of the public service organization, where the innovation is to be applied, is a challenge that both practitioners and researchers struggle to solve. We highlight the importance of analysing contextual factors at several levels of the implementation system, as well as the importance of considering how the practical everyday work situations of the front-line workers influence their application of the innovation in question. We illustrate this by exploring the implementation process of a specific work inclusion measure, looking at its wider context and some of its implementation outcomes at a specific public agency. The intention is to illustrate the significance of considering the contextual complexity influencing implementation work as a reminder for practitioners to take this into account in their planning and practices.

  5. TEHORIES OF CONNECTIONS – PRACTICAL IMPLICATIONS IN ACQUIRING MOTOR SKILLS

    OpenAIRE

    Zoran Milošević; Nebojša Maksimović; Nada Milošević; Borislav Obradović

    2010-01-01

    Theories of learning which are classified in two broad schools as theories of connections and cognitive theories, differ among themselves according to specific interaction relationships between external stimulus (S), reaction and behavior and organism (R), i.e. particular learner (O). In relation to pedagogical practices, predominance of a certain school is not rare, often without any objective insight into their potentials related to age, sex, learning contents and other determinants. Suppor...

  6. Perspectives on academic misconduct: implications for education and practice.

    Science.gov (United States)

    Klainberg, Marilyn B; McCrink, Andrea; Eckardt, Patricia; Schecter, Rose; Bongiorno, Anne; Sedhom, Laila

    2014-01-01

    From Harvard to high school, concern related to academic misconduct, specifically cheating and its impact on societal issues, has become a great concern for educational communities. While a significant number of studies on ethical behaviors in practice in other professions such as business have been published, little research exists on registered nurses in practice. Even fewer studies have, for registered nurses, addressed if there is an association between perceived academic misconduct as students and perceived unethical behaviors in the workplace. The purpose of this study was to determine the relationship between perceptions of registered professional nurses' (RNs) current workplace behaviors and the RNs' retrospective perceptions of their academic misconduct as students. A convenience sample of 1 66 RNs enrolled in master's degree programs at four university schools of nursing completed questionnaires regarding their beliefs and behaviors. The outcome of this study was significant. Results revealed a strong relationship between unethical behaviors of the RN in practice and their prior academic misconduct when they were students.

  7. Informal Online Learning Practices: Implications for Distance Education

    Directory of Open Access Journals (Sweden)

    Fawn Winterwood

    2010-02-01

    Full Text Available This qualitative ethnographic study examines five American teenagers’ historical and current digitally-mediated multiliteracy practices within digital popular culture. The participants included three male and two female students of a private high school in the Midwestern United States. The study is framed by the notion that literacy is a socially, culturally, and historically situated discursive construct rather than a purely individualized cognitive endeavor. This social constructivist theory of literacy emphasizes the social conditions necessary to navigate the economic, social, and political worlds of the 21st century. The purpose of the study was to explore the students’ multiliteracy practices that they enact through their activities within digital popular culture. Data collection methods included synchronous interviews facilitated by video conferencing tools as well as observation of the participants’ online activities and member checks conducted via email and instant messaging. The analytic strategy employed during this study was informed by Clarke’s (2005 situational analysis method. The study’s findings indicate that literacy practices in which the study participants have engaged through informal learning activities within digital youth culture have had a much greater impact on enabling them to cultivate the multimodal literacies necessary within a postmodern digital era than have their formal educational experiences

  8. Factors Influencing Mini-CEX Rater Judgments and Their Practical Implications: A Systematic Literature Review.

    Science.gov (United States)

    Lee, Victor; Brain, Keira; Martin, Jenepher

    2017-06-01

    At present, little is known about how mini-clinical evaluation exercise (mini-CEX) raters translate their observations into judgments and ratings. The authors of this systematic literature review aim both to identify the factors influencing mini-CEX rater judgments in the medical education setting and to translate these findings into practical implications for clinician assessors. The authors searched for internal and external factors influencing mini-CEX rater judgments in the medical education setting from 1980 to 2015 using the Ovid MEDLINE, PsycINFO, ERIC, PubMed, and Scopus databases. They extracted the following information from each study: country of origin, educational level, study design and setting, type of observation, occurrence of rater training, provision of feedback to the trainee, research question, and identified factors influencing rater judgments. The authors also conducted a quality assessment for each study. Seventeen articles met the inclusion criteria. The authors identified both internal and external factors that influence mini-CEX rater judgments. They subcategorized the internal factors into intrinsic rater factors, judgment-making factors (conceptualization, interpretation, attention, and impressions), and scoring factors (scoring integration and domain differentiation). The current theories of rater-based judgment have not helped clinicians resolve the issues of rater idiosyncrasy, bias, gestalt, and conflicting contextual factors; therefore, the authors believe the most important solution is to increase the justification of rater judgments through the use of specific narrative and contextual comments, which are more informative for trainees. Finally, more real-world research is required to bridge the gap between the theory and practice of rater cognition.

  9. General practice registrars' intentions for future practice: implications for rural medical workforce planning.

    Science.gov (United States)

    Harding, Catherine; Seal, Alexa; McGirr, Joe; Caton, Tim

    2016-11-01

    The models of practice that general practice registrars (GPRs) envisage undertaking will affect workforce supply. The aim of this research was to determine practice intentions of current GPRs in a regional general practice training program (Coast City Country General Practice Training). Questionnaires were circulated to 220 GPRs undertaking general practice placements to determine characteristics of ideal practice models and intentions for future practice. Responses were received for 99 participants (45%). Current GPRs intend to work an average of less than eight half-day sessions/week, with male participants intending to work more hours (t(91)=3.528, P=0.001). More than one-third of this regional cohort intends to practice in metropolitan centres. Proximity to family and friends was the most important factor influencing the choice of practice location. Men ranked remuneration for work as more important (t (88)=-4.280, Pmedical graduates intend to own their own practice compared with 52% of international medical graduates (χ 2 (1)=8.498, P=0.004). Future general practitioners (GPs) intend to work fewer hours than current GPs. Assumptions about lifestyle factors, practice models and possible professional roles should be carefully evaluated when developing strategies to recruit GPs and GPRs into rural practice.

  10. Documenting Sociolinguistic Variation in Lesser-Studied Indigenous Communities: Challenges and Practical Solutions

    Science.gov (United States)

    Mansfield, John; Stanford, James

    2017-01-01

    Documenting sociolinguistic variation in lesser-studied languages presents methodological challenges, but also offers important research opportunities. In this paper we examine three key methodological challenges commonly faced by researchers who are outsiders to the community. We then present practical solutions for successful variationist…

  11. International Graduate Students' Academic Writing Practices in Malaysia: Challenges and Solutions

    Science.gov (United States)

    Singh, Manjet Kaur Mehar

    2015-01-01

    This article focuses on the challenges faced by non-native English speaking international graduate students in their academic writing practices while they studied at a university in Malaysia as well as the solutions they employed when faced with the challenges. Academic Literacies Questionnaire was used to collect data. Based on 131 participants,…

  12. Practical Solutions for Addressing Labor-Related Barriers to Bhutan's Private Employment Growth

    OpenAIRE

    World Bank Group

    2017-01-01

    This note provides practical solutions for addressing the labor-related barriers that impede Bhutan's private sector employment growth: (i) lack of workers with relevant experience and skills, (ii) restrictions on employing non-Bhutanese workers, and (iii) lack of interest among Bhutanese workers in private sector employment opportunities (Enterprise Survey 2015). This note draws on intern...

  13. Evaluating Remote Reference Service: A Practical Guide to Problems and Solutions

    Science.gov (United States)

    Pomerantz, Jeffrey; Mon, Lorri; McClure, Charles R.

    2008-01-01

    This paper identifies key methodological issues affecting quality of data in the evaluation of remote reference services. Despite a growing number of studies in this area, no comprehensive effort has been made to identify potential problems and suggest solutions. The strategies proposed in this paper offer practical ways in which libraries can…

  14. Retrofitting the Low Impact Development Practices into Developed Urban areas Including Barriers and Potential Solution

    Science.gov (United States)

    Shafique, Muhammad; Kim, Reeho

    2017-06-01

    Low impact development (LID)/green infrastructure (GI) practices have been identified as the sustainable practices of managing the stormwater in urban areas. Due to the increasing population, most of the cities are more developing which results in the change of natural area into impervious areas (roads, buildings etc.). Moreover, urbanization and climate change are causing many water-related problems and making over cities unsafe and insecure. Under these circumstances, there is a need to introduce new stormwater management practices into developed cities to reduce the adverse impacts of urbanization. For this purpose, retrofitting low impact development practices demands more attention to reduce these water-related problems and trying to make our cities sustainable. In developed areas, there is a little space is available for the retrofitting of LID practices for the stormwater management. Therefore, the selection of an appropriate place to retrofitting LID practices needs more concern. This paper describes the successfully applied retrofitting LID practices around the globe. It also includes the process of applying retrofitting LID practices at the suitable place with the suitable combination. Optimal places for the retrofitting of different LID practices are also mentioned. This paper also highlights the barriers and potential solutions of retrofitting LID practices in urban areas.

  15. Retrofitting the Low Impact Development Practices into Developed Urban areas Including Barriers and Potential Solution

    Directory of Open Access Journals (Sweden)

    Shafique Muhammad

    2017-06-01

    Full Text Available Low impact development (LID/green infrastructure (GI practices have been identified as the sustainable practices of managing the stormwater in urban areas. Due to the increasing population, most of the cities are more developing which results in the change of natural area into impervious areas (roads, buildings etc.. Moreover, urbanization and climate change are causing many water-related problems and making over cities unsafe and insecure. Under these circumstances, there is a need to introduce new stormwater management practices into developed cities to reduce the adverse impacts of urbanization. For this purpose, retrofitting low impact development practices demands more attention to reduce these water-related problems and trying to make our cities sustainable. In developed areas, there is a little space is available for the retrofitting of LID practices for the stormwater management. Therefore, the selection of an appropriate place to retrofitting LID practices needs more concern. This paper describes the successfully applied retrofitting LID practices around the globe. It also includes the process of applying retrofitting LID practices at the suitable place with the suitable combination. Optimal places for the retrofitting of different LID practices are also mentioned. This paper also highlights the barriers and potential solutions of retrofitting LID practices in urban areas.

  16. KNOWLEDGE OF DIVERSE LEARNERS: IMPLICATIONS FOR THE PRACTICE OF TEACHING

    Directory of Open Access Journals (Sweden)

    Fadzilah Abd Rahman

    2010-07-01

    Full Text Available Knowledge of Diverse Learners (KDL is increasingly recognized as an essential component of knowledge base for effective teaching as in today’s schools, teachers must be prepared to teach a diverse population of student (Banks et al. 2005. In other words, teachers need to be aware that their students in a classroom are and always have been different from one another in a variety of ways. KDL refers to an understanding of diversity of students in terms of their abilities and interests and how they respond to diverse situations; an application of different teaching strategies; and how various types of classroom activities might be managed. Although KDL has come to be seen as important, details of its development, depth and quality among pre-service teachers (PSTs has remained something of mystery, as has the capability of PSTs to adapt and employ KDL into their actual teaching. As an effort to develop coherent understanding of the feature of prospective teachers regarding KDL, this paper addresses three questions. First, to what extent are the PSTs prepared for KDL as they are finishing the teacher education programmes? Secondly, how do the PSTs apply the KDL in their teaching practices? Thirdly, how do PSTs reflect on their practice in undertaking the elements of KDL during the teaching practices? This paper illustrates the results of a study involving a sample of 74 PSTs at a university in Malaysia. At the beginning of the study, 74 PSTs were given a questionnaire. 11 PSTs have been observed and interviewed. Result indicates that PSTs were able to develop KDL and show their understanding of it, yet not readily apply such knowledge in modified situations.

  17. The uses and implications of standards in general practice consultations

    DEFF Research Database (Denmark)

    Lippert, Maria Laura; Reventlow, Susanne; Kousgaard, Marius Brostrøm

    2017-01-01

    Quality standards play an increasingly important role in primary care through their inscription in various technologies for improving professional practice. While ‘hard’ biomedical standards have been the most common and debated, current quality development initiatives increasingly seek to include...... as manifestations of an inherent conflict between principles of patient-centredness and formal biomedical quality standards. However, this study suggests that standards on the ‘softer’ aspects of care may just as well interfere with a clinical approach relying on situated and attentive interactions with patients....

  18. [Cultural diversity and stereotyping: implication for the medical practice].

    Science.gov (United States)

    Durieux-Paillard, S; Loutan, L

    2005-09-28

    Increasing number of migrants worldwide brings doctors to treat patients of various origins. Patients' diversity enriches health professionals but also induces a risk of mutual incomprehension, due to cultural and language barriers. Multicultural context stimulates unwittingly stereotyping, based on a simplistic assessment of the patient's culture. Stereotyping is also influenced by the political and media coverage. Studies underscored that universally, minorities patients have an unequal access to health care in host countries. Health professionals should be aware that racial stereotyping exists in medical practice: it is a first step to bridge cultural gap between them and their patients.

  19. Toward an Ontology of Practices in Educational Administration: Theoretical Implications for Research and Practice

    Science.gov (United States)

    Newton, Paul; Riveros, Augusto

    2015-01-01

    In this article, we argue for a study of educational administration centered on an "ontology of practices." This is an initial proposal for thinking about and conceptualizing practices in educational administration. To do this, first, we explore how practices are constituted and how they configure the social realities of practitioners.…

  20. Practical Implications of Empirically Studying Moral Decision-Making

    Science.gov (United States)

    Heinzelmann, Nora; Ugazio, Giuseppe; Tobler, Philippe N.

    2012-01-01

    This paper considers the practical question of why people do not behave in the way they ought to behave. This question is a practical one, reaching both into the normative and descriptive domains of morality. That is, it concerns moral norms as well as empirical facts. We argue that two main problems usually keep us form acting and judging in a morally decent way: firstly, we make mistakes in moral reasoning. Secondly, even when we know how to act and judge, we still fail to meet the requirements due to personal weaknesses. This discussion naturally leads us to another question: can we narrow the gap between what people are morally required to do and what they actually do? We discuss findings from neuroscience, economics, and psychology, considering how we might bring our moral behavior better in line with moral theory. Potentially fruitful means include nudging, training, pharmacological enhancement, and brain stimulation. We conclude by raising the question of whether such methods could and should be implemented. PMID:22783157

  1. Practical implications of empirically studying moral decision-making.

    Science.gov (United States)

    Heinzelmann, Nora; Ugazio, Giuseppe; Tobler, Philippe N

    2012-01-01

    This paper considers the practical question of why people do not behave in the way they ought to behave. This question is a practical one, reaching both into the normative and descriptive domains of morality. That is, it concerns moral norms as well as empirical facts. We argue that two main problems usually keep us form acting and judging in a morally decent way: firstly, we make mistakes in moral reasoning. Secondly, even when we know how to act and judge, we still fail to meet the requirements due to personal weaknesses. This discussion naturally leads us to another question: can we narrow the gap between what people are morally required to do and what they actually do? We discuss findings from neuroscience, economics, and psychology, considering how we might bring our moral behavior better in line with moral theory. Potentially fruitful means include nudging, training, pharmacological enhancement, and brain stimulation. We conclude by raising the question of whether such methods could and should be implemented.

  2. A multidirectional communication model: implications for social marketing practice.

    Science.gov (United States)

    Thackeray, Rosemary; Neiger, Brad L

    2009-04-01

    The landscape of sending and receiving information has changed dramatically in the past 25 years. The communication process is changing from being unidirectional to multidirectional as consumers are becoming active participants by creating, seeking, and sharing information using a variety of channels and devices. The purpose of this article is to describe how this shift in the communication process- where gatekeepers control the creation and content of information and consumers are less active recipients to one that reflects a multidirectional and more dynamic process with participative consumers-will affect the social marketing process. This shift in communication does not represent an option for social marketers so much as a necessity. As professionals respond to this evolving communication model, the practice of social marketing can remain vibrant as a relevant consumer-oriented approach to behavior change.

  3. Exploring public perceptions of solutions to tree diseases in the UK: Implications for policy-makers.

    Science.gov (United States)

    Jepson, Paul; Arakelyan, Irina

    2017-10-01

    Tree diseases are on the increase in many countries and the implications of their appearance can be political, as well as ecological and economic. Preventative policy approaches to tree diseases are difficult to formulate because dispersal pathways for pest and pathogens are numerous, poorly known and likely to be beyond human management control. Genomic techniques could offer the quickest and most predictable approach to developing a disease tolerant native ash. The population of European Ash ( Fraxinus Excelsi or) has suffered major losses in the last decade, due to the onset of Hymenoscyphus fraxineus (previously called Chalara Fraxinea ) commonly known in the UK as ash dieback. This study presents evidence on the public acceptability of tree-breed solutions to the spread of Chalara , with the main aim to provide science and policy with an up-stream 'steer' on the likely public acceptability of different tree breeding solutions. The findings showed that whilst there was a firm anti-GM and ' we shouldn't tamper with nature ' attitude among UK publics, there was an equally firm and perhaps slightly larger pragmatic attitude that GM (science and technology) should be used if there is a good reason to do so, for example if it can help protect trees from disease and help feed the world. The latter view was significantly stronger among younger age groups (Millennials), those living in urban areas and when the (GM)modified trees were destined for urban and plantation, rather than countryside settings. Overall, our findings suggest that the UK government could consider genomic solutions to tree breeding with more confidence in the future, as large and influential publics appear to be relaxed about the use of genomic techniques to increase tolerance of trees to disease.

  4. Psychoacoustic entropy theory and its implications for performance practice

    Science.gov (United States)

    Strohman, Gregory J.

    This dissertation attempts to motivate, derive and imply potential uses for a generalized perceptual theory of musical harmony called psychoacoustic entropy theory. This theory treats the human auditory system as a physical system which takes acoustic measurements. As a result, the human auditory system is subject to all the appropriate uncertainties and limitations of other physical measurement systems. This is the theoretic basis for defining psychoacoustic entropy. Psychoacoustic entropy is a numerical quantity which indexes the degree to which the human auditory system perceives instantaneous disorder within a sound pressure wave. Chapter one explains the importance of harmonic analysis as a tool for performance practice. It also outlines the critical limitations for many of the most influential historical approaches to modeling harmonic stability, particularly when compared to available scientific research in psychoacoustics. Rather than analyze a musical excerpt, psychoacoustic entropy is calculated directly from sound pressure waves themselves. This frames psychoacoustic entropy theory in the most general possible terms as a theory of musical harmony, enabling it to be invoked for any perceivable sound. Chapter two provides and examines many widely accepted mathematical models of the acoustics and psychoacoustics of these sound pressure waves. Chapter three introduces entropy as a precise way of measuring perceived uncertainty in sound pressure waves. Entropy is used, in combination with the acoustic and psychoacoustic models introduced in chapter two, to motivate the mathematical formulation of psychoacoustic entropy theory. Chapter four shows how to use psychoacoustic entropy theory to analyze the certain types of musical harmonies, while chapter five applies the analytical tools developed in chapter four to two short musical excerpts to influence their interpretation. Almost every form of harmonic analysis invokes some degree of mathematical reasoning

  5. Helmet wearing in Kenya: prevalence, knowledge, attitude, practice and implications.

    Science.gov (United States)

    Bachani, A M; Hung, Y W; Mogere, S; Akunga, D; Nyamari, J; Hyder, A A

    2017-03-01

    In light of the increasing prevalence of motorcycles on Kenyan roads, there is a need to address the safety of individuals using this mode of transport. Helmet use has been proven to be effective in preventing head injuries and fatalities in the event of a crash. This study aims to understand the prevalence of helmet use as well as knowledge, attitudes, and practices in two districts in Kenya over a 5-year period (2010-2014). Observational studies on helmet use at randomly selected locations throughout each district were done every quarter to estimate the prevalence of helmet use. Roadside knowledge, attitude, and practice (KAP) surveys were done two times a year in each district. Helmet use among motorcycle drivers and passengers in Thika and Naivasha was assessed through systematic observations at randomly selected locations in the two districts between August 2010 and December 2014. Roadside KAP surveys were administered in both sites to motorcyclists in areas where they stopped, including motorcycle bays, petrol stations and rest areas near the helmet observation sites. Secondary analysis of trauma registries was also used. Negative binomial regressions were used to assess trends of helmet wearing among motorcyclists over time, and logistic regressions were used to analyze associated risk factors as well as association with health outcomes among those admitted to the four hospitals. A total of 256,851 motorcycles were observed in the two target districts during the study period. Overall, prevalence of helmet use among motorcycle drivers in Thika and Naivasha across all periods was 35.12% (95% confidence interval [CI]: 34.87%-35.38%) and 37.42% (95% CI: 37.15%-37.69%) respectively. Prevalence of helmet wearing remained similar after the passage of a traffic amendment bill. These results were not statistically significant in either Thika or in Naivasha. Data from the KAP survey showed that respondents recognized the life-saving effect of wearing a helmet, but

  6. Practical solutions for multi-objective optimization: An application to system reliability design problems

    International Nuclear Information System (INIS)

    Taboada, Heidi A.; Baheranwala, Fatema; Coit, David W.; Wattanapongsakorn, Naruemon

    2007-01-01

    For multiple-objective optimization problems, a common solution methodology is to determine a Pareto optimal set. Unfortunately, these sets are often large and can become difficult to comprehend and consider. Two methods are presented as practical approaches to reduce the size of the Pareto optimal set for multiple-objective system reliability design problems. The first method is a pseudo-ranking scheme that helps the decision maker select solutions that reflect his/her objective function priorities. In the second approach, we used data mining clustering techniques to group the data by using the k-means algorithm to find clusters of similar solutions. This provides the decision maker with just k general solutions to choose from. With this second method, from the clustered Pareto optimal set, we attempted to find solutions which are likely to be more relevant to the decision maker. These are solutions where a small improvement in one objective would lead to a large deterioration in at least one other objective. To demonstrate how these methods work, the well-known redundancy allocation problem was solved as a multiple objective problem by using the NSGA genetic algorithm to initially find the Pareto optimal solutions, and then, the two proposed methods are applied to prune the Pareto set

  7. Semantic web implications for technologies and business practices

    CERN Document Server

    2016-01-01

    This book examines recent developments in semantic systems that can respond to situations and environments and events. The contributors to this book cover how to design, implement, and utilize disruptive technologies from the semantic and Web 3.0 arena. The editor and the contributors discuss two fundamental sets of disruptive technologies: the development of semantic technologies including description logics, ontologies, and agent frameworks; and the development of semantic information rendering including graphical forms of displays of high-density time-sensitive data to improve situational awareness. Beyond practical illustrations of emerging technologies, the goal of this book is to help readers learn about managing information resources in new ways and reinforcing the learning as they read on.   ·         Examines the contrast of competing paradigms and approaches to problem solving and decision-making using technology tools and techniques ·         Covers how to use semantic principle...

  8. The implication of transcultural psychiatry for clinical practice.

    Science.gov (United States)

    Moldavsky, Daniel

    2003-01-01

    This article deals with the main concepts of Transcultural Psychiatry and their applications to everyday psychiatric practice. Transcultural psychiatry has undergone a conceptual reformulation in the last two decades. Having started with a comparative approach, which focused on the diverse manifestations of mental disorders among different societies, it broadened its scope, aiming at present to incorporate social and cultural aspects of illness into the clinical framework. Therefore, transcultural psychiatry now focuses more on what is called the illness experience than on the disease process, the latter understood as illness as it is viewed by health practitioners. Western medicine, of which psychiatry is a part, is grounded in positivist epistemological principles that stress the biological processes of disease. The intention of the paper is to develop an interest in alternative but also complementary ways of thinking. Modern transcultural psychiatry interprets some epidemiological and clinical aspects of major mental disorders (such as schizophrenia and depression) in a different light. However, it also distances itself from the absolute relativism of antipsychiatry, centering on clinical facts and helping clinicians in their primary task of alleviating suffering. An important contribution in addressing this task is the formulation of a cultural axis within the DSM model of multiaxial evaluation. A clinical vignette of a cultural formulation applied to a clinical discussion of a case is described.

  9. Blood specimen labelling errors: Implications for nephrology nursing practice.

    Science.gov (United States)

    Duteau, Jennifer

    2014-01-01

    Patient safety is the foundation of high-quality health care, as recognized both nationally and worldwide. Patient blood specimen identification is critical in ensuring the delivery of safe and appropriate care. The practice of nephrology nursing involves frequent patient blood specimen withdrawals to treat and monitor kidney disease. A critical review of the literature reveals that incorrect patient identification is one of the major causes of blood specimen labelling errors. Misidentified samples create a serious risk to patient safety leading to multiple specimen withdrawals, delay in diagnosis, misdiagnosis, incorrect treatment, transfusion reactions, increased length of stay and other negative patient outcomes. Barcode technology has been identified as a preferred method for positive patient identification leading to a definitive decrease in blood specimen labelling errors by as much as 83% (Askeland, et al., 2008). The use of a root cause analysis followed by an action plan is one approach to decreasing the occurrence of blood specimen labelling errors. This article will present a review of the evidence-based literature surrounding blood specimen labelling errors, followed by author recommendations for completing a root cause analysis and action plan. A failure modes and effects analysis (FMEA) will be presented as one method to determine root cause, followed by the Ottawa Model of Research Use (OMRU) as a framework for implementation of strategies to reduce blood specimen labelling errors.

  10. PRACTICAL IMPLICATIONS OF USING INDUCED TRANSIENTS FOR LEAK DETECTION

    Directory of Open Access Journals (Sweden)

    Marko V. Ivetic

    2007-06-01

    Full Text Available This paper deals with practical problems of leak detection by methods based on hydraulic transient analysis. Controlled and safe transients can be generated and the response of the network, with the relevant information, can be monitored and analysed. Information about leaks, contained in the monitored pressure signal, cannot be easily retrieved, due to reflections, noise etc. On the basis of numerical experiments on a simple network, merits and limitations of several methods for signal analysis (time domain analysis, spectral density function and wavelet transform have been examined. Certain amount of information can be extracted from the time history of the pressure signal, assuming the first reflection of the pressure wave is captured with very high time resolution and accuracy. Only relatively large leaks can be detected using this methodology. As a way to increase the sensitivity of this method it is suggested that transforms in frequency domain and, especially, wavelet transforms, are used. The most promising method for leakage location and quantification seems to be based on wavelet analysis.

  11. PRACTICAL IMPLICATIONS OF USING INDUCED TRANSIENTS FOR LEAK DETECTION

    Directory of Open Access Journals (Sweden)

    Marko V. Ivetic

    2007-01-01

    Full Text Available This paper deals with practical problems of leak detection by methods based on hydraulic transient analysis. Controlled and safe transients can be generated and the response of the network, with the relevant information, can be monitored and analysed. Information about leaks, contained in the monitored pressure signal, cannot be easily retrieved, due to reflections, noise etc. On the basis of numerical experiments on a simple network, merits and limitations of several methods for signal analysis (time domain analysis, spectral density function and wavelet transform have been examined. Certain amount of information can be extracted from the time history of the pressure signal, assuming the first reflection of the pressure wave is captured with very high time resolution and accuracy. Only relatively large leaks can be detected using this methodology. As a way to increase the sensitivity of this method it is suggested that transforms in frequency domain and, especially, wavelet transforms, are used. The most promising method for leakage location and quantification seems to be based on wavelet analysis.

  12. Greek Immigrants in Australia: Implications for Culturally Sensitive Practice.

    Science.gov (United States)

    Georgiades, Savvas Daniel

    2015-10-01

    This exploratory research examined adjustment challenges, resiliencies, attitudes, emotional health, economic stability, criminal involvement, victimization and service experiences, and some cultural propensities of Greek Immigrants (GIs) in Australia using a convenient multi-generational sample (n = 123; response rate = .5). Data were collected via surveys, telephone, and personal-interviews in four major Australian cities. Among other things, the study revealed that Greek identity and cultural customs are often significant to first generation GIs. Adjustment challenges upon entry include primarily language, housing, and transportation difficulties, nostalgia for relatives and the motherland, unfamiliarity with socio-cultural systems, unemployment, money challenges, and lack of friendships. Christian faith, the extended family, family values and traditions, cultural pride for ancient Greek achievements, and a hard 'work ethic' are notable resiliencies that support GIs in their struggles and solidify their pursuit for happiness and success. Financial concerns, aging, and nostalgia for relatives and the motherland were the primary causes of socio-emotional instability. Attitudinal differences in the respondents based on age, gender, and socio-economic status, cross-cultural comparisons, and recommendations for culturally-sensitive practice with GIs are analyzed and methodological limitations illuminated. Future research needs in the field are also highlighted.

  13. Implications of new GALLEX results for the Mikheyev-Smirnov-Wolfenstein solution of the solar neutrino problem

    Science.gov (United States)

    Gelb, James M.; Kwong, Waikwok; Rosen, S. P.

    1992-01-01

    We compare the implications for Be-7 and pp neutrinos of the two Mikheyev-Smirnov-Wolfenstein fits to the new GALLEX solar neutrino measurements. Small-mixing-angle solutions tend to suppress the former as electron neutrinos, but not the latter, and large-angle solutions tend to reduce both by about a factor of two. The consequences for BOREXINO and similar solar neutrino-electron scattering experiments are discussed.

  14. Implications of new GALLEX results for the Mikheyev-Smirnov-Wolfenstein solution of the solar neutrino problem

    International Nuclear Information System (INIS)

    Gelb, J.M.; Kwong, W.; Rosen, S.P.

    1992-01-01

    We compare the implications for 7 Be and pp neutrinos of the two Mikheyev-Smirnov-Wolfenstein fits to the new GALLEX solar neutrino measurements. Small-mixing-angle solutions tend to suppress the former as electron neutrinos, but not the latter, and large-angle solutions tend to reduce both by about a factor of 2. The consequences for BOREXINO and similar solar neutrino-electron scattering experiments are discussed

  15. Youth Work Transitions: A Review with Implications for Counselling and Career Practice

    Science.gov (United States)

    Parada, Filomena; Young, Richard A.

    2013-01-01

    We critically review studies highlighting youth's work transitions and derive some implications for career and counselling theory and practice. We first discuss today's hypermodern world, specifically the meanings being conveyed by today's complex social realities and their impact on individuals' (work) lives. An overview of…

  16. Understanding Parental Grief as a Response to Mental Illness: Implications for Practice

    Science.gov (United States)

    Penzo, Jeanine A.; Harvey, Pat

    2008-01-01

    Parents who are raising children with mental illness struggle with feelings of grief and loss. Kubler-Ross' (1969) stages of grieving (denial, anger, bargaining, depression, and acceptance) are examined as experienced by parents raising children with chronic mental illness. Practice implications for social workers who are working with children and…

  17. "Forest Grove School District v. T.A." Supreme Court Case: Implications for School Psychology Practice

    Science.gov (United States)

    Dixon, Shauna G.; Eusebio, Eleazar C.; Turton, William J.; Wright, Peter W. D.; Hale, James B.

    2011-01-01

    The 2009 "Forest Grove School District v. T.A." United States Supreme Court case could have significant implications for school psychology practice. The Court ruled that the parents of a student with a disability were entitled to private school tuition reimbursement even though T.A. had not been identified with a disability or previously…

  18. SOME IMPLICATIONS OF A CONCEPT OF GROWTH MOTIVATION FOR ADULT EDUCATION THEORY AND PRACTICE.

    Science.gov (United States)

    NOREEN, DAVID SHELDON

    THIS STUDY EXAMINED GROWTH MOTIVATION AS A DEVELOPING CONCEPT AND AS A THEORETICAL CONSTRUCT, AND THE IMPLICATIONS OF THIS THEORY FOR ADULT EDUCATION THEORY AND PRACTICE. SPECIAL ATTENTION WAS GIVEN TO THE THEORETICAL CONSTRUCTS OF ABRAHAM MASLOW, TO THE NATURE OF GROWTH MOTIVATION CONCEPTS IN GENERAL, AND TO FORMS OF SELF UNDERSTANDING AND…

  19. Addressing Cross-Cultural Teamwork Barriers: Implications for Industry Practice and Higher Education Curricula

    Science.gov (United States)

    Levitt, Steven R.

    2016-01-01

    This study explores cultural factors affecting international team dynamics and the implications for industry practice and higher education. Despite decades of studying and experience with cultural diversity, international work groups continue to be challenged by ethnocentrism and prejudices. Central to the context is that cultural differences in…

  20. Elder Abuse: Systematic Review and Implications for Practice.

    Science.gov (United States)

    Dong, Xin Qi

    2015-06-01

    This article is based on the lecture for the 2014 American Geriatrics Society Outstanding Scientific Achievement for Clinical Investigation Award. Elder abuse is a global public health and human rights problem. Evidence suggests that elder abuse is prevalent, predictable, costly, and sometimes fatal. This review will highlight the global epidemiology of elder abuse in terms of its prevalence, risk factors, and consequences in community populations. The global literature in PubMed, MEDLINE, PsycINFO, BIOSIS, Science Direct, and Cochrane Central was searched. Search terms included elder abuse, elder mistreatment, elder maltreatment, prevalence, incidence, risk factors, protective factors, outcomes, and consequences. Studies that existed only as abstracts, case series, or case reports or recruited individuals younger than 60; qualitative studies; and non-English publications were excluded. Tables and figures were created to highlight the findings: the most-detailed analyses to date of the prevalence of elder abuse according to continent, risk and protective factors, graphic presentation of odds ratios and confidence intervals for major risk factors, consequences, and practical suggestions for health professionals in addressing elder abuse. Elder abuse is common in community-dwelling older adults, especially minority older adults. This review identifies important knowledge gaps, such as a lack of consistency in definitions of elder abuse; insufficient research with regard to screening; and etiological, intervention, and prevention research. Concerted efforts from researchers, community organizations, healthcare and legal professionals, social service providers, and policy-makers should be promoted to address the global problem of elder abuse. © 2015, Copyright the Author Journal compilation © 2015, The American Geriatrics Society.

  1. Analytical implications of using practice theory in workplace information literacy research

    DEFF Research Database (Denmark)

    Moring, Camilla Elisabeth; Lloyd, Annemaree

    2013-01-01

    Introduction: This paper considers practice theory and the analytical implications of using this theoretical approach in information literacy research. More precisely the aim of the paper is to discuss the translation of practice theoretical assumptions into strategies that frame the analytical...... focus and interest when researching workplace information literacy. Two practice theoretical perspectives are selected, one by Theodore Schatzki and one by Etienne Wenger, and their general commonalities and differences are analysed and discussed. Analysis: The two practice theories and their main ideas...... of what constitute practices, how practices frame social life and the central concepts used to explain this, are presented. Then the application of the theories within workplace information literacy research is briefly explored. Results and Conclusion: The two theoretical perspectives share some...

  2. Implications of the new sepsis definition on research and practice.

    Science.gov (United States)

    Peach, Brian C

    2017-04-01

    practice will be essential, to determine if the Sepsis 3 definition, its associated clinical criteria, and the qSOFA need further revision. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Logo! 8 a practical introduction, with circuit solutions and example programs

    CERN Document Server

    Kruse, Stefan

    2015-01-01

    Addressing students and engineers, but also hobby engineers, this practical guide will help to easily and cost-effectively implement technical solutions in home and installation technology, as well as small-scale automation solutions in machine and plant engineering. The book descriptively illustrates how to plan LOGO! 8 projects, develop programs and how to select the hardware. Standard control technology scenarios are demonstrated by building on the fundamentals of modern information technology and with the help of several real-life sample switches. In addition, readers are provided with practice-oriented descriptions of various basic and special LOGO! 8 modules with which specific tasks can be very flexibly implemented. Compared to former generations and competing products, LOGO! 8 comprises an integrated Ethernet interface, easy Internet control, a space-saving design and also more digital and analog outputs. The basic and special functions of the logic module can be used to replace several switching devi...

  4. Practices and health perception of preparation of Brassica vegetables: translating survey data to technological and nutritional implications

    NARCIS (Netherlands)

    Nugrahedi, P.Y.; Hantoro, I.; Verkerk, R.; Dekker, M.; Steenbekkers, L.P.A.

    2015-01-01

    Food preparation practices are known to have large nutritional implications on the final product. This article describes survey data on preparation practices of Brassica vegetables and the translation of these data into technological and nutritional implications using knowledge on the mechanisms of

  5. Wind power plants and the landscape: Analysis of conflict and methods of solution - practical examples

    International Nuclear Information System (INIS)

    Brux, H.

    1993-01-01

    The conflict between wind power plants and the appearance of the landscape is explained. Legal regulations forcing one to take it into account are pointed out. After an introduction into the theoretical basis, methods of solution for the operation of aesthetic landscape judgments are introduced by examples from planning practice. Finally, the frequently unused possibilities of site optimisation with the aid of applied biology and landscape planning are pointed out. (orig.) [de

  6. Solution structure of CXCL5--a novel chemokine and adipokine implicated in inflammation and obesity.

    Directory of Open Access Journals (Sweden)

    Krishna Mohan Sepuru

    Full Text Available The chemokine CXCL5 is selectively expressed in highly specialized cells such as epithelial type II cells in the lung and white adipose tissue macrophages in muscle, where it mediates diverse functions from combating microbial infections by regulating neutrophil trafficking to promoting obesity by inhibiting insulin signaling. Currently very little is known regarding the structural basis of how CXCL5 mediates its novel functions. Towards this missing knowledge, we have solved the solution structure of the CXCL5 dimer by NMR spectroscopy. CXCL5 is a member of a subset of seven CXCR2-activating chemokines (CAC that are characterized by the highly conserved ELR motif in the N-terminal tail. The structure shows that CXCL5 adopts the typical chemokine fold, but also reveals several distinct differences in the 30 s loop and N-terminal residues; not surprisingly, crosstalk between N-terminal and 30 s loop residues have been implicated as a major determinant of receptor activity. CAC function also involves binding to highly sulfated glycosaminoglycans (GAG, and the CXCL5 structure reveals a distinct distribution of positively charged residues, suggesting that differences in GAG interactions also influence function. The availability of the structure should now facilitate the design of experiments to better understand the molecular basis of various CXCL5 functions, and also serve as a template for the design of inhibitors for use in a clinical setting.

  7. The role of non-verbal behaviour in racial disparities in health care: implications and solutions.

    Science.gov (United States)

    Levine, Cynthia S; Ambady, Nalini

    2013-09-01

    People from racial minority backgrounds report less trust in their doctors and have poorer health outcomes. Although these deficiencies have multiple roots, one important set of explanations involves racial bias, which may be non-conscious, on the part of providers, and minority patients' fears that they will be treated in a biased way. Here, we focus on one mechanism by which this bias may be communicated and reinforced: namely, non-verbal behaviour in the doctor-patient interaction. We review 2 lines of research on race and non-verbal behaviour: (i) the ways in which a patient's race can influence a doctor's non-verbal behaviour toward the patient, and (ii) the relative difficulty that doctors can have in accurately understanding the nonverbal communication of non-White patients. Further, we review research on the implications that both lines of work can have for the doctor-patient relationship and the patient's health. The research we review suggests that White doctors interacting with minority group patients are likely to behave and respond in ways that are associated with worse health outcomes. As doctors' disengaged non-verbal behaviour towards minority group patients and lower ability to read minority group patients' non-verbal behaviours may contribute to racial disparities in patients' satisfaction and health outcomes, solutions that target non-verbal behaviour may be effective. A number of strategies for such targeting are discussed. © 2013 John Wiley & Sons Ltd.

  8. Probability of causation tables and their possible implications for the practice of diagnostic radiology

    International Nuclear Information System (INIS)

    Gur, D.; Wald, N.

    1986-01-01

    In compliance with requirements in the Orphan Drug Act (97-414) of 1983, tables were recently constructed by an ad hoc committee of the National Institutes of Health (NIH) in which the probabilities that certain specific cancers are caused by previous radiation exposure are estimated. The reports of the NIH committee and a National Academy of Science oversight committee may have broad implications for the future practice of diagnostic radiology. The basis on which the probability of causation tables were established and some of the possible implications for diagnostic radiology are discussed

  9. Ancient Ethical Practices of Dualism and Ethical Implications for Future Paradigms in Nursing.

    Science.gov (United States)

    Milton, Constance L

    2016-07-01

    Paradigms contain theoretical structures to guide scientific disciplines. Since ancient times, Cartesian dualism has been a prominent philosophy incorporated in the practice of medicine. The discipline of nursing has continued the body-mind emphasis with similar paradigmatic thinking and theories of nursing that separate body and mind. Future trends for paradigm and nursing theory development are harkening to former ways of thinking. In this article the author discusses the origins of Cartesian dualism and implications for its current usage. The author shall illuminate what it potentially means to engage in dualism in nursing and discuss possible ethical implications for future paradigm and theory development in nursing. © The Author(s) 2016.

  10. Australian general practitioner attitudes to clinical practice guidelines and some implications for translating osteoarthritis care into practice.

    Science.gov (United States)

    Basedow, Martin; Runciman, William B; Lipworth, Wendy; Esterman, Adrian

    2016-11-01

    Clinical practice guidelines (CPGs) have been shown to improve processes of care and health outcomes, but there is often a discrepancy between recommendations for care and clinical practice. This study sought to explore general practitioner (GP) attitudes towards CPGs, in general and specifically for osteoarthritis (OA), with the implications for translating OA care into practice. A self-administered questionnaire was conducted in January 2013 with a sample of 228 GPs in New South Wales and South Australia. Seventy-nine GPs returned questionnaires (response rate 35%). Nearly all GPs considered that CPGs support decision-making in practice (94%) and medical education (92%). Very few respondents regarded CPGs as a threat to clinical autonomy, and most recognised that individual patient circumstances must be taken into account. Shorter CPG formats were preferred over longer and more comprehensive formats, with preferences being evenly divided among respondents for short, 2-3-page summaries, flowcharts or algorithms and single page checklists. GPs considered accessibility to CPGs to be important, and electronic formats were popular. Familiarity and use of The Royal Australian College of General Practitioners OA Guideline was poor, with most respondents either not aware of it (30%; 95% confidence interval (CI) 27 - 41%), had never used it (19%; 95% CI 12 - 29%) or rarely used it (34%; 95% CI 25-45%). If CPGs are to assist with the translation of evidence into practice, they must be easily accessible and in a format that encourages use.

  11. ICT-Enabled Time-Critical Clinical Practices: Examining the Affordances of an Information Processing Solution

    Directory of Open Access Journals (Sweden)

    Leonard Hoon

    2015-11-01

    Full Text Available In this paper, we present a case study of a decision-support system deployment at The Alfred Hospital, in Melbourne, Australia. This work outlines Information and Communications Technology (ICT affordances and their actualisations in time-critical clinical practices to enable better information processing. From our study findings, we present a stage-wise model describing the role played by ICT in the context of the Trauma Centre practices. This addresses a knowledge gap surrounding the role and impact of ICT in the delivery of quality improvements to processes and culture in time-critical environments, amid increasing expenditure on ICT globally. Our model has implications for research and practice, such that we observe for the first time how information standards, synergy and renewal are developed between the system and its users in order to reduce error rates in the healthcare context. Through the study findings, we demonstrate that healthcare quality can be further refined as ICT allows for knowledge dissemination and informs existing practices.

  12. The down syndrome behavioral phenotype: implications for practice and research in occupational therapy.

    Science.gov (United States)

    Daunhauer, Lisa A; Fidler, Deborah J

    2011-01-01

    ABSTRACT Down syndrome (DS) is the most common chromosomal cause of intellectual disability. The genetic causes of DS are associated with characteristic outcomes, such as relative strengths in visual-spatial skills and relative challenges in motor planning. This profile of outcomes, called the DS behavioral phenotype, may be a critical tool for intervention planning and research in this population. In this article, aspects of the DS behavioral phenotype potentially relevant to occupational therapy practice are reviewed. Implications and challenges for etiology-informed research and practice are discussed.

  13. Implications of applying solar industry best practice resource estimation on project financing

    International Nuclear Information System (INIS)

    Pacudan, Romeo

    2016-01-01

    Solar resource estimation risk is one of the main solar PV project risks that influences lender’s decision in providing financing and in determining the cost of capital. More recently, a number of measures have emerged to mitigate this risk. The study focuses on solar industry’s best practice energy resource estimation and assesses its financing implications to the 27 MWp solar PV project study in Brunei Darussalam. The best practice in resource estimation uses multiple data sources through the measure-correlate-predict (MCP) technique as compared with the standard practice that rely solely on modelled data source. The best practice case generates resource data with lower uncertainty and yields superior high-confidence energy production estimate than the standard practice case. Using project financial parameters in Brunei Darussalam for project financing and adopting the international debt-service coverage ratio (DSCR) benchmark rates, the best practice case yields DSCRs that surpass the target rates while those of standard practice case stay below the reference rates. The best practice case could also accommodate higher debt share and have lower levelized cost of electricity (LCOE) while the standard practice case would require a lower debt share but having a higher LCOE. - Highlights: •Best practice solar energy resource estimation uses multiple datasets. •Multiple datasets are combined through measure-correlate-predict technique. •Correlated data have lower uncertainty and yields superior high-confidence energy production. •Best practice case yields debt-service coverage ratios (DSCRs) that surpass the benchmark rates. •Best practice case accommodates high debt share and have low levelized cost of electricity.

  14. Screening for diabetes in unconventional locations: resource implications and economics of screening in optometry practices.

    Science.gov (United States)

    Howse, Jennifer H; Jones, Steve; Hungin, A Pali S

    2011-10-01

    Unconventional locations outwith general medical practice may prove opportunities for screening. The aim was to determine the resource implications and economics of a screening service using random capillary blood glucose (rCBG) tests to detect raised blood glucose levels in the "at risk" population attending high street optometry practices. A screening service was implemented in optometry practices in North East England: the cost of the service and the implication of different screening strategies was estimated. The cost of a screening test was £5.53-£11.20, depending on the screening strategy employed and who carried out the testing. Refining the screening strategy to target those ≥40 years with BMI of ≥25 kg/m(2) and/or family history of diabetes resulted in a cost per case referred to the GP of £14.38-£26.36. Implementing this strategy in half of optometric practices in England would have the potential to identify up to 150,000 new cases of diabetes and prediabetes a year. Optometry practices provide an effective way of identifying people who would benefit from further investigation for diabetes. Effectiveness could be improved further by improving cooperation and communication between optometrists and medical practitioners. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  15. Problems in the fingerprints based polycyclic aromatic hydrocarbons source apportionment analysis and a practical solution

    International Nuclear Information System (INIS)

    Zou, Yonghong; Wang, Lixia; Christensen, Erik R.

    2015-01-01

    This work intended to explain the challenges of the fingerprints based source apportionment method for polycyclic aromatic hydrocarbons (PAH) in the aquatic environment, and to illustrate a practical and robust solution. The PAH data detected in the sediment cores from the Illinois River provide the basis of this study. Principal component analysis (PCA) separates PAH compounds into two groups reflecting their possible airborne transport patterns; but it is not able to suggest specific sources. Not all positive matrix factorization (PMF) determined sources are distinguishable due to the variability of source fingerprints. However, they constitute useful suggestions for inputs for a Bayesian chemical mass balance (CMB) analysis. The Bayesian CMB analysis takes into account the measurement errors as well as the variations of source fingerprints, and provides a credible source apportionment. Major PAH sources for Illinois River sediments are traffic (35%), coke oven (24%), coal combustion (18%), and wood combustion (14%). - Highlights: • Fingerprint variability poses challenges in PAH source apportionment analysis. • PCA can be used to group compounds or cluster measurements. • PMF requires results validation but is useful for source suggestion. • Bayesian CMB provide practical and credible solution. - A Bayesian CMB model combined with PMF is a practical and credible fingerprints based PAH source apportionment method

  16. General practice integration in Australia. Primary health services provider and consumer perceptions of barriers and solutions.

    Science.gov (United States)

    Appleby, N J; Dunt, D; Southern, D M; Young, D

    1999-08-01

    To identify practical examples of barriers and possible solutions to improve general practice integration with other health service providers. Twelve focus groups, including one conducted by teleconference, were held across Australia with GPs and non GP primary health service providers between May and September, 1996. Focus groups were embedded within concept mapping sessions, which were used to conceptually explore the meaning of integration in general practice. Data coding, organising and analysis were based on the techniques documented by Huberman and Miles. Barriers to integration were perceived to be principally due to the role and territory disputes between the different levels of government and their services, the manner in which the GP's role is currently defined, and the system of GP remuneration. Suggestions on ways to improve integration involved two types of strategies. The first involves initiatives implemented 'top down' through major government reform to service structures, including the expansion of the role of divisions of general practice, and structural changes to the GP remuneration systems. The second type of strategy suggested involves initiatives implemented from the 'bottom up' involving services such as hospitals (e.g. additional GP liaison positions) and the use of information technology to link services and share appropriate patient data. The findings support the need for further research and evaluation of initiatives aimed at achieving general practice integration at a systems level. There is little evidence to suggest which types of initiatives improve integration. However, general practice has been placed in the centre of the health care debate and is likely to remain central to the success of such initiatives. Clarification of the future role and authority of general practice will therefore be required if such integrative strategies are to be successful at a wider health system level.

  17. Multiobjective optimization of urban water resources: Moving toward more practical solutions

    Science.gov (United States)

    Mortazavi, Mohammad; Kuczera, George; Cui, Lijie

    2012-03-01

    The issue of drought security is of paramount importance for cities located in regions subject to severe prolonged droughts. The prospect of "running out of water" for an extended period would threaten the very existence of the city. Managing drought security for an urban water supply is a complex task involving trade-offs between conflicting objectives. In this paper a multiobjective optimization approach for urban water resource planning and operation is developed to overcome practically significant shortcomings identified in previous work. A case study based on the headworks system for Sydney (Australia) demonstrates the approach and highlights the potentially serious shortcomings of Pareto optimal solutions conditioned on short climate records, incomplete decision spaces, and constraints to which system response is sensitive. Where high levels of drought security are required, optimal solutions conditioned on short climate records are flawed. Our approach addresses drought security explicitly by identifying approximate optimal solutions in which the system does not "run dry" in severe droughts with expected return periods up to a nominated (typically large) value. In addition, it is shown that failure to optimize the full mix of interacting operational and infrastructure decisions and to explore the trade-offs associated with sensitive constraints can lead to significantly more costly solutions.

  18. Entanglements in Marginal Solutions: A Means of Tuning Pre-Aggregation of Conjugated Polymers with Positive Implications for Charge Transport

    KAUST Repository

    Hu, Hanlin

    2015-06-17

    The solution-processing of conjugated polymers, just like commodity polymers, is subject to solvent and molecular weight-dependent solubility, interactions and chain entanglements within the polymer, all of which can influence the crystallization and microstructure development in semi-crystalline polymers and consequently affect charge transport and optoelectronic properties. Disentanglement of polymer chains in marginal solvents was reported to work via ultrasonication, facilitating the formation of photophysically ordered polymer aggregates. In this contribution, we explore how a wide range of technologically relevant solvents and formulations commonly used in organic electronics influence chain entanglement and the aggregation behaviour of P3HT using a combination of rheological and spectrophotometric measurements. The specific viscosity of the solution offers an excellent indication of the degree of entanglements in the solution, which is found to be related to the solubility of P3HT in a given solvent. Moreover, deliberately disentangling the solution in the presence of solvophobic driving forces, leads consistently to formation of photophysically visible aggregates which is indicative of local and perhaps long range order in the solute. We show for a broad range of solvents and molecular weights that disentanglement ultimately leads to significant ordering of the polymer in the solid state and a commensurate increase in charge transport properties. In doing so we demonstrate a remarkable ability to tune the microstructure which has important implications for transport properties. We discuss its potential implications in the context of organic photovoltaics.

  19. Entanglements in Marginal Solutions: A Means of Tuning Pre-Aggregation of Conjugated Polymers with Positive Implications for Charge Transport

    KAUST Repository

    Hu, Hanlin; Zhao, Kui; Fernandes, Nikhil J.; Boufflet, Pierre; Bannock, James Henry; Yu, Liyang; de Mello, John C; Stingelin, Natalie; Heeney, Martin; Giannelis, Emmanuel P.; Amassian, Aram

    2015-01-01

    The solution-processing of conjugated polymers, just like commodity polymers, is subject to solvent and molecular weight-dependent solubility, interactions and chain entanglements within the polymer, all of which can influence the crystallization and microstructure development in semi-crystalline polymers and consequently affect charge transport and optoelectronic properties. Disentanglement of polymer chains in marginal solvents was reported to work via ultrasonication, facilitating the formation of photophysically ordered polymer aggregates. In this contribution, we explore how a wide range of technologically relevant solvents and formulations commonly used in organic electronics influence chain entanglement and the aggregation behaviour of P3HT using a combination of rheological and spectrophotometric measurements. The specific viscosity of the solution offers an excellent indication of the degree of entanglements in the solution, which is found to be related to the solubility of P3HT in a given solvent. Moreover, deliberately disentangling the solution in the presence of solvophobic driving forces, leads consistently to formation of photophysically visible aggregates which is indicative of local and perhaps long range order in the solute. We show for a broad range of solvents and molecular weights that disentanglement ultimately leads to significant ordering of the polymer in the solid state and a commensurate increase in charge transport properties. In doing so we demonstrate a remarkable ability to tune the microstructure which has important implications for transport properties. We discuss its potential implications in the context of organic photovoltaics.

  20. Determinism and Underdetermination in Genetics: Implications for Students' Engagement in Argumentation and Epistemic Practices

    Science.gov (United States)

    Jiménez-Aleixandre, María Pilar

    2014-02-01

    In the last two decades science studies and science education research have shifted from an interest in products (of science or of learning), to an interest in processes and practices. The focus of this paper is on students' engagement in epistemic practices (Kelly in Teaching scientific inquiry: Recommendations for research and implementation. Sense Publishers, Rotterdam, pp 99-117, 2008), or on their practical epistemologies (Wickman in Sci Educ 88(3):325-344, 2004). In order to support these practices in genetics classrooms we need to take into account domain-specific features of the epistemology of genetics, in particular issues about determinism and underdetermination. I suggest that certain difficulties may be related to the specific nature of causality in genetics, and in particular to the correspondence between a given set of factors and a range of potential effects, rather than a single one. The paper seeks to bring together recent developments in the epistemology of biology and of genetics, on the one hand, with science education approaches about epistemic practices, on the other. The implications of these perspectives for current challenges in learning genetics are examined, focusing on students' engagement in epistemic practices, as argumentation, understood as using evidence to evaluate knowledge claims. Engaging in argumentation in genetics classrooms is intertwined with practices such as using genetics models to build explanations, or framing genetics issues in their social context. These challenges are illustrated with studies making part of our research program in the USC.

  1. Honorary Authorship Practices in Environmental Science Teams: Structural and Cultural Factors and Solutions.

    Science.gov (United States)

    Elliott, Kevin C; Settles, Isis H; Montgomery, Georgina M; Brassel, Sheila T; Cheruvelil, Kendra Spence; Soranno, Patricia A

    2017-01-01

    Overinclusive authorship practices such as honorary or guest authorship have been widely reported, and they appear to be exacerbated by the rise of large interdisciplinary collaborations that make authorship decisions particularly complex. Although many studies have reported on the frequency of honorary authorship and potential solutions to it, few have probed how the underlying dynamics of large interdisciplinary teams contribute to the problem. This article reports on a qualitative study of the authorship standards and practices of six National Science Foundation-funded interdisciplinary environmental science teams. Using interviews of the lead principal investigator and an early-career member on each team, our study explores the nature of honorary authorship practices as well as some of the motivating factors that may contribute to these practices. These factors include both structural elements (policies and procedures) and cultural elements (values and norms) that cross organizational boundaries. Therefore, we provide recommendations that address the intersection of these factors and that can be applied at multiple organizational levels.

  2. How to communicate climate change 'impact and solutions' to vulnerable population of Indian Sundarbans? From theory to practice.

    Science.gov (United States)

    Chowdhury, Abhiroop; Maiti, Subodh Kumar; Bhattacharyya, Santanu

    2016-01-01

    Global consciousness on climate change problems and adaptation revolves around the disparity of information sharing and communication gap between theoretical scientific knowledge at academic end and practical implications of these at the vulnerable populations' end. Coastal communities facing socio-economic stress, like densely populated Sundarbans, are the most affected part of the world, exposed to climate change problems and uncertainties. This article explores the successes of a socio-environmental project implemented at Indian Sundarbans targeted towards economic improvement and aims at communicating environmental conservation through organized community participation. Participatory rural appraisal (PRA) and the wealth rank tool (WRT) were used to form a "group based organization" with 2100 vulnerable families to give them knowledge about capacity building, disaster management, resource conservation and sustainable agriculture practices. Training was conducted with the selected group members on resource conservation, institution building, alternative income generation activities (AIGA) like, Poultry, Small business, Tricycle van, Organic farming and disaster management in a participatory mode. The climate change 'problems-solutions' were communicated to this socio-economically marginalized and ostracized community through participatory educational theater (PET). WRT revealed that 45 % of the population was under economic stress. Out of 2100 beneficiaries', 1015 beneficiaries' started organic farming, 133 beneficiaries' adopted poultry instead of resource exploitive livelihood and 71 beneficiaries' engaged themselves with small business, which was the success stories of this project. To mitigate disaster, 10-committees were formed and the endemic knowledge about climate change was recorded by participatory method validated through survey by structured questionnaire. As a part of this project 87 ha of naked deforested mudflat was reclaimed with endangered

  3. Contested Practice: Political Activism in Nursing and Implications for Nursing Education.

    Science.gov (United States)

    Buck-McFadyen, Ellen; MacDonnell, Judith

    2017-07-27

    Canadian nurses have a social mandate to address health inequities for the populations they serve, as well as to speak out on professional and broader social issues. Although Canadian nursing education supports the role of nurses as advocates for social justice and leadership for health care reform, little is known about how nurse educators understand activism and how this translates in the classroom. A comparative life history study using purposeful sampling and a critical feminist lens was undertaken to explore political activism in nursing and how nurse educators foster political practice among their students. Findings from interviews and focus groups with 26 Ontario nurse educators and nursing students suggested that neoliberal dynamics in both the practice setting and in higher education have constrained nurses' activist practice and favour a technical rational approach to nursing education. Implications and strategies to inspire political action in nursing education are discussed.

  4. Women's self-perception and self-care practice: implications for health care delivery.

    Science.gov (United States)

    Mendias, E P; Clark, M C; Guevara, E B

    2001-01-01

    Mexican American women experience unique health care needs related to integration of Mexican and American cultures. To learn how to better promote self-care practices and service utilization in women of Mexican origin living in Texas, researchers used a qualitative approach to interview a convenience sample of 11 low-income women attending a health clinic. Researchers collected narrative data about the women's perceptions of health, wellness, and self-care. Using the matrix approach described by Miles and Huberman, we organized findings around women's roles, including participants' descriptions of themselves, their health and wellness awareness, self-care practices for health/illness and wellness/nonwellness, barriers to self-care, origin of self-care practices, and perceptions of life control. Implications for health planning and service delivery are presented.

  5. Reflecting on reflection in interprofessional education: implications for theory and practice.

    Science.gov (United States)

    Clark, Phillip G

    2009-05-01

    Interprofessional education (IPE) involves learning, and learning requires reflection. Educators need to "reflect more on reflection" if they are to be effective teachers in ensuring the learning outcomes essential for teamwork and interprofessional practice (IPP), including incorporating both theory and practice into the development of educational interventions. First, this discussion surveys the IPE-relevant literature on reflection, and then defines and refines the multidimensional concept of reflection as it relates to IPE in developing and implementing teamwork learning programs and experiences. Second, specific methods to promote reflection are presented and explored, including self-assessments, journaling, and written papers. Actual samples from student journals and assignments provide examples of the impacts of using these methods on participant reflection and learning. Finally, implications for an expanded understanding and application of reflection for IPE will be discussed, and recommendations made for educational practice and research in this area.

  6. [A framework for evaluating ethical issues of public health initiatives: practical aspects and theoretical implications].

    Science.gov (United States)

    Petrini, Carlo

    2015-01-01

    The "Framework for the Ethical Conduct of Public Health Initiatives", developed by Public Health Ontario, is a practical guide for assessing the ethical implications of evidence-generating public health initiatives, whether research or non-research activities, involving people, their biological materials or their personal information. The Framework is useful not only to those responsible for determining the ethical acceptability of an initiative, but also to investigators planning new public health initiatives. It is informed by a theoretical approach that draws on widely shared bioethical principles. Two considerations emerge from both the theoretical framework and its practical application: the line between practice and research is often blurred; public health ethics and biomedical research ethics are based on the same common heritage of values.

  7. Science, practice and mythology: a definition and examination of the implications of scientism in medicine.

    Science.gov (United States)

    Loughlin, Michael; Lewith, George; Falkenberg, Torkel

    2013-06-01

    Scientism is a philosophy which purports to define what the world 'really is'. It adopts what the philosopher Thomas Nagel called 'an epistemological criterion of reality', defining what is real as that which can be discovered by certain quite specific methods of investigation. As a consequence all features of experience not revealed by those methods are deemed 'subjective' in a way that suggests they are either not real, or lie beyond the scope of meaningful rational inquiry. This devalues capacities that (we argue) are in fact essential components of good reasoning and virtuous practice. Ultimately, the implications of scientism for statements of value undermine value-judgements essential for science itself to have a sound basis. Scientism has implications, therefore, for ontology, epistemology and also for which claims we can assert as objective truths about the world. Adopting scientism as a world view will have consequences for reasoning and decision-making in clinical and other contexts. We analyse the implications of this approach and conclude that we need to reject scientism if we are to avoid stifling virtuous practice and to develop richer conceptions of human reasoning.

  8. Studying physician-adolescent patient communication in community-based practices: recruitment challenges and solutions.

    Science.gov (United States)

    Bodner, Michael E; Bilheimer, Alicia; Gao, Xiaomei; Lyna, Pauline; Alexander, Stewart C; Dolor, Rowena J; Østbye, Truls; Bravender, Terrill; Tulsky, James A; Graves, Sidney; Irons, Alexis; Pollak, Kathryn I

    2015-11-13

    Practice-based studies are needed to assess how physicians communicate health messages about weight to overweight/obese adolescent patients, but successful recruitment to such studies is challenging. This paper describes challenges, solutions, and lessons learned to recruit physicians and adolescents to the Teen Communicating Health Analyzing Talk (CHAT) study, a randomized controlled trial of a communication skills intervention for primary care physicians to enhance communication about weight with overweight/obese adolescents. A "peer-to-peer" approach was used to recruit physicians, including the use of "clinic champions" who liaised between study leaders and physicians. Consistent rapport and cooperative working relationships with physicians and clinic staff were developed and maintained. Adolescent clinic files were reviewed (HIPAA waiver) to assess eligibility. Parents could elect to opt-out for their children. To encourage enrollment, confidentiality of audio recordings was emphasized, and financial incentives were offered to all participants. We recruited 49 physicians and audio-recorded 391 of their overweight/obese adolescents' visits. Recruitment challenges included 1) physician reticence to participate; 2) variability in clinic operating procedures; 3) variability in adolescent accrual rates; 4) clinic open access scheduling; and 5) establishing communication with parents and adolescents. Key solutions included the use of a "clinic champion" to help recruit physicians, pro-active, consistent communication with clinic staff, and adapting calling times to reach parents and adolescents. Recruiting physicians and adolescents to audio-recorded, practice-based health communication studies can be successful. Anticipated challenges to recruiting can be met with advanced planning; however, optimal solutions to challenges evolve as recruitment progresses.

  9. NICE guideline on antibiotic prophylaxis against infective endocarditis: attitudes to the guideline and implications for dental practice in Ireland.

    LENUS (Irish Health Repository)

    2009-03-28

    To investigate attitudes of Irish dental practitioners, cardiologists and patients with cardiac lesions to the new NICE guideline for antibiotic prophylaxis against infective endocarditis and to determine the implications of this guideline for dental practice in Ireland.

  10. On the Assessment of Paramedic Competence: A Narrative Review with Practice Implications.

    Science.gov (United States)

    Tavares, W; Boet, S

    2016-02-01

    Paramedicine is experiencing significant growth in scope of practice, autonomy, and role in the health care system. Despite clinical governance models, the degree to which paramedicine ultimately can be safe and effective will be dependent on the individuals the profession deems suited to practice. This creates an imperative for those responsible for these decisions to ensure that assessments of paramedic competence are indeed accurate, trustworthy, and defensible. The purpose of this study was to explore and synthesize relevant theoretical foundations and literature informing best practices in performance-based assessment (PBA) of competence, as it might be applied to paramedicine, for design or evaluation of assessment programs. A narrative review methodology was applied to focus intentionally, but broadly, on purpose relevant, theoretically derived research that could inform assessment protocols in paramedicine. Primary and secondary studies from a number of health professions that contributed to and informed best practices related to the assessment of paramedic clinical competence were included and synthesized. Multiple conceptual frameworks, psychometric requirements, and emerging lines of research are forwarded. Seventeen practice implications are derived to promote understanding as well as best practices and evaluation criteria for educators, employers, and/or licensing/certifying bodies when considering the assessment of paramedic competence. The assessment of paramedic competence is a complex process requiring an understanding, appreciation for, and integration of conceptual and psychometric principles. The field of PBA is advancing rapidly with numerous opportunities for research.

  11. Teacher Strategies for Effective Intervention with Students Presenting Social, Emotional and Behavioural Difficulties: Implications for Policy and Practice

    Science.gov (United States)

    Cooper, Paul

    2011-01-01

    In this paper some key practice and policy implications emerging from a review of literature on effective teacher strategies for social, emotional and behavioural difficulties are set out. Particular attention is given to implications in relation to the development of teachers' skills.

  12. AT on Buried LPG Tanks Over 13 m3: An Innovative and Practical Solution

    Science.gov (United States)

    Di Fratta, Crescenzo; Ferraro, Antonio; Tscheliesnig, Peter; Lackner, Gerald; Correggia, Vincenzo; Altamura, Nicola

    In Italy, since 2005, techniques based on Acoustic Emission have been introduced for testing of underground LPG tanks up to 13 m3, according to the European standard EN 12818:2004. The testing procedure for these tanks plans to install one or more pairs of sensors inside the "dome" suited for the access to the valves and fittings of the tank, directly on the accessible metal shell. This methodology is not applicable for the underground LPG buried tanks, where it is necessary to install a larger number of AE sensors, in order to cover at 100% the whole tank shell, even at very deep positions. Already in 2004, the European standard EN 12820 (Appendix C - Informative)give the possibility to use Acoustic Emission testing of LPG underground or buried tanks with a capacity exceeding 13 m3, but no technique was specified for the application. In 2008, TÜV AUSTRIA ITALIA - BLU SOLUTIONS srl - Italian company of TÜV AUSTRIA Group - has developed a technique to get access at tank shell, where tank capacity is greater than 13 m3 and its' diameter greater than 3,5 m. This methodology was fully in comply with the provisions of the European Standard EN 12819:2010, becoming an innovative solution widely appreciated and is used in Italy since this time. Currently, large companies and petrochemical plants, at the occurrence of the tank's requalification, have engaged TÜV AUSTRIA ITALIA - BLU SOLUTIONS to install such permanent predispositions, which allow access to the tank shell - test object - with diameters from 4 to 8 m. Through this access, you can install the AE sensors needed to cover at 100% the tank surface and then to perform AE test. In an economic crisis period, this technique is proving a valid and practically applicable answer, in order to reduce inspection costs and downtime by offering a technically advanced solution (AT), increasing the safety of the involved operators, protecting natural resources and the environment.

  13. Implications of Nursing Clinical Practice to The Student’s Spiritual Health

    Directory of Open Access Journals (Sweden)

    Bhandesa Asthadi Mahendra

    2018-01-01

    Full Text Available This study aimed to clarify the implications of Nursing Clinical Practice (PLKK to the spiritual health of STIKES Bali students. This study employed purposive sampling method to determine the number of respondents. To conduct this study, the fourth grade of nursing students were recruited as the sample with total number 136 respondents. A questionnaire about spirituality from World Health Organization (WHO was used in this study as the instrument. In addition, the data were analysed by using quantitative descriptive technique. The result showed that 50.0% of students had a very good spiritual health, 42.6% had good spiritual health, 6.6% had moderate spiritual health, and 0.7 % had poor spiritual health. It can be interpreted that spiritual health of nursing students of STIKES Bali is good after conducting Nursing Clinical Practice. Thus, this study can be concluded that Nursing Clinical Practice has implication to the ability of students to love themselves and others meaningfully as the evidence of students’ spiritual health.

  14. Citizen Science and Biomedical Research: Implications for Bioethics Theory and Practice

    Directory of Open Access Journals (Sweden)

    Chris W Callaghan

    2016-10-01

    Full Text Available Certain trends in scientific research have important relevance to bioethics theory and practice. A growing stream of literature relates to increasing transparency and inclusivity of populations (stakeholders in scientific research, from high volume data collection, synthesis, and analysis to verification and ethical scrutiny. The emergence of this stream of literature has implications for bioethics theory and practice. This paper seeks to make explicit these streams of literature and to relate these to bioethical issues, through consideration of certain extreme examples of scientific research where bioethical engagement is vital. Implications for theory and practice are derived, offering useful insights derived from multidisciplinary theory. Arguably, rapidly developing fields of citizen science such as informing science and others seeking to maximise stakeholder involvement in both research and bioethical engagement have emerged as a response to these types of issues; radically enhanced stakeholder engagement in science may herald a new maximally inclusive and transparent paradigm in bioethics based on lessons gained from exposure to increasingly uncertain ethical contexts of biomedical research.

  15. Space-time slicing in Horndeski theories and its implications for non-singular bouncing solutions

    Science.gov (United States)

    Ijjas, Anna

    2018-02-01

    In this paper, we show how the proper choice of gauge is critical in analyzing the stability of non-singular cosmological bounce solutions based on Horndeski theories. We show that it is possible to construct non-singular cosmological bounce solutions with classically stable behavior for all modes with wavelengths above the Planck scale where: (a) the solution involves a stage of null-energy condition violation during which gravity is described by a modification of Einstein's general relativity; and (b) the solution reduces to Einstein gravity both before and after the null-energy condition violating stage. Similar considerations apply to galilean genesis scenarios.

  16. Chemical analysis of freshly prepared and stored capsaicin solutions: implications for tussigenic challenges.

    Science.gov (United States)

    Kopec, Scott E; DeBellis, Ronald J; Irwin, Richard S

    2002-01-01

    The purpose of this study was to assess the stability of stored capsaicin solutions and the actual concentrations of prepared solutions. Capsaicin solutions ranging in concentration from 0.5 to 128 microM were mixed and analyzed using high performance liquid chromatography. Samples of varying concentrations were then stored under 4 environmental conditions: 4 degrees C and protected from light, room temperature (RT) exposed to light, RT protected from light, and -20 degrees C and protected from light. The concentrations were measured every other month for 1 year. Actual concentrations of freshly prepared solutions were on average 88.3% of predicted. For solutions stored at 4 degrees C, there was a decrease only in the lower concentrations (0.5, 1, and 2 microM) after 2 months (P=0.003). Solutions stored at RT exposed to light decreased in concentration after 6 months (P=0.020), and solutions stored at RT protected from light decreased in concentration after 4 months (P=0.026). The group stored at -20 degrees C decreased in concentration after 1 year (P=0.033). We conclude that the actual concentration of capsaicin solution is less than predicted, and solutions of 4 microM or higher concentration are stable for 1 year if stored at 4 degrees C protected from light.

  17. Reflections on Klein's radical notion of phantasy and its implications for analytic practice.

    Science.gov (United States)

    Blass, Rachel B

    2017-06-01

    Analysts may incorporate many of Melanie Klein's important contributions (e.g., on preoedipal dynamics, envy, and projective identification) without transforming their basic analytic approach. In this paper I argue that adopting the Kleinian notion of unconscious phantasy is transformative. While it is grounded in Freud's thinking and draws out something essential to his work, this notion of phantasy introduces a radical change that defines Kleinian thinking and practice and significantly impacts the analyst's basic clinical approach. This impact and its technical implications in the analytic situation are illustrated and discussed. Copyright © 2017 Institute of Psychoanalysis.

  18. Boiling characteristics of dilute polymer solutions and implications for the suppression of vapor explosions

    Energy Technology Data Exchange (ETDEWEB)

    Bang, K.H.; Kim, M.H. [Univ. of Science and Technology, Pohang (Korea, Republic of)

    1995-09-01

    Quenching experiments of hot solid spheres in dilute aqueous solutions of polyethylene oxide polymer have been conducted for the purpose of investigating the physical mechanisms of the suppression of vapor explosions in this polymer solutions. Two spheres of 22.2mm and 9.5mm-diameter were tested in the polymer solutions of various concentrations at 30{degrees}C. Minimum film boiling temperature ({Delta}T{sub MFB}) in this highly-subcooled liquid rapidly decreased from over 700{degrees}c for pure water to about 150{degrees}C as the polymer concentration was increased up to 300ppm for 22.2mm sphere, and it decreased to 350{degrees}C for 9.5mm sphere. This rapid reduction of minimum film boiling temperature in the PEO aqueous solutions can explain its ability of the suppression of spontaneous vapor explosions. The ability of suppression of vapor explosions by dilute polyethylene oxide solutions against an external trigger pressure was tested by dropping molten tin into the polymer solutions at 25{degrees}C. It was observed that in 50ppm solutions more mass fragmented than in pure water, but produced weaker explosion pressures. The explosion was completely suppressed in 300ppm solutions with the external trigger. The debris size distributions of fine fragments smaller than 0.7mm were shown almost identical regardless of the polymer concentrations.

  19. Problems in the fingerprints based polycyclic aromatic hydrocarbons source apportionment analysis and a practical solution.

    Science.gov (United States)

    Zou, Yonghong; Wang, Lixia; Christensen, Erik R

    2015-10-01

    This work intended to explain the challenges of the fingerprints based source apportionment method for polycyclic aromatic hydrocarbons (PAH) in the aquatic environment, and to illustrate a practical and robust solution. The PAH data detected in the sediment cores from the Illinois River provide the basis of this study. Principal component analysis (PCA) separates PAH compounds into two groups reflecting their possible airborne transport patterns; but it is not able to suggest specific sources. Not all positive matrix factorization (PMF) determined sources are distinguishable due to the variability of source fingerprints. However, they constitute useful suggestions for inputs for a Bayesian chemical mass balance (CMB) analysis. The Bayesian CMB analysis takes into account the measurement errors as well as the variations of source fingerprints, and provides a credible source apportionment. Major PAH sources for Illinois River sediments are traffic (35%), coke oven (24%), coal combustion (18%), and wood combustion (14%). Copyright © 2015. Published by Elsevier Ltd.

  20. Tissue-Engineered Solutions in Plastic and Reconstructive Surgery: Principles and Practice.

    Science.gov (United States)

    Al-Himdani, Sarah; Jessop, Zita M; Al-Sabah, Ayesha; Combellack, Emman; Ibrahim, Amel; Doak, Shareen H; Hart, Andrew M; Archer, Charles W; Thornton, Catherine A; Whitaker, Iain S

    2017-01-01

    Recent advances in microsurgery, imaging, and transplantation have led to significant refinements in autologous reconstructive options; however, the morbidity of donor sites remains. This would be eliminated by successful clinical translation of tissue-engineered solutions into surgical practice. Plastic surgeons are uniquely placed to be intrinsically involved in the research and development of laboratory engineered tissues and their subsequent use. In this article, we present an overview of the field of tissue engineering, with the practicing plastic surgeon in mind. The Medical Research Council states that regenerative medicine and tissue engineering "holds the promise of revolutionizing patient care in the twenty-first century." The UK government highlighted regenerative medicine as one of the key eight great technologies in their industrial strategy worthy of significant investment. The long-term aim of successful biomanufacture to repair composite defects depends on interdisciplinary collaboration between cell biologists, material scientists, engineers, and associated medical specialties; however currently, there is a current lack of coordination in the field as a whole. Barriers to translation are deep rooted at the basic science level, manifested by a lack of consensus on the ideal cell source, scaffold, molecular cues, and environment and manufacturing strategy. There is also insufficient understanding of the long-term safety and durability of tissue-engineered constructs. This review aims to highlight that individualized approaches to the field are not adequate, and research collaboratives will be essential to bring together differing areas of expertise to expedite future clinical translation. The use of tissue engineering in reconstructive surgery would result in a paradigm shift but it is important to maintain realistic expectations. It is generally accepted that it takes 20-30 years from the start of basic science research to clinical utility

  1. Physician practice management companies: implications for hospital-based integrated delivery systems.

    Science.gov (United States)

    Burns, L R; Robinson, J C

    1997-01-01

    Physician practice management companies (PPMCs) are one of the most visible entrants into the industry of managing physician practices, and anywhere from 100-150 are already in operation. Although PPMCs and hospital-based integrated delivery systems (IDSs) differ from each other in many ways, they share a number of common features, including the pursuit of capitation contracts from payors. As a result, PPMCs pose a growing, direct threat to hospital systems in competing for managed care contracts that cover physician service. PPMCs also provide an alternative to hospital-based IDSs at the local market level for physician group consolidation. This article looks at the structure, operation, and strategy of PPMCs and examines what implications their growth will have for hospital-based IDSs.

  2. Future trends in health and health care: implications for social work practice in an aging society.

    Science.gov (United States)

    Spitzer, William J; Davidson, Kay W

    2013-01-01

    Major economic, political, demographic, social, and operational system factors are prompting evolutionary changes in health care delivery. Of particular significance, the "graying of America" promises new challenges and opportunities for health care social work. At the same time, the Patient Protection and Affordable Care Act of 2010, evolution of Accountable Care Organizations, and an emphasis on integrated, transdisciplinary, person-centered care represent fundamental shifts in service delivery with implications for social work practice and education. This article identifies the aging shift in American demography, its impact on health policy legislation, factors influencing fundamentally new service delivery paradigms, and opportunities of the profession to address the health disparities and care needs of an aging population. It underscores the importance of social work inclusion in integrated health care delivery and offers recommendations for practice education.

  3. Optimal use of video for teaching the practical implications of studying business information systems

    DEFF Research Database (Denmark)

    Fog, Benedikte; Ulfkjær, Jacob Kanneworff Stigsen; Schlichter, Bjarne Rerup

    that video should be introduced early during a course to prevent students’ misconceptions of working with business information systems, as well as to increase motivation and comprehension within the academic area. It is also considered of importance to have a trustworthy person explaining the practical......The study of business information systems has become increasingly important in the Digital Economy. However, it has been found that students have difficulties understanding the practical implications thereof and this leads to a motivational decreases. This study aims to investigate how to optimize...... not sufficiently reflect the theoretical recommendations of using video optimally in a management education. It did not comply with the video learning sequence as introduced by Marx and Frost (1998). However, it questions if the level of cognitive orientation activities can become too extensive. It finds...

  4. Interviewing children in custody cases: implications of research and policy for practice.

    Science.gov (United States)

    Saywitz, Karen; Camparo, Lorinda B; Romanoff, Anna

    2010-01-01

    Research on child interviewing has burgeoned over the past 25 years as expectations about children's agency, competence, and participation in society have changed. This article identifies recent trends in research, policy, and theory with implications for the practice of interviewing children in cases of contested divorce and for the weight to be given the information children provide. A number of fields of relevant research are identified, including studies of families who have participated in the family law system, studies of child witnesses in the field, experimental studies of the effects of interview techniques on children's memory and suggestibility, and ethnographic methods that elicit children's views of their own experiences. Finally, a set of 10 principles for practice are delineated based on the best available science. Copyright 2010 John Wiley & Sons, Ltd.

  5. Identifying Practical Solutions to Meet America’s Fiber Needs: Proceedings from the Food & Fiber Summit

    Directory of Open Access Journals (Sweden)

    Amy R. Mobley

    2014-07-01

    Full Text Available Fiber continues to be singled out as a nutrient of public health concern. Adequate intakes of fiber are associated with reduced risk for cardiovascular disease, cancer, diabetes, certain gastrointestinal disorders and obesity. Despite ongoing efforts to promote adequate fiber through increased vegetable, fruit and whole-grain intakes, average fiber consumption has remained flat at approximately half of the recommended daily amounts. Research indicates that consumers report increasingly attempting to add fiber-containing foods, but there is confusion around fiber in whole grains. The persistent and alarmingly low intakes of fiber prompted the “Food & Fiber Summit,” which assembled nutrition researchers, educators and communicators to explore fiber’s role in public health, current fiber consumption trends and consumer awareness data with the objective of generating opportunities and solutions to help close the fiber gap. The summit outcomes highlight the need to address consumer confusion and improve the understanding of sources of fiber, to recognize the benefits of various types of fibers and to influence future dietary guidance to provide prominence and clarity around meeting daily fiber recommendations through a variety of foods and fiber types. Potential opportunities to increase fiber intake were identified, with emphasis on meal occasions and food categories that offer practical solutions for closing the fiber gap.

  6. Identifying Practical Solutions to Meet America’s Fiber Needs: Proceedings from the Food & Fiber Summit

    Science.gov (United States)

    Mobley, Amy R.; Jones, Julie Miller; Rodriguez, Judith; Slavin, Joanne; Zelman, Kathleen M.

    2014-01-01

    Fiber continues to be singled out as a nutrient of public health concern. Adequate intakes of fiber are associated with reduced risk for cardiovascular disease, cancer, diabetes, certain gastrointestinal disorders and obesity. Despite ongoing efforts to promote adequate fiber through increased vegetable, fruit and whole-grain intakes, average fiber consumption has remained flat at approximately half of the recommended daily amounts. Research indicates that consumers report increasingly attempting to add fiber-containing foods, but there is confusion around fiber in whole grains. The persistent and alarmingly low intakes of fiber prompted the “Food & Fiber Summit,” which assembled nutrition researchers, educators and communicators to explore fiber’s role in public health, current fiber consumption trends and consumer awareness data with the objective of generating opportunities and solutions to help close the fiber gap. The summit outcomes highlight the need to address consumer confusion and improve the understanding of sources of fiber, to recognize the benefits of various types of fibers and to influence future dietary guidance to provide prominence and clarity around meeting daily fiber recommendations through a variety of foods and fiber types. Potential opportunities to increase fiber intake were identified, with emphasis on meal occasions and food categories that offer practical solutions for closing the fiber gap. PMID:25006857

  7. Practical Considerations for Determination of Glass Transition Temperature of a Maximally Freeze Concentrated Solution.

    Science.gov (United States)

    Pansare, Swapnil K; Patel, Sajal Manubhai

    2016-08-01

    Glass transition temperature is a unique thermal characteristic of amorphous systems and is associated with changes in physical properties such as heat capacity, viscosity, electrical resistance, and molecular mobility. Glass transition temperature for amorphous solids is referred as (T g), whereas for maximally freeze concentrated solution, the notation is (T g'). This article is focused on the factors affecting determination of T g' for application to lyophilization process design and frozen storage stability. Also, this review provides a perspective on use of various types of solutes in protein formulation and their effect on T g'. Although various analytical techniques are used for determination of T g' based on the changes in physical properties associated with glass transition, the differential scanning calorimetry (DSC) is the most commonly used technique. In this article, an overview of DSC technique is provided along with brief discussion on the alternate analytical techniques for T g' determination. Additionally, challenges associated with T g' determination, using DSC for protein formulations, are discussed. The purpose of this review is to provide a practical industry perspective on determination of T g' for protein formulations as it relates to design and development of lyophilization process and/or for frozen storage; however, a comprehensive review of glass transition temperature (T g, T g'), in general, is outside the scope of this work.

  8. ERRORS AND CORRECTIVE FEEDBACK IN WRITING: IMPLICATIONS TO OUR CLASSROOM PRACTICES

    Directory of Open Access Journals (Sweden)

    Maria Corazon Saturnina A Castro

    2017-10-01

    Full Text Available Error correction is one of the most contentious and misunderstood issues in both foreign and second language teaching. Despite varying positions on the effectiveness of error correction or the lack of it, corrective feedback remains an institution in the writing classes. Given this context, this action research endeavors to survey prevalent attitudes of teachers and students toward corrective feedback and examine their implications to classroom practices.  This paper poses the major problem:  How do teachers’ perspectives on corrective feedback match the students’ views and expectations about error treatment in their writing? Professors of the University of the Philippines who teach composition classes and over a hundred students enrolled in their classes were surveyed.  Results showed that there are differing perceptions of teachers and students regarding corrective feedback. These oppositions must be addressed as they have implications to current pedagogical practices which include constructing and establishing appropriate lesson goals, using alternative corrective strategies, teaching grammar points in class even in the tertiary level, and further understanding the learning process.

  9. Interactions between grape skin cell wall material and commercial enological tannins. Practical implications.

    Science.gov (United States)

    Bautista-Ortín, Ana Belén; Cano-Lechuga, Mario; Ruiz-García, Yolanda; Gómez-Plaza, Encarna

    2014-01-01

    Commercial enological tannins were used to investigate the role that cell wall material plays in proanthocyanidin adsorption. Insoluble cell wall material, prepared from the skin of Vitis vinifera L. cv. Monastrell berries, was combined with solutions containing six different commercial enological tannins (proanthocyanidin-type tannins). Analysis of the proanthocyanidins in the solution, after fining with cell wall material, using phloroglucinolysis and size exclusion chromatography, provided quantitative and qualitative information on the non-adsorbed compounds. Cell wall material showed strong affinity for the proanthocyanidins, one of the commercial tannins being bound up to 61% in the experiment. Comparison of the molecular mass distribution of the commercial enological tannins in solution, before and after fining, suggested that cell walls affinity for proanthocyanidins was more related with the proanthocyanidin molecular mass than with their percentage of galloylation. These interactions may have some enological implications, especially as regards the time of commercial tannins addition to the must/wine. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. Implications of current resident work-hour guidelines on the future practice of surgery in Canada.

    Science.gov (United States)

    Maruscak, Adam A; VanderBeek, Laura; Ott, Michael C; Kelly, Stephen; Forbes, Thomas L

    2012-01-01

    Work-hour restrictions have had a profound impact on surgical training. However, little is known of how work-hour restrictions may affect the future practice patterns of current surgical residents. The purpose of this study is to compare the anticipated career practice patterns of surgical residents who are training within an environment of work-hour restrictions with the current practice of faculty surgeons. An electronic survey was sent to all surgery residents and faculty at 2 Canadian university-affiliated medical centers. The survey consisted of questions regarding expected (residents) or current (faculty) practice patterns. A total of 149 residents and 125 faculty members completed the survey (50.3% and 52.3% response rates, respectively). A greater proportion of males were in the faculty cohort than in the resident group (77.6% vs 62.4%, p = 0.0003). More faculty than residents believed that work-hour restrictions have a negative impact on both residency education (40.8% vs 20.8%, p = 0.008) and preparation for a surgical career (56.8% vs 19.5%, p implications and might require larger surgical groups and reconsideration of resource allocation. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  11. Association of radionuclides with different molecular size fractions in soil solution: implications for plant uptake

    International Nuclear Information System (INIS)

    Nisbet, A.F.; Shaw, S.; Salbu, B.

    1993-01-01

    The feasibility of using hollow fibre ultrafiltration to determine the molecular size distribution of radionuclides in soil solution was investigated. The physical and chemical composition of soil plays a vital role in determining radionuclide uptake by plant roots. Soil solution samples were extracted from loam, peat and sand soils that had been artificially contaminated with 137 Cs, 90 Sr, 239 Pu and 241 Am six years previously as part of a five-year lysimeter study on radionuclide uptake to crops. Ultrafiltration of soil solution was performed using hollow fibre cartridges with a nominal molecular weight cut off of 3 and 10 kD. The association of 137 Cs, 90 Sr, 239 Pu and 241 Am with different molecular size fractions of the soil solution is discussed in terms of radionuclide bioavailability to cabbage grown in the same three soils. 137 Cs and 90 Sr were present in low molecular weight forms and as such were mobile in soil and potentially available for uptake by the cabbage. In contrast, a large proportion (61-87%) of the 239 Pu and 241 Am were associated with colloidal and high molecular weight material and therefore less available for uptake by plant roots. The contribution from low molecular weight species of 239 Pu and 241 Am to the total activity in soil solution decreased in the order loam ≥ peat ≥ sand. Association of radionuclides with low molecular weight species of less than 3 kD did not, however, automatically imply availability to plants. (author)

  12. Correctional officers' perceptions of a solution-focused training program: potential implications for working with offenders.

    Science.gov (United States)

    Pan, Peter Jen Der; Deng, Liang-Yu F; Chang, Shona Shih Hua; Jiang, Karen Jye-Ru

    2011-09-01

    The purpose of this exploratory study was to explore correctional officers' perceptions and experiences during a solution-focused training program and to initiate development of a modified pattern for correctional officers to use in jails. The study uses grounded theory procedures combined with a follow-up survey. The findings identified six emergent themes: obstacles to doing counseling work in prisons, offenders' amenability to change, correctional officers' self-image, advantages of a solution-focused approach (SFA), potential advantages of applying SFA to offenders, and the need for the consolidation of learning and transformation. Participants perceived the use of solution-focused techniques as appropriate, important, functional, and of only moderate difficulty in interacting with offenders. Finally, a modified pattern was developed for officers to use when working with offenders in jails. Suggestions and recommendations are made for correctional interventions and future studies.

  13. Factors that affect general practice as a choice of medical speciality: implications for policy development.

    Science.gov (United States)

    Vohra, Amit; Ladyshewsky, Richard; Trumble, Stephen

    2017-11-28

    Objective This article critically appraises the range of personal, professional and social factors that affect the choice of speciality across medical students, prevocational doctors, general practice registrars and general practitioners. Methods This qualitative study applied constructs from the fields of decision theory and career theory to better understand the complex nature of choosing a speciality. In all, 47 in-depth interviews were conducted with participants at different stages of their career cycle. The data was codified and analysed using NVivo to identify key factors that influenced speciality choice. Results The research identified 77 individual findings influencing general practice as a choice of medical speciality. These were distilled into a matrix to show that factors such as money, prestige and peer interaction did not have a compelling effect, whereas clinical and academic role models, flexibility, work-life balance, scope of practice, connection with patients, training environment and practical opportunities did. Conclusion The findings indicate that the decision in relation to the choice of medical speciality is a complex cognitive process that is undertaken within a personal, social and professional context particular to each individual. What is known about the topic? Current literature aims to quantify changes in attitudes towards choice of speciality or the effect of particular variables in isolation while ignoring the complexity of this decision process and how the numerous variables compare with each other. What does this paper add? The present study is the first intergenerational research on this topic in the Australian context and the paper dismisses the role of prestige and remuneration as key drivers of choice in picking general practice as a speciality, noting that money is merely a 'hygiene factor'. What are the implications for policy makers? A policy framework outlining 10 key principles is presented to assist policy makers seeking

  14. Tissue-Engineered Solutions in Plastic and Reconstructive Surgery: Principles and Practice

    Science.gov (United States)

    Al-Himdani, Sarah; Jessop, Zita M.; Al-Sabah, Ayesha; Combellack, Emman; Ibrahim, Amel; Doak, Shareen H.; Hart, Andrew M.; Archer, Charles W.; Thornton, Catherine A.; Whitaker, Iain S.

    2017-01-01

    Recent advances in microsurgery, imaging, and transplantation have led to significant refinements in autologous reconstructive options; however, the morbidity of donor sites remains. This would be eliminated by successful clinical translation of tissue-engineered solutions into surgical practice. Plastic surgeons are uniquely placed to be intrinsically involved in the research and development of laboratory engineered tissues and their subsequent use. In this article, we present an overview of the field of tissue engineering, with the practicing plastic surgeon in mind. The Medical Research Council states that regenerative medicine and tissue engineering “holds the promise of revolutionizing patient care in the twenty-first century.” The UK government highlighted regenerative medicine as one of the key eight great technologies in their industrial strategy worthy of significant investment. The long-term aim of successful biomanufacture to repair composite defects depends on interdisciplinary collaboration between cell biologists, material scientists, engineers, and associated medical specialties; however currently, there is a current lack of coordination in the field as a whole. Barriers to translation are deep rooted at the basic science level, manifested by a lack of consensus on the ideal cell source, scaffold, molecular cues, and environment and manufacturing strategy. There is also insufficient understanding of the long-term safety and durability of tissue-engineered constructs. This review aims to highlight that individualized approaches to the field are not adequate, and research collaboratives will be essential to bring together differing areas of expertise to expedite future clinical translation. The use of tissue engineering in reconstructive surgery would result in a paradigm shift but it is important to maintain realistic expectations. It is generally accepted that it takes 20–30 years from the start of basic science research to clinical utility

  15. Implications of leading crop production practices on environmental quality and human health.

    Science.gov (United States)

    Udeigwe, Theophilus K; Teboh, Jasper M; Eze, Peter N; Stietiya, M Hashem; Kumar, Vipan; Hendrix, James; Mascagni, Henry J; Ying, Teng; Kandakji, Tarek

    2015-03-15

    Globally, much weight is currently being placed on agriculture to provide food for the growing population as well as feedstock for the bioenergy industry. Unfortunately, the intensification of agricultural operations to satisfy these growing needs has been associated with a number of environmental and human health risks. A review of publications on the subject was conducted and emphasis was placed on articles focusing on agriculture, environment, and public health as well as their interactions. Supporting information was also gathered from publications of various agricultural and environmental agencies. Agricultural practices with potential negative implications on the environment and human health were identified broadly as: (a) utilization of biosolids and animal manures, (b) use of agricultural chemicals, (c) management of post-harvest residue, (d) irrigation, and (e) tillage operations. Soil, water, and air contamination by nutrients, heavy metals, pathogens, and pesticides, as well as air contamination by particulate matters, noxious gases, and pathogens were among the leading environmental impacts. Some of the human-health impacts identified included neurological and reproductive defects, cardiovascular risks, cancers and other diseases (of kidney, liver, lung, and skin), skin allergies, gastroenteritis, and methemoglobinemia. Continual awareness on the impacts of the reviewed agricultural practices on environmental quality and human health and the implementation of experimentally-backed best management practices in agricultural systems remain indispensable. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Informal care and the self-management partnership: implications for Australian health policy and practice.

    Science.gov (United States)

    Essue, Beverley M; Jowsey, Tanisha; Jeon, Yun-Hee; Mirzaei, Masoud; Pearce-Brown, Carmen L; Aspin, Clive; Usherwood, Tim P

    2010-11-01

    The Serious and Continuing Illness Policy and Practice Study (SCIPPS) aims to improve the care and support for patients with chronic illness and their family carers. Here we describe the carers' contribution to the self-management partnership and discuss the policy and practice implications that are relevant to improving the support available for informal care in Australia. A secondary analysis of SCIPPS data. Fourteen carers of patients between 45 and 85 years with chronic heart failure, chronic obstructive pulmonary disease and diabetes were conveniently sampled from western Sydney and the Australian Capital Territory. Semi-structured interviews were conducted. Data were analysed using qualitative content analysis. Key roles that carers perform in the self-management partnership included: home helper; lifestyle coach; advocate; technical care manager; and health information interpreter. Two negative consequences of juggling these roles included: self-neglect and conflict. Rigid eligibility criteria limit carers' access to essential support programs which underestimates and undervalues their contributions to the self-management partnership. Support services should focus on the development of practical skills to perform the caregiving roles. In addition, health professionals require support to work more effectively with carers to minimise the conflict that can overshadow the care and self-management partnership.

  17. Transport of fluid and solutes in the body II. Model validation and implications.

    Science.gov (United States)

    Gyenge, C C; Bowen, B D; Reed, R K; Bert, J L

    1999-09-01

    A mathematical model of short-term whole body fluid, protein, and ion distribution and transport developed earlier [see companion paper: C. C. Gyenge, B. D. Bowen, R. K. Reed, and J. L. Bert. Am. J. Physiol. 277 (Heart Circ. Physiol. 46): H1215-H1227, 1999] is validated using experimental data available in the literature. The model was tested against data measured for the following three types of experimental infusions: 1) hyperosmolar saline solutions with an osmolarity in the range of 2,000-2,400 mosmol/l, 2) saline solutions with an osmolarity of approximately 270 mosmol/l and composition comparable with Ringer solution, and 3) an isosmotic NaCl solution with an osmolarity of approximately 300 mosmol/l. Good agreement between the model predictions and the experimental data was obtained with respect to the trends and magnitudes of fluid shifts between the intra- and extracellular compartments, extracellular ion and protein contents, and hematocrit values. The model is also able to yield information about inaccessible or difficult-to-measure system variables such as intracellular ion contents, cellular volumes, and fluid fluxes across the vascular capillary membrane, data that can be used to help interpret the behavior of the system.

  18. Knowledge creation for practical solutions appropriate to a changing world of work

    Directory of Open Access Journals (Sweden)

    Wayne F. Cascio

    2001-12-01

    Full Text Available Only one, long-term sustainable source of competitive advantage exist: the intellectual capital that resides in the minds of people. The ongoing development of people as strategic assets is essential because of three defining forces of our time: globalisation, the information revolution, and the speed of change. Each of these forces is examined in the article against the backdrop of some important changes in the psychological contract. The challenge is to create knowledge for practical solutions, appropriate to a changing world of work. Opsomming Slegs een, lang termyn, standhoudende bron van mededingendheid bestaan: die intellektuele kapitaal wat in mense weggelê is. Die deurlopende ontwikkeling van mense as strategiese bate is noodsaaklik as gevolg van drie deurslaggewende, teenswoordige kragte: globalisering, die inligtingsrevolusie, en die spoed van verandering. Elk van hierdie kragte word bespreek in die artikel teen die agtergrond van beduidende verskuiwings in die sielkundige kontrak. Die uitdaging is om kennis vir praktiese oplossings te skep wat op ’n veranderende wêreld van werk van toepassing sal wees.

  19. Web GIS in practice VII: stereoscopic 3-D solutions for online maps and virtual globes

    Science.gov (United States)

    Boulos, Maged N.K.; Robinson, Larry R.

    2009-01-01

    Because our pupils are about 6.5 cm apart, each eye views a scene from a different angle and sends a unique image to the visual cortex, which then merges the images from both eyes into a single picture. The slight difference between the right and left images allows the brain to properly perceive the 'third dimension' or depth in a scene (stereopsis). However, when a person views a conventional 2-D (two-dimensional) image representation of a 3-D (three-dimensional) scene on a conventional computer screen, each eye receives essentially the same information. Depth in such cases can only be approximately inferred from visual clues in the image, such as perspective, as only one image is offered to both eyes. The goal of stereoscopic 3-D displays is to project a slightly different image into each eye to achieve a much truer and realistic perception of depth, of different scene planes, and of object relief. This paper presents a brief review of a number of stereoscopic 3-D hardware and software solutions for creating and displaying online maps and virtual globes (such as Google Earth) in "true 3D", with costs ranging from almost free to multi-thousand pounds sterling. A practical account is also given of the experience of the USGS BRD UMESC (United States Geological Survey's Biological Resources Division, Upper Midwest Environmental Sciences Center) in setting up a low-cost, full-colour stereoscopic 3-D system.

  20. Practical Solutions for Reducing Container Ships’ Waiting Times at Ports Using Simulation Model

    Institute of Scientific and Technical Information of China (English)

    Abdorreza Sheikholeslami; Gholamreza Ilati; Yones Eftekhari Yeganeh

    2013-01-01

    The main challenge for container ports is the planning required for berthing container ships while docked in port. Growth of containerization is creating problems for ports and container terminals as they reach their capacity limits of various resources which increasingly leads to traffic and port congestion. Good planning and management of container terminal operations reduces waiting time for liner ships. Reducing the waiting time improves the terminal’s productivity and decreases the port difficulties. Two important keys to reducing waiting time with berth allocation are determining suitable access channel depths and increasing the number of berths which in this paper are studied and analyzed as practical solutions. Simulation based analysis is the only way to understand how various resources interact with each other and how they are affected in the berthing time of ships. We used the Enterprise Dynamics software to produce simulation models due to the complexity and nature of the problems. We further present case study for berth allocation simulation of the biggest container terminal in Iran and the optimum access channel depth and the number of berths are obtained from simulation results. The results show a significant reduction in the waiting time for container ships and can be useful for major functions in operations and development of container ship terminals.

  1. The Golden Rule and its Consequences: A Practical and Effective Solution for World Peace

    Directory of Open Access Journals (Sweden)

    Zahra Rakhshani

    2017-02-01

    Full Text Available Peace is something desirable and requested by all nations in the world. What makes it necessary to address this issue is the critical, undesirable state of the current world that, despite statements by international organizations with the theme of peace, reveals growing conflict and war and irreversible damages caused by them. This article seeks to provide a practical and effective solution for achieving peace in the global community. To this end, it introduces the golden rule (treating others as you wish others to treat you as a rule common to all nations. This rule which has a special place in moral philosophy and has been the common denominator of all religions and schools of thought from ancient times until the present provides peace throughout the world through its mechanism. With the use of analytical methods, this study examines and explains it. The results show that the most effective and powerful way to achieve world peace is the adherence to the golden rule.

  2. Clinical neurofeedback: case studies, proposed mechanism, and implications for pediatric neurology practice.

    Science.gov (United States)

    Legarda, Stella B; McMahon, Doreen; Othmer, Siegfried; Othmer, Sue

    2011-08-01

    Trends in alternative medicine use by American health care consumers are rising substantially. Extensive literature exists reporting on the effectiveness of neurofeedback in the treatment of autism, closed head injury, insomnia, migraine, depression, attention deficit hyperactivity disorder, epilepsy, and posttraumatic stress disorder. We speculated that neurofeedback might serve as a therapeutic modality for patients with medically refractory neurological disorders and have begun referring patients to train with clinical neurofeedback practitioners. The modality is not always covered by insurance. Confident their child's medical and neurological needs would continue to be met, the parents of 3 children with epilepsy spectrum disorder decided to have their child train in the modality. The children's individual progress following neurofeedback are each presented here. A proposed mechanism and practice implications are discussed.

  3. Teacher education policies, practices, and reform in Scotland: Implications in the Indian context

    Directory of Open Access Journals (Sweden)

    Pradeep Kumar Misra

    2015-12-01

    Full Text Available India, a country of 1.27 billion, nowadays needs reforms, improvements, and new approaches in teacher education to cater to the demands of changing economy and society. This call to improve teacher education becomes more significant considering the fact that 50% of India’s current population is below the age of 25 and over 65% below 35. There are two ways to proceed in this direction. First, making an internal review and assessment of present scenario of teacher education and suggesting need-based measures. The second one is to learn from those countries that have recently reviewed their teacher education systems and are continuously working for the betterment of teacher education. Following second approach, present paper analyzes teacher education policies, practices, and reform in Scotland, argues that concerns and commitments to reform teacher education in India and Scotland are similar, and suggests implications of Scottish experiences in the Indian context.

  4. State Definitions of Social Work Practice: Implications for our Professional Identity.

    Science.gov (United States)

    Hill, Katharine; Fogel, Sondra; Plitt Donaldson, Linda; Erickson, Christina

    2017-01-01

    For over a century, the social work profession has been concerned with describing the unique and specific characteristics that define its core functions in society; however, the profession has yet to agree to a single definition of social work. In the absence of a unifying definition, 51 different statutory definitions of social work have been created by each state and the District of Columbia. Using qualitative methods, each statutory definition of social work was analyzed to gain an understanding of how social work is defined and understood across the United States. Findings indicate that 57% of the statutory language blend the full range of micro to macro social work practice skills into their definition. However, even within these and those remaining, there are vast differences in definitions. Implications for state licensing laws, are considered, along with how this impacts education, the work force, and professional identity.

  5. Implications of American Indian gambling for social work research and practice.

    Science.gov (United States)

    Momper, Sandra L

    2010-04-01

    Since the 1988 passage of the Indian Gaming and Regulatory Act (IGRA), American Indian tribal communities have rapidly opened up casinos. American Indian participation in recreational gambling has increased, resulting in an increase in problem and pathological gambling. However, increased revenues from gaming have significantly benefited tribes. Background information on the Supreme Court case that led to passage of the IGRA and subsequently the opening of casinos on Indian reservations is provided. Data are presented on American Indian gambling studies that explore the impact of gambling on the development of problem or pathological gambling among American Indians. Reports and data are presented on the effects of gambling on the socioeconomic development of tribal communities. The implications of American Indian gaming for social work research and practice are discussed.

  6. On some practical implications of the recent EU-directive on radiation protection

    International Nuclear Information System (INIS)

    Tschurlovits, M

    1998-01-01

    The following practical implications of the EU 96 directive on radiation protection in Austria are discussed: Quantitative justification and optimization of the recent standards is needed. The reduction of the annual dose limit to 20 mSv will affect a very small percentage of the persons subject to monitoring. The reduction of dose limits in external exposure of the population will not be dramatic at all. The model used to set up limits for internal exposure was changed to single intake; this implies some changes in design and monitoring. The deletion of convenient figures for 'unknown' radionuclides will make environmental and release monitoring more complex without gaining a higher level of protection. (A.K.)

  7. The socio-materiality of learning practices and implications for the field of learning technology

    Directory of Open Access Journals (Sweden)

    Aditya Johri

    2011-12-01

    Full Text Available Although the use of digital information technologies in education has becomecommonplace, there are few, if any, central guiding frameworks or theories thatexplicate the relationship between technology and learning practices. In thispaper, I argue that such a theoretical framework can assist scholars and practitionersalike by working as a conduit to study and design learning technologies.Towards this goal, I propose socio-materiality as a key theoretical construct withvaluable insights and implications for the field of learning technology. Sociomaterialityhelps balance the disproportionate attention given to either the socialimplications of technology use or the material aspects of technology design.Furthermore, I forward ‘socio-material bricolage' as a useful analytical frameworkto examine and design technology-infused learning environments. I illustratethe value of the framework by applying it to three case studies of formaland informal technology-based learning.

  8. The hypothesis of a continuum in suicidality: a discussion on its validity and practical implications

    Directory of Open Access Journals (Sweden)

    Jerneja Sveticic

    2012-07-01

    Full Text Available The idea of a progression in suicide phenomena, from death wishes to suicide attempts and completed suicides, is quite old and widely present in literature. This model of interpreting suicidality has great relevance in preventative approaches, since it gives the opportunity of intercepting suicidal trajectories at several different stages. However, this may not be the case for many situations, and the hypothesis of a continuum can be true only in a limited number of cases, probably embedded with a specific psychopathological scenario (e.g. depression and with a frequency that should not permit generalisations. This paper reviews the available evidence about the existence and validity of this construct, and discusses its practical implications.

  9. Patient acceptability and practical implications of pharmacokinetic studies in patients with advanced cancer.

    Science.gov (United States)

    Dobbs, N A; Twelves, C J; Ramirez, A J; Towlson, K E; Gregory, W M; Richards, M A

    1993-01-01

    We have studied the practical implications and acceptability to patients of pharmacokinetic studies in 34 women receiving anthracyclines for advanced breast cancer. The following parameters were recorded: age, ECOG performance status, psychological state (Rotterdam Symptom Checklist), cytotoxic drug and dose, number of venepunctures for treatment and sampling, and time when the sampling cannula was removed. Immediately after finishing pharmacokinetic sampling, patients completed a questionnaire which revealed that (i) all patients understood sampling was for research, (ii) 35% of patients experienced problems with sampling, (iii) benefits from participation were perceived by 56% of patients. Of 20 patients later questioned after completion of their treatment course, 40% recalled difficulties with blood sampling. Factors identifying in advance those patients who tolerate pharmacokinetic studies poorly were not identified but the number of venepunctures should be minimised. Patients may also perceive benefits from 'non-therapeutic' research.

  10. 1251 seed calibration using afterloading equipment SeedSelectron. Practical solution to meet the recommendations of the AAPM

    International Nuclear Information System (INIS)

    Perez-Calatayud, J.; Richart, J.; Perez-Garcia, J.; Guirado, D.; Ballester, F.; Rodriguez, S.; Santos, M.; Depiaggio, M.; Carmona, V.; Lliso, F.; Camacho, C.; Pujades, M. C.

    2011-01-01

    SeedSelectron is a system used in the afterloader permanent implant brachytherapy seeds 1-125 interstitial prostate. Two aspects are critical when you can meet the recommendations of the AAPM: a practical difficulty to check the quantity of seed required, and the great uncertainty of all measured diodes. The purpose of this paper is to present a practical solution that has been adopted to implement the recommendations of the AAPM

  11. Black Truffle Harvesting in Spanish Forests: Trends, Current Policies and Practices, and Implications on its Sustainability

    Science.gov (United States)

    Garcia-Barreda, Sergi; Forcadell, Ricardo; Sánchez, Sergio; Martín-Santafé, María; Marco, Pedro; Camarero, J. Julio; Reyna, Santiago

    2018-04-01

    The European black truffle is a mycorrhizal fungus native to Spanish Mediterranean forests. In most Spanish regions it was originally commercially harvested in the second half of the 20th century. Experts agree that wild truffle yields suffered a sharp decline during the 1970s and 1980s. However, official statistics for Spanish harvest are scarce and seemingly conflicting, and little attention has been paid to the regime for the exploitation of truffle-producing forests and its implications on the sustainability of this resource. Trends in harvest from 1969 to 2013 and current harvesting practices were analyzed as a case study, taking into account that Spain is a major truffle producer worldwide, but at the same time truffles have only recently been exploited. The available statistical sources, which include an increasing proportion of cultivated truffles since the mid-1990s, were explored, with estimates from Truffle Harvesters Federation showing higher consistency. Statistical sources were then compared with proxies for wild harvest (rents from truffle leases in public forests) to corroborate time trends in wild harvesting. Results suggest that black truffle production is recovering in recent years thanks to plantations, whereas wild harvest is still declining. The implications of Spanish legal and institutional framework on sustainability of wild truffle use are reviewed. In the current scenario, the decline of wild harvest is likely to continue and eventually make commercial harvesting economically unattractive, thus aggravating sustainability issues. Strengthening of property rights, rationalization of harvesting pressure, forest planning and involvement of public stakeholders are proposed as corrective measures.

  12. Female science teacher beliefs and attitudes: implications in relation to gender and pedagogical practice

    Science.gov (United States)

    Zapata, Mara; Gallard, Alejandro J.

    2007-10-01

    Beliefs and attitudes resulting from the unique life experiences of teachers frame interactions with learners promoting gender equity or inequity and the reproduction of social views about knowledge and power as related to gender. This study examines the enactment of a female science teacher's pedagogy (Laura), seeking to understand the implications of her beliefs and attitudes, as framed by her interpretations and daily manifestations, as she interacts with students. Distinct influences inform the conceptual framework of this study: (a) the social organization of society at large, governed by understood and unspoken patriarchy, present both academically and socially; (b) the devaluing of women as "knowers" of scientific knowledge as defined by a western and male view of science; (c) the marginalization or "feminization" of education and pedagogical knowledge. The findings reflect tensions between attitudes and beliefs and actual teacher practice suggesting the need for awareness within existing or new teachers about their positions as social agents and the sociological implications related to issues of gender within which we live and work, inclusive of science teaching and learning.

  13. The practice and clinical implications of tablet splitting in international health

    Science.gov (United States)

    Elliott, Ivo; Mayxay, Mayfong; Yeuichaixong, Sengchanh; Lee, Sue J; Newton, Paul N

    2014-01-01

    Objective Tablet splitting is frequently performed to facilitate correct dosing, but the practice and implications in low-income settings have rarely been discussed. Methods We selected eight drugs, with narrow therapeutic indices or critical dosages, frequently divided in the Lao PDR (Laos). These were split, by common techniques used in Laos, by four nurses and four laypersons. The mean percentage deviation from the theoretical expected weight and weight loss of divided tablets/capsules were recorded. Results Five of eight study drugs failed, on splitting, to meet European Pharmacopoeia recommendations for tablet weight deviation from the expected weight of tablet/capsule halves with 10% deviating by more than 25%. There was a significant difference in splitting accuracy between nurses and laypersons (P = 0.027). Coated and unscored tablets were less accurately split than uncoated (P = 0.03 and 0.0019 for each half) and scored (0.0001 for both halves) tablets. Conclusion These findings have potential clinical implications on treatment outcome and the development of antimicrobial resistance. Investment by drug companies in a wider range of dosage units, particularly for narrow therapeutic index and critical dosage medicines, is strongly recommended. PMID:24702766

  14. Implications of Derived Rule Following of Roulette Gambling for Clinical Practice.

    Science.gov (United States)

    Wilson, Alyssa N; Grant, Tara

    2015-05-01

    Problem gambling is a global concern, and behavior analytic attention has increasingly focused on reasons for why problem gambling occurs and conditions under which it is maintained. However, limited knowledge currently exists on the process to which self-generated rules maintain gambling behaviors. Therefore, the current study assessed six recreational gamblers on a roulette game before and after discrimination training to establish a self-rule to wager on red or black. Following discrimination training, all six participants altered their response allocation among red or black and consistently responded according to the newly derived self-rule. Results maintained during 1-week follow-up sessions across all participants. Implications for clinical application of self-awareness and self-generated rule following are discussed. Implications for practice • Demonstration of how stimuli such as color can alter gambling behavior • Procedures to assist clients with changing self-rules about gambling behavior • Using self-generated rule formulation for more contextually appropriate target behaviors • Highlights how self-generated rules can be altered to change clinical target behaviors.

  15. Food beliefs and practices in urban poor communities in Accra: implications for health interventions.

    Science.gov (United States)

    Boatemaa, Sandra; Badasu, Delali Margaret; de-Graft Aikins, Ama

    2018-04-02

    Poor communities in low and middle income countries are reported to experience a higher burden of chronic non-communicable diseases (NCDs) and nutrition-related NCDs. Interventions that build on lay perspectives of risk are recommended. The objective of this study was to examine lay understanding of healthy and unhealthy food practices, factors that influence food choices and the implications for developing population health interventions in three urban poor communities in Accra, Ghana. Thirty lay adults were recruited and interviewed in two poor urban communities in Accra. The interviews were audio-taped, transcribed and analysed thematically. The analysis was guided by the socio-ecological model which focuses on the intrapersonal, interpersonal, community, structural and policy levels of social organisation. Food was perceived as an edible natural resource, and healthy in its raw state. A food item retained its natural, healthy properties or became unhealthy depending on how it was prepared (e.g. frying vs boiling) and consumed (e.g. early or late in the day). These food beliefs reflected broader social food norms in the community and incorporated ideas aligned with standard expert dietary guidelines. Healthy cooking was perceived as the ability to select good ingredients, use appropriate cooking methods, and maintain food hygiene. Healthy eating was defined in three ways: 1) eating the right meals; 2) eating the right quantity; and 3) eating at the right time. Factors that influenced food choice included finances, physical and psychological state, significant others and community resources. The findings suggest that beliefs about healthy and unhealthy food practices are rooted in multi-level factors, including individual experience, family dynamics and community factors. The factors influencing food choices are also multilevel. The implications of the findings for the design and content of dietary and health interventions are discussed.

  16. Glass-surface area to solution-volume ratio and its implications to accelerated leach testing

    International Nuclear Information System (INIS)

    Pederson, L.R.; Buckwalter, C.Q.; McVay, G.L.; Riddle, B.L.

    1982-10-01

    The value of glass surface area to solution volume ratio (SA/V) can strongly influence the leaching rate of PNL 76-68 glass. The leaching rate is largely governed by silicon solubility constraints. Silicic acid in solution reduced the elemental release of all glass components. No components are leached to depths greater than that of silicon. The presence of the reaction layer had no measurable effect on the rate of leaching. Accelerated leach testing is possible since PNL 76-68 glass leaching is solubility-controlled (except at very low SA/V values). A series of glasses leached with SA/V x time = constant will yield identical elemental release

  17. Caffeine's implications for women's health and survey of obstetrician-gynecologists' caffeine knowledge and assessment practices.

    Science.gov (United States)

    Anderson, Britta L; Juliano, Laura M; Schulkin, Jay

    2009-09-01

    Caffeine has relevance for women's health and pregnancy, including significant associations with spontaneous abortion and low birth weight. According to scientific data, pregnant women and women of reproductive age should be advised to limit their caffeine consumption. This article reviews the implications of caffeine for women's psychological and physical health, and presents data on obstetrician-gynecologists' (ob-gyns) knowledge and practices pertaining to caffeine. Ob-gyns (N = 386) who are members of the American College of Obstetricians and Gynecologists' Collaborative Ambulatory Research Network responded to a 21-item survey about caffeine. Although most knew that caffeine is passed through breast milk, only 24.8% were aware that caffeine metabolism significantly slows as pregnancy progresses. Many respondents were not aware of the caffeine content of commonly used products, such as espresso and Diet Coke, with 14.3% and 57.8% indicating amounts within an accurate range, respectively. Furthermore, ob-gyns did not take into account large differences in caffeine content across different caffeinated beverages with most recommending one to two servings of coffee or tea or soft drinks per day. There was substantial inconsistency in what was considered to be "high levels" of maternal caffeine consumption, with only 31.6% providing a response. When asked to indicate the risk that high levels of caffeine have on various pregnancy outcomes, responses were not consistent with scientific data. For example, respondents overestimated the relative risk of stillbirths and underestimated the relative risk of spontaneous abortion. There was great variability in assessment and advice practices pertaining to caffeine. More than half advise their pregnant patients to consume caffeine under certain circumstances, most commonly to alleviate headache and caffeine withdrawal. The data suggest that ob-gyns could benefit from information about caffeine and its relevance to their

  18. A model of fluid and solute exchange in the human: validation and implications.

    Science.gov (United States)

    Bert, J L; Gyenge, C C; Bowen, B D; Reed, R K; Lund, T

    2000-11-01

    In order to understand better the complex, dynamic behaviour of the redistribution and exchange of fluid and solutes administered to normal individuals or to those with acute hypovolemia, mathematical models are used in addition to direct experimental investigation. Initial validation of a model developed by our group involved data from animal experiments (Gyenge, C.C., Bowen, B.D., Reed, R.K. & Bert, J.L. 1999b. Am J Physiol 277 (Heart Circ Physiol 46), H1228-H1240). For a first validation involving humans, we compare the results of simulations with a wide range of different types of data from two experimental studies. These studies involved administration of normal saline or hypertonic saline with Dextran to both normal and 10% haemorrhaged subjects. We compared simulations with data including the dynamic changes in plasma and interstitial fluid volumes VPL and VIT respectively, plasma and interstitial colloid osmotic pressures PiPL and PiIT respectively, haematocrit (Hct), plasma solute concentrations and transcapillary flow rates. The model predictions were overall in very good agreement with the wide range of experimental results considered. Based on the conditions investigated, the model was also validated for humans. We used the model both to investigate mechanisms associated with the redistribution and transport of fluid and solutes administered following a mild haemorrhage and to speculate on the relationship between the timing and amount of fluid infusions and subsequent blood volume expansion.

  19. Exploration of DGVM Parameter Solution Space Using Simulated Annealing: Implications for Forecast Uncertainties

    Science.gov (United States)

    Wells, J. R.; Kim, J. B.

    2011-12-01

    Parameters in dynamic global vegetation models (DGVMs) are thought to be weakly constrained and can be a significant source of errors and uncertainties. DGVMs use between 5 and 26 plant functional types (PFTs) to represent the average plant life form in each simulated plot, and each PFT typically has a dozen or more parameters that define the way it uses resource and responds to the simulated growing environment. Sensitivity analysis explores how varying parameters affects the output, but does not do a full exploration of the parameter solution space. The solution space for DGVM parameter values are thought to be complex and non-linear; and multiple sets of acceptable parameters may exist. In published studies, PFT parameters are estimated from published literature, and often a parameter value is estimated from a single published value. Further, the parameters are "tuned" using somewhat arbitrary, "trial-and-error" methods. BIOMAP is a new DGVM created by fusing MAPSS biogeography model with Biome-BGC. It represents the vegetation of North America using 26 PFTs. We are using simulated annealing, a global search method, to systematically and objectively explore the solution space for the BIOMAP PFTs and system parameters important for plant water use. We defined the boundaries of the solution space by obtaining maximum and minimum values from published literature, and where those were not available, using +/-20% of current values. We used stratified random sampling to select a set of grid cells representing the vegetation of the conterminous USA. Simulated annealing algorithm is applied to the parameters for spin-up and a transient run during the historical period 1961-1990. A set of parameter values is considered acceptable if the associated simulation run produces a modern potential vegetation distribution map that is as accurate as one produced by trial-and-error calibration. We expect to confirm that the solution space is non-linear and complex, and that

  20. Bariatric surgery and the changing current scope of general surgery practice: implications for general surgery residency training.

    Science.gov (United States)

    Mostaedi, Rouzbeh; Ali, Mohamed R; Pierce, Jonathan L; Scherer, Lynette A; Galante, Joseph M

    2015-02-01

    The scope of general surgery practice has evolved tremendously in the last 20 years. However, clinical experience in general surgery residency training has undergone relatively little change. To evaluate the current scope of academic general surgery and its implications on surgical residency. The University HealthSystem Consortium and Association of American Medical Colleges established the Faculty Practice Solution Center (FPSC) to characterize physician productivity. The FPSC is a benchmarking tool for academic medical centers created from revenue data collected from more than 90,000 physicians who practice at 95 institutions across the United States. The FPSC database was queried to evaluate the annual mean procedure frequency per surgeon (PFS) in each calendar year from 2006 through 2011. The associated work relative value units (wRVUs) were also examined to measure physician effort and skill. During the 6-year period, 146 distinct Current Procedural Terminology codes were among the top 100 procedures, and 16 of these procedures ranked in the top 10 procedures in at least 1 year. The top 10 procedures accounted for more than half (range, 52.5%-57.2%) of the total 100 PFS evaluated for each year. Laparoscopic Roux-en-Y gastric bypass was consistently among the top 10 procedures in each year (PFS, 18.2-24.6). The other most frequently performed procedures included laparoscopic cholecystectomy (PFS, 30.3-43.5), upper gastrointestinal tract endoscopy (PFS, 26.5-34.3), mastectomy (PFS, 16.5-35.0), inguinal hernia repair (PFS, 15.5-22.1), and abdominal wall hernia repair (PFS, 21.6-26.1). In all years, laparoscopic Roux-en-Y gastric bypass generated the highest number of wRVUs (wRVUs, 491.0-618.2), and laparoscopic cholecystectomy was regularly the next highest (wRVUs, 335.8-498.7). A significant proportion of academic general surgery is composed of bariatric surgery, yet surgical training does not sufficiently emphasize the necessary exposure to technical expertise

  1. The solicitation of an undue advantage: theoretical and practical problems caused by the legislative virus, and their comprehensive solution

    Directory of Open Access Journals (Sweden)

    Василь Миколайович Киричко

    2018-03-01

    The solution to the theoretical and practical problems caused by the specified virus is possible only by introducing several changes to the system of the Criminal Code of Ukraine. Projects of such changes are developed by the author and reflected in the publication. In case of their adoption, the specified legislative virus will be completely eliminated.

  2. Bioavailability and ecotoxicity of arsenic species in solution culture and soil system: implications to remediation.

    Science.gov (United States)

    Bolan, Nanthi; Mahimairaja, Santiago; Kunhikrishnan, Anitha; Seshadri, Balaji; Thangarajan, Ramya

    2015-06-01

    In this work, bioavailability and ecotoxicity of arsenite (As(III)) and arsenate (As(V)) species were compared between solution culture and soil system. Firstly, the adsorption of As(III) and As(V) was compared using a number of non-allophanic and allophanic soils. Secondly, the bioavailability and ecotoxicity were examined using germination, phytoavailability, earthworm, and soil microbial activity tests. Both As-spiked soils and As-contaminated sheep dip soils were used to test bioavailability and ecotoxicity. The sheep dip soil which contained predominantly As(V) species was subject to flooding to reduce As(V) to As(III) and then used along with the control treatment soil to compare the bioavailability between As species. Adsorption of As(V) was much higher than that of As(III), and the difference in adsorption between these two species was more pronounced in the allophanic than non-allophanic soils. In the solution culture, there was no significant difference in bioavailability and ecotoxicity, as measured by germination and phytoavailability tests, between these two As species. Whereas in the As-spiked soils, the bioavailability and ecotoxicity were higher for As(III) than As(V), and the difference was more pronounced in the allophanic than non-allophanic soils. Bioavailability of As increased with the flooding of the sheep dip soils which may be attributed to the reduction of As(V) to As(III) species. The results in this study have demonstrated that while in solution, the bioavailability and ecotoxicity do not vary between As(III) and As(V), in soils, the latter species is less bioavailable than the former species because As(V) is more strongly retained than As(III). Since the bioavailability and ecotoxicity of As depend on the nature of As species present in the environment, risk-based remediation approach should aim at controlling the dynamics of As transformation.

  3. Practical implications of ICRP26 for recording and regulation of radiation exposure

    International Nuclear Information System (INIS)

    Ward, F.A.; Woodhouse, J.A.; Kennedy, J.W.

    1982-01-01

    The paper compares the system of dose limitation recommended in ICRP Publication 26 with that based upon previous ICRP Publications upon which the current United Kingdom Legislation is based. Particular attention is given to the implication of the place given to the concept of committed dose in the system of dose limitation. The present dosimetry procedures in use within British Nuclear Fuels Ltd are outlined together with their practical limitations, and attention is drawn to the particular technical problems associated with plutonium uptake assessments. A number of other practical issues are identified such as dose records and the supplementary dose information which would require recording and the need for the re-education of employees in the new control concepts. A proposal is presented for internal dose recording based initially upon environmental measurements but subject to subsequent modification by preferred assessments based upon in-vivo and urinalysis techniques. Finally an assessment and, where appropriate, suspension procedure is proposed to control long-term exposure arising from plutonium intakes based upon an averaging period of 15 years. (author)

  4. [Network clusters of symptoms as elementary syndromes of psychopathology: implications for clinical practice].

    Science.gov (United States)

    Goekoop, R; Goekoop, J G

    2016-01-01

    In a recent publication we reported the existence of around 11 (to 15) 'elementary syndromes' that may combine in various ways, rather like 'building blocks', to explain the wide range of psychiatric symptoms. 'Bridge symptoms' seem to be responsible both for combining large sets of symptoms into elementary syndromes and for combining the various elementary syndromes to form one globally connected network structure. To discuss the implication of these findings for clinical practice. We performed a network analysis of symptom scores. Elementary syndromes provide a massive simplification of the description of psychiatric disease. Instead of the more than 300 categories in DSM-5, we now need to consider only a handful of elementary syndromes and personality domains. This modular representation of psychiatric illnesses allows us to make a complete, systematic and efficient assessment of patients and a systematic review of treatment options. Clinicians, patients, managerial staff and insurance companies can verify whether symptom reduction is taking place in the most important domains of psychopathology. Unlike classic multidimensional methods of disease description, network models of psychopathology can be used to explain comorbidity patterns, predict the clinical course of psychopathology and to designate primary targets for therapeutic interventions. A network view on psychopathology could significantly improve everyday clinical practice.

  5. Narrative in interprofessional education and practice: implications for professional identity, provider-patient communication and teamwork.

    Science.gov (United States)

    Clark, Phillip G

    2014-01-01

    Health and social care professionals increasingly use narrative approaches to focus on the patient and to communicate with each other. Both effective interprofessional education (IPE) and practice (IPP) require recognizing the various values and voices of different professions, how they relate to the patient's life story, and how they interact with each other at the level of the healthcare team. This article analyzes and integrates the literature on narrative to explore: self-narrative as an expression of one's professional identity; the co-creation of the patient's narrative by the professional and the patient; and the interprofessional multi-vocal narrative discourse as co-constructed by members of the healthcare team. Using a narrative approach to thinking about professional identity, provider-patient communication, and interprofessional teamwork expands our thinking about both IPE and IPP by providing new insights into the nature of professional practice based on relationships to oneself, the patient, and others on the team. How professionals define themselves, gather and present information from the patient, and communicate as members of a clinical team all have important dimensions that can be revealed by a narrative approach. Implications and conclusions for the further development of the narrative approach in IPE and IPP are offered.

  6. Interrogating the Contested Spaces of Rural Aging: Implications for Research, Policy, and Practice.

    Science.gov (United States)

    Skinner, Mark W; Winterton, Rachel

    2018-01-18

    Informed by a critical turn underway in rural gerontology, this article explores how the intersection of global and local trends relating to population aging and rural change create contested spaces of rural aging. The aim is to build our understanding of rural as a dynamic context within which the processes, outcomes, and experiences of aging are created, confronted, and contested by older adults and their communities. A review of key developments within gerontology and rural studies reveals how competing policies, discourses, and practices relating to healthy aging and aging in place, rural citizenship and governmentality, and social inclusion and inequality combine in particular ways to empower or disempower a diverse range of older rural adults aging in a diverse range of rural communities. The article provides a contextually sensitive perspective on potential sources of conflict and exclusion for older adults in dynamic rural spaces and further enhances our understanding of how rural physical and social environments are constructed and experienced in older age. A framework for interrogating emergent questions about aging in rural contexts is developed and implications for advancing research, policy, and practice are discussed. © The Author(s) 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Implications of RDoC for the research and practice of psychotherapy.

    Science.gov (United States)

    Hershenberg, Rachel; Goldfried, Marvin R

    2015-03-01

    The field of psychotherapy is at an important juncture. Recent changes in the field include (a) the skeptical reception of the fifth edition of the Diagnostic and Statistical Manual and (b) NIMH's prioritization of an alternative classification system to guide translational and intervention research. Moreover, (c) the field continues to be held accountable to governmental agencies and third-party payers to demonstrate its empirical basis. Thus, psychological research as it relates to the practice of psychotherapy is at a crossroads. In this article, we provide a brief overview of several generations of psychotherapy outcome research, including the consequences that followed in the 1980s as psychotherapy research moved toward randomized controlled trials for clinical disorders. We delineate the inherent strengths and limitations of this movement and address how the NIMH has recently responded with the Research Domain Criteria (RDoC). We then address philosophical and practical implications of the emphasis on a neuroscientific conceptualization of psychological problems. Finally, we discuss opportunities for a next generation of convergent science that incorporates, rather than replaces, psychosocial variables across stages of translational research and treatment development. Copyright © 2014. Published by Elsevier Ltd.

  8. Technological Implications of Supply Chain Practices in Agri-Food Sector: A Review

    Directory of Open Access Journals (Sweden)

    Rahul Mor

    2015-08-01

    Full Text Available Today, the global business environment compels enterprises to consider rest of the world in their competitive strategy analysis where firms ignore external factors such as economic trends, competitive positions or technology advancement in other countries. While going truly global with supply chain management, a company develops product in the United States, produce in India and trade in Europe, and they have changed the traditional operation management & logistical activities. This change in trade and the modernization of transport infrastructures have elevated the importance of flow management to new levels. Manufacturers and researchers have noticed many problems concerning supply chain activities, and usually either a system or subcomponent in supply chains is discussed in the literature, but they fails to answer the rational (why, what, how behind them. This paper addresses a review of the principles, bottlenecks and strategies of supply chain practices for organizations with an emphasis on the implications of Indian agri-food sector. Findings of this review reveal that the human & environmental issues, improved product visibility, food safety/quality and the associated economic benefits in sustainable agri-food supply chains can be achieved through innovation, collaboration, elimination of uncertainties and introducing global SCM practices into green & lean initiatives.

  9. EDUCATIONAL POLICIES AND PRACTICAL IMPLICATIONS FOR CHILDREN WITH INTELLECTUAL DISABILITY IN REPUBLIC OF MACEDONIA

    Directory of Open Access Journals (Sweden)

    Aleksandra Karovska Ristovska

    2017-12-01

    Full Text Available Educational policy for children with intellectual disability in Republic of Macedonia is not always consistent with the practical implications. The subject of this research was to gain an insight into the current condition of the persons with intellectual disabilities in Macedonia, before all an insight into the barriers that they are facing in their attempts to access educational information and services. This was done through conducting a qualitative (desk-top analyses of the national legislations; semi-structured interviews with parents of persons with intellectual disabilities and focus groups with relevant stakeholders and a quantitative research (quality of life research for the disabled persons. In the research a total number of 213 examinees were included. As in many other cases, and in many other countries, policy and practice are not always coherent. Legislation in the area of education in our country has to be modified and accommodated to the needs of the persons with disabilities and their parents or care-givers. The final conclusion from our research is that the persons with ID are still on the margins of society, and they lead everyday battles to prove that their needs must be taken into consideration in context of their human rights. Although awareness for the importance of the rightful treatment of this problem is not on a satisfactory level, still we can notice a shift in perception and liberation of prejudice.

  10. Breaking bad news revisited: the push for negotiated disclosure and changing practice implications.

    Science.gov (United States)

    Arber, Anne; Gallagher, Ann

    2003-04-01

    This article revisits the ethical, legal, professional and emotional issues involved with disclosing bad news. The authors examine the push for disclosure that has come from a number of quarters in the UK, including ethical and legal challenges, in particular the Bristol Royal Inquiry Report, professional codes of conduct, health policy and the expectations of the public. The contribution of nurses to breaking bad news is not widely discussed in the literature. With the development of new nursing roles and evidence-based practice it is timely to consider the role of nurses in this process. The article highlights some limitations with current guidelines for breaking bad news, in particular, that these guidelines tend to be constructed from a professional standpoint and lack patient-centred evidence. The issue of emotional labour and how it relates to giving bad news is discussed with respect to professional staff and patients. The article concludes by raising some practice implications, including: the importance of context and continuity; the significance of information and support; the desirable qualities of the professional; and issues to consider in determining patient preferences.

  11. Natural spatial and temporal variations in groundwater chemistry in fractured, sedimentary rocks: scale and implications for solute transport

    International Nuclear Information System (INIS)

    Hoven, Stephen J. van der; Kip Solomon, D.; Moline, Gerilynn R.

    2005-01-01

    Natural tracers (major ions, δ 18 O, and O 2 ) were monitored to evaluate groundwater flow and transport to a depth of 20 m below the surface in fractured sedimentary (primarily shale and limestone) rocks. Large temporal variations in these tracers were noted in the soil zone and the saprolite, and are driven primarily by individual storm events. During nonstorm periods, an upward flow brings water with high TDS, constant δ 18 O, and low dissolved O 2 to the water table. During storm events, low TDS, variable δ 18 O, and high dissolved O 2 water recharges through the unsaturated zone. These oscillating signals are rapidly transmitted along fracture pathways in the saprolite, with changes occurring on spatial scales of several meters and on a time scale of hours. The variations decreased markedly below the boundary between the saprolite and less weathered bedrock. Variations in the bedrock units occurred on time scales of days and spatial scales of at least 20 m. The oscillations of chemical conditions in the shallow groundwater are hypothesized to have significant implications for solute transport. Solutes and colloids that adsorb onto aquifer solids can be released into solution by decreases in ionic strength and pH. The decreases in ionic strength also cause thermodynamic undersaturation of the groundwater with respect to some mineral species and may result in mineral dissolution. Redox conditions are also changing and may result in mineral dissolution/precipitation. The net result of these chemical variations is episodic transport of a wide range of dissolved solutes or suspended particles, a phenomenon rarely considered in contaminant transport studies

  12. Accumulation of dissolved gases at hydrophobic surfaces in water and sodium chloride solutions: Implications for coal flotation

    Energy Technology Data Exchange (ETDEWEB)

    Hampton, M.A.; Nguyen, A.V. [University of Queensland, Brisbane, Qld. (Australia). Division of Chemical Engineering

    2009-08-15

    Dissolved gases can preferentially accumulate at the hydrophobic solid-water interface as revealed by neutron reflectivity measurements. In this paper, atomic force microscopy (AFM) was used to examine accumulation of dissolved gases at a hydrophobic surface in water and sodium chloride solutions. The solvent-exchange method was used to artificially form gaseous domains accumulated at the interface suitable for AFM imaging. Smooth graphite surfaces were used as model surfaces to minimize the secondary effect of surface roughness on the imaging. The concentration of NaCl up to 1 M was found to have a negligible influence on the geometry and population of pre-existing nanobubbles, nanopancakes and nanobubble-nanopancake composites. The implications of the findings on coal flotation in saline water are discussed in terms of attraction between hydrophobic surfaces in water, bubble-particle attachment and hydrophobic coagulation between particles.

  13. Identification, assessment and intervention--Implications of an audit on dyslexia policy and practice in Scotland.

    Science.gov (United States)

    Reid, Gavin; Deponio, Pamela; Davidson Petch, Louise

    2005-08-01

    This article reports on research commissioned by the Scottish Executive Education Department (SEED). It aimed to establish the range and extent of policy and provision in the area of specific learning difficulties (SpLD) and dyslexia throughout Scotland. The research was conducted between January and June 2004 by a team from the University of Edinburgh. The information was gathered from a questionnaire sent to all education authorities (100% response rate was achieved). Additional information was also obtained from supplementary interviews and additional materials provided by education authorities. The results indicated that nine education authorities in Scotland (out of 32) have explicit policies on dyslexia and eight authorities have policies on SpLD. It was noted however that most authorities catered for dyslexia and SpLD within a more generic policy framework covering aspects of Special Educational Needs or within documentation on 'effective learning'. In relation to identification thirty-six specific tests, or procedures, were mentioned. Classroom observation, as a procedure was rated high by most authorities. Eleven authorities operated a formal staged process combining identification and intervention. Generally, authorities supported a broader understanding of the role of identification and assessment and the use of standardized tests was only part of a wider assessment process. It was however noted that good practice in identification and intervention was not necessarily dependent on the existence of a dedicated policy on SpLD/dyslexia. Over fifty different intervention strategies/programmes were noted in the responses. Twenty-four authorities indicated that they had developed examples of good practice. The results have implications for teachers and parents as well as those involved in staff development. Pointers are provided for effective practice and the results reflect some of the issues on the current debate on dyslexia particularly relating to early

  14. Investigating Assessment Bias for Constructed Response Explanation Tasks: Implications for Evaluating Performance Expectations for Scientific Practice

    Science.gov (United States)

    Federer, Meghan Rector

    frequently incorporate multivalent concepts into explanations of change, resulting in explanatory practices that were scientifically non-normative. However, use of follow-up question approaches was found to resolve this source of bias and thereby increase the validity of inferences about student understanding. The second study focused on issues of item and instrument structure, specifically item feature effects and item position effects, which have been shown to influence measures of student performance across assessment tasks. Results indicated that, along the instrument item sequence, items with similar surface features produced greater sequencing effects than sequences of items with dissimilar surface features. This bias could be addressed by use of a counterbalanced design (i.e., Latin Square) at the population level of analysis. Explanation scores were also highly correlated with student verbosity, despite verbosity being an intrinsically trivial aspect of explanation quality. Attempting to standardize student response length was one proposed solution to the verbosity bias. The third study explored gender differences in students' performance on constructed-response explanation tasks using impact (i.e., mean raw scores) and differential item function (i.e., item difficulties) patterns. While prior research in science education has suggested that females tend to perform better on constructed-response items, the results of this study revealed no overall differences in gender achievement. However, evaluation of specific item features patterns suggested that female respondents have a slight advantage on unfamiliar explanation tasks. That is, male students tended to incorporate fewer scientifically normative concepts (i.e., key concepts) than females for unfamiliar taxa. Conversely, females tended to incorporate more scientifically non-normative ideas (i.e., naive ideas) than males for familiar taxa. Together these results indicate that gender achievement differences for this

  15. A multi-disciplinary approach to medication safety and the implication for nursing education and practice.

    Science.gov (United States)

    Adhikari, Radha; Tocher, Jennifer; Smith, Pam; Corcoran, Janet; MacArthur, Juliet

    2014-02-01

    Medication management is a complex multi-stage and multi-disciplinary process, involving doctors, pharmacists, nurses and patients. Errors can occur at any stage from prescribing, dispensing and administering, to recording and reporting. There are a number of safety mechanisms built into the medication management system and it is recognised that nurses are the final stage of defence. However, medication error still remains a major challenge to patient safety globally. This paper aims to illustrate two main aspects of medication safety practices that have been elicited from an action research study in a Scottish Health Board and three local Higher Education Institutions: firstly current medication safety practices in two clinical settings; and secondly pre and post-registration nursing education and teaching on medication safety. This paper is based on Phase One and Two of an Action Research project. An ethnography-style observational method, influenced by an Appreciative Inquiry (AI) approach was adapted to study the everyday medication management systems and practices of two hospital wards. This was supplemented by seven in-depth interviews with nursing staff, numerous informal discussions with healthcare professionals, two focus-groups, one peer-interview and two in-depth individual interviews with final year nursing students from three Higher Education Institutions in Scotland. This paper highlights the current positive practical efforts in medication safety practices in the chosen clinical areas. Nursing staff do employ the traditional 'five right' principles - right patient, right medication, right dose, right route and right time - for safe administration. Nursing students are taught these principles in their pre-registration nursing education. However, there are some other challenges remaining: these include the establishment of a complete medication history (reconciliation) when patients come to hospital, the provision of an in-depth training in

  16. Solution structure of human intestinal fatty acid binding protein: Implications for ligand entry and exit

    International Nuclear Information System (INIS)

    Zhang Fengli; Luecke, Christian; Baier, Leslie J.; Sacchettini, James C.; Hamilton, James A.

    1997-01-01

    The human intestinal fatty acid binding protein (I-FABP) is a small (131 amino acids) protein which binds dietary long-chain fatty acids in the cytosol of enterocytes. Recently, an alanine to threonine substitution at position 54 in I-FABP has been identified which affects fatty acid binding and transport, and is associated with the development of insulin resistance in several populations including Mexican-Americans and Pima Indians. To investigate the molecular basis of the binding properties of I-FABP, the 3D solution structure of the more common form of human I-FABP (Ala54) was studied by multidimensional NMR spectroscopy.Recombinant I-FABP was expressed from E. coli in the presence and absence of 15N-enriched media. The sequential assignments for non-delipidated I-FABP were completed by using 2D homonuclear spectra (COSY, TOCSY and NOESY) and 3D heteronuclear spectra(NOESY-HMQC and TOCSY-HMQC). The tertiary structure of human I-FABP was calculated by using the distance geometry program DIANA based on 2519 distance constraints obtained from the NMR data. Subsequent energy minimization was carried out by using the program SYBYL in the presence of distance constraints. The conformation of human I-FABP consists of 10 antiparallel β-strands which form two nearly orthogonal β-sheets of five strands each, and two short α-helices that connect the β-strands A and B. The interior of the protein consists of a water-filled cavity between the two β-sheets. The NMR solution structure of human I-FABP is similar to the crystal structure of rat I-FABP.The NMR results show significant conformational variability of certain backbone segments around the postulated portal region for the entry and exit of fatty acid ligand

  17. Solution structure of human intestinal fatty acid binding protein: Implications for ligand entry and exit

    Energy Technology Data Exchange (ETDEWEB)

    Zhang Fengli [Boston University School of Medicine, Department of Biophysics (United States); Luecke, Christian [Johann Wolfgang Goethe-Universitaet (Germany); Baier, Leslie J. [NIDDK, NIH, Phoenix Epidemiology and Clinical Research Branch (United States); Sacchettini, James C. [Texas A and M University, Department of Biochemistry and Biophysics (United States); Hamilton, James A. [Boston University School of Medicine, Department of Biophysics (United States)

    1997-04-15

    The human intestinal fatty acid binding protein (I-FABP) is a small (131 amino acids) protein which binds dietary long-chain fatty acids in the cytosol of enterocytes. Recently, an alanine to threonine substitution at position 54 in I-FABP has been identified which affects fatty acid binding and transport, and is associated with the development of insulin resistance in several populations including Mexican-Americans and Pima Indians. To investigate the molecular basis of the binding properties of I-FABP, the 3D solution structure of the more common form of human I-FABP (Ala54) was studied by multidimensional NMR spectroscopy.Recombinant I-FABP was expressed from E. coli in the presence and absence of 15N-enriched media. The sequential assignments for non-delipidated I-FABP were completed by using 2D homonuclear spectra (COSY, TOCSY and NOESY) and 3D heteronuclear spectra(NOESY-HMQC and TOCSY-HMQC). The tertiary structure of human I-FABP was calculated by using the distance geometry program DIANA based on 2519 distance constraints obtained from the NMR data. Subsequent energy minimization was carried out by using the program SYBYL in the presence of distance constraints. The conformation of human I-FABP consists of 10 antiparallel {beta}-strands which form two nearly orthogonal {beta}-sheets of five strands each, and two short {alpha}-helices that connect the {beta}-strands A and B. The interior of the protein consists of a water-filled cavity between the two {beta}-sheets. The NMR solution structure of human I-FABP is similar to the crystal structure of rat I-FABP.The NMR results show significant conformational variability of certain backbone segments around the postulated portal region for the entry and exit of fatty acid ligand.

  18. Hydrolysis of Laboratory Made Tholins in Aqueous Solutions: Implications for Prebiotic Chemistry on Titan

    Science.gov (United States)

    Neish, Catherine; Somogyi, Á.; Lunine, J.; Smith, M.

    2008-09-01

    Laboratory experiments that simulate the reactions occurring in Titan's thick nitrogen-methane atmosphere produce complex organic precipitates known as tholins. Tholins have the general formula CxHyNz, and are spectrally similar to Titan's haze. When placed in liquid water, specific water soluble compounds in the tholins have been shown to produce oxygenated organic species with activation energies in the range of 60 ± 10 kJ mol-1 and half-lives between 0.3 and 17 days at 273 K (Neish et al. 2008). Oxygen incorporation into such materials - a necessary step towards the formation of biological molecules - is therefore fast compared to the freezing of impact melts and cryolavas on Titan. The rates quoted above are for reactions occurring in pure liquid water. The composition of impact melts and lavas on Titan are not likely to be pure water, but rather contain a few percent ammonia. Tobie et al. (2005) predict that Titan has a subsurface water layer with an ammonia concentration of 14 wt. % in the present era. The presence of ammonia would likely change the reaction rates and yields of the hydrolysis reactions of tholins. We have therefore extended our work to include the measurement of tholin hydrolysis rate coefficients in ammonia-water solutions. In this work, tholins were synthesized from a 0.98 N2/0.02 CH4 atmosphere in a high voltage AC flow discharge reactor, and dissolved in a 13 wt. % ammonia-water solution. Rates were determined by monitoring intensity changes of select species over time using high resolution FT-ICR MS. Comparisons between rates of similar species observed at different pH will be presented. This work was supported by the NASA Exobiology Program. C. Neish was supported by an NSERC Postgraduate Scholarship.

  19. Kindergartners' Mental Models of the Day and Night Cycle: Implications for Instructional Practices in Early Childhood Classrooms

    Science.gov (United States)

    Saçkes, Mesut

    2015-01-01

    This study aims to examine kindergarten children's mental models of the day and night cycle and provide implications for pedagogical practices targeting space science concepts in early childhood classrooms. A total of 46 kindergartners participated in the study, their age ranging from 60 to 75 months, including 22 boys and 24 girls.…

  20. In the "Best Interest" of the Student: Perceptions and Implications for Leadership Practices in Secondary Schools in Kenya

    Science.gov (United States)

    Jwan, Julius Ouma

    2011-01-01

    This paper discusses the contrasting views of what constitutes the "best interests" of students and the implications of such perceptions for leadership practices in secondary schools in Kenya. The paper is based on a study conducted to establish the students', teachers' and principals' perceptions of democratic school leadership--in line…

  1. How the Government Defines "Rural" Has Implications for Education Policies and Practices. Issues & Answers. REL 2007-010

    Science.gov (United States)

    Arnold, Michael L.; Biscoe, Belinda; Farmer, Thomas W.; Robertson, Dylan L.; Shapley, Kathy L.

    2007-01-01

    Clearly defining what rural means has tangible implications for public policies and practices in education, from establishing resource needs to achieving the goals of No Child Left Behind in rural areas. The word "rural" has many meanings. It has been defined in reference to population density, geographic features, and level of economic…

  2. The Implications of the National Minimum Wage for Training Practices and Skill Utilisation in the United Kingdom Hospitality Industry

    Science.gov (United States)

    Norris, Gill; Williams, Steve; Adam-Smith, Derek

    2003-01-01

    Two key issues thrown up by the 1999 introduction of the National Minimum Wage (NMW) in the United Kingdom are its likely impact on employers' training practices in low paying sectors of the economy and the implications for skills. Based on a study of the hospitality industry, this article assesses the limited significance of the differential,…

  3. Continuing medical education revisited: theoretical assumptions and practical implications: a qualitative study.

    Science.gov (United States)

    Dionyssopoulos, Alexander; Karalis, Thanassis; Panitsides, Eugenia A

    2014-12-31

    Recent research has evidenced that although investment in Continuing Medical Education (CME), both in terms of participation as well as financial resources allocated to it, has been steadily increasing to catch up with accelerating advances in health information and technology, effectiveness of CME is reported to be rather limited. Poor and disproportional returns can be attributed to failure of CME courses to address and stimulate an adult audience. The present study initially drew on research findings and adult learning theories, providing the basis for comprehending adult learning, while entailing practical implications on fostering effectiveness in the design and delivery of CME. On a second level, a qualitative study was conducted with the aim to elucidate parameters accounting for effectiveness in educational interventions. Qualitative data was retrieved through 12 in-depth interviews, conducted with a random sample of participants in the 26th European Workshop of Advanced Plastic Surgery (EWAPS). The data underwent a three level qualitative analysis, following the "grounded theory" methodology, comprising 'open coding', 'axial coding' and 'selective coding'. Findings from the EWAPS study come in line with relevant literature, entailing significant implications for the necessity to apply a more effective and efficient paradigm in the design and delivery of educational interventions, advocating for implementing learner-centered schemata in CME and benefiting from a model that draws on the learning environment and social aspects of learning. What emerged as a pivotal parameter in designing educational interventions is to focus on small group educational events which could provide a supportive friendly context, enhance motivation through learner-centered approaches and allow interaction, experimentation and critical reflection. It should be outlined however that further research is required as the present study is limited in scope, having dealt with a limited

  4. US military primary care: problems, solutions, and implications for civilian medicine.

    Science.gov (United States)

    Mundell, Benjamin F; Friedberg, Mark W; Eibner, Christine; Mundell, William C

    2013-11-01

    The US Military Health System (MHS), which is responsible for providing care to active and retired members of the military and their dependents, faces challenges in delivering cost-effective, high-quality primary care while maintaining a provider workforce capable of meeting both peacetime and wartime needs. The MHS has implemented workforce management strategies to address these challenges, including "medical home" teams for primary care and other strategies that expand the roles of nonphysician providers such as physician assistants, nurse practitioners, and medical technicians. Because these workforce strategies have been implemented relatively recently, there is limited evidence of their effectiveness. If they prove successful, they could serve as a model for the civilian sector. However, because the MHS model features a broad mix of provider types, changes to civilian scope-of-practice regulations for nonphysician providers would be necessary before the civilian provider mix could replicate that of the MHS.

  5. Differential solubility of curcuminoids in serum and albumin solutions: implications for analytical and therapeutic applications

    Directory of Open Access Journals (Sweden)

    Quitschke Wolfgang W

    2008-11-01

    Full Text Available Abstract Background Commercially available curcumin preparations contain a mixture of related polyphenols, collectively referred to as curcuminoids. These encompass the primary component curcumin along with its co-purified derivatives demethoxycurcumin and bisdemethoxycurcumin. Curcuminoids have numerous biological activities, including inhibition of cancer related cell proliferation and reduction of amyloid plaque formation associated with Alzheimer disease. Unfortunately, the solubility of curcuminoids in aqueous solutions is exceedingly low. This restricts their systemic availability in orally administered formulations and limits their therapeutic potential. Results Methods are described that achieve high concentrations of soluble curcuminoids in serum. Solid curcuminoids were either mixed directly with serum, or they were predissolved in dimethyl sulfoxide and added as aliquots to serum. Both methods resulted in high levels of curcuminoid-solubility in mammalian sera from different species. However, adding aliquots of dimethyl sulfoxide-dissolved curcuminoids to serum proved to be more efficient, producing soluble curcuminoid concentrations of at least 3 mM in human serum. The methods also resulted in the differential solubility of individual curcuminoids in serum. The addition of dimethyl sulfoxide-dissolved curcuminoids to serum preferentially solubilized curcumin, whereas adding solid curcuminoids predominantly solubilized bisdemethoxycurcumin. Either method of solubilization was equally effective in inhibiting dose-dependent HeLa cell proliferation in culture. The maximum concentration of curcuminoids achieved in serum was at least 100-fold higher than that required for inhibiting cell proliferation in culture and 1000-fold higher than the concentration that has been reported to prevent amyloid plaque formation associated with Alzheimer disease. Curcuminoids were also highly soluble in solutions of purified albumin, a major component of

  6. A Case Study with an Identified Bully: Policy and Practice Implications

    Directory of Open Access Journals (Sweden)

    Huddleston, Lillie

    2011-07-01

    Full Text Available Objective: Bullying is a serious public health problem that may include verbal or physical injury as well as social isolation or exclusion. As a result, research is needed to establish a database for policies and interventions designed to prevent bullying and its negative effects. This paper presented a case study that contributed to the literature by describing an intervention for bullies that has implications for research, practice and related policies regarding bullying.Methods: An individualized intervention for an identified bully was implemented using the Participatory Culture-Specific Intervention Model (PCSIM; Nastasi, Moore, & Varjas, 2004 with a seventh-grade middle school student. Ecological and culture-specific perspectives were used to develop and implement the intervention that included psychoeducational sessions with the student and consultation with the parent and school personnel. A mixed methods intervention design was used with the following informants: the target student, the mother of the student, a teacher and the school counselor. Qualitative data included semi-structured interviews with the parent, teacher and student, narrative classroom observations and evaluation/feedback forms filled out by the student and interventionist. Quantitative data included the following quantitative surveys (i.e., Child Posttraumatic Stress Reaction Index [CPTS-RI] and the Behavior Assessment Scale for Children, 2nd Edition. Both qualitative and quantitative data were used to evaluate the acceptability, integrity and efficacy of this intervention.Results: The process of intervention design, implementation and evaluation are described through an illustrative case study. Qualitative and quantitative findings indicated a decrease in internalizing, externalizing and bullying behaviors as reported by the teacher and the mother, and a high degree of acceptability and treatment integrity as reported by multiple stakeholders.Conclusion: This case

  7. ANALYTICAL SOLUTIONS FOR RADIATIVE TRANSFER: IMPLICATIONS FOR GIANT PLANET FORMATION BY DISK INSTABILITY

    International Nuclear Information System (INIS)

    Boss, Alan P.

    2009-01-01

    The disk instability mechanism for giant planet formation is based on the formation of clumps in a marginally gravitationally unstable protoplanetary disk, which must lose thermal energy through a combination of convection and radiative cooling if they are to survive and contract to become giant protoplanets. While there is good observational support for forming at least some giant planets by disk instability, the mechanism has become theoretically contentious, with different three-dimensional radiative hydrodynamics codes often yielding different results. Rigorous code testing is required to make further progress. Here we present two new analytical solutions for radiative transfer in spherical coordinates, suitable for testing the code employed in all of the Boss disk instability calculations. The testing shows that the Boss code radiative transfer routines do an excellent job of relaxing to and maintaining the analytical results for the radial temperature and radiative flux profiles for a spherical cloud with high or moderate optical depths, including the transition from optically thick to optically thin regions. These radial test results are independent of whether the Eddington approximation, diffusion approximation, or flux-limited diffusion approximation routines are employed. The Boss code does an equally excellent job of relaxing to and maintaining the analytical results for the vertical (θ) temperature and radiative flux profiles for a disk with a height proportional to the radial distance. These tests strongly support the disk instability mechanism for forming giant planets.

  8. Practical and Scholarly Implications of Information Behaviour Research: A Pilot Study of Research Literature

    Science.gov (United States)

    Koh, Kyungwon; Rubenstein, Ellen; White, Kelvin

    2015-01-01

    Introduction: This pilot study examined how current information behaviour research addresses the implications and potential impacts of its findings. The goal was to understand what implications and contributions the field has made and how effectively authors communicate implications of their findings. Methods: We conducted a content analysis of 30…

  9. Technetium99m shortage: Practical solutions to manage lack of the radio-isotope in nuclear medicine departments

    International Nuclear Information System (INIS)

    Biechlin-Chassel, M.L.; Francois-Joubert, A.; Bolot, C.; Desruet, M.D.; Bourrel, F.; Pelegrin, M.; Couret, I.; Lao, S.; Quelven, I.

    2010-01-01

    Technetium 99m ( 99m Tc) shortage crisis regularly affect nuclear medicine activity and oblige the community to find solutions in order to perform most of the prescribed exams and avoid systematic substitutions by other non-nuclear medicine techniques. Firstly, some practical solutions can be set up in radiopharmacy departments such as using more than two generators together, realizing fractionated elutions, preparing radiopharmaceuticals with elutions providing from different generators.. Then, it could be interesting to have a reflexion in nuclear medicine departments to convene patients the days when 99m Tc supply is sufficient, to pool some exams or to make substitutions with more available isotopes. (authors)

  10. Selecting for creativity and innovation potential: implications for practice in healthcare education.

    Science.gov (United States)

    Patterson, Fiona; Zibarras, Lara Dawn

    2017-05-01

    The ability to innovate is an important requirement in many organisations. Despite this pressing need, few selection systems in healthcare focus on identifying the potential for creativity and innovation and so this area has been vastly under-researched. As a first step towards understanding how we might select for creativity and innovation, this paper explores the use of a trait-based measure of creativity and innovation potential, and evaluates its efficacy for use in selection for healthcare education. This study uses a sample of 188 postgraduate physicians applying for education and training in UK General Practice. Participants completed two questionnaires (a trait-based measure of creativity and innovation, and a measure of the Big Five personality dimensions) and were also rated by assessors on creative problem solving measured during a selection centre. In exploring the construct validity of the trait-based measure of creativity and innovation, our research clarifies the associations between personality, and creativity and innovation. In particular, our study highlights the importance of motivation in the creativity and innovation process. Results also suggest that Openness to Experience is positively related to creativity and innovation whereas some aspects of Conscientiousness are negatively associated with creativity and innovation. Results broadly support the utility of using a trait-based measure of creativity and innovation in healthcare selection processes, although practically this may be best delivered as part of an interview process, rather than as a screening tool. Findings are discussed in relation to broader implications for placing more priority on creativity and innovation as selection criteria within healthcare education and training in future.

  11. Practical implications for RPV irradiation surveillance under long term operation based on latest research results

    International Nuclear Information System (INIS)

    Hein, H.; Keim, E.; Barthelmes, J.; Schnabel, H.

    2015-01-01

    The international programs CARISMA, CARINA and LONGLIFE belong to the research programs which have been performed during the last 10 years to study the irradiation behavior of RPV steels under long term operation of more than 60 years. Some characteristic but different irradiated RPV steels used in Pressurized Water Reactors have been extensively investigated in each of those three programs. Whereas the CARISMA and CARINA programs were mainly focused on material testing to study the irradiation-induced change of material properties in terms of fracture toughness, the main objective of LONGLIFE was to investigate the change of microstructure with various analysis techniques and to understand the mechanisms behind. In this way it was possible to get a comprehensive material characterization in terms of macro-physical properties and micro-structural features for a number of RPV steels which have been studied at different irradiation levels up to 8*10 19 cm -2 (E > 1 MeV). The essential macro-physical and micro-structural results are summarized, in particular regarding the impact of copper and nickel, and the neutron flux on the irradiation behavior and with respect to possible late irradiation effects under long term operation. Moreover, the change of material properties is linked with embrittlement mechanisms such as formation of element specific precipitations, segregations, and matrix defects. Well-known trend curves are also applied to the measured T 41 and T 0 data in order to assess their appropriateness for long term operation. Based on the comprehensive available data base, practical implications for RPV irradiation surveillance programs under long term operation are highlighted with respect to issues like material specific application of reference temperature concepts, data scattering, prediction of high fluence behavior and how to cope with possible late irradiation effects. Finally, best practices for RPV irradiation surveillance programs are suggested from

  12. Practices and discourses of ubuntu: Implications for an African model of disability?

    Directory of Open Access Journals (Sweden)

    Maria Berghs

    2017-01-01

    Full Text Available Background: Southern African scholars and activists working in disability studies have argued that ubuntu or unhu is a part of their world view. Objectives: Thinking seriously about ubuntu, as a shared collective humanness or social ethics, means to examine how Africans have framed a struggle for this shared humanity in terms of decolonisation and activism. Method: Three examples of applications of ubuntu are given, with two mainly linked to making explicit umaka. Firstly, ubuntu is linked to making visible the invisible inequalities for a common humanity in South Africa. Secondly, it becomes correlated to the expression of environmental justice in West and East African countries. Results: An African model of disability that encapsulates ubuntu is correlated to how Africans have illustrated a social ethics of a common humanity in their grassroots struggles against oppression and disablement in the 20th century. Ubuntu also locates disability politically within the wider environment and practices of sustainability which are now important to the post-2105 agenda, Convention on the Rights of Persons with Disabilities (CRPD and the (UN Sustainable Development Goals linked to climate change. Conclusion: A different kind of political action linked to social justice seems to be evolving in line with ubuntu. This has implications for the future of disability studies.

  13. Practices and discourses of ubuntu: Implications for an African model of disability?

    Science.gov (United States)

    Berghs, Maria

    2017-01-01

    Southern African scholars and activists working in disability studies have argued that ubuntu or unhu is a part of their world view. Thinking seriously about ubuntu, as a shared collective humanness or social ethics, means to examine how Africans have framed a struggle for this shared humanity in terms of decolonisation and activism. Three examples of applications of ubuntu are given, with two mainly linked to making explicit umaka. Firstly, ubuntu is linked to making visible the invisible inequalities for a common humanity in South Africa. Secondly, it becomes correlated to the expression of environmental justice in West and East African countries. An African model of disability that encapsulates ubuntu is correlated to how Africans have illustrated a social ethics of a common humanity in their grassroots struggles against oppression and disablement in the 20th century. Ubuntu also locates disability politically within the wider environment and practices of sustainability which are now important to the post-2105 agenda, Convention on the Rights of Persons with Disabilities (CRPD) and the (UN) Sustainable Development Goals linked to climate change. A different kind of political action linked to social justice seems to be evolving in line with ubuntu . This has implications for the future of disability studies.

  14. Implications for research and practice of the biographic approach for storytelling.

    Science.gov (United States)

    Ewens, Beverley; Hendricks, Joyce; Sundin, Deb

    2017-01-23

    Background Intensive care unit survivors face many physical and psychological difficulties during their recovery following discharge from hospital. These difficulties can significantly affect their quality of life. Healthcare providers and survivors' families often do not understand what recovery means in this population, which may affect the support provided. Aim To consider the potential of the biographical method in helping to create stories that illustrate recovery in intensive care survivors and other populations. Discussion This paper identifies how the biographical approach has provided survivors with a way to uncover the hidden parts of their lives through diaries and interviews, and reveal the hidden stories of intensive care survivorship and recovery. Conclusion The application of the biographical method enabled stories to be created that identified the disruption survivors encounter as they struggle to appear recovered. Implications for practice The biographical method can illuminate experiences uncaptured by other methods. This insight into recovery journeys can help healthcare practitioners and family members to understand and recognise the need for support during recovery.

  15. Mapping patterns of change in emotion-focused psychotherapy: Implications for theory, research, practice, and training.

    Science.gov (United States)

    Watson, Jeanne C

    2018-05-01

    An important objective in humanistic-experiential psychotherapies and particularly emotion-focused psychotherapy (EFT) is to map patterns of change. Effective mapping of the processes and pathways of change requires that in-session processes be linked to in-session resolutions, immediate post-session changes, intermediate outcome, final therapy outcome, and longer-term change. This is a challenging and long-term endeavour. Fine-grained descriptions of in-session processes that lead to resolution of specific interpersonal and intrapersonal issues linked with longer-term outcomes are the foundation of EFT, the process-experiential approach. In this paper, evidence in support of EFT as a treatment approach will be reviewed along with research on two mechanisms of change, viewed as central to EFT, clients' emotional processing and the therapeutic relationship conditions. The implications for psychotherapy research are discussed. Given the methodological constraints, there is a need for more innovative methodologies and strategies to investigate specific psychotherapy processes within and across different approaches to map patterns and mechanisms of change to enhance theory, research, practice, and training.

  16. "Suffering" in palliative sedation: Conceptual Analysis and Implications for Decision-Making in Clinical Practice.

    Science.gov (United States)

    Bozzaro, Claudia; Schildmann, Jan

    2018-04-21

    Palliative sedation is an increasingly used and, simultaneously, challenging practice at the end of life. Many controversies associated with this therapy are rooted in implicit differences regarding the understanding of "suffering" as prerequisite for palliative sedation. The aim of this paper is to inform the current debates by a conceptual analysis of two different philosophical accounts of suffering, (1) the subjective and holistic concept and (2) the objective and gradual concept and by a clinical-ethical analysis of the implications of each account for decisions about palliative sedation. We will show that while the subjective and holistic account of suffering fits well with the holistic approach of palliative care, there are considerable challenges to justify limits to requests for palliative sedation. By contrast, the objective and gradual account fits well with the need for an objective basis for clinical decisions in the context of palliative sedation, but runs the risk of falling short when considering the individual and subjective experience of suffering at the end of life. We will conclude with a plea for the necessity of further combined conceptual and empirical research to develop a sound and feasible understanding of suffering which can contribute to consistent decision-making about palliative sedation. Copyright © 2018. Published by Elsevier Inc.

  17. English in the multilingual classroom: implications for research, policy and practice

    Directory of Open Access Journals (Sweden)

    Janina Brutt-Griffler

    2017-11-01

    Full Text Available Purpose – The shift in the function of English as a medium of instruction together with its use in knowledge construction and dissemination among scholars continue to fuel the global demand for high-level proficiency in the language. These components of the global knowledge economy mean that the ability of nations to produce multilinguals with advanced English proficiency alongside their mastery of other languages has become a key to global competitiveness. That need is helping to drive one of the greatest language learning experiments the world has ever known. It carries significant implications for new research agendas and teacher preparation in applied linguistics. Design/methodology/approach – Evidence-based decision-making, whether it pertains to language policy decisions, instructional practices, teacher professional development or curricula/program building, needs to be based on a rigorous and systematically pursued program of research and assessment. Findings – This paper seeks to advance these objectives by identifying new research foci that underscore a student-centered approach. Originality/value – It introduces a new theoretical construct – multilingual proficiency – to underscore the knowledge that the learner develops in the process of language learning that makes for the surest route to the desired high levels of language proficiency. The paper highlights the advantages of a student-centered approach that focuses on multilingual proficiency for teachers and explores the concomitant conclusions for teacher development.

  18. Evidence behind FDA alerts for drugs with adverse cardiovascular effects: implications for clinical practice.

    Science.gov (United States)

    Rackham, Daniel M; C Herink, Megan; Stevens, Ian G; Cardoza, Natalie M; Singh, Harleen

    2014-01-01

    The U.S. Food and Drug Administration (FDA) periodically publishes Drug Safety Communications and Drug Alerts notifying health care practitioners and the general public of important information regarding drug therapies following FDA approval. These alerts can result in both positive and negative effects on patient care. Most clinical trials are not designed to detect long-term safety end points, and postmarketing surveillance along with patient reported events are often instrumental in signaling the potential harmful effect of a drug. Recently, many cardiovascular (CV) safety announcements have been released for FDA-approved drugs. Because a premature warning could discourage a much needed treatment or prompt a sudden discontinuation, it is essential to evaluate the evidence supporting these FDA alerts to provide effective patient care and to avoid unwarranted changes in therapy. Conversely, paying attention to these warnings in cases involving high-risk patients can prevent adverse effects and litigation. This article reviews the evidence behind recent FDA alerts for drugs with adverse CV effects and discusses the clinical practice implications. © 2013 Pharmacotherapy Publications, Inc.

  19. Child abuse and neglect in Cambodian refugee families: characteristics and implications for practice.

    Science.gov (United States)

    Chang, Janet; Rhee, Siyon; Berthold, S Megan

    2008-01-01

    This study examines the characteristics and patterns of child maltreatment among Cambodian refugee families in Los Angeles and assesses the implications for child welfare practice with Cambodian refugee families. Data were extracted from 243 active Cambodian case files maintained by the Los Angeles County Department of Children and Family Services (LAC-DCFS). Some of the major findings include (1) Cambodian child maltreatment cases were most frequently reported to the LAC-DCFS among various Asian Pacific ethnic groups; (2) Cambodian refugee families were more likely to be charged with neglect, while their Asian Pacific counterparts were more likely charged with physical abuse; (3) the circumstances under which maltreatment occurred most frequently were parental substance abuse and mental illness; and (4) while fathers who maltreated their child were likely to use alcohol, mothers were also more likely to have a mental health problem such as depression. This study suggests the importance of collaboration between Child Protective Service agencies, substance abuse programs, traditional healers, mental health services, and other social service agencies for effective child abuse prevention and intervention efforts.

  20. Weaning at Anglo-Saxon Raunds: Implications for changing breastfeeding practice in Britain over two millennia.

    Science.gov (United States)

    Haydock, Hannah; Clarke, Leon; Craig-Atkins, Elizabeth; Howcroft, Rachel; Buckberry, Jo

    2013-08-01

    This study investigated stable-isotope ratio evidence of weaning for the late Anglo-Saxon population of Raunds Furnells, Northamptonshire, UK. δ(15)N and δ(13)C values in rib collagen were obtained for individuals of different ages to assess the weaning age of infants within the population. A peak in δ(15) N values at about 2-year-old, followed by a decline in δ(15) N values until age three, indicates a change in diet at that age. This change in nitrogen isotope ratios corresponds with the mortality profile from the site, as well as with archaeological and documentary evidence on attitudes towards juveniles in the Anglo-Saxon period. The pattern of δ(13) C values was less clear. Comparison of the predicted age of weaning to published data from sites dating from the Iron Age to the 19th century in Britain reveals a pattern of changing weaning practices over time, with increasingly earlier commencement and shorter periods of complementary feeding in more recent periods. Such a change has implications for the interpretation of socioeconomic changes during this period of British history, since earlier weaning is associated with decreased birth spacing, and could thus have contributed to population growth. Copyright © 2013 Wiley Periodicals, Inc.

  1. Assessing health in an urban neighborhood: community process, data results and implications for practice.

    Science.gov (United States)

    Idali Torres, M

    1998-06-01

    This article examines the community process and data results of a health assessment conducted in an urban neighborhood of a middle-size city in Western Massachusetts. It describes the four-stage development process of the Health Assessment Project (HAP), a collaboration of the UMASS School of Public Health faculty and students, community based organizations and youth residents: (1) planning with a contemporary participatory approach, (2) implementing the data collection with traditional survey methodology, (3) tailoring the data analysis for a presentation at a community forum and report, and (4) incorporating the community's reaction to data results. In addition, it presents selected data results on health conditions of individual household members and perceived community health concerns and resources. Salient data results include high rates of chronic health conditions such as asthma and other respiratory problems among residents 0-18, back pain and other musculoskeletal among younger adults 19-54, and high blood pressure and other cardi-circulatory problems among older adults age 55 and older. The three most prevalent perceived community concerns are substance abuse, gangs and drug dealing. Identified community resources include sources of (1) providers of primary care, (2) health information as family/friends and Spanish media, (3) social activity such as churches and schools. Finally, this paper concludes by discussing implications for community health practice.

  2. Alaska Tundra Travel Modeling Project and implications for seismic best management practices

    Energy Technology Data Exchange (ETDEWEB)

    Schultz, G. [Alaska Dept. of Natural Resources, Anchorage, AK (United States)

    2007-07-01

    Much of the oil and gas exploration in the Alaskan North Slope depends on winter off-road travel to gain access to remote exploration areas. A study was conducted to relate vehicular off-road travel to tundra disturbance. Four types of vehicles were driven on the tundra on specific plots at various times throughout early to mid winter in an effort to determine if travel could occur earlier than current practice without impacting tundra integrity. Variables were measured the summer before travel, at the time of travel and the summers following travel. The results were used to develop a management tool to determine when conditions are adequate to allow winter vehicular off-road travel. It was determined that the soil temperature should be 5 degrees C or colder at a depth of 30 cm, with snow depths of 15 cm in coastal sedge tundra or 23 cm in foothills tussock tundra. This presentation also discussed the implications for managing off-road travel associated with seismic operations and recent changes in the types of vehicles used for these operations. figs.

  3. Analytical Methods for Quantification of Vitamin D and Implications for Research and Clinical Practice.

    Science.gov (United States)

    Stokes, Caroline S; Lammert, Frank; Volmer, Dietrich A

    2018-02-01

    A plethora of contradictory research surrounds vitamin D and its influence on health and disease. This may, in part, result from analytical difficulties with regard to measuring vitamin D metabolites in serum. Indeed, variation exists between analytical techniques and assays used for the determination of serum 25-hydroxyvitamin D. Research studies into the effects of vitamin D on clinical endpoints rely heavily on the accurate assessment of vitamin D status. This has important implications, as findings from vitamin D-related studies to date may potentially have been hampered by the quantification techniques used. Likewise, healthcare professionals are increasingly incorporating vitamin D testing and supplementation regimens into their practice, and measurement errors may be also confounding the clinical decisions. Importantly, the Vitamin D Standardisation Programme is an initiative that aims to standardise the measurement of vitamin D metabolites. Such a programme is anticipated to eliminate the inaccuracies surrounding vitamin D quantification. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  4. Accuracy of flash glucose monitoring and continuous glucose monitoring technologies: Implications for clinical practice.

    Science.gov (United States)

    Ajjan, Ramzi A; Cummings, Michael H; Jennings, Peter; Leelarathna, Lalantha; Rayman, Gerry; Wilmot, Emma G

    2018-02-01

    Continuous glucose monitoring and flash glucose monitoring technologies measure glucose in the interstitial fluid and are increasingly used in diabetes care. Their accuracy, key to effective glycaemic management, is usually measured using the mean absolute relative difference of the interstitial fluid sensor compared to reference blood glucose readings. However, mean absolute relative difference is not standardised and has limitations. This review aims to provide a consensus opinion on assessing accuracy of interstitial fluid glucose sensing technologies. Mean absolute relative difference is influenced by glucose distribution and rate of change; hence, we express caution on the reliability of comparing mean absolute relative difference data from different study systems and conditions. We also review the pitfalls associated with mean absolute relative difference at different glucose levels and explore additional ways of assessing accuracy of interstitial fluid devices. Importantly, much data indicate that current practice of assessing accuracy of different systems based on individualised mean absolute relative difference results has limitations, which have potential clinical implications. Healthcare professionals must understand the factors that influence mean absolute relative difference as a metric for accuracy and look at additional assessments, such as consensus error grid analysis, when evaluating continuous glucose monitoring and flash glucose monitoring systems in diabetes care. This in turn will ensure that management decisions based on interstitial fluid sensor data are both effective and safe.

  5. Sociolegal and practice implications of caring for LGBT people with dementia.

    Science.gov (United States)

    Peel, Elizabeth; Taylor, Helen; Harding, Rosie

    2016-11-30

    The needs of lesbian, gay, bisexual and trans (LGBT) people with dementia are poorly recognised. This is due partly to assumptions that all older people are heterosexual or asexual. One quarter of gay or bisexual men and half of lesbian or bisexual women have children, compared with 90% of heterosexual women and men, which means LGBT older adults are more likely to reside in care homes. Older LGBT people may be unwilling to express their sexual identities in care settings and this can affect their care. Members of older people's informal care networks must be recognised to ensure their involvement in the lives of residents in care settings continues. However, healthcare professionals may not always realise that many LGBT people rely on their families of choice or wider social networks more than on their families of origin. This article explores sociolegal issues that can arise in the care of older LGBT people with dementia, including enabling autonomy, capacity and applying legal frameworks to support their identities and relationships. It also highlights implications for practice.

  6. Practicing Multicultural Education through Religiously Affiliated Schools and Its Implications for Social Change

    Directory of Open Access Journals (Sweden)

    Miftahur Rohman

    2017-06-01

    Full Text Available Having varied ethnics, cultures, religions, or faiths, Indonesia is considered a multicultural nation in today’s world. This equity can be dangerous; but also can be advantageous if myriad interests of citizens are able to be nurtured through education, including religious schools. The research was conducted to explore multicultural practices in the State-owned Islamic High School (MAN 3 and the Catholic High School (SMA Stella Duce 2 in Yogyakarta Indonesia. Data was gathered via qualitative method by means of comparative study, aiming at seeking similarities and differences on promoting multicultural education values. Findings show similarities of teachers’ attitudes and characteristics as facilitator, accommodator, or assimilator whereas the differences include their leadership role in intrareligious dialog at MAN 3 and dialog leaders at SMA Stella Duce 2. Other issues include diverse understandings of religion and its perceived violence. The research formulates two categories of teacher as being multicultural-intrareligious pluralist and multicultural-intrareligious humanist. It also discusses implications on social change as a result of cultural interchange at those schools.

  7. Neurological and Psychiatric Diseases and Their Unique Cognitive Profiles: Implications for Nursing Practice and Research

    Science.gov (United States)

    Vance, David E.; Dodson, Joan E.; Watkins, Jason; Kennedy, Bridgett H.; Keltner, Norman L.

    2013-01-01

    To successfully negotiate and interact with one’s environment, optimal cognitive functioning is needed. Unfortunately, many neurological and psychiatric diseases impede certain cognitive abilities such as executive functioning or speed of processing; this can produce a poor fit between the patient and the cognitive demands of his or her environment. Such non-dementia diseases include bipolar disorder, schizophrenia, post-traumatic stress syndrome, depression, and anxiety disorders, just to name a few. Each of these diseases negatively affects particular areas of the brain, resulting in distinct cognitive profiles (e.g., deficits in executive functioning but normal speed of processing as seen in schizophrenia). In fact, it is from these cognitive deficits in which such behavioral and emotional symptoms may manifest (e.g., delusions, paranoia). This article highlights the distinct cognitive profiles of such common neurological and psychiatric diseases. An understanding of such disease-specific cognitive profiles can assist nurses in providing care to patients by knowing what cognitive deficits are associated with each disease and how these cognitive deficits impact everyday functioning and social interactions. Implications for nursing practice and research are posited within the framework of cognitive reserve and neuroplasticity. PMID:23422693

  8. Surgical Pathology of Gastrointestinal Stromal Tumors: Practical Implications of Morphologic and Molecular Heterogeneity for Precision Medicine.

    Science.gov (United States)

    Charville, Gregory W; Longacre, Teri A

    2017-11-01

    Gastrointestinal stromal tumor (GIST), the most common mesenchymal neoplasm of the gastrointestinal tract, exhibits diverse histologic and clinical manifestations. With its putative origin in the gastrointestinal pacemaker cell of Cajal, GIST can arise in association with any portion of the tubular gastrointestinal tract. Morphologically, GISTs are classified as spindled or epithelioid, though each of these subtypes encompasses a broad spectrum of microscopic appearances, many of which mimic other histologic entities. Despite this morphologic ambiguity, the diagnosis of GIST is aided in many cases by immunohistochemical detection of KIT (CD117) or DOG1 expression. The natural history of GIST ranges from that of a tumor cured by surgical resection to that of a locally advanced or even widely metastatic, and ultimately fatal, disease. This clinicopathologic heterogeneity is paralleled by an underlying molecular diversity: the majority of GISTs are associated with spontaneous activating mutations in KIT, PDGFRA, or BRAF, while additional subsets are driven by genetic lesions-often inherited-of NF1 or components of the succinate dehydrogenase enzymatic complex. Specific gene mutations correlate with particular anatomic or morphologic characteristics and, in turn, with distinct clinical behaviors. Therefore, prognostication and treatment are increasingly dictated not only by morphologic clues, but also by accompanying molecular genetic features. In this review, we provide a comprehensive description of the heterogenous molecular underpinnings of GIST, including implications for the practicing pathologist with regard to morphologic identification, immunohistochemical diagnosis, and clinical management.

  9. A coupled conductive-convective thermo-poroelastic solution and implications for wellbore stability

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Yarlong [Petro-Geotech Inc., Suite no.300, 840-6th Avenue, S.W., Calgary, AB (Canada) T2P 3E5; Dusseault, Maurice B. [Porous Media Research Institute, Department of Earth Sciences, University of Waterloo, Waterloo, ON (Canada) N2L 361

    2003-06-01

    Steam injection is widely used in heavy oil reservoirs to enhance oil recovery; elevated temperatures increase fluid mobility in several ways, but can also generate damage through shearing, crushing of weak grains, and casing impairment by shear, collapse, or buckling. Disposal of cold produced water by injection can generate thermally induced extensional fracturing, increasing the effective wellbore radius. Drilling with long open-hole sections can lead to rock temperature changes as large as 30-40 C at the casing shoe through mud heating at depth and upward mud circulation, dramatically impacting wellbore stability. Clearly, thermal stress analysis of open and cased boreholes is of primary interest for drilling and completion planning, as bottom-hole temperature changes can have as large an impact as bottom-hole pressure changes. Local wellbore stresses are the sum of far-field, pore pressure and thermally induced stresses; they may be highly inhomogeneous because of different rock properties and heat transport processes. These stresses, combined with thermal weakening and pore pressure changes, may lead to phenomena such as formation damage, sand production, shale shrinkage, and various modes of instability (shearing, spalling, fracturing, etc.). Previous studies of thermally induced stresses were primarily based on assumptions of low permeability and heat conduction only; this is inadequate when high-permeability formations are encountered. To analyze induced stresses and formation damage, a geomechanics model that is fully coupled to diffusive transport processes is employed. By assuming a constant wellbore pressure and temperature boundary condition, a closed-form solution including heat conduction and convection is obtained for the stresses near a cylindrical wellbore. The stability of an open-hole subject to non-isothermal, non-hydrostatic in situ loading and various conditions is then investigated. Our studies indicate that maximum tangential stresses are

  10. Adapting crop management practices to climate change: Modeling optimal solutions at the field scale

    NARCIS (Netherlands)

    Lehmann, N.; Finger, R.; Klein, T.; Calanca, P.; Walter, A.

    2013-01-01

    Climate change will alter the environmental conditions for crop growth and require adjustments in management practices at the field scale. In this paper, we analyzed the impacts of two different climate change scenarios on optimal field management practices in winterwheat and grain maize production

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

    Science.gov (United States)

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

    2007-01-01

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

  12. Evidence-based integrated environmental solutions for secondary lead smelters: Pollution prevention and waste minimization technologies and practices

    Energy Technology Data Exchange (ETDEWEB)

    Genaidy, A.M., E-mail: world_tek_inc@yahoo.com [University of Cincinnati, Cincinnati, Ohio (United States); Sequeira, R. [University of Cincinnati, Cincinnati, Ohio (United States); Tolaymat, T. [U.S. Environmental Protection Agency, Office of Research and Development, Cincinnati, Ohio (United States); Kohler, J. [US Environmental Protection Agency, Office of Solid Waste and Emergency Response, Washington DC (United States); Rinder, M. [WorldTek Inc, Cincinnati (United States)

    2009-05-01

    An evidence-based methodology was adopted in this research to establish strategies to increase lead recovery and recycling via a systematic review and critical appraisal of the published literature. In particular, the research examines pollution prevention and waste minimization practices and technologies that meet the following criteria: (a) reduce/recover/recycle the largest quantities of lead currently being disposed of as waste, (b) technically and economically viable, that is, ready to be diffused and easily transferable, and (c) strong industry interest (i.e., industry would consider implementing projects with higher payback periods). The following specific aims are designed to achieve the study objectives: Aim 1 - To describe the recycling process of recovering refined lead from scrap; Aim 2 - To document pollution prevention and waste management technologies and practices adopted by US stakeholders along the trajectory of LAB and lead product life cycle; Aim 3 - To explore improved practices and technologies which are employed by other organizations with an emphasis on the aforementioned criteria; Aim 4 - To demonstrate the economic and environmental costs and benefits of applying improved technologies and practices to existing US smelting operations; and Aim 5 - To evaluate improved environmental technologies and practices using an algorithm that integrates quantitative and qualitative criteria. The process of identifying relevant articles and reports was documented. The description of evidence was presented for current practices and technologies used by US smelters as well as improved practices and technologies. Options for integrated environmental solutions for secondary smelters were introduced and rank ordered on the basis of costs (i.e., capital investment) and benefits (i.e., production increases, energy and flux savings, and reduction of SO2 and slag). An example was provided to demonstrate the utility of the algorithm by detailing the costs and

  13. Evidence-based integrated environmental solutions for secondary lead smelters: pollution prevention and waste minimization technologies and practices.

    Science.gov (United States)

    Genaidy, A M; Sequeira, R; Tolaymat, T; Kohler, J; Rinder, M

    2009-05-01

    An evidence-based methodology was adopted in this research to establish strategies to increase lead recovery and recycling via a systematic review and critical appraisal of the published literature. In particular, the research examines pollution prevention and waste minimization practices and technologies that meet the following criteria: (a) reduce/recover/recycle the largest quantities of lead currently being disposed of as waste, (b) technically and economically viable, that is, ready to be diffused and easily transferable, and (c) strong industry interest (i.e., industry would consider implementing projects with higher payback periods). The following specific aims are designed to achieve the study objectives: Aim 1 - To describe the recycling process of recovering refined lead from scrap; Aim 2 - To document pollution prevention and waste management technologies and practices adopted by US stakeholders along the trajectory of LAB and lead product life cycle; Aim 3 - To explore improved practices and technologies which are employed by other organizations with an emphasis on the aforementioned criteria; Aim 4 - To demonstrate the economic and environmental costs and benefits of applying improved technologies and practices to existing US smelting operations; and Aim 5 - To evaluate improved environmental technologies and practices using an algorithm that integrates quantitative and qualitative criteria. The process of identifying relevant articles and reports was documented. The description of evidence was presented for current practices and technologies used by US smelters as well as improved practices and technologies. Options for integrated environmental solutions for secondary smelters were introduced and rank ordered on the basis of costs (i.e., capital investment) and benefits (i.e., production increases, energy and flux savings, and reduction of SO(2) and slag). An example was provided to demonstrate the utility of the algorithm by detailing the costs and

  14. Depleted Hydrocarbon Reservoirs Present a Safe and Practical Burial Solution for Graphite Waste

    International Nuclear Information System (INIS)

    Rahmani, L.

    2016-01-01

    A solution for graphite waste is proposed that combines reliance on thick impermeable host rock that is needed to confine the long-life radioactivity content of most irradiated graphite with low capitalistic and operational unit volume costs that are required to render this bulky waste form manageable. The solution, uniquely applicable to irradiated graphite due to its low dose rates, moderate mechanical strength and light density, consists in three steps: first, graphite is fine-crushed under water; second, it is made in an aqueous suspension; third, the suspension is injected into a deep, disused hydrocarbon reservoir. Each of these steps only involves well mastered techniques. Regulatory changes that may allow this solution to be added to the gamut of available waste routes, geochemical issues, availability of depleted reservoirs and cost projections are presented. (author)

  15. Report: EPA Needs to Improve Management Practices to Ensure a Successful Customer Technology Solutions Project

    Science.gov (United States)

    Report #10-P-0194, August 23, 2010. Although EPA indicated it could avoid spending more than $115.4 million over 8.5 years by consolidating the desktop computing environment, improved management practices are needed.

  16. Cattle brucellosis in traditional livestock husbandry practice in Southern and Eastern Ethiopia, and its zoonotic implication

    Directory of Open Access Journals (Sweden)

    Niguse Fekadu

    2011-04-01

    Full Text Available Abstract Background Cattle brucellosis has significant economic and zoonotic implication for the rural communities in Ethiopia in consequence of their traditional life styles, feeding habits and disease patterns. Hence, knowledge of brucellosis occurrence in traditional livestock husbandry practice has considerable importance in reducing the economic and public health impacts of the disease. Methods A total of 1623 cattle sera were serially tested using the rose Bengal test as screening and complement fixation test as confirmatory tests. The Stata survey command was used to establish prevalences for the overall and individual variables, while potential risk factors for seropositivity were analyzed using a multivariable logistic regression analysis. Results The results showed that 3.5% (95% CI = 2.4, 4.5% of the animals and 26.1% (95% CI = 18.6, 33.7 of the herds tested had antibodies against Brucella species. Village level seroprevalence ranged from 0% to 100%. A higher seroprevalence was observed in pastoral system than mixed farming although this variable was not significant in the final model. The final logistic regression model identified herd size; with large (odd ratio (OR = 8.0, 95% CI = 1.9, 33.6 and medium herds (OR = 8.1, 95% CI = 1.9, 34.2 showing higher risk of Brucella infection when compared to small herds. Similarly, the odds of Brucella infection was higher in cattle aged above 4 years when compared to age groups of 1-2 (OR = 5.4, 2.1, 12.9 and 3-4 years (OR = 3.1, 95% CI = 1.0, 9.6. Herd level analysis of the risk factors revealed that large and medium herds as well as herds kept with multiple livestock species were at higher risk of acquiring Brucella infection. Brucellosis in traditional livestock husbandry practices certainly poses a zoonotic risk to the public, in consequence of raw milk consumption, close contact with animals and provision of assistance during parturition. Due to lack of diagnostic facilities and

  17. Predicting the unpredictable: Critical analysis and practical implications of predictive anticipatory activity

    Directory of Open Access Journals (Sweden)

    Julia eMossbridge

    2014-03-01

    Full Text Available A recent meta-analysis of experiments from seven independent laboratories (n=26 published since 1978 indicates that the human body can apparently detect randomly delivered stimuli occurring 1-10 seconds in the future (Mossbridge, Tressoldi, & Utts, 2012. The key observation in these studies is that human physiology appears to be able to distinguish between unpredictable dichotomous future stimuli, such as emotional vs. neutral images or sound vs. silence. This phenomenon has been called presentiment (as in feeling the future. In this paper we call it predictive anticipatory activity or PAA. The phenomenon is predictive because it can distinguish between upcoming stimuli; it is anticipatory because the physiological changes occur before a future event; and it is an activity because it involves changes in the cardiopulmonary, skin, and/or nervous systems. PAA is an unconscious phenomenon that seems to be a time-reversed reflection of the usual physiological response to a stimulus. It appears to resemble precognition (consciously knowing something is going to happen before it does, but PAA specifically refers to unconscious physiological reactions as opposed to conscious premonitions. Though it is possible that PAA underlies the conscious experience of precognition, experiments testing this idea have not produced clear results. The first part of this paper reviews the evidence for PAA and examines the two most difficult challenges for obtaining valid evidence for it: expectation bias and multiple analyses. The second part speculates on possible mechanisms and the theoretical implications of PAA for understanding physiology and consciousness. The third part examines potential practical applications.

  18. A review of factors that affect contact angle and implications for flotation practice.

    Science.gov (United States)

    Chau, T T; Bruckard, W J; Koh, P T L; Nguyen, A V

    2009-09-30

    Contact angle and the wetting behaviour of solid particles are influenced by many physical and chemical factors such as surface roughness and heterogeneity as well as particle shape and size. A significant amount of effort has been invested in order to probe the correlation between these factors and surface wettability. Some of the key investigations reported in the literature are reviewed here. It is clear from the papers reviewed that, depending on many experimental conditions such as the size of the surface heterogeneities and asperities, surface cleanliness, and the resolution of measuring equipment and data interpretation, obtaining meaningful contact angle values is extremely difficult and such values are reliant on careful experimental control. Surface wetting behaviour depends on not only surface texture (roughness and particle shape), and surface chemistry (heterogeneity) but also on hydrodynamic conditions in the preparation route. The inability to distinguish the effects of each factor may be due to the interplay and/or overlap of two or more factors in each system. From this review, it was concluded that: Surface geometry (and surface roughness of different scales) can be used to tune the contact angle; with increasing surface roughness the apparent contact angle decreases for hydrophilic materials and increases for hydrophobic materials. For non-ideal surfaces, such as mineral surfaces in the flotation process, kinetics plays a more important role than thermodynamics in dictating wettability. Particle size encountered in flotation (10-200 microm) showed no significant effect on contact angle but has a strong effect on flotation rate constant. There is a lack of a rigid quantitative correlation between factors affecting wetting, wetting behaviour and contact angle on minerals; and hence their implication for flotation process. Specifically, universal correlation of contact angle to flotation recovery is still difficult to predict from first principles

  19. Biological variation in musculoskeletal injuries: current knowledge, future research and practical implications.

    Science.gov (United States)

    Collins, Malcolm; September, Alison V; Posthumus, Michael

    2015-12-01

    Evidence from familial and genetic association studies have reported that DNA sequence variants play an important role, together with non-genetic factors, in the aetiology of both exercise-associated and occupational-associated acute and chronic musculoskeletal soft tissue injuries. The associated variants, which have been identified to date, may contribute to the interindividual variation in the structure and, by implication, mechanical properties of the collagen fibril and surrounding matrix within musculoskeletal soft tissues, as well as their response to mechanical loading and other stimuli. Future work should focus on the establishment of multidisciplinary international consortia for the identification of biologically relevant variants involved in modulating injury risk. These consortia will improve the limitations of the published hypothesis-driven genetic association studies, since they will allow resources to be pooled in recruiting large well-characterised cohorts required for whole-genome screening. Finally, clinicians and coaches need to be aware that many direct-to-consumer companies are currently marketing genetic tests directly to athletes without it being requested by an appropriately qualified healthcare professional, and without interpretation alongside other clinical indicators or lifestyle factors. These specific genetic tests are premature and are not necessarily required to evaluate susceptibility to musculoskeletal soft tissue injury. Current practice should rather consider susceptibility through known risk factors such as a positive family history of a specific injury, a history of other tendon and/or ligament injuries and participation in activities associated with the specific musculoskeletal injuries. Potential susceptible athletes may then be individually managed to reduce their risk profile. 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/

  20. Human papillomavirus vaccine and cervical cancer prevention: practice and policy implications for pharmacists.

    Science.gov (United States)

    McIntosh, Jennifer; Sturpe, Deborah A; Khanna, Niharika

    2008-01-01

    To review the epidemiology and natural history of human papillomavirus (HPV), summarize relevant clinical trials of the prophylactic HPV vaccines, and describe the practice and policy implications that HPV vaccine represents for pharmacists. Search of Medline through June 2007 using keywords human papillomavirus vaccine, Gardasil, and Cervarix; meeting abstracts; bibliographies from selected articles; and National Institutes of Health clinical trials registry. English language review articles, clinical trials, and published abstracts were considered for inclusion. HPV is a sexually transmitted infection that is necessary for the development of cervical cancer, and types 16 and 18 are associated with 70% of cases of invasive cervical cancer worldwide. A quadrivalent prophylactic vaccine against HPV-6, -11, -16, and -18 is currently available, and a bivalent vaccine targeting HPV-16 and -18 is under review by the Food and Drug Administration. Both are highly effective at preventing persistent HPV infection and precancerous lesions caused by vaccine-specific HPV. HPV vaccine is currently indicated for girls aged 9 to 26 years, but ongoing trials are evaluating the efficacy in other populations. Implementation of a vaccine administration program is an area of opportunity for new policies to include pharmacists in the administration of prophylactic HPV vaccines. Pharmacists are allowed to administer vaccinations in 46 states and can potentially play a role in HPV vaccine administration. For this to happen, however, multiple legal and regulatory changes must occur. Prophylactic HPV vaccines safely and effectively prevent HPV infection and precancerous lesions in the cervix. The availability of these vaccines also create new clinical opportunities for community pharmacists, provided needed legal, regulatory, and policy changes are made.

  1. Defining the relationship between COPD and CVD: what are the implications for clinical practice?

    Science.gov (United States)

    Morgan, Ann D; Zakeri, Rosita; Quint, Jennifer K

    2018-01-01

    Cardiovascular diseases (CVDs) are arguably the most important comorbidities in chronic obstructive pulmonary disease (COPD). CVDs are common in people with COPD, and their presence is associated with increased risk for hospitalization, longer length of stay and all-cause and CVD-related mortality. The economic burden associated with CVD in this population is considerable and the cumulative cost of treating comorbidities may even exceed that of treating COPD itself. Our understanding of the biological mechanisms that link COPD and various forms of CVD has improved significantly over the past decade. But despite broad acceptance of the prognostic significance of CVDs in COPD, there remains widespread under-recognition and undertreatment of comorbid CVD in this population. The reasons for this are unclear; however institutional barriers and a lack of evidence-based guidelines for the management of CVD in people with COPD may be contributory factors. In this review, we summarize current knowledge relating to the prevalence and incidence of CVD in people with COPD and the mechanisms that underlie their coexistence. We discuss the implications for clinical practice and highlight opportunities for improved prevention and treatment of CVD in people with COPD. While we advocate more active assessment for signs of cardiovascular conditions across all age groups and all stages of COPD severity, we suggest targeting those aged under 65 years. Evidence indicates that the increased risks for CVD are particularly pronounced in COPD patients in mid-to-late-middle-age and thus it is in this age group that the benefits of early intervention may prove to be the most effective. PMID:29355081

  2. A systematic review on the neural effects of music on emotion regulation: implications for music therapy practice.

    Science.gov (United States)

    Moore, Kimberly Sena

    2013-01-01

    Emotion regulation (ER) is an internal process through which a person maintains a comfortable state of arousal by modulating one or more aspects of emotion. The neural correlates underlying ER suggest an interplay between cognitive control areas and areas involved in emotional reactivity. Although some studies have suggested that music may be a useful tool in ER, few studies have examined the links between music perception/production and the neural mechanisms that underlie ER and resulting implications for clinical music therapy treatment. Objectives of this systematic review were to explore and synthesize what is known about how music and music experiences impact neural structures implicated in ER, and to consider clinical implications of these findings for structuring music stimuli to facilitate ER. A comprehensive electronic database search resulted in 50 studies that met predetermined inclusion and exclusion criteria. Pertinent data related to the objective were extracted and study outcomes were analyzed and compared for trends and common findings. Results indicated there are certain music characteristics and experiences that produce desired and undesired neural activation patterns implicated in ER. Desired activation patterns occurred when listening to preferred and familiar music, when singing, and (in musicians) when improvising; undesired activation patterns arose when introducing complexity, dissonance, and unexpected musical events. Furthermore, the connection between music-influenced changes in attention and its link to ER was explored. Implications for music therapy practice are discussed and preliminary guidelines for how to use music to facilitate ER are shared.

  3. Closing the research to practice gap in children's mental health: structures, solutions, and strategies.

    Science.gov (United States)

    Jensen, Peter S; Foster, Michael

    2010-03-01

    Failure to apply research on effective interventions spans all areas of medicine, including children's mental health services. This article examines the policy, structural, and economic problems in which this gap originates. We identify four steps to close this gap. First, the field should develop scientific measures of the research-practice gap. Second, payors should link incentives to outcomes-based performance measures. Third, providers and others should develop improved understanding and application of effective dissemination and business models. Fourth, efforts to link EBP to clinical practice should span patient/consumers, providers, practices, plans, and purchasers. The paper discusses each of these in turn and relates them to fundamental problems of service delivery.

  4. Several Ideas on Integration of SCRUM Practices within Microsoft Solutions Framework

    Directory of Open Access Journals (Sweden)

    Alavandhar Jai Vigneshwar

    2017-05-01

    Full Text Available In order to develop and deliver a software project successfully, any software development organisation has to follow a well-known and recognised software engineering process for successful delivery and maintenance of the software. However, when the organisation is willing to follow a new software development process, the success rate of adopting a new software engineering process is a question mark. In the paper, we aim at studying and comparing two software engineering processes, which are based on different paradigms or models, and proposing a hybrid methodology, which integrates advantages of both compared methods. They are Microsoft Solutions Framework as a representative for an iterative methodology and SCRUM for agile software development. The comparative analysis will help a software development company to make the transition easier from Microsoft Solutions Framework to SCRUM or vice versa.

  5. Standard practice for exposure of metals and alloys by alternate immersion in neutral 3.5% Sodium Chloride solution

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    1999-01-01

    1.1 This practice covers procedures for making alternate immersion stress corrosion tests in 3.5 % sodium chloride (NaCl) (). It is primarily for tests of aluminum alloys (Test Method G 47) and ferrous alloys, but may be used for other metals exhibiting susceptibility to chloride ions. It sets forth the environmental conditions of the test and the means for controlling them. Note 1 Alternate immersion stress corrosion exposures are sometimes made in substitute ocean water (without heavy metals) prepared in accordance with Specification D 1141. The general requirements of this present practice are also applicable to such exposures except that the reagents used, the solution concentration, and the solution pH should be as specified in Specification D 1141. 1.2 This practice can be used for both stressed and unstressed corrosion specimens. Historically, it has been used for stress-corrosion cracking testing, but is often used for other forms of corrosion, such as uniform, pitting, intergranular, and galvanic. ...

  6. A practical extension of hydrodynamic theory of porous transport for hydrophilic solutes.

    Science.gov (United States)

    Bassingthwaighte, James B

    2006-03-01

    The equations for transport of hydrophilic solutes through aqueous pores provide a fundamental basis for examining capillary-tissue exchange and water and solute flux through transmembrane channels, but the theory remains incomplete for ratios, alpha, of sphere diameters to pore diameters greater than 0.4. Values for permeabilities, P, and reflection coefficients, sigma, from Lewellen, working with Lightfoot et al., at alpha = 0.5 and 0.95, were combined with earlier values for alpha solute. The new expression for the diffusive hindrance is F'(alpha) = (1 - alpha2)(3/2) phi/[1 + 0.2 x alpha2 x (1 - alpha2)16], and for the drag factor is G'(alpha) = (1 - 2alpha(2)/3 - 0.20217 alpha5)/(1 - 0.75851 alpha5) - 0.0431[1 - (1 - alpha10)]. All of these converge monotonically to the correct limits at alpha = 1. These are the first expressions providing hydrodynamically based estimates of sigma(alpha) and P(alpha) over 0 < alpha < 1 They should be accurate to within 1-2%.

  7. Practical solution of plastic deformation problems in elastic-plastic range

    Science.gov (United States)

    Mendelson, A; Manson, S

    1957-01-01

    A practical method for solving plastic deformation problems in the elastic-plastic range is presented. The method is one of successive approximations and is illustrated by four examples which include a flat plate with temperature distribution across the width, a thin shell with axial temperature distribution, a solid cylinder with radial temperature distribution, and a rotating disk with radial temperature distribution.

  8. [Turnover of Non-medical Staff in Outpatient Oncology Practices: Is Building Social Capital a Solution?].

    Science.gov (United States)

    Gloede, T D; Ernstmann, N; Baumann, W; Groß, S E; Ansmann, L; Nitzsche, A; Neumann, M; Wirtz, M; Schmitz, S; Schulz-Nieswandt, F; Pfaff, H

    2015-11-01

    While a lot is known about potential and actual turnover of non-medical hospital staff, only few data exist for the outpatient setting. In addition, little is known about actual instruments which leaders can use to influence staff turnover in physician practices. In the literature, the social capital of an organisation, which means the amount of trust, common values and reciprocal behaviour in the organisation, has been discussed as a possible field of action. In the present study, staff turnover as perceived by outpatient haematologists and oncologists is presented and analysed as to whether social capital is associated with that staff turnover. In conclusion, measures to increase the social capital of a practice are presented. The present study is based on data gathered in a questionnaire-based survey with members of the Professional Organisation of -Office-Based Haematologists and Oncologists (N=551). The social capital of the practice was captured from the haematologists and oncologists using an existing and validated scale. To analyse the impact of the practice's social capital on staff turnover, as perceived by the physicians, bivariate correlations and linear regression analyses were calculated. In total, 152 haematologists and oncologists participated in the study which represents a response rate of 28%. In the regression analyses, social capital appears as a significant and strong predictor of staff turnover (beta=-0.34; pturnover although the underlying study design does not allow for drawing causal conclusions regarding this relationship. To create social capital in their practice, outpatient physicians may apply measures that facilitate social interaction among staff, foster trust and facilitate cooperation. Such measures may already be applied when hiring and training new staff, but also continuously when leading employees and when organising work tasks, e.g., by establishing regular team meetings. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Enterprise architecture patterns practical solutions for recurring IT-architecture problems

    CERN Document Server

    Perroud, Thierry

    2013-01-01

    Every enterprise architect faces similar problems when designing and governing the enterprise architecture of a medium to large enterprise. Design patterns are a well-established concept in software engineering, used to define universally applicable solution schemes. By applying this approach to enterprise architectures, recurring problems in the design and implementation of enterprise architectures can be solved over all layers, from the business layer to the application and data layer down to the technology layer.Inversini and Perroud describe patterns at the level of enterprise architecture

  10. Customer Relationship Management System in Occupational Safety & Health Companies: Research on Practice and Preliminary Design Solution

    Directory of Open Access Journals (Sweden)

    Robert Fabac

    2011-10-01

    Full Text Available One of the most prominent contemporary trends in formation of companies is the approach to development of a customer-oriented company. In this matter, various versions related to the intensity of this orientation are differentiated. Customer relationship management (CRM system is a well-known concept, and its practice is being studied and improved in connection to various sectors. Companies providing services of occupational safety and health (OHS mainly cooperate with a large number of customers and the quality of this cooperation largely affects the occupational safety and health of employees. Therefore, it is of both scientific and wider social interest to study and improve the relationship of these companies with their customers. This paper investigates the practice of applying CRM in Croatian OHS companies. It identifies the existing conditions and suggests possible improvements in the practice of CRM, based on experts’ assessments using analytic hierarchy process evaluation. Universal preliminary design was created as a framework concept for the formation of a typical customer-oriented OHS services company. Preliminary design includes a structural view, which provides more details through system diagrams, and an illustration of main cooperation processes of a company with its customer.

  11. Exploring science teachers' perceptions of experimentation: implications for restructuring school practical work

    Science.gov (United States)

    Wei, Bing; Li, Xiaoxiao

    2017-09-01

    It is commonly recognised that practical work has a distinctive and central role in science teaching and learning. Although a large number of studies have addressed the definitions, typologies, and purposes of practical work, few have consulted practicing science teachers. This study explored science teachers' perceptions of experimentation for the purpose of restructuring school practical work in view of science practice. Qualitative interviews were conducted with 87 science teachers at the secondary school level. In the interviews, science teachers were asked to make a comparison between students' experiments and scientific experiments. Eight dimensions of experimentation were generated from the qualitative data analysis, and the distributions of these eight dimensions between the two types of experiments were compared and analysed. An ideal model of practical work was suggested for restructuring practical work at the secondary school level, and some issues related to the effective enactment of practical work were discussed.

  12. Situated Literacy Practices Amongst Artisans in the South West of Nigeria: Developmental and Pedagogical Implications

    Science.gov (United States)

    Ade-Ojo, Gordon O.

    2012-01-01

    This paper reports an aspect of a larger study on literacy practices, needs and perceptions of artisans in a part of the South West region of Nigeria. Using an ethnographic approach to research, it identified a variety of literacy practices, events and mediums, thus confirming the notion of literacy as social practice. The study employed a…

  13. Ballet as a movement-based contemplative practice? Implications for neuroscientific studies

    NARCIS (Netherlands)

    van Vugt, Marieke

    2014-01-01

    There is a rising scientific interest in the neuroscience behind contemplative practices (see e.g., Vago and Silbersweig, 2012 for a review), including movement-based practices such as yoga and tai chi. Given that, it becomes important to ask how such contemplative practices differ from Western

  14. The timing of maternal depressive symptoms and mothers' parenting practices with young children: implications for pediatric practice.

    Science.gov (United States)

    McLearn, Kathryn Taaffe; Minkovitz, Cynthia S; Strobino, Donna M; Marks, Elisabeth; Hou, William

    2006-07-01

    The prevalence of maternal depressive symptoms and its associated consequences on parental behaviors, child health, and development are well documented. Researchers have called for additional work to investigate the effects of the timing of maternal depressive symptoms at various stages in the development of the young child on the emergence of developmentally appropriate parenting practices. For clinicians, data are limited about when or how often to screen for maternal depressive symptoms or how to target anticipatory guidance to address parental needs. We sought to determine whether concurrent maternal depressive symptoms have a greater effect than earlier depressive symptoms on the emergence of maternal parenting practices at 30 to 33 months in 3 important domains of child safety, development, and discipline. Secondary analyses from the Healthy Steps National Evaluation were conducted for this study. Data sources included a self-administered enrollment questionnaire and computer-assisted telephone interviews with the mother when the Healthy Steps children were 2 to 4 and 30 to 33 months of age. The 30- to 33-month interview provided information about 4 safety practices (ie, always uses car seat, has electric outlet covers, has safety latches on cabinets, and lowered temperature on the water heater), 6 child development practices (ie, talks daily to child while working, plays daily with child, reads daily to child, limits child television and video watching to or = 3 daily routines, and being more nurturing), and 3 discipline practices (ie, uses more reasoning, uses more harsh punishment, and ever slapped child on the face or spanked the child with an object). The parenting practices were selected based on evidence of their importance for child health and development, near complete data, and sample variability. The discipline practices were constructed from the Parental Response to Misbehavior Scale. Maternal depressive symptoms were assessed using a 14-item

  15. Position Statement on Motivations, Methodologies, and Practical Implications of Educational Neuroscience Research: fMRI Studies of the Neural Correlates of Creative Intelligence

    Science.gov (United States)

    Geake, John

    2011-01-01

    In this position statement it is argued that educational neuroscience must necessarily be relevant to, and therefore have implications for, both educational theory and practice. Consequently, educational neuroscientific research necessarily must embrace educational research questions in its remit.

  16. Can biofuels be a solution to climate change? The implications of land use change-related emissions for policy

    Science.gov (United States)

    Khanna, Madhu; Crago, Christine L.; Black, Mairi

    2011-01-01

    Biofuels have gained increasing attention as an alternative to fossil fuels for several reasons, one of which is their potential to reduce the greenhouse gas (GHG) emissions from the transportation sector. Recent studies have questioned the validity of claims about the potential of biofuels to reduce GHG emissions relative to the liquid fossil fuels they are replacing when emissions owing to direct (DLUC) and indirect land use changes (ILUC) that accompany biofuels are included in the life cycle GHG intensity of biofuels. Studies estimate that the GHG emissions released from ILUC could more than offset the direct GHG savings by producing biofuels and replacing liquid fossil fuels and create a ‘carbon debt’ with a long payback period. The estimates of this payback period, however, vary widely across biofuels from different feedstocks and even for a single biofuel across different modelling assumptions. In the case of corn ethanol, this payback period is found to range from 15 to 200 years. We discuss the challenges in estimating the ILUC effect of a biofuel and differences across biofuels, and its sensitivity to the assumptions and policy scenarios considered by different economic models. We also discuss the implications of ILUC for designing policies that promote biofuels and seek to reduce GHG emissions. In a first-best setting, a global carbon tax is needed to set both DLUC and ILUC emissions to their optimal levels. However, it is unclear whether unilateral GHG mitigation policies, even if they penalize the ILUC-related emissions, would increase social welfare and lead to optimal emission levels. In the absence of a global carbon tax, incentivizing sustainable land use practices through certification standards, government regulations and market-based pressures may be a viable option for reducing ILUC. PMID:22482030

  17. The Profile of Adolescent’ Moral Intelligence and Practical Solution to Its Improvement Efforts

    Directory of Open Access Journals (Sweden)

    Prasetiawan Hardi

    2018-01-01

    Full Text Available High moral quality is needed by adolescent to be success in their personal and educational life. Those who have high morale quality can be considered as morally intelligent Individuals. This study is aimed to collect information about adolescents’ moral intelligent by using moral intelligence Instrument that consists of seven aspects, empathy, self control, conscience, respect, kindness, tolerance dan fairness, furthermore, alternative solution is given to improve their moral intelligence. Subject of this study was selected through simple random sampling. Based on the result of the survey, it was found that students in a State Junior high school in Yogyakarta have 69% moral intelligence percentage. In other words, they have medium moral Intelligence. Adolescents’ moral quality develops through continuous process in their life. One of many methods that can be done to improve moral intelligence is guidance and counseling service, in specific, group counseling with self- management technique.

  18. Advancing Psychologically Informed Practice for Patients With Persistent Musculoskeletal Pain: Promise, Pitfalls, and Solutions.

    Science.gov (United States)

    Keefe, Francis J; Main, Chris J; George, Steven Z

    2018-05-01

    There has been growing interest in psychologically oriented pain management over the past 3 to 4 decades, including a 2011 description of psychologically informed practice (PIP) for low back pain. PIP requires a broader focus than traditional biomechanical and pathology-based approaches that have been traditionally used to manage musculoskeletal pain. A major focus of PIP is addressing the behavioral aspects of pain (ie, peoples' responses to pain) by identifying individual expectations, beliefs, and feelings as prognostic factors for clinical and occupational outcomes indicating progression to chronicity. Since 2011, the interest in PIP seems to be growing, as evidenced by its use in large trials, inclusion in scientific conferences, increasing evidence base, and expansion to other musculoskeletal pain conditions. Primary care physicians and physical therapists have delivered PIP as part of a stratified care approach involving screening and targeting of treatment for people at high risk for continued pain-associated disability. Furthermore, PIP is consistent with recent national priorities emphasizing nonpharmacological pain management options. In this perspective, PIP techniques that range in complexity are described, considerations for implementation in clinical practice are offered, and future directions that will advance the understanding of PIP are outlined.

  19. Dual agency and ethics conflicts in correctional practice: sources and solutions.

    Science.gov (United States)

    Cervantes, Ana Natasha; Hanson, Annette

    2013-01-01

    Psychiatrists working in corrections, particularly in areas that have a shortage of forensic practitioners, may encounter a variety of ethics-related conflicts, especially when working both as clinicians and forensic evaluators within smaller systems. Such conflicts may include unavoidable dual treating and forensic evaluator relationships, and awareness of information that may complicate patient treatment or influence forensic opinions. Additional conflicts may arise if the psychiatrist is also retained privately to conduct forensic evaluations involving inmates in the same facility or facilities where the psychiatrist is otherwise employed, specifically because he may have duties to both a retaining party and an employer. Early-career psychiatrists, those who are completing their training in forensic psychiatry, and general psychiatrists who practice in corrections may be unfamiliar with the ethics-related dilemmas that arise in jails or prisons. Ethics courses during medical school and residency, while required, rarely discuss dilemmas specific to correctional settings. Furthermore, many psychiatrists practicing in corrections do not undergo formal training in forensic psychiatry, and even among different fellowship programs, the amount of time devoted to corrections varies significantly. The authors discuss hypothetical cases that reflect situations encountered, particularly by psychiatric fellows, forensic psychiatrists new to correctional work, and nonforensic clinicians working in corrections, a setting where dual agency is common and at times in conflict with core principles of ethics, including beneficence, nonmaleficence, neutrality, objectivity, and justice.

  20. Prostate Brachytherapy Case Volumes by Academic and Nonacademic Practices: Implications for Future Residency Training

    International Nuclear Information System (INIS)

    Orio, Peter F.; Nguyen, Paul L.; Buzurovic, Ivan; Cail, Daniel W.; Chen, Yu-Wei

    2016-01-01

    Purpose: The use of prostate brachytherapy has continued to decline in the United States. We examined the national practice patterns of both academic and nonacademic practices performing prostate brachytherapy by case volume per year to further characterize the decline and postulate the effect this trend might have on training the next generation of residents. Methods and Materials: Men diagnosed with prostate cancer who had undergone radiation therapy in 2004 to 2012 were identified. The annual brachytherapy case volume at each facility was determined and further categorized into ≤12 cases per year (ie, an average of ≤1 cases per month), 13 to 52 cases per year, and ≥53 cases per year (ie, an average of ≥1 cases per week) in academic practices versus nonacademic practices. Results: In 2004 to 2012, academic practices performing an average of ≤1 brachytherapy cases per month increased from 56.4% to 73.7%. In nonacademic practices, this percentage increased from 60.2% to 77.4% (P<.0001 for both). Practices performing an average of ≥1 cases per week decreased among both academic practices (from 6.7% to 1.5%) and nonacademic practices (from 4.5% to 2.7%). Conclusions: Both academic and nonacademic radiation oncology practices have demonstrated a significant reduction in the use of prostate brachytherapy from 2004 to 2012. With the case volume continuing to decline, it is unclear whether we are prepared to train the next generation of residents in this critical modality.

  1. Shells and containers under complex impact shock conditions - a practical solution concept

    International Nuclear Information System (INIS)

    Krieg, R.

    2000-01-01

    Many practically relevant impact processes are not as hard as a projectile impact but calculation or experimental assessment are difficult. Recent experiments at Karlsruhe Research Center show that many of these processes are similar, independent of geometry and scale, even for complex geometries and conditions. The preconditions and scaling factors for transfer of the model results to real dimensions are presented, and experimental facilities for investigating liquid impact on container walls are described. The latter were originally developed for analyses of serious accidents in nuclear facilities but can be used for other purposes as well. Using a concrete example, it was shown that the load of liquid impact on a shell with relatively filigrane protruding structures is lower by a factor of 14 than the impact of a comparable solid [de

  2. Financing energy efficiency investments. Third party financing: practical problems and possible solutions

    International Nuclear Information System (INIS)

    Warren, A.

    1992-01-01

    Third Party Financing means the packaging together of both technical aid and the necessary funding for energy cost saving investments by an outside company (outside to the energy user that is), using the energy cost savings themselves to pay for that investment. There are two key factors which differentiate Third Party Financing and conventional approaches to the implementation of energy conservation projects, the first of which is the provision of all the necessary technical services - both initial and detailed energy audits, engineering design and implementation - from one source. The second difference involves viewing the energy cost savings as a ''stream oincome'' which will repay the cost of the investment. This approach has a number of attractions to energy users: the outside company brings both its technical expertise and the necessary up-front capital to fund the energy saving investment. In addition, because the payments to the outside company are contingent, either wholly or in part, upon the level and timing of the energy cost savings the technical and financial risk for the investment is transferred from the energy user to the outside company. However, although simple in concept, third party financing is complex in practice. How does an energy user judge one third party financing proposal against another? If an agreement is made, how are energy savings measured or what happens if there is a dispute between the two parties? These are examples of the practical questions addressed in this paper which must be resolved if third party financing is to be used to assist energy saving. (Author)

  3. Practical technical solution for clay-contaminated sands used in concrete

    Directory of Open Access Journals (Sweden)

    Estephane Pierre

    2017-01-01

    Full Text Available Sand, whether natural or manufactured, shows in many instances varying degrees of high levels of clay contamination. This fact is encountered in different parts of the globe and can lead to serious problems in adjusting concrete mix proportions and requiring high water to cement ratios and/or high dosages of superplasticizers without necessarily meeting the workability requirements, even when the sand is previously washed with fresh water. In this paper, different types of sand from the Gulf Cooperation Council (GCC region are being screened, analysed for their clay contents and consequent effects on plastic concrete quality. A technical solution is being proposed based on engineered superplasticizers. A testing protocol has been established to verify the robustness of optimized mix designs demonstrating the performance of the admixture in terms of initial and extended workability. In particular, it will be demonstrated that the customized concrete admixtures constitute by themselves a stand-alone answer to the usage of clay-contaminated sands in concrete.

  4. Food safety and ecologization: practical solutions to problems at the regional level in current economic conditions

    Directory of Open Access Journals (Sweden)

    Lysochenko Alla, A.

    2015-03-01

    Full Text Available Ensuring food security and greening both at the level of the country, and at the level of regions are main objectives of modern agroeconomic policy. The state support creates favorable conditions for dynamic development of agrarian and industrial complex, raises investment opportunities and competitiveness of agricultural producers. A realization of the actions directed on assistance to the enterprises making import-substituting production of the regional agro-industrial complex is actual in modern economic conditions. The solution of this problem consists of investment projects implementation and production expansion of the operating enterprises. Considering new economic conditions, the ensuring financial stability of agricultural producers, availability of the food to needy segments of the population, production of valeologically safe food, and also increase efficiency of use of natural resources and conditions along with preservation of quality of environment at the local, regional and global levels are particularly acute challenges. State regulation of development of an agrofood complex of Russia remains a necessary condition for its reproduction functioning, and the social and economic policy has to provide economic availability of the food to all groups of the population that causes need of standard and legal fixing of mechanisms offood security achievement at the regional level.

  5. Work and Psychiatric Illness in Aotearoa/New Zealand: Implications for Career Practice

    Science.gov (United States)

    Southern, Annie; Miller, Judi

    2012-01-01

    This paper aims to examine the influence of Maori culture upon psychiatric service provision in Aotearoa/New Zealand and the implications of this for career counselling of people with experience of mental illness in Aotearoa/New Zealand. The research explored the experiences of a group of women in Aotearoa/New Zealand who have been diagnosed with…

  6. Redefining the WISC-R: Implications for Professional Practice and Public Policy.

    Science.gov (United States)

    Macmann, Gregg M.; Barnett, David W.

    1992-01-01

    The factor structure of the Wechsler Intelligence Scale for Children (Revised) was examined in the standardization sample using new methods of factor analysis. The substantial overlap across factors was most parsimoniously represented by a single general factor. Implications for public policy regarding the purposes and outcomes of special…

  7. Acute changes in clinical breast measurements following bra removal: Implications for surgical practice

    Directory of Open Access Journals (Sweden)

    Joanna Scurr

    2015-03-01

    Conclusions: Internipple distance and breast projection can be measured first following bra removal, followed by sternal notch to nipple distance, any measures associated with the vertical nipple position should be made more than 6 min after bra removal. These guidelines have implications for breast surgery, particularly for unilateral reconstruction based on the residual breast position.

  8. "Learning to Listen": Boys' Gender Narratives--Implications for Theory and Practice

    Science.gov (United States)

    Farrell, Francis

    2016-01-01

    Purpose: The purpose of this paper is to critically investigate year 6 and year 9 boys' constructions of masculinity in the light of theories of inclusive masculinity and to consider the implications of the findings for critical masculinities scholarship in educational research. Design/methodology/approach: Qualitative data was collected through…

  9. Shifting the Focus: Children's Image-Making Practices and Their Implications for Analysis

    Science.gov (United States)

    Lomax, Helen Jayne

    2012-01-01

    This paper provides analytic focus on the productive and editorial contexts of children and young people's image-making, making visible its implications for the analysis of photographs. Drawing on participatory research in which children and young people worked alongside researchers to create a visual narrative of their lived experiences of…

  10. An Examination of the Role of Emotions in Antiracist Pedagogy: Implications, Scholarship, and Practices

    Science.gov (United States)

    Grosland, Tanetha J.

    2013-01-01

    Tanetha Grosland's goal is to inform and extend the current knowledge base concerning the intersection of antiracist pedagogy and emotions, and its implications for reconceptualizing such pedagogy. Therefore, she begins by addressing some fundamental theoretical claims about antiracist education. Then utilizing two sources to contextualize…

  11. Coronary heart disease in South Asian immigrants: synthesis of research and implications for health promotion and prevention in nursing practice.

    Science.gov (United States)

    Mathews, Rahel; Zachariah, Rachel

    2008-07-01

    Although the literature reflects that Asian Indians in the United States and globally have the highest rates of morbidity and mortality because of coronary heart disease (CHD) and diabetes, few studies have described the clinical implications in the United States. Traditional risk factors dictate practice, yet these risk factors do not fully explain the rates. Central obesity, lipoprotein (a), and insulin resistance may have a strong role. The literature suggests that proactive nursing using culturally specific clinical measures are necessary to reduce risk factors for CHD and diabetes in South Asians. Additional research and prevention strategies focused on immigrant South Asians in the United States are recommended.

  12. Risk and Rationality in Adolescent Decision Making: Implications for Theory, Practice, and Public Policy.

    Science.gov (United States)

    Reyna, Valerie F; Farley, Frank

    2006-09-01

    Crime, smoking, drug use, alcoholism, reckless driving, and many other unhealthy patterns of behavior that play out over a lifetime often debut during adolescence. Avoiding risks or buying time can set a different lifetime pattern. Changing unhealthy behaviors in adolescence would have a broad impact on society, reducing the burdens of disease, injury, human suffering, and associated economic costs. Any program designed to prevent or change such risky behaviors should be founded on a clear idea of what is normative (what behaviors, ideally, should the program foster?), descriptive (how are adolescents making decisions in the absence of the program?), and prescriptive (which practices can realistically move adolescent decisions closer to the normative ideal?). Normatively, decision processes should be evaluated for coherence (is the thinking process nonsensical, illogical, or self-contradictory?) and correspondence (are the outcomes of the decisions positive?). Behaviors that promote positive physical and mental health outcomes in modern society can be at odds with those selected for by evolution (e.g., early procreation). Healthy behaviors may also conflict with a decision maker's goals. Adolescents' goals are more likely to maximize immediate pleasure, and strict decision analysis implies that many kinds of unhealthy behavior, such as drinking and drug use, could be deemed rational. However, based on data showing developmental changes in goals, it is important for policy to promote positive long-term outcomes rather than adolescents' short-term goals. Developmental data also suggest that greater risk aversion is generally adaptive, and that decision processes that support this aversion are more advanced than those that support risk taking. A key question is whether adolescents are developmentally competent to make decisions about risks. In principle, barring temptations with high rewards and individual differences that reduce self-control (i.e., under ideal

  13. Underutilization of information and knowledge in everyday medical practice: Evaluation of a computer-based solution

    Directory of Open Access Journals (Sweden)

    Fritz Peter

    2008-11-01

    Full Text Available Abstract Background The medical history is acknowledged as the sine qua non for quality medical care because recognizing problems is pre-requisite for managing them. Medical histories typically are incomplete and inaccurate, however. We show here that computers are a solution to this issue of information gathering about patients. Computers can be programmed to acquire more complete medical histories with greater detail across a range of acute and chronic issues than physician histories. Methods Histories were acquired by physicians in the usual way and by a computer program interacting directly with patients. Decision-making of what medical issues were queried by computer were made internally by the software, including determination of the chief complaint. The selection of patients was from admissions to the Robert-Bosch-Hospital, Stuttgart, Germany by convenience sampling. Physician-acquired and computer-acquired histories were compared on a patient-by-patient basis for 45 patients. Results The computer histories reported 160 problems not recorded in physician histories or slightly more than 3.5 problems per patient. However, physicians but not the computer reported 13 problems. The data show that computer histories reported problems across a range of organ systems, that the problems detected by computer but not physician histories were both acute and chronic and that the computer histories detected a significant number of issues important for preventing further morbidity. Conclusion A combination of physician and computer-acquired histories, in non-emergent situations, with the latter available to the physician at the time he or she sees the patient, is a far superior method for collecting historical data than the physician interview alone.

  14. School Psychology 2010--Part 2: School Psychologists' Professional Practices and Implications for the Field

    Science.gov (United States)

    Castillo, Jose M.; Curtis, Michael J.; Gelley, Cheryl

    2012-01-01

    Every 5 years, the National Association of School Psychologists (NASP) conducts a national study of the field. Surveys are sent to randomly selected regular members of NASP to gather information on school psychologists' demographic characteristics, context for professional practices, and professional practices. The latest iteration of the national…

  15. Best practices in risk and crisis communication: Implications for natural hazards management

    Science.gov (United States)

    Toddi A. Steelman; Sarah McCaffrey

    2013-01-01

    As societies evolve, often the most appropriate response to the hazard must also evolve. However, such shifts in appropriate response to a hazard, whether at the individual or at the societal level, are rarely straightforward: Closing the gap between desired practice and current practice requires effective communication. Although there is a significant literature on...

  16. Comparison of Transformational Leadership Practices: Implications for School Districts and Principal Preparation

    Science.gov (United States)

    Quin, Jeff; Deris, Aaron; Bischoff, Greg; Johnson, James T.

    2015-01-01

    The purpose of this study was to determine the leadership practices needed to improve academic achievement and generate positive change in school organizations. The study was also conducted to provide insight to principal preparation programs and school districts about effective transformational leadership practices. A quantitative research method…

  17. Intensive Care Unit Structure Variation and Implications for Early Mobilization Practices. An International Survey.

    Science.gov (United States)

    Bakhru, Rita N; McWilliams, David J; Wiebe, Douglas J; Spuhler, Vicki J; Schweickert, William D

    2016-09-01

    Early mobilization (EM) improves outcomes for mechanically ventilated patients. Variation in structure and organizational characteristics may affect implementation of EM practices. We queried intensive care unit (ICU) environment and standardized ICU practices to evaluate organizational characteristics that enable EM practice. We recruited 151 ICUs in France, 150 in Germany, 150 in the United Kingdom, and 500 in the United States by telephone. Survey domains included respondent characteristics, hospital and ICU characteristics, and ICU practices and protocols. We surveyed 1,484 ICU leaders and received a 64% response rate (951 ICUs). Eighty-eight percent of respondents were in nursing leadership roles; the remainder were physiotherapists. Surveyed ICUs were predominantly mixed medical-surgical units (67%), and 27% were medical ICUs. ICU staffing models differed significantly (P equipment were highly variable among respondents. International ICU structure and practice is quite heterogeneous, and several factors (multidisciplinary rounds, setting daily goals for patients, presence of a dedicated physiotherapist, country, and nurse/patient staffing ratio) are significantly associated with the practice of EM. Practice and barriers may be far different based upon staffing structure. To achieve successful implementation, whether through trials or quality improvement, ICU staffing and practice patterns must be taken into account.

  18. Determinism and Underdetermination in Genetics: Implications for Students' Engagement in Argumentation and Epistemic Practices

    Science.gov (United States)

    Jiménez-Aleixandre, María Pilar

    2014-01-01

    In the last two decades science studies and science education research have shifted from an interest in products (of science or of learning), to an interest in processes and practices. The focus of this paper is on students' engagement in epistemic practices (Kelly in "Teaching scientific inquiry: Recommendations for research and…

  19. Outsourcing and Digitized Work Spaces: Some Implications of the Intersections of Globalization, Development, and Work Practices

    Science.gov (United States)

    Smith, Beatrice Quarshie

    2006-01-01

    Drawing on an ongoing project examining the literacies prevalent at an outsourcing site, this article explores the changing nature of workplace practices enabled by new information and communication technologies. It also examines the complex geopolitical dynamics of these practices, the discourses of development, and globalization. The author…

  20. Benchmarking Professional Development Practices across Youth-Serving Organizations: Implications for Extension

    Science.gov (United States)

    Garst, Barry A.; Baughman, Sarah; Franz, Nancy

    2014-01-01

    Examining traditional and contemporary professional development practices of youth-serving organizations can inform practices across Extension, particularly in light of the barriers that have been noted for effectively developing the professional competencies of Extension educators. With professional development systems changing quickly,…

  1. Practice of using human excreta as fertilizer and implications for health in Nghean Province, Vietnam

    DEFF Research Database (Denmark)

    Phuc, P. D.; Konradsen, Flemming; Phuong, P. T.

    2006-01-01

    The ancient practice of applying latrine wastes to agricultural land has maintained soil fertility in Vietnam for several centuries but may be associated with health risks if the wastes are inadequately treated before usage. This study aimed at investigating the perceptions and handling practices...... to respondents with a low educational level (chi2 = 7.6; phealth impacts of latrine waste use in agriculture are to be reduced, then it is suggested that sustainable interventions should take into consideration farmers current excreta-use practices.......The ancient practice of applying latrine wastes to agricultural land has maintained soil fertility in Vietnam for several centuries but may be associated with health risks if the wastes are inadequately treated before usage. This study aimed at investigating the perceptions and handling practices...

  2. A nuclear gas turbine perspective: The indirect cycle (IDC) offers a practical solution

    International Nuclear Information System (INIS)

    McDonald, C.F.

    1996-01-01

    The current generation of nuclear power plants are based on light water reactors and steam cycle power conversion systems. This coupling yields a power plant efficiency of less than 30% when dry-cooled. By utilizing a higher temperature heat source, and a more efficient prime-mover, the next generation of nuclear power plants have the potential for an efficiency of close to 50%, with attendant fuel savings and reduced heat rejection to the environment. The nuclear closed Brayton cycle (NCBC) gas turbine plant involves the coupling of a high temperature reactor (HTR) and a high efficiency helium gas turbine. Studies over many years have shown the merits of an indirect cycle (IDC) approach in which an intermediate heat exchanger is used to transfer the reactor thermal energy to the prime-mover. The major advantages of this include the following: (1) multipurpose nuclear heat source; (2) gas turbine operation in a clean non-nuclear environment; (3) power conversion system simplicity; and (4) maximum utilization of existing technology. An additional factor, which may dominate the above is that the IDC approach is in concert with the only active gas-cooled reactor program remaining in the world, namely a high temperature test reactor (HTTR) under construction in Japan, the culmination of which will be the demonstration of a viable high temperature nuclear heat source. The major theme of this paper is that the IDC nuclear gas turbine offers a practical NCBC power plant concept for operation in the second or third decades of the 21st century

  3. A qualitative study of intimate partner violence universal screening by family therapy interns: implications for practice, research, training, and supervision.

    Science.gov (United States)

    Todahl, Jeffrey L; Linville, Deanna; Chou, Liang-Ying; Maher-Cosenza, Patricia

    2008-01-01

    Although a few family therapy researchers and clinicians have urged universal screening for intimate partner violence (IPV), how screening is implemented-and, in particular, client and therapist response to screening-is vaguely defined and largely untested. This qualitative study examined the dilemmas experienced by couples and family therapy interns when implementing universal screening for IPV in an outpatient clinic setting. Twenty-two graduate students in a COAMFTE-accredited program were interviewed using qualitative research methods grounded in phenomenology. Three domains, 7 main themes, and 26 subthemes were identified. The three domains that emerged in this study include (a) therapist practice of universal screening, (b) client response to universal screening, and (c) therapist response to universal screening. Implications for practice, research, training, and supervision are discussed.

  4. Youth with Behavioral Health Disorders Aging Out of Foster Care: a Systematic Review and Implications for Policy, Research, and Practice.

    Science.gov (United States)

    Kang-Yi, Christina D; Adams, Danielle R

    2017-01-01

    This systematic review aimed to (1) identify and summarize empirical studies on youth with behavioral health disorders aging out of foster care and (2) address implications for behavioral health policy, research, and practice. We identified previous studies by searching PubMed, PsycINFO, EBSCO, and ISI Citation Indexes and obtaining references from key experts in the child welfare field. A total of 28 full articles published between 1991 and 2014 were reviewed and summarized into the key areas including systems of care, disability type, transition practice area, study methods, study sample, transition outcome measures, study analysis, and study findings. Considering how fast youth who have behavioral health disorders fall through the crack as they exit foster care, one cannot understate the importance of incorporating timely and appropriate transition planning and care coordination for youth who have behavioral health disorders aging out of foster care into the usual case management performed by behavioral health systems and service providers.

  5. Engaging diverse student audiences in contemporary blended learning environments in Australian higher business education: Implications for Design and Practice

    Directory of Open Access Journals (Sweden)

    Graeme Pye

    2015-11-01

    Full Text Available This research reports on a student audience engaging in an Australian university’s undergraduate commerce program core unit that is offered across three separate geographic campus locations and online. The research extends upon work undertaken on student engagement in online settings and lies in the domain of blended learning design and practice in the Australian higher education business context. Findings, inter alia, are presented across six major student engagement dimensions as applied to the interplay between online and located/campus learning (i.e. Online Active Learning, Online Social Interaction, Online Collaboration, Online Teaching, Online Assessment, and Online Contact with Staff. Implications for blended learning design, eLearning and practice in such complex environments are examined.

  6. Governance implications of nanomaterials companies' inconsistent risk perceptions and safety practices

    Science.gov (United States)

    Engeman, Cassandra D.; Baumgartner, Lynn; Carr, Benjamin M.; Fish, Allison M.; Meyerhofer, John D.; Satterfield, Terre A.; Holden, Patricia A.; Harthorn, Barbara Herr

    2012-03-01

    Current research on the nanotechnology industry indicates its downstream expansion at a rapid pace, while toxicological research and best practices for environmental health and safety are still being developed. Companies that use and/or produce engineered nanomaterials (ENMs) have enormous potential to influence safe-handling practices for ENMs across the product life cycle. Knowledge of both industry practices and leaders' perceptions of risk is vital for understanding how companies will act to control potential environmental and health risks. This article reports results from a new international survey of nanomaterials companies in 14 countries. In this survey, company participants reported relatively high levels of uncertainty and/or perceived risk with regard to ENMs. However, these perspectives were not accompanied by expected risk-avoidant practices or preferences for regulatory oversight. A majority of companies indicated "lack of information" as a significant impediment to implementing nano-specific safety practices, but they also reported practices that were inconsistent with widely available guidance. Additionally, in the absence of safe-handling regulations, companies reported nano-specific health and safety programs that were narrow in scope. Taken together, these findings indicate that health and safety guidance is not reaching industry. While industry leaders' reluctance toward regulation might be expected, their own reported unsafe practices and recognition of possible risks suggest a more top-down approach from regulators is needed to protect workers and the environment.

  7. Governance implications of nanomaterials companies' inconsistent risk perceptions and safety practices

    Energy Technology Data Exchange (ETDEWEB)

    Engeman, Cassandra D. [University of California, Santa Barbara, Department of Sociology (United States); Baumgartner, Lynn; Carr, Benjamin M.; Fish, Allison M.; Meyerhofer, John D. [UC Center for the Environmental Implications of Nanotechnology (UC CEIN), University of California, Santa Barbara (United States); Satterfield, Terre A. [University of California, Santa Barbara, NSF Center for Nanotechnology and Society (United States); Holden, Patricia A. [UC Center for the Environmental Implications of Nanotechnology (UC CEIN), University of California, Santa Barbara (United States); Harthorn, Barbara Herr, E-mail: harthorn@cns.ucsb.edu [University of California, Santa Barbara, NSF Center for Nanotechnology and Society (United States)

    2012-03-15

    Current research on the nanotechnology industry indicates its downstream expansion at a rapid pace, while toxicological research and best practices for environmental health and safety are still being developed. Companies that use and/or produce engineered nanomaterials (ENMs) have enormous potential to influence safe-handling practices for ENMs across the product life cycle. Knowledge of both industry practices and leaders' perceptions of risk is vital for understanding how companies will act to control potential environmental and health risks. This article reports results from a new international survey of nanomaterials companies in 14 countries. In this survey, company participants reported relatively high levels of uncertainty and/or perceived risk with regard to ENMs. However, these perspectives were not accompanied by expected risk-avoidant practices or preferences for regulatory oversight. A majority of companies indicated 'lack of information' as a significant impediment to implementing nano-specific safety practices, but they also reported practices that were inconsistent with widely available guidance. Additionally, in the absence of safe-handling regulations, companies reported nano-specific health and safety programs that were narrow in scope. Taken together, these findings indicate that health and safety guidance is not reaching industry. While industry leaders' reluctance toward regulation might be expected, their own reported unsafe practices and recognition of possible risks suggest a more top-down approach from regulators is needed to protect workers and the environment.

  8. Governance implications of nanomaterials companies’ inconsistent risk perceptions and safety practices

    International Nuclear Information System (INIS)

    Engeman, Cassandra D.; Baumgartner, Lynn; Carr, Benjamin M.; Fish, Allison M.; Meyerhofer, John D.; Satterfield, Terre A.; Holden, Patricia A.; Harthorn, Barbara Herr

    2012-01-01

    Current research on the nanotechnology industry indicates its downstream expansion at a rapid pace, while toxicological research and best practices for environmental health and safety are still being developed. Companies that use and/or produce engineered nanomaterials (ENMs) have enormous potential to influence safe-handling practices for ENMs across the product life cycle. Knowledge of both industry practices and leaders’ perceptions of risk is vital for understanding how companies will act to control potential environmental and health risks. This article reports results from a new international survey of nanomaterials companies in 14 countries. In this survey, company participants reported relatively high levels of uncertainty and/or perceived risk with regard to ENMs. However, these perspectives were not accompanied by expected risk-avoidant practices or preferences for regulatory oversight. A majority of companies indicated “lack of information” as a significant impediment to implementing nano-specific safety practices, but they also reported practices that were inconsistent with widely available guidance. Additionally, in the absence of safe-handling regulations, companies reported nano-specific health and safety programs that were narrow in scope. Taken together, these findings indicate that health and safety guidance is not reaching industry. While industry leaders’ reluctance toward regulation might be expected, their own reported unsafe practices and recognition of possible risks suggest a more top-down approach from regulators is needed to protect workers and the environment.

  9. The national occupational therapy practice analysis: findings and implications for competence.

    Science.gov (United States)

    Dunn, W; Cada, E

    1998-10-01

    This article reports some of the findings from a national study of occupational therapy practice conducted by the National Board for Certification in Occupational Therapy (NBCOT) as part of its fiduciary responsibility to ensure that its entry-level certification examination is formulated on the basis of current practice. The NBCOT developed a survey with input from approximately 200 occupational therapy leaders and then used it to solicit information about current practice from 4,000 occupational therapists and 3,000 occupational therapy assistants. The sample included geographical location, experience level, and practice area distributions. Approximately 50% of the sample responded to the survey. Data indicate similarities and differences in occupational therapist and occupational therapy assistant practice (e.g., occupational therapists spend more time conducting evaluations, planning interventions, and supervising, whereas occupational therapy assistants spend more time providing interventions), an increased emphasis on population-based services (e.g., serving a business or industry rather than an individual worker), and an emphasis on occupation as a core knowledge base for practice. From a continuing competency perspective, the data can be useful to the profession; we can plan continuing education to address topics that practitioners have indicated are critical to their practice. The findings will be useful for revising the entry-level certification examination and may guide thinking about the parameters of continuing competence because the responses represent a cross-section of the profession.

  10. Work-Life Balance Practices Among Irish Hotel Employees:Implications for HRM

    OpenAIRE

    Farrell, Kathleen

    2015-01-01

    The aim of this paper is to examine work-life balance in the Irish hotel sector from an employee perspective with implications for HRM. 246 questionnaires from employees were returned which was a 22% response rate. Company benefits were not associated with numerical flexibility, but company benefits were associated with functional flexibility and work-life balance supports. This would suggest an integrated approach to human resource management (HRM), whereby some companies engage in a contemp...

  11. Paradigm Shift or Annoying Distraction: Emerging Implications of Web 2.0 for Clinical Practice

    OpenAIRE

    Spallek, H.; O’Donnell, J.; Clayton, M.; Anderson, P.; Krueger, A.

    2010-01-01

    Web 2.0 technologies, known as social media, social technologies or Web 2.0, have emerged into the mainstream. As they grow, these new technologies have the opportunity to influence the methods and procedures of many fields. This paper focuses on the clinical implications of the growing Web 2.0 technologies. Five developing trends are explored: information channels, augmented reality, location-based mobile social computing, virtual worlds and serious gaming, and collaborative research network...

  12. The Medicaid personal care services program: implications for social work practice.

    Science.gov (United States)

    Oktay, J S; Palley, H A

    1991-05-01

    Results of a survey of Medicaid personal care programs in 15 states and the District of Columbia in 1987 show that these programs suffer from many problems. Low wages and slow payment make recruitment and retention of qualified workers difficult. Other problems include lack of coordination among agencies, lack of adequate standards for training or supervision of workers, unequal access to programs, and inequities among states. Implications for social workers are discussed.

  13. Best practice - market mechanisms, transparency and control aid the enforcement of energy-efficient solutions in the market

    International Nuclear Information System (INIS)

    Kaegi, W.; Schaefli, M.; Siegrist, S.; Haessig, W.

    2004-01-01

    This final report for the Swiss Federal Office of Energy (SFOE) presents the results of a study that examined how the immense potential for saving energy in the building area can be tapped. The report examines the question why so-called 'best practice' solutions have not been so successful on the market place and which measures are necessary to make them more popular. In particular, the report looks at thermal solar installations, fan-assisted balanced ventilation systems, windows, insulation and air-water heat pumps. Various factors are examined in detail, including the relationship between market players, their level of knowledge and education, market structures and legal considerations as well as financial viability, preferences and external costs. Measures to be taken are recommended for the educational area as well as for increasing the level of competition in the building sector

  14. Goethe's Conception of "Experiment as Mediator" and Implications for Practical Work in School Science

    Science.gov (United States)

    Park, Wonyong; Song, Jinwoong

    2018-03-01

    There has been growing criticism over the aims, methods, and contents of practical work in school science, particularly concerning their tendency to oversimplify the scientific practice with focus on the hypothesis-testing function of experiments. In this article, we offer a reading of Johann Wolfgang von Goethe's scientific writings—particularly his works on color as an exquisite articulation of his ideas about experimentation—through the lens of practical school science. While avoiding the hasty conclusions made from isolated experiments and observations, Goethe sought in his experiments the interconnection among diverse natural phenomena and rejected the dualistic epistemology about the relation of humans and nature. Based on a close examination of his color theory and its underlying epistemology, we suggest three potential contributions that Goethe's conception of scientific experimentation can make to practical work in school science.

  15. Labour recruitment practices and its class implications: comparing workers in Singapore’s segmented labour market

    OpenAIRE

    Ye, J.

    2013-01-01

    This paper contributes to the literature on labour migration by considering the class commonalities and differences as refracted through gender that are embedded within recruitment practices of different workers. Recent writings on the recruitment of labour migrants often distinguish between low-waged and middle-income workers without clearly addressing the the linkages between recruitment practices of both. By adopting a comparative framework between Bangladeshi male migrants and transnation...

  16. Exploring how Australian occupational therapists and physiotherapists understand each other's professional values: implications for interprofessional education and practice.

    Science.gov (United States)

    Aguilar, Alejandra; Stupans, Ieva; Scutter, Sheila; King, Sharron

    2014-01-01

    This article provides insight into the values Australian occupational therapists and physiotherapists consider essential for their practice and the values that they perceive as important for each other. Findings from a study that employed the Delphi technique to identify the values occupational therapists and physiotherapists consider essential for their practice were compared with interview results that provide insight into how these professionals perceive one another's values. The results from this comparison indicate that occupational therapy and physiotherapy participants have limited knowledge of each other's values. This is evidenced by participants only identifying a minority of the values considered essential within the other profession and not identifying many of the values that guide daily practice within the other profession. The results hold implications for interprofessional education and practice, where knowledge of the values of other professions in the team is essential. To enable interprofessional collaboration, professions need to make their values explicit and provide their students, practitioners and educators with opportunities to learn about their own values and the values of other professions.

  17. Earth Science Informatics Community Requirements for Improving Sustainable Science Software Practices: User Perspectives and Implications for Organizational Action

    Science.gov (United States)

    Downs, R. R.; Lenhardt, W. C.; Robinson, E.

    2014-12-01

    Science software is integral to the scientific process and must be developed and managed in a sustainable manner to ensure future access to scientific data and related resources. Organizations that are part of the scientific enterprise, as well as members of the scientific community who work within these entities, can contribute to the sustainability of science software and to practices that improve scientific community capabilities for science software sustainability. As science becomes increasingly digital and therefore, dependent on software, improving community practices for sustainable science software will contribute to the sustainability of science. Members of the Earth science informatics community, including scientific data producers and distributers, end-user scientists, system and application developers, and data center managers, use science software regularly and face the challenges and the opportunities that science software presents for the sustainability of science. To gain insight on practices needed for the sustainability of science software from the science software experiences of the Earth science informatics community, an interdisciplinary group of 300 community members were asked to engage in simultaneous roundtable discussions and report on their answers to questions about the requirements for improving scientific software sustainability. This paper will present an analysis of the issues reported and the conclusions offered by the participants. These results provide perspectives for science software sustainability practices and have implications for actions that organizations and their leadership can initiate to improve the sustainability of science software.

  18. Molecular Structure of Salt Solutions: A New View of the Interface with Implications for Heterogeneous Atmospheric Chemistry

    Czech Academy of Sciences Publication Activity Database

    Jungwirth, Pavel; Tobias, D. J.

    2001-01-01

    Roč. 105, č. 43 (2001), s. 10468-10472 ISSN 1089-5647 R&D Projects: GA MŠk LN00A032 Institutional research plan: CEZ:AV0Z4040901 Keywords : air-solution interface * salt solutions * molecular dynamics Subject RIV: CF - Physical ; Theoretical Chemistry Impact factor: 3.379, year: 2001

  19. Nurse practitioner organizational climate in primary care settings: implications for professional practice.

    Science.gov (United States)

    Poghosyan, Lusine; Nannini, Angela; Stone, Patricia W; Smaldone, Arlene

    2013-01-01

    The expansion of the nurse practitioner (NP) workforce in primary care is key to meeting the increased demand for care. Organizational climates in primary care settings affect NP professional practice and the quality of care. This study investigated organizational climate and its domains affecting NP professional practice in primary care settings. A qualitative descriptive design, with purposive sampling, was used to recruit 16 NPs practicing in primary care settings in Massachusetts. An interview guide was developed and pretested with two NPs and in 1 group interview with 7 NPs. Data collection took place in spring of 2011. Individual interviews lasted from 30-70 minutes, were audio recorded, and transcribed. Data were analyzed using Atlas.ti 6.0 software by 3 researchers. Content analysis was applied. Three previously identified themes, NP-physician relations, independent practice and autonomy, and professional visibility, as well as two new themes, organizational support and resources and NP-administration relations emerged from the analyses. NPs reported collegial relations with physicians, challenges in establishing independent practice, suboptimal relationships with administration, and lack of support. NP contributions to patient care were invisible. Favorable organizational climates should be promoted to support the expanding of NP workforce in primary care and to optimize recruitment and retention efforts. © 2013.

  20. Work-life Balance Practices Among Irish Hotel Employees and Implications for HRM

    OpenAIRE

    Farrell, Kathleen

    2015-01-01

    The aim of this article is to examine work-life balance in the Irish hotel sector from an employee perspective with implications for HRM. This particular article presents part of a larger study on work flexibility and work-family balance (Farrell, 2012). The study included a survey of managers and employees. Two-hundred and forty-six questionnaires from employees were returned which was a 22% response rate from the original sample group. The research data show that company benefits were not ...

  1. What Do People Believe About Memory? Implications for the Science and Pseudoscience of Clinical Practice.

    Science.gov (United States)

    Lynn, Steven Jay; Evans, James; Laurence, Jean-Roch; Lilienfeld, Scott O

    2015-12-01

    We examine the evidence concerning what people believe about memory. We focus on beliefs regarding the permanence of memory and whether memory can be repressed and accurately recovered. We consider beliefs about memory among the undergraduate and general population, mental health professionals, judges, jurors, and law enforcement officers to provide a broad canvass that extends to the forensic arena, as well as to psychiatry, psychology, and allied disciplines. We discuss the implications of these beliefs for the education of the general public and mental health professionals regarding the science and pseudoscience of memory and the use of suggestive procedures in psychotherapy.

  2. Nurses' knowledge, clinical practice and attitude towards unconventional medicine: Implications for intercultural healthcare.

    Science.gov (United States)

    Gyasi, Razak Mohammed; Abass, Kabila; Adu-Gyamfi, Samuel; Accam, Burnett Tetteh

    2017-11-01

    The aim of this hospital-based, cross-sectional study was to examine nurses' knowledge, personal and professional practices and attitude towards complementary and alternative medical therapies in urban Ghana. Using convenience sampling technique, cross-sectional data were collected from 210 registered and practicing nurses with self-administered questionnaire based on the Complementary and Alternative Medicine (CAM) Health Belief Questionnaire (CHBQ). Descriptive statistics and the associations between variables were calculated using Pearson's Chi-square test and/or Fisher's exact test with p training curriculum can improve CAM knowledge and professional practice among nurses, and in turn, enhance evidence-based patient care within the framework of intercultural healthcare system in Ghana. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Food beliefs and practices during pregnancy in Ghana: implications for maternal health interventions.

    Science.gov (United States)

    de-Graft Aikins, Ama

    2014-01-01

    Ghanaian women's food beliefs and practices during pregnancy and the scope for developing more effective maternal health interventions were explored in this study. Thirty-five multiethnic Ghanaian women between the ages of 29 and 75 were interviewed about pregnancy food beliefs and practices. I show that, based on the data analysis, their knowledge about food was drawn from lifeworlds (family and friends), educational settings, health professionals, mass media, and body-self knowledge (unique pregnancy experiences). Core lay ideas converged with expert knowledge on maternal health nutrition. Multiple external factors (e.g., economics, cultural representations of motherhood) and internal factors (e.g., the unpredictable demands of the pregnant body) influenced pregnancy food practices. I suggest and discuss a need for culturally situated multilevel interventions.

  4. Coach behaviours and practice structures in youth soccer: implications for talent development.

    Science.gov (United States)

    Cushion, Chris; Ford, Paul R; Williams, A Mark

    2012-01-01

    Coaches are central to talent development in youth soccer and what they say and do impacts on players' achievements and well-being. Researchers have systematically observed coach behaviour and practice activities within this setting (i.e. 'what coaches do'). We review this research in light of contemporary discussion that highlights a potential 'theory-practice' divide. Our main example focuses on the discrepancy between coaching behaviour and research from the sports science sub-discipline areas of motor learning and skill acquisition that relate to how best to design practice sessions and provide instruction (i.e., 'what coaches should probably do'). The underlying reasons for this discrepancy are discussed and recommendations made to address this disparity in research, education and coach behaviours.

  5. Constraints to exclusive breastfeeding practice among breastfeeding mothers in Southwest Nigeria: implications for scaling up

    Directory of Open Access Journals (Sweden)

    Agunbiade Ojo M

    2012-04-01

    Full Text Available Abstract Background The practice of exclusive breastfeeding is still low despite the associated benefits. Improving the uptake and appropriating the benefits will require an understanding of breastfeeding as an embodied experience within a social context. This study investigates breastfeeding practices and experiences of nursing mothers and the roles of grandmothers, as well as the work-related constraints affecting nurses in providing quality support for breastfeeding mothers in Southwest Nigeria. Methods Using a concurrent mixed method approach, a structured questionnaire was administered to 200 breastfeeding mothers. In-depth interviews were also held with breastfeeding mothers (11, nurses (10 and a focus group discussion session with grandmothers. Results Breastfeeding was perceived as essential to baby's health. It strengthens the physical and spiritual bond between mothers and their children. Exclusive breastfeeding was considered essential but demanding. Only a small proportion (19% of the nursing mothers practiced exclusive breastfeeding. The survey showed the major constraints to exclusive breastfeeding to be: the perception that babies continued to be hungry after breastfeeding (29%; maternal health problems (26%; fear of babies becoming addicted to breast milk (26%; pressure from mother-in-law (25%; pains in the breast (25%; and the need to return to work (24%. In addition, the qualitative findings showed that significant others played dual roles with consequences on breastfeeding practices. The desire to practice exclusive breastfeeding was often compromised shortly after child delivery. Poor feeding, inadequate support from husband and conflicting positions from the significant others were dominant constraints. The nurses decried the effects of their workload on providing quality supports for nursing mothers. Conclusion Breastfeeding mothers are faced with multiple challenges as they strive to practice exclusive breastfeeding. Thus

  6. NICE guidelines, clinical practice and antisocial personality disorder: the ethical implications of ontological uncertainty.

    Science.gov (United States)

    Pickersgill, M D

    2009-11-01

    The British National Institute for Health and Clinical Excellence (NICE) has recently (28 January 2009) released new guidelines for the diagnosis, treatment and prevention of the psychiatric category antisocial personality disorder (ASPD). Evident in these recommendations is a broader ambiguity regarding the ontology of ASPD. Although, perhaps, a mundane feature of much of medicine, in this case, ontological uncertainty has significant ethical implications as a product of the profound consequences for an individual categorised with this disorder. This paper argues that in refraining from emphasising uncertainty, NICE risks reifying a controversial category. This is particularly problematical given that the guidelines recommend the identification of individuals "at risk" of raising antisocial children. Although this paper does not argue that NICE is "wrong" in any of its recommendations, more emphasis should have been placed on discussions of the ethical implications of diagnosis and treatment, especially given the multiple uncertainties associated with ASPD. It is proposed that these important issues be examined in more detail in revisions of existing NICE recommendations, and be included in upcoming guidance. This paper thus raises key questions regarding the place and role of ethics within the current and future remit of NICE.

  7. The social context of career choice among millennial nurses: implications for interprofessional practice.

    Science.gov (United States)

    Price, Sheri; McGillis Hall, Linda; Angus, Jan; Peter, Elizabeth

    2013-11-01

    Health human resource and workforce planning is a global priority. Given the critical nursing shortage, and the fact that nurses are the largest group of healthcare providers, health workforce planning must focus on strategies to enhance both recruitment and retention of nurses. Understanding early socialization to career choice can provide insight into professional perceptions and expectations that have implications for recruitment, retention and interprofessional collaboration. This interpretive narrative inquiry utilized Polkinghorne's theory of narrative emplotment to understand the career choice experiences of 12 millennial nurses (born between 1980 and 2000) in Eastern Canada. Participants were interviewed twice, face-to-face, 4 to 6 weeks apart prior to commencing their nursing program. The narratives present career choice as a complex consideration of social positioning. The findings provide insight into how nursing is perceived to be positioned in relation to medicine and how the participants struggled to locate themselves within this social hierarchy. Implications of this research highlight the need to ensure that recruitment messaging and organizational policies promote interprofessional collaboration from the onset of choosing a career in the health professions. Early professional socialization strategies during recruitment and education can enhance future collaboration between the health professions.

  8. Ethical implications for clinical practice and future research in "at risk" individuals.

    Science.gov (United States)

    Singh, Fiza; Mirzakhanian, Heline; Fusar-Poli, Paolo; de la Fuente-Sandoval, Camilo; Cadenhead, Kristin S

    2012-01-01

    The last 15 years have witnessed a shift in schizophrenia research with increasing interest in earlier stages of illness with the hope of early intervention and ultimately prevention of psychotic illness. Large-scale longitudinal studies have identified clinical and biological risk factors associated with increased risk of psychotic conversion, which together with symptomatic and demographic risk factors may improve the power of prediction algorithms for psychotic transition. Despite these advances, 45-70% of at risk subjects in most samples do not convert to frank psychosis, but continue to function well below their age matched counterparts. The issue is of utmost importance in light of the upcoming DSM-V and the possible inclusion of the attenuated psychotic symptoms syndrome (APSS) diagnosis, with clinical and ethical implications. Clinical considerations include feasibility of reliably diagnosing the at risk state in non-academic medical centers, variable psychotic conversion rates, a non-uniform definition of conversion and extensive debate about treatment for individuals with an ill-defined outcome. On the ethical side, diagnosing APSS could lead to unnecessary prescribing of antipsychotics with long-term deleterious consequences, slow research by providing a false sense of comfort in the diagnosis, and have psychosocial implications for those who receive a diagnosis. Thus it may be prudent to engage at risk populations early and to use broad-spectrum treatments with low risk benefit ratios to relieve functional impairments, while simultaneously studying all subsets of the at risk population.

  9. Point-of-care testing for chlamydia and gonorrhoea: implications for clinical practice.

    Directory of Open Access Journals (Sweden)

    Lisa Natoli

    Full Text Available Point-of-care (POC testing for chlamydia (CT and gonorrhoea (NG offers a new approach to the diagnosis and management of these sexually transmitted infections (STIs in remote Australian communities and other similar settings. Diagnosis of STIs in remote communities is typically symptom driven, and for those who are asymptomatic, treatment is generally delayed until specimens can be transported to the reference laboratory, results returned and the patient recalled. The objective of this study was to explore the clinical implications of using CT/NG POC tests in routine clinical care in remote settings.In-depth qualitative interviews were conducted with a purposively selected group of 18 key informants with a range of sexual health and laboratory expertise.Participants highlighted the potential impact POC testing would have on different stages of the current STI management pathway in remote Aboriginal communities and how the pathway would change. They identified implications for offering a POC test, specimen collection, conducting the POC test, syndromic management of STIs, pelvic inflammatory disease diagnosis and management, interpretation and delivery of POC results, provision of treatment, contact tracing, management of client flow and wait time, and re-testing at 3 months after infection.The introduction of POC testing to improve STI service delivery requires careful consideration of both its advantages and limitations. The findings of this study will inform protocols for the implementation of CT/NG POC testing, and also STI testing and management guidelines.

  10. Point-of-Care Testing for Chlamydia and Gonorrhoea: Implications for Clinical Practice

    Science.gov (United States)

    Natoli, Lisa; Maher, Lisa; Shephard, Mark; Hengel, Belinda; Tangey, Annie; Badman, Steven G.; Ward, James; Guy, Rebecca J.

    2014-01-01

    Objectives Point-of-care (POC) testing for chlamydia (CT) and gonorrhoea (NG) offers a new approach to the diagnosis and management of these sexually transmitted infections (STIs) in remote Australian communities and other similar settings. Diagnosis of STIs in remote communities is typically symptom driven, and for those who are asymptomatic, treatment is generally delayed until specimens can be transported to the reference laboratory, results returned and the patient recalled. The objective of this study was to explore the clinical implications of using CT/NG POC tests in routine clinical care in remote settings. Methods In-depth qualitative interviews were conducted with a purposively selected group of 18 key informants with a range of sexual health and laboratory expertise. Results Participants highlighted the potential impact POC testing would have on different stages of the current STI management pathway in remote Aboriginal communities and how the pathway would change. They identified implications for offering a POC test, specimen collection, conducting the POC test, syndromic management of STIs, pelvic inflammatory disease diagnosis and management, interpretation and delivery of POC results, provision of treatment, contact tracing, management of client flow and wait time, and re-testing at 3 months after infection. Conclusions The introduction of POC testing to improve STI service delivery requires careful consideration of both its advantages and limitations. The findings of this study will inform protocols for the implementation of CT/NG POC testing, and also STI testing and management guidelines. PMID:24956111

  11. The Radical Reform of Administrative Policies in New South Wales School Education: Practical and Theoretical Implications.

    Science.gov (United States)

    Macpherson, R. J. S.

    The government of New South Wales (Australia) is attempting to enhance the quality of public education by radically altering management structures and practices. Despite some popular objections, political intervention was mandated and warranted due to excessive centralization in administrative policy making, curriculum development, and resource…

  12. Consumer adoption of social networking sites: implications for theory and practice

    NARCIS (Netherlands)

    Lorenzo Romero, Carlota; Constantinides, Efthymios; Alarcon-del-Amo, Maria-del-Carmen

    2011-01-01

    Purpose – The purpose of this paper is to study factors affecting the acceptance of social networking sites (SNS), analyze users' practices and behavior in these environments and assess the degree of acceptance of SNS in The Netherlands. Design/methodology/approach – An extended technology

  13. Developmental Surveillance and Screening Practices by Pediatric Primary Care Providers: Implications for Early Intervention Professionals

    Science.gov (United States)

    Porter, Sallie; Qureshi, Rubab; Caldwell, Barbara Ann; Echevarria, Mercedes; Dubbs, William B.; Sullivan, Margaret W.

    2016-01-01

    This study used a survey approach to investigate current developmental surveillance and developmental screening practices by pediatric primary care providers in a diverse New Jersey county. A total of 217 providers were contacted with a final sample size of 57 pediatric primary care respondents from 13 different municipalities. Most providers…

  14. Comparing the Effects of Instructional and Transformational Leadership on Student Achievement: Implications for Practice

    Science.gov (United States)

    Shatzer, Ryan H.; Caldarella, Paul; Hallam, Pamela R.; Brown, Bruce L.

    2014-01-01

    The purpose of this study was to compare transformational and instructional leadership theories, examine the unique impact that school leaders have on student achievement, and determine which specific leadership practices are associated with increased student achievement. The sample for this study consisted of 590 teachers in 37 elementary schools…

  15. Exploring a Pluralist Understanding of Learning for Sustainability and Its Implications for Outdoor Education Practice

    Science.gov (United States)

    Paulus, Susanne C.

    2016-01-01

    This article explores a pluralist understanding of learning for sustainability in educational theory and relates it to outdoor education practice. In brief, this kind of learning can be described as a deep engagement with an individual's multiple identities and the personal location in diverse geo-physical and socio-cultural surroundings. I…

  16. Local Economic Trading Schemes and their implications for marketing assumptions, concepts, and practices

    NARCIS (Netherlands)

    Crowther, D.; Greene, A-M.; Hosking, D.M.

    2002-01-01

    This paper focuses on the relationship between a particular social practice - local exchange trading systems or schemes (LETS) - and what we here call the "mainstream" marketing paradigm. It begins by discussing some of the key principles that are thought to set LETS apart from other, "more

  17. Literacy in Cross-Cultural Perspective: Implications for Policy and Practice.

    Science.gov (United States)

    Street, B.

    This paper reviews some of the issues in the new literacy studies and the questions, from an anthropological perspective, of self, person, and identity that affect literacy practices. It is suggested that in discussing literacy, it is better to start from a cultural viewpoint rather than an educational one. The traditional autonomous model of…

  18. Implications of Online Learning for the Conceptual Development and Practice of Distance Education

    Science.gov (United States)

    Garrison, Randy

    2009-01-01

    The purpose of this article is to examine the foundational principles and practices of distance education for the purpose of understanding recent developments in the areas of online and blended learning. It is argued that mainstream distance education has not embraced the full collaborative potential of online learning. Distance education…

  19. Understanding Barriers to Safer Sex Practice in Zimbabwean Marriages: Implications for Future HIV Prevention Interventions

    Science.gov (United States)

    Mugweni, Esther; Omar, Mayeh; Pearson, Stephen

    2015-01-01

    Against the backdrop of high human immunodeficiency virus (HIV) prevalence in stable relationships in Southern Africa, our study presents sociocultural barriers to safer sex practice in Zimbabwean marriages. We conducted 36 in-depth interviews and four focus group discussions with married men and women in Zimbabwe in 2008. Our aim was to identify…

  20. The Use of Assessment Criteria to Ensure Consistency of Marking: Some Implications for Good Practice.

    Science.gov (United States)

    Saunders, Mark N. K.; Davis, Susan M.

    1998-01-01

    Lecturers at a British university participated in two workshops to examine the consistency of assessments of undergraduates' work. Use of both analytical and global quality measures, when clearly understood by the raters, improved assessment practices. Ongoing discussion of evaluation criteria was recommended. (SK)

  1. Children of Color and Parental Incarceration: Implications for Research, Theory, and Practice

    Science.gov (United States)

    Graham, James A.; Harris, Yvette R.

    2013-01-01

    Practical information about culturally appropriate interventions with children of incarcerated parents (CIPs) of color and their families is notably sparse. This study uses a cultural-ecological perspective to contextualize individual, family, and legal issues inherent in many intervention programs for CIPs of color. The authors highlight…

  2. The Social Psychology of Black-White Interracial Interactions: Implications for Culturally Competent Clinical Practice

    Science.gov (United States)

    Jordan, Alexander H.; Lovett, Benjamin J.; Sweeton, Jennifer L.

    2012-01-01

    Social psychological research suggests that because of concerns about being perceived in stereotypical ways, people may experience negative affect and diminished attention and cognitive capacity during interracial interactions. The authors discuss this research in relation to therapy and assessment and also offer practical suggestions for ensuring…

  3. Bourdieu's Habitus and Field: Implications on the Practice and Theory of Critical Action Learning

    Science.gov (United States)

    Warwick, Rob; McCray, Janet; Board, Douglas

    2017-01-01

    This paper considers the logic of practice of the French sociologist Pierre Bourdieu in relation to critical action learning: in particular "habitus" which is co-created with field and the interplay amongst the two in the form of misrecognition and risk. We draw on interviews with participants who have experienced action learning as part…

  4. Revisioning Assessment through a Children's Rights Approach: Implications for Policy, Process and Practice

    Science.gov (United States)

    Elwood, Jannette; Lundy, Laura

    2010-01-01

    The linkage between the impact of assessment and compliance with children's rights is a connection, which although seemingly obvious, is nonetheless rarely made, particularly by governments, which, as signatories to the relevant human rights treaties, have the primary responsibility for ensuring that educational practice is compatible with…

  5. The Implications of Autonomist Marxism for Research and Practice in Education and Technology

    Science.gov (United States)

    Hall, Richard

    2015-01-01

    This article considers the relevance of Autonomist Marxism for both research and practice in education and technology. The article situates the Autonomist perspective against that of traditional Marxist thought--illustrating how certain core Autonomist concepts enable a critical reading of developments in information and communication technology.…

  6. Contemplative Practices in Early Childhood: Implications for Self-Regulation Skills and School Readiness

    Science.gov (United States)

    Willis, Elizabeth; Dinehart, Laura H.

    2014-01-01

    This article examines the development of self-regulation skills in early childhood and the possibilities of children's contemplative practices as a viable tool to facilitate this development. Current research indicates that self-regulation skills in early childhood education make a significant contribution to school readiness, and long-term…

  7. The Socio-Materiality of Learning Practices and Implications for the Field of Learning Technology

    Science.gov (United States)

    Johri, Aditya

    2011-01-01

    Although the use of digital information technologies in education has become commonplace, there are few, if any, central guiding frameworks or theories that explicate the relationship between technology and learning practices. In this paper, I argue that such a theoretical framework can assist scholars and practitioners alike by working as a…

  8. Aging and Cognitive Performance: Challenges and Implications for Physicians Practicing in the 21st Century

    Science.gov (United States)

    Durning, Steven J.; Artino, Anthony R.; Holmboe, Eric; Beckman, Thomas J.; van der Vleuten, Cees; Schuwirth, Lambert

    2010-01-01

    The demands of physician practice are growing. Some specialties face critical shortages and a significant percentage of physicians are aging. To improve health care it is paramount to understand and address challenges, including cognitive issues, facing aging physicians. In this article, we outline several issues related to cognitive performance…

  9. Mathematics Reform Curricula and Special Education: Identifying Intersections and Implications for Practice

    Science.gov (United States)

    Sayeski, Kristin L.; Paulsen, Kim J.

    2010-01-01

    In many general education classrooms today, teachers are using "reform" mathematics curricula. These curricula emphasize the application of mathematics in real-life contexts and include such practices as collaborative, group problem solving and student-generated algorithms. Students with learning disabilities in the area of mathematics can…

  10. Material Enactments of Identities and Learning in Everyday Community Practices: Implications for Pedagogy

    Science.gov (United States)

    Aberton, Helen

    2012-01-01

    In recent years there has been an upsurge of interest in applying actor-network theory (ANT) to educational research and analysis. This article presents an account of how an ANT analysis of socio-material practices with a focus on objects can bring informal learning and identity formation to view. It is based on a doctoral study of the everyday…

  11. A Gendered Study of the Working Patterns of Classical Musicians: Implications for Practice

    Science.gov (United States)

    Bennett, Dawn

    2008-01-01

    Despite an increase in participation at all levels of the music profession, women continue to experience fewer opportunities to forge careers in music and are less likely than men to apply for leadership positions. This article presents results from a study in which 152 instrumental musicians reflected upon their professional practice and career…

  12. Surgical specialty procedures in rural surgery practices: implications for rural surgery training.

    Science.gov (United States)

    Sticca, Robert P; Mullin, Brady C; Harris, Joel D; Hosford, Clint C

    2012-12-01

    Specialty procedures constitute one eighth of rural surgery practice. Currently, general surgeons intending to practice in rural hospitals may not get adequate training for specialty procedures, which they will be expected to perform. Better definition of these procedures will help guide rural surgery training. Current Procedural Terminology codes for all surgical procedures for 81% of North Dakota and South Dakota rural surgeons were entered into the Dakota Database for Rural Surgery. Specialty procedures were analyzed and compared with the Surgical Council on Resident Education curriculum to determine whether general surgery training is adequate preparation for rural surgery practice. The Dakota Database for Rural Surgery included 46,052 procedures, of which 5,666 (12.3%) were specialty procedures. Highest volume specialty categories included vascular, obstetrics and gynecology, orthopedics, cardiothoracic, urology, and otolaryngology. Common procedures in cardiothoracic and vascular surgery are taught in general surgical residency, while common procedures in obstetrics and gynecology, orthopedics, urology, and otolaryngology are usually not taught in general surgery training. Optimal training for rural surgery practice should include experience in specialty procedures in obstetrics and gynecology, orthopedics, urology, and otolaryngology. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. The attitudes and beliefs of a female science teacher: Implications in relation to gender and pedagogical practice

    Science.gov (United States)

    Zapata, Mara

    In this case study of a female science teacher named Laura, numerous observations, field notes, researcher interpretations, and assertions were developed. As meanings were negotiated, intent of actions was defined using significant statements, clustered to produce invariant meaning units. Both the participant's intents and how she interpreted her experiences were central to the understandings sought in this study. Whenever Laura planned for teaching science, taught, or otherwise interacted with students, the following four themes seemed to frame her actions: (1) Responsibility to Nurture/Mother/Mentor (2) Connecting to and Relating (3) Meeting Gender-Specific Expectations (4) Promoting the Fighter/Survivor Within. Each theme is examined in relation to attitudes and beliefs about teaching and learning science, and conclusions and assertions are expressed. The findings of this study point to the tensions between Laura's attitudes and beliefs and her pedagogical practices, disconfirming these as they pertain to gender in relation to teaching and learning science. It was not evident as part of her daily practice that student experiences were used in an attempt to create connections between their lives and science, although Laura always emphasized that science is a way of life. The findings support questioning the role of intentionality and a teacher's perceived ability to adhere to intentions while practicing within the norms established by the social institution of schools operating within the larger structures of society. The major findings and implications are relevant to the manner teachers are prepared and encouraged to enact their practice by departments and boards of education, prepared by institutions of higher education and subsequent participation in professional development. Specifically, calling attention to how these educational frameworks emphasize or de-emphasize the role of teachers and promote cognizance in terms of the culture of schools, reflective

  14. Sustainability of current agriculture practices, community perception, and implications for ecosystem health: an Indian study.

    Science.gov (United States)

    Sarkar, Atanu; Patil, Shantagouda; Hugar, Lingappa B; vanLoon, Gary

    2011-12-01

    In order to support agribusiness and to attain food security for ever-increasing populations, most countries in the world have embraced modern agricultural technologies. Ecological consequences of the technocentric approaches, and their sustainability and impacts on human health have, however, not received adequate attention particularly in developing countries. India is one country that has undergone a rapid transformation in the field of agriculture by adopting strategies of the Green Revolution. This article provides a comparative analysis of the effects of older and newer paradigms of agricultural practices on ecosystem and human health within the larger context of sustainability. The study was conducted in three closely situated areas where different agricultural practices were followed: (a) the head-end of a modern canal-irrigated area, (b) an adjacent dryland, and (c) an area (the ancient area) that has been provided with irrigation for some 800 years. Data were collected by in-depth interviews of individual farmers, focus-group discussions, participatory observations, and from secondary sources. The dryland, receiving limited rainfall, continues to practice diverse cropping centered to a large extent on traditional coarse cereals and uses only small amounts of chemical inputs. On the other hand, modern agriculture in the head-end emphasizes continuous cropping of rice supported by extensive and indiscriminate use of agrochemicals. Market forces have, to a significant degree, influenced the ancient area to abandon much of its early practices of organic farming and to take up aspects of modern agricultural practice. Rice cultivation in the irrigated parts has changed the local landscape and vegetation and has augmented the mosquito population, which is a potential vector for malaria, Japanese encephalitis and other diseases. Nevertheless, despite these problems, perceptions of adverse environmental effects are lowest in the heavily irrigated area.

  15. Learning from collaborative research on sustainably managing fresh water: implications for ethical research-practice engagement

    Directory of Open Access Journals (Sweden)

    Margaret L. Ayre

    2018-03-01

    Full Text Available Since the mid-2000s, there has been increasing recognition of the promise of collaborative research and management for addressing complex issues in sustainably managing fresh water. A large variety of collaborative freshwater research and management processes is now evident around the world. However, how collective knowledge development, coproduction, or cocreation is carried out in an ethical manner is less well known. From the literature and our experiences as applied, transdisciplinary researchers and natural resource management practitioners, we seek to describe and explore these aspects of empirical cases of collaborative freshwater research and management. Drawing on cases from Indigenous community-based natural resource management in northern Australia, flood and drought risk management in Bulgaria, water management and climate change adaptation in the Pacific, and regional catchment and estuary management in Victoria and New South Wales in Australia, we identify lessons to support improved collaborative sustainable freshwater management research and practice. Cocreation represents an emerging approach to participation and collaboration in freshwater management research-practice and can be seen to constitute four interlinked and iterative phases: coinitiation, codesign, coimplementation, and coevaluation. For freshwater researchers and managers and their collaborators, paying attention to these phases and the ethical dilemmas that arise within each phase will support the cocreation of more effective and ethical research-practice through: sensitizing collaborators to the need for reflexivity in research-practice, proposing action research codesign as a method for managing emergent questions and outcomes, and supporting more equitable outcomes for collaborators through an emphasis on coevaluation and collaborative articulation of the links between research outputs and practice outcomes.

  16. Awareness of food nutritive value and eating practices among Nigerian bank workers: Implications for nutritional counseling and education.

    Science.gov (United States)

    Eze, Ngozi M; Maduabum, Felicia O; Onyeke, Nkechi G; Anyaegunam, Ngozi J; Ayogu, Chinwe A; Ezeanwu, Bibian Amaka; Eseadi, Chiedu

    2017-03-01

    Adequate nutrition is an important aspect of a healthy lifestyle for all individuals, including bank staff. The objective of this study was to investigate the awareness of food nutritive value and eating practices among bank workers in Lagos State, Nigeria.The study adopted a cross-sectional descriptive survey design. A purposive sample of 250 bank workers took part in the study. Means and Student t tests were employed for data analysis.Results showed that bank workers were aware of the nutritive value of foods, and that eating practices commonly adopted included skipping breakfast, eating breakfast at work, buying food at work from the bank canteen, eating in between meals, buying snacks as lunch, and consuming soft drinks daily, among others. There were no significant differences between male and female bank workers in mean responses on food nutritive value or in eating practices adopted.Good eating habits will help bank workers not only to improve their nutritional well-being, but also to prevent nutrition-related diseases. The implications for nutritional counseling and education are discussed in the context of these findings.

  17. Privacy Practices of Health Social Networking Sites: Implications for Privacy and Data Security in Online Cancer Communities.

    Science.gov (United States)

    Charbonneau, Deborah H

    2016-08-01

    While online communities for social support continue to grow, little is known about the state of privacy practices of health social networking sites. This article reports on a structured content analysis of privacy policies and disclosure practices for 25 online ovarian cancer communities. All of the health social networking sites in the study sample provided privacy statements to users, yet privacy practices varied considerably across the sites. The majority of sites informed users that personal information was collected about participants and shared with third parties (96%, n = 24). Furthermore, more than half of the sites (56%, n = 14) stated that cookies technology was used to track user behaviors. Despite these disclosures, only 36% (n = 9) offered opt-out choices for sharing data with third parties. In addition, very few of the sites (28%, n = 7) allowed individuals to delete their personal information. Discussions about specific security measures used to protect personal information were largely missing. Implications for privacy, confidentiality, consumer choice, and data safety in online environments are discussed. Overall, nurses and other health professionals can utilize these findings to encourage individuals seeking online support and participating in social networking sites to build awareness of privacy risks to better protect their personal health information in the digital age.

  18. Procedural confidence in hospital based practitioners: implications for the training and practice of doctors at all grades

    Directory of Open Access Journals (Sweden)

    Tsagkaraki Petroula A

    2009-01-01

    Full Text Available Abstract Background Medical doctors routinely undertake a number of practical procedures and these should be performed competently. The UK Postgraduate Medical Education and Training Board (PMETB curriculum lists the procedures trainees should be competent in. We aimed to describe medical practitioner's confidence in their procedural skills, and to define which practical procedures are important in current medical practice. Methods A cross sectional observational study was performed measuring procedural confidence in 181 hospital practitioners at all grades from 2 centres in East Anglia, England. Results Both trainees and consultants provide significant service provision. SpR level doctors perform the widest range and the highest median number of procedures per year. Most consultants perform few if any procedures, however some perform a narrow range at high volume. Cumulative confidence for the procedures tested peaks in the SpR grade. Five key procedures (central line insertion, lumbar puncture, pleural aspiration, ascitic aspiration, and intercostal drain insertion are the most commonly performed, are seen as important generic skills, and correspond to the total number of procedures for which confidence can be maintained. Key determinants of confidence are gender, number of procedures performed in the previous year and total number of procedures performed. Conclusion The highest volume of service requirement is for six procedures. The procedural confidence is dependent upon gender, number of procedures performed in the previous year and total number of procedures performed. This has implications for those designing the training curriculum and with regards the move to shorten the duration of training.

  19. Infant and Young Child Feeding Behavior among Working Mothers in India: Implications for Global Health Policy and Practice

    Directory of Open Access Journals (Sweden)

    Vinay Kumar, MD, MPH

    2014-12-01

    Full Text Available Background: The National Guidelines on Infant and Young Child Feeding introduced in 2006 recommended the initiation of breastfeeding immediately after birth, preferably within one hour; exclusive breastfeeding for the first six months; appropriate and adequate complementary feeding from six months of age while continuing breastfeeding; and continued breastfeeding up to the age of two years or beyond. Working women in India constitute a dominant and expanding pool of mothers. There is paucity of research focused on feeding behavior within this group. Method: One hundred and fifty working women answered a structured questionnaire about their demographics, birth history, levels of awareness and practice of feeding guidelines, and perceptions about breastfeeding and counseling. Data analysis was carried out using Microsoft Excel and the Statistical Package for the Social Sciences. Results: Majority of participants belonged to 21-39 years age group, had nuclear families, received college education, and delivered in institutional setups. Gaps were observed between the mother’s levels of awareness and practice for different tenets of national guidelines. Higher education, longer maternity leave, higher income, and utilization of counseling services facilitated adoption of optimal feeding behavior. Most women perceived breast milk to be superior to any alternative and favored provision of counseling during last trimester. Conclusions and Global Health Implications: Counseling women on optimal feeding behavior is a potential intervention to convert its awareness into actual practice. The lessons learned from this study can help refine both national and global Mother and Child Health policies and programs.

  20. A population-based audit of ethnicity and breast cancer risk in one general practice catchment area in North London, UK: implications for practice

    Directory of Open Access Journals (Sweden)

    Ferris Michelle

    2007-09-01

    Full Text Available Abstract Objectives To conduct a pilot population-based study within a general practice catchment area to determine whether the incidence of breast cancer was increased in the Ashkenazi population. Design Population-based cohort study. Setting A single general practice catchment area in North London. Participants 1947 women over the age of 16 who responded to a questionnaire about ethnicity and breast cancer. Main outcome measures Incidence of breast cancer, ethnicity. Results This study showed a 1.5-fold (95% CI 0.93–2.39 increase in breast cancer risk in the Ashkenazim compared with the non-Ashkenazi white population. The increased incidence was for both premenopausal and postmenopausal breast cancer (expected incidence pre:post is 1:4 whereas in the Ashkenazim it was 1:1; 51 and 52% of cases respectively. This increase was not shown in the Sephardim. Asians had a reduction in incidence (OR = 0.44; 95% CI 0.10–1.89. Results were adjusted for other risk factors for breast cancer. Conclusion This study showed a 1.5-fold increase in breast cancer rates in Ashkenazim compared with the non-Jewish white population when adjusted for age (i.e. corrections were made to allow comparison of age groups and this is not observed in the Sephardic population. The proportion of premenopausal breast cancer was just over double that of the general population. This is the first general practice population-based study in the UK to address this issue and has implications for general practitioners who care for patients from the Ashkenazi community.

  1. Restructuring patient flow logistics around patient care needs: implications and practicalities from three critical cases.

    Science.gov (United States)

    Villa, Stefano; Barbieri, Marta; Lega, Federico

    2009-06-01

    To make hospitals more patient-centered it is necessary to intervene on patient flow logistics. The study analyzes three innovative redesign projects implemented at three Italian hospitals. The three hospitals have reorganized patient flow logistics around patient care needs using, as proxies, the expected length of stay and the level of nursing assistance. In order to do this, they have extensively revised their logistical configuration changing: (1) the organization of wards, (2) the hospital's physical lay-out, (3) the capacity planning system, and (4) the organizational roles supporting the patient flow management. The study describes the changes implemented as well as the results achieved and draws some general lessons that provide useful hints for those other hospitals involved in such type of redesign projects. The paper ends by discussing some policy implications. In fact, the results achieved in the three cases investigated provide interesting material for further discussion on clinical, operational, and economic issues.

  2. Health and environmental implications of rural female entrepreneurship practices in osun state Nigeria.

    Science.gov (United States)

    Akinbami, Catherine A O; Momodu, Abiodun S

    2013-09-01

    In rural Nigeria, food processing is mostly engaged in by women and children. Most of these processes are done using outdated technologies that make use of traditional woodstoves. This article presents the health and environmental implications of the rural female entrepreneurs involved in food processing and proffer means of bettering the lot of these women to handle these hazards. A partially structured questionnaire and focus group discussion was used to capture data from respondents. The study revealed that about 73 % of women involved in direct production of garri and palm oil processing could be at risk of early death or disability-adjusted life years from the mentioned diseases. The article concludes that the rural female entrepreneur needs to be better positioned to handle these hazards, for her health, that of her children, as well as for the environment.

  3. No Fault Found events in maintenance engineering Part 1: Current trends, implications and organizational practices

    International Nuclear Information System (INIS)

    Khan, Samir; Phillips, Paul; Jennions, Ian; Hockley, Chris

    2014-01-01

    This paper presents the first part of a state of the art review on the No Fault Found (NFF) phenomenon. The aim has been to compile a systematic reference point for burgeoning NFF literature, and to provide a comprehensive overview for gaining an understanding of NFF knowledge and concepts. Increasing systems complexities have seen a rise in the number of unknown failures that are being reported during operational service. Units tagged as ‘NFF’ are evidence that a serviceable component was removed, and attempts to troubleshoot the root cause have been unsuccessful. There are many reasons on how these failures manifest themselves and these papers describe the prominent issues that have persisted across a variety of industrial applications and processes for decades. This article, in particular, deals with the impact of NFF from an organizational culture and human factors point of view. It also highlights recent developments in NFF standards, its financial implications and safety concerns

  4. Paradigm shift or annoying distraction: emerging implications of web 2.0 for clinical practice.

    Science.gov (United States)

    Spallek, H; O'Donnell, J; Clayton, M; Anderson, P; Krueger, A

    2010-01-01

    Web 2.0 technologies, known as social media, social technologies or Web 2.0, have emerged into the mainstream. As they grow, these new technologies have the opportunity to influence the methods and procedures of many fields. This paper focuses on the clinical implications of the growing Web 2.0 technologies. Five developing trends are explored: information channels, augmented reality, location-based mobile social computing, virtual worlds and serious gaming, and collaborative research networks. Each trend is discussed based on their utilization and pattern of use by healthcare providers or healthcare organizations. In addition to explorative research for each trend, a vignette is presented which provides a future example of adoption. Lastly each trend lists several research challenge questions for applied clinical informatics.

  5. A critical review of the implication of nanotechnology in modern dental practice

    Science.gov (United States)

    Verma, Sanjeev Kumar; Prabhat, K. C.; Goyal, Lata; Rani, Manita; Jain, Amit

    2010-01-01

    Curiosity has its own reason for existing. For thousands of years, mankind has been harnessing its curiosity into inquiry and the process of scientific methodology. If we consider technology as an engine, then science is its fuel. Science of miniaturization (nanotechnology) is manipulating matter at nanometer level and the application of the same to medicine is called nanomedicine. Nanotechnology holds promise for advanced diagnostics, targeted drug delivery, and biosensors. When we gain access to hold the nanorobots, we will be able to treat very rapidly a number of diseases that are a continuous threat for mankind today. The present article aims to provide an early glimpse on the impact and future implication of nanotechnology in dentistry, especially in oral surgery and orthodontics. PMID:22442549

  6. Trust in leadership: meta-analytic findings and implications for research and practice.

    Science.gov (United States)

    Dirks, Kurt T; Ferrin, Donald L

    2002-08-01

    In this study, the authors examined the findings and implications of the research on trust in leadership that has been conducted during the past 4 decades. First, the study provides estimates of the primary relationships between trust in leadership and key outcomes, antecedents, and correlates (k = 106). Second, the study explores how specifying the construct with alternative leadership referents (direct leaders vs. organizational leadership) and definitions (types of trust) results in systematically different relationships between trust in leadership and outcomes and antecedents. Direct leaders (e.g., supervisors) appear to be a particularly important referent of trust. Last, a theoretical framework is offered to provide parsimony to the expansive literature and to clarify the different perspectives on the construct of trust in leadership and its operation.

  7. Road safety practices among commercial motorcyclists in a rural town in Nigeria: implications for health education.

    Science.gov (United States)

    Amoran, O E; Eme, Owoaje; Giwa, O A; Gbolahan, O B

    This cross-sectional, community-based study was carried out among commercial motorcyclists in Igboora. All the commercial motor parks in Igboora were visited and all the commercial motorcyclists who consented to participate in the study were interviewed. Information on the respondents' socio-demographic characteristics, and the practice of road safety measures was collected using an interviewer administered questionnaire. A total of 299 motorcyclists were interviewed. All (100%) of them were males. The mean age of the respondents was 27.4 +/- 7.4 years. One hundred eighty-two (60.7%) of the motorcyclists had the correct knowledge of the purpose of Highway Code. Only 70 (23.3%) could recognize more than half of the currently used road safety codes and 47 (15.7%) obey these road safety codes more than half of the time they see it. Only 183 (61.2%) of them had a driving license and 72 (24.1%) were able to produce these licenses on demand. All (100%) of the respondents did not use any protective helmet. Those who have longer years of working experience, higher level of education and higher knowledge of the safety codes practice it more regularly (r = 0.198, p = 0.001, chi2= 9.31, p = 0.025, and r = 0.28, p = 0.001 respectively). One hundred thirty-six (45.5%) have been involved in at least one accident in the preceding year. The overall incidence of road traffic accident was 2.16 per 1,000. There was however on statistically significant association between the practice of road safety codes and the occurrence of road traffic accidents (chi2= 0.176, p = 0.916). The study shows that the practice of road safety measures was low in this rural Nigerian community and was not associated with the incidence of road traffic accidents. Introducing road safety education particularly targeted at educating the motorcyclists on the importance and practice of road safety measures would lead to an increase in the practice of the safety measures and hopefully a reduction in the incidence

  8. Acceptability of evidence-based neonatal care practices in rural Uganda – implications for programming

    Directory of Open Access Journals (Sweden)

    Kiguli Juliet

    2008-06-01

    Full Text Available Abstract Background Although evidence-based interventions to reach the Millennium Development Goals for Maternal and Neonatal mortality reduction exist, they have not yet been operationalised and scaled up in Sub-Saharan African cultural and health systems. A key concern is whether these internationally recommended practices are acceptable and will be demanded by the target community. We explored the acceptability of these interventions in two rural districts of Uganda. Methods We conducted 10 focus group discussions consisting of mothers, fathers, grand parents and child minders (older children who take care of other children. We also did 10 key informant interviews with health workers and traditional birth attendants. Results Most maternal and newborn recommended practices are acceptable to both the community and to health service providers. However, health system and community barriers were prevalent and will need to be overcome for better neonatal outcomes. Pregnant women did not comprehend the importance of attending antenatal care early or more than once unless they felt ill. Women prefer to deliver in health facilities but most do not do so because they cannot afford the cost of drugs and supplies which are demanded in a situation of poverty and limited male support. Postnatal care is non-existent. For the newborn, delayed bathing and putting nothing on the umbilical cord were neither acceptable to parents nor to health providers, requiring negotiation of alternative practices. Conclusion The recommended maternal-newborn practices are generally acceptable to the community and health service providers, but often are not practiced due to health systems and community barriers. Communities associate the need for antenatal care attendance with feeling ill, and postnatal care is non-existent in this region. Health promotion programs to improve newborn care must prioritize postnatal care, and take into account the local socio-cultural situation

  9. Acceptability of evidence-based neonatal care practices in rural Uganda - implications for programming.

    Science.gov (United States)

    Waiswa, Peter; Kemigisa, Margaret; Kiguli, Juliet; Naikoba, Sarah; Pariyo, George W; Peterson, Stefan

    2008-06-21

    Although evidence-based interventions to reach the Millennium Development Goals for Maternal and Neonatal mortality reduction exist, they have not yet been operationalised and scaled up in Sub-Saharan African cultural and health systems. A key concern is whether these internationally recommended practices are acceptable and will be demanded by the target community. We explored the acceptability of these interventions in two rural districts of Uganda. We conducted 10 focus group discussions consisting of mothers, fathers, grand parents and child minders (older children who take care of other children). We also did 10 key informant interviews with health workers and traditional birth attendants. Most maternal and newborn recommended practices are acceptable to both the community and to health service providers. However, health system and community barriers were prevalent and will need to be overcome for better neonatal outcomes. Pregnant women did not comprehend the importance of attending antenatal care early or more than once unless they felt ill. Women prefer to deliver in health facilities but most do not do so because they cannot afford the cost of drugs and supplies which are demanded in a situation of poverty and limited male support. Postnatal care is non-existent. For the newborn, delayed bathing and putting nothing on the umbilical cord were neither acceptable to parents nor to health providers, requiring negotiation of alternative practices. The recommended maternal-newborn practices are generally acceptable to the community and health service providers, but often are not practiced due to health systems and community barriers. Communities associate the need for antenatal care attendance with feeling ill, and postnatal care is non-existent in this region. Health promotion programs to improve newborn care must prioritize postnatal care, and take into account the local socio-cultural situation and health systems barriers including the financial burden. Male

  10. Secondary education student bodily practices: implications of gender in and outside physical education classes

    Directory of Open Access Journals (Sweden)

    Aline Fernanda Ferreira

    2016-03-01

    Full Text Available Abstract The present study aimed to analyze the bodily practices of high school students inside and outside of the physical education classes from the perspective of gender. A total of 426 students (63.7% girls and 36.3% boys enrolled in the 2nd year of public high schools in a municipality in the interior of São Paulo State participated in the study. To collect the data, a questionnaire was elaborated and analyzed based on categories of survey and systematic cross-gender comparisons. The results showed that, in general, boys are more physically active than girls, regarding practices inside and outside of physical education classes. Distinctions were found regarding the bodily manisfestations chosen by each group, the behavior associated with the social and the cultural contexts to which boys and girls are exposed from birth to adult life.

  11. Hysterectomy Pathway as the Global Engine of Practice Change: Implications for Value in Care

    Directory of Open Access Journals (Sweden)

    Amin Sanei-Moghaddam

    2017-09-01

    Results: Physician respondents found the clinical pathway to be practical, beneficial to patients, and up-to-date with the latest evidence-based literature. Key barriers to the use of the pathway that were identified by physicians included perceived waste of time, inappropriateness for some of the patient groups, improper incentive structure, and excessive bureaucracy surrounding the process.  Overall, patient respondents were satisfied with the tool and found it to be helpful with the decision-making process of choosing a hysterectomy route.  Conclusions: Physicians and patients found the developed tools to be practical and beneficial. Findings of this study will help to use pathways as a unifying framework to shape future care of patients needing hysterectomy and add value to their care.

  12. Traditional massage of newborns in Nepal: implications for trials of improved practice.

    Science.gov (United States)

    Mullany, Luke C; Darmstadt, Gary L; Khatry, Subarna K; Tielsch, James M

    2005-04-01

    Mustard oil massage of newborns is an integral component of traditional care practices in many communities. Recent evidence suggests that this practice may have detrimental effects, particularly for preterm infants or for those whose skin barrier function is otherwise sub-optimal. Other natural oils such as sunflower, sesame or safflower seed oil may have a beneficial impact on newborn health and survival. Little is known, however, about cultural and other factors related to the acceptance and uptake of alternative, more beneficial oils for massage of the newborn. A questionnaire concerning the usage and reasons for application of mustard and other oils to newborn skin was administered to the caretakers of 8580 newborns in Sarlahi district of rural Nepal. Four focus group discussions among representative groups were conducted to describe the perceived benefits of oil massage and the factors involved in the decision to apply oil. The potential for the introduction of alternative natural oils was explored. Approximately 99 per cent of newborns were massaged at least once with mustard oil in the 2 weeks after birth, and 80 per cent were massaged at least twice daily. Promotion of strength, maintenance of health, and provision of warmth were the most commonly cited reasons for application of mustard oil. Focus group discussion participants noted that smell, oiliness, mode of pre-massage preparation, and perceived absorptive potential on the skin are important contextual factors involved in the practice. Caretakers are willing to consider adaptation of established traditions for the promotion of positive health outcomes if essential contextual criteria are met. An understanding of cultural, social, and economic factors that shape the context of traditional healthcare practices is essential to the design and implementation of intervention trials examining the relative efficacy of application of oils in reducing neonatal mortality and morbidity.

  13. Managing health and safety risks: Implications for tailoring health and safety management system practices.

    Science.gov (United States)

    Willmer, D R; Haas, E J

    2016-01-01

    As national and international health and safety management system (HSMS) standards are voluntarily accepted or regulated into practice, organizations are making an effort to modify and integrate strategic elements of a connected management system into their daily risk management practices. In high-risk industries such as mining, that effort takes on added importance. The mining industry has long recognized the importance of a more integrated approach to recognizing and responding to site-specific risks, encouraging the adoption of a risk-based management framework. Recently, the U.S. National Mining Association led the development of an industry-specific HSMS built on the strategic frameworks of ANSI: Z10, OHSAS 18001, The American Chemistry Council's Responsible Care, and ILO-OSH 2001. All of these standards provide strategic guidance and focus on how to incorporate a plan-do-check-act cycle into the identification, management and evaluation of worksite risks. This paper details an exploratory study into whether practices associated with executing a risk-based management framework are visible through the actions of an organization's site-level management of health and safety risks. The results of this study show ways that site-level leaders manage day-to-day risk at their operations that can be characterized according to practices associated with a risk-based management framework. Having tangible operational examples of day-to-day risk management can serve as a starting point for evaluating field-level risk assessment efforts and their alignment to overall company efforts at effective risk mitigation through a HSMS or other processes.

  14. The optimisation principle and the new ICRP recommendations: practical implications on operational radiation protection

    International Nuclear Information System (INIS)

    Lochard, J.

    1992-01-01

    The formulation of the optimisation principle proposed by the International Commission of Radiological Protection in its new recommendations is largely oriented towards better control of individual doses. In this perspective, the concept of doe constraint and the reference to equity in dose distributions are becoming key elements within the optimisation process. This paper discusses some first reflexions regarding this new orientation and outlines the main impacts that must be forwarded to the practical level. (author)

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

    Science.gov (United States)

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

    2014-02-01

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

  16. Green Service Practices: Performance Implications and the Role of Environmental Management Systems

    OpenAIRE

    Christina W. Y. Wong; Chee Yew Wong; Sakun Boon-itt

    2013-01-01

    Research on the effects of environmental management has largely neglected the importance of green service practices and their impact on environmental protection and cost reduction. There is also little knowledge on how service-oriented firms may leverage their efforts in providing green services to achieve performance improvement through their existing environmental management system (EMS). Grounded in the natural resource-based view in conjunction with the contingency theory, we develop a mo...

  17. A randomized study of multimedia informational aids for research on medical practices: implications for informed consent

    Science.gov (United States)

    Kraft, Stephanie A; Constantine, Melissa; Magnus, David; Porter, Kathryn M.; Lee, Sandra Soo-Jin; Green, Michael; Kass, Nancy E; Wilfond, Benjamin S.; Cho, Mildred K

    2016-01-01

    Background/aims Participant understanding is a key element of informed consent for enrollment in research. However, participants often do not understand the nature, risks, benefits, or design of the studies in which they take part. Research on medical practices, which studies standard interventions rather than new treatments, has the potential to be especially confusing to participants because it is embedded within usual clinical care. Our objective in this randomized study was to compare the ability of a range of multimedia informational aids to improve participant understanding in the context of research on medical practices. Methods We administered a Web-based survey to members of a proprietary online panel sample selected to match national U.S. demographics. Respondents were randomized to one of five arms: four content-equivalent informational aids (animated videos, slideshows with voiceover, comics, and text), and one no-intervention control. We measured knowledge of research on medical practices using a summary knowledge score from 10 questions based on the content of the informational aids. We used ANOVA and paired t-tests to compare knowledge scores between arms. Results There were 1500 completed surveys (300 in each arm). Mean knowledge scores were highest for the slideshows with voiceover (65.7%), followed by the animated videos (62.7%), comics (60.7%), text (57.2%), and control (50.3%). Differences between arms were statistically significant except between the slideshows with voiceover and animated videos and between the animated videos and comics. Informational aids that included an audio component (animated videos and slideshows with voiceover) had higher knowledge scores than those without an audio component (64.2% versus 59.0%, peffectively than text alone. However, the relatively low knowledge scores suggest that targeted informational aids may be needed to teach some particularly challenging concepts. Nonetheless, our results demonstrate the

  18. NON-TERRITORIAL AUTONOMY IN RUSSIA: PRACTICAL IMPLICATIONS OF THEORETICAL APPROACHES

    Directory of Open Access Journals (Sweden)

    Tatiana RUDNEVA

    2012-06-01

    Full Text Available Despite the theoretical possibility to use non-territorial autonomy as a mechanism through which ethnic groups can fulfil their right to selfdetermination along with other minority rights, not many states have been willing to put theory into practice. The article offers an explanation why wider applicability of NTA is problematic by arguing that the theory itself is not yet polished enough to be implemented. The study includes examination of both theoretical approaches and empirical data from a case study of an attempt to establish NTAs in the Russian Federation. The findings suggest that inconsistencies and unclarities in the theory do correlate with practical flaws of NTAs, which allows to suggest that when the theory is tested empirically, the reality reveals all the flaws of the theory. The results indicate that the concept of NTA needs further refinement and development to make it more practice-oriented and applicable. As the problem of minority rights is still to be dealt with, we also propose a model of global union of NTAs where each ethnic group is represented by a non-governmental organisation, which seems to be more applicable than the others, alongside a number of other mechanisms that are even more essential and universal and focus on defending basic human rights

  19. Organizational climate in primary care settings: implications for nurse practitioner practice.

    Science.gov (United States)

    Poghosyan, Lusine; Nannini, Angela; Clarke, Sean

    2013-03-01

    The purpose of this review is to investigate literature related to organizational climate, define organizational climate, and identify its domains for nurse practitioner (NP) practice in primary care settings. A search was conducted using MEDLINE, PubMed, HealthSTAR/Ovid, ISI Web of Science, and several other health policy and nursingy databases. In primary care settings, organizational climate for NPs is a set of organizational attributes, which are perceived by NPs about their practice setting, emerge from the way the organization interacts with NPs, and affect NP behaviors and outcomes. Autonomy, NP-physician relations, and professional visibility were identified as organizational climate domains. NPs should be encouraged to assess organizational climate in their workplace and choose organizations that promote autonomy, collegiality between NPs and physicians, and encourage professional visibility. Organizational and NP awareness of qualities that foster NP practice will be a first step for developing strategies to creating an optimal organizational climate for NPs to deliver high-quality care. More research is needed to develop a comprehensive conceptual framework for organizational climate and develop new instruments to accurately measure organizational climate and link it to NP and patient outcomes. ©2012 The Author(s) Journal compilation ©2012 American Association of Nurse Practitioners.

  20. Microscope use in clinical veterinary practice and potential implications for veterinary school curricula.

    Science.gov (United States)

    Stewart, Sherry M; Dowers, Kristy L; Cerda, Jacey R; Schoenfeld-Tacher, Regina M; Kogan, Lori R

    2014-01-01

    Microscopy (skill of using a microscope) and the concepts of cytology (study of cells) and histology (study of tissues) are most often taught in professional veterinary medicine programs through the traditional method of glass slides and light microscopes. Several limiting factors in veterinary training programs are encouraging educators to explore innovative options for teaching microscopy skills and the concepts of cytology and histology. An anonymous online survey was administered through the Colorado Veterinary Medical Association to Colorado veterinarians working in private practice. It was designed to assess their current usage of microscopes for cytological and histological evaluation of specimens and their perceptions of microscope use in their veterinary education. The first part of the survey was answered by 183 veterinarians, with 104 indicating they had an onsite diagnostic lab. Analysis pertaining to the use of the microscope in practice and in veterinary programs was conducted on this subset. Most respondents felt the amount of time spent in the curriculum using a microscope was just right for basic microscope use and using the microscope for viewing and learning about normal and abnormal histological sections and clinical cytology. Participants felt more emphasis could be placed on clinical and diagnostic cytology. Study results suggest that practicing veterinarians frequently use microscopes for a wide variety of cytological diagnostics. However, only two respondents indicated they prepared samples for histological evaluation. Veterinary schools should consider these results against the backdrop of pressure to implement innovative teaching techniques to meet the changing needs of the profession.

  1. Knowledge, Attitudes, and Practices of Pediatric Dentists Regarding Speech Evaluation of Patients: Implications for Dental Education.

    Science.gov (United States)

    Van Eyndhoven, Lisa; Chussid, Steven; Yoon, Richard K

    2015-11-01

    The aim of this cross-sectional study was to determine pediatric dentists' attitudes about speech evaluation in the dental setting and assess their knowledge of speech development and pathology. In October 2013, members of the American Academy of Pediatric Dentistry were invited to participate in an electronic questionnaire. Categories of questions were demographics, attitudes and confidence in speech pathology, and theoretical and practical knowledge of speech development and speech pathology. Theoretical knowledge was assessed using questions about phonetics and speech milestones. Practical knowledge was determined with three 30-second interview-style video clips. A total of 539 responses were received for a response rate of 10.4%. The majority of respondents reported feeling that speech evaluation should be part of the pediatric dental visit (72.8%) and felt confident in their ability to detect speech issues (73.2%). However, they did poorly on the theoretical knowledge questions (41.9%) as well as the practical knowledge questions (8.5%). There was a statistically significant difference in theoretical score between gender and type of occupation (pspeech issues, they currently have insufficient training and knowledge to do so.

  2. Thermodynamics of Highly Supersaturated Aqueous Solutions of Poorly Water-Soluble Drugs-Impact of a Second Drug on the Solution Phase Behavior and Implications for Combination Products.

    Science.gov (United States)

    Trasi, Niraj S; Taylor, Lynne S

    2015-08-01

    There is increasing interest in formulating combination products that contain two or more drugs. Furthermore, it is also common for different drug products to be taken simultaneously. This raises the possibility of interactions between different drugs that may impact formulation performance. For poorly water-soluble compounds, the supersaturation behavior may be a critical factor in determining the extent of oral absorption. The goal of the current study was to evaluate the maximum achievable supersaturation for several poorly water-soluble compounds alone, and in combination. Model compounds included ritonavir, lopinavir, paclitaxel, felodipine, and diclofenac. The "amorphous solubility" for the pure drugs was determined using different techniques and the change in this solubility was then measured in the presence of differing amounts of a second drug. The results showed that "amorphous solubility" of each component in aqueous solution is substantially decreased by the second component, as long as the two drugs are miscible in the amorphous state. A simple thermodynamic model could be used to predict the changes in solubility as a function of composition. This information is of great value when developing co-amorphous or other supersaturating formulations and should contribute to a broader understanding of drug-drug physicochemical interactions in in vitro assays as well as in the gastrointestinal tract. © 2015 Wiley Periodicals, Inc. and the American Pharmacists Association.

  3. Empowerment and Social Support: Implications for Practice and Programming among Minority Women with Substance Abuse and Criminal Justice Histories

    Science.gov (United States)

    Barringer, Alexandra; Hunter, Bronwyn A.; Salina, Doreen; Jason, Leonard A.

    2016-01-01

    Programs for women with substance abuse and criminal justice histories often incorporate empowerment and social support into service delivery systems. Women’s empowerment research has focused on the relationship between women’s personal identities and the larger sociopolitical context, with an emphasis on how community based resources are critical for promoting well-being. Social support often protects against negative outcomes for individuals who live with chronic stress. However, few studies have evaluated community resource knowledge and empowerment among marginalized women or how social support might strengthen or weaken this relationship. This study investigated resource knowledge, social support and empowerment among 200 minority women in substance abuse recovery who had recent criminal justice involvement. Results indicated that resource knowledge was related to empowerment and belonging social support marginally moderated this relationship. In addition, education level increased and current involvement in the criminal justice system decreased empowerment. Implications for research, practice and policy are discussed. PMID:27084362

  4. Adaptive practices in heart failure care teams: implications for patient-centered care in the context of complexity

    Directory of Open Access Journals (Sweden)

    Tait GR

    2015-08-01

    member and could extend to other settings. Conclusion: Adaptive practices emerged unpredictably and were variably experienced by team members. Our study offers an empirically grounded explanation of how HF care teams self-organize and how adaptive practices emerge from nonlinear interdependencies among diverse agents. We use these insights to reframe the question of palliative care integration, to ask how best to foster palliative care-aligned adaptive practices in HF care. This work has implications for health care’s growing challenge of providing care to those with chronic medical illness in complex, team-based settings. Keywords: palliative care, qualitative, complex adaptive system, multimorbidity, health care teams

  5. Knowledge, behavioral practices, and experiences of outdoor fallers: Implications for prevention programs.

    Science.gov (United States)

    Chippendale, Tracy; Raveis, Victoria

    2017-09-01

    Although the epidemiology and prevention of falls has been well studied, the focus has been on indoor rather than outdoor falls. Older adults' knowledge of outdoor risk factors and their outdoor fall prevention practices have not been examined. To fill this gap, and to inform the development of a prevention program, we sought to explore the experiences and fall prevention knowledge and practices of older adults who had sustained an outdoor fall. A cross-sectional study using random digit telephone dialing was used to survey community dwelling seniors (N=120) across the five boroughs of New York City. We used the Outdoor Falls Questionnaire (OFQ), a valid and reliable tool as the survey instrument. Perceived outdoor fall risks, strategies used for prevention, and outdoor fall experiences were examined. SPSS version 21 was used for descriptive analysis of participant characteristics and to determine frequencies of perceived outdoor fall risks and strategies used for prevention. Phenomenological analysis was used with the qualitative data. Qualitative and quantitative data were analyzed separately and a mixed methods matrix was used to interpret and integrate the findings. Analysis revealed diverse unmet education and training needs including the importance of using single vision glasses, understanding the fall risks associated with recreational areas and parking lots, safe outdoor walking strategies, safe carrying of items on level and uneven surfaces, as well as when walking up and down stairs, and safety in opening/closing doors. Study findings are informative for outdoor fall prevention programs as well as practice. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. An examination of current stroke rehabilitation practice in Peru: Implications for interprofessional education.

    Science.gov (United States)

    McDonald, Cody L; Fuhs, Amy K; Kartin, Deborah

    2018-05-01

    This study aimed to better understand current clinical practice of rehabilitation professionals in Lima, Peru, and to explore the existence of and potential for interprofessional collaboration. A secondary purpose was to assess rehabilitation professionals' agreement with evidence-based stroke rehabilitation statements and confidence performing stroke rehabilitation tasks prior to and following an interprofessional stroke rehabilitation training. Current clinical practice for rehabilitation professionals in Peru differs from high-income counties like the United States, as physical therapists work with dysphagia and feeding, prosthetist orthotists serve a strictly technical role, and nurses have a limited role in rehabilitation. Additionally, while opportunity for future interprofessional collaboration within stroke rehabilitation exists, it appears to be discouraged by current health system policies. Pre- and post-training surveys were conducted with a convenience sample of 107 rehabilitation professionals in Peru. Survey response options included endorsement of professionals for rehabilitation tasks and a Likert scale of agreement and confidence. Training participants largely agreed with evidence-based stroke rehabilitation statements. Differences in opinion remained regarding the prevalence of dysphagia and optimal frequency of therapy post-stroke. Substantially increased agreement post-training was seen in favour of early initiation of stroke rehabilitation and ankle foot orthosis use. Participants were generally confident performing traditional profession-specific interventions and educating patients and families. Substantial increases were seen in respondents' confidence to safely and independently conduct bed to chair transfers and determine physiological stability. Identification of key differences in rehabilitation professionals' clinical practice in Peru is a first step toward strengthening the development of sustainable rehabilitation systems and

  7. Cancer pain management in China: current status and practice implications based on the ACHEON survey

    Directory of Open Access Journals (Sweden)

    Xia Z

    2017-08-01

    Full Text Available Zhongjun Xia Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, ChinaPurpose: Cancer pain can seriously impact the quality of life (QoL of patients, and optimal management practices are therefore of paramount importance. The ACHEON survey queried physicians and patients from 10 Asian countries/regions to assess current clinical practices in cancer pain management in Asia. This study presents the data obtained for cancer pain management in mainland China, with an emphasis on practices related to opioid drugs.Materials and methods: In several tertiary hospitals across China, 250 patients experiencing cancer pain and 100 physicians were surveyed on questions designed to assess current cancer pain management practices and cancer pain impact on QoL.Results: The patient survey showed that 88% of patients reported moderate-to-severe cancer pain, with a median duration of 6 months. The physician survey showed that medical school/residency training with regard to cancer pain management was inadequate in ~80% of physicians. A total of 80% of physicians and 67.2% of patients reported that pain scale was used during pain assessment; 84% of physicians expressed that physician-perceived pain severity was not completely consistent with actual pain the patient experienced. Of the 147 patients who recalled the medication received, 83.7% were administered opioid prescriptions. Of the 240 patients who received treatment, 43.8% perceived the inadequacy of controlling pain. The primary barriers from physicians perceived to optimal pain management included patients’ fear of side effects (58%, patients’ fear of addiction (53%, patients’ reluctance to report pain (43%, physicians’ reluctance to prescribe (29%, physicians’ inadequacy of pain assessment (27% and excessive regulation of opioid analgesics (47%.Conclusion: Knowledge of cancer pain management should be strengthened among physicians. Quantitative pain assessment and principle-based pain

  8. A randomized study of multimedia informational aids for research on medical practices: Implications for informed consent.

    Science.gov (United States)

    Kraft, Stephanie A; Constantine, Melissa; Magnus, David; Porter, Kathryn M; Lee, Sandra Soo-Jin; Green, Michael; Kass, Nancy E; Wilfond, Benjamin S; Cho, Mildred K

    2017-02-01

    Participant understanding is a key element of informed consent for enrollment in research. However, participants often do not understand the nature, risks, benefits, or design of the studies in which they take part. Research on medical practices, which studies standard interventions rather than new treatments, has the potential to be especially confusing to participants because it is embedded within usual clinical care. Our objective in this randomized study was to compare the ability of a range of multimedia informational aids to improve participant understanding in the context of research on medical practices. We administered a web-based survey to members of a proprietary online panel sample selected to match national US demographics. Respondents were randomized to one of five arms: four content-equivalent informational aids (animated videos, slideshows with voice-over, comics, and text) and one no-intervention control. We measured knowledge of research on medical practices using a summary knowledge score from 10 questions based on the content of the informational aids. We used analysis of variance and paired t-tests to compare knowledge scores between arms. There were 1500 completed surveys (300 in each arm). Mean knowledge scores were highest for the slideshows with voice-over (65.7%), followed by the animated videos (62.7%), comics (60.7%), text (57.2%), and control (50.3%). Differences between arms were statistically significant except between the slideshows with voice-over and animated videos and between the animated videos and comics. Informational aids that included an audio component (animated videos and slideshows with voice-over) had higher knowledge scores than those without an audio component (64.2% vs 59.0%, p informational aids with a character-driven story component (animated videos and comics) and those without. Our results show that simple multimedia aids that use a dual-channel approach, such as voice-over with visual reinforcement, can

  9. Cancer survivorship care-planning: Practice, research, and policy implications for social work.

    Science.gov (United States)

    Wagner, Richard W; Pritzker, Suzanne

    2016-01-01

    Increasing numbers of cancer survivors are living longer than 5 years from their diagnosis date. This has resulted in a growing population of cancer survivors, expected to reach 19 million by 2024. Survivors frequently experience late effects caused by cancer and its treatment, reducing survivors' quality of life in multiple domains. Survivorship care-plans may aid the many physical, psychosocial, and financial needs that emerge posttreatment. However, the lack of reimbursement mechanisms, the limited amount of effectiveness research, and minimal guidelines for content and delivery are barriers to the widespread provision of survivorship care-plans. Challenges and opportunities for social work practice, research, and policy are identified and discussed.

  10. Women's experiences of long term sickness absence: implications for rehabilitation practice and theory.

    Science.gov (United States)

    Ockander, Marlene K; Timpka, Toomas

    2003-01-01

    In most European countries, spells of long-term absence contribute the largest number of days that are reimbursed as a result of sickness absence. This group is growing and it is constituted mainly of women. The present study seeks further knowledge about what happens then and there, i.e. how women on long-term sickness absence handle and explain, for themselves and others, this interruption in their daily life. Semi-structured interviews were performed with 82 middle-aged women with personal experience of long-term sickness absence. The women's accounts of sickness absence contained interpretations of what had happened to them, how things were at present, and what they thought the future would bring. Three different accounts could be distinguished: crisis, breakpoint, and migration. The perception of their own situation and especially what they thought about their future was associated with their feeling of power to take the initiative, and their well-being. From this study the authors have found implications for central topics of importance: time elapse, sense of coherence, reorientation/adaptation, vital goals, and gender.

  11. Childhood Adversities and Substance Misuse Among the Incarcerated: Implications for Treatment and Practice in Correctional Settings.

    Science.gov (United States)

    Marotta, Phillip L

    2017-05-12

    Incarcerated populations have high rates of childhood adversities and substance use problems. Moreover, childhood adversities are well-documented predictors of substance misuse. To investigate the impact of childhood sexual and physical abuse, caregiver abuse of drugs or alcohol, and time spent in foster care on several substance misuse outcomes. Data comes from a sample of 16,043 incarcerated men and women in the United States Survey of Inmates in State and Federal Facilities. Bivariate analyses revealed differences by sex in childhood adversities and socioeconomic characteristics. Logistic regression analyses assessed the data for a link between childhood adversities and substance misuse after adjusting for other variables. Analyses were stratified by sex to show differences in predictors of substance misuse between men and women. Childhood adversities increased the risk of many substance misuse outcomes. The prevalence of physical abuse, sexual abuse, foster care, and caretaker abuse of drugs or alcohol were greatest for inmates who reported injecting and sharing drugs. Growing up with a caregiver that used drugs or alcohol was a consistent predictor of increased risk of substance misuse for men and women. However, childhood sexual abuse increased risk for only women. Inmates who experience physical abuse, sexual abuse, foster care involvement and caretakers who use drugs and alcohol are at an increased risk of substance misuse, injecting drug use and syringe sharing. Implications suggest correctional HIV prevention and substance misuse programs must address unresolved trauma and important gender differences.

  12. [Sexual health and intellectual disability: a narrative literature review and its implications for nursing practice.

    Science.gov (United States)

    Pariseau-Legault, Pierre; Holmes, Dave

    2017-09-01

    Issues associated with affectivity and sexuality in the context of intellectual disability have recently been the subject of various interdisciplinary discussions in academia. In nursing, interventions in sexual health are supported with hesitation and those issues constitute a marginal field of nursing research. A narrative literature review was realized in order to establish a portrait of the knowledge produced on this topic in the last decade. This paper illustrates three specific research areas recently developed, namely issues related to sexual autonomy, contextual factors positively or negatively contributing to emotional and sexual life, and the experiences of people identified as having an intellectual disability in this regard. On the basis of these results, different issues related to sexuality and intellectual disability are discussed, including those associated with the negotiation process of affective and sexual life, parenthood as a mediator of emotional and sexual expression, and the inclusiveness issues of sexual diversity in health interventions. Implications for nursing are finally discussed in light of the recent development of its role in sexual health.

  13. Genetic and epigenetic features in radiation sensitivity. Part II: implications for clinical practice and radiation protection

    International Nuclear Information System (INIS)

    Bourguignon, Michel H.; Gisone, Pablo A.; Perez, Maria R.; Michelin, Severino; Dubner, Diana; Giorgio, Marina di; Carosella, Edgardo D.

    2005-01-01

    Recent progress especially in the field of gene identification and expression has attracted greater attention to the genetic and epigenetic susceptibility to cancer, possibly enhanced by ionising radiation. This issue is especially important for radiation therapists since hypersensitive patients may suffer from adverse effects in normal tissues following standard radiation therapy, while normally sensitive patients could receive higher doses of radiation, offering a better likelihood of cure for malignant tumours. Although only a small percentage of individuals are ''hypersensitive'' to radiation effects, all medical specialists using ionising radiation should be aware of the aforementioned progress in medical knowledge. The present paper, the second of two parts, reviews human disorders known or strongly suspected to be associated with hypersensitivity to ionising radiation. The main tests capable of detecting such pathologies in advance are analysed, and ethical issues regarding genetic testing are considered. The implications for radiation protection of possible hypersensitivity to radiation in a part of the population are discussed, and some guidelines for nuclear medicine professionals are proposed. (orig.)

  14. Psychological variables potentially implicated in opioid-related mortality as observed in clinical practice.

    Science.gov (United States)

    Passik, Steven D; Lowery, Amy

    2011-06-01

    Opioid-related deaths in the United States have become a public health problem, with accidental and unintended overdoses being especially troubling. Screening for psychological risk factors is an important first step in safeguarding against nonadherence practices and identifying patients who may be vulnerable to the risks associated with opioid therapy. Validated screening instruments can aid in this attempt as a complementary tool to clinicians' assessments. A structured screening is imperative as part of an assessment, as clinician judgment is not the most reliable method of identifying nonadherence. As a complement to formal screening, we present for discussion and possible future study certain psychological variables observed during years of clinical practice that may be linked to medication nonadherence and accidental overdose. These variables include catastrophizing, fear, impulsivity, attention deficit disorders, existential distress, and certain personality disorders. In our experience, chronic pain patients with dual diagnoses may become "chemical copers" as a way of coping with their negative emotion. For these patients, times of stress could lead to accidental overdose. Behavioral, cognitive-behavioral (acceptance and commitment, dialectical behavior), existential (meaning-centered, dignity), and psychotropic therapies have been effective in treating these high-risk comorbidities, while managing expectations of pain relief appears key to preventing accidental overdose. Wiley Periodicals, Inc.

  15. Critical thinking, nurse education and universities: some thoughts on current issues and implications for nursing practice.

    Science.gov (United States)

    Morrall, Peter; Goodman, Benny

    2013-09-01

    When in the latter part of the 20th century nurse 'training' in the UK left the old schools of nursing (based within the health delivery system) and entered universities, the promise was not just a change of focus from training to education but an embracement of 'higher' education. Specifically, nurses were to be exposed to the demands of thinking rather than just doing - and critical thinking at that. However, despite a history of critical perspectives informing nursing theory, that promise may be turning sour. The insidious saturation of the university system in bureaucracy and managerialism has, we argue, undermined critical thinking. A major funding restructuring of higher education in the UK, coinciding with public concern about the state of nursing practice, is undermining further the viability of critical thinking in nursing and potentially the acceptability of university education for nurses. Nevertheless, while critical thinking in universities has decayed, there is no obvious educational alternative that can provide this core attribute, one that is even more necessary to understand health and promote competent nursing practice in an increasingly complex and globalising world. We propose that nurse academics and their colleagues from many other academic and professional disciplines engage in collegiate 'moral action' to re-establish critical thinking in UK universities. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. Race-Based Health Disparities and the Digital Divide: Implications for Nursing Practice.

    Science.gov (United States)

    Price, Zula

    2015-12-01

    Knowledge of the sources of race-based health disparities could improve nursing practice and education in minority underserved communities. This purpose of this paper was to consider if Black-nonBlack health disparities were at least in part explained by Black-nonBlack disparities in access to Internet-based health information. With data on the U.S. adult population from the 2012 General Social Survey, the parameters of a health production function in which computer usage as an input was estimated. It was found that while there are Black-nonBlack disparities in health, once computer usage was accounted for, Black-nonBlack health disparities disappeared. This suggests nursing and health interventions that improve Internet access for Black patients in underserved communities could improve the health of Black Americans and close the racial health disparities gap. These findings complement recent nursing researchfindings that suggest closing Black-nonBlack disparities in computer access, the "digital divide," can render nursing practice more effective in providing care to minority and underserved communities.

  17. New perspectives on the theory of justice: implications for physical therapy ethics and clinical practice.

    Science.gov (United States)

    Edwards, Ian; Delany, Clare M; Townsend, Anne F; Swisher, Laura Lee

    2011-11-01

    Recent revisions of physical therapy codes of ethics have included a new emphasis concerning health inequities and social injustice. This emphasis reflects the growing evidence regarding the importance of social determinants of health, epidemiological trends for health service delivery, and the enhanced participation of physical therapists in shaping health care reform in a number of international contexts. This perspective article suggests that there is a "disconnect" between the societal obligations and aspirations expressed in the revised codes and the individualist ethical frameworks that predominantly underpin them. Primary health care is an approach to health care arising from an understanding of the nexus between health and social disadvantage that considers the health needs of patients as expressive of the health needs of the communities of which they are members. It is proposed that re-thinking ethical frameworks expressed in codes of ethics can both inform and underpin practical strategies for working in primary health care. This perspective article provides a new focus on the ethical principle of justice: the ethical principle that arguably remains the least consensually understood and developed in the ethics literature of physical therapy. A relatively recent theory of justice known as the "capability approach to justice" is discussed, along with its potential to assist physical therapy practitioners to further develop moral agency in order to address situations of health inequity and social injustice in clinical practice.

  18. Clinical leadership in contemporary clinical practice: implications for nursing in Australia.

    Science.gov (United States)

    Davidson, P M; Elliott, D; Daly, J

    2006-04-01

    Leadership in the clinical practice environment is important to ensure both optimal patient outcomes and successive generations of motivated and enthusiastic clinicians. The present paper seeks to define and describe clinical leadership and identify the facilitators and barriers to clinical leadership. We also describe strategies to develop clinical leaders in Australia. Key drivers to the development of nursing leaders are strategies that recognize and value clinical expertise. These include models of care that highlight the importance of the nursing role; evidence-based practice and measurement of clinical outcomes; strategies to empower clinicians and mechanisms to ensure participation in clinical decision-making. Significant barriers to clinical leadership are organizational structures that preclude nurses from clinical decision making; the national shortage of nurses; fiscal constraints; absence of well evaluated models of care and trends towards less skilled clinicians. Systematic, strategic initiatives are required to nurture and develop clinical leaders. These strategies need to be collegial collaborations between the academic and health care sectors in order to provide a united voice for advancing the nursing profession.

  19. Compaction creep of simulated anhydrite fault gouge by pressure solution: theory v. experiments and implications for fault sealing

    NARCIS (Netherlands)

    Pluymakers, A. M. H; Spiers, Christopher

    2015-01-01

    The sealing and healing behaviour of faults filled with anhydrite gouge, by processes such as pressure solution, is of interest in relation both to the integrity of faults cutting geological storage systems sealed by anhydrite caprocks and to seismic events that may nucleate in anhydrite-bearing

  20. Exact Solution of a Faraday's Law Problem that Includes a Nonlinear Term and Its Implication for Perturbation Theory.

    Science.gov (United States)

    Fulcher, Lewis P.

    1979-01-01

    Presents an exact solution to the nonlinear Faraday's law problem of a rod sliding on frictionless rails with resistance. Compares the results with perturbation calculations based on the methods of Poisson and Pincare and of Kryloff and Bogoliuboff. (Author/GA)

  1. The importance, measurement and practical implications of worker's expectations for return to work.

    Science.gov (United States)

    Young, Amanda E; Besen, Elyssa; Choi, YoonSun

    2015-01-01

    Workers' own expectations for return to work consistently predict work status. To advance the understanding of the relationship between RTW expectations and outcomes, we reviewed existing measures to determine those which we felt were the most likely to capture the construct. A comprehensive search of the work-disability rehabilitation literature was undertaken. The review of the measures was conducted in three steps: first, a review of terminology; second, an examination of whether a time reference was included; third, an evaluation of ease of comprehension, and applicability across contexts. A total of 42 different measures were identified. One of the most striking findings was the inconsistency in terminology. Measures were also limited by not including a time reference. Problems were also identified with regards to ease of understanding, utility of response options, and applicability in a wide variety of research and applied settings. Most previously used measures contain elements that potentially limit utility. However, it would seem that further development can overcome these, resulting in a tool that provides risk prediction information, and an opportunity to start a conversation to help identify problems that might negatively impact a worker's movement through the RTW process and the outcomes achieved. Implications for Rehabilitation Return to work is an integral part of workplace injury management. The capture of RTW expectations affords a way to identify the potential for less than optimal RTW processes and outcomes. A mismatch between an injured worker's expectations and what other stakeholders might expect suggests that efforts could be made to determine what is causing the injured worker's concerns. Once underling issues are identified, work can be put into resolving these so that the worker's return to the workplace is not impeded.

  2. Framing Tobacco Dependence as a "Brain Disease": Implications for Policy and Practice.

    Science.gov (United States)

    Morphett, Kylie; Carter, Adrian; Hall, Wayne; Gartner, Coral

    2017-07-01

    Like other forms of drug dependence, tobacco dependence is increasingly being described as a "chronic brain disease." The potential consequences of this medical labelling have been examined in relation to other addictions, but the implications for tobacco control have been neglected. Some have posited that biomedical conceptions of addiction will reduce stigma and increase uptake of efficacious treatments. Others have countered that it could increase stigma, reduce treatment seeking, and deter unassisted quitting. We explored how smokers respond to the labelling of smoking as a brain disease. Semi-structured interviews with 29 Australian smokers recruited using purposive sampling. Thematic analysis was used to analyze the results. Most participants questioned the accuracy of the brain disease label as applied to smoking. They believed that smoking was not a chronic disease because they perceived smoking to be an individual's choice. In addition, many believed that this label would increase the stigma that they already felt and, did not want to adopt a "sick role" in relation to their smoking. Describing smoking as a brain disease is more likely to alienate smokers than to engage them in quitting. The application of overly medical labels of smoking are inconsistent with smokers own conceptualizations of their smoking, and may have unintended consequences if they are widely disseminated in healthcare settings or antismoking campaigns. The participants in this project believed that biomedical labels of smoking as a "brain disease" or a "chronic disease" were discordant their existing understandings of their smoking. Explanations of addiction that downplay or ignore the role of choice and autonomy risk being perceived as irrelevant by smokers, and could lead to suspicion of health professionals or an unwillingness to seek treatment. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights

  3. Yarning/Aboriginal storytelling: towards an understanding of an Indigenous perspective and its implications for research practice.

    Science.gov (United States)

    Geia, Lynore K; Hayes, Barbara; Usher, Kim

    2013-12-01

    There is increasing recognition of Indigenous perspectives from various parts of the world in relation to storytelling, research and its effects on practice. The recent emergence of storytelling or yarning as a research method in Australian Aboriginal and Torres Strait Island studies and other Indigenous peoples of the world is gaining momentum. Narratives, stories, storytelling and yarning are emerging methods in research and has wide ranging potential to shape conventional research discourse making research more meaningful and accessible for researchers. In this paper we argue for the importance of Indigenous research methods and Indigenous method(ology), within collaborative respectful partnerships with non-Indigenous researchers. It is imperative to take these challenging steps together towards better outcomes for Indigenous people and their communities. In the Australian context we as researchers cannot afford to allow the gap between Aboriginal and Torres Strait Islanders and mainstream Australia health outcomes to grow even wider. One such pathway is the inclusion of Aboriginal storytelling or yarning from an Aboriginal and Torres Strait perspective within Indigenous and non-Indigenous research paradigms. Utilising Aboriginal storytelling or yarning will provide deeper understanding; complementing a two-way research paradigm for collaborative research. Furthermore, it has significant social implications for research and clinical practice amongst Indigenous populations; thus complementing the biomedical medical paradigm.

  4. Parenting, family life, and well-being among sexual minorities: nursing policy and practice implications.

    Science.gov (United States)

    Weber, Scott

    2008-06-01

    Parenting and family life are fundamental social constructs in human society and in law and public policy. Family structures and support systems provide important economic and psychological advantages for parents as well as for their children. Stigma toward lesbian and gay parents often marginalize individuals in these families and restrict family members' full expression of social citizenship, humanity, and personhood. Stigma directly contributes to increased risk for substance abuse, anxiety, and depressive illness among both parents and children. This article reviews the relevant policy literature to deconstruct the impacts of stigma on the psychological health and well-being of sexual minority parents so that psychiatric/mental health nurses and other health care providers can identify and counter these effects in their practices and advocate for policy improvements.

  5. Social Work Practice with Arab Families: The Implications of Spirituality vis-à-vis Islam

    Directory of Open Access Journals (Sweden)

    Ronald E. Hall

    2007-12-01

    Full Text Available In the aftermath of September 11, 2001, spiritualism has become apparent as critical to social work practice with Arab families. Regrettably, research on Arab families today is all but non-existent.Their belief in Islam is the fastest growing form of spirituality in Central Asia. Social workers who do not acknowledge this fact will be at a severe disadvantage in their attempts to treat Arab clientele. It is not compulsory that practitioners endorse client belief systems or other aspects of their spirituality, but practitioners should acknowledge said systems as a critical point in the client’s frame of reference. In the interest of social justice, social workers are thus challenged to develop creative treatment strategies less confined to Western bias.

  6. The long-term career outcome study: lessons learned and implications for educational practice.

    Science.gov (United States)

    Durning, Steven J; Dong, Ting; LaRochelle, Jeffrey L; Artino, Anthony R; Gilliland, William R; DeZee, Kent J; Saguil, Aaron; Cruess, David F; Picho, Katherine; McManigle, John E

    2015-04-01

    The work of the Long-Term Career Outcome Study has been a program of scholarship spanning 10 years. Borrowing from established quality assurance literature, the Long-Term Career Outcome Study team has organized its scholarship into three phases; before medical school, during medical school, and after medical school. The purpose of this commentary is to address two fundamental questions: (1) what has been learned? and (2) how does this knowledge translate to educational practice and policy now and into the future? We believe that answers to these questions are relevant not only to our institution but also to other educational institutions seeking to provide high-quality health professions education. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

  7. Never say die: death euphemisms, misunderstandings and their implications for practice.

    Science.gov (United States)

    Rawlings, Deborah; Tieman, Jennifer J; Sanderson, Christine; Parker, Deborah; Miller-Lewis, Lauren

    2017-07-02

    A Massive Open Online Course (MOOC) on death and dying was conducted to open the dialogue around death and dying. In one activity, participants were asked to engage with language and to think of alternative words (or euphemisms) that are used to describe death. To reflect from a nursing perspective how language enables and sometimes disguises important messages and conversations. Four hundred and seventy one participants provided 3053 euphemisms. Euphemisms were varied, with many providing commentary on their purpose and use. As a society we have become quite creative in the use of euphemisms, but need to be mindful of misunderstandings and misinterpretations which can cause embarrassment and distress in clinical situations. This paper describes some of the euphemisms that were provided, examining why they are used and how their use can be easily misconstrued in daily life and in clinical practice.

  8. Stakeholder perceptions of job stress in an industrialized country: implications for policy and practice.

    Science.gov (United States)

    Page, Kathryn M; LaMontagne, Anthony D; Louie, Amber M; Ostry, Aleck S; Shaw, Andrea; Shoveller, Jeannie A

    2013-08-01

    We used a secondary, qualitative analysis of stakeholder perceptions of work stress in Australia to characterize the context for policy and practice intervention. Themes included: Individual versus contextual descriptions of stress; perceived 'gender' differences in manifesting and reporting of stress; the work/home interface; and perceived sectoral and occupational differences in compensation claim rates. We found that people often still perceive stress as an individual rather than organizational problem and view work stress as a stereotypically feminine weakness that affects only certain people. Organizations downplay and overlook risks, increasing worker reluctance to report stressors, creating barriers to job stress interventions. Our study may be relevant to other industrial countries where researchers currently study job stress interventions to improve their effectiveness. Comprehensive approaches can increase knowledge and decrease stigma about job stress and mental illness, and target both work- and non-work-related influences on mental health.

  9. Knowledge, attitude, and practice about malaria: Socio-demographic implications for malaria control in rural Ghana.

    Science.gov (United States)

    Assan, Abraham; Takian, Amirhossein; Hanafi-Bojd, Ahmad Ali; Rahimiforoushani, Abbas; Nematolahi, Shahrzad

    2017-11-01

    Despite continuing international attention to malaria prevention, the disease remains a global public health problem. We investigated socio-demographic factors influencing knowledge, attitudes, and practices about malaria in rural Ghana. Our survey looked at 354 households. Mean knowledge score was higher among individuals with a history of volunteers having visited their households to educate them about malaria; families with 4-6 members; and males. Households with at least one under-five-aged child also had significantly higher knowledge scores. Households with at least one pregnant woman evinced a positive attitude towards malaria prevention. National malaria control strategies have achieved positive results in the fight against malaria. Nonetheless, multipronged community-based health strategies that integrate malaria programs and population growth control initiatives may be able to reach by 2030 the sustainable development goal of eliminating malaria.

  10. Authoritative parenting and drug-prevention practices: implications for antidrug ads for parents.

    Science.gov (United States)

    Stephenson, Michael T; Quick, Brian L; Atkinson, Joshua; Tschida, David A

    2005-01-01

    This research employed the theory of reasoned action to investigate the role of authoritative parenting in 3 drug-prevention behaviors: (a) parental monitoring, (b) parent-child discussions, and (c) awareness of the child's environment. A phone survey of 158 parents of adolescents in 7th, 9th, and 11th grades revealed that authoritative parenting was correlated with parenting practices that reduce the likelihood of adolescent drug use, including discussing family rules about drugs, discussing strategies to avoid drugs, discussing those in trouble with drugs, parental monitoring, knowing the child's plans for the coming day, and personally knowing the child's friends well. Additionally, authoritative parenting moderated the attitude-behavioral intention relation for parental monitoring and awareness of the child's environment, with the weakest relation detected for low-authoritative parents. The utility of these findings in helping design and target antidrug messages for parents more effectively is discussed.

  11. Social work and adverse childhood experiences research: implications for practice and health policy.

    Science.gov (United States)

    Larkin, Heather; Felitti, Vincent J; Anda, Robert F

    2014-01-01

    Medical research on "adverse childhood experiences" (ACEs) reveals a compelling relationship between the extent of childhood adversity, adult health risk behaviors, and principal causes of death in the United States. This article provides a selective review of the ACE Study and related social science research to describe how effective social work practice that prevents ACEs and mobilizes resilience and recovery from childhood adversity could support the achievement of national health policy goals. This article applies a biopsychosocial perspective, with an emphasis on mind-body coping processes to demonstrate that social work responses to adverse childhood experiences may contribute to improvement in overall health. Consistent with this framework, the article sets forth prevention and intervention response strategies with individuals, families, communities, and the larger society. Economic research on human capital development is reviewed that suggests significant cost savings may result from effective implementation of these strategies.

  12. Systematic Review of Cyberbullying Interventions for Youth and Parents With Implications for Evidence-Based Practice.

    Science.gov (United States)

    Hutson, Elizabeth; Kelly, Stephanie; Militello, Lisa K

    2018-02-01

    Cyberbullying is a new risk factor for the well-being of pediatric populations. Consequences of cyberbullying include both physical and mental health concerns such as depression, anxiety, and somatic concerns. Adolescents who have been victims of cyberbullying and developed secondary symptoms are often recommended to visit a healthcare provider to obtain effective, evidence-based treatment. To date, no interventions exist in the healthcare setting for adolescents who are victims of cyberbullying. The purpose of this project is to review interventional studies on cyberbullying that have components for adolescents who have been involved with cyberbullying and their parents and to provide recommendations on effective intervention components with the goal of guiding clinical practice. A systematic review was conducted using the Institute of Medicine guidelines. A comprehensive electronic literature search was completed targeting interventions of cyberbullying in any setting. No date limits were used. Literature was searched in MEDLINE, Cumulative Index of Nursing and Allied Health Literature (CINAHL), PubMed, Communication and Mass Media Complete, Education Information Resource Center (ERIC), and PsycINFO databases. The following search terms were applied "cyberbullying" + "intervention" or "treatment" or "therapy" or "program." Only articles with a pediatric population were selected for review. Seventeen cyberbullying intervention programs in 23 articles were found to meet the search criteria. The most frequently used intervention components included education on cyberbullying for the adolescent, coping skills, empathy training, communication and social skills, and digital citizenship. Parent education on cyberbullying was also found to be important and was included in programs with significant outcomes. As youth present to healthcare providers with symptoms related to cyberbullying, effective interventions are needed to guide evidence-based practice. This review

  13. Prevention of mental and behavioural disorders: implications for policy and practice

    Science.gov (United States)

    SAXENA, SHEKHAR; JANÉ-LLOPIS, EVA; HOSMAN, CLEMENS

    2006-01-01

    There is sufficient evidence indicating the efficacy of interventions in reducing risk factors, increasing protective factors, preventing psychiatric symptoms and new cases of mental disorders. Macro-policy interventions to improve nutrition, housing and education or to reduce economic insecurity have proven to reduce mental health problems. Specific interventions to increase resilience in children and adolescents through parenting and early interventions, and programmes for children at risk for mental disorders such as those who have a mentally ill parent or have suffered parental loss or family disruption, have also shown to increase mental well-being and decrease depressive symptoms and the onset of depressive disorders. Interventions for the adult population, from macro-policy strategies, such as taxation of alcohol products or workplace legislation, to individual support for those with signs of a mental disorder, can reduce mental health problems and associated social and economic burdens. Exercise, social support or community participation have also shown to improve mental health of older populations. Public mental health will benefit from continuing building the evidence base through combining different evaluation methods across low, middle and high income countries. The translation of evidence into policy and practice calls for action at the international, national and local level, including building capacity, advocacy, mainstreaming mental health into public health and other policies and securing infrastructures and sustainability. Mental health professionals have an important role to play in improving the evidence on prevention and promotion in mental health, in engaging relevant stakeholders for developing programmes, and as professional care providers in their practice. PMID:16757984

  14. Sexual Behavior and Vaginal Practices During Pregnancy and Postpartum: Implications for HIV Prevention Strategies.

    Science.gov (United States)

    Kinuthia, John; Richardson, Barbra A; Drake, Alison L; Matemo, Daniel; Unger, Jennifer A; McClelland, Raymond S; John-Stewart, Grace

    2017-02-01

    Understanding sexual behaviors and vaginal practices of pregnant and breastfeeding women in sub-Saharan Africa is critical to inform HIV prevention strategies during these periods. HIV-uninfected women presenting for antenatal care in western Kenya were enrolled and followed through 36 weeks postpartum. Sexual behavior and vaginal practices were ascertained by structured questionnaires. Logistic regression was used to assess correlates of unprotected sex, vaginal washing, and vaginal drying. Among 1252 women enrolled, 78.4% were married (of whom 15.1% were in polygamous unions), 1.4% had a known HIV-infected partner, and 33.6% had a partner of unknown HIV status. At enrollment, 58.5% reported sex in the past month (94.3% unprotected) and 4.5% reported forced sex. Odds of unprotected sex at enrollment was >11-fold higher in married than in unmarried women (P < 0.001) and lower among women who reported partners of unknown HIV status or HIV-infected compared with HIV-uninfected partners. Median time to postpartum resumption of sex was 7 weeks (interquartile range 4-12). Prevalence of unprotected sex in the past week increased from 6.6% to 60.0% between 2 and 36 weeks postpartum (P < 0.001). Vaginal washing was reported by 60.1% of women at enrollment and prevalence remained stable postpartum; vaginal drying was reported by 17.9% at enrollment and decreased to 6.1% at 36 weeks postpartum (P < 0.001). Vaginal washing and drying were associated with forced sex. High rates of unknown partner HIV status, polygamy, and less frequent condom use among pregnant/postpartum women underscore the need for female-controlled HIV prevention interventions. Vaginal washing and drying may present challenges to microbicide use.

  15. The 'greying' of the United Kingdom nursing workforce: implications for employment policy and practice.

    Science.gov (United States)

    Buchan, J

    1999-10-01

    One in five nurses on the United Kingdom (UK) professional register is aged 50 years or older. Over the next few years, the profession will lose, through retirement, many of its most experienced practitioners. The significance for policy makers and for employers of this age-shift is two-fold. Firstly it is clear that greater numbers of nurses and midwives are reaching, or soon will reach, potential retirement age. Secondly many more nurses are now reaching their middle years and they are likely to have different requirements and attitudes to nursing work. This paper examines the employment policy and practice of the ageing of the UK nursing population. The paper examines data from official sources, and information from attitudinal surveys and case studies with employing organizations to assess the major effects of the ageing of the nursing workforce. Key findings are that the age profile of those nurses working in the National Health Service appears to be 'younger' than that of the total population, with the age profile of nurses working in nursing homes and as practice nurses being older than that of the NHS nursing workforce. However, the overall age profile of NHS nurses masks considerable variation between specialties and trusts, and the 'pool' of potential nurse returners from which the NHS and other employers attempts to recruit, is declining in numbers, as it too ages. Other major issues requiring policy attention are the provision of appropriate flexible hours to older nurses who have caring responsibilities, improving access to continuing professional development, and reducing pension provision inflexibility.

  16. Prevention of mental and behavioural disorders: implications for policy and practice.

    Science.gov (United States)

    Saxena, Shekhar; Jané-Llopis, Eva; Hosman, Clemens

    2006-02-01

    There is sufficient evidence indicating the efficacy of interventions in reducing risk factors, increasing protective factors, preventing psychiatric symptoms and new cases of mental disorders. Macro-policy interventions to improve nutrition, housing and education or to reduce economic insecurity have proven to reduce mental health problems. Specific interventions to increase resilience in children and adolescents through parenting and early interventions, and programmes for children at risk for mental disorders such as those who have a mentally ill parent or have suffered parental loss or family disruption, have also shown to increase mental well-being and decrease depressive symptoms and the onset of depressive disorders. Interventions for the adult population, from macro-policy strategies, such as taxation of alcohol products or workplace legislation, to individual support for those with signs of a mental disorder, can reduce mental health problems and associated social and economic burdens. Exercise, social support or community participation have also shown to improve mental health of older populations. Public mental health will benefit from continuing building the evidence base through combining different evaluation methods across low, middle and high income countries. The translation of evidence into policy and practice calls for action at the international, national and local level, including building capacity, advocacy, mainstreaming mental health into public health and other policies and securing infrastructures and sustainability. Mental health professionals have an important role to play in improving the evidence on prevention and promotion in mental health, in engaging relevant stakeholders for developing programmes, and as professional care providers in their practice.

  17. Assessing the nutritional status of older individuals in family practice: Evaluation and implications for management.

    Science.gov (United States)

    Mastronuzzi, Tecla; Paci, Claudio; Portincasa, Piero; Montanaro, Nicoletta; Grattagliano, Ignazio

    2015-12-01

    Malnutrition is emerging as a multidimensional concern of ageing with a high prevalence among nursing home residents. This study investigated the extent of malnutrition among old subjects in family practice and its relationship with major complications. Over 75 years old subjects (n = 274) filled the Mini Nutritional Assessment questionnaire. Appearance of major events in the following 6 months were registered. MNA scored were 11.5 ± 3.1, with 175 (64%) subjects showing no malnutrition, 69 (25%) resulted at risk, and 30 (11%) malnourished. Within at risk group, 1.4% was resident, 7% bed rested, 8% had a history of major bone fracture, 33% was demented and 24.6% hospitalized at least once in the last year. Among malnourished patients, 10% was resident, ten bed rested with 70% showing multiple bedsores, 20% have had bone fractures, 60% were demented and 13% hospital admitted in the previous year. In over 90% of them, malnutrition had neither diagnosed nor considered before. During follow-up, a significantly higher number of major events including death occurred in the malnourished group. By multivariate logistic regression, n = 56 (20.4%) patients resulted at risk of major complications. The sensitivity of the questionnaire in identifying these patients was 84% with the cut-off value of 7 associated with the highest prediction (positive predictive value, 0.92; negative predictive value, 0.71) yielding a specificity of 92%. The prevalence of malnutrition is high among older subjects in the setting of family practice. The Mini Nutritional Assessment allows to identify malnourished subjects better than BMI and effectively predicts the risk of major events. Copyright © 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  18. Integrating substance abuse care with community diabetes care: implications for research and clinical practice

    Directory of Open Access Journals (Sweden)

    Ghitza UE

    2013-01-01

    Full Text Available Udi E Ghitza,1 Li-Tzy Wu,2 Betty Tai11Center for the Clinical Trials Network, National Institute on Drug Abuse, National Institutes of Health, United States Department of Health and Human Services, Bethesda, MD, 2Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USAAbstract: Cigarette smoking and alcohol use are prevalent among individuals with diabetes in the US, but little is known about screening and treatment for substance use disorders in the diabetic population. This commentary discusses the scope and clinical implications of the public health problem of coexisting substance use and diabetes, including suggestions for future research. Diabetes is the seventh leading cause of death in the US, and is associated with many severe health complications like cardiovascular disease, stroke, kidney damage, and limb amputations. There are an estimated 24 million adults in the US with type 2 diabetes. Approximately 20% of adults aged 18 years or older with diabetes report current cigarette smoking. The prevalence of current alcohol use in the diabetic population is estimated to be around 50%–60% in epidemiological surveys and treatment-seeking populations. Cigarette smoking is associated with an increased risk of type 2 diabetes in a dose-dependent manner and is an independent modifiable risk factor for development of type 2 diabetes. Diabetic patients with an alcohol or other drug use disorder show a higher rate of adverse health outcomes. For example, these patients experience more frequent and severe health complications as well as an increased risk of hospitalization, and require longer hospital stays. They are also less likely to seek routine care for diabetes or adhere to diabetes treatment than those without an alcohol or other drug use disorder. The Affordable Care Act of 2010 and the Mental Health Parity Act and Addiction Equity Act of 2008 provide opportunities for facilitating integration of

  19. Attitudes of psychology students to depression and its treatment: Implications for clinical practice.

    Science.gov (United States)

    Economou, M; Peppou, L E; Geroulanou, K; Kontoangelos, K; Prokopi, A; Pantazi, A; Zervakaki, A; Stefanis, C N

    2017-01-01

    . The core misconception espoused pertains to the view that major depression is not a medical illness; a finding which can also be interpreted in light of the lingering controversy on the medicalization of normal sadness and human predicament. The clinical implications of these findings are substantial. Mental health professionals-educators should reflect on their own beliefs and attitudes towards depression, as they may convey stigmatizing messages to their students and thus perpetuate the stigmatization of the illness. Concomitantly, psychology students' attitudes to depression and its treatment might render them incapable of understanding their patients, responding to their needs and providing them with appropriate help, while they may hinder their effective collaboration with psychiatrists.

  20. The use of music on Barney & Friends: implications for music therapy practice and research.

    Science.gov (United States)

    McGuire , K M

    2001-01-01

    movement and props/costumes was also prevalent, and may have contributed to high interobserver reliability of tempo. Implications for music therapists and teachers working with young children and music researchers examining various epistemological questions of music learning and behavior are discussed.

  1. Adult instructors’ perceptions on ICT and diffusion practices: implications for equity of access

    Directory of Open Access Journals (Sweden)

    Bertha Salinas-Amescua

    2007-06-01

    Full Text Available This study suggests equity of access goes beyond technological availability. Based on a larger exploratory study of the initial implementation stage of the Mexican government’s community technology centers, CTCs (“plazas comunitarias”, adult education instructors’ perceptions and diffusion practices are described as a mediating factor to understand non-access of poor adults. The theoretical perspective integrates concepts from innovation diffusion studies, while questioning the limitations of this theory in terms of understanding instructors’ practices. Thus, the relation between human agency and structure, from Giddens’ Theory of Structuration, is incorporated. Qualitative data from 16 CTCs are interpreted inductively. It is concluded that CTCs were a top-down innovation; instructors perceived and diffused CTCs in very different ways, thus limiting equity of access. These social practices stem from social actors’ routines, which institutionalized courses of action; understanding them could illuminate the complexity of the diffusion process, generally depicted in linear form. Résumé : La présente étude laisse entendre que l’équité d’accès va au delà de la disponibilité technologique. Établie sur une étude préliminaire plus large de la première étape de mise en œuvre des centres communautaires de technologie du gouvernement mexicain, les CCT (« plazas comunitarias », les perceptions des instructeurs dans le domaine de l’enseignement aux adultes et les pratiques de diffusion sont décrites comme un facteur médiateur permettant de comprendre pourquoi les adultes pauvres ne peuvent y avoir accès. La perspective théorique intègre des concepts provenant d’études sur la diffusion de l’innovation tout en questionnant les limites de cette théorie en ce qui concerne la compréhension des pratiques des instructeurs. Ainsi, la relation entre l’agence et la structure humaine, de la théorie de structuration de

  2. Dissolved carbon and nitrogen dynamics in paddy fields under different water management practices and implications on green-house gas emissions

    Science.gov (United States)

    Miniotti, Eleonora; Said-Pullicino, Daniel; Bertora, Chiara; Pelissetti, Simone; Sacco, Dario; Grignani, Carlo; Lerda, Cristina; Romani, Marco; Celi, Luisella

    2013-04-01

    trends were not observed in the IRR treatment. The differences in DOC contents and in Eh trend between treatments could possibly explain the increasing trend in cumulative methane emissions in the order IRRtreatment, limited nitrification resulted in lowest nitrate concentrations in solution at all depths. However, when flooding was delayed (DRY) or substituted with rotational irrigation (IRR), greater nitrification and nitrate leaching along the soil profile were observed possibly resulting in important N losses. Differences in soil redox conditions between treatments also influenced nitrous oxide emissions with IRR showing the highest fluxes and cumulative emissions. The results of this field study show that alternative water management practices may have important implications on nutrient availability, fertilizer efficiency, losses of DOC and nitrates to surface and subsurface waters, soil C stocks as well as GHG emissions. Suggesting alternative management practices therefore requires a holistic evaluation of the extent of all the processes involved. This research was partly supported by the Italian Ministry of Agriculture, Food and Forestry within the project POLORISO.

  3. Conservation practice establishment in two northeast Iowa watersheds: Strategies, water quality implications, and lessons learned

    Science.gov (United States)

    Gassman, Philip W.; Tisl, J.A.; Palas, E.A.; Fields, C.L.; Isenhart, T.M.; Schilling, K.E.; Wolter, C.F.; Seigley, L.S.; Helmers, M.J.

    2010-01-01

    Coldwater trout streams are important natural resources in northeast Iowa. Extensive efforts have been made by state and federal agencies to protect and improve water quality in northeast Iowa streams that include Sny Magill Creek and Bloody Run Creek, which are located in Clayton County. A series of three water quality projects were implemented in Sny Magill Creek watershed during 1988 to 1999, which were supported by multiple agencies and focused on best management practice (BMP) adoption. Water quality monitoring was performed during 1992 to 2001 to assess the impact of these installed BMPs in the Sny Magill Creek watershed using a paired watershed approach, where the Bloody Run Creek watershed served as the control. Conservation practice adoption still occurred in the Bloody Run Creek watershed during the 10-year monitoring project and accelerated after the project ended, when a multiagency supported water quality project was implemented during 2002 to 2007. Statistical analysis of the paired watershed results using a pre/post model indicated that discharge increased 8% in Sny Magill Creek watershed relative to the Bloody Run Creek watershed, turbidity declined 41%, total suspended sediment declined 7%, and NOx-N (nitrate-nitrogen plus nitrite-nitrogen) increased 15%. Similar results were obtained with a gradual change statistical model.The weak sediment reductions and increased NOx-N levels were both unexpected and indicate that dynamics between adopted BMPs and stream systems need to be better understood. Fish surveys indicate that conditions for supporting trout fisheries have improved in both streams. Important lessons to be taken from the overall study include (1) committed project coordinators, agency collaborators, and landowners/producers are all needed for successful water quality projects; (2) smaller watershed areas should be used in paired studies; (3) reductions in stream discharge may be required in these systems in order for significant sediment

  4. Production of Molecular Iodine and Tri-iodide in the Frozen Solution of Iodide: Implication for Polar Atmosphere.

    Science.gov (United States)

    Kim, Kitae; Yabushita, Akihiro; Okumura, Masanori; Saiz-Lopez, Alfonso; Cuevas, Carlos A; Blaszczak-Boxe, Christopher S; Min, Dae Wi; Yoon, Ho-Il; Choi, Wonyong

    2016-02-02

    The chemistry of reactive halogens in the polar atmosphere plays important roles in ozone and mercury depletion events, oxidizing capacity, and dimethylsulfide oxidation to form cloud-condensation nuclei. Among halogen species, the sources and emission mechanisms of inorganic iodine compounds in the polar boundary layer remain unknown. Here, we demonstrate that the production of tri-iodide (I3(-)) via iodide oxidation, which is negligible in aqueous solution, is significantly accelerated in frozen solution, both in the presence and the absence of solar irradiation. Field experiments carried out in the Antarctic region (King George Island, 62°13'S, 58°47'W) also showed that the generation of tri-iodide via solar photo-oxidation was enhanced when iodide was added to various ice media. The emission of gaseous I2 from the irradiated frozen solution of iodide to the gas phase was detected by using cavity ring-down spectroscopy, which was observed both in the frozen state at 253 K and after thawing the ice at 298 K. The accelerated (photo-)oxidation of iodide and the subsequent formation of tri-iodide and I2 in ice appear to be related with the freeze concentration of iodide and dissolved O2 trapped in the ice crystal grain boundaries. We propose that an accelerated abiotic transformation of iodide to gaseous I2 in ice media provides a previously unrecognized formation pathway of active iodine species in the polar atmosphere.

  5. Accounting for health-care outcomes: implications for intensive care unit practice and performance.

    Science.gov (United States)

    Sorensen, Roslyn; Iedema, Rick

    2010-08-01

    The aim of this study was to understand the environment of health care, and how clinicians and managers respond in terms of performance accountability. A qualitative method was used in a tertiary metropolitan teaching intensive care unit (ICU) in Sydney, Australia, including interviews with 15 clinical managers and focus groups with 29 nurses of differing experience. The study found that a managerial focus on abstract goals, such as budgets detracted from managing the core business of clinical work. Fractures were evident within clinical units, between clinical units and between clinical and managerial domains. These fractures reinforced the status quo where seemingly unconnected patient care activities were undertaken by loosely connected individual clinicians with personalized concepts of accountability. Managers must conceptualize health services as an interconnected entity within which self-directed teams negotiate and agree objectives, collect and review performance data and define collective practice. Organically developing regimens of care within and across specialist clinical units, such as in ICUs, directly impact upon health service performance and accountability.

  6. Implications of food insecurity on global health policy and nursing practice.

    Science.gov (United States)

    Kregg-Byers, Claudia M; Schlenk, Elizabeth A

    2010-09-01

    The purpose is to discuss the concept of food insecurity (FI) and its impact on current global health policy and nursing practice. Food insecurity. Literature review. FI means a nonsustainable food system that interferes with optimal self-reliance and social justice. Individuals experiencing FI lack nutritionally adequate and safe foods in their diet. Resources play a significant role in FI by affecting whether or not people obtain culturally, socially acceptable food through regular marketplace sources as opposed to severe coping strategies, such as emergency food sources, scavenging, and stealing. Persons who are living in poverty, female heads of household, single parents, people living with many siblings, landless people, migrants, immigrants, and those living in certain geographical regions constitute populations at risk and most vulnerable to FI. FI influences economics through annual losses of gross domestic product due to reduced human productivity. FI affects individuals and households and is largely an unobservable condition, making data collection and analysis challenging. Policy and research have focused on macronutrient sufficiency and deprivation, making it difficult to draw attention and research dollars to FI. Persons experiencing FI exhibit clinical signs such as less healthy diets, poor health status, poor diabetes and chronic disease management, and impaired cognitive function. Nurses can recognize the physical, psychosocial, and personal consequences that those with FI face and manage daily.

  7. The relationship between maternal self-efficacy and parenting practices: implications for parent training.

    Science.gov (United States)

    Sanders, M R; Woolley, M L

    2005-01-01

    The present study examined the relationship between maternal self-efficacy, dysfunctional discipline practices and child conduct problems. Specifically, three levels of self-efficacy, global, domain and task-specific self-efficacy, were assessed in mothers of 2- to 8-year-old children with conduct problems (clinic group, n=45) and non-clinic mothers from the community (non-clinic group, n=79). Measures of global, domain and task-specific self-efficacy were completed by mothers. Clinic mothers reported significantly lower self-efficacy than non-clinic mothers for all but one of the parenting tasks assessed. Both groups of mothers reported lowest self-efficacy for similar parenting tasks. In the sample as a whole self-efficacy measures were significant predictors of maternal discipline style after controlling for other parent, child and risk factors. Of the self-efficacy variables behavioural self-efficacy was the best predictor of mothers discipline style. The findings support the importance of developing parenting strategies that enable parents to generalize their parenting skills to a diverse range of diverse parenting contexts both in the home and in the community.

  8. Practical implications of procedures developed in IDEA project - Comparison with traditional methods

    International Nuclear Information System (INIS)

    Andrasi, A.; Bouvier, C.; Brandl, A.; De Carlan, L.; Fischer, H.; Franck, D.; Hoellriegl, V.; Li, W. B.; Oeh, U.; Ritt, J.; Roth, P.; Schlagbauer, M.; Schmitzer, Ch; Wahl, W.; Zombori, P.

    2007-01-01

    The idea of the IDEA project aimed to improve assessment of incorporated radionuclides through developments of more reliable and possibly faster in vivo and bioassay monitoring techniques and making use of such enhancements for improvements in routine monitoring. In direct in vivo monitoring technique the optimum choice of the detectors to be applied for different monitoring tasks has been investigated in terms of material, size and background in order to improve conditions namely to increase counting efficiency and reduce background. Detailed studies have been performed to investigate the manifold advantageous applications and capabilities of numerical simulation method for the calibration and optimisation of in vivo counting systems. This calibration method can be advantageously applied especially in the measurement of low-energy photon emitting radionuclides, where individual variability is a significant source of uncertainty. In bioassay measurements the use of inductively coupled plasma mass spectrometry (ICP-MS) can improve considerably both the measurement speed and the lower limit of detection currently achievable with alpha spectrometry for long-lived radionuclides. The work carried out in this project provided detailed guidelines for optimum performance of the technique of ICP-MS applied mainly for the determination of uranium and thorium nuclides in the urine including sampling procedure, operational parameters of the instruments and interpretation of the measured data. The paper demonstrates the main advantages of investigated techniques in comparison with the performances of methods commonly applied in routine monitoring practice. (authors)

  9. Practical Implications for an Effective Radiology Residency Quality Improvement Program for Milestone Assessment.

    Science.gov (United States)

    Leddy, Rebecca; Lewis, Madelene; Ackerman, Susan; Hill, Jeanne; Thacker, Paul; Matheus, Maria; Tipnis, Sameer; Gordon, Leonie

    2017-01-01

    Utilization of a radiology resident-specific quality improvement (QI) program and curriculum based on the Accreditation Council for Graduate Medical Education (ACGME) milestones can enable a program's assessment of the systems-based practice component and prepare residents for QI implementation post graduation. This article outlines the development process, curriculum, QI committee formation, and resident QI project requirements of one institution's designated radiology resident QI program. A method of mapping the curriculum to the ACGME milestones and assessment of resident competence by postgraduate year level is provided. Sample projects, challenges to success, and lessons learned are also described. Survey data of current trainees and alumni about the program reveal that the majority of residents and alumni responders valued the QI curriculum and felt comfortable with principles and understanding of QI. The most highly valued aspect of the program was the utilization of a resident education committee. The majority of alumni responders felt the residency quality curriculum improved understanding of QI, assisted with preparation for the American Board of Radiology examination, and prepared them for QI in their careers. In addition to the survey results, outcomes of resident project completion and resident scholarly activity in QI are evidence of the success of this program. It is hoped that this description of our experiences with a radiology resident QI program, in accordance with the ACGME milestones, may facilitate the development of successful QI programs in other diagnostic radiology residencies. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  10. Expanding concepts in ischaemic heart disease: implications for clinical practice and research

    International Nuclear Information System (INIS)

    Maseri, A.; Pasceri, V.; Giordano, A.; Trani, C.

    1996-01-01

    In the late Eighties, a series of observations from several institutions around the world has dramatically revolutionized the traditional notion that the occurrence of myocardial infarction was related most of the time to the development of critical flow-limiting coronary stenosis. All these studies showed that the infarct-related artery had only minimal or mild stenosis in about two thirds of the cases. Therefore, contrary to our previous beliefs, in clinical practice the detection of coronary stenosis has a lesser role in the prognostic assessment of patients with ischaemic heart disease, unless associated with extensive ischemia or with phases of instability. In fact, the major determinants of prognosis are represented by age, left ventricular function, effort tolerance and especially by the clinical stability or instability of angina. According to the Bayesian an theorem, in low risk patients any diagnostic test has a very low predictive accuracy, unless very high specificity criteria are used. The value of diagnostic tests in the assessment of patients' prognosis should be evaluated in intermediate risk groups. The emphasis of clinical research has, therefore, shifted from the detection of flow-limiting stenosis to the study of the multiple and varied dynamic causes of stable and unstable ischaemia, where the possibilities of making new, seminal observations are greater

  11. Milk siblingship, religious and secular: History, applications, and implications for practice.

    Science.gov (United States)

    Thorley, Virginia

    2014-12-01

    Milk kinship has religious and practical importance to Muslim families that is not well understood in Western cultures. The relationship occurs when an infant receives the milk of a woman other than the biological mother, creating familial relationships between the child and the woman whose milk is received. As milk siblings, her children and the recipient infant must never marry each other. Midwives in Western countries may encounter this in relation to human milk banking. This review provides a context for respectfully assisting families with their decision making when they are offered banked milk. A database search was conducted and other publications were found manually. Milk siblingship can be religious or secular. In Islam similar prohibitions on marriage exist to those for blood relations. The mothers therefore have to be known to each other to prevent an inappropriate marriage. This relationship has been a barrier to use of human milk banks by Muslim families as milk from several mothers is usually pooled. Nevertheless, donor milk has been used for premature neonates in two Islamic countries, applying the religious requirements. Recent interpretations by some Islamic scholars permitting milk banking may be acceptable to some families, but others will heed other rulings. NICU staff may encounter difficulties in providing banked human milk to infants from Muslim families. Different rulings exist and Muslim families in Western countries come from a variety of traditions. Sensitivity is required to explore these issues with families. Copyright © 2014 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  12. Social smoking implications for public health, clinical practice, and intervention research.

    Science.gov (United States)

    Schane, Rebecca E; Glantz, Stanton A; Ling, Pamela M

    2009-08-01

    Social smoking is increasingly prevalent and poses a challenge to traditional cessation practices. Tobacco companies conducted extensive research on social smokers long before health authorities did and marketed products to promote this smoking behavior. Research is described and mechanisms identified that are used to promote social smoking to help improve cessation strategies in this growing group. Searches from 2006 to 2008 of previously secret tobacco industry documents using keywords social smoker, light smoker, casual smoker, youth smoker, and occasional smoker, followed by snowball searching. Data analysis was conducted in 2008. Tobacco industry research identified characteristics of social smokers that include: (1) denial of personal nicotine addiction; (2) self-categorization as a nonsmoker; (3) propensity for decreased tobacco use in response to smoke-free laws; (4) variations in age, education, ethnicity, and socioeconomic backgrounds; and (5) a perceived immunity to personal health effects of tobacco but fear of consequences to others. Tobacco companies developed marketing strategies aimed at social smokers, including "non-habit forming" cigarettes. Previously considered a transient behavior, social smoking is also a stable consumption pattern. Focused clinical questions to detect social smoking are needed and may include, "Have you smoked any cigarettes or used any tobacco products in the past month?" as opposed to "Are you a smoker?" Clinicians should recognize that social smokers might be motivated to quit after education on the dangers of secondhand smoke rather than on personal health risks or with pharmacotherapy.

  13. The Changing Health Care Landscape and Implications of Organizational Ethics on Modern Medical Practice.

    Science.gov (United States)

    Castlen, Joseph P; Cote, David J; Moojen, Wouter A; Robe, Pierre A; Balak, Naci; Brennum, Jannick; Ammirati, Mario; Mathiesen, Tiit; Broekman, Marike L D

    2017-06-01

    Medicine is rapidly changing, both in the level of collective medical knowledge and in how it is being delivered. The increased presence of administrators in hospitals helps to facilitate these changes and ease administrative workloads on physicians; however, tensions sometimes form between physicians and administrators. This situation is based on perceptions from both sides that physicians obstruct cost-saving measures and administrators put profits before patients. In reality, increasing patient populations and changes in health care are necessitating action by hospitals to prevent excessive spending as health care systems become larger and more difficult to manage. Recognizing the cause of changes in health care, which do not always originate with physicians and administrators, along with implementing changes in hospitals such as increased physician leadership, could help to ease tensions and promote a more collaborative atmosphere. Ethically, there is a need to preserve physician autonomy, which is a tenet of medical professionalism, and a need to rein in spending costs and ensure that patients receive the best possible care. Physicians and administrators both need to have a well-developed personal ethic to achieve these goals. Physicians need be allowed to retain relative autonomy over their practices as they support and participate in administrator-led efforts toward distributive justice. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Management strategies of mothers of school-age children with autism: implications for practice.

    Science.gov (United States)

    Joosten, Annette V; Safe, Anneleise P

    2014-08-01

    Mothering children with autism results in mothers spending more time on daily tasks as well as managing the disorder. The need for mothers to self-manage often increases when the child is school aged. Mothers develop strategies, and occupational therapists and other health professional rely on or expect mothers to be involved in meeting the extra needs of their children with autism and other family members. Little is known about the strategies adopted by the mothers. The aim of this study was to explore the strategies mothers used to manage their roles and emotions, and their child's behaviours. In-depth individual interviews were conducted with seven mothers and data were analysed in this qualitative study using phenomenological analysis. Findings revealed that the mothers had adopted strategies to manage their roles, their emotions and their child's behaviour. However, the strategies were often shaped by the expectations of others or circumstances beyond their control and at times added further to their stress. Mothers of children with autism developed strategies to self-manage their lives and their child's disorder. However, even when these strategies were effective, they sometimes placed further stress on the mothers. The mothers provided insights to how they coped but need help to consider the support they require and therapists need to consider the pressures of expecting mothers to self-manage their child's disorder, their own lives and their family. Family-centred practice emphasising collaboration with mothers needs to be maintained with school-aged children. © 2014 Occupational Therapy Australia.

  15. Weight compensation characteristics of Armeo®Spring exoskeleton: implications for clinical practice and research.

    Science.gov (United States)

    Perry, Bonnie E; Evans, Emily K; Stokic, Dobrivoje S

    2017-02-17

    Armeo®Spring exoskeleton is widely used for upper extremity rehabilitation; however, weight compensation provided by the device appears insufficiently characterized to fully utilize it in clinical and research settings. Weight compensation was quantified by measuring static force in the sagittal plane with a load cell attached to the elbow joint of Armeo®Spring. All upper spring settings were examined in 5° increments at the minimum, maximum, and two intermediate upper and lower module length settings, while keeping the lower spring at minimum. The same measurements were made for minimum upper spring setting and maximum lower spring setting at minimum and maximum module lengths. Weight compensation was plotted against upper module angles, and slope was analyzed for each condition. The Armeo®Spring design prompted defining the slack angle and exoskeleton balance angle, which, depending on spring and length settings, divide the operating range into different unloading and loading regions. Higher spring tensions and shorter module lengths provided greater unloading (≤6.32 kg of support). Weight compensation slope decreased faster with shorter length settings (minimum length = -0.082 ± 0.002 kg/°; maximum length = -0.046 ± 0.001 kg/°) independent of spring settings. Understanding the impact of different settings on the Armeo®Spring weight compensation should help define best clinical practice and improve fidelity of research.

  16. Evolution and Phylogenetic Diversity of Yam Species (Dioscorea spp.: Implication for Conservation and Agricultural Practices.

    Directory of Open Access Journals (Sweden)

    Marie Florence Sandrine Ngo Ngwe

    Full Text Available Yams (Dioscorea spp. consist of approximately 600 species. Presently, these species are threatened by genetic erosion due to many factors such as pest attacks and farming practices. In parallel, complex taxonomic boundaries in this genus makes it more challenging to properly address the genetic diversity of yam and manage its germplasm. As a first step toward evaluating and preserving the genetic diversity yam species, we use a phylogenetic diversity (PD approach that has the advantage to investigate phylogenetic relationships and test hypotheses of species monophyly while alleviating to the problem of ploidy variation within and among species. The Bayesian phylogenetic analysis of 62 accessions from 7 species from three regions of Cameroon showed that most Dioscorea sections were monophyletic, but species within sections were generally non-monophyletic. The wild species D. praehensilis and cultivated D. cayenensis were the species with the highest PD. At the opposite, D. esculenta has a low PD and future studies should focus on this species to properly address its conservation status. We also show that wild species show a stronger genetic structure than cultivated species, which potentially reflects the management of the yam germplasm by farmers. These findings show that phylogenetic diversity is a promising approach for an initial investigation of genetic diversity in a crop consisting of closely related species.

  17. The voice of the child in parental divorce: implications for clinical practice and mental health practitioners.

    Science.gov (United States)

    Brand, Carrie; Howcroft, Greg; Hoelson, Christopher Norman

    2017-09-01

    Research on parental divorce suggests that the nature of the divorce process, as experienced by the child, is the most important factor in his or her post-divorce adjustment. Research regarding children's experiences of the divorce process has been limited and the adult perspective has dominated the discourse on divorce; only recently has research started to consider children's viewpoint. This article describes a narrative inquiry into the experiences and perceptions of parental divorce, of 9- to 10-year-old children. Its aim is to use children's stories of parental divorce to inform the practice of professionals working with such children. The research adopted a narrative paradigm. Unstructured interviews were conducted with five children whose parents were divorced. Data were analysed thematically. Seven themes were identified. The first theme explored children's endeavours to describe and explain parental divorce. An additional six themes were developed around the types of stories children told of the divorce process. The seven themes were: (i) What is a divorcement; (ii) Stories of loss; (iii) Stories of gain; (iv) Stories of change; (v) Stories of stability; (vi) Healing stories; and (vii) Complicating stories. On the basis of the narratives elicited from children on parental divorce, this article proposes several guidelines for professionals such as psychologists, registered counsellors, social workers, and teachers as well as parents in their possible interventions with children. Some guidelines may also be of use to family and maintenance courts, and the government departments of health and education.

  18. The Interplay Between Housing Stability and Child Separation: Implications for Practice and Policy.

    Science.gov (United States)

    Rog, Debra J; Henderson, Kathryn A; Lunn, Laurel M; Greer, Andrew L; Ellis, Mei Ling

    2017-09-01

    Greater understanding of how residential stability affects child separation and reunification among homeless families can guide both child welfare and homeless policy and practice. This article draws upon two longitudinal studies examining services and housing for homeless families and their relationship to family and housing stability. Both studies were conducted in the same state at roughly the same time with similar instruments. The first study, examining families' experiences and outcomes following entry into the homeless service system in three counties in Washington State, found that at 18 months following shelter entry, families that are intact with their children were significantly more likely to be housed in their own housing (46%) than families that were separated from one or more of their children (31%). The second study, a quasiexperimental evaluation of a supportive housing program for homeless families with multiple housing barriers, found that the rates of reunification for Child Protective Services (CPS)-involved families receiving supportive housing was comparable to that for families entering public housing without services, but significantly higher than the rate of reunification for families entering shelter. Taken together, the findings from both studies contribute to the evidence underscoring the importance of housing assistance to homeless families involved in the child welfare system. © Society for Community Research and Action 2017.

  19. Exercise-induced bronchospasm: implications for patients with or without asthma in primary care practice

    Directory of Open Access Journals (Sweden)

    Hayden ML

    2011-11-01

    Full Text Available Stuart W Stoloff1, Gene L Colice2, Mary Lou Hayden3, Timothy J Craig4, Nancy K Ostrom5, Nemr S Eid6, Jonathan P Parsons71University of Nevada School of Medicine, Reno, NV, 2Washington Hospital Center, Washington, DC, 3University of Virginia, Charlottesville, VA, 4Pennsylvania State University, Hershey, PA, 5Allergy and Asthma Medical Group and Research Center, San Diego, CA, 6University of Louisville, Louisville, KY, 7Ohio State University Asthma Center, Columbus, OH, USAAbstract: Exercise-induced bronchospasm (EIB can represent a substantial barrier to physical activity. We present the cases of two patients with EIB, one with asthma, and one without asthma, who were evaluated at our primary care practice. The first case was a 44-year-old man with a history of seasonal allergic rhinitis but no asthma, who reported difficulty breathing when playing tennis. The second case was a 45-year-old woman who presented with persistent, generally well-controlled asthma, who was now experiencing bouts of coughing and wheezing during exercise. In both cases, an exercise challenge was used to diagnose EIB, and patients were prescribed a short-acting beta agonist to be used immediately before initiating exercise. EIB is a frequently encountered problem among patients presenting to primary care specialists. Affected patients should be made aware of the importance of proactive treatment with a short-acting beta agonist before initiating any exercise.Keywords: asthma, compliance, exercise-induced bronchospasm

  20. Implications of natural occlusion of ventilated racks on ammonia and sanitation practices.

    Science.gov (United States)

    Creamer, Michelle A; Petty, Joann; Martin, Tara; Bergdall, Valerie; Hickman-Davis, Judy M

    2014-03-01

    Examination of ventilated rat racks prior to semiannual sanitation revealed silicone nozzles and ventilation ports that were partially or completely occluded with granular debris. We subsequently sought to document performance standards for rack sanitation and investigate the effect of ventilation port occlusion on rack function and animal husbandry practices. We hypothesized that individually ventilated cages with occluded airflow would require more frequent cage changes, comparable to those for static cages (that is, every 3 to 4 d). Sprague-Dawley rats were housed under one of 4 conditions: no airflow occlusion, occluded air-supply inlet, occluded air-exhaust outlet, and occlusion of both inlet and outlet. Cages were changed when daily ammonia concentration exceeded 20 ppm or after 14 d had elapsed. Most cages with unoccluded or partial airflow occlusion remained below the 20 ppm limit until day 12 or 13. Cages with occlusion of both inlet and outlet exceeded 20 ppm ammonia by as early as day 5. Airflow was significantly lower in cages with occlusion of both inlet and outlet airflow. Weekly inspection revealed that occlusion of ventilation ports was detectable by 3 mo after semiannual sanitation. This study demonstrates that silicone nozzles should be removed prior to rack sanitation to improve the effectiveness of cleaning ventilation ports and nozzles. While the rack is in use, silicone nozzles and ventilation ports should be inspected regularly to identify occlusion that is likely to diminish environmental quality in the cage. Intracage ammonia levels are significantly higher when both inlet and outlet airflow are occluded.

  1. A Greek perspective on concepts of death and expression of grief, with implications for practice.

    Science.gov (United States)

    Mystakidou, Kyriaki; Tsilika, Eleni; Parpa, Efi; Katsouda, Emmanuela; Vlahos, Lambros

    2003-12-01

    Death has been conceptualised in different ways by different cultures and civilizations. It is increasingly entering into the public consciousness and society is now more ready to discuss and lessen the fear of dying and grief than it has been in the past few decades. In Greece, by Classical times there was an increase in burial rituals and commemorative practices compared to earlier periods. When Christianity was introduced into Greece it attempted to change the way the dead were mourned, preaching immortality of the soul and resurrection of the dead. Nevertheless, the way people grieve and bury their dead in Greece has not changed greatly since before the introduction of Christianity, except for the difficulty experienced in witnessing burial procedures observed in the large cities. Burial and bereavement traditions were introduced to help Greeks cope with death and bereavement. In Greece today beliefs about grief and death are based both on the ancient and the Christian Orthodox traditions. Healthcare professionals need to develop cultural competence to improve nursing and future health care. If care is culturally informed and tailored its quality is improved.

  2. Routine perinatal and paediatric post-mortem radiography: detection rates and implications for practice

    Energy Technology Data Exchange (ETDEWEB)

    Arthurs, Owen J. [NHS Foundation Trust, Department of Radiology Great Ormond Street Hospital for Children, London (United Kingdom); University College London, Institute of Child Health, London (United Kingdom); Calder, Alistair D. [NHS Foundation Trust, Department of Radiology Great Ormond Street Hospital for Children, London (United Kingdom); Kiho, Liina [Camelia Botnar Laboratories Great Ormond Street Hospital for Children, Department of Paediatric Pathology, London (United Kingdom); Taylor, Andrew M. [Great Ormond Street Hospital for Children, Cardiorespiratory Unit, London (United Kingdom); UCL Institute of Cardiovascular Science, London (United Kingdom); University College London, Institute of Child Health, London (United Kingdom); Sebire, Neil J. [Camelia Botnar Laboratories Great Ormond Street Hospital for Children, Department of Paediatric Pathology, London (United Kingdom); University College London, Institute of Child Health, London (United Kingdom)

    2014-03-15

    Routine perinatal and paediatric post-mortem plain radiography allows for the diagnosis and assessment of skeletal dysplasias, fractures and other bony abnormalities. The aim of this study was to review the diagnostic yield of this practice. We identified 1,027 cases performed in a single institution over a 21/2-year period, including babygrams (whole-body examinations) and full skeletal surveys. Images were reported prior to autopsy in all cases. Radiology findings were cross-referenced with the autopsy findings using an autopsy database. We scored each case from 0 to 4 according to the level of diagnostic usefulness. The overall abnormality rate was 126/1,027 (12.3%). There was a significantly higher rate of abnormality when a skeletal survey was performed (18%) rather than a babygram (10%; P < 0.01); 90% (665/739) of babygrams were normal. Of the 74 abnormal babygrams, we found 33 incidental non-contributory cases, 19 contributory, 20 diagnostic, and 2 false-positive cases. There were only 2 cases out of 739 (0.27%) in whom routine post-mortem imaging identified potentially significant abnormalities that would not have been detected if only selected imaging had been performed. A policy of performing selected, rather than routine, foetal post-mortem radiography could result in a significant cost saving. Routine post-mortem paediatric radiography in foetuses and neonates is neither diagnostically useful nor cost-effective. A more evidence-based, selective protocol should yield significant cost savings. (orig.)

  3. Routine perinatal and paediatric post-mortem radiography: detection rates and implications for practice

    International Nuclear Information System (INIS)

    Arthurs, Owen J.; Calder, Alistair D.; Kiho, Liina; Taylor, Andrew M.; Sebire, Neil J.

    2014-01-01

    Routine perinatal and paediatric post-mortem plain radiography allows for the diagnosis and assessment of skeletal dysplasias, fractures and other bony abnormalities. The aim of this study was to review the diagnostic yield of this practice. We identified 1,027 cases performed in a single institution over a 21/2-year period, including babygrams (whole-body examinations) and full skeletal surveys. Images were reported prior to autopsy in all cases. Radiology findings were cross-referenced with the autopsy findings using an autopsy database. We scored each case from 0 to 4 according to the level of diagnostic usefulness. The overall abnormality rate was 126/1,027 (12.3%). There was a significantly higher rate of abnormality when a skeletal survey was performed (18%) rather than a babygram (10%; P < 0.01); 90% (665/739) of babygrams were normal. Of the 74 abnormal babygrams, we found 33 incidental non-contributory cases, 19 contributory, 20 diagnostic, and 2 false-positive cases. There were only 2 cases out of 739 (0.27%) in whom routine post-mortem imaging identified potentially significant abnormalities that would not have been detected if only selected imaging had been performed. A policy of performing selected, rather than routine, foetal post-mortem radiography could result in a significant cost saving. Routine post-mortem paediatric radiography in foetuses and neonates is neither diagnostically useful nor cost-effective. A more evidence-based, selective protocol should yield significant cost savings. (orig.)

  4. The concept of antifragility and its implications for the practice of risk analysis.

    Science.gov (United States)

    Aven, Terje

    2015-03-01

    Nassim Taleb's antifragile concept has been shown considerable interest in the media and on the Internet recently. For Taleb, the antifragile concept is a blueprint for living in a black swan world (where surprising extreme events may occur), the key being to love variation and uncertainty to some degree, and thus also errors. The antonym of "fragile" is not robustness or resilience, but "please mishandle" or "please handle carelessly," using an example from Taleb when referring to sending a package full of glasses by post. In this article, we perform a detailed analysis of this concept, having a special focus on how the antifragile concept relates to common ideas and principles of risk management. The article argues that Taleb's antifragile concept adds an important contribution to the current practice of risk analysis by its focus on the dynamic aspects of risk and performance, and the necessity of some variation, uncertainties, and risk to achieve improvements and high performance at later stages. © 2014 Society for Risk Analysis.

  5. Transference, counter-transference and repetition: some implications for nursing practice.

    Science.gov (United States)

    Jones, Alun C

    2005-11-01

    This discussion paper offers an introductory text for nurses and explores the psychoanalytic ideas of transference, counter-transference and repetition compulsion. Disguised case vignettes provide illustrations of the ideas as they might apply to nursing, including professional practice and occupational choice. The literature suggests that transference can be a source of creativity as well as destructiveness and influence important communications with oneself and others including the choice of nursing and other health professions as an occupation. Recognizing possibilities of transference, counter-transference along with repetitive patterns of behaviours, can help nurses of all specialities to address situations constructively by responding thoughtfully and appropriately. This discussion concludes with the suggestions that we know little about the motivational factors underlying nursing as an occupational preference; moreover, nursing does not have a culture of personal therapy. As such nurses are denied opportunities to understand the possible reasons underlying their occupational choice or gain experiential knowledge of interpersonal dynamics occurring between patients and colleagues. Transference and counter-transference are thought to have some bearing on all relationships. Forming a natural part of the way human beings relate to each other, transference and counter-transference can bring about sincere human interest, caring and concern. However, there is also potential for disagreements. Recognizing the possible origins of relational difficulties can offer opportunities for professional development to nurses along with the benefits for health service users.

  6. Biosimilars for psoriasis: worldwide overview of regulatory guidelines, uptake and implications for dermatology clinical practice.

    Science.gov (United States)

    Cohen, A D; Wu, J J; Puig, L; Chimenti, S; Vender, R; Rajagopalan, M; Romiti, R; de la Cruz, C; Skov, L; Zachariae, C; Young, H S; Foley, P; van der Walt, J M; Naldi, L; Prens, E P; Blauvelt, A

    2017-12-01

    The introduction of biological drugs for the treatment of patients with psoriasis has revolutionized treatment paradigms and enabled numerous patients to achieve disease control with an acceptable safety profile. However, the high cost of biologics limits access to these medications for the majority of patients worldwide. In recent years, the introduction of biosimilars for inflammatory diseases has become a fast evolving field. The future use of biosimilars offers the potential for decreased cost and increased access to biologics for patients with psoriasis. For approval of biosimilars, different regulatory agencies use highly variable methods for definition, production, approval, marketing and postmarketing surveillance. Due to potential interchangeability between biologics and biosimilars, traceability and pharmacovigilance are required to collect accurate data about adverse events in patients with psoriasis; spontaneous reporting, registries and use of 'big data' should facilitate this process on a global basis. The current article describes biosimilar regulatory guidelines and examples of biosimilar uptake in clinical practice in several countries around the world. As it is apparent that biological therapy treatment decisions may become more physician independent, the International Psoriasis Council recommends that dermatologists should take an active role in the development of biosimilar prescribing policies with their respective healthcare settings and government agencies. © 2017 British Association of Dermatologists.

  7. The 3T3 neutral red uptake phototoxicity test: Practical experience and implications for phototoxicity testing - The report of an ECVAM-EFPIA workshop

    NARCIS (Netherlands)

    Ceridono, M.; Tellner, P.; Bauer, D.; Barroso, J.; Alépée, N.; Corvi, R.; Smedt, A. de; Fellows, M.D.; Gibbs, N.K.; Heisler, E.; Jacobs, A.; Jirova, D.; Jones, D.; Kandárová,H.; Kasper, P.; Akunda, J.K.; Krul, C.; Learn, D.; Liebsch, M.; Lynch, A.M.; Muster, W.; Nakamura, K.; Nash, J.F.; Pfannenbecker, U.; Phillips, G.; Robles, C.; Rogiers, V.; Water, F. van de; Liminga, U.W.; Vohr, H.W.; Wattrelos, O.; Woods, J.; Zuang, V.; Kreysa, J.; Wilcox, P.

    2012-01-01

    This is the report from the “ECVAM–EFPIA workshop on 3T3 NRU Phototoxicity Test: Practical Experience and Implications for Phototoxicity Testing”, jointly organized by ECVAM and EFPIA and held on the 25–27 October 2010 in Somma Lombardo, Italy. The European Centre for the Validation of Alternative

  8. Threat Assessment and Targeted Violence at Institutions of Higher Education: Implications for Policy and Practice Including Unique Considerations for Community Colleges

    Science.gov (United States)

    Bennett, Laura; Bates, Michael

    2015-01-01

    This article provides an overview of the research on targeted violence, including campus violence, and the implications for policy and practice at institutions of higher education. Unique challenges of threat assessment in the community college setting are explored, and an overview of an effective threat assessment policy and team at William…

  9. Care-Seeking for Diarrhoea in Southern Malawi: Attitudes, Practices and Implications for Diarrhoea Control

    Directory of Open Access Journals (Sweden)

    Salule Masangwi

    2016-11-01

    Full Text Available This paper examined care-seeking behaviour and its associated risk factors when a family member had diarrhoea. Data was obtained from a survey conducted in Chikwawa, a district in Southern Malawi. Chikwawa is faced with a number of environmental and socioeconomic problems and currently diarrhoea morbidity in the district is estimated at 24.4%, statistically higher than the national average of 17%. Using hierarchically built data from a survey of 1403 households nested within 33 communities, a series of two level binary logistic regression models with Bayesian estimation were used to determine predictors of care-seeking behaviour. The results show that 68% of mothers used oral rehydration solutions (ORS the last time a child in their family had diarrhoea. However, when asked on the action they take when a member of their household has diarrhoea two thirds of the mothers said they visit a health facility. Most respondents (73% mentioned distance and transport costs as the main obstacles to accessing their nearest health facility and the same proportion of respondents mentioned prolonged waiting time and absence of health workers as the main obstacles encountered at the health facilities. The main predictor variables when a member of the family had diarrhoea were maternal age, distance to the nearest health facility, school level, and relative wealth, household diarrhoea endemicity, and household size while the main predictor variables when a child had diarrhoea were existence of a village health committee (VHC, distance to the nearest health facility, and maternal age. Most households use ORS for the treatment of diarrhoea and village health committees and health surveillance assistants (HSAs are important factors in this choice of treatment. Health education messages on the use and efficacy of ORS to ensure proper and prescribed handling are important. There is need for a comprehensive concept addressing several dimensions of management and

  10. Climate change projections of West Nile virus infections in Europe: implications for blood safety practices.

    Science.gov (United States)

    Semenza, Jan C; Tran, Annelise; Espinosa, Laura; Sudre, Bertrand; Domanovic, Dragoslav; Paz, Shlomit

    2016-03-08

    West Nile virus (WNV) is transmitted by mosquitoes in both urban as well as in rural environments and can be pathogenic in birds, horses and humans. Extrinsic factors such as temperature and land use are determinants of WNV outbreaks in Europe, along with intrinsic factors of the vector and virus. With a multivariate model for WNV transmission we computed the probability of WNV infection in 2014, with July 2014 temperature anomalies. We applied the July temperature anomalies under the balanced A1B climate change scenario (mix of all energy sources, fossil and non-fossil) for 2025 and 2050 to model and project the risk of WNV infection in the future. Since asymptomatic infections are common in humans (which can result in the contamination of the donated blood) we estimated the predictive prevalence of WNV infections in the blood donor population. External validation of the probability model with 2014 cases indicated good prediction, based on an Area Under Curve (AUC) of 0.871 (SD = 0.032), on the Receiver Operating Characteristic Curve (ROC). The climate change projections for 2025 reveal a higher probability of WNV infection particularly at the edges of the current transmission areas (for example in Eastern Croatia, Northeastern and Northwestern Turkey) and an even further expansion in 2050. The prevalence of infection in (blood donor) populations in the outbreak-affected districts is expected to expand in the future. Predictive modelling of environmental and climatic drivers of WNV can be a valuable tool for public health practice. It can help delineate districts at risk for future transmission. These areas can be subjected to integrated disease and vector surveillance, outreach to the public and health care providers, implementation of personal protective measures, screening of blood donors, and vector abatement activities.

  11. Estimating the Number of Organ Donors in Australian Hospitals—Implications for Monitoring Organ Donation Practices

    Science.gov (United States)

    Pilcher, David; Gladkis, Laura; Arcia, Byron; Bailey, Michael; Cook, David; Cass, Yael; Opdam, Helen

    2015-01-01

    Background The Australian DonateLife Audit captures information on all deaths which occur in emergency departments, intensive care units and in those recently discharged from intensive care unit. This information provides the opportunity to estimate the number of donors expected, given present consent rates and contemporary donation practices. This may then allow benchmarking of performance between hospitals and jurisdictions. Our aim was to develop a method to estimate the number of donors using data from the DonateLife Audit on the basis of baseline patient characteristics alone. Methods All intubated patient deaths at contributing hospitals were analyzed. Univariate comparisons of donors to nondonors were performed. A logistic regression model was developed to estimate expected donor numbers from data collected between July 2012 and December 2013. This was validated using data from January to April 2014. Results Between July 2012 and April 2014, 6861 intubated patient deaths at 68 hospitals were listed on the DonateLife Audit of whom 553 (8.1%) were organ donors. Factors independently associated with organ donation included age, brain death, neurological diagnoses, chest x-ray findings, PaO2/FiO2, creatinine, alanine transaminase, cancer, cardiac arrest, chronic heart disease, and peripheral vascular disease. A highly discriminatory (area under the receiver operatory characteristic, 0.940 [95% confidence interval, 0.924-0.957]) and well-calibrated prediction model was developed which accurately estimated donor numbers. Three hospitals appeared to have higher numbers of actual donors than expected. Conclusions It is possible to estimate the expected number of organ donors. This may assist benchmarking of donation outcomes and interpretation of changes in donation rates over time. PMID:25919766

  12. Practical implications of understanding the influence of motivations on commitment to voluntary urban conservation stewardship.

    Science.gov (United States)

    Asah, Stanley T; Blahna, Dale J

    2013-08-01

    Although the word commitment is prevalent in conservation biology literature and despite the importance of people's commitment to the success of conservation initiatives, commitment as a psychological phenomenon and its operation in specific conservation behaviors remains unexplored. Despite increasing calls for conservation psychology to play a greater role in meeting conservation goals, applications of the psychological sciences to specific conservation behaviors, illustrating their utility to conservation practice, are rare. We examined conservation volunteers' motivations and commitment to urban conservation volunteering. We interviewed key informant volunteers and used interview findings to develop psychometric scales that we used to assess motivations and commitment to volunteer. We surveyed 322 urban conservation volunteers and used factor analysis to reveal how volunteers structure their motivations and commitment to volunteer for urban conservation activities. Six categories of motivations and 2 categories of commitment emerged from factor analysis. Volunteers were motivated by desires to help the environment, defend and enhance the ego, career and learning opportunities, escape and exercise, social interactions, and community building. Two forms of commitment, affective and normative commitment, psychologically bind people to urban conservation volunteerism. We used linear-regression models to examine how these categories of motivations influence volunteers' commitment to conservation volunteerism. Volunteers' tendency to continue to volunteer for urban conservation, even in the face of fluctuating counter urges, was motivated by personal, social, and community functions more than environmental motivations. The environment, otherwise marginally important, was a significant motivator of volunteers' commitment only when volunteering met volunteers' personal, social, and community-building goals. Attention to these personal, social, and community

  13. [New legal regulations for palliative care with implications for politics and practice].

    Science.gov (United States)

    Melching, Heiner

    2017-01-01

    In December 2015 two different laws were adopted. Both are of importance for palliative care. One of the laws criminalizes commercial, "business-like" assisted suicide (§ 217 German Criminal Code), the other one aims to improve hospice and palliative care in Germany. Through the latter far-reaching changes in Social Code Books V and XI, as well as of the Hospital Finance Act have been made. This new Act to Improve Hospice and Palliative Care (HPG) focuses, amongst others, on: (a) Better funding of hospice services, by raising the minimum grant for patients in inpatient hospices paid per day by the health insurance funds by about 28.5%, and for outpatient hospice services by about 18%; (b) further development of general outpatient nursing and medical palliative care, and the networking of different service providers; (c) introduction of an arbitration procedure for service provider agreements to be concluded between the health insurance funds and the teams providing specialized home palliative care (SAPV); (d) the right to individual advice and support by the health insurance funds; (e) care homes may offer their residents advance care planning programs to be funded by the statutory health insurers; (f) palliative care units in hospitals can be remunerated outside the DRG system by per diem rates; (g) separate funding and criteria for multi-professional palliative care services within a hospital.While little concrete impact on hospice and palliative care can be expected following the new § 217 German Criminal Code, the HPG provides a good basis to improve care. For this purpose, however, which complementary and more concrete agreements are made to put the new legal regulations into practice will be crucial.

  14. Global Health Systems and Policy Development: Implications for Health Literacy Research, Theory and Practice.

    Science.gov (United States)

    Rowlands, Gillian; Dodson, Sarity; Leung, Angela; Levin-Zamir, Diane

    2017-01-01

    Accessible and responsive health systems are critical to population health and human development. While progress has been made toward global health and development targets, significant inequities remain within and between countries. Expanding health inequities suggest a widespread and systemic neglect of vulnerable citizens, and a failure to enshrine within policies a responsibility to tailor care to the variable capabilities of citizens. Implementation of health and social policies that drive the design of accessible health systems, services, products and infrastructure represents the next frontier for health reform. Within this chapter we argue the need to consider health and health literacy across policy domains, to operationalize the intent to address inequities in health in meaningful and pragmatic ways, and to actively monitor progress and impact within the context of the Sustainable Development Goals (SDGs). We contend that viewing and developing policies and systems within a health literacy framework will assist in placing citizens and equity considerations at the center of development efforts. In this chapter, we explore the relationship between health literacy and equitable access to health care, and the role of health system and policy reform. We first explore international policies, health literacy, and the SDGs. We then explore national policies and the role that national and local services and systems play in building health literacy, and responding to the health literacy challenges of citizens. We discuss the World Health Organization's (WHO) Framework for Integrated People-Centered Health Services and the way in which health services are being encouraged to understand and respond to citizen health literacy needs. Each section of the chapter ends with a summary and a review of health literacy research and practice. Throughout, we illustrate our points through 'vignettes' from around the world.

  15. Brand Name Statin Prescribing in a Resident Ambulatory Practice: Implications for Teaching Cost-Conscious Medicine.

    Science.gov (United States)

    Ryskina, Kira L; Pesko, Michael F; Gossey, J Travis; Caesar, Erica Phillips; Bishop, Tara F

    2014-09-01

    Several national initiatives aim to teach high-value care to residents. While there is a growing body of literature on cost impact of physicians' therapeutic decisions, few studies have assessed factors that influence residents' prescribing practices. We studied factors associated with intensive health care utilization among internal medicine residents, using brand name statin prescribing as a proxy for higher-cost care. We conducted a retrospective, cross-sectional analysis of statin prescriptions by residents at an urban academic internal medicine program, using electronic health record data between July 1, 2010, and June 30, 2011. For 319 encounters by 90 residents, patients were given a brand name statin in 50% of cases. When categorized into quintiles, the bottom quintile of residents prescribed brand name statins in 2% of encounters, while the top quintile prescribed brand name statins in 98% of encounters. After adjusting for potential confounders, including patient characteristics and supervising attending, being in the primary care track was associated with lower odds (odds ratio [OR], 0.38; P  =  .02; 95% confidence interval [CI], 0.16-0.86), and graduating from a medical school with an above-average hospital care intensity index was associated with higher odds of prescribing brand name statins (OR, 1.70; P  =  .049; 95% CI, 1.003-2.88). We found considerable variation in brand name statin prescribing by residents. Medical school attended and residency program type were associated with resident prescribing behavior. Future interventions should raise awareness of these patterns in an effort to teach high-value, cost-conscious care to all residents.

  16. Theoretical and practical implications on the subjects charged with duties of conducting special investigation activity

    Directory of Open Access Journals (Sweden)

    Obadă Dumitru

    2017-10-01

    Full Text Available This paper is an endeavor to analyze Moldova’s legal framework aimed at regulating Special investigative activity (SIA in terms of subjects or, in other words, of procedural exponents, invested by a legislator with duties of carrying out SIM. It is also an attempt to reveal the normative inconsistencies specified in the regulatory content of the Criminal Procedural Law, including a verifiable analysis of the legal norms stipulated in the Code of Criminal Procedure, as well as other regulations related to this specific area of state activity specified in the related legislation. Moreover, the author sought to highlight the adverse legal effects that may be generated by the misinterpretation and misapplication of the legal norms related to SIA. While carrying out this study, we have taken into account the practice of law enforcement by state bodies in conducting criminal investigations, as well as the attempt to clarify and define the concept of “carrying out special investigative activity”. The research is also an attempt to clarify the competences of procedural subjects in charge of conducting SIA, as well as their functional interdependence in this activity. Furthermore, the study reasons upon some author’s assertions regarding the legal nature of SIM results from the perspective of the theory of evidence, particularly the admissibility of evidence obtained through SIM, the procedural stage at which the SIM can be performed, the impact of the current normative inadvertences regarding the possibility of taking evidence by means of SIM. The research has also been focused on identifying the prosecutor’s functional characteristics in conducting special investigative activity.

  17. Understanding the mental health consequences of family separation for refugees: Implications for policy and practice.

    Science.gov (United States)

    Miller, Alexander; Hess, Julia Meredith; Bybee, Deborah; Goodkind, Jessica R

    2018-01-01

    Consistent evidence documents the negative impacts of family separation on refugee mental health and concerns for the welfare of distant family members and desire to reunite with family members as priorities for refugees postmigration. Less is known about refugees' emic perspectives on their experiences of family separation. Using mixed methods data from a community-based mental health intervention study, we found that family separation was a major source of distress for refugees and that it was experienced in a range of ways: as fear for family still in harm's way, as a feeling of helplessness, as cultural disruption, as the greatest source of distress since resettlement, and contributing to mixed emotions around resettlement. In addition to these qualitative findings, we used quantitative data to test the relative contribution of family separation to refugees' depression/anxiety symptoms, posttraumatic stress disorder (PTSD) symptoms, and psychological quality of life. Separation from a family member was significantly related to all 3 measures of mental health, and it explained significant additional variance in all 3 measures even after accounting for participants' overall level of trauma exposure. Relative to 26 other types of trauma exposure, family separation was 1 of only 2 traumatic experiences that explained additional variance in all 3 measures of mental health. Given the current global refugee crisis and the need for policies to address this large and growing issue, this research highlights the importance of considering the ways in which family separation impacts refugee mental health and policies and practices that could help ameliorate this ongoing stressor. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  18. Acute fluid ingestion in the treatment of orthostatic intolerance - important implications for daily practice.

    Science.gov (United States)

    Z'Graggen, W J; Hess, C W; Humm, A M

    2010-11-01

    Rapid water ingestion improves orthostatic intolerance (OI) in multiple system atrophy (MSA) and postural tachycardia syndrome (PoTS). We compared haemodynamic changes after water and clear soup intake, the latter being a common treatment strategy for OI in daily practice. Seven MSA and seven PoTS patients underwent head-up tilt (HUT) without fluid intake and 30 min after drinking 450 ml of water and clear soup, respectively. All patients suffered from moderate to severe OI because of neurogenic orthostatic hypotension (OH) and excessive orthostatic heart rate (HR) increase, respectively. Beat-to-beat cardiovascular indices were measured non-invasively. In MSA, HUT had to be terminated prematurely in 2/7 patients after water, but in 6/7 after clear soup. At 3 min of HUT, there was an increase in blood pressure of 15.7(8.2)/8.3(2.3) mmHg after water, but a decrease of 11.6(18.9)/8.1(9.2) mmHg after clear soup (P clear soup. The attenuation of excessive orthostatic HR increase did not differ significantly after water and clear soup drinking. In MSA, clear soup cannot substitute water for eliciting a pressor effect, but even worsens OI after rapid ingestion. In PoTS, acute water and clear soup intake both result in improvement of OI. These findings cannot solely be explained by difference in osmolarity but may reflect some degree of superimposed postprandial hypotension in widespread autonomic failure in MSA compared to the mild and limited autonomic dysfunction in PoTS. © 2010 The Author(s). Journal compilation © 2010 EFNS.

  19. Potential contamination of shipboard air samples by diffusive emissions of PCBs and other organic pollutants: implications and solutions.

    Science.gov (United States)

    Lohmann, Rainer; Jaward, Foday M; Durham, Louise; Barber, Jonathan L; Ockenden, Wendy; Jones, Kevin C; Bruhn, Regina; Lakaschus, Soenke; Dachs, Jordi; Booij, Kees

    2004-07-15

    Air samples were taken onboard the RRS Bransfield on an Atlantic cruise from the United Kingdom to Halley, Antarctica, from October to December 1998, with the aim of establishing PCB oceanic background air concentrations and assessing their latitudinal distribution. Great care was taken to minimize pre- and post-collection contamination of the samples, which was validated through stringent QA/QC procedures. However, there is evidence that onboard contamination of the air samples occurred,following insidious, diffusive emissions on the ship. Other data (for PCBs and other persistent organic pollutants (POPs)) and examples of shipboard contamination are presented. The implications of these findings for past and future studies of global POPs distribution are discussed. Recommendations are made to help critically appraise and minimize the problems of insidious/diffusive shipboard contamination.

  20. The Operation of the Joint Protocol: Theoretical and Practical Implications Revisited

    International Nuclear Information System (INIS)

    Horbach, N.

    2008-01-01

    Convention and the 1963 Vienna Convention), is even more urgent in respect of its operation under the revised nuclear liability treaties. Any interpretation making the operation of the Joint Protocol ineffective, distorted or even obsolete as to its main object and purpose, would warrant critical analysis as to its benefits it in practice would provide for its Contracting Parties, considering to join any of the revised treaties. This paper aims to provide an analysis of the legal complications involved in respect of the operation of the Joint Protocol, especially in its interrelation with the revised nuclear liability treaties.(author)

  1. Semi-automatic handling of meteorological ground measurements using WeatherProg: prospects and practical implications

    Science.gov (United States)

    Langella, Giuliano; Basile, Angelo; Bonfante, Antonello; De Mascellis, Roberto; Manna, Piero; Terribile, Fabio

    2016-04-01

    WeatherProg is a computer program for the semi-automatic handling of data measured at ground stations within a climatic network. The program performs a set of tasks ranging from gathering raw point-based sensors measurements to the production of digital climatic maps. Originally the program was developed as the baseline asynchronous engine for the weather records management within the SOILCONSWEB Project (LIFE08 ENV/IT/000408), in which daily and hourly data where used to run water balance in the soil-plant-atmosphere continuum or pest simulation models. WeatherProg can be configured to automatically perform the following main operations: 1) data retrieval; 2) data decoding and ingestion into a database (e.g. SQL based); 3) data checking to recognize missing and anomalous values (using a set of differently combined checks including logical, climatological, spatial, temporal and persistence checks); 4) infilling of data flagged as missing or anomalous (deterministic or statistical methods); 5) spatial interpolation based on alternative/comparative methods such as inverse distance weighting, iterative regression kriging, and a weighted least squares regression (based on physiography), using an approach similar to PRISM. 6) data ingestion into a geodatabase (e.g. PostgreSQL+PostGIS or rasdaman). There is an increasing demand for digital climatic maps both for research and development (there is a gap between the major of scientific modelling approaches that requires digital climate maps and the gauged measurements) and for practical applications (e.g. the need to improve the management of weather records which in turn raises the support provided to farmers). The demand is particularly burdensome considering the requirement to handle climatic data at the daily (e.g. in the soil hydrological modelling) or even at the hourly time step (e.g. risk modelling in phytopathology). The key advantage of WeatherProg is the ability to perform all the required operations and

  2. Review of occupational medicine practice guidelines for interventional pain management and potential implications.

    Science.gov (United States)

    Manchikanti, Laxmaiah; Singh, Vijay; Derby, Richard; Helm, Standiford; Trescot, Andrea M; Staats, Peter S; Prager, Joshua P; Hirsch, Joshua A

    2008-01-01

    In the modern day environment, workers' compensation costs continue to be a challenge, with a need to balance costs, benefits, and quality of medical care. The cost of workers' compensation care affects all stakeholders including workers, employers, providers, regulators, legislators, and insurers. Consequently, a continued commitment to quality, accessibility to care, and cost containment will help ensure that workers are afforded accessible, high quality, and cost-effective care. In 2004, workers' compensation programs in all 50 states, the District of Columbia, and federal programs in the United States combined received an income of $87.4 billion while paying out only $56 billion in medical and cash benefits with $31.4 billion or 37% in administrative expenses and profit. Occupational diseases represented only 8% of the workers' compensation claims and 29% of the cost. The American College of Occupational and Environmental Medicine (ACOEM) has published several guidelines; though widely adopted by WCPs, these guidelines evaluate the practice of medicine of multiple specialties without adequate expertise and expert input from the concerned specialties, including interventional pain management. An assessment of the ACOEM guidelines utilizing Appraisal of Guidelines for Research and Evaluation (AGREE) criteria, the criteria developed by the American Medical Association (AMA), the Institute of Medicine (IOM), and other significantly accepted criteria, consistently showed very low scores (evidence, standard of care, or expert consensus. Based on the evaluation utilizing appropriate and current evidence-based medicine (EBM) principles, the evidence ratings for diagnostic techniques of lumbar discography; cervical, thoracic, and lumbar facet joint nerve blocks and sacroiliac joint nerve blocks; therapeutic cervical and lumbar medial branch blocks and radiofrequency neurolysis; cervical interlaminar epidural steroid injections, caudal epidural steroid injections, and

  3. Bed Bug Infestations and Control Practices in China: Implications for Fighting the Global Bed Bug Resurgence

    Directory of Open Access Journals (Sweden)

    Changlu Wang

    2011-04-01

    Full Text Available The bed bug resurgence in North America, Europe, and Australia has elicited interest in investigating the causes of the widespread and increasing infestations and in developing more effective control strategies. In order to extend global perspectives on bed bug management, we reviewed bed bug literature in China by searching five Chinese language electronic databases. We also conducted telephone interviews of 68 pest control firms in two cities during March 2011. In addition, we conducted telephone interviews to 68 pest control companies within two cities in March 2011. Two species of bed bugs (Cimex lectularius L. and Cimex hemipterus (F. are known to occur in China. These were common urban pests before the early1980s. Nationwide “Four-Pest Elimination” campaigns (bed bugs being one of the targeted pests were implemented in China from 1960 to the early 1980s. These campaigns succeeded in the elimination of bed bug infestations in most communities. Commonly used bed bug control methods included applications of hot water, sealing of bed bug harborages, physical removal, and applications of residual insecticides (mainly organophosphate sprays or dusts. Although international and domestic travel has increased rapidly in China over the past decade (2000–2010, there have only been sporadic new infestations reported in recent years. During 1999–2009, all documented bed bug infestations were found in group living facilities (military dormitories, worker dormitories, and prisons, hotels, or trains. One city (Shenzhen city near Hong Kong experienced significantly higher number of bed bug infestations. This city is characterized by a high concentration of migratory factory workers. Current bed bug control practices include educating residents, washing, reducing clutter, putting items under the hot sun in summer, and applying insecticides (pyrethroids or organophosphates. There have not been any studies or reports on bed bug insecticide

  4. Genomics and infectious disease: a call to identify the ethical, legal and social implications for public health and clinical practice.

    Science.gov (United States)

    Geller, Gail; Dvoskin, Rachel; Thio, Chloe L; Duggal, Priya; Lewis, Michelle H; Bailey, Theodore C; Sutherland, Andrea; Salmon, Daniel A; Kahn, Jeffrey P

    2014-01-01

    Advances in genomics are contributing to the development of more effective, personalized approaches to the prevention and treatment of infectious diseases. Genetic sequencing technologies are furthering our understanding of how human and pathogen genomic factors - and their interactions - contribute to individual differences in immunologic responses to vaccines, infections and drug therapies. Such understanding will influence future policies and procedures for infectious disease management. With the potential for tailored interventions for particular individuals, populations or subpopulations, ethical, legal and social implications (ELSIs) may arise for public health and clinical practice. Potential considerations include balancing health-related benefits and harms between individuals and the larger community, minimizing threats to individual privacy and autonomy, and ensuring just distribution of scarce resources. In this Opinion, we consider the potential application of pathogen and host genomic information to particular viral infections that have large-scale public health consequences but differ in ELSI-relevant characteristics such as ease of transmission, chronicity, severity, preventability and treatability. We argue for the importance of anticipating these ELSI issues in advance of new scientific discoveries, and call for the development of strategies for identifying and exploring ethical questions that should be considered as clinical, public health and policy decisions are made.

  5. Walking to the beat of different drums: practical implications for the use of acoustic rhythms in gait rehabilitation.

    Science.gov (United States)

    Roerdink, Melvyn; Bank, Paulina J M; Peper, C Lieke E; Beek, Peter J

    2011-04-01

    Acoustic rhythms are frequently used in gait rehabilitation, with positive instantaneous and prolonged transfer effects on various gait characteristics. The gait modifying ability of acoustic rhythms depends on how well gait is tied to the beat, which can be assessed with measures of relative timing of auditory-motor coordination. We examined auditory-motor coordination in 20 healthy elderly individuals walking to metronome beats with pacing frequencies slower than, equal to, and faster than their preferred cadence. We found that more steps were required to adjust gait to the beat, the more the metronome rate deviated from the preferred cadence. Furthermore, participants anticipated the beat with their footfalls to various degrees, depending on the metronome rate; the faster the tempo, the smaller the phase advance or phase lead. Finally, the variability in the relative timing between footfalls and the beat was smaller for metronome rates closer to the preferred cadence, reflecting superior auditory-motor coordination. These observations have three practical implications. First, instantaneous effects of acoustic stimuli on gait characteristics may typically be underestimated given the considerable number of steps required to attune gait to the beat in combination with the usual short walkways. Second, a systematic phase lead of footfalls to the beat does not necessarily reflect a reduced ability to couple gait to the metronome. Third, the efficacy of acoustic rhythms to modify gait depends on metronome rate. Gait is coupled best to the beat for metronome rates near the preferred cadence. Copyright © 2011 Elsevier B.V. All rights reserved.

  6. Emerging themes in using narrative in geriatric care: Implications for patient-centered practice and interprofessional teamwork.

    Science.gov (United States)

    Clark, Phillip G

    2015-08-01

    Narrative approaches are increasingly used with older adults by different health professionals in a variety of care settings to provide unique and powerful insights into the patient's lifeworld and the meaning of their illness. Understanding these approaches requires insight into the narratives of both the patient and the provider. Different health professions have differing attitudes toward aging and are socialized into distinct ways of framing the problems of older adults. In a patient assessment, they may co-construct different stories that create the basis for interprofessional collaboration, posing challenges for communication among members of the team. This paper develops a conceptual framework for characterizing the use of narrative as the development of sets of "voices" reflecting a dynamic interaction between the provider and the patient, including the use of master narratives, stories and counterstories, and plots and subplots. The literature on the use of narrative with older adults in the professions of medicine, nursing, and social work is reviewed comparatively to develop a typology of these professional differences and the basis for them. Implications and recommendations for the development of new models of patient-centered care and interprofessional practice with older adults are developed. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Feasibility, Acceptability, and Clinical Trends of a Mindfulness-Informed Child Welfare Intervention: Implications for Trauma-Focused Practice

    Directory of Open Access Journals (Sweden)

    Samantha M. Brown

    2017-09-01

    Full Text Available Exposure to stress and early life trauma have been linked to child maltreatment and parental substance misuse. These issues often co-occur, yet few child welfare services target their shared underlying causes in a single intervention. Teaching mindfulness-informed strategies to substance-misusing families in the child welfare system may be one promising trauma-informed approach. As part of a larger pilot study testing the initial efficacy of a mindfulness-informed intervention for parents in public child welfare, this study explored the feasibility, acceptability, and clinical trends of the intervention using weekly reports of stress, coping, and mindfulness. Findings show support for the feasibility and acceptability of the intervention as well as positive responses to the intervention on measures of stress and mindfulness. However, the impact of the intervention varied with regard to improving weekly coping among participants. Implications for the integration of mindfulness into child welfare practice as a trauma-informed approach are discussed.

  8. Provider-agency fit in substance abuse treatment organizations: implications for learning climate, morale, and evidence-based practice implementation.

    Science.gov (United States)

    Ramsey, Alex T; van den Berk-Clark, Carissa

    2015-05-12

    current research benefits from a strong theoretical framework, consistent findings, and significant practical implications for substance abuse treatment agencies. Comprehensive attempts to strengthen outcomes related to EBP implementation must consider both provider- and agency-level characteristics regarding EBP use. Organizational efforts to more closely align provider attitudes and agency priorities will likely constitute a key strategy in fostering the implementation of EBPs in substance abuse treatment organizations.

  9. Verified solutions for the gravitational attraction to an oblate spheroid: Implications for planet mass and satellite orbits

    Science.gov (United States)

    Hofmeister, Anne M.; Criss, Robert E.; Criss, Everett M.

    2018-03-01

    Forces external to the oblate spheroid shape, observed from planetary to galactic scales, are demonstrably non-central, which has important ramifications for planetary science. We simplify historic formulae and derive new analytical solutions for the gravitational potential and force outside a constant density oblate. Numerical calculations that sum point mass contributions in a >109 element mesh confirm our equations. We show that contours of constant force and potential about oblate bodies are closely approximated by two confocal families whose foci (f) respectively are (9/10)½ae and (3/5)½ae for a body with f = ae. This leads to useful approximations that address internal density variations. We demonstrate that the force on a general point is not directed towards the oblate's center, nor are forces simply proportional to the inverse square of that distance, despite forces in the equatorial and axial directions pointing towards the center. Our results explain complex dynamics of galactic systems. Because most planets and stars have an aspect ratio >0.9, the spherical approximation is reasonable except for orbits within ∼2 body radii. We show that applying the "generalized" potential, which assumes central forces, yields J2 values half those expected for oblate bodies, and probably underestimates masses of Uranus and Neptune by ∼0.2%. We show that the inner Saturnian moons are subject to non-central forces, which may affect calculations of their orbital precession. Our new series should improve interpretation of flyby data.

  10. Low temperature hydrolysis of laboratory tholins in ammonia-water solutions: Implications for prebiotic chemistry on Titan

    Science.gov (United States)

    Neish, Catherine D.; Somogyi, Árpád; Lunine, Jonathan I.; Smith, Mark A.

    2009-05-01

    Laboratory tholins react rapidly in 13 wt% ammonia-water at low temperature, producing complex organic molecules containing both oxygen and altered nitrogen functional groups. These reactions display first-order kinetics with half-lives between 0.3 and 14 days at 253 K. The reaction timescales are much shorter than the freezing timescales of impact melts and volcanic sites on Titan, providing ample time for the formation of oxygenated, possibly prebiotic, molecules on its surface. Comparing the rates of the hydrolysis reactions in ammonia-water to those measured in pure water [Neish, C.D, Somogyi, A., Imanaka, H., Lunine, J.I., Smith, M.A., 2008a. Astrobiology 8, 273-287], we find that incorporation of oxygen into the tholins is faster in the presence of ammonia. The rate increases could be due to the increased pH of the solution, or to the availability of new reaction pathways made possible by the presence of ammonia. Using labeled 15NH 3 water, we find that ammonia does incorporate into some products, and that the reactions with ammonia are largely independent of those with water. A related study in HO18 confirms water as the source of the oxygen incorporated into the oxygen containing products.

  11. A Practical Anodic and Cathodic Curve Intersection Model to Understand Multiple Corrosion Potentials of Fe-Based Glassy Alloys in OH- Contained Solutions.

    Science.gov (United States)

    Li, Y J; Wang, Y G; An, B; Xu, H; Liu, Y; Zhang, L C; Ma, H Y; Wang, W M

    2016-01-01

    A practical anodic and cathodic curve intersection model, which consisted of an apparent anodic curve and an imaginary cathodic line, was proposed to explain multiple corrosion potentials occurred in potentiodynamic polarization curves of Fe-based glassy alloys in alkaline solution. The apparent anodic curve was selected from the measured anodic curves. The imaginary cathodic line was obtained by linearly fitting the differences of anodic curves and can be moved evenly or rotated to predict the number and value of corrosion potentials.

  12. Learning, Action and Solutions in Action Learning: Investigation of Facilitation Practice Using the Concept of Living Theories

    Science.gov (United States)

    Sanyal, Chandana

    2018-01-01

    This paper explores the practice of action learning (AL) facilitation in supporting AL set members to address their 'messy' problems through a self-reflexive approach using the concept of 'living theory' [Whitehead, J., and J. McNiff. 2006. "Action Research Living Theory." London: Sage]. The facilitation practice is investigated through…

  13. Ocular pharmacokinetics and tolerability of bimatoprost ophthalmic solutions administered once or twice daily in rabbits, and clinical dosing implications

    Directory of Open Access Journals (Sweden)

    Shen J

    2017-09-01

    Full Text Available Jie Shen,1 Margot L Goodkin,2 Warren Tong,2 Mayssa Attar3 1Clinical Pharmacology, 2Clinical Development, 3Clinical Pharmacology, Metabolism and Immunology, Allergan plc, Irvine, CA, USA Purpose: Fixed-combination medications can benefit patients requiring multiple agents to lower their intraocular pressure (IOP, but combining agents with complementary mechanisms of action is challenging if their dosing frequency differs. This study compares in vivo pharmacokinetic and ocular tolerability of bimatoprost 0.01% ophthalmic solutions dosed once or twice daily. Reports of twice-daily dosing in glaucoma patients are also reviewed.Methods: New Zealand White rabbits were administered bimatoprost 0.01% monotherapy or fixed-combination bimatoprost 0.01%/brimonidine 0.1%, once or twice daily in both eyes for 4 days. Ocular tissues were harvested and analyzed by liquid chromatography-tandem mass spectrometry. The pharmacokinetic parameters calculated included maximum observed concentration, time to maximum concentration, and area under the concentration-time curve.Results: Due to extensive metabolism, bimatoprost concentration was below the quantitation limit by 1 hour post-dose in all samples. Bimatoprost acid exposure, however, could be measured up to 6–8 hours post-dose and was similar in the aqueous humor and iris-ciliary body (pharmacological site of action of animals treated once or twice daily with either bimatoprost 0.01% or fixed-combination bimatoprost 0.01%/brimonidine 0.1%. Increasing dosage frequency in rabbits did not raise the incidence of drug-related conjunctival hyperemia (most common adverse event associated with bimatoprost use in humans, suggesting comparable ocular tolerability of the once- and twice-daily regimens for each formulation.Conclusion: Bimatoprost 0.01% administered once or twice daily as monotherapy and in fixed-combination with brimonidine 0.1% in rabbits show similar pharmacokinetic profiles of bimatoprost acid

  14. Ocular pharmacokinetics and tolerability of bimatoprost ophthalmic solutions administered once or twice daily in rabbits, and clinical dosing implications

    Science.gov (United States)

    Shen, Jie; Goodkin, Margot L; Tong, Warren; Attar, Mayssa

    2017-01-01

    Purpose Fixed-combination medications can benefit patients requiring multiple agents to lower their intraocular pressure (IOP), but combining agents with complementary mechanisms of action is challenging if their dosing frequency differs. This study compares in vivo pharmacokinetic and ocular tolerability of bimatoprost 0.01% ophthalmic solutions dosed once or twice daily. Reports of twice-daily dosing in glaucoma patients are also reviewed. Methods New Zealand White rabbits were administered bimatoprost 0.01% monotherapy or fixed-combination bimatoprost 0.01%/brimonidine 0.1%, once or twice daily in both eyes for 4 days. Ocular tissues were harvested and analyzed by liquid chromatography-tandem mass spectrometry. The pharmacokinetic parameters calculated included maximum observed concentration, time to maximum concentration, and area under the concentration-time curve. Results Due to extensive metabolism, bimatoprost concentration was below the quantitation limit by 1 hour post-dose in all samples. Bimatoprost acid exposure, however, could be measured up to 6–8 hours post-dose and was similar in the aqueous humor and iris-ciliary body (pharmacological site of action) of animals treated once or twice daily with either bimatoprost 0.01% or fixed-combination bimatoprost 0.01%/brimonidine 0.1%. Increasing dosage frequency in rabbits did not raise the incidence of drug-related conjunctival hyperemia (most common adverse event associated with bimatoprost use in humans), suggesting comparable ocular tolerability of the once- and twice-daily regimens for each formulation. Conclusion Bimatoprost 0.01% administered once or twice daily as monotherapy and in fixed-combination with brimonidine 0.1% in rabbits show similar pharmacokinetic profiles of bimatoprost acid, especially in the iris-ciliary body. Key findings from previous clinical studies suggest that by varying the concentration of benzalkonium chloride (a preservative with corneal penetration-enhancing properties

  15. Concordance between local, institutional, and central pathology review in glioblastoma: implications for research and practice: a pilot study.

    Science.gov (United States)

    Gupta, Tejpal; Nair, Vimoj; Epari, Sridhar; Pietsch, Torsten; Jalali, Rakesh

    2012-01-01

    There is significant inter-observer variation amongst the neuro-pathologists in the typing, subtyping, and grading of glial neoplasms for diagnosis. Centralized pathology review has been proposed to minimize this inter-observer variation and is now almost mandatory for accrual into multicentric trials. We sought to assess the concordance between neuro-pathologists on histopathological diagnosis of glioblastoma. Comparison of local, institutional, and central neuro-oncopathology reporting in a cohort of 34 patients with newly diagnosed supratentorial glioblastoma accrued consecutively at a tertiary-care institution on a prospective trial testing the addition of a new agent to standard chemo-radiation regimen. Concordance was sub-optimal between local histological diagnosis and central review, fair between local diagnosis and institutional review, and good between institutional and central review, with respect to histological typing/subtyping. Twelve (39%) of 31 patients with local histological diagnosis had identical tumor type, subtype and grade on central review. Overall agreement was modestly better (52%) between local diagnosis and institutional review. In contrast, 28 (83%) of 34 patients had completely concordant histopathologic diagnosis between institutional and central review. The inter-observer reliability test showed poor agreement between local and central review (kappa statistic=0.12, 95% confidence interval (CI): -0.03-0.32, P=0.043), but moderate agreement between institutional and central review (kappa statistic=0.51, 95%CI: 0.17-0.84, P=0.00003). Agreement between local diagnosis and institutional review was fair. There exists significant inter-observer variation regarding histopathological diagnosis of glioblastoma with significant implications for clinical research and practice. There is a need for more objective, quantitative, robust, and reproducible criteria for better subtyping for accurate diagnosis.

  16. Shared meanings of success, happiness, and health among adults with cerebral palsy and physiotherapists: implications for practice and research.

    Science.gov (United States)

    Gannotti, Mary E; Blanchard, Yvette; Blumberg, Lisa; LaRocco, Diana

    2018-01-25

    To describe shared meanings of success, happiness, and health of adults with cerebral palsy and physiotherapists. Ethnography employed open ended/semi-structured interviews and structured questionnaires (Satisfaction with Life Scale, Beck Depression Inventory-II ® , Oxford Happiness Questionnaire, Life Habits Questionnaire, Medical Outcomes Study-Social Support Survey, and PROMIS ® Pain Interference Scale). Content analysis of qualitative data and principal components analysis of questionnaire responses identified shared meanings. Fourteen adults with cerebral palsy and 15 physiotherapists (median age 46) had similar levels of education. For both groups, social achievements, personal goals, employment, and supporting a family defined success. Adults with cerebral palsy more frequently identified tenacity and persistence as important for success. Both groups described happiness as spending time with loved ones, recreational activities, and having purpose in life. Adults with cerebral palsy identified the importance of self-acceptance for happiness. For both, health included self-care of mind/spirit, cardiovascular and musculoskeletal wellness, and physical fitness (the ability to perform physical tasks). Analysis of questionnaire responses identified shared meanings (eigenvalue 41, 95% explained variance). Adults with cerebral palsy and physiotherapists share similar experiences, behaviors, and feelings about success, happiness, and health. This knowledge may improve communication, enhance evidence-based practice, and foster services to support wellbeing. Implications for rehabilitation Cerebral palsy is a life-long condition, but we know little about social and physical outcomes for adults with cerebral palsy. Lack of understanding about meanings of success, happiness, and health may be a barrier for consumers accessing and for providers delivering evidence-based services. Physiotherapists and adults with cerebral palsy share similar meanings (feelings

  17. A qualitative understanding of the effects of reusable sanitary pads and puberty education: implications for future research and practice.

    Science.gov (United States)

    Hennegan, Julie; Dolan, Catherine; Steinfield, Laurel; Montgomery, Paul

    2017-06-27

    The management of menstruation has come to the fore as a barrier to girls' education attainment in low income contexts. Interventions have been proposed and piloted, but the emerging nature of the field means limited evidence is available to understand their pathways of effect. This study describes and compares schoolgirls' experiences of menstruation in rural Uganda at the conclusion of a controlled trial of puberty education and sanitary pad provision to elucidate pathways of effect in the interventions. Semi-structured interviews were undertaken with schoolgirls who participated in the Menstruation and the Cycle of Poverty trial concurrent with the final set of quantitative surveys. A framework approach and cross-case analysis were employed to describe and compare the experiences of 27 menstruating girls across the four intervention conditions; education (n = 8), reusable sanitary pads (n = 8), education with reusable sanitary pads (n = 6), and control (n = 5). Themes included: menstrual hygiene, soiling, irritation and infection, physical experience, knowledge of menstruation, psychological, social and cultural factors, and support from others. Those receiving reusable pads experienced improvements in comfort and reliability. This translated into reduced fears around garment soiling and related school absenteeism. Other menstrual hygiene challenges of washing, drying and privacy remained prominent. Puberty education improved girls' confidence to discuss menstruation and prompted additional support from teachers and peers. Findings have important implications for the development and evaluation of future interventions. Results suggest the provision of menstrual absorbents addresses one core barrier to menstrual health, but that interventions addressing broader needs such as privacy may improve effectiveness. Puberty education sessions should increase attention to body awareness and include strategies to address a wider range of practical menstrual challenges

  18. The Pursuit of K: Reflections on the Current State-of-the-Art in Stress Intensity Factor Solutions for Practical Aerospace Applications

    Science.gov (United States)

    CraigMcClung, R.; Lee, Yi-Der; Cardinal, Joseph W.; Guo, Yajun

    2012-01-01

    The elastic stress intensity factor (SIF, commonly denoted as K) is the foundation of practical fracture mechanics (FM) analysis for aircraft structures. This single parameter describes the first-order effects of stress magnitude and distribution as well as the geometry of both structure/component and crack. Hence, the calculation of K is often the most significant step in fatigue analysis based on FM. This presentation will provide several reflections on the current state-of-the-art in SIF solution methods used for practical aerospace applications, including a brief historical perspective, descriptions of some recent and ongoing advances, and comments on some remaining challenges. Newman and Raju made significant early contributions to practical structural analysis by developing closed-form SIF equations for surface and corner cracks in simplified geometries, often based on empirical fits of finite element (FE) solutions. Those solutions (and others like them) were sometimes revised as new analyses were conducted or limitations discovered. The foundational solutions have exhibited striking longevity, despite the relatively "coarse" FE models employed many decades ago. However, in recent years, the accumulation of different generations of solutions for the same nominal geometry has led to some confusion (which solution is correct?), and steady increases in computational capabilities have facilitated the discovery of inaccuracies in some (not all!) of the legacy solutions. Some examples of problems and solutions are presented and discussed, including the challenge of maintaining consistency with legacy design applications. As computational power has increased, the prospect of calculating large numbers of SIF solutions for specific complex geometries with advanced numerical methods has grown more attractive. Fawaz and Andersson, for example, have been generating literally millions of new SIF solutions for different combinations of multiple cracks under simplified

  19. A possible solution for corruption in South Africa with the church as initiator: A practical theological approach

    Directory of Open Access Journals (Sweden)

    Amanda L. du Plessis

    2013-03-01

    Full Text Available According to Transparency International, Africa is the most corrupt region in the world. In South Africa, there is an annual ’loss’ of about R30 billion as a result of bribery and corruption. It would appear that it is exactly the poor and the vulnerable who suffer most under the scourge of corruption. The purpose of this research was to investigate the effect of corruption on victim(s and to evaluate it in an effort to formulate solutions as to how such individuals can be guided and supported in the suffering and hardship that they endure and that specifically emanate from corruption. In the research, an effort was made to move away from the trend of the fragmenting of aid and to present guidelines or suggestions that can lead to a global solution, where multi-disciplinary involvement can be facilitated. The researchers agree that the church can play a key role in this, and the solution was sought in the principles expounded in 1 Corinthians 12. The research method known as action research was investigated as a workable method to be used by the multi-disciplinary aid team in their struggle against corruption. In the final instance, the principles used by Touching Africa in their work were investigated so that these could also be used in the quest for a solution.

  20. DISPOWER. A socio-economic analysis of technical solutions and practices for the integration of distributed generation

    International Nuclear Information System (INIS)

    Ten Donkelaar, M.; Scheepers, M.J.J.

    2004-07-01

    Socio-economic impacts of technical solutions and approaches that are being developed for the integration of distributed generation (DG) in electricity distribution systems are analyzed. For this analysis an inventory was made of technical options, solutions and approaches on the basis of a questionnaire that has been distributed among DG (technical) experts. The questionnaire was not meant to give an exhaustive overview, but to gain insight in the possible technical solutions, options and approaches and the economic interactions between different actors in the electricity market. The different technical options and solutions have been divided into four main categories. Four technologies, one of each category, have been studied in more detail to analyse their impact on the financial relationships between the actors in the distribution network. The four technologies are: wind power prediction tool (planning tool), grid control unit (power quality device), power operation and power quality management system (ICT device), and power storage device. To assess the impact of the investments in the proposed technologies on all actors involved (and different from the actor investing), an assessment tool has been developed to qualitatively identify the economic impacts of a number of these options. This assessment tool takes into account the financial transactions between the parties on the distribution network. The analysis also discusses the allocation of the economic value of certain benefits through contracts and economic network regulation