Sample records for subject specialists identify

  1. The changing role of the subject specialist

    Directory of Open Access Journals (Sweden)

    Michael Cotta-Schønberg


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

  2. 22 CFR 61.6 - Consultation with subject matter specialists. (United States)


    ... FREE FLOW OF AUDIO-VISUAL MATERIALS § 61.6 Consultation with subject matter specialists. (a) The... assisting the Department in its determination of whether materials for which export certification or import... determine eligibility of material for certification or authentication based in part on the opinions obtained...

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

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    Ming-Hsin Phoebe Chiu


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

  4. Specialists of social work as key subjects in the field of social work

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    Y. V. Oresheta


    Full Text Available In the presented article an author is analyze social work as type of professional activity and is carried out the sociological analysis of specialists of social work as key subjects in the field of social work. As social work is important direction of activity in any state, it methodological bases, key tasks and main principles though are something alike, however differ depending on legal, organizational, financial possibilities of the state and necessities of clients. Specialists of social work provide realization of social work on national, regional and local levels on enterprises, in establishments, organizations of different pattern of ownership. Professional activity of specialists of social work in Ukraine must correspond the basic requirements and tasks, to certain in Order of Ministry of social policy of Ukraine from 25.05.2012 year «About assertion of new release of qualifying description of profession «Specialist on social work»». In the article is also analyses the short history and features of social work as the type of professional activity in Ukraine, professional requirements to the specialists of social work, their task, role and function are specified. It is set that a necessary condition for a capture this profession is social orientation of personality, presence of the proper social qualities, such as: humanism, goodwill, justice, to responsibility and others. One of entrance terms of efficiency of social work is the presence of skilled shots of the proper level. A considerable value for successful professionalism has an orientation of specialist of social work which plugs the system of values and motivation of him to activity. For a social worker as the professional an important place is occupied by the awareness of itself by the subject of professional activity, that is professional identity.

  5. Subject Specialist Mentors in the LifeLong Learning Sector: who needs them? A case study approach

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    Bailey, Wayne


    Full Text Available Mentoring has become a key to success in many fields and different organisations, and has now become one of the important roles within initial teacher training in the Lifelong Learning Sector. The training of mentors, in particular, subject specialist mentors, is therefore fundamental to ensure that trainees on initial teacher training courses develop with regard to teaching and ensuring they have the necessary subject knowledge. Research was based on a case study at the University Campus Barnsley (part of the University of Huddersfield. Findings from subject specialist mentors, through focus groups, and trainees on a Certificate in Education/Professional or Post Graduate Certificate in Education (Cert Ed/PGCE initial teacher training course, through questionnaires highlighted some interesting development needs. The research has found that there is a changing profile of the subject specialist mentor who supports trainees on initial teacher training courses, in particular they feel that they are not only mentors, but also coaches.

  6. Study regarding the relevance of the accounting subjects in the economic vocational training of non-accountant specialists

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    Galina Bădicu


    Full Text Available The responsibility for the skills of specialists in the economic field belongs to universities, which, by modernizing the curriculum, must take into account the requirements of the professional environment (employers, where the role of the economic specialist extends beyond narrow knowledge, flexibility and high capacity to address various problems. From this perspective, in order to enhance the role of the academic environment and to develop the professional skills of the graduating economists, it is necessary to correlate the competencies and the requirements about educational outcomes. With regard to the relevance of the accounting subjects in the professional training of non-accountant economic specialists, given the competing interests of universities, students and employers in the field of education, we proposed a debate with the view to design strategies of accounting education in the higher economic education of the Republic of Moldova. The article represents a study based on the documentation of the university curriculum in undergraduate programs. With the view to test and validate the necessity of studying accounting subjects in the professional training of non-accounting economic specialists, a questionnaire was developed and implemented. The general research idea refers to the need to study accounting in economic education and practice, which could have an impact over the competitiveness of the Economics graduate.

  7. The Discursive Construction of Power in Teacher Partnerships: Language and Subject Specialists in Mainstream Schools. (United States)

    Creese, Angela


    Shows how language and subject teachers in London secondary schools are positioned differently through their discursive performance of pedagogues and knowledge and how members of classroom communities view language and subject teachers as unequal. Data analysis dew on ethnography of communication and semiotic functional approaches to explain the…

  8. Could cognitive vulnerability identify high-risk subjects for schizophrenia? (United States)

    Sarfati, Yves; Hardy-Baylé, Marie-Christine


    This review puts into questions the possible role of cognitive vulnerability markers in prediction and prevention of schizophrenia. Until recently, none of the identified cognitive anomalies has been proved to be definitive. However, as new promising candidates are emerging (DS-CPT, CPT-IP, P suppression, Saccadic Eye Movements), the predictive value of these trait-type anomalies may be criticized regarding four issues, which are discussed: technical, metrological, theoretical, and clinical. As things stand, the existence of a cognitive vulnerability marker, which testify to a permanent pathological trait, does not constitute a sufficient factor to identify and treat subjects who are at risk for schizophrenia. Copyright 2002 Wiley-Liss, Inc.

  9. Pediatric Specialists (United States)

    ... Healthy Children > Family Life > Medical Home > Pediatric Specialists Pediatric Specialists Article Body ​Your pediatrician may refer your child to a pediatric specialist for further evaluation and treatment. Pediatric specialists ...

  10. Homeroom Teachers or Specialist Teachers?: Considerations for the Workforce for Teaching English as a Subject at Elementary Schools in Japan (United States)

    Okumura, Shinji


    In Japan, English will be officially taught as an academic subject for elementary fifth and sixth graders from 2020. This is a strong initiative of language-in-education policy, aiming at efficient articulation between elementary and junior high schools and targeting the development of English proficiency from early ages simultaneously. However,…

  11. The changing role of subjects connected with book history and publishing in the education of library specialists in Estonia

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    Aile Möldre


    Full Text Available Gives an overview of the development of library education in Estonia since the beginning of teaching library science on the academic level in 1927 up to the present day. The author concentrates on studying the role and share of the courses that deal with book history and contemporary development of the book trade during different periods of time (the Soviet era, and after the restoration of independence in 1991. The last part of the article presents data on the evaluation of the usefulness and necessity of these subjects by public librarians and students of the Tallinn Pedagogical University.


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    Full Text Available The paper is about the training, the mission and the condition of the 21th century specialist, who must keep up with the challenges of the informational era, which is rapidly establishing and embracing human society. It analyzes the characteristics of the digital age, information overload, technological impact, communication, which requiring specialists to increasingly leverage their digital techniques, both in training and activity.

  13. Information Seeking Behavior & Information Resources Management:Mental Process Selecting Subjects & Identifying Information Needs Case study: Graduate Students in Women seminaries of Shiraz of Academic year 1393- 1394(

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    Zohre Eftekhar


    Full Text Available The aim of this research is Information Resources Management: Mental Process Selecting SubjectsIdentifying Information Needs. The research method used in this study is a Quantitative method. Sampling is purposeful. This means that it includes graduate Students in Women seminaries of Shiraz who have information-seeking experience and are able to express their views and information needs. The sample was selected according to the random sampling method with Cochran formula from 710 students. According to this sampling method there is 241 Graduate Students included in 1392-1393 seminaries year of  Women seminaries of Shiraz. This is a survey research Which has been carried out by employing a questionnaire and SPSS for windows to analyze data. The results showed that students for selecting subjectsidentifying information needs used methods and media such as Prying Mind, reviewing of information resources, Consulting with subject specialists.

  14. Intrinsic, identified, and controlled types of motivation for school subjects in young elementary school children. (United States)

    Guay, Frédéric; Chanal, Julien; Ratelle, Catherine F; Marsh, Herbert W; Larose, Simon; Boivin, Michel


    There are two approaches to the differential examination of school motivation. The first is to examine motivation towards specific school subjects (between school subject differentiation). The second is to examine school motivation as a multidimensional concept that varies in terms of not only intensity but also quality (within school subject differentiation). These two differential approaches have led to important discoveries and provided a better understanding of student motivational dynamics. However, little research has combined these two approaches. This study examines young elementary students' motivations across school subjects (writing, reading, and maths) from the stance of self-determination theory. First, we tested whether children self-report different levels of intrinsic, identified, and controlled motivation towards specific school subjects. Second, we verified whether children self-report differentiated types of motivation across school subjects. Participants were 425 French-Canadian children (225 girls, 200 boys) from three elementary schools. Children were in Grades 1 (N=121), 2 (N=126), and 3 (N=178). Results show that, for a given school subject, young elementary students self-report different levels of intrinsic, identified, and controlled motivation. Results also indicate that children self-report different levels of motivation types across school subjects. Our findings also show that most differentiation effects increase across grades. Some gender effects were also observed. These results highlight the importance of distinguishing among types of school motivation towards specific school subjects in the early elementary years.

  15. Identifying cancer subjects with acute respiratory failure at high risk for intubation and mechanical ventilation. (United States)

    Lemiale, Virginie; Lambert, Jérôme; Canet, Emmanuel; Mokart, Djamel; Pène, Frederic; Rabbat, Antoine; Kouatchet, Achille; Vincent, François; Bruneel, Fabrice; Gruson, Didier; Chevret, Sylvie; Azoulay, Elie


    We sought to identify risk factors for mechanical ventilation in patients with malignancies and acute respiratory failure (ARF). We analyzed data from a previous randomized controlled trial in which nonintubated oncology and hematology subjects with ARF were randomized to early bronchoalveolar lavage or routine care in 16 ICUs in France. Consecutive patients with malignancies were admitted to the ICU for ARF in 2005 and 2006 with no intervention. During the study period, 219 patients were admitted to the ICU for ARF, and 8 patients were not included due to a nonintubation order. Data on the underlying disease, pulmonary involvement, and extrapulmonary organ dysfunctions were recorded at admission in the 211 remaining subjects. Ventilatory support included oxygen only (49 subjects), noninvasive ventilation (NIV) only (81 subjects), NIV followed by invasive mechanical ventilation (49 subjects), and first-line invasive mechanical ventilation (32 subjects). The 81 subjects who required invasive mechanical ventilation were compared with the 130 subjects who remained on oxygen or NIV. Factors associated with invasive mechanical ventilation by multivariate analysis were the oxygen flow required at ICU admission, the number of quadrants involved on chest x-ray, and hemodynamic dysfunction. Mortality rates for subjects who had NIV failure were 65.3% compared with 50% for subjects who were first-line intubated (P = .34). In cancer patients with ARF, hypoxemia, extent of pulmonary infiltration on chest x-ray, or hemodynamic dysfunction are risk factors for invasive mechanical ventilation. Mortality was not significantly different between NIV failure and first-line intubation. Copyright © 2014 by Daedalus Enterprises.

  16. Identifying the effective evidence sources to use in developing Clinical Guidelines for Acute Stroke Management: lived experiences of the search specialist and project manager. (United States)

    Parkhill, Anne; Hill, Kelvin


    The Australian National Stroke Foundation appointed a search specialist to find the best available evidence for the second edition of its Clinical Guidelines for Acute Stroke Management. To identify the relative effectiveness of differing evidence sources for the guideline update. We searched and reviewed references from five valid evidence sources for clinical and economic questions: (i) electronic databases; (ii) reference lists of relevant systematic reviews, guidelines, and/or primary studies; (iii) table of contents of a number of key journals for the last 6 months; (iv) internet/grey literature; and (v) experts. Reference sources were recorded, quantified, and analysed. In the clinical portion of the guidelines document, there was a greater use of previous knowledge and sources other than electronic databases for evidence, while there was a greater use of electronic databases for the economic section. The results confirmed that searchers need to be aware of the context and range of sources for evidence searches. For best available evidence, searchers cannot rely solely on electronic databases and need to encompass many different media and sources.

  17. Recurrence analysis of the EEG during sleep accurately identifies subjects with mental health symptoms. (United States)

    McCarty, David E; Punjabi, Naresh M; Kim, Paul Y; Frilot, Clifton; Marino, Andrew A


    Analysis of brain recurrence (ABR) is a novel computational method that uses two variables for sleep depth and two for sleep fragmentation to quantify temporal changes in non-random brain electrical activity. We postulated that ABR of the sleep-staged EEG could identify an EEG signature specific for the presence of mental health symptoms. Using the Mental Health Inventory Questionnaire (MHI-5) as ground truth, psychological distress was assessed in a study cohort obtained from the Sleep Heart Health Study. Subjects with MHI-5 50. Sixteen ABR markers derived from the EEG were analyzed using linear discriminant analysis to identify marker combinations that reliably classified individual subjects. A biomarker function computed from 12 of the markers accurately classified the subjects based on their MHI-5 scores (AUROC=82%). Use of additional markers did not improve classification accuracy. Subgroup analysis (20 highest and 20 lowest MHI-5 scores) improved classification accuracy (AUROC=89%). Biomarker values for individual subjects were significantly correlated with MHI-5 score (r=0.36, 0.54 for N=68, 40, respectively). ABR of EEGs obtained during sleep successfully classified subjects with regard to the severity of mental health symptoms, indicating that mood systems were reflected in brain electrical activity. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. Identifying current training provision and future training needs in allergy available for UK general practice trainees: national cross-sectional survey of General Practitioner Specialist Training programme directors. (United States)

    Ellis, Jayne; Rafi, Imran; Smith, Helen; Sheikh, Aziz


    There are ongoing concerns about the quality of care provision for allergy in primary care. To identify current training provision in allergy to GP trainees and to understand how this could be enhanced. A cross-sectional survey of GP Speciality Training (GPST) programme directors was undertaken. Programme directors of the 174 GPST schemes were sent an online questionnaire which was informed by the content of the Royal College of General Practitioners curriculum. Quantitative data were descriptively analysed and a thematic analysis was undertaken of free text responses. We obtained responses from 146 directors representing 106 training programmes. Responses indicated that two-thirds (62%, 95% CI 53.1 to 71.5) of programmes were providing at least some allergy training, with the remaining third stating that they either provided no training or were unsure. Overall, one-third (33%, 95% CI 22.7 to 42.2) of programme directors believed that all the relevant allergy-related curriculum requirements were being met. Where provided, this training was believed to be best for organ-specific allergic disorders but was thought to be poorer for systemic allergic disorders, particularly food allergy where 67% (95% CI 57.5 to 76.5) of respondents indicated that training was poor. There was considerable interest in increasing the allergy training provided, preferably through eLearning modules and problem-based learning materials supported by those with relevant specialist knowledge. This UK-wide survey has identified important gaps in the training of GP trainees in relation to allergy care. Addressing these gaps, particularly in the management of systemic allergic disorders, should help to improve delivery of primary care-based allergy care.

  19. Specialist Bibliographic Databases (United States)


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

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


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


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

  1. Identifying a correlated spin fluctuation in an entangled spin chain subject to a quantum phase transition. (United States)

    Shimizu, Kaoru; Tokura, Yasuhiro


    This paper presents a theoretical framework for analyzing the quantum fluctuation properties of a quantum spin chain subject to a quantum phase transition. We can quantify the fluctuation properties by examining the correlation between the fluctuations of two neighboring spins subject to the quantum uncertainty. To do this, we first compute the reduced density matrix ρ of the spin pair from the ground state |Ψ⟩ of a spin chain, and then identify the quantum correlation part ρ(q) embedded in ρ. If the spin chain is translationally symmetric and characterized by a nearest-neighbor two-body spin interaction, we can determine uniquely the form of ρ(q) as W|Φ〉〈Φ| with the weight W ≤1, and quantify the fluctuation properties using the two-spin entangled state |Φ〉. We demonstrate the framework for a transverse-field quantum Ising spin chain and indicate its validity for more general spin chain models.

  2. Multivariate synchrony modules identified through multiple subject community detection in functional brain networks. (United States)

    Bolaños, Marcos E; Bernat, Edward M; Aviyente, Selin


    The functional connectivity of the human brain may be described by modeling interactions among its neural assemblies as a graph composed of vertices and edges. It has recently been shown that functional brain networks belong to a class of scale-free complex networks for which graphs have helped define an association between function and topology. These networks have been shown to possess a heterogenous structure composed of clusters, dense regions of strongly associated nodes, which represent multivariate relationships among nodes. Network clustering algorithms classify the nodes based on a similarity measure representing the bivariate relationships and similar to unsupervised learning is performed without a priori information. In this paper, we propose a method for partitioning a set of networks representing different subjects and reveal a community structure common to multiple subjects. We apply this community identifying algorithm to functional brain networks during a cognitive control task, in particular the error-related negativity (ERN), to evaluate how the brain organizes itself during error-monitoring.

  3. Subjectivity

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    Jesús Vega Encabo


    Full Text Available In this paper, I claim that subjectivity is a way of being that is constituted through a set of practices in which the self is subject to the dangers of fictionalizing and plotting her life and self-image. I examine some ways of becoming subject through narratives and through theatrical performance before others. Through these practices, a real and active subjectivity is revealed, capable of self-knowledge and self-transformation. 

  4. The Use of Single-Subject Research to Identify Evidence-Based Practice in Special Education (United States)

    Horner, Robert H.; Carr, Edward G.; Halle, James; McGee, Gail; Odom, Samuel; Wolery, Mark


    Single-subject research plays an important role in the development of evidence-based practice in special education. The defining features of single-subject research are presented, the contributions of single-subject research for special education are reviewed, and a specific proposal is offered for using single-subject research to document…

  5. Do Subjective Measures Improve the Ability to Identify Limited Health Literacy in a Clinical Setting? (United States)

    Goodman, Melody S; Griffey, Richard T; Carpenter, Christopher R; Blanchard, Melvin; Kaphingst, Kimberly A


    Existing health literacy assessments developed for research purposes have constraints that limit their utility for clinical practice, including time requirements and administration protocols. The Brief Health Literacy Screen (BHLS) consists of 3 self-administered Single-Item Literacy Screener (SILS) questions and obviates these clinical barriers. We assessed whether the addition of SILS items or the BHLS to patient demographics readily available in ambulatory clinical settings reaching underserved patients improves the ability to identify limited health literacy. We analyzed data from 2 cross-sectional convenience samples of patients from an urban academic emergency department (n = 425) and a primary care clinic (n = 486) in St. Louis, Missouri. Across samples, health literacy was assessed using the Rapid Estimate of Adult Literacy in Medicine-Revised (REALM-R), Newest Vital Sign (NVS), and the BHLS. Our analytic sample consisted of 911 adult patients, who were primarily female (62%), black (66%), and had at least a high school education (82%); 456 were randomly assigned to the estimation sample and 455 to the validation sample. The analysis showed that the best REALM-R estimation model contained age, sex, education, race, and 1 SILS item (difficulty understanding written information). In validation analysis this model had a sensitivity of 62%, specificity of 81%, a positive likelihood ratio (LR(+)) of 3.26, and a negative likelihood ratio (LR(-)) of 0.47; there was a 28% misclassification rate. The best NVS estimation model contained the BHLS, age, sex, education and race; this model had a sensitivity of 77%, specificity of 72%, LR(+) of 2.75, LR(-) of 0.32, and a misclassification rate of 25%. Findings suggest that the BHLS and SILS items improve the ability to identify patients with limited health literacy compared with demographic predictors alone. However, despite being easier to administer in clinical settings, subjective estimates of health literacy have

  6. Intrinsic, Identified, and Controlled Types of Motivation for School Subjects in Young Elementary School Children (United States)

    Guay, Frederic; Chanal, Julien; Ratelle, Catherine F.; Marsh, Herbert W.; Larose, Simon; Boivin, Michel


    Background: There are two approaches to the differential examination of school motivation. The first is to examine motivation towards specific school subjects (between school subject differentiation). The second is to examine school motivation as a multidimensional concept that varies in terms of not only intensity but also quality (within school…

  7. Identifying Evidence-Based Special Education Interventions from Single-Subject Research (United States)

    Freeman, Jennifer; Sugai, George


    Special educators are required to use evidence-based academic and behavioral interventions in their classrooms (U.S. Department of Education, 2010). No rigorous and comprehensive database currently exists to support educators. Within the field of special education, single-subject research is the primary research methodology (Horner, Carr, Halle,…

  8. Comparison of Nonoverlap Methods for Identifying Treatment Effect in Single-Subject Experimental Research (United States)

    Rakap, Salih; Snyder, Patricia; Pasia, Cathleen


    Debate is occurring about which result interpretation aides focused on examining the experimental effect should be used in single-subject experimental research. In this study, we examined seven nonoverlap methods and compared results using each method to judgments of two visual analysts. The data sources for the present study were 36 studies…

  9. Identifying the null subject: evidence from event-related brain potentials. (United States)

    Demestre, J; Meltzer, S; García-Albea, J E; Vigil, A


    Event-related brain potentials (ERPs) were recorded during spoken language comprehension to study the on-line effects of gender agreement violations in controlled infinitival complements. Spanish sentences were constructed in which the complement clause contained a predicate adjective marked for syntactic gender. By manipulating the gender of the antecedent (i.e., the controller) of the implicit subject while holding constant the gender of the adjective, pairs of grammatical and ungrammatical sentences were created. The detection of such a gender agreement violation would indicate that the parser had established the coreference relation between the null subject and its antecedent. The results showed a complex biphasic ERP (i.e., an early negativity with prominence at anterior and central sites, followed by a centroparietal positivity) in the violating condition as compared to the non-violating conditions. The brain reacts to NP-adjective gender agreement violations within a few hundred milliseconds of their occurrence. The data imply that the parser has properly coindexed the null subject of an infinitive clause with its antecedent.

  10. Knot numbers used as labels for identifying subject matter of a khipu

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    Alberto Saez-Rodriguez


    Full Text Available This investigation presents a new way to look at the numerical khipu, a knotted-string recording device from Pachacamac (Peru, and the types of information it contains. In addition to celestial coordinates, khipu knots apparently pertain to an early form of double-entry accounting. This study hypothesizes that the khipu sample has the recording capacity needed to register double-entry-like accounts. After the identification of its subject matter, the khipu sample was studied in an attempt to ascertain whether the knot values could represent instructions from the Inca state administration to a local accounting center. The results indicate that the numerical information in the pairing quadrants (determined by the distribution of S- and Z-knots should be read from top to bottom along the full length of the string and can then provide certain complementary details regarding the projected corn stocks of the Inca stat

  11. Integrative Genomics Identifies Novel Associations with APOL1 Risk Genotypes in Black NEPTUNE Subjects. (United States)

    Sampson, Matthew G; Robertson, Catherine C; Martini, Sebastian; Mariani, Laura H; Lemley, Kevin V; Gillies, Christopher E; Otto, Edgar A; Kopp, Jeffrey B; Randolph, Anne; Vega-Warner, Virginia; Eichinger, Felix; Nair, Viji; Gipson, Debbie S; Cattran, Daniel C; Johnstone, Duncan B; O'Toole, John F; Bagnasco, Serena M; Song, Peter X; Barisoni, Laura; Troost, Jonathan P; Kretzler, Matthias; Sedor, John R


    APOL1 variants have been associated with renal phenotypes in blacks. To refine clinical outcomes and discover mechanisms of APOL1-associated kidney injury, we analyzed clinical and genomic datasets derived from 90 black subjects in the Nephrotic Syndrome Study Network (NEPTUNE), stratified by APOL1 risk genotype. Ninety subjects with proteinuria ≥0.5 g/d were enrolled at first biopsy for primary nephrotic syndrome and followed. Clinical outcomes were determined, and renal histomorphometry and sequencing of Mendelian nephrotic syndrome genes were performed. APOL1 variants were genotyped, and glomerular and tubulointerstitial transcriptomes from protocol renal biopsy cores were analyzed for differential and correlative gene expression. Analyses were performed under the recessive model (high-risk genotype defined by two risk alleles). APOL1 high-risk genotype was significantly associated with a 17 ml/min per 1.73 m(2) lower eGFR and a 69% reduction in the probability of complete remission at any time, independent of histologic diagnosis. Neither APOL1 risk group was enriched for Mendelian mutations. On renal biopsy, high-risk genotype was associated with increased fractional interstitial area, interstitial fibrosis, and tubular atrophy. Risk genotype was not associated with intrarenal APOL1 mRNA expression levels. Differential expression analysis demonstrated an increased steady-state level of five genes associated with the high-risk genotype (CXCL9, CXCL11, and UBD in glomerulus; SNOR14B and MUC13 in tubulointerstitium). APOL1 tubulointerstitial coexpression analysis showed coexpression of APOL1 mRNA levels with a group of intrarenal transcripts that together were associated with increased interstitial fibrosis and tubular atrophy. These data indicate the high-risk APOL1 genotype confers renal risk across histopathologic diagnoses. Copyright © 2016 by the American Society of Nephrology.

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

    DEFF Research Database (Denmark)

    Sakalauskaite, Dominyka

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

  13. Development of a mnemonic screening tool for identifying subjects with Hunter syndrome. (United States)

    Cohn, Gabriel M; Morin, Isabelle; Whiteman, David A H


    The Hunter Outcome Survey (HOS), an international, long-term observational registry of patients with Hunter syndrome, was used to develop a simple mnemonic screening tool (HUNTER) to aid in the diagnosis of Hunter syndrome. Data regarding the prediagnosis prevalence of ten specific signs and symptoms present in individual patients enrolled in the HOS were used to develop the HUNTER mnemonic screening tool. A total score of 6 or greater using a weighting scheme in which certain manifestations were assigned a weight of 2 (facial dysmorphism, nasal obstruction or rhinorrhea, enlarged tongue, enlarged liver, enlarged spleen, joint stiffness) and others assigned a weight of 1 (hernia, hearing impairment, enlarged tonsils, airway obstruction or sleep apnea) correctly identified 95 % of patients who had no family history of Hunter syndrome or who were not diagnosed prenatally. No association between age at diagnosis and HUNTER score was found. The HUNTER mnemonic appears to be a useful screening tool. Further validation in the clinical setting will be necessary to confirm its utility.

  14. Genetic variants associated with subjective well-being, depressive symptoms and neuroticism identified through genome-wide analyses (United States)

    Derringer, Jaime; Gratten, Jacob; Lee, James J; Liu, Jimmy Z; de Vlaming, Ronald; Ahluwalia, Tarunveer S; Buchwald, Jadwiga; Cavadino, Alana; Frazier-Wood, Alexis C; Davies, Gail; Furlotte, Nicholas A; Garfield, Victoria; Geisel, Marie Henrike; Gonzalez, Juan R; Haitjema, Saskia; Karlsson, Robert; van der Laan, Sander W; Ladwig, Karl-Heinz; Lahti, Jari; van der Lee, Sven J; Miller, Michael B; Lind, Penelope A; Liu, Tian; Matteson, Lindsay; Mihailov, Evelin; Minica, Camelia C; Nolte, Ilja M; Mook-Kanamori, Dennis O; van der Most, Peter J; Oldmeadow, Christopher; Qian, Yong; Raitakari, Olli; Rawal, Rajesh; Realo, Anu; Rueedi, Rico; Schmidt, Börge; Smith, Albert V; Stergiakouli, Evie; Tanaka, Toshiko; Taylor, Kent; Thorleifsson, Gudmar; Wedenoja, Juho; Wellmann, Juergen; Westra, Harm-Jan; Willems, Sara M; Zhao, Wei; Amin, Najaf; Bakshi, Andrew; Bergmann, Sven; Bjornsdottir, Gyda; Boyle, Patricia A; Cherney, Samantha; Cox, Simon R; Davis, Oliver S P; Ding, Jun; Direk, Nese; Eibich, Peter; Emeny, Rebecca T; Fatemifar, Ghazaleh; Faul, Jessica D; Ferrucci, Luigi; Forstner, Andreas J; Gieger, Christian; Gupta, Richa; Harris, Tamara B; Harris, Juliette M; Holliday, Elizabeth G; Hottenga, Jouke-Jan; De Jager, Philip L; Kaakinen, Marika A; Kajantie, Eero; Karhunen, Ville; Kolcic, Ivana; Kumari, Meena; Launer, Lenore J; Franke, Lude; Li-Gao, Ruifang; Liewald, David C; Koini, Marisa; Loukola, Anu; Marques-Vidal, Pedro; Montgomery, Grant W; Mosing, Miriam A; Paternoster, Lavinia; Pattie, Alison; Petrovic, Katja E; Pulkki-Råback, Laura; Quaye, Lydia; Räikkönen, Katri; Rudan, Igor; Scott, Rodney J; Smith, Jennifer A; Sutin, Angelina R; Trzaskowski, Maciej; Vinkhuyzen, Anna E; Yu, Lei; Zabaneh, Delilah; Attia, John R; Bennett, David A; Berger, Klaus; Bertram, Lars; Boomsma, Dorret I; Snieder, Harold; Chang, Shun-Chiao; Cucca, Francesco; Deary, Ian J; van Duijn, Cornelia M; Eriksson, Johan G; Bültmann, Ute; de Geus, Eco J C; Groenen, Patrick J F; Gudnason, Vilmundur; Hansen, Torben; Hartman, Catharine A; Haworth, Claire M A; Hayward, Caroline; Heath, Andrew C; Hinds, David A; Hyppönen, Elina; Iacono, William G; Järvelin, Marjo-Riitta; Jöckel, Karl-Heinz; Kaprio, Jaakko; Kardia, Sharon L R; Keltikangas-Järvinen, Liisa; Kraft, Peter; Kubzansky, Laura D; Lehtimäki, Terho; Magnusson, Patrik K E; Martin, Nicholas G; McGue, Matt; Metspalu, Andres; Mills, Melinda; de Mutsert, Renée; Oldehinkel, Albertine J; Pasterkamp, Gerard; Pedersen, Nancy L; Plomin, Robert; Polasek, Ozren; Power, Christine; Rich, Stephen S; Rosendaal, Frits R; den Ruijter, Hester M; Schlessinger, David; Schmidt, Helena; Svento, Rauli; Schmidt, Reinhold; Alizadeh, Behrooz Z; Sørensen, Thorkild I A; Spector, Tim D; Starr, John M; Stefansson, Kari; Steptoe, Andrew; Terracciano, Antonio; Thorsteinsdottir, Unnur; Thurik, A Roy; Timpson, Nicholas J; Tiemeier, Henning; Uitterlinden, André G; Vollenweider, Peter; Wagner, Gert G; Weir, David R; Yang, Jian; Conley, Dalton C; Smith, George Davey; Hofman, Albert; Johannesson, Magnus; Laibson, David I; Medland, Sarah E; Meyer, Michelle N; Pickrell, Joseph K; Esko, Tõnu; Krueger, Robert F; Beauchamp, Jonathan P; Koellinger, Philipp D; Benjamin, Daniel J; Bartels, Meike; Cesarini, David


    We conducted genome-wide association studies of three phenotypes: subjective well-being (N = 298,420), depressive symptoms (N = 161,460), and neuroticism (N = 170,910). We identified three variants associated with subjective well-being, two with depressive symptoms, and eleven with neuroticism, including two inversion polymorphisms. The two depressive symptoms loci replicate in an independent depression sample. Joint analyses that exploit the high genetic correlations between the phenotypes (|ρ^| ≈ 0.8) strengthen the overall credibility of the findings, and allow us to identify additional variants. Across our phenotypes, loci regulating expression in central nervous system and adrenal/pancreas tissues are strongly enriched for association. PMID:27089181

  15. Screening for elevated albuminuria and subsequently hypertension identifies subjects in which treatment may be warranted to prevent renal function decline. (United States)

    Özyilmaz, Akin; de Jong, Paul E; Bakker, Stephan J L; Visser, Sipke T; Thio, Chris; Gansevoort, Ron T


    We investigated whether initial population screening for elevated albuminuria with subsequent screening for hypertension in case albuminuria is elevated may be of help to identify subjects at risk for accelerated decline in kidney function. We included subjects who participate in the PREVEND observational, general population-based cohort study and had two or more glomerular filtration rate (eGFR) measurements available during follow-up. Elevated albuminuria was defined as an albumin concentration ≥20 mg/L in a first morning urine sample confirmed by an albumin excretion ≥30 mg/day in two 24-h urines. Hypertension was defined as systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg or use of blood pressure-lowering drugs. eGFR was estimated with the CKD-EPI creatinine-cystatin C equation. Overall, 6471 subjects were included with a median of 4 [95% confidence interval (CI) 2-5] eGFR measurements during a follow-up of 11.3 (95% CI 4.0-13.7) years. Decline in eGFR was greater in the subgroups with elevated albuminuria. This held true, not only in subjects with known hypertension (-1.84 ± 2.27 versus -1.16 ± 1.45 mL/min/1.73 m 2 per year, P albuminuria had higher blood pressure than subjects with normoalbuminuria, and in subjects with elevated albuminuria as yet undiagnosed hypertension was twice as prevalent as diagnosed hypertension. Initial screening for elevated albuminuria followed by screening for hypertension may help to detect subjects with increased risk for a steeper decline in kidney function.

  16. Heart specialists' art of care. (United States)

    Speight, J D; Blixt, S L


    Primary care physicians who encourage patients to interact in the medical interview receive high ratings of patient satisfaction with art of care. To determine if this finding holds true in specialty medicine, we designed a two-factor [art of care (high/low); heart specialty (cardiology/cardiovascular surgery)] four-group analogue study. Videotapes for each of the four conditions depicted the first interview between (actor) patient with coronary artery disease and (actor) specialist. The high art of care physicians elicited the patient's story in his own words and encouraged questions and feedback during the interview; the low art of care physicians did not encourage patient interaction. The cardiologists discussed medical treatment and the cardiovascular surgeons discussed surgical treatment. A pilot study of the instrument we developed indicated that the Art of Care Scale, Technical Quality of Care Scale, and Willingness to be Treated Scale demonstrated high internal consistency and that the Art of Care Scale and the Technical Quality of Care Scale defined two dimensions. In the final study, 124 graduate students in education in a midwestern United States university each viewed one videotape and used the instrument to evaluate the physician. Subjects rated the specialists who encouraged patients to interact higher on the Art of Care Scale than specialists who did not encourage interaction. Art of Care Scale Scores predicted subjects' willingness to be treated by the physician they viewed on the videotape. No significant differences in ratings of Art of Care could be attributed to specialty.

  17. Automated detection and quantification of micronodules in thoracic CT scans to identify subjects at risk for silicosis (United States)

    Jacobs, C.; Opdam, S. H. T. T.; van Rikxoort, E. M.; Mets, O. M.; Rooyackers, J.; de Jong, P. A.; Prokop, M.; van Ginneken, B.


    Silica dust-exposed individuals are at high risk of developing silicosis, a fatal and incurable lung disease. The presence of disseminated micronodules on thoracic CT is the radiological hallmark of silicosis but locating micronodules, to identify subjects at risk, is tedious for human observers. We present a computer-aided detection scheme to automatically find micronodules and quantify micronodule load. The system used lung segmentation, template matching, and a supervised classification scheme. The system achieved a promising sensitivity of 84% at an average of 8.4 false positive marks per scan. In an independent data set of 54 CT scans in which we defined four risk categories, the CAD system automatically classified 83% of subjects correctly, and obtained a weighted kappa of 0.76.

  18. Screening for albuminuria with subsequent screening for hypertension and hypercholesterolaemia identifies subjects in whom treatment is warranted to prevent cardiovascular events

    NARCIS (Netherlands)

    Ozyilmaz, Akin; Bakker, Stephan J. L.; de Zeeuw, Dick; de Jong, Paul E.; Gansevoort, Ron T.


    Background. In the general population, many subjects have yet unrecognized hypertension and hypercholesterolaemia, and are thus not treated. We investigated whether population screening for elevated albuminuria can identify subjects with previously unrecognized hypertension and/or

  19. Dynamic Connectivity States Estimated from Resting fMRI Identify Differences among Schizophrenia, Bipolar Disorder, and Healthy Control Subjects

    Directory of Open Access Journals (Sweden)

    Barnaly eRashid


    Full Text Available Schizophrenia and bipolar disorder share significant overlap in clinical symptoms, brain characteristics, and risk genes, and both are associated with dysconnectivity among large-scale brain networks. Resting state functional magnetic resonance imaging (rsfMRI data facilitates studying macroscopic connectivity among distant brain regions. Standard approaches to identifying such connectivity include seed-based correlation and data-driven clustering methods such as independent component analysis (ICA but typically focus on average connectivity. In this study, we utilize ICA on rsfMRI data to obtain intrinsic connectivity networks (ICNs in cohorts of healthy controls (HC and age matched schizophrenia and bipolar disorder patients. Subsequently, we investigated difference in functional network connectivity (FNC, defined as pairwise correlations among the timecourses of ICNs, between healthy controls and patients. We quantified differences in both static (average and dynamic (windowed connectivity during the entire scan duration. Disease-specific differences were identified in connectivity within different dynamic states. Schizophrenia patients showed more differences from healthy subjects than did bipolars, including both hyper and hypo connectivity in one common connectivity state (dynamic state 3. Also group differences between schizophrenia and bipolar patients were identified in patterns (states of connectivity involving the frontal (dynamic state 1 and frontal-parietal regions (dynamic state 3. Our results provide new information about these illnesses and strongly suggest that state-based analyses are critical to avoid averaging together important factors that can help distinguish these clinical groups.

  20. Genome-wide association analysis identifies genetic variations in subjects with myalgic encephalomyelitis/chronic fatigue syndrome. (United States)

    Schlauch, K A; Khaiboullina, S F; De Meirleir, K L; Rawat, S; Petereit, J; Rizvanov, A A; Blatt, N; Mijatovic, T; Kulick, D; Palotás, A; Lombardi, V C


    Myalgic encephalomyelitis, also known as chronic fatigue syndrome or ME/CFS, is a multifactorial and debilitating disease that has an impact on over 4 million people in the United States alone. The pathogenesis of ME/CFS remains largely unknown; however, a genetic predisposition has been suggested. In the present study, we used a DNA single-nucleotide polymorphism (SNP) chip representing over 906,600 known SNPs to analyze DNA from ME/CFS subjects and healthy controls. To the best of our knowledge, this study represents the most comprehensive genome-wide association study (GWAS) of an ME/CFS cohort conducted to date. Here 442 SNPs were identified as candidates for association with ME/CFS (adjusted P-valuegene. Among these, two candidate SNPs resulted in missense substitutions, one in a pattern recognition receptor and the other in an uncharacterized coiled-coil domain-containing protein. We also identified five SNPs that cluster in the non-coding regions of T-cell receptor loci. Further examination of these polymorphisms may help identify contributing factors to the pathophysiology of ME/CFS, as well as categorize potential targets for medical intervention strategies.

  1. New biomarkers of coffee consumption identified by the non-targeted metabolomic profiling of cohort study subjects.

    Directory of Open Access Journals (Sweden)

    Joseph A Rothwell

    Full Text Available Coffee contains various bioactives implicated with human health and disease risk. To accurately assess the effects of overall consumption upon health and disease, individual intake must be measured in large epidemiological studies. Metabolomics has emerged as a powerful approach to discover biomarkers of intake for a large range of foods. Here we report the profiling of the urinary metabolome of cohort study subjects to search for new biomarkers of coffee intake. Using repeated 24-hour dietary records and a food frequency questionnaire, 20 high coffee consumers (183-540 mL/d and 19 low consumers were selected from the French SU.VI.MAX2 cohort. Morning spot urine samples from each subject were profiled by high-resolution mass spectrometry. Partial least-square discriminant analysis of multidimensional liquid chromatography-mass spectrometry data clearly distinguished high consumers from low via 132 significant (p-value<0.05 discriminating features. Ion clusters whose intensities were most elevated in the high consumers were annotated using online and in-house databases and their identities checked using commercial standards and MS-MS fragmentation. The best discriminants, and thus potential markers of coffee consumption, were the glucuronide of the diterpenoid atractyligenin, the diketopiperazine cyclo(isoleucyl-prolyl, and the alkaloid trigonelline. Some caffeine metabolites, such as 1-methylxanthine, were also among the discriminants, however caffeine may be consumed from other sources and its metabolism is subject to inter-individual variation. Receiver operating characteristics curve analysis showed that the biomarkers identified could be used effectively in combination for increased sensitivity and specificity. Once validated in other cohorts or intervention studies, these specific single or combined biomarkers will become a valuable alternative to assessment of coffee intake by dietary survey and finally lead to a better understanding of

  2. Accuracy of the screening physical examination to identify subclinical atherosclerosis and peripheral arterial disease in asymptomatic subjects. (United States)

    Cournot, Maxime; Boccalon, Henri; Cambou, Jean-Pierre; Guilloux, Jérôme; Taraszkiewicz, Dorota; Hanaire-Broutin, Hélène; Chamontin, Bernard; Galinier, Michel; Ferrières, Jean


    This study assessed the accuracy of the screening vascular physical examination for predicting asymptomatic peripheral arterial disease (PAD) or subclinical atherosclerosis in asymptomatic and apparently healthy subjects. A standardized physical examination and a carotid and femoral ultrasonography were administered to 2736 men and women aged 20 to 90 years old, with no personal history of cardiovascular disease (CVD) and no complaint of neurologic, coronary, or lower limb symptom. We assessed the accuracy of auscultation for bruits and pulse palpation for identifying the presence of significant carotid stenosis, carotid plaque, femoral plaque, and ankle-brachial index (ABI) factors. The absence of both pedal pulses also provided additional information, beyond risk factors, on the presence of an ABI <0.9 (+LR, 3.57; 95% CI, 1.93 to 6.60). The presence of a carotid bruit did not affect the likelihood of carotid stenosis, plaque, or intima-media thickness above the median. Unlike carotid auscultation, pulse palpation and auscultation for femoral bruits provided valuable information on the presence of asymptomatic PAD and underlying atherosclerosis in apparently healthy subjects.

  3. Reliability of Two Methods for Identifying the Postural Phase of Gait Initiation in Healthy and Poststroke Subjects. (United States)

    Sousa, Andreia S; Silva, Augusta; Santos, Rubim


    This study aims to compare 2 methods of assessing the postural phase of gait initiation, in regard to intrasession reliability, in healthy and poststroke subjects. As a secondary aim, this study aims to analyze anticipatory postural adjustments during gait initiation based on the center of pressure (CoP) displacements in poststroke participants. The CoP signal was acquired during gait initiation in 15 poststroke subjects and 23 healthy controls. Postural phase was identified through a baseline-based method and a maximal displacement-based method. In both healthy and poststroke participants, higher intraclass correlation coefficient and lower coefficient of variation values were obtained with the baseline-based method when compared with the maximal displacement-based method. Poststroke participants presented decreased CoP displacement backward and toward the first swing limb compared with controls when the baseline-based method was used. With the maximal displacement based method, there were differences between groups only regarding backward CoP displacement. Postural phase duration in medial-lateral direction was also increased in poststroke participants when using the maximal displacement based method. The findings obtained indicate that the baseline-based method is more reliable detecting the onset of gait initiation in both groups, while the maximal displacement-based method presents greater sensitivity for poststroke participants.

  4. The use of Spielberger's State-Trait Personality Inventory (trait anxiety subscale) with naval subaquatic specialists. (United States)

    Van Wijk, Charles H


    Panic behavior poses a particular threat to the health and safety of subaquatic occupational specialists. Trait anxiety has previously been identified as a marker of panic behavior under water, and Spielberger's State-Trait Personality Inventory (trait anxiety subscale) has been previously used to measure trait anxiety among subaquatic specialists. Using archived data, the trait anxiety scores of subaquatic specialists were analyzed to meet 3 objectives: 1stly - to develop a trait anxiety profile of subaquatic specialists; 2ndly - to investigate the predictive value of trait anxiety measures upon entering an occupational field; and 3rdly - to establish the reliability of these scores over time. Archival trait-anxiety data from 322 subjects were analyzed statistically. Analysis of the available scores revealed a highly homogenous as well as a very low trait anxiety profile for the investigated occupational group. Additionally, low trait anxiety was somewhat associated with success during specialist training: fewer candidates with high trait anxiety scores completed their qualification. Moreover, measurement of trait anxiety was stable over time, which suggests that when scores for this occupational group are screened, deviations from previous scores could signify a potential need for referral to an intervention from health professionals. Using the trait anxiety subscale as part of occupational health surveillance of subaquatic specialists could support prevention of accidents by identifying high-risk candidates during their annual health assessments, and referral for timeous intervention.

  5. The value of structured data elements from electronic health records for identifying subjects for primary care clinical trials. (United States)

    Ateya, Mohammad B; Delaney, Brendan C; Speedie, Stuart M


    An increasing number of clinical trials are conducted in primary care settings. Making better use of existing data in the electronic health records to identify eligible subjects can improve efficiency of such studies. Our study aims to quantify the proportion of eligibility criteria that can be addressed with data in electronic health records and to compare the content of eligibility criteria in primary care with previous work. Eligibility criteria were extracted from primary care studies downloaded from the UK Clinical Research Network Study Portfolio. Criteria were broken into elemental statements. Two expert independent raters classified each statement based on whether or not structured data items in the electronic health record can be used to determine if the statement was true for a specific patient. Disagreements in classification were discussed until 100 % agreement was reached. Statements were also classified based on content and the percentages of each category were compared to two similar studies reported in the literature. Eligibility criteria were retrieved from 228 studies and decomposed into 2619 criteria elemental statements. 74 % of the criteria elemental statements were considered likely associated with structured data in an electronic health record. 79 % of the studies had at least 60 % of their criteria statements addressable with structured data likely to be present in an electronic health record. Based on clinical content, most frequent categories were: "disease, symptom, and sign", "therapy or surgery", and "medication" (36 %, 13 %, and 10 % of total criteria statements respectively). We also identified new criteria categories related to provider and caregiver attributes (2.6 % and 1 % of total criteria statements respectively). Electronic health records readily contain much of the data needed to assess patients' eligibility for clinical trials enrollment. Eligibility criteria content categories identified by our study can be

  6. Staff Specialist Survival Course (United States)


    The syllabus for this 4.5-day course addresses the challenges for today’s staff specialists and provides not only hands-on review of actual artifacts...but also case studies to enhance learners’ actual experiences. Background The course was designed to magnify the staff specialist’s skills in

  7. Heating Systems Specialist. (United States)

    Air Force Training Command, Sheppard AFB, TX.

    This instructional package is intended for use in training Air Force personnel enrolled in a program for apprentice heating systems specialists. Training includes instruction in fundamentals and pipefitting; basic electricity; controls, troubleshooting, and oil burners; solid and gas fuel burners and warm air distribution systems; hot water…

  8. Diet Therapy Specialist. (United States)

    Air Force Training Command, Sheppard AFB, TX.

    This four-volume student text is intended for use in training Air Force diet therapy specialists. The first volume, a study guide and workbook for self-directed instruction, covers nutrition, food processing and preparation, therapeutic diets, security precautions in medical food service, procedures for ordering equipment and supplies, food…

  9. Amino acid positions subject to multiple coevolutionary constraints can be robustly identified by their eigenvector network centrality scores. (United States)

    Parente, Daniel J; Ray, J Christian J; Swint-Kruse, Liskin


    As proteins evolve, amino acid positions key to protein structure or function are subject to mutational constraints. These positions can be detected by analyzing sequence families for amino acid conservation or for coevolution between pairs of positions. Coevolutionary scores are usually rank-ordered and thresholded to reveal the top pairwise scores, but they also can be treated as weighted networks. Here, we used network analyses to bypass a major complication of coevolution studies: For a given sequence alignment, alternative algorithms usually identify different, top pairwise scores. We reconciled results from five commonly-used, mathematically divergent algorithms (ELSC, McBASC, OMES, SCA, and ZNMI), using the LacI/GalR and 1,6-bisphosphate aldolase protein families as models. Calculations used unthresholded coevolution scores from which column-specific properties such as sequence entropy and random noise were subtracted; "central" positions were identified by calculating various network centrality scores. When compared among algorithms, network centrality methods, particularly eigenvector centrality, showed markedly better agreement than comparisons of the top pairwise scores. Positions with large centrality scores occurred at key structural locations and/or were functionally sensitive to mutations. Further, the top central positions often differed from those with top pairwise coevolution scores: instead of a few strong scores, central positions often had multiple, moderate scores. We conclude that eigenvector centrality calculations reveal a robust evolutionary pattern of constraints-detectable by divergent algorithms--that occur at key protein locations. Finally, we discuss the fact that multiple patterns coexist in evolutionary data that, together, give rise to emergent protein functions. © 2015 Wiley Periodicals, Inc.

  10. Amino acid positions subject to multiple co-evolutionary constraints can be robustly identified by their eigenvector network centrality scores (United States)

    Parente, Daniel J.; Ray, J. Christian J.; Swint-Kruse, Liskin


    As proteins evolve, amino acid positions key to protein structure or function are subject to mutational constraints. These positions can be detected by analyzing sequence families for amino acid conservation or for co-evolution between pairs of positions. Co-evolutionary scores are usually rank-ordered and thresholded to reveal the top pairwise scores, but they also can be treated as weighted networks. Here, we used network analyses to bypass a major complication of co-evolution studies: For a given sequence alignment, alternative algorithms usually identify different, top pairwise scores. We reconciled results from five commonly-used, mathematically divergent algorithms (ELSC, McBASC, OMES, SCA, and ZNMI), using the LacI/GalR and 1,6-bisphosphate aldolase protein families as models. Calculations used unthresholded co-evolution scores from which column-specific properties such as sequence entropy and random noise were subtracted; “central” positions were identified by calculating various network centrality scores. When compared among algorithms, network centrality methods, particularly eigenvector centrality, showed markedly better agreement than comparisons of the top pairwise scores. Positions with large centrality scores occurred at key structural locations and/or were functionally sensitive to mutations. Further, the top central positions often differed from those with top pairwise co-evolution scores: Instead of a few strong scores, central positions often had multiple, moderate scores. We conclude that eigenvector centrality calculations reveal a robust evolutionary pattern of constraints – detectable by divergent algorithms – that occur at key protein locations. Finally, we discuss the fact that multiple patterns co-exist in evolutionary data that, together, give rise to emergent protein functions. PMID:26503808

  11. Investigating an approach to identifying the biomechanical differences between intercostal cartilage in subjects with pectus excavatum and normals in vivo: preliminary assessment of normal subjects (United States)

    Rechowicz, Krzysztof; McKenzie, Frederic; Yan, Zhenzhen; Bawab, Sebastian; Ringleb, Stacie


    The cause of pectus excavatum (PE) is unknown and little research has been done to assess the material properties of the PE costal cartilage. One source reported, after studying ex vivo various properties of the costal cartilage in cases of PE that the biomechanical stability of PE cartilage is decreased when compared to that of normals. Building on this idea, it would be beneficial to measure the biomechanical properties of the costal cartilages in vivo to further determine the differences between PE subjects and normals. An approach to doing this would be to use a modified FARO arm, which can read applied loads and resulting deflections. These values can be used to establish a finite element model of the chest area of a person with PE. So far, a validated technique for the registration between a CT based 3D model of the ribcage and a skin surface scan in case of PE has been addressed. On the basis of the data gathered from 10 subjects with normal chests using a robot arm, stylus and 3D laser scanner, we tried to evaluate the influence of inter-measurement respiration of a subject on results accuracy and the possibility of using the stylus for deflection measurement. In addition, we established the best strategy for taking measurements.

  12. Common Features of Training of Information Specialists. (United States)

    Seeger, Thomas, Ed.; Wersig, Gernot, Ed.

    This is a collection of 14 papers presented at a professional association conference to explore the possibilities of how the Federation Internationale de Documentation (FID) could improve the education and training of information specialists. The subject was approached from four viewpoints: (1) professional aspects of education and training; (2)…

  13. Library Media Specialists: Premier Information Specialists for the Information Age (United States)

    Neuman, Delia


    The information age has given library media specialists an unprecedented opportunity to play a leading role in helping teachers, administrators, and especially students access and use information intelligently. As the school's premier information specialist; the library media specialist has a unique role to play in helping everyone in the school…

  14. Core subjects at the end of primary school: identifying and explaining relative strengths of children with specific language impairment (SLI). (United States)

    Durkin, Kevin; Mok, Pearl L H; Conti-Ramsden, Gina


    In general, children with specific language impairment (SLI) tend to fall behind their typically developing (TD) peers in educational attainment. Less is known about how children with SLI fare in particular areas of the curriculum and what predicts their levels of performance. To compare the distributions of performance of children with SLI in three core school subjects (English, Mathematics and Science); to test the possibility that performance would vary across the core subjects; and to examine the extent to which language impairment predicts performance. This study was conducted in England and reports historical data on educational attainments. Teacher assessment and test scores of 176 eleven-year-old children with SLI were examined in the three core subjects and compared with known national norms. Possible predictors of performance were measured, including language ability at ages 7 and 11, educational placement type, and performance IQ. Children with SLI, compared with national norms, were found to be at a disadvantage in core school subjects. Nevertheless, some children attained the levels expected of TD peers. Performance was poorest in English; relative strengths were indicated in Science and, to a lesser extent, in Mathematics. Language skills were significant predictors of performance in all three core subjects. PIQ was the strongest predictor for Mathematics. For Science, both early language skills at 7 years and PIQ made significant contributions. Language impacts on the school performance of children with SLI, but differentially across subjects. English for these children is the most challenging of the core subjects, reflecting the high levels of language demand it incurs. Science is an area of relative strength and mathematics appears to be intermediate, arguably because some tasks in these subjects can be performed with less reliance on verbal processing. Many children with SLI do have the potential to reach or exceed educational targets that are set

  15. Genetic variants associated with subjective well-being, depressive symptoms, and neuroticism identified through genome-wide analyses (United States)

    Very few genetic variants have been associated with depression and neuroticism, likely because of limitations on sample size in previous studies. Subjective well-being, a phenotype that is genetically correlated with both of these traits, has not yet been studied with genome-wide data. We conducted ...

  16. Genetic variants associated with subjective well-being, depressive symptoms, and neuroticism identified through genome-wide analyses

    NARCIS (Netherlands)

    A. Okbay (Aysu); Baselmans, B.M.L. (Bart M.L.); J.E. de Neve (Jan-Emmanuel); P. Turley (Patrick); M. Nivard (Michel); Fontana, M.A. (Mark Alan); Meddens, S.F.W. (S. Fleur W.); Linnér, R.K. (Richard Karlsson); Rietveld, C.A. (Cornelius A); J. Derringer; J. Gratten (Jacob); J.J. Lee (James J.); Liu, J.Z. (Jimmy Z); R. de Vlaming (Ronald); SAhluwalia, T. (Tarunveer); Buchwald, J. (Jadwiga); A. Cavadino (Alana); A.C. Frazier-Wood (Alexis C.); Furlotte, N.A. (Nicholas A); Garfield, V. (Victoria); Geisel, M.H. (Marie Henrike); J.R. Gonzalez (Juan R.); Haitjema, S. (Saskia); R. Karlsson (Robert); Der Laan, S.W. (Sander Wvan); K.-H. Ladwig (Karl-Heinz); J. Lahti (Jari); S.J. van der Lee (Sven); P.A. Lind (Penelope); Liu, T. (Tian); Matteson, L. (Lindsay); E. Mihailov (Evelin); M. Miller (Mike); CMinica, C. (Camelia); MNolte, I. (Ilja); D.O. Mook-Kanamori (Dennis); P.J. van der Most (Peter); C. Oldmeadow (Christopher); Y. Qian (Yong); O. Raitakari (Olli); R. Rawal (R.); A. Realo; Rueedi, R. (Rico); Schmidt, B. (Börge); A.V. Smith (Albert Vernon); E. Stergiakouli (Evangelia); T. Tanaka (Toshiko); K.D. Taylor (Kent); Wedenoja, J. (Juho); Wellmann, J. (Juergen); H.J. Westra (Harm-Jan); MWillems, S. (Sara); Zhao, W. (Wei); L.C. Study (LifeLines Cohort); N. Amin (Najaf); Bakshi, A. (Andrew); P.A. Boyle (Patricia); Cherney, S. (Samantha); Cox, S.R. (Simon R); G. Davies (Gail); O.S.P. Davis (Oliver S.); J. Ding (Jun); N. Direk (Nese); Eibich, P. (Peter); R. Emeny (Rebecca); Fatemifar, G. (Ghazaleh); J.D. Faul; L. Ferrucci (Luigi); A.J. Forstner (Andreas); C. Gieger (Christian); Gupta, R. (Richa); T.B. Harris (Tamara B.); J.M. Harris (Juliette); E.G. Holliday (Elizabeth); J.J. Hottenga (Jouke Jan); P.L. de Jager (Philip); M. Kaakinen (Marika); E. Kajantie (Eero); Karhunen, V. (Ville); I. Kolcic (Ivana); M. Kumari (Meena); L.J. Launer (Lenore); L. Franke (Lude); Li-Gao, R. (Ruifang); Koini, M. (Marisa); A. Loukola (Anu); P. Marques-Vidal; G.W. Montgomery (Grant); M. Mosing (Miriam); L. Paternoster (Lavinia); A. Pattie (Alison); K. Petrovic (Katja); Pulkki-R'back, L. (Laura); L. Quaye (Lydia); R'ikkönen, K. (Katri); I. Rudan (Igor); R. Scott (Rodney); J.A. Smith (Jennifer A); A.R. Sutin; Trzaskowski, M. (Maciej); Vinkhuyze, A.E. (Anna E.); L. Yu (Lei); D. Zabaneh (Delilah); J. Attia (John); D.A. Bennett (David A.); Berger, K. (Klaus); L. Bertram (Lars); D.I. Boomsma (Dorret); H. Snieder (Harold); Chang, S.-C. (Shun-Chiao); F. Cucca (Francesco); I.J. Deary (Ian J.); C.M. van Duijn (Cornelia); K. Hagen (Knut); U. Bültmann (Ute); E.J. Geus (Eeco); P.J.F. Groenen (Patrick); V. Gudnason (Vilmundur); T. Hansen (T.); Hartman, C.A. (Catharine A); C.M.A. Haworth (Claire M.); C. Hayward (Caroline); A.C. Heath (Andrew C.); D.A. Hinds (David A.); E. Hypponen (Elina); W.G. Iacono (William); M.-R. Jarvelin (Marjo-Riitta); K.-H. JöCkel (Karl-Heinz); J. Kaprio (Jaakko); S.L.R. Kardia (Sharon); Keltikangas-J'rvinen, L. (Liisa); P. Kraft (Peter); Kubzansky, L.D. (Laura D.); Lehtim'ki, T. (Terho); P.K. Magnusson (Patrik); N.G. Martin (Nicholas); M. McGue (Matt); A. Metspalu (Andres); M. Mills (Melinda); R. de Mutsert (Reneé); A.J. Oldehinkel (Albertine); G. Pasterkamp (Gerard); N.L. Pedersen (Nancy); R. Plomin (Robert); O. Polasek (Ozren); C. Power (Christopher); S.S. Rich (Stephen); F.R. Rosendaal (Frits); H.M. den Ruijter (Hester ); Schlessinger, D. (David); R. Schmidt (Reinhold); R. Svento (Rauli); R. Schmidt (Reinhold); B.Z. Alizadeh (Behrooz); T.I.A. Sørensen (Thorkild); DSpector, T. (Tim); Steptoe, A. (Andrew); A. Terracciano; A.R. Thurik (Roy); N.J. Timpson (Nicholas); H.W. Tiemeier (Henning); A.G. Uitterlinden (André); P. Vollenweider (Peter); Wagner, G.G. (Gert G.); D.R. Weir (David); J. Yang (Joanna); Conley, D.C. (Dalton C.); G.D. Smith; Hofman, A. (Albert); M. Johannesson (Magnus); D. Laibson (David); S.E. Medland (Sarah Elizabeth); M.N. Meyer (Michelle N.); Pickrell, J.K. (Joseph K.); Esko, T. (T'nu); R.F. Krueger; J.P. Beauchamp (Jonathan); Ph.D. Koellinger (Philipp); D.J. Benjamin (Daniel J.); M. Bartels (Meike); D. Cesarini (David)


    textabstractVery few genetic variants have been associated with depression and neuroticism, likely because of limitations on sample size in previous studies. Subjective well-being, a phenotype that is genetically correlated with both of these traits, has not yet been studied with genome-wide data.

  17. Genetic variants associated with subjective well-being, depressive symptoms, and neuroticism identified through genome-wide analyses

    NARCIS (Netherlands)

    Okbay, Aysu; Baselmans, Bart M L; De Neve, Jan-Emmanuel; Turley, Patrick; Nivard, Michel G; Fontana, Mark Alan; Meddens, S Fleur W; Linnér, Richard Karlsson; Rietveld, Cornelius A; Derringer, Jaime; Gratten, Jacob; Lee, James J; Liu, Jimmy Z; de Vlaming, Ronald; Ahluwalia, Tarunveer S; Buchwald, Jadwiga; Cavadino, Alana; Frazier-Wood, Alexis C; Furlotte, Nicholas A; Garfield, Victoria; Geisel, Marie Henrike; Gonzalez, Juan R; Haitjema, Saskia; Karlsson, Robert; van der Laan, Sander W; Ladwig, Karl-Heinz; Lahti, Jari; van der Lee, Sven J; Lind, Penelope A; Liu, Tian; Matteson, Lindsay; Mihailov, Evelin; Miller, Michael B; Minica, Camelia C; Nolte, Ilja M; Mook-Kanamori, Dennis; van der Most, Peter J; Oldmeadow, Christopher; Qian, Yong; Raitakari, Olli; Rawal, Rajesh; Realo, Anu; Rueedi, Rico; Schmidt, Börge; Smith, Albert V; Stergiakouli, Evie; Tanaka, Toshiko; Taylor, Kent; Wedenoja, Juho; Wellmann, Juergen; Westra, Harm-Jan; Willems, Sara M; Zhao, Wei; Amin, Najaf; Bakshi, Andrew; Boyle, Patricia A; Cherney, Samantha; Cox, Simon R; Davies, Gail; Davis, Oliver S P; Ding, Jun; Direk, Nese; Eibich, Peter; Emeny, Rebecca T; Fatemifar, Ghazaleh; Faul, Jessica D; Ferrucci, Luigi; Forstner, Andreas; Gieger, Christian; Gupta, Richa; Harris, Tamara B; Harris, Juliette M; Holliday, Elizabeth G; Hottenga, Jouke-Jan; De Jager, Philip L; Kaakinen, Marika A; Kajantie, Eero; Karhunen, Ville; Kolcic, Ivana; Kumari, Meena; Launer, Lenore J; Franke, Lude; Li-Gao, Ruifang; Koini, Marisa; Loukola, Anu; Marques-Vidal, Pedro; Montgomery, Grant W; Mosing, Miriam A; Paternoster, Lavinia; Pattie, Alison; Petrovic, Katja E; Pulkki-Råback, Laura; Quaye, Lydia; Räikkönen, Katri; Rudan, Igor; Scott, Rodney J; Smith, Jennifer A; Sutin, Angelina R; Trzaskowski, Maciej; Vinkhuyzen, Anna E; Yu, Lei; Zabaneh, Delilah; Attia, John R; Bennett, David A; Berger, Klaus; Bertram, Lars; Boomsma, Dorret I; Snieder, Harold; Chang, Shun-Chiao; Cucca, Francesco; Deary, Ian J; van Duijn, Cornelia M; Eriksson, Johan G; Bültmann, Ute; de Geus, Eco J C; Groenen, Patrick J F; Gudnason, Vilmundur; Hansen, Torben; Hartman, Catharine A; Haworth, Claire M A; Hayward, Caroline; Heath, Andrew C; Hinds, David A; Hyppönen, Elina; Iacono, William G; Järvelin, Marjo-Riitta; Jöckel, Karl-Heinz; Kaprio, Jaakko; Kardia, Sharon L R; Keltikangas-Järvinen, Liisa; Kraft, Peter; Kubzansky, Laura D; Lehtimäki, Terho; Magnusson, Patrik K E; Martin, Nicholas G; McGue, Matt; Metspalu, Andres; Mills, Melinda; de Mutsert, Renée; Oldehinkel, Albertine J; Pasterkamp, Gerard; Pedersen, Nancy L; Plomin, Robert; Polasek, Ozren; Power, Christine; Rich, Stephen S; Rosendaal, Frits R; den Ruijter, Hester M; Schlessinger, David; Schmidt, Helena; Svento, Rauli; Schmidt, Reinhold; Alizadeh, Behrooz Z; Sørensen, Thorkild I A; Spector, Tim D; Steptoe, Andrew; Terracciano, Antonio; Thurik, A Roy; Timpson, Nicholas J; Tiemeier, Henning; Uitterlinden, André G; Vollenweider, Peter; Wagner, Gert G; Weir, David R; Yang, Jian; Conley, Dalton C; Smith, George Davey; Hofman, Albert; Johannesson, Magnus; Laibson, David I; Medland, Sarah E; Meyer, Michelle N; Pickrell, Joseph K; Esko, Tõnu; Krueger, Robert F; Beauchamp, Jonathan P; Koellinger, Philipp D; Benjamin, Daniel J; Bartels, Meike; Cesarini, David

    Very few genetic variants have been associated with depression and neuroticism, likely because of limitations on sample size in previous studies. Subjective well-being, a phenotype that is genetically correlated with both of these traits, has not yet been studied with genome-wide data. We conducted

  18. Genetic variants associated with subjective well-being, depressive symptoms, and neuroticism identified through genome-wide analyses

    DEFF Research Database (Denmark)

    Okbay, Aysu; Baselmans, Bart M L; De Neve, Jan-Emmanuel


    Very few genetic variants have been associated with depression and neuroticism, likely because of limitations on sample size in previous studies. Subjective well-being, a phenotype that is genetically correlated with both of these traits, has not yet been studied with genome-wide data. We conduct...

  19. Comparison of subjective lameness evaluation, force platforms and an inertial-sensor system to identify mild lameness in an equine osteoarthritis model. (United States)

    Donnell, J R; Frisbie, D D; King, M R; Goodrich, L R; Haussler, K K


    When mild lameness exists, agreement between clinicians is often controversial due to its subjective nature. The goal of the study was to compare subjective and objective methods to identify the presence of mild lameness using an established model of osteoarthritis (OA) in which OA was induced by creating a unilateral carpal osteochondral fragment (OCF) in the middle carpal joint of 16 horses. Subjective lameness evaluations (blinded and unblinded), force platforms (FP), and an inertial-sensor system (ISS) were used to detect forelimb lameness at four time points. Limbs identified as lame by each method were compared as well as compared with the OCF limb at each time point. Spearman correlations were calculated between all outcome parameters. Independent of time, blinded subjective evaluation (54%) and the ISS (60%) identified a higher percentage of horses as lame in the OCF limb compared to FP (40%). Blinded subjective evaluation and the ISS agreed which forelimb was lame more often (50%) compared with blinded subjective evaluation and the FP (38%). Induction of mild lameness within the OCF limb was supported by an increase in the frequency of horses considered lame by both subjective evaluations the ISS and a decrease (3.6%) in mean (among all horses) peak vertical force from baseline to post OCF induction. The percentage of horses identified as lame in the OCF limb, independent of time, was highest with the ISS (60%) followed by blinded subjective evaluation (51%) and the FP (42%). It was concluded that the best agreement was between subjective evaluation and the inertial-sensor system. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Genome-wide association analysis in asthma subjects identifies SPATS2L as a novel bronchodilator response gene. (United States)

    Himes, Blanca E; Jiang, Xiaofeng; Hu, Ruoxi; Wu, Ann C; Lasky-Su, Jessica A; Klanderman, Barbara J; Ziniti, John; Senter-Sylvia, Jody; Lima, John J; Irvin, Charles G; Peters, Stephen P; Meyers, Deborah A; Bleecker, Eugene R; Kubo, Michiaki; Tamari, Mayumi; Nakamura, Yusuke; Szefler, Stanley J; Lemanske, Robert F; Zeiger, Robert S; Strunk, Robert C; Martinez, Fernando D; Hanrahan, John P; Koppelman, Gerard H; Postma, Dirkje S; Nieuwenhuis, Maartje A E; Vonk, Judith M; Panettieri, Reynold A; Markezich, Amy; Israel, Elliot; Carey, Vincent J; Tantisira, Kelan G; Litonjua, Augusto A; Lu, Quan; Weiss, Scott T


    Bronchodilator response (BDR) is an important asthma phenotype that measures reversibility of airway obstruction by comparing lung function (i.e. FEV(1)) before and after the administration of a short-acting β(2)-agonist, the most common rescue medications used for the treatment of asthma. BDR also serves as a test of β(2)-agonist efficacy. BDR is a complex trait that is partly under genetic control. A genome-wide association study (GWAS) of BDR, quantified as percent change in baseline FEV(1) after administration of a β(2)-agonist, was performed with 1,644 non-Hispanic white asthmatic subjects from six drug clinical trials: CAMP, LOCCS, LODO, a medication trial conducted by Sepracor, CARE, and ACRN. Data for 469,884 single-nucleotide polymorphisms (SNPs) were used to measure the association of SNPs with BDR using a linear regression model, while adjusting for age, sex, and height. Replication of primary P-values was attempted in 501 white subjects from SARP and 550 white subjects from DAG. Experimental evidence supporting the top gene was obtained via siRNA knockdown and Western blotting analyses. The lowest overall combined P-value was 9.7E-07 for SNP rs295137, near the SPATS2L gene. Among subjects in the primary analysis, those with rs295137 TT genotype had a median BDR of 16.0 (IQR = [6.2, 32.4]), while those with CC or TC genotypes had a median BDR of 10.9 (IQR = [5.0, 22.2]). SPATS2L mRNA knockdown resulted in increased β(2)-adrenergic receptor levels. Our results suggest that SPATS2L may be an important regulator of β(2)-adrenergic receptor down-regulation and that there is promise in gaining a better understanding of the biological mechanisms of differential response to β(2)-agonists through GWAS.

  1. Aplication of artificial neural network model in aviation specialist training

    Directory of Open Access Journals (Sweden)

    Висиль Миколайович Казак


    Full Text Available This paper reviews the application of artificial neural network (ANN model in aviation specialist training. The ANN model is based on the dependence of residual knowledge of subjects of study on their individual abilities. The residual knowledge is the skills acquired by the subject before he is going for an occupation.  The presented ANN model gives the possibility to predict the level of professional training of the specialists with high accuracy

  2. In search of Leonardo: computer-based facial image analysis of Renaissance artworks for identifying Leonardo as subject (United States)

    Tyler, Christopher W.; Smith, William A. P.; Stork, David G.


    One of the enduring mysteries in the history of the Renaissance is the adult appearance of the archetypical "Renaissance Man," Leonardo da Vinci. His only acknowledged self-portrait is from an advanced age, and various candidate images of younger men are difficult to assess given the absence of documentary evidence. One clue about Leonardo's appearance comes from the remark of the contemporary historian, Vasari, that the sculpture of David by Leonardo's master, Andrea del Verrocchio, was based on the appearance of Leonardo when he was an apprentice. Taking a cue from this statement, we suggest that the more mature sculpture of St. Thomas, also by Verrocchio, might also have been a portrait of Leonardo. We tested the possibility Leonardo was the subject for Verrocchio's sculpture by a novel computational technique for the comparison of three-dimensional facial configurations. Based on quantitative measures of similarities, we also assess whether another pair of candidate two-dimensional images are plausibly attributable as being portraits of Leonardo as a young adult. Our results are consistent with the claim Leonardo is indeed the subject in these works, but we need comparisons with images in a larger corpora of candidate artworks before our results achieve statistical significance.

  3. Cognitive versus social aspects of pragmatic meaning: on the importance of identifying the subject as an ethical agent

    Directory of Open Access Journals (Sweden)

    Kanavillil Rajagopalan


    Full Text Available

    Is it possible to reconcile the cognitive and the social aspects of pragmatic meaning? Or could it be that the two are doomed forever to be locked in a perennial tug-of-war? I argue in this paper that the radical versions of both these theses are faulty for the same reason: viz, that of seeking to capture in a handful of deterministic rules everything that takes place at the pragmatic level. Furthermore, I argue that there is an urgent need to look upon the subject of language as a conscientious agent just as much as a person endowed with consciousness. In other words, the ethical question is invariably present in the confrontation between the cognitive and the social.

  4. Perinatal asphyxia in a specialist hospital in Port Harcourt, Nigeria ...

    African Journals Online (AJOL)

    Perinatal asphyxia in a specialist hospital in Port Harcourt, Nigeria. BA West, PI Opara. Abstract. Objectives: To find the prevalence, and identify risk factors and outcome in neonates who were admitted into the Braithewaite Memorial Specialist Hospital (BMSH) for perinatal asphyxia. Method: This was a descriptive cross ...

  5. Identifying the key elements of an education package to up-skill multidisciplinary adult specialist palliative care teams caring for young adults with life-limiting conditions: an online Delphi study. (United States)

    Sivell, Stephanie; Lidstone, Victoria; Taubert, Mark; Thompson, Catherine; Nelson, Annmarie


    To collect the views of experts to inform the development of an education package for multidisciplinary adult specialist palliative care (SPC) teams caring for young people with life-limiting conditions. A modified online Delphi process collated expert opinion on format, delivery and content of an education package to up-skill adult SPC teams. Round 1 participants (n=44) answered free-text questions, generating items for Round 2. In Round 2, 68 participants rated the extent to which they agreed/disagreed with the items on 5-point Likert-type scales. Median and mean scores assessed the importance of each item. IQR scores assessed level of consensus for each item; items lacking consensus were rerated by 35 participants in Round 3. In the Delphi, consensus was reached on a range of suggested formats, on who should deliver the training, and on several clinical, psychosocial and practical topics. Development of a continuous/rolling programme of education, tailored for content and mode of delivery and incorporated into working practice is recommended. As a direct outcome of the results of this study, a series of six linked study days has been established, focusing specifically on the issues around caring for young adults with life-limiting conditions and palliative care needs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to


    Taylor, Andrew; Sutherland, Adam


    Clinical supervision is defined by Barber and Norman as having four main functions: educational, supportive, managerial and development of self-awareness.1 It is common practice within initial pharmacy education for clinical supervision to take place at undergraduate, pre-registration and foundation level pharmacist stages. But what about the specialist trainees? It is probably a fair observation that the amount of clinical supervision provided for pharmacists undergoing their advanced level practice drops vividly.One study suggests that clinical supervision improves patient outcomes,2 however this and many other studies are related to nursing clinical supervision, there is little published evidence to support this claim with regards to pharmacy clinical supervision.We present a case where effective clinical supervision of a specialist trainee had a direct impact on patient safety and outcome in a paediatric intensive care unit. The case involves a child with a presentation of sepsis related to group A Streptococcus toxic shock syndrome (TSS) and associated acute kidney injury (AKI) that may have been precipitated or worsened iatrogenically. An experienced band 7 pharmacist attends the daily ward round and refers complex patients to the nominated senior specialist pharmacist. An educational pharmacist ward round takes place twice a week where the band 7 pharmacist will present each patient, proposed pharmaceutical management plan and the patient's care is discussed in an open, non-judgemental forum.After each discussion an agreed action plan is implemented, further educational needs identified and goals agreed to meet them. A strong component of this ward round is a reflective element with the senior pharmacist encouraging specialist trainees to reflect verbally. Significant event reflections will be documented. The specialist trainee identified that this patient required senior review, and referred the patient up appropriately.Following independent assessment by


    Directory of Open Access Journals (Sweden)

    Natalia Evgenievna Vodopyanova


    Full Text Available The article contains the results of the empirical research internallysubject factors that facilitate and impede professional burnout of young specialists socionomic professions from positions of subject-resource approach.The results of empirical research found that the resistance to professional burnout of young specialists associated with high rates of resource value-semantic sphere and positive attitude on self-efficacy. Development of professional burnout contributes to the experience of the loss of vital values.

  8. Comparing success rates of anesthesia providers versus trauma surgeons in their use of palpation to identify the cricothyroid membrane in female subjects: a prospective observational study. (United States)

    Hiller, Kenneth N; Karni, Ron J; Cai, Chunyun; Holcomb, John B; Hagberg, Carin A


    The primary aim of this study was to compare the success rates of anesthesia providers vs trauma surgeons in their use of palpation to identify the cricothyroid membrane (CTM). The secondary aim was to explore whether prior training and experience performing surgical airways affected the success rates for identifying the CTM. Four female adults participated in this prospective observational study. The participants had varying measurements of neck anatomy that were known or theorized to affect the accuracy of identifying the CTM location. For test purposes, the subjects were positioned with optimal neck extension via placement of a shoulder roll. Anesthesia providers (n = 57) and surgeons (n = 14) of various training levels and clinical experience marked the presumed CTM location on each subject. These palpation markings were then referenced against the ultrasound-confirmed CTM location, and the success rates for identifying the CTM were compared between groups. The overall success rate using palpation to identify the CTM was ≤ 50%, and there were no differences in success rates between the anesthesia providers and trauma surgeons (16% vs 26%, respectively; absolute difference, -10%; 95% confidence interval, -23 to 3; P = 0.15). Furthermore, there were no significant differences in the success rates for identifying the CTM based on either clinical experience or emergency surgical airway experience. The success rates for identifying the CTM using palpation were low and not significantly different for anesthesia providers and surgeons, collectively, as well as for the various levels of training. Anesthesiologists' ability to mark the CTM location correctly did not improve with years of experience.

  9. What Is a Pediatric Infectious Diseases Specialist? (United States)

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

  10. An automated method for identifying an independent component analysis-based language-related resting-state network in brain tumor subjects for surgical planning. (United States)

    Lu, Junfeng; Zhang, Han; Hameed, N U Farrukh; Zhang, Jie; Yuan, Shiwen; Qiu, Tianming; Shen, Dinggang; Wu, Jinsong


    As a noninvasive and "task-free" technique, resting-state functional magnetic resonance imaging (rs-fMRI) has been gradually applied to pre-surgical functional mapping. Independent component analysis (ICA)-based mapping has shown advantage, as no a priori information is required. We developed an automated method for identifying language network in brain tumor subjects using ICA on rs-fMRI. In addition to standard processing strategies, we applied a discriminability-index-based component identification algorithm to identify language networks in three different groups. The results from the training group were validated in an independent group of healthy human subjects. For the testing group, ICA and seed-based correlation were separately computed and the detected language networks were assessed by intra-operative stimulation mapping to verify reliability of application in the clinical setting. Individualized language network mapping could be automatically achieved for all subjects from the two healthy groups except one (19/20, success rate = 95.0%). In the testing group (brain tumor patients), the sensitivity of the language mapping result was 60.9%, which increased to 87.0% (superior to that of conventional seed-based correlation [47.8%]) after extending to a radius of 1 cm. We established an automatic and practical component identification method for rs-fMRI-based pre-surgical mapping and successfully applied it to brain tumor patients.

  11. Stoma coloproctology nurse specialist: a case study. (United States)

    Chaney, Ursula; Hasson, Felicity; Keeney, Sinead; Sinclair, Marlene; Poulton, Brenda; McKenna, Hugh P


    The aim of this paper is to provide insight into the role of a Stoma Coloproctology Nurse Specialist. This paper presents the findings of an in-depth case study of a stoma coloproctology nurse specialist employed in one health board area in Northern Ireland. This case study was part of a larger study exploring innovative nursing and midwifery roles in Northern Ireland. Specialist nursing roles have evolved and developed in response to changing health care needs, patient expectations, changes in professional regulation and government initiatives. A case study approach was adopted. Semi-structured interviews with the post holder (PH), her line manager and the human resource manager were undertaken. Non-participant observation of the PH's practice was also carried out. Analysis was undertaken on secondary data such as job specification, annual reports and other documentation relating to the post. Findings illustrate the PH's function and the impact of the role on patient care. Examples of innovative practices relating to providing care, support and guidance for patients and their families were identified; however, limitations to her role were also identified. The PH provides an invaluable service to patients, demonstrating a positive impact on care. However, the findings suggest the importance of establishing clear role boundaries, which may lead to professional growth and practice development. Although this study provides a valuable insight into the role of a Stoma Coloproctology Nurse Specialist a number of challenges exist, as the CNS role requires policy and appropriate educational preparation to practice at an advanced level. Further research investigating the development of the CNS role in the clinical setting and its relationship to members of the multi-professional team would be beneficial.


    Directory of Open Access Journals (Sweden)

    Vladimir A. Romanov


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

  13. Immuno-informatics based approaches to identify CD8+ T cell epitopes within the Leishmania donovani 3-ectonucleotidase in cured visceral leishmaniasis subjects. (United States)

    Vijayamahantesh; Amit, Ajay; Dikhit, Manas R; Singh, Ashish K; Venkateshwaran, T; Das, V N R; Das, Pradeep; Bimal, Sanjiva


    Leishmaniases are vector-borne diseases for which no vaccine exists. These diseases are caused by the Leishmania species complex. Activation of the CD8 + T cell is crucial for protection against intracellular pathogens, and peptide antigens are attractive strategies for the precise activation of CD8 + T in vaccine development against intracellular infections. The traditional approach to mine the epitopes is an arduous task. However, with the advent of immunoinformatics, in silico epitope prediction tools are available to expedite epitope identification. In this study, we employ different immunoinformatics tools to predict CD8 + T cell specific 9 mer epitopes presented by HLA-A*02 and HLA-B40 within the highly conserved 3'-ectonucleotidase of Leishmania donovani. We identify five promiscuous epitopes, which have no homologs in humans, theoretically cover 85% of the world's population and are highly conserved (100%) among Leishmania species. Presentation of selected peptides was confirmed by T2 cell line based HLA-stabilization assay, and three of them were found to be strong binders. The in vitro peptide stimulation of peripheral blood mononuclear cells (PBMC) from cured HLA-A02 + visceral leishmaniasis (VL) subjects produced significantly higher IFN-γ, IL-2 and IL-12 compared to no peptide control healthy subjects. Further, CD8 + cells from treated VL subjects produced significantly higher intracellular IFN-γ, lymphocyte proliferation and cytotoxic activity against selected peptides from the PBMCs of treated HLA-A02 + VL subjects. Thus, the CD8 + T cell specific epitopes shown in this study will speed up the development of polytope vaccines for leishmaniasis. Copyright © 2017. Published by Elsevier Masson SAS.

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

    Directory of Open Access Journals (Sweden)

    S. Bazhenov


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

  15. findings from specialist treatment centres

    African Journals Online (AJOL)

    A retrospective study of OTC and prescription medicine misuse among 9 063 patients from 23 specialist substance abuse treatment centres in Cape Town, South Africa, between 1998 and 2000. Results. OTC and prescription medicine misuse places a burden on health and social services in South Africa. This is evidenced ...

  16. ISD Designed Medical Specialist Training. (United States)

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

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

  17. Symptomatic response to blocked and unblocked pentagastrin stimulation in functional dyspepsia - Comparison of responders and non-responders to omeprazole identified in a single-subject trial model

    DEFF Research Database (Denmark)

    Madsen, L.G.; Bytzer, P.


    Background: The role of acid in functional dyspepsia is controversial and drug treatment trials indicate that only a subset of patients has acid-related symptoms. A novel single-subject trial design, the Random Starting Day trial (RSD trial), was developed to identify acid-related symptoms. We...... was expected not to be influenced by gastric acid stimulation or type of treatment. Methods: Nineteen patients were evaluated. Symptomatic response to pentagastrin (6 mu g/kg) was assessed twice in each patient following placebo and omeprazole (40 mg bid) treatment in a randomized, double-blind, cross......-over design. Epigastric pain was assessed every 15 for 90 min after stimulation using a 5-graded Likert scale and a VAS scale. A positive acid provocation test was defined as an increase of the Likert score of epigastric pain by at least one grade after pentagastrin stimulation during placebo treatment...

  18. Issues And Challenges Of Instructional Technology Specialists In Alberta Colleges

    Directory of Open Access Journals (Sweden)

    Margaret Spence


    Full Text Available Under pressure to become more cost effective and competitive in the delivery of educational courses and programs, Alberta colleges have identified the integration of communication and information technologies as an appropriate response to these fiscal demands. This requires highly skilled computer and communication technologists who are both technology specialists and pedagogical experts. Twenty-eight Instructional Technology Specialists at fourteen Alberta colleges responded to a written survey. Follow-up interviews were held with seven respondents. Respondents perceived the college’s administration as lacking understanding of the implications of integrating technology into teaching and uncertain about ongoing funding for projects. As Instructional Technology Specialists they brought a variety of backgrounds and experiences to their work. They provided a broad range of services and maintained currency through ongoing formal and informal professional development. For these IT Specialists, their concerns are about growth and a better balance between the technical and pedagogical aspects of technology.

  19. Impact of Subject Specialists on Teaching: Application to Physiology

    Directory of Open Access Journals (Sweden)

    B. V. Owoyele


    Full Text Available The study investigated the impact of teachers on the teaching of a physiology course to performing arts students of the University of Ilorin. Questionnaires and personal observations were used to assess students' perception of the course and performance, the examination results in the two years before and after the takeover of the course by physiology teachers were obtained and analysed. The results showed that the students appreciated the teaching by core physiology teachers than the teaching by performing arts teachers and the initial phobias of the students were significantly doused. The average performance by the students did not change significantly and this further justified the taking over of the course by physiology teachers.

  20. Experiences of gynecological cancer patients receiving care from specialist nurses: a qualitative systematic review. (United States)

    Cook, Olivia; McIntyre, Meredith; Recoche, Katrina; Lee, Susan


    was utilized in this review. An initial limited search of MEDLINE and CINAHL was undertaken followed by a comprehensive search using all identified keywords and index terms across all included databases. The reference lists of all identified reports and articles were hand searched for additional studies. Each paper was independently assessed by two independent reviewers for methodological validity prior to inclusion in the review using the standardized critical appraisal instrument from the Joanna Briggs Institute the Qualitative Assessment and Review Instrument. When disagreement arose between the reviewers, the given paper was independently appraised by a third reviewer. Data were extracted from papers included in the review using the standardized data extraction tool from Joanna Briggs Institute the Qualitative Assessment and Review Instrument. Data extraction was completed independently by two reviewers. Extracted findings from seven included papers were grouped according to similarity in meaning from which 11 categories were developed. These categories were then subjected to a meta-synthesis that produced a set of three synthesized findings. Key findings were extracted from six included papers and classified as unequivocal (U) or credible (C). A total of 30 findings were extracted and aggregated into 11 categories based on similarity in meaning. From the 11 categories, three synthesized findings were developed: i) Tailored care: specialist nurses play a role in understanding and meeting the individual needs of women with gynecological cancer; ii) Accessible care: specialist nurses guide women with gynecological cancer along the continuum of care and are an easily accessed source of knowledge and support; iii) Dependable expertise: women with gynecological cancer express trust and reassurance in the experience and expertise of the specialist nurse. This systematic review synthesized the findings of seven studies that captured the experiences of women with

  1. A genome-wide association study in 19 633 Japanese subjects identified LHX3-QSOX2 and IGF1 as adult height loci. (United States)

    Okada, Yukinori; Kamatani, Yoichiro; Takahashi, Atsushi; Matsuda, Koichi; Hosono, Naoya; Ohmiya, Hiroko; Daigo, Yataro; Yamamoto, Kazuhiko; Kubo, Michiaki; Nakamura, Yusuke; Kamatani, Naoyuki


    Previous genome-wide association studies (GWASs) have identified several loci associated with human height; however, such evidence was mostly reported in Caucasian populations. Since the different distributions of height between populations suggest their different genetic backgrounds, analysis in different populations would be useful. Here, we present the results of a GWAS for adult height in 19 633 Japanese subjects. We found eight significantly associated loci that satisfied the genome-wide significance level (P height to this locus (rs1457595, P = 1.2 x 10(-5)). We observed large differences in the allele frequencies of rs17032362 and rs1457595 between Japanese (34 and 9%, respectively) and Caucasian (1.7 and 0%, respectively) populations, thereby suggesting weak statistical powers for the IGF1 locus in the previous Caucasian GWASs for height. We extensively compared our results with those of previous reports on the Caucasian and Korean populations. We were able to replicate all four loci previously reported in Koreans (EFEMP1, ZBTB38, HMGA1 and PLAG1, P height-associated loci identified in our study and the previous GWASs demonstrated an effect size of 1.26 cm (95% confidence interval: 1.18-1.34) per 1.0 increase of the normalized Z score for height-increasing alleles, explaining 4.6% of the total variance of adult height.

  2. Specialist training in pediatric anesthesia

    DEFF Research Database (Denmark)

    Hansen, Tom G


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

  3. Decision making in specialist forensic psychiatric (the psychological aspect

    Directory of Open Access Journals (Sweden)

    Shmakova E.V.


    Full Text Available The article presents the results of a study of psychological factors of decision making amongforensic psychiatric specialists. Given the survey data of10 medical psychologists and 10 psychiatrists carrying out compulsory treatment in the psychiatric hospital №5, Moscow Department of Public Health, in comparison with the control group, consisting of professionals working in the field of education, manufacturing, services and technology. Methodical complex included: 1. The Epstein questionnaire of the intuitive style (adaptation Kornilova T. V., Kornilov S. A.; A new questionnaire of tolerance/intolerance to uncertainty (Kornilova T. V.; Melbourne questionnaire of decision making (adaptation T. V.Kornilova; The questionnaire «Personal factors of decision making»(T.V. Kornilova; TheV. Smecalo and V. M. Kucher method; The Tsvetkova Method; 7. The questionnaire «Styles of thinking» by R. Bramsonand Harrison (adaptation of A. A. Alekseev; 8.The questionnaire «Scale of base convictions» (R.Yanov-Boulemane, adaptation M.A. Padun, A.V. Kotelnikov; 9. The check-list aimed to identify the type of decisions taken by the expert in professional activity, their frequency, importance, subjective evaluation is necessary for decision making qualities and to evaluate the most significant opinions of other persons in the decision-making process. There were defined the characteristics of decision making depending on gender. The relationships between type of activity and frequency of occurrence of different types of decisions in professional activities of specialists were revealed. Analyzed the relationship between consideration of the views of others when making decisions and activity.

  4. What Is a Pediatric Sports Medicine Specialist? (United States)

    ... induced asthma Concussions Nutrition and supplement issues Diabetes Eating disorders Stress fractures Heat illness Unique conditions of the athlete with special needs Where Can I Find A Pediatric Sports Medicine Specialist? Pediatric sports medicine specialists practice in ...

  5. What Is an Adolescent Health Specialist? (United States)

    ... behavioral, and emotional health care needs—from physical exams and immunizations to reproductive and mental health care. What Type of Training Do Adolescent Health Specialists Have? Adolescent health specialists are medical doctors who have completed at least 4 years ...

  6. Making Hospitals Less Traumatic. Child Life Specialists. (United States)

    Jessee, Peggy O.


    Discusses the importance of child life specialists and programs in helping children cope with the stress and anxiety of hospital experiences. These specialists and programs promote children's growth and development both in the hospital and after returning home. (BB)

  7. Inter-tester Reliability in Classifying Acute and Subacute Low Back Pain Patients into Clinical Subgroups: A Comparison of Specialists and Non-Specialists. A Pilot Study. (United States)

    Paatelma, Markku; Karvqnen, Eira; Heinqnen, Ari


    Many systems have been suggested for classifying low back pain (LBP); the most commonly used among physiotherapists involves a pathoanatomical/pathophysiological tissue classification system. Few studies have examined whether this form of classification of LBP disorders can be performed in a reliable manner between specialists with advanced training, or between specialists with advanced training and non-specialists who lack advanced training. The purpose of this paper was to examine the inter-tester reliability of two specialists, and the ability of a specialist and non-specialist to independently classify patients with LBP, utilizing clinical tests and history-based classification methods after a short educational course on the classification system. Subjects were acute or sub-acute patients with LBP who visited their occupational healthcare or municipal healthcare center. Inter-tester reliability between the specialist and non-specialists was at almost the same level: overall Kappa 0.60 (95%CI; 0.40 to 0.85), overall agreement 70%, as between the two specialists: overall Kappa 0.65 (95%CI; 0.33-0.86), overall agreement 77%. The findings suggest that a short educational course can provide rather reliable examination tools to allow non-specialized physiotherapists to classify patients according to tissue origination.

  8. Professional Insiders/Outsiders? Teacher Professionalism and the Primary School Physical Education Specialist (United States)

    Brooks, Caroline; DinanThompson, Maree


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

  9. Learning Mathematics for Teaching Mathematics: Non-Specialist Teachers' Mathematics Teacher Identity (United States)

    Crisan, Cosette; Rodd, Melissa


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

  10. Invisible Roles of Doctoral Program Specialists (United States)

    Bachman, Eva Burns; Grady, Marilyn L.


    The purpose of this study was to investigate the roles of doctoral program specialists in Big Ten universities. Face-to-face interviews with 20 doctoral program specialists employed in institutions in the Big Ten were conducted. Participants were asked to describe their roles within their work place. The doctoral program specialists reported their…

  11. Thoracic ultrasonography for the pulmonary specialist. (United States)

    Koenig, Seth J; Narasimhan, Mangala; Mayo, Paul H


    Thoracic ultrasonography is a noninvasive and readily available imaging modality that has important applications in pulmonary medicine outside of the ICU. It allows the clinician to diagnose a variety of thoracic disorders at the point of care. Ultrasonography is useful in imaging lung consolidation, pleural-based masses and effusions, pneumothorax, and diaphragmatic dysfunction. It can identify complex or loculated effusions and be useful in planning treatment. Identifying intrathoracic mass lesions can guide sampling by aspiration and biopsy. This article summarizes thoracic ultrasonography applications for the pulmonary specialist, related procedural codes, and reimbursement. The major concepts are illustrated with cases. These case summaries are enhanced with online supplemental videos and chest radiograph, chest CT scan, and ultrasound correlation.

  12. Sleep Deprivation in Young and Healthy Subjects Is More Sensitively Identified by Higher Frequencies of Electrodermal Activity than by Skin Conductance Level Evaluated in the Time Domain

    Directory of Open Access Journals (Sweden)

    Hugo F. Posada-Quintero


    Full Text Available We analyzed multiple measures of the autonomic nervous system (ANS based on electrodermal activity (EDA and heart rate variability (HRV for young healthy subjects undergoing 24-h sleep deprivation. In this study, we have utilized the error awareness test (EAT every 2 h (13 runs total, to evaluate the deterioration of performance. EAT consists of trials where the subject is presented words representing colors. Subjects are instructed to press a button (“Go” trials or withhold the response if the word presented and the color of the word mismatch (“Stroop No-Go” trial, or the screen is repeated (“Repeat No-Go” trials. We measured subjects' (N = 10 reaction time to the “Go” trials, and accuracy to the “Stroop No-Go” and “Repeat No-Go” trials. Simultaneously, changes in EDA and HRV indices were evaluated. Furthermore, the relationship between reactiveness and vigilance measures and indices of sympathetic control based on HRV were analyzed. We found the performance improved to a stable level from 6 through 16 h of deprivation, with a subsequently sustained impairment after 18 h. Indices of higher frequencies of EDA related more to vigilance measures, whereas lower frequencies index (skin conductance leve, SCL measured the reactiveness of the subject. We conclude that indices of EDA, including those of the higher frequencies, termed TVSymp, EDASymp, and NSSCRs, provide information to better understand the effect of sleep deprivation on subjects' autonomic response and performance.

  13. [The fiscal position of medical specialists]. (United States)

    Stevens, S; Moors, M


    Independent medical specialists in the Netherlands are treated as entrepreneurs for tax purposes and therefore enjoy tax benefits. A change in the legal relationship between medical specialists and hospitals is foreseen in 2015. Independent medical specialists will then no longer be considered to be entrepreneurs. This could negatively affect their tax position. The Dutch government has adopted a policy aimed at controlling expenses arising from medical specialists' fees. According to this policy, the formation of regional practices or mega-practices of specialists will be discouraged. In contrast, the current fiscal legislation encourages medical specialists to incorporate their practice into regional practices or mega-practices or to become shareholders of their hospitals. It has been proposed that fiscal benefits be linked to certain aspects of entrepreneurship, such as investing in medical equipment or employing medical personnel.

  14. The specialist nurse: a classification system. (United States)

    Whyte, S


    This paper focuses on the important developments of specialty nursing practice within Australia and reports the results of a recent survey of specialist nurses in Victoria. Debate among the worldwide nursing community reflects confusion and ambiguity about specialist practice. Similarly, variation, duplication and inconsistency characterise the status of specialist nurse education in Australia. This situation contributes to role problems for specialist nurses and may arise from their lack of contribution to the decision making process. Seventy-five nurses undertaking a range of specialist nursing courses offered by three educational providers (a university, major teaching hospital and professional organisation) completed a survey questionnaire to establish the extent to which they agreed with the major recommendations proposed in the National Review of Specialist Nurse Education (Specialist Review) (Russell et al 1997). Despite contention within the profession, specialist nurses in Victoria show support for a unified approach toward definition, title and credentials. The discussion specifically addresses the implications for the future classification of specialist nurses in Australia.

  15. Scholarly Productivity of School Psychology Faculty Members in Specialist-Level Programs: 2002-2011 (United States)

    Laurent, Jeff; Runia, Elizabeth


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

  16. contribution of specialists in the sadf sjampanjeglas

    African Journals Online (AJOL)

    performing their national service, it is essential to bear in mind that the whole motivation for the employment of such personnel in their specialist directions is to increase the efficiency of the. SADF in the execution of its role in defence of the nation. Specialists must therefore receive such military training and exposure as to ...

  17. Urban revival in the polish specialist literature


    Rogatka, Krzysztof


    The aim of this article is to review and assess the Polish specialist literature on urban revival, i.e. all the actions undertaken to revitalise and restructure urban areas. The discussion of this issue was based on classification of the specialist literature on urban revival into four thematic groups: socio-demographic, spatial-functional, economic and cultural.

  18. Today's School Library Media Specialist Leader (United States)

    Dees, Dianne C.; Alexander, Kristi; Besara, Rachel; Cambisios, Robb; Kent, Teresa; Delgado, Jodie Player


    Whether it is high school, middle school, or elementary school, the library media specialist hits the ground running each day. For many, their background is the classroom, and, as media specialists, they have taken on the largest classroom in the school. Leadership is the ability to influence or inspire others to achieve shared goals. The media…

  19. Pre-diagnostic genotyping identifies T1D subjects with impaired Treg IL-2 signaling and an elevated proportion of FOXP3+IL-17+cells. (United States)

    Marwaha, A K; Panagiotopoulos, C; Biggs, C M; Staiger, S; Del Bel, K L; Hirschfeld, A F; Priatel, J J; Turvey, S E; Tan, R


    T-regulatory cells (Tregs) are essential for immune tolerance, and animal studies implicate their dysfunction in type 1 diabetes (T1D) pathogenesis. Tregs require interleukin-2 (IL-2) for their suppressive function, and variants in IL-2/IL-2R pathway genes have been associated with T1D. We previously reported that recent-onset T1D subjects have an increased population of FOXP3 lo Tregs that secrete the pro-inflammatory cytokine, interleukin-17 (IL-17). We hypothesize that IL-2 signaling defects may drive T1D development by skewing protective Tregs towards an inflammatory Th17 phenotype. Overall, we found that the proportion of FOXP3 + IL-17 + cells in T1D subjects pre-diagnosis was unchanged compared with healthy controls. However, stratification by IL2RA single-nucleotide polymorphisms revealed that T1D subjects with the rs3118470 CC risk variant have Tregs with IL-2 signaling defects and an increased proportion of FOXP3 + IL-17 + cells before diagnosis. These data suggest a potential mechanism for genetically controlled loss of Treg function via dysfunctional IL-2 signaling in T1D.

  20. Assessing blood brain barrier dynamics or identifying or measuring selected substances, including ethanol or toxins, in a subject by analyzing Raman spectrum signals (United States)

    Lambert, James L. (Inventor); Borchert, Mark S. (Inventor)


    A non-invasive method for analyzing the blood-brain barrier includes obtaining a Raman spectrum of a selected portion of the eye and monitoring the Raman spectrum to ascertain a change to the dynamics of the blood brain barrier.Also, non-invasive methods for determining the brain or blood level of an analyte of interest, such as glucose, drugs, alcohol, poisons, and the like, comprises: generating an excitation laser beam at a selected wavelength (e.g., at a wavelength of about 400 to 900 nanometers); focusing the excitation laser beam into the anterior chamber of an eye of the subject so that aqueous humor, vitreous humor, or one or more conjunctiva vessels in the eye is illuminated; detecting (preferably confocally detecting) a Raman spectrum from the illuminated portion of the eye; and then determining the blood level or brain level (intracranial or cerebral spinal fluid level) of an analyte of interest for the subject from the Raman spectrum. In certain embodiments, the detecting step may be followed by the step of subtracting a confounding fluorescence spectrum from the Raman spectrum to produce a difference spectrum; and determining the blood level and/or brain level of the analyte of interest for the subject from that difference spectrum, preferably using linear or nonlinear multivariate analysis such as partial least squares analysis. Apparatus for carrying out the foregoing methods are also disclosed.

  1. Professional training of future specialists with the use of information technologies

    Directory of Open Access Journals (Sweden)

    Виктор Семенович Корнилов


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

  2. Are Peer Specialists Happy on the Job? (United States)

    Jenkins, Sarah; Chenneville, Tiffany; Salnaitis, Christina


    This study was designed to examine the impact of role clarity and job training on job satisfaction among peer specialists. A 3-part survey assessing job training, job satisfaction, and role clarity was administered online to 195 peer specialists who are members of the International Association of Peer Specialists. Data was analyzed using descriptive statistics, correlational analyses to include multiple linear regressions and analysis of variance. Self-study and online training methods were negatively correlated with job satisfaction while job shadowing was positively correlated with job satisfaction. Role clarity was positively correlated with job satisfaction and job training satisfaction as well as job shadowing and one-on-one training. The use of self-study and online training for peer specialists is contraindicated by current findings, which suggest the need to utilize job shadowing or training methods that allow for personal interaction between peer specialists and their colleagues. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  3. Specialist gelator for ionic liquids. (United States)

    Hanabusa, Kenji; Fukui, Hiroaki; Suzuki, Masahiro; Shirai, Hirofusa


    Cyclo(l-beta-3,7-dimethyloctylasparaginyl-L-phenylalanyl) (1) and cyclo(L-beta-2-ethylhexylasparaginyl-L-phenylalanyl) (2), prepared from L-asparaginyl-L-phenylalanine methyl ester, have been found to be specialist gelators for ionic liquids. They can gel a wide variety of ionic liquids, including imizazolium, pyridinium, pyrazolidinium, piperidinium, morpholinium, and ammonium salts. The mean minimum gel concentrations (MGCs) necessary to make gels at 25 degrees C were determined for ionic liquids. The gel strength increased at a rate nearly proportional to the concentration of added gelator. The strength of the transparent gel of 1-butylpyridinium tetrafluoroborate ([C(4)py]BF(4)), prepared at a concentration of 60 g L(-1) (gelator 1/[C(4)py]BF(4)), was ca. 1500 g cm(-2). FT-IR spectroscopy indicated that a driving force for gelation was intermolecular hydrogen bonding between amides and that the phase transition from gel to liquid upon heating was brought about by the collapse of hydrogen bonding. The gels formed from ionic liquids were very thermally stable; no melting occurs up to 140 degrees C when the gels were prepared at a concentration of 70 g L(-1) (gelator/ionic liquid). The ionic conductivities of the gels were nearly the same as those of pure ionic liquids. The gelator had electrochemical stability and a wide electrochemical window. When the gels were prepared from ionic liquids containing propylene carbonate, the ionic conductivities of the resulting gels increased to levels rather higher than those of pure ionic liquids. The gelators also gelled ionic liquids containing supporting electrolytes.

  4. Geriatric oncology in the Netherlands: a survey of medical oncology specialists and oncology nursing specialists. (United States)

    Jonker, J M; Smorenburg, C H; Schiphorst, A H; van Rixtel, B; Portielje, J E A; Hamaker, M E


    To identify ways to improve cancer care for older patients, we set out to examine how older patients in the Netherlands are currently being evaluated prior to oncological treatment and to explore the potential obstacles in the incorporation of a geriatric evaluation, using a web-based survey sent to Dutch medical oncology specialists and oncology nursing specialists. The response rate was 34% (183 out of 544). Two-thirds of respondents reported that a geriatric evaluation was being used, although primarily on an ad hoc basis only. Most respondents expressed a desire for a routine evaluation or more intensive collaboration with the geriatrician and 86% of respondents who were not using a geriatric evaluation expressed their interest to do so. The most important obstacles were a lack of time or personnel and insufficient availability of a geriatrician to perform the assessment. Thus, over 30% of oncology professionals in the Netherlands express an interest in geriatric oncology. Important obstacles to a routine implementation of a geriatric evaluation are a lack of time, or insufficient availability of geriatricians; this could be overcome with policies that acknowledge that quality cancer care for older patients requires the investment of time and personnel. © 2014 John Wiley & Sons Ltd.

  5. Attitudes Toward Alzheimer's Care-Seeking Among Korean Americans: Effects of Knowledge, Stigma, and Subjective Norm. (United States)

    Casado, Banghwa Lee; Hong, Michin; Lee, Sang E


    Early detection of Alzheimer's disease (AD) ensures that affected individuals and their caregivers can make appropriate plans for health care needs, yet many ethnic minorities delay seeking care for AD until the disease has progressed. This study examined attitudes toward care-seeking for AD among Korean Americans (KAs) and identified factors affecting their attitudes. A cross-sectional survey was used to collect data from 234 KA adults. We conducted hierarchical regression analyses to examine the effects of sociocultural background (age, gender, education, cultural orientation), AD knowledge and exposure to AD, and beliefs about AD (stigma of pity, shame, and public avoidance) and AD care (subjective norm) on KAs' attitudes toward seeking AD care from primary care physicians (PCPs) and AD specialists. We also tested whether knowledge of AD moderated the impact of beliefs about AD and AD care on KAs' attitudes toward seeking AD care. For both PCPs and AD specialists, the subjective norm had the strongest effect on KAs' attitudes toward care seeking (β = 0.557 for PCPs, β = 0.360 for specialists). Effects of stigma beliefs disappeared in the presence of the subjective norm. AD knowledge moderated the impact of the subjective norm on the attitudes toward both PCPs (β = -1.653) and specialists (β = -1.742). The significance of the subjective norm in KAs' attitudes toward AD care-seeking underscores the importance of public education, and our study suggests that increasing AD knowledge could facilitate a change in public attitudes toward seeking AD care.

  6. Surveying air traffic control specialist perception of scheduling regulations (United States)

    Thompson, Darrius E.

    While there have been several studies conducted on air traffic controller fatigue, there is a lack of research on the subject since the scheduling policy changes that took place in 2012. The effectiveness of these changes has yet to be measured. The goal of this study was to investigate air traffic control specialist views towards the number of hours scheduled between shifts, changes in perception since 2012 regulation changes, and external factors that impact fatigue. A total of 54 FAA air traffic control specialist completed an online questionnaire. The results from the survey showed that the majority of respondents felt the 2012 regulation changes were not sufficient to address fatigue issues, and work with some amount sleep deprivation. The factors that appeared to have the most significant effect on fatigue included facility level, age group, availability of recuperative breaks, and children under 18 in the home.

  7. [Collaboration between occupational physicians and other specialists including insurance physicians]. (United States)

    Rijkenberg, A M; van Sprundel, M; Stassijns, G


    Collaboration between various stakeholders is essential for a well-operating vocational rehabilitation process. Researchers have mentioned, among other players, insurance physicians, the curative sector and employers. In 2011 the WHO organised the congress "Connecting Health and Labour: What role for occupational health in primary care". The congress was also attended by representatives of the WONCA (World Organisations of Family Medicine). In general, everyone agreed that occupational health aspects should continue to be seen as an integral part of primary health care. However, it is not easy to find literature on this subject. For this reason we conducted a review. We searched for literature relating to collaboration with occupational physicians in Dutch, English and German between 2001 and autumn 2011. Our attention focused on cooperation with specialists and insurance physicians. Therefore, we searched PUBMED using MeSH terms and made use of the database from the "Tijdschrift voor bedrijfs- en verzekeringsgeneeskunde (TBV) [Dutch Journal for Occupational - and Insurance Medicine]". We also checked the database from the "Deutsches Arzteblatt [German Medical Journal]" and made use of the online catalogue from THIEME - eJOURNALS. Last but not least, I used the online catalogue from the German paper "Arbeits -, Sozial -, Umweltmedizin [Occupational -, Social -, Milieu Medicine]". Additionally, we made use of the "snowball - method" to find relevant literature. We found many references to this subject. The Netherlands in particular has done a lot of research in this field. However, there is little research on the cooperation between occupational physicians and specialists; in particular insurance physicians. This is interesting, because several authors have mentioned its importance. However, cooperation with other specialists seems not to be the norm. Therefore, cooperation between curative physicians (specialists but also family doctors), insurance physicians and

  8. Contemporary challenges for specialist nursing in interstitial lung disease

    Directory of Open Access Journals (Sweden)

    Anne Marie Russell


    To explain the similarities and differences between clinical nurse specialists (CNSs and advanced nurse practitioners (ANPs in the context of ILD specialism To review contemporary nursing specialism in the UK’s government subsidised healthcare system To stimulate discussion and debate across the European/international respiratory community regarding the clinical and academic development of the ILD CNS To identify key priorities that will support collaboration across the ILD interdisciplinary workforce in clinical practice and research

  9. Senior Program Specialist | IDRC - International Development ...

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

    Job Summary Working as a member of one or two multi-disciplinary teams under the guidance of the Program Leader (PL), Program Manager (PM) if applicable, and Director Program Area (DPA), the Senior Program Specialist:

  10. Agricultural Chemical Sourcebook for Wildlife Contaminants Specialists (United States)

    US Fish and Wildlife Service, Department of the Interior — The purpose of this handbook is to provide information to contaminant specialists involved in evaluating agricultural chemical impacts on wetlands. The handbook...

  11. Probation Officers and Correctional Treatment Specialists. (United States)

    Alpert, Andrew D.


    Discusses the changes in the work of probation officers and correctional treatment specialists. Includes information about job outlook, earnings, training requirements, and working conditions as well as sources of additional information. (JOW)

  12. Validation of a rapid type 1 diabetes autoantibody screening assay for community-based screening of organ donors to identify subjects at increased risk for the disease. (United States)

    Wasserfall, C; Montgomery, E; Yu, L; Michels, A; Gianani, R; Pugliese, A; Nierras, C; Kaddis, J S; Schatz, D A; Bonifacio, E; Atkinson, M A


    The Network for Pancreatic Organ donors with Diabetes (nPOD) programme was developed in response to an unmet research need for human pancreatic tissue obtained from individuals with type 1 diabetes mellitus and people at increased risk [i.e. autoantibody (AAb)-positive] for the disease. This necessitated the establishment of a type 1 diabetes-specific AAb screening platform for organ procurement organizations (OPOs). Assay protocols for commercially available enzyme-linked immunosorbent assays (elisas) determining AAb against glutamic acid decarboxylase (GADA), insulinoma-associated protein-2 (IA-2A) and zinc transporter-8 (ZnT8A) were modified to identify AAb-positive donors within strict time requirements associated with organ donation programmes. These rapid elisas were evaluated by the international islet AAb standardization programme (IASP) and used by OPO laboratories as an adjunct to routine serological tests evaluating donors for organ transplantation. The rapid elisas performed well in three IASPs (2011, 2013, 2015) with 98-100% specificity for all three assays, including sensitivities of 64-82% (GADA), 60-64% (IA-2A) and 62-68% (ZnT8A). Since 2009, nPOD has screened 4442 organ donors by rapid elisa; 250 (5·6%) were identified as positive for one AAb and 14 (0.3%) for multiple AAb with 20 of these cases received by nPOD for follow-up studies (14 GADA+, two IA-2A(+) , four multiple AAb-positive). Rapid screening for type 1 diabetes-associated AAb in organ donors is feasible, allowing for identification of non-diabetic, high-risk individuals and procurement of valuable tissues for natural history studies of this disease. © 2016 British Society for Immunology.

  13. The clinical nurse specialist as brief psychotherapist. (United States)

    Shires, B; Tappan, T


    As managed care continues to flourish, the psychiatric clinical nurse specialist may function as a case manager for a managed care company or as a utilization review nurse for a hospital, community provider, or administrator. Stressing the strengths of the psychiatric clinical nurse specialist as brief therapist, the author reviews elements of the brief treatment model, including assessment, focus of treatment, knowledge of community resources, patient education, group skills, crisis intervention, and treatment planning.

  14. Integrated system for training of aviation specialists

    Directory of Open Access Journals (Sweden)

    J. Stankunas


    Full Text Available Co-operation between university and industrial potential is one of the most effective ways of organizing expensive studies in a small country. Co-operation between civil universities and military schools and structures is expedient in preparing reserve military specialist. An integrated system for the preparation of the specialists of civil and military aviation is precondition for the development of integrated management system of aviation and air space

  15. Development status and prospect of rehabilitation clinical nurse specialist

    Directory of Open Access Journals (Sweden)

    Xiao-ping WANG


    Full Text Available Through access to a lot of relevant information on the role of the rehabilitation nurse specialist functions, explore how rehabilitation specialist nurse qualifications provides a basis for our rehabilitation specialist nurse cultivating and development.

  16. From the State Specialist's Desk. (United States)

    Caffyn, Lois


    Advantages and disadvantages to writing behavioral objectives, especially for teachers of language arts, are discussed. The three commonly accepted domains of learnings--cognitive, affective, and psychomotor--are presented in relation to verbs used to indicate learning in those domains. Steps in identifying evidences of learning are: (1) State…

  17. The use of Spielberger’s State-Trait Personality Inventory (trait anxiety subscale) with naval subaquatic specialists


    Van Wijk, Charles H


    Objectives: Panic behavior poses a particular threat to the health and safety of subaquatic occupational specialists. Trait anxiety has previously been identified as a marker of panic behavior under water, and Spielberger’s State-Trait Personality Inventory (trait anxiety subscale) has been previously used to measure trait anxiety among subaquatic specialists. Using archived data, the trait anxiety scores of subaquatic specialists were analyzed to meet 3 objectives: 1stly – to develop a trait...

  18. Think Stoma Nurse: a tool to trigger referral to specialist care. (United States)

    Hanley, Judy; Adams, Jane

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

  19. Stars For Citizens With Urban Star Parks and Lighting Specialists (United States)

    Grigore, Valentin


    General contextOne hundred years ago, almost nobody imagine a life without stars every night even in the urban areas. Now, to see a starry sky is a special event for urban citizens.It is possible to see the stars even inside cities? Yes, but for that we need star parks and lighting specialists as partners.Educational aspectThe citizens must be able to identify the planets, constellations and other celestial objects in their urban residence. This is part of a basic education. The number of the people living in the urban area who never see the main constellations or important stars increase every year. We must do something for our urban community.What is an urban star park?An urban public park where we can see the main constellations can be considered an urban star park. There can be organized a lot of activities as practical lessons of astronomy, star parties, etc.Classification of the urban star parksA proposal for classification of the urban star parks taking in consideration the quality of the sky and the number of the city inhabitants:Two categories:- city star parks for cities with parks for cities with > 100.000 inhabitantsFive levels of quality:- 1* level = can see stars of at least 1 magnitude with the naked eyes- 2* level = at least 2 mag- 3* level = at least 3 mag- 4* level= at least 4 mag- 5* level = at least 5 magThe urban star urban park structure and lighting systemA possible structure of a urban star park and sky-friend lighting including non-electric illumination are descripted.The International Commission on IlluminationA description of this structure which has as members national commissions from all over the world.Dark-sky activists - lighting specialistsNational Commissions on Illumination organize courses of lighting specialist. Dark-sky activists can become lighting specialists. The author shows his experience in this aspect as a recent lighting specialist and his cooperation with the Romanian National Commission on Illumination working for a

  20. Differences in quality standards when prescribing nutritional support: Differences between specialist and non-specialist physicians. (United States)

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


    Adequate nutritional support includes many different aspects, but poor understanding of clinical nutrition by health care professionales often results in an inadequate prescription. A study was conducted to compare enteral and parenteral nutritional support plans prescribed by specialist and non-specialist physicians. Non-specialist physicians recorded anthropometric data from only 13.3% of patients, and none of them performed nutritional assessments. Protein amounts provided by non-specialist physicians were lower than estimated based on ESPEN (10.29g of nitrogen vs 14.62; P<.001). Differences were not statistically significant in the specialist group (14.88g of nitrogen; P=.072). Calorie and glutamine provision and laboratory controls prescribed by specialists were significantly closer to those recommended by clinical guidelines. Nutritional support prescribed by specialists in endocrinology and nutrition at San Pedro de Alcántara Hospital was closer to clinical practice guideline standards and of higher quality as compared to that prescribed by non-specialists. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.


    Directory of Open Access Journals (Sweden)

    I. I. Leonovich


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

  2. Caring for cancer patients on non-specialist wards.

    LENUS (Irish Health Repository)

    Gill, Finola


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

  3. Clinical nurse specialist education: actualizing the systems leadership competency. (United States)

    Thompson, Cathy J; Nelson-Marten, Paula


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

  4. Subjective Illness theory and coping

    Directory of Open Access Journals (Sweden)

    Gessmann H.-W.


    Full Text Available The article presents a view of a problem of subjective illness theory in context of coping behavior. The article compiles the results of the latest studies of coping; discloses the way subjective illness theory affects the illness coping and patient's health; presents the study of differences in coping behaviour of patients at risk of heart attack and oncology. The article is recommended for specialists, concerned with psychological reasons of pathogenic processes and coping strategies of patients.

  5. Avionics Instrument Systems Specialist (AFSC 32551). (United States)

    Miller, Lawrence B.; Crowcroft, Robert A.

    This six-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for avionics instrument systems specialists. Covered in the individual volumes are career field familiarization (career field progression and training, security, occupational safety and health, and career field reference material);…

  6. Specialist Teams Needed to Support Youth. (United States)

    Mellin, Laurel M.


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

  7. Librarians/Media Specialists: Unsung Superheroes (United States)

    Burgess, Jan


    School librarians can be an important resource for school administrators, provided that the right relationship is in place between them. In this article, the author reports on the critical points emphasized with librarians/media specialists in a recent panel presentation on their changing roles: (1) the importance of building ongoing relationships…

  8. Ethics and the Library Media Specialist (United States)

    Baxter, Veanna


    It is common belief that most people can distinguish between right and wrong actions and usually make decisions to do the right thing. As educators, library media specialists are called upon to make decisions every day. Those decisions chart the course for that particular day and the future, for themselves and for those they work with. In this…

  9. Apprentice Food Service Specialist (AFSC 62230). (United States)

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

    This two-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for apprentice food service specialists. Covered in the first volume are fundamentals of food preparation and service (careers in food service, food service sanitation, principles of food preparation and service, and baking…

  10. Readying the Health Education Specialist for Emergencies (United States)

    Geiger, Brian F.; Firsing, Stephen L., III; Beric, Bojana; Rodgers, Joel B.


    This article provides a resourceful guide for the health education specialist to improve emergency management knowledge and skills specific to their setting, including training and preparing for emergencies and providing adequate support to students, clients, and colleagues. Five steps guide competent health education practice before, during, and…

  11. Professional Training of Marketing Specialists: Foreign Experience (United States)

    Zakharchenko, Yuliia


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

  12. STS-88 Mission Specialist Krikalev checks equipment (United States)


    STS-88 Mission Specialist Sergei Konstantinovich Krikalev, a Russian cosmonaut, looks over equipment inside a module at the Space Station Processing Facility. Betsy Ahearn, with Boeing, is at his right. Mission STS-88 is targeted for launch on Dec. 3, 1998. It is the first U.S. flight for the assembly of the International Space Station and will carry the Unity connecting module.

  13. Dual Role of the Urban Reading Specialist (United States)

    Lapp, Diane; Fisher, Douglas; Flood, James; Frey, Nancy


    Reading specialists in several San Diego schools assist both in providing tutoring to students and coach peers, a dual role that has helped to create and sustain schoolwide improvements in literacy. In just a few years, these high-poverty schools have doubled the number of 2nd graders reading at grade level.

  14. Host specialist clownfishes are environmental niche generalists (United States)

    Litsios, Glenn; Kostikova, Anna; Salamin, Nicolas


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


    African Journals Online (AJOL)


    Sep 15, 2009 ... In this study, the development of a model is regarded as being consistent with middle-range theory generation (George 2002:6), which, in turn, guides the education practice of specialist nurses. According to Smith and Liehr,. [m]iddle range theory can be defined as a set of related ideas that are focused on ...

  16. No evidence for larger leaf trait plasticity in ecological generalists compared to specialists

    Czech Academy of Sciences Publication Activity Database

    Dostál, Petr; Fischer, M.; Chytrý, M.; Prati, D.


    Roč. 44, č. 3 (2017), s. 511-521 ISSN 0305-0270 R&D Projects: GA ČR GA15-09119S; GA ČR GB14-36079G Institutional support: RVO:67985939 Keywords : ecological generalists and specialists * phenotypic plasticity * multispecies experiments Subject RIV: EH - Ecology, Behaviour Impact factor: 4.248, year: 2016

  17. Teacher-School Library Media Specialist Collaboration through Social Marketing Strategies: An Information Behavior Study (United States)

    Immroth, Barbara; Lukenbill, W. Bernard


    This research was supported in part though an IMLS Kent State University Grant supporting Information Literacy. Based on the importance of teacher-school library media specialist collaboration, this study seeks to advance knowledge involving the dynamics of this special relationship. The subjects were a group of student librarians--themselves…

  18. Apprentice Still Photographer Specialist, 16-2. Military Curriculum Materials for Vocational and Technical Education. (United States)

    Ohio State Univ., Columbus. National Center for Research in Vocational Education.

    This military-developed text contains four volumes of materials for use in training apprentice still photography specialists. Covered in the individual volumes are the following topics: general subjects (safety and environmental protection); still photographic fundamentals (sensitized black and white film materials, photographic exposure, still…

  19. Specialist pre-operative assessment clinics. (United States)

    Dhesi, J K; Swart, M


    While specialist pre-operative assessment is not new, its focus has evolved in response to more operations and changes in the surgical population. Patients are older and have more long-term medical comorbidities. At the same time, there has been a move from paternalistic medical decision-making to shared decision-making, based on an individual patient's choice or preference. Specialist pre-operative consultations have had to adapt to these changes by broadening their scope. Pre-operative clinics have a central role in shared decision-making, coordinating and planning care before, during and after surgery, including rehabilitation and discharge planning. Multiple specialties need to work together to deliver quality patient-centred care. © 2015 The Association of Anaesthetists of Great Britain and Ireland.

  20. Information specialist for a coming age (5) (United States)

    Sakajoh, Mitsunobu

    Deluge of conflicting and overwhelming information and media are creating a state of information anxiety. In such a society, an organization is also seeking a variety of information in wide corporate activities. The searcher, looking for information, must determine for him/herself not only which databases to search, but also which database system will deliver a fullest, good and trustworthy information of his needs. Commercial databases here in Japan have been accepted and searched by increased number of searchers as well as end-users. In the 90's, our online specialist's challenge is no longer to find information; we have to aim at professional information specialists to respond with increased educational and consultant role to assist further increasing number of end-users.

  1. Burnout Syndrome of Leisure Time Activities Specialist.


    REBROVÁ, Iveta


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

  2. Specialists' expectations regarding joint treatment guidelines for primary and secondary care

    NARCIS (Netherlands)

    Kasje, WN; Denig, P; Haaijer-Ruskamp, FM


    Objective. To identify factors that may hinder or facilitate specialists' use of joint treatment guidelines for primary and secondary care. Design. Qualitative study using focus group discussions based on a topic guide with open-ended questions. Main outcome measures. Themes identified by two

  3. Activities of Intellectual Disability Clinical Nurse Specialists in Ireland. (United States)

    Doody, Owen; Slevin, Eamonn; Taggart, Laurence

    The aim of this study was to identify the contribution of Irish intellectual disability clinical nurse specialists (ID CNSs) to service delivery. A nonexperimental descriptive design was selected to survey ID CNSs presently working in Ireland. The questionnaire was developed based on focus group interviews, available literature, and expert panel views. Ethical approval and access were granted to all ID CNSs in Ireland. Thirty-two responded (33.68% response rate) from all work areas (voluntary organizations or health service executive) practicing within residential, community, or school services. Respondents were surveyed across a range of areas (demographic details and support to client, staff, family, organization, community, other agencies, and professional development). Findings identify that ID CNSs are active in all aspects of their roles as clinical specialist, educator, communicator, researcher, change agent, and leader, thus supporting person-centered care and improving service delivery. To meet changing healthcare demands, promote person-centered care, and improve service delivery, the CNS role in ID should be developed and supported. The findings merit a further study on ID CNS role activity, possible variables influencing role activity, and team members' views.

  4. Relationship between Personality Types Conceptualized by C. G. Jung and Latvian IT Specialist Preferences

    Directory of Open Access Journals (Sweden)

    Maris Dargis


    Full Text Available General people’s personality types, as well as idiosyncrasies and cognition and perception characteristics specific to each type, are a common research item, especially in such areas as pedagogics, human resource management, etc. Personality traits characteristic for individuals and teams of certain specific avocations (i.e., project teams, however, are a much less explored subject. In this area, the amount of conducted research is congruent with the geopolitical location and directly correlates with the possibility of finding practical applications for the findings of said research. This study presents the initial findings of such research, within the scope of which the idiosyncrasies common for IT specialists were explored using the Myers-Briggs Type Indicator (MBTI model. These initial findings can be used as the foundation for further study on the subject, helping to create a general Latvian IT specialist’s personality profile, and, possibly, identifying the areas that need development, while taking into consideration the tendencies and requirements of the Latvian IT market, as well as those of  the labour market worldwide.

  5. Nurse prescribing as an aspect of future role expansion: the views of Irish clinical nurse specialists.

    LENUS (Irish Health Repository)

    Lockwood, Emily B


    AIM: Nurses and midwives are expanding the scope of their professional practice, assuming additional responsibilities including the management and prescribing of medications. The aim of the study was to discover the attitudes of clinical nurse specialists (CNSs) in Ireland to nurse prescribing and to examine perceived barriers to engaging in this aspect of future role expansion. BACKGROUND: The expansion of the nursing role in relation to nurse prescribing is an ongoing process and is subject to incremental iterations of legislation and professional policy. Nurse prescribing as an expanded role function has become a reality in many countries. Ireland has addressed the matter in a formal and systematic way through legislation. METHOD: A questionnaire was administered to a sample of 283 CNSs practising in a variety of care settings in Ireland. Attitudes were measured using Likert-type attitudinal scales, designed specifically for the study. RESULTS AND CONCLUSIONS: Findings indicate that the majority of clinical nurse specialists were positively disposed toward nurse prescribing as a future role expansion. The fear of litigation was identified as the most significant barrier to nurse prescribing. The majority of respondents equated nurse prescribing with increased autonomy and holistic care. The findings indicate that there is a need for further examination of the educational requirements of the CNS in relation to nurse prescribing. The legislative implications for nurse prescribing and fear of legal consequences need to be considered prior to any implementation of nurse prescribing. IMPLICATIONS FOR NURSING MANAGEMENT: While senior clinicians are willing to embrace future role expansion in the area of nurse prescribing, their Nurse Managers should recognize that facilitation of nurse prescribing needs to address the legal and educational requirements for such activity. Failure to address these requirements can represent a barrier to role expansion. This paper offers

  6. From Hospital to Ambulatory Care: Realigning the Practice of Clinical Nurse Specialists. (United States)

    Negley, Kristin D; Cordes, Mary E; Evenson, Laura K; Schad, Shauna P


    This article describes how a large healthcare organization expanded the practice of clinical nurse specialists from the hospital to the ambulatory setting. Clinical nurse specialist practice traditionally focused on actualizing the 3 spheres of influence (patient, nurse, and organization) in the hospital setting. Changes in the healthcare system shifting patient care to the ambulatory setting created opportunities for clinical nurse specialists to improve patient outcomes in this setting. An innovation framework from the Mayo Clinic Center for Innovation based on inspiration, generation of ideas, experimenting, and diffusion was used to assess and prioritize the work of clinical nurse specialists in the ambulatory setting. Clinical nurse specialists became integral members of hospital and ambulatory nursing leadership. In the ambulatory setting, they are partnering to standardize patient care, providing tools for nurses to practice to full scope, and identifying and providing solutions for patient safety issues. Aligning clinical nurse specialists in the hospital and ambulatory care settings allows partnership with multidisciplinary teams to ensure that evidence-based practices and standardized care are infused across the continuum of care. Evidence-based practices and standardized care encourage nurses to practice to full scope and focus on improved patient outcomes.

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

    Directory of Open Access Journals (Sweden)

    Jörg Müller

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

  8. Sports Medicine: What is a Sports Medicine Specialist? (United States)

    What is a Sports Medicine Specialist? A physician with significant specialized training in both the treatment and prevention of illness and injury. The Sports Medicine Specialist helps patients maximize function and minimize ...

  9. Contemporary engagement with social media amongst hernia surgery specialists. (United States)

    Lui, D H; McDonald, J J; de Beaux, A; Tulloh, B; Brady, R R W


    Healthcare professional engagement is increasing. This study aims to identify levels of adoption and engagement of several social media platforms by a large international cohort of hernia surgery specialists. Hernia specialists attending the 38th International Congress of the European Hernia Society were identified. A manual search was then performed on Twitter, ResearchGate, and LinkedIn to identify those who had named accounts. Where accounts were identified, data on markers of utilisation were assessed. 759 surgeons (88.5% male) from 57 countries were identified. 334 surgeons (44%) engaged with a social media platform. 39 (5.1%) had Twitter accounts, 189 (24.9%) had ResearchGate accounts and 265 (34.9%) had LinkedIn accounts. 137 surgeons (18.1%) had accounts on 2 or more social media platforms. There was no gender association with social media account ownership (p > 0.05). Engagement in one social media platform was associated with increased engagement and utilisation on other platforms; LinkedIn users were more likely to have Twitter accounts (p ResearchGate profiles (p < 0.001). Surgeons on all three SM platforms were more likely to have high markers of engagement across all SM platforms (multiple outcomes, p < 0.05). Geographical variation was noted with UK and South American Surgeons being more likely to be present on Twitter than their counterparts (p = 0.031). The level of engagement with social media amongst Hernia surgeons is similar to other surgical specialities. Geographical variation in SM engagement is seen. Engagement with one SM platform is associated with presence on multiple platforms.

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

    Directory of Open Access Journals (Sweden)

    Randive Bharat


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

  11. [Learning how to learn for specialist further education]. (United States)

    Breuer, G; Lütcke, B; St Pierre, M; Hüttl, S


    The world of medicine is becoming from year to year more complex. This necessitates efficient learning processes, which incorporate the principles of adult education but with unchanged periods of further education. The subject matter must be processed, organized, visualized, networked and comprehended. The learning process should be voluntary and self-driven with the aim of learning the profession and becoming an expert in a specialist field. Learning is an individual process. Despite this, the constantly cited learning styles are nowadays more controversial. An important factor is a healthy mixture of blended learning methods, which also use new technical possibilities. These include a multitude of e‑learning options and simulations, which partly enable situative learning in a "shielded" environment. An exemplary role model of the teacher and feedback for the person in training also remain core and sustainable aspects in medical further education.

  12. School Library Media Specialist-Teacher Collaboration: Characteristics, Challenges, Opportunities (United States)

    Cooper, O. P.; Bray, Marty


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

  13. Elder Specialists: Psychosocial Aspects of Medical Education in Geriatric Care (United States)

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


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

  14. Problems of forming professional competencies of future marketing specialists


    Putintsev, A.; Prischepa, N.


    The article investigates aspects of professional competence that determines conditions for forming pedagogic basis for developing professionally important qualities of economic specialists in the modern economic space; theoretical analysis of different views of the problem of forming professionalism of future marketing specialists is performed; ways of forming professionalism of future marketing specialists are defined.

  15. Subject Orientation of Teaching and Academic Subjects in the Context of Different Didactic Approaches

    Directory of Open Access Journals (Sweden)

    I. M. Osmolovskaya


    Full Text Available The paper is devoted to the research findings concerning the didactic characteristics and means of subject-oriented teaching. The research question includes the content of the general secondary education regarded as the design object. The process of selecting and structuring materials is reviewed from the theoretical standpoint, and the attempt is made to identify the ways of selecting materials for students’ learning from the social experience reflected in culture. The author introduces the concept of subject-orientation as a tool providing pedagogic adaptation of social experience in the process of teaching content development. Subject-oriented teaching is defined in the context of traditional knowledge, as well as the competence and student-oriented didac- tic approaches; the forms and means of its realization being indicated providing the new ways for introducing and understanding the educational subject. The research results can be used by the specialists in didactic, curricula developers, authors of textbooks in various subjects

  16. Periodontal maintenance in a specialist periodontal clinic and in general dental practice. (United States)

    Preshaw, Philip M; Heasman, Peter A


    To monitor the efficacy of periodontal maintenance whether conducted in a specialist periodontology clinic or in the practice of the referring general dentist. Thirty-five subjects with a diagnosis of moderate-severe chronic periodontitis who were referred to the specialist clinic received periodontal non-surgical therapy. Following a 6-month healing phase, subjects were randomly allocated to one of two groups: A (n=18, periodontal maintenance provided within the specialist clinic) or B (n=17, periodontal maintenance provided by the referring general dentist in accordance with written instructions provided by the specialist). All subjects were examined at months 0 (corresponding to 6 months post-completion of non-surgical therapy), 6 and 12. Full-mouth plaque index (PI), % bleeding on probing (%BOP) and probing depth (PD) measurements were recorded. PDs were also recorded at eight test sites which, prior to non-surgical therapy, exhibited PD 5-8 mm, BOP and radiographic alveolar bone loss. Standardized radiographs were exposed at test sites at months 0 and 12, and bone changes assessed using digital subtraction radiography (DSR). As a result of the non-surgical therapy, statistically significant improvements in all clinical parameters were recorded. In the maintenance period, mean PI increased significantly from months 0 to 12 (p0.05). No other clinical parameters changed significantly in the maintenance phase of the study. Reductions in %BOP, mouth mean PD and mean test sites PD achieved by the non-surgical therapy were maintained and did not differ significantly whether subjects were allocated to group A or group B (p>0.05). Current smokers had significantly deeper PD than non-smokers and former smokers at all time points (pperiodontal maintenance can be provided in general dental practice with the same expected outcomes compared with maintenance that is provided in a specialist clinic, providing that general dentists are given specific instructions regarding the

  17. Perceptions of Nigerian medical specialists on research

    Directory of Open Access Journals (Sweden)

    Abdulraheem Olarongbe Mahmoud


    Full Text Available The current research aimed at collating the views of medical specialists on disease priorities, class and outcomes of health research in Nigeria, and draw appropriate policy implications. Structured questionnaires were distributed to consent 90 randomly selected medical specialists practising in six Nigerian tertiary health institutions. Participants' background information, relative disease priority, research types and class, type and class of publication media, frequency of publications, challenges faced in publishing research, impact of their research on health practice or policy, and inventions made were probed. Fifty-one out of the 90 questionnaires distributed were returned giving a response rate of 63.3%. Sixty-four point six percent indicated that the highest priority should be given to non communicable diseases while still recognizing that considerations should be giving to the others. They were largely “always” involved in simple low budget retrospective studies or cross-sectional and medical education studies (67.8% and over a third (37.5% had never been involved in clinical trials. They largely preferred to “always” publish in PubMed indexed journals that are foreign-based (65.0%. They also indicated that their research works very rarely resulted in inventions (4% and change (4% in clinical practice or health policy. Our study respondents indicated that they were largely involved in simple low budget research works that rarely had significant impacts and outcomes. We recommend that adequate resources and research infrastructures particularly funding be made available to medical specialists in Nigeria. Both undergraduate and postgraduate medical education in Nigeria should emphasize research training in their curricula.

  18. Academic Information Security Researchers: Hackers or Specialists? (United States)

    Dadkhah, Mehdi; Lagzian, Mohammad; Borchardt, Glenn


    In this opinion piece, we present a synopsis of our findings from the last 2 years concerning cyber-attacks on web-based academia. We also present some of problems that we have faced and try to resolve any misunderstandings about our work. We are academic information security specialists, not hackers. Finally, we present a brief overview of our methods for detecting cyber fraud in an attempt to present general guidelines for researchers who would like to continue our work. We believe that our work is necessary for protecting the integrity of scholarly publishing against emerging cybercrime.

  19. Specialist nectar-yeasts decline with urbanization in Berlin (United States)

    Wehner, Jeannine; Mittelbach, Moritz; Rillig, Matthias C.; Verbruggen, Erik


    Nectar yeasts are common inhabitants of insect-pollinated flowers but factors determining their distribution are not well understood. We studied the influence of host identity, environmental factors related to pollution/urbanization, and the distance to a target beehive on local distribution of nectar yeasts within Robinia pseudoacacia L. and Tilia tomentosa Moench in Berlin, Germany. Nectar samples of six individuals per species were collected at seven sites in a 2 km radius from each target beehive and plated on YM-Agar to visualise the different morphotypes, which were then identified by sequencing a section of the 26S rDNA gene. Multivariate linear models were used to analyze the effects of all investigated factors on yeast occurrence per tree. Yeast distribution was mainly driven by host identity. The influence of the environmental factors (NO2, height of construction, soil sealing) strongly depended on the radius around the tree, similar to the distance of the sampled beehive. Incidence of specialist nectar-borne yeast species decreased with increasing pollution/urbanization index. Given that specialist yeast species gave way to generalist yeasts that have a reduced dependency on pollinators for between-flower dispersal, our results indicate that increased urbanization may restrict the movement of nectar-specialized yeasts, via limitations of pollinator foraging behavior.

  20. Smoking among French infertility specialists: habits, opinions and patients' management. (United States)

    Freour, Thomas; Dessolle, Lionel; Jean, Miguel; Barriere, Paul


    The deleterious effects of tobacco on fertility are now largely demonstrated. Little is known, however, about how infertility doctors communicate on smoking and about their own smoking habits. In this study, we examined smoking habits among French infertility specialists and their attitudes towards infertile couples' exposure to tobacco. A postal survey was sent in 2009 to the 803 French certified physicians (gynaecologists, urologists, endocrinologists and embryologists) specializing in infertility. Demographical data, smoking habits and attitude towards patients' smoking were recorded. Statistical analysis and multiple correspondence analysis were performed in order to identify differences among physicians according to age, gender, occupation or smoking status. Response rate was 42.3%. Half of the respondents were male, 41% were under 45 years, 37% were embryologists and 53.3% were gynaecologists. Thirteen percent reported current smoking. More than 80% always asked their patients about smoking status and cannabis consumption. Most physicians specifically informed infertile couples on tobacco, advised them to quit and proposed smoking cessation therapies. Only 24% refused care unless smoking cessation occurred. Statistical analysis showed some differences among subgroups according to gender, occupation or age. Surprisingly, results were comparable according to smoking status. Most infertility specialists are aware of the deleterious effects of tobacco on fertility and ask their patients to quit. The heterogeneity in infertile patients' management, however, underlines the need for better professional and patients' information on smoking. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  1. Common care practices among effective community-based specialist palliative care teams: a qualitative study. (United States)

    Seow, Hsien; Bainbridge, Daryl; Brouwers, Melissa; Bryant, Deanna; Tan Toyofuku, Sue; Kelley, Mary Lou


    Evidence has shown that, despite wide variation in models of care, community-based specialist palliative care teams can improve outcomes and reduce acute care use at end of life. The goal of this study was to explore similarities in care practices among effective and diverse specialist teams to inform the development of other community-based teams. Interviews with 78 providers and administrators from 11 distinct community-based specialist palliative care teams from Ontario, Canada were conducted. Interviews were audio-recorded, transcribed and analysed using an inductive approach to identify common themes. 3 key themes across all teams emerged. First, the distinct models of care were generally summarised into 3 models: primary care and specialist providers either collaborated by transferring, sharing or consulting in care. Second, teams explicitly or implicitly followed 7 common care practices related to: specialised expertise 24/7; intrateam communication; timeliness; physical symptom and psychosocial-spiritual management; education; peace and fulfilment; and advocacy for patient preferences. Third, all teams emphasised the importance of team building, even more than using clinical tools and processes. Despite wide variation in models of care among community-based specialist palliative care teams, this large qualitative study identified several common themes in care practices that can guide the development of other teams. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  2. Postgraduate medical education and specialist training in Singapore. (United States)

    Chew, C H; Chee, Y C


    The Singapore Medical School celebrates its Centenary in 2005. This historical review is presented on Singapore's postgraduate medical education and specialist training programmes. The special informal role of the Alumni Association and its members during the early years and soon after World War II is highlighted. Postgraduate education and specialist training was more formalised only during the challenging years when Singapore became more autonomous and politically independent with the establishment of the Academy of Medicine, the School's postgraduate medical studies, the Singapore Medical Association, specialist societies and, more recently, the College of Family Physicians. Specialist training programmes and the process of specialist accreditation are also outlined. While Singapore has gone far towards developing a comprehensive programme of postgraduate medical education and specialist training, the process is still evolving and can be improved upon. As long as we keep pace with relevant and realistic strategies, the future for postgraduate medical training and specialist training should be assured.

  3. E-learning for medical imaging specialists: introducing blended learning in a nuclear medicine specialist course. (United States)

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


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

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

    NARCIS (Netherlands)

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


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

  5. Auditing GPs' prescribing habits : Cardiovascular prescribing frequently continues medication initiated by specialists

    NARCIS (Netherlands)

    de Vries, C.S; van Diepen, N.M; de Jong-van den Berg, L T W

    Objective: To determine to what extent general practitioners' (GPs) prescribing behaviour is a result of repeat prescribing of medication which has been initiated by specialists. Method: During a 4-week period, pharmacists identified GPs' prescriptions for a large group of cardiovascular drugs.

  6. A Needs Assessment of Aquaculture Extension Agents, Specialists, and Program Administrators in Extension Programming (United States)

    Schwarz, Michael H.; Gibson, Jerry


    The study reported here identified continuing education and training needs of aquaculture Extension agents, specialists, and program administrators in 10 competency areas relating to the need for continuing education or training. Fourteen resources on the AquaNIC Web site were also evaluated, as was the efficacy of the AQUA-EXT listserv. Data were…

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

    NARCIS (Netherlands)

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


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

  8. Identifying Low-risk Patients for Early Discharge From Emergency Department Without Using Subjective Descriptions of Chest Pain: Insights From Providing Rapid Out of Hospital Acute Cardiovascular Treatment (PROACT) 3 and 4 Trials. (United States)

    Sepehrvand, Nariman; Zheng, Yinggan; Armstrong, Paul W; Welsh, Robert C; Ezekowitz, Justin A


    Several accelerated diagnostic protocols (ADPs) have been developed to allow emergency department (ED) physicians to identify appropriate patients for safe early discharge after presentation with symptom of chest pain. Most ADPs require chest pain to be described and modify the algorithm based on the subjective chest pain characteristics. We investigated the performance of three established major ADPs simplified by eliminating the need for chest pain as a descriptor. We pooled patients from PROACT-3 and -4 trials, in which patients presenting to emergency medical services with chest pain or dyspnea were enrolled. The simplified Vancouver Chest Pain Rule (sVCPR), the simplified Emergency Department Assessment of Chest Pain Score (sEDACS) ADP and the Accelerated Diagnostic protocol to Assess Patients with chest pain using contemporary troponins as the only biomarker (ADAPT-ADP) were compared using the sensitivity, specificity, and positive and negative predictive values (NPV). The primary outcome of interest was 30-day major adverse cardiac events (MACE); the diagnosis of acute coronary syndrome (ACS) occurring within 30 days after ED presentation was also explored. A total of 1,081 patients were included (median age = 67 years, 53% male, median GRACE score = 113) of which 222 ACS diagnoses and 150 cardiac events occurred within 30 days after index ED presentation. The sVCPR, sEDACS ≥ 3, and ADAPT-ADP, respectively, identified 9.7, 13.3, and 4.1% of patients as low risk with a sensitivity and NPV of 100% for the primary outcome of 30-day MACE. The sEDACS-ADP identified 24.2% of patients as low risk with a cut-point score of 4 (sensitivity of 98.0% and NPV of 98.8%). The sVCPR, sEDACS ≥ 3, and ADAPT-ADP, respectively, had NPVs of 98.1, 95.8, and 93.3% in identifying patients at higher risk of ACS diagnosis within 30 days after index ED visit. The diagnostic protocols performed well without their chest pain characteristics component. Further studies are

  9. Training specialists in international relations: rethinking the new paradigm

    Directory of Open Access Journals (Sweden)

    Elena V. Voevoda


    Full Text Available The article considers new tasks of universities and faculties training students of international relations. The author analyzes the essence of the concept "paradigm" in education because paradigm serves as the basis of the educational process in universities. The content of professional education depends on the aims of professional education of specialists in international relations. The process of globalization, global changes, challenges and threats bring about the necessity to study specific features of international cooperation in ecology, psychology of conflict, psychology of leadership, etc. In the age of globalization, national economies are converging while national cultures are diverging. Representatives of different nations realize the importance of preserving cultural identity. It is of vital importance to instil tolerance in future specialists in international relations and prepare them for cross-cultural communication. At the same time, it is necessary that they should not only enjoy individual freedom and national cultural identity, but realize their own responsibility to the state. In the modern world, the axiological and educational functions of professional training are growing. At the same time, it is crucial to let the students build a number of professionally relevant competences that will make it possible for them to effectively perform their professional functions. It is the competence-based approach that makes the basis of Federal state education standards, including education standards for faculties of international relations. Another direction that needs developing is training and retraining lecturers for universities specializing in international relations. Foreign language training of lecturers in basic subjects will make it possible for the, to give lectures in foreign languages, particularly in English, which, in its turn, will help to make Russia's universities more competitive.

  10. Clinical nurse specialists as entrepreneurs: constrained or liberated. (United States)

    Austin, Lynn; Luker, Karen; Roland, Martin; Ronald, Martin


    This qualitative study explored the experiences of two groups of clinical nurse specialists--continence advisors and tissue viability nurses--working in primary care in the UK. In particular, the study focused on how clinical nurse specialists' relationships with other health-care professionals had an impact on their role. Clinical nurse specialists are recognized worldwide as having expertise in a given field, which they use to develop the practice of others. Additionally, clinical nurse specialists share many of the characteristics of entrepreneurs, which they use to develop services related to their speciality. However, little research has been conducted in relation to clinical nurse specialists' experiences as they attempt to diversify nursing practice. An ethnographic approach was adopted comprising many elements of Glaserian grounded theory. Data were collected via participant observation and face-to-face interviews with 22 clinical nurse specialists. Services provided by clinical nurse specialists were not static, clinical nurse specialists being the main drivers for service developments. However, clinical nurse specialists encountered difficulties when introducing new ideas. Given their role as advisors, clinical nurse specialists lacked authority to bring about change and were dependent on a number of mechanisms to bring about change, including 'cultivating relationships' with more powerful others, most notably the speciality consultant. The UK government has pledged to 'liberate the talents of nurses' so that their skills can be used to progress patient services. This study highlights the fact that a lack of collaborative working practices between health-care professionals led to clinical nurse specialists being constrained. Health-care organizations need to provide an environment in which the entrepreneurial skills of clinical nurse specialists may be capitalized on. In the absence of an outlet for their ideas regarding service developments, clinical

  11. The internal medicine specialist and neurosurgery

    Directory of Open Access Journals (Sweden)

    A. Pizzini


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

  12. Tenth target fabrication specialists` meeting: Proceedings

    Energy Technology Data Exchange (ETDEWEB)

    Foreman, L.R.; Stark, J.C. [comp.


    This tenth meeting of specialists in target fabrication for inertial confinement is unique in that it is the first meeting that was completely unclassified. As a result of the new classification, we were able to invite more foreign participation. In addition to participants from the US, UK, and Canada, representatives from France, Japan, and two Russian laboratories attended, about 115 in all. This booklet presents full papers and poster sessions. Indirect and direct drive laser implosions are considered. Typical topics include: polymer or aluminium or resorcinol/formaldehyde shells, laser technology, photon tunneling microscopy as a characterization tool, foams, coatings, hohlraums, and beryllium capsules. Hydrogen, deuterium, tritium, and beryllium are all considered as fuels.

  13. Knowledge Assessment Software in Mining Specialist Training (United States)

    Lebedev, Vladimir; Puhova, Olga


    The article reviews the knowledge assessment software module of electronic teaching and testing in mining specialist training. To develop the software module integrated programming environment state-of-the-art is used. Its advantage consists in small computer resource consumption, simple editing, and protection against the users' trying to find out the correct answers to test tasks. The software makes it possible to learn the ongoing learning information systematically and consistently as well as to assess the current knowledge in mining. The developed module meets the following requirements: a software module user-friendly interface, the storage of passed test results to be used for subsequent viewing, analyses, and evaluation, fast troubleshooting in case of any troubles with a stable module operation, and further software function extension and upgrading.

  14. Twelve Scientific Specialists of the Peenemuende Team (United States)


    Twelve scientific specialists of the Peenemuende team at the front of Building 4488, Redstone Arsenal, Huntsville, Alabama. They led the Army's space efforts at ABMA before transfer of the team to National Aeronautic and Space Administration (NASA), George C. Marshall Space Flight Center (MSFC). (Left to right) Dr. Ernst Stuhlinger, Director, Research Projects Office; Dr. Helmut Hoelzer, Director, Computation Laboratory: Karl L. Heimburg, Director, Test Laboratory; Dr. Ernst Geissler, Director, Aeroballistics Laboratory; Erich W. Neubert, Director, Systems Analysis Reliability Laboratory; Dr. Walter Haeussermarn, Director, Guidance and Control Laboratory; Dr. Wernher von Braun, Director Development Operations Division; William A. Mrazek, Director, Structures and Mechanics Laboratory; Hans Hueter, Director, System Support Equipment Laboratory;Eberhard Rees, Deputy Director, Development Operations Division; Dr. Kurt Debus, Director Missile Firing Laboratory; Hans H. Maus, Director, Fabrication and Assembly Engineering Laboratory

  15. Multidisciplinary training of cancer specialists in Europe

    DEFF Research Database (Denmark)

    Benstead, Kim; Turhal, Nazim Serdar; O'Higgins, Niall


    . Questionnaires were sent to National Societies of Radiation Oncology and Medical Oncology concerning similarities and differences in training programs and multidisciplinary care in member states in Europe. Results indicated wide variation in training systems and practice. Data were lacking for Surgery because...... Surgical Oncology is not recognised as a speciality in the EU and most specialist training in cancer surgery is organ based. A period of time in cross-disciplinary training in each of the other two disciplines for all trainees in Medical Oncology, Radiation Oncology and Surgical Oncology (including all...... surgeons training in cancer surgery) is recommended. This is likely to improve the value of multidisciplinary meetings and may result in improved patient care. The Expert Group on Cancer Control of the European Commission has endorsed this recommendation....

  16. The Advanced Practice Clinical Nurse Specialist. (United States)

    Mayo, Ann M; Ray, Melinda Mercer; Chamblee, Tracy B; Urden, Linda D; Moody, Rachel

    The clinical nurse specialist (CNS), one of the 4 advanced practice registered nurse (APRN) categories, has a unique role to play in contributing to high-quality patient care and system-level change across multiple health care settings. CNS practice requires advanced knowledge and skills, including specialty expertise, the ability to integrate new knowledge and innovation into the system of care, the ability to consult and collaborate with all health professions, and the mentoring of nursing staff to support and fully implement that new knowledge. The purpose of this article was to describe the role of the CNS, explain the background of the CNS role as it relates to APRN practice, provide current CNS workforce statistics, and share opportunities for hospitals and health systems to strategically use CNSs to advance patient and organizational goals.

  17. Qualitative and structural analysis of the managerial competency of future physical education and sport specialists

    Directory of Open Access Journals (Sweden)

    Dubrevskiy Y.M.


    Full Text Available Purpose: identifying theoretical and practical communication management competence in vocational training of future specialists of physical education and sport. Material: analysis of 220 literary sources of psycho-pedagogical nature, sports theory, control theory, methods of physical education, which cover the administrative aspect of modern specialist training. Results: the need to form a managerial competency in the process of future specialists in education and sport preparation with regard to its qualitative and structural characteristics was established in the research. Conclusions: there is an evidence that the meaningful impact on the development of managerial competency takes place successfully under conditions of personal socialization in the communicative environment; orientation towards systematic assimilation of knowledge about the phenomenon of management, focus on the effective implementation of activities; development of professional and individual characteristics, which together meet the objectives and content of the pedagogical preparation of students.

  18. Professional and Moral Stability Development of Prospective Specialists in the Context of Educational Modernization

    Directory of Open Access Journals (Sweden)

    I. B. Svezhentseva


    Full Text Available The paper analyzes the specificity of the prospective specialists’ professional and moral stability development in the context of educational system modernization; the essence, components, criteria and levels of the above characteristic being defined along with its development prospects in the course of vocational training. The essence of professional moral stability is defined as the integrative quality and inherent characteristic of professionalism, guaranteeing personal self-realization of a prospective specialist in professional activity. According to the theoretical concepts of activity and personal development, the structure of professional moral stability is identified including the following components: cognitive, emotionally-moral, motivationally-stimulating, and functionally- practical. The research outcome and the data interpretation allowed the author to single out the pedagogic conditions increasing the effectiveness of profession- ally-moral stability development. The functional development model of the quality in question was devised, based on the leading concepts of subjective- functional, person-oriented, acmeological and culturalogical approaches. The research outcome includes developing the informational didactic materials: the vocational teachers’ course – «Introduction to Vocational Training», and the optional students’ course – «Moral Qualities Development of Vo- cational Training Students». 

  19. Perceptions of Private Dental Practitioners of Specialist Prosthodontic Dental Services in Gujarat: A Survey. (United States)

    Shah, Rachana J; Shah, Sujal G; Vyas, Sneha; Patel, Ghanshyam C


    To identify the perceptions towards and utilization of specialist Prosthodontic services among Private Dental Practitioners (PDPs) of Gujarat state. To study the influence of presence or absence of a Prosthodontic post graduate course during the PDP's dental education and years of experience in practice on the decisions to treat Prosthodontic cases themselves or to utilise Prosthodontic speciality services. A postal questionnaire examined by a panel of Prosthodontists, piloted on 15 PDPs, was sent to 150 randomly selected private dental practitioners of Gujarat state. The collected data were subjected to descriptive and Chi-square statistical analysis. Though 78.64 % dentists considered the treatment provided by the Prosthodontist to be effective, only 34.95 % of them availed their services. 33 % PDPs without a Prosthodontic post graduate course in their institute were significantly more likely to refer patients to a Prosthodontist. Years of experience had no influence on utilization of Prosthodontic speciality service. 18.44 % PDPs had a Prosthodontic speciality clinic in their region, 65.04 % did not have, whereas 11.65 % were not aware of such clinic. PDPs have high regards for the Prosthodontic speciality but their reported demand was less as compared to other specialities indicating a need for the Prosthodonitst to put in efforts to make the PDPs aware of their services.

  20. Transition from specialist to primary diabetes care: A qualitative study of perspectives of primary care physicians

    Directory of Open Access Journals (Sweden)

    Liddy Clare


    Full Text Available Abstract Background The growing prevalence of diabetes and heightened awareness of the benefits of early and intensive disease management have increased service demands and expectations not only of primary care physicians but also of diabetes specialists. While research has addressed issues related to referral into specialist care, much less has been published about the transition from diabetes specialists back to primary care. Understanding the concerns of family physicians related to discharge of diabetes care from specialist centers can support the development of strategies that facilitate this transition and result in broader access to limited specialist services. This study was undertaken to explore primary care physician (PCP perspectives and concerns related to reassuming responsibility for diabetes care after referral to a specialized diabetes center. Methods Qualitative data were collected through three focus groups. Sessions were audio-taped and transcribed verbatim. Data were coded and sorted with themes identified using a constant comparison method. The study was undertaken through the regional academic referral center for adult diabetes care in Ottawa, Canada. Participants included 22 primary care physicians representing a variety of referral frequencies, practice types and settings. Results Participants described facilitators and barriers to successful transition of diabetes care at the provider, patient and systems level. Major facilitators included clear communication of a detailed, structured plan of care, ongoing access to specialist services for advice or re-referral, continuing education and mentoring for PCPs. Identified provider barriers were gaps in PCP knowledge and confidence related to diabetes treatment, excessive workload and competing time demands. Systems deterrents included reimbursement policies for health professionals and inadequate funding for diabetes medications and supplies. At the PCP-patient interface

  1. Brazilian infectious diseases specialists: who and where are they? (United States)

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


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

  2. Value, Challenges, and Satisfaction of Certification for Multiple Sclerosis Specialists


    Gulick, Elsie E.; Halper, June


    Background: Specialist certification among interdisciplinary multiple sclerosis (MS) team members provides formal recognition of a specialized body of knowledge felt to be necessary to provide optimal care to individuals and families living with MS. Multiple sclerosis specialist certification (MS Certified Specialist, or MSCS) first became available in 2004 for MS interdisciplinary team members, but prior to the present study had not been evaluated for its perceived value, challenges, and sat...

  3. Educational programme on radiation protection for veterinary medicine specialists

    Energy Technology Data Exchange (ETDEWEB)

    Djuric, G.; Popovic, D. [School of Veterinary Medicine, Dept. of Radiology and Radiation Hygiene and Dept. of Physics, Belgrade (Yugoslavia)


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

  4. Expanding subjectivities

    DEFF Research Database (Denmark)

    Lundgaard Andersen, Linda; Soldz, Stephen


    A major theme in recent psychoanalytic thinking concerns the use of therapist subjectivity, especially “countertransference,” in understanding patients. This thinking converges with and expands developments in qualitative research regarding the use of researcher subjectivity as a tool to understa...

  5. 22 CFR 501.6 - Appointment of Overseas Specialists. (United States)


    ...; English Teaching Specialists; Correspondents; Engineers for the Voice of America; Regional Librarian... equivalent), claimed language proficiency and other background or factors which may be related to the work...

  6. Methodological bases of innovative training of specialists in nanotechnology field

    Directory of Open Access Journals (Sweden)

    FIGOVSKY Oleg Lvovich


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

  7. Do Industry Specialist Auditors Add Value in Mergers and Acquisitions?

    National Research Council Canada - National Science Library

    Ho-Young Lee; Vivek Mande; Jong Chool Park


    ...) are higher for acquiring firms audited by industry specialists. External auditors are uniquely positioned to provide assurance on the financial statements of their acquiring clients both before and...

  8. Inter-observer agreement of canine and feline paroxysmal event semiology and classification by veterinary neurology specialists and non-specialists. (United States)

    Packer, Rowena M A; Berendt, Mette; Bhatti, Sofie; Charalambous, Marios; Cizinauskas, Sigitas; De Risio, Luisa; Farquhar, Robyn; Hampel, Rachel; Hill, Myfanwy; Mandigers, Paul J J; Pakozdy, Akos; Preston, Stephanie M; Rusbridge, Clare; Stein, Veronika M; Taylor-Brown, Fran; Tipold, Andrea; Volk, Holger A


    Advances in mobile technology mean vets are now commonly presented with videos of paroxysmal events by clients, but the consistency of the interpretation of these videos has not been investigated. The objective of this study was to investigate the level of agreement between vets (both neurology specialists and non-specialists) on the description and classification of videos depicting paroxysmal events, without knowing any results of diagnostic workup. An online questionnaire study was conducted, where participants watched 100 videos of dogs and cats exhibiting paroxysmal events and answered questions regarding: epileptic seizure presence (yes/no), seizure type, consciousness status, and the presence of motor, autonomic and neurobehavioural signs. Agreement statistics (percentage agreement and kappa) calculated for each variable, with prevalence indices calculated to aid their interpretation. Only a fair level of agreement (κ = 0.40) was found for epileptic seizure presence. Overall agreement of seizure type was moderate (κ = 0.44), with primary generalised seizures showing the highest level of agreement (κ = 0.60), and focal the lowest (κ =0.31). Fair agreement was found for consciousness status and the presence of autonomic signs (κ = 0.21-0.40), but poor agreement for neurobehavioral signs (κ = 0.16). Agreement for motor signs ranged from poor (κ = ≤ 0.20) to moderate (κ = 0.41-0.60). Differences between specialists and non-specialists were identified. The relatively low levels of agreement described here highlight the need for further discussions between neurology experts regarding classifying and describing epileptic seizures, and additional training of non-specialists to facilitate accurate diagnosis. There is a need for diagnostic tools (e.g. electroencephalogram) able to differentiate between epileptic and non-epileptic paroxysms.

  9. Economic evaluation of nurse practitioner and clinical nurse specialist roles: A methodological review. (United States)

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


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

  10. Radiological Operations Support Specialist (ROSS) Pilot Course Summary and Recommendations

    Energy Technology Data Exchange (ETDEWEB)

    Alai, M. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Askin, A. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Buddemeier, B. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Wogan, L. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Doshi, P. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Tai, L. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)


    In support of the Department of Homeland Security / Science and Technology Directorate’s (DHS/S&T) creation of a new position called the Radiological Operations Support Specialist (ROSS), Lawrence Livermore National Laboratory (LLNL) in Sub-task 1.1 and 1.2 has assisted in the development of the ROSS skills, knowledge, and abilities (SKAs); identified potentially relevant training; cross-mapped the training to the SKAs; and identified gaps in the training related to the SKAs, as well as their respective level of training knowledge - current versus desired. In the follow on task, Sub-task 1.3, a 5 day ROSS Pilot Training course was developed to fill the priority gaps identified in Sub-Task 1.2. Additionally, in Sub-Task 1.5, LLNL has performed a gap analysis of electronic tools, handbooks, and job-aides currently available to the ROSS and developed recommendations for additional and next generation tools to ensure the operational effectiveness of the ROSS position. This document summarizes the feedback received from the instructors and pilot course observers on what worked in the course and what could be improved as well as an assessment of the Pre- and Post-Test administered to the students.

  11. Pharmacy specialists' attitudes toward pharmaceutical service quality at community pharmacies. (United States)

    Urbonas, Gvidas; Jakušovaitė, Irayda; Savickas, Arūnas


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

  12. A qualitative investigation of specialist orthodontists in New Zealand. Part 1. Orthodontists and orthodontic practice. (United States)

    Soma, Kieran J; Thomson, W Murray; Morgaine, Kate C; Harding, Winifred J


    Current knowledge of orthodontic practice is largely anecdotal and the lack of systematic knowledge can create barriers to better identifying the factors that make a successful orthodontist. The aim of this study was to investigate the routine practising lives of New Zealand orthodontists in order to generate an understanding of the reality of orthodontic specialist practice and its effects on their professional and personal lives. Semi-structured interviews were conducted involving 19 practising orthodontists (four females, 15 males; mean age 50 years) throughout New Zealand.Transcribed interviews were analysed for themes using an applied grounded theory approach. A core category of 'practising orthodontists' was derived, and related themes were grouped under the sub-categories of: (a) NZ orthodontic specialist practice; (b) NZ specialist orthodontists; and (c) work-life balance. The present paper reports on the first two subcategories. Themes elucidated under the specialist practice sub-category included modernisation, changing social norms, practice arrangement, branch practice, staffing, competition, legislation, advertising, the future and the provision of orthodontics by non-specialists. Themes in the orthodontic specialist sub-category were prior experience, postgraduate training, recent graduates, reasons for specialising, generational differences, females in orthodontics, NZ and overseas practice, the ageing profession and the prospect of an orthodontist shortage. This investigation has shed light on orthodontists and the practice of orthodontics in New Zealand and determined aspects rarely discussed in the current or previous literature. It will be valuable to observe how orthodontists and orthodontic practice continue to evolve in response to changes in NZ society.

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

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


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

  14. Randomised clinical trial of early specialist palliative care plus standard care versus standard care alone in patients with advanced cancer

    DEFF Research Database (Denmark)

    Groenvold, Mogens; Petersen, Morten Aagaard; Damkier, Anette


    BACKGROUND: Beneficial effects of early palliative care have been found in advanced cancer, but the evidence is not unequivocal. AIM: To investigate the effect of early specialist palliative care among advanced cancer patients identified in oncology departments. SETTING/PARTICIPANTS: The Danish...... Palliative Care Trial (DanPaCT) ( NCT01348048) is a multicentre randomised clinical trial comparing early referral to a specialist palliative care team plus standard care versus standard care alone. The planned sample size was 300. At five oncology departments, consecutive patients...... scales and survival. RESULTS: Totally 145 patients were randomised to early specialist palliative care versus 152 to standard care. Early specialist palliative care showed no effect on the primary outcome of change in primary need (-4.9 points (95% confidence interval -11.3 to +1.5 points); p = 0...

  15. Work-family balance by women GP specialist trainees in Slovenia: a qualitative study. (United States)

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


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

  16. The clinical nurse specialist and psychiatrist in joint practice. (United States)

    Shires, B W; Spector, P M


    The authors describe a joint practice model between a clinical nurse specialist and psychiatrist. The authors address factors to consider in establishing a joint practice--negotiation of roles and benefits as well as clinical supervision. In addition, specific clinical responsibilities for the nurse specialist, as well as potential expanded duties, are outlined.

  17. Training School Library Media Specialists For Nigerian Schools in ...

    African Journals Online (AJOL)

    The importance of training school library media specialists for the attainment of quality education in the school system cannot be overemphasized. The role of the school library media specialist has changed with developments in information communication and integration into library and information service which has ...

  18. Pattern of facial palsy in a typical Nigerian specialist hospital ...

    African Journals Online (AJOL)

    Pattern of facial palsy in a typical Nigerian specialist hospital. S Lamina, S Hanif. Abstract. Background: Data on incidence of facial palsy is generally lacking in Nigeria. Objective: To assess six years' incidence of facial palsy in Murtala Muhammed Specialist Hospital (MMSH), Kano, Nigeria. Method: The records of patients ...

  19. Documentation of Extension Specialists' Involvement in Graduate Education. (United States)

    Murdock, Edward C.; York, Alan C.


    Describes the changes in the roles of the Cooperative Extension Service and extension specialists affiliated with universities. Reports the results of survey research and concludes that extension specialists should actively pursue the opportunity to direct graduate students. Contains 16 references. (DDR)

  20. attitude of cleft care specialists in africa towards presurgical ...

    African Journals Online (AJOL)


    Dec 12, 2012 ... A. T. Adeyemi, BDS, FWACS Senior Lecturer, O. O. Bankole, Department of Child Oral Health, College of Medicine, ... Younger specialists have a more favorable attitude towards pre-surgical orthopaedics than older specialists. INTRODUCTION. Management of cleft lip and ... compromising aesthetics (7).

  1. Stress, satisfaction and burnout among Dutch medical specialists

    NARCIS (Netherlands)

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


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

  2. Value, challenges, and satisfaction of certification for multiple sclerosis specialists. (United States)

    Gulick, Elsie E; Halper, June


    Specialist certification among interdisciplinary multiple sclerosis (MS) team members provides formal recognition of a specialized body of knowledge felt to be necessary to provide optimal care to individuals and families living with MS. Multiple sclerosis specialist certification (MS Certified Specialist, or MSCS) first became available in 2004 for MS interdisciplinary team members, but prior to the present study had not been evaluated for its perceived value, challenges, and satisfaction. A sample consisting of 67 currently certified MS specialists and 20 lapsed-certification MS specialists completed the following instruments: Perceived Value of Certification Tool (PVCT), Perceived Challenges and Barriers to Certification Scale (PCBCS), Overall Satisfaction with Certification Scale, and a demographic data form. Satisfactory reliability was shown for the total scale and four factored subscales of the PVCT and for two of the three factored PCBCS subscales. Currently certified MS specialists perceived significantly greater value and satisfaction than lapsed-certification MS specialists in terms of employer and peer recognition, validation of MS knowledge, and empowering MS patients. Lapsed-certification MS specialists reported increased confidence and caring for MS patients using evidence-based practice. Both currently certified and lapsed-certification groups reported dissatisfaction with MSCS recognition and pay/salary rewards. The results of this study can be used in efforts to encourage initial certification and recertification of interdisciplinary MS team members.

  3. School Library Media Specialists as Effective School Leaders (United States)

    Everhart, Nancy


    According to the National Board for Professional Teaching Standards (2006), "Accomplished library media specialists are instructional leaders who forge greater opportunities for learners" (55). As one of the few school personnel responsible for all students, the media specialist can serve as a coordinator and an advocate. They can ensure equitable…

  4. Need for Specialist Teachers in Early Childhood Education (ECE ...

    African Journals Online (AJOL)


    Key words: Specialist Teachers, Early childhood, Sustainable. Development. Introduction. Early childhood is one of the major stages .... The relationship at this stage between the teacher and children tends to be closer that the teacher becomes a surrogate parent. Need for Specialist Teachers in Early Childhood Education ...

  5. Local adaptation in oviposition choice of a specialist herbivore

    NARCIS (Netherlands)

    Wei, Xianqin; Vrieling, Klaas; Mulder, Patrick P.J.; Klinkhamer, Peter G.L.


    Specialist herbivores feed on a restricted number of related plant species and may suffer food shortage if overexploitation leads to periodic defoliation of their food plants. The density, size and quality of food plants are important factors that determine the host plant choice of specialist

  6. Exploring the interface between 'physician-assisted death' and palliative care: cross-sectional data from Australasian palliative care specialists. (United States)

    Sheahan, L


    Legalisation of physician-assisted dying (PAD) remains a highly contested issue. In the Australasian context, the opinion and perspective of palliative care specialists have not been captured empirically, and are required to inform better the debate around this issue, moving forward. To identify current attitudes and experiences of palliative care specialists in Australasia regarding requests for physician-assisted suicide and voluntary euthanasia, and to capture the opinion of palliative care specialists on the legalisation of these practices in the Australasian context. An anonymous, cross-sectional, online survey of Australasian specialists in palliative care, addressing the following six areas: (i) demographics; (ii) frequency of requests, and response given; (iii) understanding of the term 'voluntary euthanasia'; (iv) opinion regarding legalisation of physician-assisted suicide and voluntary euthanasia in Australasia, and willingness to participate if legal; (v) identification of the most important values guiding this opinion; and (vi) anticipated impact that legalisation of assisted death would have on palliative care practice. Important findings include: (i) palliative care specialists are largely opposed to the legalisation of PAD; (ii) the proportional titration of opioids is not understood by any palliative care specialist studied to be 'voluntary euthanasia'; and (iii) there is a wide variation in frequency of requests, and one-third of palliative care specialists express discomfort in dealing with requests for assisted suicide or euthanasia. Key areas for future research at the interface between PAD and best practice end-of-life care are identified, including exploration into why palliative care specialists are largely opposed to PAD, and consideration of the impact 'the opioid misconception' may have on the literature informing this debate. © 2016 Royal Australasian College of Physicians.

  7. Conjunction of Multizone Infiltration Specialists (COMIS) fundamentals

    Energy Technology Data Exchange (ETDEWEB)

    Feustel, H.E.; Rayner-Hooson, A. (eds.)


    The COMIS workshop (Conjunction of Multizone Infiltration Specialists) was a joint research effort to develop a multizone infiltration mode. This workshop (October 1988--September 1989) was hosted by the Energy Performance of Buildings Group at Lawrence Berkeley Laboratory's Applied Science Division. The task of the workshop was to develop a detailed multizone infiltration program taking crack flow, HVAC-systems, single-sided ventilation and transport mechanism through large openings into account. This work was accomplished not by investigating into numerical description of physical phenomena but by reviewing the literature for the best suitable algorithm. The numerical description of physical phenomena is clearly a task of IEA-Annex XX Air Flow Patterns in Buildings,'' which will be finished in September 1991. Multigas tracer measurements and wind tunnel data will be used to check the model. The agenda integrated all participants' contributions into a single model containing a large library of modules. The user-friendly program is aimed at researchers and building professionals. From its announcement in December 1986, COMIS was well received by the research community. Due to the internationality of the group, several national and international research programmes were co-ordinated with the COMIS workshop. Colleagues for France, Italy, Japan, The Netherlands, People's Republic of China, Spain, Sweden, Switzerland, and the United States of America were working together on the development of the model. Even though this kind of co-operation is well known in other fields of research, e.g., high energy physics; for the field of building physics it is a new approach. This document contains an overview about infiltration modelling as well as the physics and the mathematics behind the COMIS model. 91 refs., 38 figs., 9 tabs.

  8. Portfolios for assessment of paediatric specialist registrars. (United States)

    Melville, C; Rees, M; Brookfield, D; Anderson, J


    In 1997 the Royal College of Paediatrics and Child Health introduced portfolios to guide and monitor the learning of specialist registrars. We studied their value for assessment. Using Bigg's SOLO criteria we devised a marking scheme based on 6 domains of competence: clinical, communication, teaching and learning, ethics and attitudes, management and evaluation, and creation of evidence. We rated portfolios according to quality of evidence presented and expectations by year of training. We similarly assessed trainee performance in the annual record of in-training assessment (RITA) interview. Specific advice based on the results of the first portfolio assessments was circulated to all trainees, instructing them to increase the structure and decrease the bulk of portfolios. A second sample of portfolios was reviewed a year later, using similar evaluations, to determine the effects. A total of 76 portfolios were assessed in year 1 by a single rater; 30 portfolios were assessed in year 2 by 2 independent raters. The quality of documentation improved from year 1 to year 2 but there was no significant increase in portfolio scores. The inter-rater correlation coefficient of the portfolio assessment method was 0.52 (Cohen's kappa 0.35). The inter-rater correlation coefficient of the RITA interview was 0.71 (Cohen's kappa 0.38). There was moderate inter-assessment correlation between portfolios and RITA interviews (kappa 0.26 in year 1 and 0.29 in year 2). Generalisability analysis suggested that 5 successive ratings by a single observer or independent ratings by 4 observers on the same occasion would be needed to yield a generalisability coefficient > 0.8 for overall portfolio rating. This method of portfolio assessment is insufficiently reliable as a sole method for high stakes, single-instance assessment, but has a place as part of a triangulation process. Repeated portfolio assessment by paired observers would increase reliability. Longer term studies are required to

  9. [Smoking among patients of selected specialist clinics of Miedzylesie Specialist Hospital in Warsaw]. (United States)

    Pytka, Dorota; Doboszyńska, Anna


    The purpose of the study is to examine the issue of smoking among patients of selected clinics of the Miedzylesie Specialist Hospital in Warsaw, assessment of nicotine addiction of smokers and motivation to give up smoking. The survey was carried out in June and July 2009 after obtaining the consent of the Director of Miedzylesie Specialist Hospital in Warsaw. The survey was participated in by 100 patients of selected specialist clinics. The survey was carried out on the basis of a questionnaire consisting of 7 questions. Furthermore, the "Test of motivation to give up smoking" (Schneider's test) and the "Assessment of nicotine addiction level" (Fagerström's test), published in the "Consensus regarding recognition and treatment of nicotine addiction", were used. When processing data, the descriptive statistics were applied. Those surveyed included 53 former cigarette smokers 47 active smokers and. In the group of former smokers, 19 people still were exposed to passive smoking. In the past, the problem regarded 41 people. Thirty former smokers smoked cigarettes among non-smokers, including young children (18 people) and when pregnant and breastfeeding (2 people). Also 30 respondents smoked despite medical contraindications and bad conscience. For 27 people, expenditures on cigarettes constituted a considerable burden of their respective household budgets, and 20 said that it was a significant item in their expenditures. Smokers have been smoking cigarettes for 30 years, on average 20 cigarettes a day. Those patients began to smoke at the age of 20. Thirty one active smokers exposed other people to passive smoking and 38 respondents smoked cigarettes despite medical contraindications and with bad conscience. For 22 people, expenditures related to smoking are a considerable burden of the household budget and for 21 people, it is a significant expenditure. Almost one half of the patients smoke cigarettes although they should brake off smoking for medical reasons. Most

  10. Quality of Life in Emergency Medicine Specialists of Teaching Hospitals

    Directory of Open Access Journals (Sweden)

    Afshin Amini


    Full Text Available Introduction: Quality of life (QOL of emergency medicine specialists can be effective in providing services to patients. The aim of the present study was evaluating the lifestyle of emergency medicine practitioners, understanding their problems, and addressing the solutions to enhance and improve their lifestyles, in teaching hospitals in Iran. Method: This descriptive cross-sectional study was conducted on emergency medicine physicians in 10 teaching hospitals of Iran in 2011. Emergency physicians with at least three years of experience who interested in the study, were enrolled in the project. All participants filled out the consent form and QOL questionnaires, then underwent physical examinations and some medical laboratory tests. Categorical variables were reported as percentages, while continuous variables expressed as means and standard deviations. p <0.05 was considered statistically significant. Results: Totally, 100 subjects participated in the study, of whom 48 were male. The mean and standard deviation of the physicians’ age were 38.7±5.1 years. 43% of physicians had an average QOL, while 37% good. 96% of studied physicians had a good condition regarding habitual history, while 93% of them had a poor condition in performing screening tests. Exercise program and personal health in individuals with normal BMI were correlated with higher levels of QOL. BMI was higher in 40-50 years old subjects than youngers. Hypertension was present in five cases (5%, hypercholesterolemia in six (6%, hypertriglyceridemia in six (6%, increased LDL in four (4%, low HDL in four (4%, and impaired FBS in 4 (4%. Conclusion: The findings showed that 63% of studied emergency physicians had an average level of QOL and other ones good. The majority of physicians had undesirable situation regarding the performance of screening tests.


    Indian Academy of Sciences (India)

    Subject Index. Variation of surface electric field during geomagnetic disturbed period at Maitri, Antarctica. 1721. Geomorphology. A simple depression-filling method for raster and irregular elevation datasets. 1653. Decision Support System integrated with Geographic. Information System to target restoration actions in water-.

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

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

    Provides subject matter expertise and guidance on IT Security to project managers, business clients and senior management. .... Supervises the execution of project plans, testing procedures, project review documents, procurement documents, prototypes, proposals, statistics, reports and standards regarding all aspects of ...

  13. The Serendipitous Survey: A Look at Primary and Specialist Palliative Social Work Practice, Preparation, and Competence. (United States)

    Sumser, Bridget; Remke, Stacy; Leimena, Meagan; Altilio, Terry; Otis-Green, Shirley


    Health professionals have begun to identify competencies needed for primary and specialist levels of palliative care practice, but little attention has been given to how these skills are acquired. The authors electronically surveyed a wide range of health social workers and educators to investigate their reported levels of preparation, training, and self-assessed competence to provide palliative and end-of-life care. Two health social work surveys were developed: one for educators and one for practitioners and students. The study used an electronic snowball sampling method with eight national social work listservs to capture a wide range of settings where health social workers may teach or practice. The survey was completed by 1149 self-identified health care social workers, 35% of whom identified as a specialist in palliative care. Health social work clinicians report competence in many skills related to palliative care and the psychosocial determinants of health, having developed these skills primarily through interprofessional and peer collaboration. A representative sample of social workers practicing in health care identify high competence in essential aspects of palliative care. This speaks to an existing pool of clinicians who, if practicing to the top of their licenses, have the potential to provide primary palliative care and contribute to the person-family centered care called for in the Institute of Medicine (IOM) report. Few programs exist to prepare social workers to work as specialists in palliative or end-of-life settings, and respondents identified key areas of practice that need to be integrated into graduate education to ensure that students, practitioners, and educators are better prepared to maximize the impact of health social work. Further research is needed to better understand how to prepare and train specialist-level palliative care social workers.

  14. The United Kingdom's specialist workforce in paediatric dentistry: current and future trends. (United States)

    Hunter, M L; Harrhy, L E; Morgan, M Z


    To provide information relevant to the current and predicted future profile of the UK's specialist workforce in paediatric dentistry. Postal questionnaire. Two hundred and twenty-one registered dentists whose names appeared on the Specialist List in Paediatric Dentistry and who were identified as resident within the United Kingdom. Questionnaires were returned by 192 specialists, a response rate of 86.9%. This paper is, however, based on data provided by 187 respondents currently practising in the United Kingdom (54 (28.9%) male and 133 (71.1%) female). The majority of respondents were based in England (138) and practised in hospital settings (120). Eighty-two respondents (14 males and 68 females) stated that they were working part-time and 57 (5 males and 52 females) indicated that they had already taken a break at some time during their career. Eighty-four (45.2%) respondents plan to retire during the next ten years. Working patterns associated with a feminised workforce will have a considerable impact on the volume of service that can be provided. Workforce planners must be cognisant of the need to increase the number of specialists in training to take account of service lost through part-time working and career breaks.

  15. Deciding about fertility preservation after specialist counselling. (United States)

    Bastings, L; Baysal, Ö; Beerendonk, C C M; IntHout, J; Traas, M A F; Verhaak, C M; Braat, D D M; Nelen, W L D M


    How do female patients experience fertility preservation (FP) consultation (FPC) with a specialist in reproductive medicine and subsequent decision-making on FP? Most patients had positive experiences with FPC, but negative experiences were found to be associated with decisional conflict and decision regret. When confronted with a need for gonadotoxic treatment, girls and young women will have to make an irreversible decision with regard to FP. Patients may experience decisional conflict and develop regret about their decision during follow-up. Patients' opportunities to ask questions during FPC and their knowledge about FP have been inversely related to decisional conflict. A questionnaire on experiences with FPC, designed after qualitative research, was retrospectively distributed to 108 patients to whom FP was offered after FPC between July 2008 and July 2013. Aiming to minimize recall bias, we defined a subgroup of patients counselled since 2011 who had not yet tried to conceive after FPC. Patients were aged ≥16 years and had either cancer or a benign disease that required gonadotoxic therapy. They received FPC in a single university hospital in the Netherlands. Apart from patients' experiences, patients' characteristics, decisional conflict and decision regret were assessed. A total of 64 patients (59.3%) responded to the questionnaire. Patients generally had positive experiences with FPC, but indicated room for improvement. Negative experiences were associated with decisional conflict regarding the FP decision (not enough time for counselling: P conflict was correlated to decision regret (P conflict. Given our retrospective design, we were not informed about the causality of the associations observed. We studied Dutch patients who were counselled in a single centre and were at least 16 years old when filling in the questionnaire. This may limit the generalizability of our data to other settings and populations. More attention should be paid to improving FPC


    National Research Council Canada - National Science Library

    Giuca Simona-Mihaela;


    .... While identifying the optimal product and price strategy and designing the product catalogue structure, the marketing specialist should definitely consider existing portfolio behaviour and estimate...

  17. Inappropriate habits of antibiotic use among medical specialists and students in Vilnius


    Barkus, Art?ras; Lisauskien?, Ingrida


    Introduction. The resistance to antibacterial drugs is an emerging worldwide problem. Numbers of inappropriate ways to use antibiotics contribute to this issue. Self-medication is one of them. This study seeks to find out how prevalent the self-medication with antibiotics, their storage at home and the inappropriate acquisition of antibacterial drugs are among medical specialists in Vilnius, Lithuania. Methods. A cross-sectional survey was conducted. To better identify the potential target gr...

  18. Comparative Study of Registered Nurse and Specialist's Attitude Toward Nurse-physician Collaboration in Hospital


    Setiawan, Setiawan


    Introduction: Relationships between nurse and physician in hospital in Indonesia have been established for a long time. This relationship keeps continue toward more professional in order to enhance quality of healthcare. The purpose of this study was to identify attitude of registered nurse and specialist toward nurse-physician collaboration in hospital. Methods: Descriptive comparative design was employed in this study. Number of respondents recruited was 87 which composed of 44 registered n...

  19. Mission Specialist Donald A. Thomas prepares to enter Columbia (United States)


    KENNEDY SPACE CENTER, FLA. -- STS-83 Mission Specialist Donald A. Thomas prepares to enter the Space Shuttle Columbia at Launch Pad 39A with assistance from white room closeout crew members (from left) Rick Welty, Bob Saulnier, and Rene Arriens.

  20. STS-88 Mission Specialist Krikalev arrives for launch (United States)


    Mission Specialist Sergei Konstantinovich Krikalev, a Russian cosmonaut, smiles on his arrival at the Shuttle Landing Facility aboard a T-38 jet aircraft. He joins other crew members Mission Commander Robert D. Cabana, Pilot Frederick W. 'Rick' Sturckow, Mission Specialist Nancy J. Currie, Mission Specialist Jerry L. Ross, and Mission Specialist James H. Newman for pre-launch preparations for mission STS-88 aboard Space Shuttle Endeavour. The scheduled time of launch is 3:56 a.m. EST on Dec. 3 from Launch Pad 39A. The mission is the first U.S. launch for the International Space Station. Endeavour carries the Unity connecting module which the crew will be mating with the Russian- built Zarya control module already in orbit. In addition to Unity, two small replacement electronics boxes are on board for possible repairs to Zarya batteries. Endeavour is expected to land at KSC at 10:17 p.m. on Monday, Dec. 14.

  1. Reducing COPD admissions with a specialist chronic disease management team. (United States)

    Annandale, Joseph; Hurlin, Claire; Lewis, Keir

    This article describes the implementation of a specialist community team working with acute care services to manage patients with COPD. It resulted in a sustained reduction in hospital admissions over one year.

  2. A report and sequelae of a specialist volunteer physician

    African Journals Online (AJOL)

    there would have been no time for training although this can be carried ... registrar), registered nurses and specialists to ensure that there is a ... Part time Juba Medical Complex. 2010 ... to include provision of clean water, sewage and waste.

  3. Residents' Perceptions of Plastic Surgeons as Craniofacial Surgery Specialists. (United States)

    Denadai, Rafael; Muraro, Carlos Alberto Salomão; Raposo-Amaral, Cassio Eduardo


    To assess residents' perceptions of plastic surgeons as craniofacial surgery specialists in Brazil. Brazilian residents were asked to choose 1 or 2 specialists that they perceived to be an expert for 14 craniofacial surgery-related scenarios. Both an overall analysis (all 14 scenarios) and subanalysis (each scenario separately) were performed. Response patterns were distributed as "plastic surgeons alone," "plastic surgeons combined with other specialists," or "without plastic surgeons." Overall, plastic surgeons were chosen more (all P plastic surgeons were chosen more (all P surgery-related scenarios and also demonstrated that "plastic surgeons alone" and "without plastic surgeons" were selected more (all P surgery residents and male residents chose more (all P plastic surgeons as experts than their peers. Residents' perceptions of plastic surgeons as craniofacial surgery specialists are limited in Brazil.

  4. Cost analysis of Periodontitis management in public sector specialist dental clinics (United States)


    Background The objective of this paper is to quantify the cost of periodontitis management at public sector specialist periodontal clinic settings and analyse the distribution of cost components. Methods Five specialist periodontal clinics in the Ministry of Health represented the public sector in providing clinical and cost data for this study. Newly-diagnosed periodontitis patients (N = 165) were recruited and followed up for one year of specialist periodontal care. Direct and indirect costs from the societal viewpoint were included in the cost analysis. They were measured in 2012 Ringgit Malaysia (MYR) and estimated from the societal perspective using activity-based and step-down costing methods, and substantiated by clinical pathways. Cost of dental equipment, consumables and labour (average treatment time) for each procedure was measured using activity-based costing method. Meanwhile, unit cost calculations for clinic administration, utilities and maintenance used step-down approach. Patient expenditures and absence from work were recorded via diary entries. The conversion from MYR to Euro was based on the 2012 rate (1€ = MYR4). Results A total of 2900 procedures were provided, with an average cost of MYR 2820 (€705) per patient for the study year, and MYR 376 (€94) per outpatient visit. Out of this, 90% was contributed by provider cost and 10% by patient cost; 94% for direct cost and 4% for lost productivity. Treatment of aggressive periodontitis was significantly higher than for chronic periodontitis (t-test, P = 0.003). Higher costs were expended as disease severity increased (ANOVA, P = 0.022) and for patients requiring surgeries (ANOVA, P periodontitis patients at public sector specialist settings were substantial and comparable with some non-communicable diseases. These findings provide basis for identifying potential cost-reducing strategies, estimating economic burden of periodontitis management and performing economic

  5. Cost analysis of periodontitis management in public sector specialist dental clinics. (United States)

    Mohd-Dom, Tuti; Ayob, Rasidah; Mohd-Nur, Amrizal; Abdul-Manaf, Mohd R; Ishak, Noorlin; Abdul-Muttalib, Khairiyah; Aljunid, Syed M; Ahmad-Yaziz, Yuhaniz; Abdul-Aziz, Hanizah; Kasan, Noordin; Mohd-Asari, Ahmad S


    The objective of this paper is to quantify the cost of periodontitis management at public sector specialist periodontal clinic settings and analyse the distribution of cost components. Five specialist periodontal clinics in the Ministry of Health represented the public sector in providing clinical and cost data for this study. Newly-diagnosed periodontitis patients (N = 165) were recruited and followed up for one year of specialist periodontal care. Direct and indirect costs from the societal viewpoint were included in the cost analysis. They were measured in 2012 Ringgit Malaysia (MYR) and estimated from the societal perspective using activity-based and step-down costing methods, and substantiated by clinical pathways. Cost of dental equipment, consumables and labour (average treatment time) for each procedure was measured using activity-based costing method. Meanwhile, unit cost calculations for clinic administration, utilities and maintenance used step-down approach. Patient expenditures and absence from work were recorded via diary entries. The conversion from MYR to Euro was based on the 2012 rate (1€ = MYR4). A total of 2900 procedures were provided, with an average cost of MYR 2820 (€705) per patient for the study year, and MYR 376 (€94) per outpatient visit. Out of this, 90% was contributed by provider cost and 10% by patient cost; 94% for direct cost and 4% for lost productivity. Treatment of aggressive periodontitis was significantly higher than for chronic periodontitis (t-test, P = 0.003). Higher costs were expended as disease severity increased (ANOVA, P = 0.022) and for patients requiring surgeries (ANOVA, P Cost of providing dental treatment for periodontitis patients at public sector specialist settings were substantial and comparable with some non-communicable diseases. These findings provide basis for identifying potential cost-reducing strategies, estimating economic burden of periodontitis management and performing

  6. Specialist surgery in the developing world: luxury or necessity? (United States)

    Wright, I G; Walker, I A; Yacoub, M H


    Patients suffering from conditions requiring specialist intervention cannot obtain treatment when facilities do not exist locally. Specialist visiting teams in a number of surgical disciplines have attempted to address these issues in collaboration with local clinicians. These interventions require careful planning and communication to achieve optimum results. Several teams have been successful in building long-term relationships that have lead to important clinical developments in the local country.

  7. Translational health research: perspectives from health education specialists


    Mata, Holly J.; Davis, Sharon


    The phrase ?from bench to bedside to curbside? is a common definition of translational research among health disparities researchers. Health Education Specialists can make important contributions to the field of clinical translational medicine, particularly in light of U.S. health care reform and a renewed emphasis on medical home or health care home models. Health Education Specialists have the training and experience to engage in and facilitate translational research, as well as the opportu...

  8. Disaster Information Specialist Pilot Project: NLM/DIMRC. (United States)

    Reynolds, Patricia; Tamanaha, Inez


    Medical librarians have often been overlooked as important contributors to hospital disaster preparedness. Recognizing the importance of medical libraries and their potential in disaster planning and management, the National Library of Medicine (NLM), Disaster Information Management Research Center (DIMRC), formed a pilot Disaster Information Specialist Project. This paper describes the preliminary activities of Bishopric Medical Library's Director, Patricia Reynolds, at Sarasota Memorial Health Care System, as a disaster information specialist in the hospital's disaster planning and preparedness.

  9. STS-46 Payload Specialist Malerba uses extinguisher during JSC firefighting (United States)


    STS-46 Atlantis, Orbiter Vehicle (OV) 104, Italian Payload Specialist Franco Malerba shoots fire extinguisher spray at the base of a blazing fire during fire fighting and fire training exercises at JSC's Fire Training Pit located across from the Gilruth Center Bldg 207. Behind Malerba are the fire fighting training instructor, firemen, and European Space Agency (ESA) Mission Specialist (MS) Claude Nicollier, holding a camcorder.

  10. Team leadership in the intensive care unit: the perspective of specialists. (United States)

    Reader, Tom W; Flin, Rhona; Cuthbertson, Brian H


    To identify the behaviors senior physicians (e.g., specialists, staff attendings) report using to lead multidisciplinary teams in the intensive care unit. Semistructured interviews focusing on team leadership, crisis management, and development of an environment that enable effective team performance in the intensive care unit. Seven general intensive care units based in National Health Service hospitals in the United Kingdom. Twenty-five senior intensive care medicine physicians. Responses to a semistructured interview were transcribed and subjected to "content" analysis. The interview analysis focused on references to the "functional" behaviors used by leaders to manage team performance and the "team development behaviors" used to build the conditions that enable effective team performance. Seven of the interviews were coded by a second psychologist to measure inter-rater reliability. Inter-rater reliability (Cohen's κ) was acceptable for both scales (κ = 0.72 and κ = 0.75). In total, 702 functional leadership behaviors (behaviors for information gathering, planning and decision-making, managing team members) were coded as being used to manage the intensive care unit, along with 216 team development behaviors (for providing team direction and establishing team norms). These behaviors were grouped together in a theoretically driven framework of intensive care unit team leadership. Intensive care unit senior physicians report using a variety of leadership behaviors to ensure high levels of team performance. The data described in this study provide insight into the team leadership behaviors used by intensive care unit team leaders and have implications for the development of team leadership training and assessment tools.

  11. Technical Training for National Simulator Evaluation Specialist (United States)


    Report No. 2. Government Accession No. 3. Recipiont’s Catalog No. DOT/FM/CT- TN9 2/14 4. T,tle and,,le 5. Report Date June 1992 TECHNICAL TRAINING... access to the Plato CBI System. Plato is the registered trademark for the Control Data System of Computer Based Education Development and Delivery...Single. ing date of the course (December 27 or Instructional program - 6:30 am-S pm 575 double. includes, daily transportaion to later) are subject to a

  12. Senior Program Specialist | IDRC - International Development ...

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

    Under the guidance of the Program Leader, and the Director Program Area: develops a detailed workplan for the CRVS Initiative in consultation with Global Financing Facility (GFF) and key stakeholders;; identifies and assesses proposals, including conceptual, methodological, operational, evaluative, and financial aspects, ...

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

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

    Participates in joint infrastructure/application development sessions by meetings with other analysts to identify, analyze, and document business requirements of ... Supervises the execution of project plans, testing procedures, project review documents, procurement documents, prototypes, proposals, statistics, reports and ...

  14. [Measuring residents' and specialists' laparoscopic technique with the MENTOR® training box]. (United States)

    Kakucs, Tímea; Lukovich, Péter; Dobó, Noémi; Benkő, Péter; Harsányi, László


    Operating room is not the ideal place to acquire laparoscopic skills since patients can be put at risk and it is also relatively expensive. Using training boxes seems to be a more appropriate way of teaching and learning the technique, but there is little data about measuring the technique of experienced specialists and comparing their results with residents. At the 1st Department of Surgery, Semmelweis University we tested 30 residents and 25 specialists in general surgery and urology on MENTOR® training box. Before training, all participants completed a questionnaire on professional experience, previous usage of training boxes, virtual simulators, and video games, and whether they played a musical instrument earlier. Subjects were asked to complete in a defined time limit 3 of the Fundamentals of Laparoscopic Surgery tasks (which is required for American surgical residents for surgical board examination), and 3 tasks decided by us. Linear regression analysis (ANOVA table) was used to evaluate the data. 16% of the specialists and 6.66% of the residents completed all tasks within time limit. Statistically significant correlation (p learning instrument handling. Nonetheless, residents acquire most of their laparoscopic surgical skills on patients in Hungary, yet. For this reason there is a need for organized training opportunities.

  15. General medical training in gastroenterology: views from specialist trainees on the challenges of dual accreditation. (United States)

    Neale, James R; Basford, Peter J


    Higher specialist training in general internal medicine (GIM) and the medical specialties has been subject to many changes and increasing subspecialisation in recent years. The 'Shape of Training' review proposes 'broad-based specialty training', shortening of training by one year, and subspecialisation to be undertaken after the certificate of specialty training is obtained. All higher level gastroenterology trainees based in the UK were invited to complete an online survey between July and September 2012 to assess their experience of gastroenterology and GIM training. Overall, 72.7% of trainees expressed satisfaction with their training in gastroenterology but significantly fewer (43.5%) expressed satisfaction with their training in GIM. Satisfaction with gastroenterology training thus is good, but satisfaction with GIM training is lower and levels of dissatisfaction have increased significantly since 2008. Up to 50% of trainees are not achieving the minimum recommended number of colonoscopy procedures for their stage of training. Experience in GIM is seen as service orientated, with a lack of training opportunities. There is a worrying difficulty in gaining the minimum required experience in endoscopy. If the length of specialist training is shortened and generalised, training in key core specialist skills such as endoscopy may be compromised further. © 2015 Royal College of Physicians.

  16. The Benefits of Deploying Health Physics Specialists to Joint Operation Areas. (United States)

    Mower, Scott; Bast, Joshua D; Myers, Margaret


    Preventive Medicine Specialists (military occupational specialty [MOS] 68S) with the health physics specialist (N4) qualification identifier possess a unique force health protection skill set. In garrison, they ensure radiation exposures to patients, occupational workers and the public from hospital activities such as radioisotope therapy and x-ray machines do not to exceed Federal law limits and kept as low as reasonably achievable. Maintaining sufficient numbers of health physics specialists (HPSs) to fill authorizations has been a consistent struggle for the Army Medical Department due to the rigorous academic requirements of the additional skill identifier-producing program. This shortage has limited MOS 68SN4 deployment opportunities in the past and prevented medical planners from recognizing the capabilities these Soldiers can bring to the fight. In 2014, for the first time, HPSs were sourced to deploy as an augmentation capability to the 172nd Preventive Medicine Detachment (PM Det), the sole PM Det supporting the Combined Joint Operations Area-Afghanistan. Considerable successes in bettering radiation safety practices and improvements in incident and accident response were achieved as a result of their deployment. The purposes of this article are to describe the mission services performed by HPSs in Afghanistan, discuss the benefits of deploying HPSs with PM Dets, and demonstrate to senior medical leadership the importance of maintaining a health physics capability in a theater environment.

  17. Problems of medical ethics from the view points of the specialist physicians in Qom

    Directory of Open Access Journals (Sweden)

    Seyyed Hassan Adeli


    Full Text Available Background and Objectives: Medical ethics has a long history worldwide; although it is a new scientific discipline. Also, it is not just for a specific single group or discipline in a treatment team; it is the entire medical community who benefits from it. Given the importance of this issue, this study examined the viewpoints of the specialist physicians in Qom province on the most common issues in medical ethics, with the hope to take a step forward through identifying common problems and solving them. Methods: This descriptive study used the Delphi Method in which the views of the specialist physicians on the medical ethics were analyzed through two questionnaires. The first questionnaire contained some open questions, and the second one was designed to rank and rate the titles of medical ethics problems in terms of their prevalence. Results: The most common problems in medical ethics derived from the first questionnaire based on the order of priority were: secrecy, doctor-patient relationship, justice, telling the truth, privacy, informed consent, relationship with colleagues, patient's participation in treatment methods, dealing with improper treatment and interaction between the physician and treatment authorities. Conclusion: By identifying the common and more important problems based on the viewpoints of the specialist physicians in Qom province, it seems necessary to pay more attention on training in order to solve these problems.

  18. Knowledge of behavioural management principles amongst specialist paediatric dental practitioners in the United Kingdom. (United States)

    Coxon, James; Hosey, Marie Therese; Newton, J Tim


    Paediatric specialist dental practitioners are often faced with the challenge of disruptive behaviour or refusal to comply with treatment. Behaviour management skills are an essential component of their role. However, little is known of the confidence or competence of practitioners in these approaches. To identify paediatric dentists' knowledge of behavioural management principles as applied to paediatric dentistry. Postal questionnaire survey of all specialists in Paediatric Dentistry on the General Dental Council UK register (n = 234), using the Knowledge of Behavioural Principles as Applied to Children Questionnaire (KBPACQ; O'Dell, 1979) adapted for the dental setting. Information was also gathered on experience in using behavioural management techniques and demographics. Responses were received from 105 practitioners (45%). Participants gave the correct answer, on average, to 38% of the items (range 0 to 75%). Knowledge of behavioural principles amongst paediatric dentists in the United Kingdom is poor, despite their widespread reported use of such techniques.

  19. Experiences of problem-based learning: issues for community specialist practitioner students. (United States)

    Carey, Lynda; Whittaker, Karen A


    In this paper, the findings from a descriptive study exploring community practitioner students' experiences of Problem-Based Learning are presented. The study was completed as part of an extended evaluation of a core module included in a post-registration community specialist practitioner programme. Data were collected via a self-completion questionnaire. The findings identify issues relating to the learning process and its influence on the knowledge gained. They illustrate that whilst the journey taken to acquire new knowledge had been difficult for students, they had benefited from the opportunity to learn with others. The findings from this small survey are discussed in conjunction with experiential learning theory and the particular needs of students being prepared for specialist practitioner roles in the community setting where collaborative practices are increasingly understood as essential for quality care.

  20. A survey on regenerative surgery performed by Swiss specialists in periodontology with special emphasis on the application of enamel matrix derivatives in infrabony defects. (United States)

    Schröen, Ola; Sahrmann, Philipp; Roos, Malgorzata; Attin, Thomas; Schmidlin, Patrick R


    This survey aimed to evaluate the common practice of regenerative periodontal surgery with special regard to the use of enamel matrix derivatives (EMD, Emdogain® ) by board-certified specialists in periodontology and non-certified, but active members of the Swiss Society of Periodontology (SSP). A cross-sectional postal survey of 533 dentists, representing all members of the SSP practising in Switzerland, was conducted. The questionnaire consisted of three sections, assessing: 1) general personal information regarding the practice setting and education, 2) general questions regarding periodontal surgery practices and 3) specific questions regarding the use of EMD. The information obtained was compared and differences between specialists and non-specialists were calculated. P-values smaller than 5% were considered significant. Sixty-nine percent of the specialists answered the questionnaire, compared to only 37.4% of the non-specialists (overall: 42.4%). In general, specialists performed surgeries more frequently, and presented a significantly higher percentage of EMD users than the non-specialists. The application guidelines were followed in general. Some differences were observed in application and selection criteria. The subjective perception of clinical success varied greatly among clinicians. Residual pockets were reported to be present in approximately one third of the defects after therapy. In conclusion, this survey revealed that EMD was used on a regular basis by dentists performing periodontal therapy. In addition, the answers by both groups generally corresponded well with the current available literature.

  1. Understanding practice patterns of glaucoma sub-specialists in India (United States)

    Choudhari, Nikhil S.; Pathak-Ray, Vanita; Kaushik, Sushmita; Vyas, Prateep; George, Ronnie


    AIM To obtain information on the prevailing practice patterns of glaucoma specialists in India. METHODS Glaucoma specialists attending the Annual Conference of the Glaucoma Society of India (GSI) were surveyed. This survey, conducted in 2013, was based on an interactive audience response system. RESULTS The information was obtained from 146 glaucoma specialists. Approximately half (n=83; 57%) had ≥10y of experience in managing glaucoma and were in institutional practice (n=74, 51%). Goldmann applanation tonometry was preferred by 103 (72%) specialists whilst n=25 (17.4%) used non-contact tonometer. Indentation gonioscopy was favoured by two-thirds (n=90, 66%) whereas stereoscopic optic disc examination and visual fields using Humphrey perimeter was performed by a majority of the specialists surveyed (n=115, 86% and n=114; 83% respectively). Nearly three quarter specialists (n=96; 72%) preferred optical coherence tomography for imaging. The primary choice for treatment of angle closure disease and primary open angle glaucoma was laser (iridotomy, n=117; 93%) and medical management (prostaglandin analogue, n=104; 78%), respectively. Approximately only a third of the specialists surveyed (n=37; 28%) were performing both trabeculectomy and implantation of a glaucoma drainage device and about half (n=64; 47%) were not operating on congenital glaucoma at all. CONCLUSION This survey has found conformance with preferred practice patterns in several areas of diagnosis and management of glaucoma, but there was diversity in a few areas. The information is a significant step towards improvement of glaucoma care in India, including planning for future strategies. PMID:29062779

  2. Identifying Foods causing Allergies/ Intolerances among Diabetic ...

    African Journals Online (AJOL)

    Objective: This study was designed to identify the foods that caused allergies / intolerances and symptoms of reaction experienced by diabetic patients attending State Specialist Hospital, Akure. Materials and Methods: Ninety-eight diabetics aged 30-80 years (30 males and 68 females) were included in the study.

  3. Eating disorders in the context of preconception care: fertility specialists' knowledge, attitudes, and clinical practices. (United States)

    Rodino, Iolanda S; Byrne, Susan M; Sanders, Katherine A


    To gauge fertility specialists' knowledge, clinical practices, and training needs in regard to eating disorders. Cross-sectional study. Fertility clinics. Eighty Australian and New Zealand fertility specialists who were members of the Fertility Society of Australia. None. Responses to an anonymously completed online questionnaire. Approximately 54% of doctors correctly identified the body mass index relevant to anorexia nervosa, and 30% identified menstrual disturbances for anorexia, while 63.8% of doctors incorrectly nominated maladaptive weight control behaviors as a characteristic of binge eating disorder. While clinicians (83.7%) agreed it was important to screen for eating disorders during preconception assessments, 35% routinely screened for eating disorders and 8.8% indicated that their clinics had clinical practice guidelines for management of eating disorders. A minority of participants (13.8%) felt satisfied with their level of university training in eating disorders, 37.5% of doctors felt confident in their ability to recognize symptoms of an eating disorder, and 96.2% indicated a need for further education and clinical guidelines. On most items examined, knowledge and clinical practices regarding eating disorders did not differ according to doctor gender or years of clinical experience working as a fertility specialist. Knowledge about eating disorders in the context of fertility treatment is important. This study highlights the uncertainty among fertility specialists in detecting features of eating disorders. The findings point to the importance of further education and training, including the development of clinical guidelines specific to fertility health care providers. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  4. Education and training module for a specialist registrar: a move forward in specialist registrar education. (United States)

    White, A; Tuckey, J; Crane, S


    A new post was created in Portsmouth. This produced the opportunity, for a new and innovative approach to the education and training module for the specialist registrar (SpR) training programme. The GP tutor with supervision from the university, designed, implemented and evaluated the module. It took place during the first five months of the SpR contract. The method used was a case study in which the SpR was encouraged to reflect on practice. The learning outcomes were documented initially by the GP tutor and,finally, by the SpR using a logbook based on the dental professional development log. Reflecting on practice enabled the SpR to produce the evidence of her own learning and plan her future learning needs. The project highlights the advantages and problems of reflecting on practice. These issues must be addressed if the conflict between the need to produce the competent doctor and the demands of an educationally sound programme are to be resolved, to create critical thinking and autonomous lifelong, self-directed learners.

  5. An introduction to implementation science for the non-specialist. (United States)

    Bauer, Mark S; Damschroder, Laura; Hagedorn, Hildi; Smith, Jeffrey; Kilbourne, Amy M


    The movement of evidence-based practices (EBPs) into routine clinical usage is not spontaneous, but requires focused efforts. The field of implementation science has developed to facilitate the spread of EBPs, including both psychosocial and medical interventions for mental and physical health concerns. The authors aim to introduce implementation science principles to non-specialist investigators, administrators, and policymakers seeking to become familiar with this emerging field. This introduction is based on published literature and the authors' experience as researchers in the field, as well as extensive service as implementation science grant reviewers. Implementation science is "the scientific study of methods to promote the systematic uptake of research findings and other EBPs into routine practice, and, hence, to improve the quality and effectiveness of health services." Implementation science is distinct from, but shares characteristics with, both quality improvement and dissemination methods. Implementation studies can be either assess naturalistic variability or measure change in response to planned intervention. Implementation studies typically employ mixed quantitative-qualitative designs, identifying factors that impact uptake across multiple levels, including patient, provider, clinic, facility, organization, and often the broader community and policy environment. Accordingly, implementation science requires a solid grounding in theory and the involvement of trans-disciplinary research teams. The business case for implementation science is clear: As healthcare systems work under increasingly dynamic and resource-constrained conditions, evidence-based strategies are essential in order to ensure that research investments maximize healthcare value and improve public health. Implementation science plays a critical role in supporting these efforts.

  6. Strategic marketing: an introduction for medical specialists. (United States)

    Lexa, Frank James; Berlin, Jonathan


    Marketing and branding are 2 of the most important factors for business success in the United States. They are particularly critical in service industries such as diagnostic imaging. However, in spite of their strategic importance in radiology success, a search of the peer-reviewed radiology literature reveals a paucity of published work that addresses marketing for imaging practices. In particular, there is a dearth of literature addressing the role (both direct and indirect) of radiologists in marketing efforts. In this article, the authors attempt to identify and correct some common misconceptions that physicians and other scientific and technical professionals have about marketing. Basic terms and preliminary concepts are introduced to provide a foundational understanding of the topic, allowing the interested reader to move forward and explore these critical issues in greater depth.


    Directory of Open Access Journals (Sweden)

    N. Benkovska


    Full Text Available Today there is an urgent need for reform in education. In particular those educational fields are need to reform that train specialists to build an effective economic system of the country, including the banking system. Thus, there is a need to study the effectiveness of implementation of pedagogical conditions of formation of professional qualities of future specialists of Banking and identify the priority areas of development of relevant education field. Considering on the specificity of training banking specialists, the focus of research is to determine the role of ICT both in future work and in preparing students for future professional activity. Thus, on the efficiency of formation of professional qualities of future banking specialists in the course of their professional training will have a positive impact such educational facilities as updating interdisciplinary integration of professional disciplines, activation of interactive learning tools for students and simulation of special learning situations aimed to awareness of the importance of competencies to carry out the professional activities. The implementation of pedagogical conditions of formation of professional qualities of future banking specialists will provide the stable positive dynamics of formation of professional qualities of future banking.

  8. An analysis of specialist surgeons and their practices

    Directory of Open Access Journals (Sweden)

    Steve Koch


    Full Text Available A purposive sample of South African specialist doctors provided data for an empirical analysis of revenues, costs and earnings associated with specialist surgical medicine. The empirical analysis includes both parametric and nonparametric regression. Parametric estimates of revenues per new patient range between R689 to R818, while cost per new patient estimates range between R694 and R749; average surgeon income per new patient falls within a similar range.  Furthermore, costs per surgery follow a cubic specification, implying increasing marginal costs at the practice level. Returns to experience are estimated to be quadratic, although imprecisely so, given limited observations. Due to the low response rate in the survey, there is a need to conduct further research into this topic, to provide better information to both specialists and the South African Department of Health, which sets pay packages for public sector health workers.

  9. Integrating HCI Specialists into Open Source Software Development Projects (United States)

    Hedberg, Henrik; Iivari, Netta

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

  10. Evaluation of Leadership Practice of Vilnius Public Health Specialists


    Rašimaitė, Brigita


    Darbo tikslas – įvertinti Vilniaus miesto visuomenės sveikatos specialistų lyderystės raišką. Uždaviniai: 1. Įvertinti Vilniaus mieste dirbančių visuomenės sveikatos specialistų nuomonę apie lyderystę. 2. Nustatyti kokiais lyderiams būdingais elgsenos bruožais labiausiai pasižymi Vilniaus mieste dirbantys visuomenės sveikatos specialistai. 3. Nustatyti Vilniaus mieste dirbančių visuomenės sveikatos specialistų asmeninės lyderystės įvaldymo lygį. 4. Įvertinti Vilniaus mieste dir...

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

    Directory of Open Access Journals (Sweden)

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


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

  12. Adult patients' experiences of NHS specialist services for chronic fatigue syndrome (CFS/ME): a qualitative study in England. (United States)

    Broughton, Jessica; Harris, Sarah; Beasant, Lucy; Crawley, Esther; Collin, Simon M


    Few studies have explored patients' experiences of treatment for CFS/ME. This study aims to fill this gap by capturing the perspective of patients who have been treated by NHS specialist CFS/ME services in England. Semi-structured interviews were conducted during the period June-September 2014 with 16 adults who were completing treatment at one of three outpatient NHS specialist CFS/ME services. Interviews were analysed thematically using constant comparison techniques, with particular attention paid to contrasting views. Three themes were identified: 'Journey to specialist services'; 'Things that help or hinder treatment'; and 'Support systems'. Within these themes nine sub-themes were identified. A wide range of factors was evident in forming participants' experiences, including personal characteristics such as perseverance and optimism, and service factors such as flexibility and positive, supportive relationships with clinicians. Participants described how specialist services played a unique role, which was related to the contested nature of the condition. Many participants had experienced a lack of validation and medical and social support before attending a specialist service. Patients' experiences of life before referral, and the concerns that they expressed about being discharged, highlighted the hardship and obstacles which people living with CFS/ME continue to experience in our society. The experiences of CFS/ME patients in our study showed that NHS specialist CFS/ME services played a vital role in patients' journeys towards an improved quality of life. This improvement came about through a process which included validation of patients' experiences, acceptance of change, practical advice and support, and therapeutic outcomes.

  13. A novel statistical method for classifying habitat generalists and specialists. (United States)

    Chazdon, Robin L; Chao, Anne; Colwell, Robert K; Lin, Shang-Yi; Norden, Natalia; Letcher, Susan G; Clark, David B; Finegan, Bryan; Arroyo, J Pablo


    We develop a novel statistical approach for classifying generalists and specialists in two distinct habitats. Using a multinomial model based on estimated species relative abundance in two habitats, our method minimizes bias due to differences in sampling intensities between two habitat types as well as bias due to insufficient sampling within each habitat. The method permits a robust statistical classification of habitat specialists and generalists, without excluding rare species a priori. Based on a user-defined specialization threshold, the model classifies species into one of four groups: (1) generalist; (2) habitat A specialist; (3) habitat B specialist; and (4) too rare to classify with confidence. We illustrate our multinomial classification method using two contrasting data sets: (1) bird abundance in woodland and heath habitats in southeastern Australia and (2) tree abundance in second-growth (SG) and old-growth (OG) rain forests in the Caribbean lowlands of northeastern Costa Rica. We evaluate the multinomial model in detail for the tree data set. Our results for birds were highly concordant with a previous nonstatistical classification, but our method classified a higher fraction (57.7%) of bird species with statistical confidence. Based on a conservative specialization threshold and adjustment for multiple comparisons, 64.4% of tree species in the full sample were too rare to classify with confidence. Among the species classified, OG specialists constituted the largest class (40.6%), followed by generalist tree species (36.7%) and SG specialists (22.7%). The multinomial model was more sensitive than indicator value analysis or abundance-based phi coefficient indices in detecting habitat specialists and also detects generalists statistically. Classification of specialists and generalists based on rarefied subsamples was highly consistent with classification based on the full sample, even for sampling percentages as low as 20%. Major advantages of the new

  14. Evolution of the perioperative clinical nurse specialist role. (United States)

    Morrison, J D


    Perioperative nursing roles continue to rapidly change as we enter the twenty-first century. The need for strong leadership skills, expert clinical skills, creative management, ongoing continuing education, and research continues to grow in every department of surgical services. The clinical nurse specialist plays an important role in addressing each of these needs. Great opportunities exist within the field of nursing for perioperative nurses to expand their practice using their creativity, ideas, and skills. Using the clinical nurse specialist in the perioperative setting can foster creativity, stimulate development of new methods based on research, and maximize the delivery of high quality care by the entire OR staff.

  15. The Economic Cost of Patients With Migraine Headache Referred to Specialist Clinics. (United States)

    Osumili, Beatrice; McCrone, Paul; Cousins, Sian; Ridsdale, Leone


    To conduct a cost of illness study to estimate the economic impact of referring people with headache to specialists. Headache is one of the commonest health conditions affecting individuals in society. Participants formed a convenience sample and were recruited from specialist headache clinics across London. Self-report data on service use over a 4-month period and lost employment were provided. These data were used to estimate economic costs. Predictors of cost were identified using multivariate analyses. The mean (standard deviation) service costs for the 4-month period was £857 (£845). The mean total cost (including lost employment) was £6588 (£11,982) with costs of informal care accounting for 74% of this figure. Total costs were on average £1079 higher for a unit increase on the headache impact test scale (P < .001; 95% CI £330 to £1784). Costs of headache are high, and increase with severity of symptoms. The annual cost to the country for those referred to specialists is estimated at £835 million. © 2017 American Headache Society.

  16. Selection mosaic exerted by specialist and generalist herbivores on chemical and physical defense of Datura stramonium.

    Directory of Open Access Journals (Sweden)

    Guillermo Castillo

    Full Text Available Selection exerted by herbivores is a major force driving the evolution of plant defensive characters such as leaf trichomes or secondary metabolites. However, plant defense expression is highly variable among populations and identifying the sources of this variation remains a major challenge. Plant populations are often distributed across broad geographic ranges and are exposed to different herbivore communities, ranging from generalists (that feed on diverse plant species to specialists (that feed on a restricted group of plants. We studied eight populations of the plant Datura stramonium usually eaten by specialist or generalist herbivores, in order to examine whether the pattern of phenotypic selection on secondary compounds (atropine and scopolamine and a physical defense (trichome density can explain geographic variation in these traits. Following co-evolutionary theory, we evaluated whether a more derived alkaloid (scopolamine confers higher fitness benefits than its precursor (atropine, and whether this effect differs between specialist and generalist herbivores. Our results showed consistent directional selection in almost all populations and herbivores to reduce the concentration of atropine. The most derived alkaloid (scopolamine was favored in only one of the populations, which is dominated by a generalist herbivore. In general, the patterns of selection support the existence of a selection mosaic and accounts for the positive correlation observed between atropine concentration and plant damage by herbivores recorded in previous studies.

  17. Selection mosaic exerted by specialist and generalist herbivores on chemical and physical defense of Datura stramonium. (United States)

    Castillo, Guillermo; Cruz, Laura L; Tapia-López, Rosalinda; Olmedo-Vicente, Erika; Olmedo-Vicente, Eika; Carmona, Diego; Anaya-Lang, Ana Luisa; Fornoni, Juan; Andraca-Gómez, Guadalupe; Valverde, Pedro L; Núñez-Farfán, Juan


    Selection exerted by herbivores is a major force driving the evolution of plant defensive characters such as leaf trichomes or secondary metabolites. However, plant defense expression is highly variable among populations and identifying the sources of this variation remains a major challenge. Plant populations are often distributed across broad geographic ranges and are exposed to different herbivore communities, ranging from generalists (that feed on diverse plant species) to specialists (that feed on a restricted group of plants). We studied eight populations of the plant Datura stramonium usually eaten by specialist or generalist herbivores, in order to examine whether the pattern of phenotypic selection on secondary compounds (atropine and scopolamine) and a physical defense (trichome density) can explain geographic variation in these traits. Following co-evolutionary theory, we evaluated whether a more derived alkaloid (scopolamine) confers higher fitness benefits than its precursor (atropine), and whether this effect differs between specialist and generalist herbivores. Our results showed consistent directional selection in almost all populations and herbivores to reduce the concentration of atropine. The most derived alkaloid (scopolamine) was favored in only one of the populations, which is dominated by a generalist herbivore. In general, the patterns of selection support the existence of a selection mosaic and accounts for the positive correlation observed between atropine concentration and plant damage by herbivores recorded in previous studies.

  18. The experiences, coping mechanisms, and impact of death and dying on palliative medicine specialists. (United States)

    Zambrano, Sofia C; Chur-Hansen, Anna; Crawford, Gregory B


    Research on the experiences, coping mechanisms, and impact of death and dying on the lives of palliative medicine specialists is limited. Most research focuses on the multidisciplinary team or on nurses who work with the dying. Fewer studies consider medical professionals trained in palliative medicine. This study aimed to explore the experiences, coping mechanisms, and impact of death and dying on palliative medicine specialists when dealing with their patients at the end of life. A qualitative research approach guided the study, one-on-one interview data were analyzed thematically. A purposeful sampling technique was employed for participant recruitment. Seven palliative medicine specialists practicing in one city participated in open-ended, in-depth interviews. The analysis of participants' accounts identified three distinct themes. These were Being with the dying, Being affected by death, and dying and Adjusting to the impact of death and dying. This study further contributes to the understanding of the impact of death and dying on professionals who care for dying patients and their families. Despite the stressors and the potential for burnout and compassion fatigue, these participants employed strategies that enhanced meaning-making and emphasized the rewards of their work. However, the consequences of work stressors cannot be underestimated in the practice of palliative care.


    Directory of Open Access Journals (Sweden)

    Irina N Emelyanova


    Full Text Available The article examines the new guidelines and priorities for modelling specialists’ training in the field of upbringing in the context of the new professional standard.Research method - content analysis for the professional standard “Specialist in the field of upbringing”. The content analysis was carried out according to the types of activities that are identified in the federal state educational standards of the pedagogical direction: pedagogical, project, cultural and educational, research, methodical, and managerial activity. The study revealed a priority of pedagogical, methodological, and managerial contents for training specialists in the field of upbringing. Socio-cultural content lags behind, scientific research content is reduced to zero.Polemical issues: “What does the emergence of new spheres of activities ‘expert in the field of social upbringing’ give us? To what degree professional and educational standards should be identical?” are considered. The need for professional training model to focus not only on the priority content outlined in the professional standards is proved. It is necessary to set cultural and developmental tasks.The model for socio-pedagogical training of a specialist in the field of social upbringing is offered on the example of the master’s level “Methodology and methods of social upbringing” educational program implemented at the Tyumen State University. A general conclusion is drawn on the need to establish a new educational policy in the field of social pedagogical training.

  20. Ensemble modeling to predict habitat suitability for a large-scale disturbance specialist (United States)

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


    To conserve habitat for disturbance specialist species, ecologists must identify where individuals will likely settle in newly disturbed areas. Habitat suitability models can predict which sites at new disturbances will most likely attract specialists. Without validation data from newly disturbed areas, however, the best approach for maximizing predictive accuracy can be unclear (Northwestern U.S.A.). We predicted habitat suitability for nesting Black-backed Woodpeckers (Picoides arcticus; a burned-forest specialist) at 20 recently (≤6 years postwildfire) burned locations in Montana using models calibrated with data from three locations in Washington, Oregon, and Idaho. We developed 8 models using three techniques (weighted logistic regression, Maxent, and Mahalanobis D2 models) and various combinations of four environmental variables describing burn severity, the north–south orientation of topographic slope, and prefire canopy cover. After translating model predictions into binary classifications (0 = low suitability to unsuitable, 1 = high to moderate suitability), we compiled “ensemble predictions,” consisting of the number of models (0–8) predicting any given site as highly suitable. The suitability status for 40% of the area burned by eastside Montana wildfires was consistent across models and therefore robust to uncertainty in the relative accuracy of particular models and in alternative ecological hypotheses they described. Ensemble predictions exhibited two desirable properties: (1) a positive relationship with apparent rates of nest occurrence at calibration locations and (2) declining model agreement outside surveyed environments consistent with our reduced confidence in novel (i.e., “no-analogue”) environments. Areas of disagreement among models suggested where future surveys could help validate and refine models for an improved understanding of Black-backed Woodpecker nesting habitat relationships. Ensemble predictions presented here can

  1. Coal industry needs more specialists with higher education levels and a better distribution of specialists within state-owned enterprises

    Energy Technology Data Exchange (ETDEWEB)

    Kolev, K.; Pavlov, D. (Asotsiatsiya Energetika (Bulgaria))


    Discusses availability of highly qualified manpower in Bulgarian coal mines in March 1988, when there were 1,231 employees with higher education - 1,146 as managers or supervisors, 85 as executives. Of the first group, 364 worked in management, 540 in basic production and 242 in auxiliary departments of combines. Analysis shows that their professional experience, academic background, knowledge and post-graduate education do not correspond to the requirements of coal mines. Only the VMGI and VMEI institutes train highly qualified coal mining specialists. In 1987 and 1988, they produced 273 mining and 253 electrical engineers, of whom only 43 started work in coal mines in 1987 as this branch may only employ 2.4 specialists per 100 workers. Bulgaria suffers from a lack of technicians and highly qualified specialists, particularly in electro-technical and electronic fields. For this reason, utilization and maintenance of mining equipment is unsatisfactory.


    Directory of Open Access Journals (Sweden)

    Irina Aleksandrovnа Levitskaya


    Full Text Available Formation of professional and personal qualities of future specialists is one of the main tasks of professional education. Institutional transformation of social relations is the foundation of innovative professional training of qualified personnel in the national economy. Professional training and organization of educational activities in modern socio-cultural realities is a process of the formation of professional and personal qualities and the formation of a value-semantic relationship to the socio-cultural space. The forms of work aimed at the formation of professional and personal qualities of future engineers on the example of a technical university are considered. It is established that the actualization of the formation of professional and personal qualities is ensured by the involvement of the subjects of the educational process in active cognitive activity, the joint solution of social problems, the development of the subject potential of future specialists, the development of various social roles. The possibilities of this approach for analyzing the peculiarities and problems of the formation of a professional-personal position are shown.

  3. What is "good reasoning" about global warming? A comparison of high school students and specialists (United States)

    Adams, Stephen Thomas

    This study compares the knowledge and reasoning about global warming of 10 twelfth grade students and 6 specialists, including scientists and policy analysts. The study uses global warming as a context for addressing the broad objective of formulating goals for scientific literacy. Subjects evaluated a set of articles about global warming and evaluated policies proposed to ameliorate global warming, including a gasoline tax and a "feebate" system of fees and rebates on automobiles. All students and one scientist participated in a full treatment involving interviews and activities with a computer program (discussed below), averaging about 3.75 hours. In addition, five specialists participated in interviews only, averaging one hour. One line of analysis focuses on knowledge content, examining how subjects applied perspectives from both natural and social sciences. This analysis is positioned as an empirical component to the movement to develop content standards for science education, as exemplified by the recommendations of Science for All Americans (SFAA). Some aspects of competent performance in the present study hinged upon knowledge and skills advocated by SFAA (e.g., fluency with themes of science such as scale). Other aspects involved such skills as evaluating economic interests behind a scientific argument in the media or considering hidden costs in a policy area. By characterizing a range of approaches to how students and specialists performed the experimental tasks, the present study affords a view of scientific literacy not possible without this type of information. Another line of analysis investigates a measure of coherent argumentation from a computer program, Convince Me, in relation to policy reasoning. The program is based on a connectionist model, ECHO. Subjects used the program to create arguments about the aforementioned policies. The study compares Convince Me's Model's Fit argumentation measure to other measures, including ratings of 6 human

  4. The role of the Diabetes Specialist Nurse | Cable | South Sudan ...

    African Journals Online (AJOL)

    There are two main types of diabetes: type 1 and type 2. Global statistics often do not differentiate between the two, therefore in this article the author refers to both types under the general term of 'diabetes'. There is, however, a greater emphasis placed upon type 2. Keywords: Role, Diabetes, Specialist, Nurse, DSN ...

  5. Evaluation of specialist referrals at a rural health care clinic. (United States)

    Biggerstaff, Mary Ellen; Short, Nancy


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

  6. Refrigeration and Cryogenics Specialist. J3ABR54530 (United States)

    Air Force Training Command, Sheppard AFB, TX.

    This document package contains an Air Force course used to train refrigeration and cryogenics specialists. The course is organized in six blocks designed for group instruction. The blocks cover the following topics: electrical principles; fundamentals of tubing and piping; metering devices, motor controls, domestic and commercial refrigeration;…

  7. Computer Cache: ERIC and the Library Media Specialist. (United States)

    Lodish, Erica K.


    Description of how library media specialists can assist teachers and administrators in retrieving useful information by using ERIC highlights its organization, the types of materials available that are especially useful to classroom teachers, and ways that it can be accessed online. A list of ERIC Clearinghouses with addresses is included. (EM)

  8. Treatment policies among Israeli specialists in paediatric dentistry. (United States)

    Gordon, M; Gorfil, C; Segal, S; Mass, E


    This was to evaluate some suggested diagnostic procedures, treatment policies and professional attitudes of specialists in paediatric dentistry, in light of the periodically published guidelines by The American Academy of Pediatric Dentistry, The European Academy of Paediatric Dentistry and The British Society of Paediatric Dentistry. Using a structured questionnaire, 67% of the Israeli specialists in paediatric dentistry, who agreed to participate in this study, were personally interviewed. Only 7.5% of the participants reported that they carry out pulp capping of primary teeth in cases of pulp exposure. Over 50% reported restoring teeth after pulpotomy with preformed crowns. Most indicated sealing pit and fissures after considering depth and morphology of the fissures and correlation with the patient's risk to caries. Cleaning teeth after eruption of the first tooth was suggested by 75.5% of the participants. A striking majority (96%) claimed that they restored permanent anterior teeth with composite resins and most used these materials for occlusal restoration in both primary and permanent posterior teeth. Most specialists advocated the use of amalgam in proximal posterior restorations. The presence of a parent in the operatory/surgery was preferred by 85% of the dentists. Israeli specialists in paediatric dentistry mostly comply with the mentioned guidelines. Further studies of this nature should also be encouraged in other countries to emphasize the importance of monitoring compliance with established and evidence based guidelines.

  9. Specialist paediatric dentistry in Sweden 2008 - a 25-year perspective. (United States)

    Klingberg, Gunilla; Andersson-Wenckert, Ingrid; Grindefjord, Margaret; Lundin, Sven-Ake; Ridell, Karin; Tsilingaridis, Georgios; Ullbro, Christer


    International Journal of Paediatric Dentistry 2010; 20: 313-321 Background. Paediatric dentistry in Sweden has been surveyed four times over the past 25 years. During this period postgraduate training, dental health, and the organization of child dental care have changed considerably. Aim. To investigate services provided by specialists in paediatric dentistry in Sweden in 2008, and to compare with data from previous surveys. Design. The same questionnaire was sent to all 30 specialist paediatric dental clinics in Sweden that had been used in previous surveys. Comparisons were made with data from 1983, 1989, 1996 and 2003. Results. Despite an unchanged number of specialists (N = 81 in 2008), the number of referrals had increased by 16% since 2003 and by almost 50% since 1983. There was greater variation in reasons for referrals. The main reason was still dental anxiety/behaviour management problems in combination with dental treatment needs (27%), followed by medical conditions/disability (18%), and high caries activity (15%). The use of different techniques for conscious sedation as well as general anaesthesia had also increased. Conclusions. The referrals to paediatric dentistry continue to increase, leading to a heavy work load for the same number of specialists. Thus, the need for more paediatric dentists remains.

  10. School Library Media Specialists' Perceptions of Collaboration, Leadership and Technology (United States)

    Powell, Jozan M.


    School impact media studies indicate that a well-staffed and funded school library media program with a certified school library media specialist (SLMS) positively correlates with increased student achievement. SLMS must have a shared understanding of their roles and responsibilities to positively impact student success. In an effort to determine…

  11. Construction of Professional Identity in Novice Library Media Specialists (United States)

    Sandford, Deborah W.


    The roles of the person who works in a school library, as well as their title--librarian, teacher-librarian, library teacher, library media specialist, school librarian, library media teacher--have undergone countless revisions since the first official school libraries opened their doors in the early 1900s. Although school library media…

  12. Mentoring a New Library Media Specialist: A Model Relationship (United States)

    Creighton, Peggy Milam


    In this article, the author discusses her experiences mentoring new library media specialists for each of the past three years. She discusses the following topics: (1) What is a mentor?; (2) What exactly is the purpose of a mentor?; (3) Why mentor?; (4) What are the professional practices of a good mentor; (5) Building a professional toolbox; (6)…

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

    African Journals Online (AJOL)

    On the basis of the above, the teachers need to be trained so as to be fully aware of the role of school library media specialists in the school. Also, governments need to support the school administration in the area of funding particularly the funding of the school library media centre so as to meet the need of the students.

  14. Bursting with Potential: Mixing a Media Specialist's Palette (United States)

    Lamb, Annette


    School media specialists must be teachers, leaders, and advocates for reading, inquiry, and learning. Partnering with classroom teachers, they must design and implement curriculum and instruction that prepare young citizens for a life that requires thinking, inquiry, problem-solving and ethical behavior. These experiences provide the foundation…

  15. Sports in elementary school : Physical education specialists vs. group teachers

    NARCIS (Netherlands)

    dr. Remo Mombarg; Ben Moolenaar; Eralt Boers; Wouter de Groot


    The aim of the project is stimulating sport participation among elementary school children in the province of Friesland. The ultimate aim is to provide three hours of physical education, provided by an physical education specialist, plus two extra hours of sport activities. Part one is about

  16. Perioperative Clinical Nurse Specialist Role Delineation: A Systematic Review (United States)


    Nurs, 18(2), 138-143. Berger, A. M., Eilers, J. G., Heermann, J. A., Warren, J. J., Franco, T., & Triolo, P. K. State-of-the- art patient care: the...Nurse Spec, 5(1 ), 25-30. Cukr, P. L. Viva la difference! The nation needs both types of advanced practice nurses: clinical nurse specialists and nurse

  17. attitude of cleft care specialists in africa towards presurgical ...

    African Journals Online (AJOL)


    Dec 12, 2012 ... and Dentistry. In general, treatment protocol for patients with cleft lip and palate are pre-surgical orthopaedics, surgical repair of the lip , palate and specialist management of associated complications such as speech ,otology and dental anomalies. Pre- surgical ... facial aesthetics with minimal scar tissue .

  18. Use of professional profiles in applications for specialist training positions

    DEFF Research Database (Denmark)

    Lundh, Andreas; Skjelsager, Karen; Wildgaard, Kim


    The seven roles of the CanMEDS system have been implemented in Danish postgraduate medical training. For each medical specialty, a professional profile describes which elements of the seven roles the specialty deems important for applicants for a specialist training position. We investigated use...

  19. Professional Training of Specialists in International Marketing in Poland (United States)

    Zukowski, Wojciech


    Polish experience in training specialists in international marketing in the context of globalization and integration processes has been studied. A range of theoretical resources, namely Market Entry Strategy for Poland; the articles dedicated to international marketing and economy development (W. Grzegorczyk, M. Viachevskyi, M. Urbanetst); program…

  20. Payload specialist Al-Saud siting in middeck area (United States)


    Payload specialist Sultan Salman Abdelazize Al-Saud seated in a posture common to weightlessness as he logs notes in Discovery's middeck area. He has headphones on connected to a portable tape recorder. Behind him on the middeck lockers is a sign which reads 'Welcome to Riyadh'. On the other wall, a sleep restraint is attached to the lockers.

  1. Counselling Challenges and Strategies for Cochlear Implant Specialists (United States)

    English, Kris


    Cochlear implant specialists daily observe patients and families grapple with a wide range of emotions. As nonprofessional counsellors, we can help patients address those emotions by providing more opportunities to talk about their thoughts and feelings. This paper will review some familiar counselling challenges, such as the disappointment that…

  2. A report and sequelae of a specialist volunteer physician

    African Journals Online (AJOL)

    did ward rounds in the First Class and Professor Woodruff amenity wards .... care. • Lack of interdepartmental coordination: This particularly applied to the relationship between the public health programmes and hospital based clinical services. • Lack of ... registrar), registered nurses and specialists to ensure that there is a ...

  3. Training Peer Specialists in Cognitive Therapy Strategies for Recovery

    National Research Council Canada - National Science Library

    Cournos, Francine; Goldfinger, Stephen M; Perry, Yael; Murakami-Brundage, Jessica; Grant, Paul M; Beck, Aaron T


    ...-oriented cognitive therapy treatment milieu, we conducted a pilot program with certified peer specialists (CPSs) to provide them skills for working with individuals who have schizophrenia (consumers). Recovery-oriented cognitive therapy emphasizes individualized goal attainment: long-term goals are broken down into intermediate and short-term goals, and...

  4. Telemarketing. Curriculum Guides & Content Outlines for Telemarketing: Telemarketing Specialist. (United States)

    Shepard, Del

    This curriculum guide and content outline for the telemarketing specialist contains seven sections: (1) specialized telemarketing tasks; (2) telemarketing selling skills; (3) marketing tasks; (4) business-related tasks; (5) business-specific tasks; (6) personnel/human resources related; and (7) communications and minimum skill tasks. Each section…

  5. A Demographic Study of Certified Orientation and Mobility Specialists. (United States)

    Wiener, William R.; Siffermann, Eileen


    A survey of 217 AER-certified orientation and mobility specialists (COMSs) found the median annual income for full-time employed COMSs was $39,000. Of the respondents, 63.7 were women, 91.5 percent were white, and the median age was 43 years. The majority entering into the field had master's degrees. (Contains references.) (CR)

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

    African Journals Online (AJOL)

    Maternal Mortality At The State Specialist Hospital Bauchi, Northern Nigeria. ... The highest maternal death was in the adolescent mothers. The primigravidas had the ... communities providing important messages for a healthy pregnancy, and safe birth remain the bedrock of containing maternal mortality in our environment.

  7. Use of professional profiles in applications for specialist training positions

    DEFF Research Database (Denmark)

    Lundh, Andreas; Skjelsager, Karen; Wildgaard, Kim


    INTRODUCTION: The seven roles of the CanMEDS system have been implemented in Danish postgraduate medical training. For each medical specialty, a professional profile describes which elements of the seven roles the specialty deems important for applicants for a specialist training position. We inv...

  8. Specialisation and specialist education in prosthetic dentistry in Europe

    NARCIS (Netherlands)

    Owall, B.; Welfare, R.; Garefis, P.; Hedzelek, W.; Hobkirk, J.; Isidor, F.; Jerolimov, V.; Jokstad, A.; Kalk, W.; Kronstrom, M.; van der Kuij, P.; Mericske-Stern, R.; Naert, I.; Narhi, T.; Nilner, K.; Polyzois, G.; Setz, J.; User, A.; Zonnenberg, A.


    This presentation reports on the results of a meeting of prosthodontists from selected European countries. The aim of the meeting was to analyse and promote specialisation and specialist education in Prosthetic Dentistry in Europe. Representatives for Europe were selected from the European

  9. EDITORIAL Specialist Physicians (Family Medicine) in private practice

    African Journals Online (AJOL)

    fees with medical schemes. 3. The Academy should inform all its members of this development by communiqué, website and SAFP Journal article. The committee is to be tasked to formulate frameworks for the private practice of specialist physicians in family medicine. This to address: • Remuneration and engagement with ...

  10. Medical cost of Lassa fever treatment in Irrua Specialist Teaching ...

    African Journals Online (AJOL)

    This cross-sectional study sought to estimate the direct medical cost of Lassa fever treatment on patients in South-South Nigeria. All the 73 confirmed Lassa fever cases admitted in the isolation ward of the Institute Of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital (ISTH) Irrua, in Edo State, Nigeria, ...

  11. Science Specialists or Classroom Teachers: Who Should Teach Elementary Science? (United States)

    Levy, Abigail Jurist; Jia, Yueming; Marco-Bujosa, Lisa; Gess-Newsome, Julie; Pasquale, Marian


    This study examined science programs, instruction, and student outcomes at 30 elementary schools in a large, urban district in the northeast United States in an effort to understand whether there were meaningful differences in the quality, quantity and cost of science education when provided by a science specialist or a classroom teacher. Student…

  12. DOC questionnaire : measuring how GPs and medical specialists rate collaboration

    NARCIS (Netherlands)

    Berendsen, A.J.; Benneker, W.H.; Groenier, K.H.; Schuling, J.; Grol, R.P.; Meyboom-de Jong, B.


    PURPOSE: This paper aims to assess the validity of a questionnaire aimed at assessing how general practitioners (GPs) and specialists rate collaboration. DESIGN/METHODOLOGY/APPROACH: Primary data were collected in The Netherlands during March to September 2006. A cross-sectional study was conducted

  13. DOC questionnaire: measuring how GPs and medical specialists rate collaboration.

    NARCIS (Netherlands)

    Berendsen, A.J.; Benneker, W.H.; Groenier, K.H.; Schuling, J.; Grol, R.P.T.M.; Meyboom-de Jong, B.


    PURPOSE: This paper aims to assess the validity of a questionnaire aimed at assessing how general practitioners (GPs) and specialists rate collaboration. DESIGN/METHODOLOGY/APPROACH: Primary data were collected in The Netherlands during March to September 2006. A cross-sectional study was conducted

  14. Foursquare: A Health Education Specialist Checks-In--A Commentary (United States)

    Haithcox-Dennis, Melissa


    More and more, health education specialists are integrating technology into their work. Whereas most are familiar with social media sites like Facebook, Twitter and LinkedIn, one relatively new form of social media, location based services (LBS), may be less familiar. Developed in 2000, LBS are software applications that are accessible from a…

  15. A Phenomenological Study of Adult Non-Art Specialists

    African Journals Online (AJOL)

    This paper is based on a study of museum visitors' experience of paintings: in particular, the experience of adult non-art specialists. Phenomenology, a form of inquiry that seeks to articulate lived experience, provided the philosophical and methodological framework for the study. Descriptions and themes relating to the ...

  16. The Burden of Specialist Urologic Care in Abuja, Federal Capital ...

    African Journals Online (AJOL)

    The Burden of Specialist Urologic Care in Abuja, Federal Capital City, Nigeria: A Single Surgeons 4-Year Case Load. ... West African Journal of Medicine ... The mean ages for male children less than 1 year old was 6.9months and 3.1years for those older while the mean age the only 2 female children seen was 11years.

  17. Study Guide for Teacher Certification Test for Media Specialists. (United States)

    Smith, Jane Bandy

    This study guide is designed for individuals preparing to take the Georgia Teacher Certification Test (TCT) for media specialists. It provides two kinds of information--narratives and bibliographic references. Content objectives are covered for the areas of: (1) management and organization; (2) personnel administration; (3) instruction and…

  18. Flower visitation by generalists and specialists : Analysis of pollinator quality

    NARCIS (Netherlands)

    Kwak, MM; Velterop, O; Sommeijer, MJ; Francke, PJ


    Flowers of Scabiosa columbaria (Dipsacaceae) are visited by a large number of insect species, generalists and one specialist. Per population one insect species or group was dominant. Syrphids, bumblebee males and the day-active night moth Autographa gamma were the most numerous visitors in Dutch

  19. Music without a Music Specialist: A Primary School Story (United States)

    de Vries, Peter A.


    This case study focuses on generalist primary (elementary) school teachers teaching music in an Australian school. With the onus for teaching music moving away from the specialist music teacher to the generalist classroom teacher, this case study adds to a growing body of literature focusing on generalist primary school teachers and music…

  20. Virtual patients: an effective educational intervention to improve paediatric basic specialist trainee education in the management of suspected child abuse?

    LENUS (Irish Health Repository)

    McEvoy, M M


    Child abuse is a particularly difficult subject to teach at both undergraduate and postgraduate level. Most doctors are dissatisfied with their training in child abuse recognition and management. We developed an interactive video based Virtual Patient to provide formal training for paediatric Basic Specialist Trainees in the recognition of suspected child abuse. The Virtual Patient case revolves around the management of suspected physical abuse in a seven month old child, who initially presents to the Emergency Department with viral upper respiratory tract symptoms. This Virtual Patient was used to facilitate a case discussion with Basic Specialist Trainees. A questionnaire was developed to determine their perception of the value of the Virtual Patient as an educational tool. Twenty five Basic Specialist Trainees completed the questionnaire. Upon completion of the case, 23\\/25 (92%) participants reported greater self confidence in their ability to recognize cases of suspected child abuse and 24\\/25 (96%) of participants reported greater self confidence in their ability to report cases of suspected child abuse. Basic Specialist Trainees perceived the Virtual Patient to be a useful educational tool. Virtual Patients may have a role to play in enhancing postgraduate training in the recognition of suspected child abuse.

  1. How much does the specialist know about cardiogastroenterology? (United States)

    Aguilar-Nájera, O; Valdovinos-García, L R; Tepox-Padrón, A; Valdovinos-Díaz, M A


    Cardiovascular disease is a growing public health problem. Forty percent of the general population will suffer from the disease by 2030, consequently requiring antithrombotic therapy. Cardiogastroenterology is a new area of knowledge that evaluates the gastrointestinal effects and complications of antithrombotic therapy. Our aim was to evaluate, through a validated questionnaire, the knowledge held by a group of specialists and residents in the areas of gastroenterology and internal medicine, about pharmacology and drug prescription, as well as gastrointestinal risks and complications, in relation to antithrombotic therapy. A validated questionnaire composed of 30 items was applied to a group of specialists and residents in the areas of gastroenterology and internal medicine. The questions were on indications, pharmacology, evaluation of risks for gastrointestinal bleeding and thromboembolic events, and use of antithrombotic therapy during endoscopic procedures. Sufficient knowledge was defined as 18 or more (≥ 60%) correct answers. The questionnaire was answered by 194 physicians: 82 (42%) internal medicine residents and gastroenterology residents and 112 (58%) specialists. Only 40 (20.6%) of the participants had sufficient knowledge of cardiogastroenterology. Residents had a higher number of correct answers than specialists (53 vs. 36%, P<.0001). The gastroenterology residents had more correct answers than the internal medicine residents, gastroenterologists, and internists (70 vs. 53, 40, and 46%, respectively, P<.001). Only residents had sufficient knowledge regarding pharmacology and the use of antithrombotic therapy in endoscopy (P<.0001). All groups had insufficient knowledge in evaluating the risk for gastrointestinal bleeding and thrombosis. Knowledge of cardiogastroenterology was insufficient in the group of residents and specialists surveyed. There is a need for medical education programs on the appropriate use of antithrombotic therapy. Copyright

  2. Radiographic changes of the pelvis in Labrador and Golden Retrievers after juvenile pubic symphysiodesis: objective and subjective evaluation. (United States)

    Boiocchi, S; Vezzoni, L; Vezzoni, A; Bronzo, V; Rossi, F


    The hypothesis of this study was that juvenile pubic symphysiodesis (JPS) results in pelvic changes that can be identified radiographically in adult dogs. The medical records at the Clinica Veterinaria Vezzoni were searched for standard ventro-dorsal views of the pelvis of adult Labrador and Golden Retrievers that had undergone JPS or had not undergone surgery. The objective assessment of radiographs included the analysis of various pelvic measurements. Subjective evaluation of radiographs was undertaken by 18 specialists and 21 general practitioners and was based on five criteria relating to 1) the acetabular fossae, 2) the pubic symphysis, 3) the margin of the cranial pubic area, 4) the pubic rami, and 5) the obturator foramen. The radiographs of 42 Labrador Retrievers and 16 Golden Retrievers were evaluated. The most useful criteria were the radiographic measurement of the shape of the obturator foramen and two different ratios of length to width of the pubic rami; these values were significantly smaller in dogs after JPS. The pelvic canal width was the same in both groups. All objective measurements were repeatable within and between evaluators. The most reliable subjective criterion was number 4, followed by number 5 in Golden Retrievers and by 2 in Labrador Retrievers. Our objective and subjective evaluations were simple and yielded useful and repeatable results. There was no significant difference between general practitioners and specialists with regard to subjective evaluation, which indicates that these evaluation criteria can be used by small animal clinicians after minimal training.

  3. Adaptive introgression from distant Caribbean islands contributed to the diversification of a microendemic adaptive radiation of trophic specialist pupfishes.

    Directory of Open Access Journals (Sweden)

    Emilie J Richards


    Full Text Available Rapid diversification often involves complex histories of gene flow that leave variable and conflicting signatures of evolutionary relatedness across the genome. Identifying the extent and source of variation in these evolutionary relationships can provide insight into the evolutionary mechanisms involved in rapid radiations. Here we compare the discordant evolutionary relationships associated with species phenotypes across 42 whole genomes from a sympatric adaptive radiation of Cyprinodon pupfishes endemic to San Salvador Island, Bahamas and several outgroup pupfish species in order to understand the rarity of these trophic specialists within the larger radiation of Cyprinodon. 82% of the genome depicts close evolutionary relationships among the San Salvador Island species reflecting their geographic proximity, but the vast majority of variants fixed between specialist species lie in regions with discordant topologies. Top candidate adaptive introgression regions include signatures of selective sweeps and adaptive introgression of genetic variation from a single population in the northwestern Bahamas into each of the specialist species. Hard selective sweeps of genetic variation on San Salvador Island contributed 5 times more to speciation of trophic specialists than adaptive introgression of Caribbean genetic variation; however, four of the 11 introgressed regions came from a single distant island and were associated with the primary axis of oral jaw divergence within the radiation. For example, standing variation in a proto-oncogene (ski known to have effects on jaw size introgressed into one San Salvador Island specialist from an island 300 km away approximately 10 kya. The complex emerging picture of the origins of adaptive radiation on San Salvador Island indicates that multiple sources of genetic variation contributed to the adaptive phenotypes of novel trophic specialists on the island. Our findings suggest that a suite of factors

  4. How Do People Who Frequently Attend Emergency Departments for Alcohol-Related Reasons Use, View, and Experience Specialist Addiction Services? (United States)

    Parkman, Thomas; Neale, Joanne; Day, Ed; Drummond, Colin


    People who frequently attend emergency departments (EDs) for alcohol-related reasons, cost health systems greatly. Although specialist addiction services may be more appropriate for their needs, drinkers often experience barriers accessing specialist alcohol-related support. This study explores how people who frequently attend EDs for alcohol-related reasons use, view, and experience specialist addiction services. We conducted semi-structured interviews with 30 individuals recruited from six EDs across London, United Kingdom. Data relating to participants' socio-demographic characteristics and service use were systematically coded using qualitative software, and analyzed following the Framework. ED usage over the last 12 months was high, whereas current use of specialist addiction services was low. We found little evidence that structural barriers were preventing participants from attending specialist services; rather, participants seemed not to require help with their alcohol use. When asked what support they desired for their drinking, only 11/30 participants identified alcohol-specific treatment. More commonly, they wanted help relating to mental health problems; social contact; paid or voluntary work; housing-related issues; or gym access. Women were more likely to be receiving, and to have support from a specialist addiction service. Conclusions/Importance: People who frequently attended EDs for alcohol-related reasons expressed low levels of interest in, and motivation for, alcohol-specific treatment but desired broader psychosocial support. Case management and assertive outreach appear to be valuable models of service delivery for this population (particularly for men). However, further qualitative and quantitative research is now needed to verify these findings in different countries, regions, and health care systems.

  5. Definition of Specific Functions and Procedural Skills Required by Cuban Specialists in Intensive Care and Emergency Medicine. (United States)

    Véliz, Pedro L; Berra, Esperanza M; Jorna, Ana R


    INTRODUCTION Medical specialties' core curricula should take into account functions to be carried out, positions to be filled and populations to be served. The functions in the professional profile for specialty training of Cuban intensive care and emergency medicine specialists do not include all the activities that they actually perform in professional practice. OBJECTIVE Define the specific functions and procedural skills required of Cuban specialists in intensive care and emergency medicine. METHODS The study was conducted from April 2011 to September 2013. A three-stage methodological strategy was designed using qualitative techniques. By purposive maximum variation sampling, 82 professionals were selected. Documentary analysis and key informant criteria were used in the first stage. Two expert groups were formed in the second stage: one used various group techniques (focus group, oral and written brainstorming) and the second used a three-round Delphi method. In the final stage, a third group of experts was questioned in semistructured in-depth interviews, and a two-round Delphi method was employed to assess priorities. RESULTS Ultimately, 78 specific functions were defined: 47 (60.3%) patient care, 16 (20.5%) managerial, 6 (7.7%) teaching, and 9 (11.5%) research. Thirty-one procedural skills were identified. The specific functions and procedural skills defined relate to the profession's requirements in clinical care of the critically ill, management of patient services, teaching and research at the specialist's different occupational levels. CONCLUSIONS The specific functions and procedural skills required of intensive care and emergency medicine specialists were precisely identified by a scientific method. This product is key to improving the quality of teaching, research, administration and patient care in this specialty in Cuba. The specific functions and procedural skills identified are theoretical, practical, methodological and social contributions to

  6. The potential Public Health Impact of Mycobacterium avium ssp. paratuberculosis: Global Opinion Survey of Topic Specialists. (United States)

    Waddell, L A; Rajić, A; Stärk, K D C; McEwen, S A


    Global research knowledge has accumulated over the past few decades, and there is reasonable evidence for a positive association between Mycobacterium avium spp. paratuberculosis and Crohn's disease in humans, although its role as a human pathogen has not been entirely accepted. For this reason, management of public health risk due to M. paratuberculosis remains an important policy issue in agri-food public health arenas in many countries. Responsible authorities must decide whether existing mitigation strategies are sufficient to prevent or reduce human exposure to M. paratuberculosis. A Web-based questionnaire was administered to topic specialists to elicit empirical knowledge and opinion on the overall public health impact of M. paratuberculosis, the importance of various routes of human exposure to the pathogen, existing mitigation strategies and the need for future strategies. The questionnaire had four sections and consisted of 20 closed and five open questions. Topic specialists believed that M. paratuberculosis is likely a risk to human health (44.8%) and, given the paucity of available evidence, most frequently ranked it as a moderate public health issue (40.1%). A significant correlation was detected between topic specialists' commitment to M. paratuberculosis in terms of the number of years or proportion of work dedicated to this topic, and the likelihood of an extreme answer (high or low) to the above questions. Topic specialists identified contact with ruminants and dairy products as the most likely routes of exposure for humans. There was consensus on exposure routes for ruminants and what commodities to target in mitigation efforts. Described mandatory programmes mainly focused on culling diseased animals and voluntary on-farm prevention programmes. Despite ongoing difficulties in the identification of subclinical infections in animals, the topic specialists largely agreed that further enhancement of on-farm programmes in affected commodities by

  7. Quality indicators in headache care: an implementation study in six Italian specialist-care centres. (United States)

    Pellesi, L; Benemei, S; Favoni, V; Lupi, C; Mampreso, E; Negro, A; Paolucci, M; Steiner, T J; Ulivi, M; Cevoli, S; Guerzoni, S


    indicators are fit for purpose. By establishing majority practice, identifying commonalities and detecting deficits as a guide to quality improvement, the quality indicators may be used to set benchmarks for quality assessment. The next step is extend use and evaluation of the indicators into non-specialist care.

  8. Establishing a Research Agenda for Understanding the Role and Impact of Mental Health Peer Specialists. (United States)

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


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

  9. [Differences and similarities between the competencies of a nursing supervisor and an advanced clinical nurse specialist]. (United States)

    del Barrio-Linares, M; Pumar-Méndez, M J


    With the aim of contributing to the development of a more specific professional regulation, the present study was to identify differences and similarities between the competencies of the nursing supervisor and clinical nurse specialist in an intensive care unit. A critical analysis of the literature published between 2003 and 2013 was conducted, identified through systematic searches in electronic databases, health management and practitioner journals and reference lists of the 17 items included. «Management and administration» and «direct clinical practice» were identified as specific competencies of nursing supervisor and clinical nurse specialist respectively. «Collaboration», «leadership» and «research» emerged as competencies shared by both profiles, but with different a operationalization way of conducting it. These findings imply that regulation, education and implementation of these profiles must address their specific skills as the distinctive approach taken in operationalizing shared. Copyright © 2014 Elsevier España, S.L.U. y SEEIUC. All rights reserved.

  10. Science without meritocracy. Discrimination among European specialists in infectious diseases and clinical microbiology: a questionnaire survey (United States)

    Tacconelli, Evelina; Poljak, Mario; Cacace, Marina; Caiati, Giovanni; Benzonana, Nur; Nagy, Elisabeth; Kortbeek, Titia


    Objective In 2009, in a European survey, around a quarter of Europeans reported witnessing discrimination or harassment at their workplace. The parity committee from the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) designed a questionnaire survey to investigate forms of discrimination with respect to country, gender and ethnicity among medical professionals in hospitals and universities carrying out activities in the clinical microbiology (CM) and infectious diseases (ID) fields. Design The survey consisted of 61 questions divided into five areas (sociodemographic, professional census and environment, leadership and generic) and ran anonymously for nearly 3 months on the ESCMID website. Subjects European specialists in CM/ID. Results Overall, we included 1274 professionals. The majority of respondents (68%) stated that discrimination is present in medical science. A quarter of them reported personal experience with discrimination, mainly associated with gender and geographic region. Specialists from South-Western Europe experienced events at a much higher rate (37%) than other European regions. The proportion of women among full professor was on average 46% in CM and 26% in ID. Participation in high-level decision-making committees was significantly (>10 percentage points) different by gender and geographic origin. Yearly gross salary among CM/ID professionals was significantly different among European countries and by gender, within the same country. More than one-third of respondents (38%) stated that international societies in CM/ID have an imbalance as for committee member distribution and speakers at international conferences. Conclusions A quarter of CM/ID specialists experienced career and research discrimination in European hospitals and universities, mainly related to gender and geographic origin. Implementing proactive policies to tackle discrimination and improve representativeness and balance in career among CM

  11. Do patients discharged from advanced practice physiotherapy-led clinics re-present to specialist medical services? (United States)

    Chang, Angela T; Gavaghan, Belinda; O'Leary, Shaun; McBride, Liza-Jane; Raymer, Maree


    -present for further specialist medical care.What does this paper add? This paper identifies that the majority (95%) of patients managed by an advanced practice physiotherapy-led service did not re-present for further medical care for the same condition within 12 months of discharge.What are the implications for practitioners? This paper supports the use of advanced practice physiotherapy-led services in the management of overburdened neurosurgical and orthopaedic specialist out-patient waiting lists.

  12. Documenting coordination of cancer care between primary care providers and oncology specialists in Canada. (United States)

    Brouwers, Melissa C; Vukmirovic, Marija; Tomasone, Jennifer R; Grunfeld, Eva; Urquhart, Robin; O'Brien, Mary Ann; Walker, Melanie; Webster, Fiona; Fitch, Margaret


    To report on the findings of the CanIMPACT (Canadian Team to Improve Community-Based Cancer Care along the Continuum) Casebook project, which systematically documented Canadian initiatives (ie, programs and projects) designed to improve or support coordination and continuity of cancer care between primary care providers (PCPs) and oncology specialists. Pan-Canadian environmental scan. Canada. Individuals representing the various initiatives provided data for the analysis. Initiatives included in the Casebook met the following criteria: they supported coordination and collaboration between PCPs and oncology specialists; they were related to diagnosis, treatment, survivorship, or personalized medicine; and they included breast or colorectal cancer or both. Data were collected on forms that were compiled into summaries (ie, profiles) for each initiative. Casebook initiatives were organized based on the targeted stage of the cancer care continuum, jurisdiction, and strategy (ie, model of care or type of intervention) employed. Thematic analysis identified similarities and differences among employed strategies, the level of primary care engagement, implementation barriers and facilitators, and initiative evaluation. The CanIMPACT Casebook profiles 24 initiatives. Eleven initiatives targeted the survivorship stage of the cancer care continuum and 15 focused specifically on breast or colorectal cancer or both. Initiative teams implemented the following strategies: nurse patient navigation, multidisciplinary care teams, electronic communication or information systems, PCP education, and multicomponent initiatives. Initiatives engaged PCPs at various levels. Implementation barriers included lack of care standardization across jurisdictions and incompatibility among electronic communication systems. Implementation facilitators included having clinical and program leaders publicly support the initiative, repurposing existing resources, receiving financial support, and

  13. Ethical attitudes of German specialists in reproductive medicine and legal regulation of preimplantation sex selection in Germany.

    Directory of Open Access Journals (Sweden)

    Miriam Wilhelm

    Full Text Available BACKGROUND: Because of its ethical and social implications, preimplantation sex selection is frequently the subject of debates. METHODS: In 2006, we surveyed specialists in reproductive medicine in Germany using an anonymous questionnaire, including sociodemographic data and questions regarding ethical problems occurring in the practice of reproductive medicine. Most questions focused on preimplantation sex selection, including 10 case vignettes, since these enabled us to describe the most difficult and ethically controversial situations. This is the first survey among specialists in reproductive medicine regarding this topic in Germany. RESULTS: 114 specialists in reproductive medicine participated, 72 males (63% and 42 females (37%, average age was 48 years (age range 29-67 years. The majority of respondents (79% favoured a regulation that limits the use of preimplantation sex selection only for medical reasons, such as X-linked diseases (including 18%: summoning an ethics commission for every case. A minority of 18% approved of the use of sex selection for non-medical reasons (4% generally and further 14% for family balancing. 90% had received obvious requests from patients. The highest approval (46% got the counselling guideline against a preimplantation sex selection and advising a normal pregnancy, if preimplantation sex selection would be allowed in Germany. The majority (67% was opposed the personal use of preimplantation sex selection for non-medical reasons, but would think about it in medical cases. In opposite to woman, 14% of the men were in favour of personal use for non-medical reasons (p=0,043. 25% of specialists in reproductive medicine feared that an allowance of preimplantation sex selection would cause a shift in the sex ratio. CONCLUSIONS: The majority of German specialists in reproductive medicine opposes preimplantation sex selection for non-medical reasons while recommending preimplantation sex selection for medical

  14. Struggling doctors in specialist training: a case control study

    DEFF Research Database (Denmark)

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

    , James D. Risk factors at medical school for subsequent professional misconduct: multicenter retrospective case-control study. BMJ 2010;340:c2040. Evans DE, Alstead EM, Brown J. Applying your clinical skills to students and trainees in academic difficulty. Clin Teach 2010;7(4):230-235. Yao DC, Wright SM....... The challenge of problem residents. J Gen Intern Med 2001;16:486-492. Papadakis MA, Hodgson CS, Theherani A, Kohatsu ND. Unprofessional behavior in medical school is associated with subsequent disciplinary action by a state medical board. Acad Med 2004;79:244-249. Ringsted C, Hodges B, Scherpbier A. ‘The...... seemed to predict struggling in postgraduate education if any. The study design is rooted in epidemiological methodology. Struggling doctors in specialist training: a case-control study. It has been reported in the international literature, that around 3-10% of doctors in post-garduate specialist...

  15. Translational health research: perspectives from health education specialists. (United States)

    Mata, Holly J; Davis, Sharon


    The phrase "from bench to bedside to curbside" is a common definition of translational research among health disparities researchers. Health Education Specialists can make important contributions to the field of clinical translational medicine, particularly in light of U.S. health care reform and a renewed emphasis on medical home or health care home models.Health Education Specialists have the training and experience to engage in and facilitate translational research, as well as the opportunity to learn from the translational efforts of other professions and enhance our research, practice, and community partnerships through translational efforts. In this paper, a Translational Health Education Research framework for health education researchers is suggested to foster increased translational efforts within our profession as well as to promote interdisciplinary collaborations to translate a variety of health-related research. A conceptual framework adapted from translational health disparities research that highlights the level and scope of translational research necessary for changes in practice and policy is also provided.

  16. STS-93 Mission Specialist Cady Coleman suits up for launch (United States)


    For the third time, during final launch preparations in the Operations and Checkout Building, STS-93 Mission Specialist Catherine G. Coleman (Ph.D.) dons her launch and entry suit. After Space Shuttle Columbia's July 20 and 22 launch attempts were scrubbed, the launch was again rescheduled for Friday, July 23, at 12:24 a.m. EDT. STS-93 is a five-day mission primarily to release the Chandra X-ray Observatory, which will allow scientists from around the world to study some of the most distant, powerful and dynamic objects in the universe. The STS-93 crew numbers five: Commander Eileen M. Collins, Pilot Jeffrey S. Ashby, and Mission Specialists Stephen A. Hawley (Ph.D.), Coleman, and Michel Tognini of France, with the Centre National d'Etudes Spatiales (CNES). Collins is the first woman to serve as commander of a shuttle mission.

  17. Some milestones: specialist education, training and assessment in Singapore. (United States)

    Chew, Chin Hin


    Singapore had its most significant milestone in 1905 when the Singapore Medical School was founded. The Academy of Medicine, founded in 1957, celebrates its Golden Anniversary in 2007. Thus, the events that influenced the development of postgraduate medicine, specialist education, training and examinations commenced rightly from 1957. These are presented chronologically. The significant roles played by the Academy, the University's Medical School and the Ministry of Health are highlighted, bearing in mind the ongoing developments in Singapore and globally over the years. To keep pace with the further developments and advances, the high gold standards in specialist training and assessment need to be refined with time. This can only be to the benefit of our patients and the community in Singapore and beyond.

  18. Physical perfection of future specialists to the management.

    Directory of Open Access Journals (Sweden)

    Dolinnyj U.A.


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

  19. Not whale-fall specialists, Osedax worms also consume fishbones. (United States)

    Rouse, Greg W; Goffredi, Shana K; Johnson, Shannon B; Vrijenhoek, Robert C


    Marine annelid worms of the genus Osedax exploit sunken vertebrate bones for food. To date, the named species occur on whale or other mammalian bones, and it is argued that Osedax is a whale-fall specialist. To assess whether extant Osedax species could obtain nutrition from non-mammalian resources, we deployed teleost bones and calcified shark cartilage at approximately 1000 m depth for five months. Although the evidence from shark cartilage was inconclusive, the teleost bones hosted three species of Osedax, each of which also lives off whalebones. This suggests that rather than being a whale-fall specialist, Osedax has exploited and continues to exploit a variety of food sources. The ability of Osedax to colonize and to grow on fishbone lends credibility to a hypothesis that it might have split from its siboglinid relatives to assume the bone-eating lifestyle during the Cretaceous, well before the origin of marine mammals.

  20. STS-86 Mission Specialist Jean-Loup Chretien at TCDT (United States)


    STS-86 Mission Specialist Jean-Loup J.M. Chretien of the French Space Agency, CNES, participates in Terminal Countdown Demonstration Test (TCDT) activities at Launch Pad 39A. This will be his third spaceflight, but first on the Space Shuttle. He flew twice as a research-cosmonaut on Russian missions. STS-86 will be the seventh docking of the Space Shuttle with the Russian Space Station Mir. During the docking, STS-86 Mission Specialist David A. Wolf will transfer to the orbiting Russian station and become a member of the Mir 24 crew, replacing U.S. astronaut C. Michael Foale, who has been on the Mir since the last docking mission, STS-84, in May. Launch of Mission STS-86 aboard the Space Shuttle Atlantis is targeted for Sept. 25.

  1. The opinions of Finnish specialist physicians on social security system

    Directory of Open Access Journals (Sweden)

    Arttu O Saarinen


    Full Text Available

    Background: We can argue that opinions are considered to be part of the physician’s professional identity. Professional identity has been considered a result of learning. After graduation physicians usually continue to study to gain a specialisation, and we can assume that this process affects their opinions because every specialty has its own “cultural climate”. Also, specialists have different views towards the welfare state because, for example, of the fact that they work with different types of population groups.

    Aim of the study: In this article we will describe how specialists feel about the current level of social security in Finland.

    Methods: The empirical analysis in our study is based on postal survey. The 2000 working age physicians’ random survey sample was picked from the register of the Finnish Medical Association (n=1092, response rate 54,6 %. The whole questionnaire included questions dealing with social security, health policy and health care system. The data was analysed using means and multinomial logistic regression analysis.

    Results: This study shows that surgeons and radiologists are the most critical of social security. These groups often think that social security is excessive. In contrast, psychiatrists show a stronger tendency to support social security. All in all, Finnish specialists are more critical of the social security system than are nonspecialised physicians.

    Conclusions: There are many similarities between Nordic countries when we look at the historical role of medical profession. We can also assume that specialist physicians' opinions on social security are quite similar compared to those of other Nordic countries.

  2. Commissioning of specialist palliative care services in England. (United States)

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


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

  3. STS-88 Mission Specialist Krikalev prepares to enter Endeavour (United States)


    STS-88 Mission Specialist Sergei Konstantinovich Krikalev, a Russian cosmonaut, is assisted with his ascent and re-entry flight suit in the white room at Launch Pad 39A before entering Space Shuttle Endeavour for launch. During the nearly 12-day mission, the six-member crew will mate the first two elements of the International Space Station -- the already-orbiting Zarya control module with the Unity connecting module carried by Endeavour. He is making his fourth spaceflight.

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

    Long, Jennifer; Long, Airdrie


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

  5. Neurofibromatosis and the role of the specialist adviser. (United States)

    Redman, Carolyn


    Neurofibromatosis (NF) is a genetic condition that mainly involves the nervous system. There are two types: NF1 affects about one in 2,500 of the population worldwide and NF2 affects one in 35,000. Both types result in complex health problems for patients and can pose significant challenges for all those involved in their management. Established in 1981, The Neuro Foundation is a patient-focused charity that funds a network of specialist advisers who work in partnership with the NHS to offer support and advice for families affected by NF and the professionals who care for them. With a significant level of autonomy, the specialist adviser role is flexible in matching the needs of those affected while working cooperatively alongside the national specialist services for NF1 and NF2. ©2012 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

  6. From Humanizing the Educational Process to Professionally Mobile Specialists Training

    Directory of Open Access Journals (Sweden)

    T. A. Fugelova


    Full Text Available Training professional mobile specialists capable of responding flexibly to dynamic changes in society is considered to be the most important issue of the modern educational system. The paper justifies the idea that technical universities should take responsibility for solving this problem by means of humanization of technical education, which implies reconsidering its values and general notions. For overcoming the technocratic trends, the author recommends to cultivate the value of professionalism in the humanization context.Professionalism is defined by using the «professional service» idea as a «purpose acknowledgment, supertask, even a mission». The main components of the above attitude lie in finding the harmony with the world and its basic values. Therefore, technical universities face the challenge of training people of intelligence with a high moral and business responsibility. The basic value of such a person is regarded as «dedication to the cause» - the constant desire to improve the world and leave behind them- selves something of value to society. For training such specialists, the educational process should provide teachers dialogue and collaboration with students to facilitate the process of self-determination and self-development of the prospective specialists

  7. Acculturation in the Professional Activities of Specialists in International Relations

    Directory of Open Access Journals (Sweden)

    Nadezhda Romanenko


    Full Text Available The article discusses the phenomenon of acculturation in the professional activities of international profile in terms of intercultural communication. The author emphasizes that acculturation problems related to intercultural communication have not only domestic but also international dimension. The article presents the theory and methodology of acculturation problems at different stages ofdevelopment of foreign and domestic scholars (specialists in cultural studies, ethnographers, ethnosociologists and specifies the defference between the concepts of acculturation and assimilation of national and regional cultures. It further describes the strategy of acculturation (separation, marginalization, integration, emphasizes the role of integration strategy that makes it possible to preserve the cultural identity of a specialist in international relations along with an awareness of the regional culture of the host country. Special attention is given to the task of the university in preventing possible assimilation of future specialists in international relations and building "immunity" to the cultural (regional adaptation and sustainable cultural identity as a representative the Russia. The article marks the mission of Russian culture as a medium of traditions, moral and spiritual values that built the Russian nation as a single community and state. The author writes that ethno-cultural component brings together many cultures, ethnic groups and nationalities of Russia, forms a common multicultural ground and brings about the need for cross-cultural awareness in international relations. That is confirmed by the State Federal Standard of Higher Education which describes specific competences that students of international relations are supposed to possess.

  8. Advocacy and Public Policy Perceptions and Involvement of Master Certified Health Education Specialists. (United States)

    Kerr, Dianne L; Van Wasshenova, Emily; Mahas, Rachel; Everhart, F Jeannine; Thompson, Amy; Boardley, Debra


    Master Certified Health Education Specialists (MCHES; n = 186) participated in a mail survey on advocacy and public policy. Over half of participants reported that they had contacted a public official or provided policy-related information to consumers or other professionals. Participants identified barriers and benefits to influencing public policy. The greatest benefit was identified as improving the health or welfare of the public while the greatest barrier was that they were busy with other priorities. Participants also described their level of involvement, knowledge, training in advocacy, and their self-efficacy in performing various advocacy activities. Most MCHES reported voting and other basic advocacy functions while far fewer had participated in more advanced advocacy activities. Although nearly 73% had formal training on advocacy and policy, only 26% received it through college coursework. Factors predictive of advocacy and policy involvement were determined through a stepwise regression analysis. Five independent variables predicted the total number of advocacy activities and when combined accounted for nearly 61% of the variance. Government-level health educators' misconception that they cannot participate in advocacy and public policy issues should be dispelled. Health education specialists with the MCHES credential need coursework and additional training on how to effectively influence public health policy.

  9. Education of specialists-cartographers in Lviv Polytechnic National University

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    Наталія Ярема


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

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

    NARCIS (Netherlands)

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


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

  11. 78 FR 14359 - Verizon Business Networks Services, Inc., Specialist-Tech Customer Service, Philadelphia, PA... (United States)


    ... Employment and Training Administration Verizon Business Networks Services, Inc., Specialist-Tech Customer Service, Philadelphia, PA; Verizon Business Networks Services, Inc., Specialist-Tech Customer Service...-Tech Customer Service, Philadelphia, Pennsylvania and Verizon Business Networks Services, Inc...

  12. Educational and evaluation strategies in the training of physician specialists (United States)

    Gaona-Flores, Verónica Alejandra; Campos-Navarro, Luz Arcelia; Arenas-Osuna, Jesús; Alcalá-Martínez, Enrique


    Teaching strategies have been defined as procedures, means or resources that teachers used to promote meaningful learning. Identify teaching strategies and evaluation used by the professor with residents in tertiary hospitals health care. This is a cross-sectional study conducted with full, associate and assistant professors of various medical specialties. A questionnaire was applied to evaluate the strategies used by professors to teach and evaluate students. We included a sample of 90 professors in 35 medical specialties. The most frequent teaching activities were: organizing students to develop presentations on specific subjects, followed by asking questions on previously reviewed subjects, In terms of the strategies employed, the most frequent "always" option was applied to case analyses. The most frequent methods used for the evaluation of theoretical knowledge were: participation in class, topic presentation and exams. Teaching activities were primarily based on the presentation of specific topics by the residents. The most commonly used educational strategies were clinical case analyses followed by problem-based learning and the use of illustrations. Evaluation of the residents' performance in theory knowledge, hinged on class participation, presentation of assigned topics and exams.

  13. How do general practitioners and specialists value their mutual communication? A survey

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    Voorn Theo B


    Full Text Available Abstract Background Communication between general practitioners (GPs and specialists is important, if we want patients to receive the right type of care at the right moment. Most communication takes place through telephone contact, letters concerning information on patients more recently also by email, and joint postgraduate training. As much research has been aimed at the content of communication between GPs and specialists, we wished to address the procedural aspects of this communication. We addressed the following research question. How do GPs and specialists assess their mutual communication through telephone, letters and postgraduate courses? Methods A cross-sectional study was conducted among a random sample of 550 GPs and 533 specialists selected from the Netherlands Medical Address Book. The response rate was 47% GPs (n = 259 and 44% specialists (n = 232. Results Specialists qualify the GPs' telephone accessibility as poor; while GPs themselves do not. Specialists think poorly of the GPs' referral letter. Merely half of GPs feels their questions are addressed appropriately by the specialist, whereas specialists think this number is considerably higher. According to specialists, GPs often do not follow the advice given by them. GPs rate their compliance much higher. Less than a quarter of GPs feel the specialist's letter arrives on time. Specialists have a different perception of this. Both parties wish to receive feedback from one and other, while in practice they do so very little. Conclusion GPs and specialists disagree on several aspects of their communication. This impedes improvements. Both GP's accessibility by phone and time span to the specialist's report could be earmarked as performance indicators. GPs and specialists should discuss amongst themselves how best to compose a format for the referral letter and the specialist's report and how to go about exchanging mutual feedback.

  14. Current Practices in Ocular Toxoplasmosis: A Survey of Brazilian Uveitis Specialists. (United States)

    Morais, Fábio Barreto; Arantes, Tiago Eugênio Faria E; Muccioli, Cristina


    To describe treatment practices for ocular toxoplasmosis among members of the Brazilian Uveitis Society. An online questionnaire sent to specialists, between October 2014 and March 2015. Most respondents (67.9%) treat all active cases. Most specialists consider visual acuity toxoplasmosis are not uniform among Brazilian specialists. Most specialists treat all cases of active retinochoroiditis. Typical cases are more frequently treated with trimethoprim/sulfamethoxazole. However, classical therapy is the regimen of choice when lesions are considered more severe.

  15. Decoupling of female host plant preference and offspring performance in relative specialist and generalist butterflies. (United States)

    Friberg, M; Posledovich, D; Wiklund, C


    The preference-performance hypothesis posits that the host plant range of plant-feeding insects is ultimately limited by larval costs associated with feeding on multiple resources, and that female egg-laying preferences evolve in response to these costs. The trade-off of either using few host plant species and being a strong competitor on them due to effective utilization or using a wide host plant range but being a poor competitor is further predicted to result in host plant specialization. This follows under the hypothesis that both females and offspring are ultimately favoured by utilizing only the most suitable host(s). We develop an experimental approach to identify such trade-offs, i.e. larval costs associated with being a host generalist, and apply a suite of experiments to two sympatric and syntopic populations of the closely related butterflies Pieris napi and Pieris rapae. These butterflies show variation in their level of host specialization, which allowed comparisons between more and less specialized species and between families within species. Our results show that, first, the link between female host preference and offspring performance was not significantly stronger in the specialist compared to the generalist species. Second, the offspring of the host plant specialist did not outperform the offspring of the generalist on the former's most preferred host plant species. Finally, the more generalized species, or families within species, did not show higher survival or consistently higher growth rates than the specialists on the less preferred plants. Thus, the preference and performance traits appear to evolve as largely separated units.

  16. Bird Communities of the Arctic Shrub Tundra of Yamal: Habitat Specialists and Generalists (United States)

    Sokolov, Vasiliy; Ehrich, Dorothée; Yoccoz, Nigel G.; Sokolov, Alexander; Lecomte, Nicolas


    Background The ratio of habitat generalists to specialists in birds has been suggested as a good indicator of ecosystem changes due to e.g. climate change and other anthropogenic perturbations. Most studies focusing on this functional component of biodiversity originate, however, from temperate regions. The Eurasian Arctic tundra is currently experiencing an unprecedented combination of climate change, change in grazing pressure by domestic reindeer and growing human activity. Methodology/Principal Findings Here we monitored bird communities in a tundra landscape harbouring shrub and open habitats in order to analyse bird habitat relationships and quantify habitat specialization. We used ordination methods to analyse habitat associations and estimated the proportions of specialists in each of the main habitats. Correspondence Analysis identified three main bird communities, inhabiting upland, lowland and dense willow shrubs. We documented a stable structure of communities despite large multiannual variations of bird density (from 90 to 175 pairs/km2). Willow shrub thickets were a hotspot for bird density, but not for species richness. The thickets hosted many specialized species whose main distribution area was south of the tundra. Conclusion/Significance If current arctic changes result in a shrubification of the landscape as many studies suggested, we would expect an increase in the overall bird abundance together with an increase of local specialists, since they are associated with willow thickets. The majority of these species have a southern origin and their increase in abundance would represent a strengthening of the boreal component in the southern tundra, perhaps at the expense of species typical of the subarctic zone, which appear to be generalists within this zone. PMID:23239978

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

    Directory of Open Access Journals (Sweden)

    Vasiliy Sokolov

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

  18. Differences in clinical characteristics between patients assessed for NHS specialist psychotherapy and primary care counselling. (United States)

    Chiesa, Marco; Fonagy, Peter; Bateman, Anthony W


    Although several studies have described patient populations in primary care counselling settings and NHS (National Health Service) specialist psychotherapy settings, there is a paucity of studies specifically comparing differences in clinical characteristics between the two groups of patients. The aim of this study is to ascertain if specialist psychotherapy referrals represent a more challenging client group than primary care counselling patients. We compare the socio-demographic features and severity of presentation in the symptomatic, interpersonal problems and global adjustment dimensions of a sample of patients (N=384) assessed by a primary care counselling service located in North London and a sample of patients (N=853) assessed in eight NHS psychotherapy centres located within urban settings in England. Both the groups completed the Brief Symptom Inventory, the Inventory of Interpersonal Problems and Clinical Outcomes in Routine Evaluation Outcome Measure. Patients referred for specialist psychotherapy services were more dysfunctional than those referred for primary care counselling. The linear function constructed to discriminate the groups showed that a combination of more psychotic symptoms, social inhibitions and higher risk of self-harm effectively identified those referred to psychotherapy services, while patients exhibiting greater levels of somatic and anxiety symptoms and non-assertiveness were more likely to be seen in primary care settings. However, similarities between the two samples were also marked, as shown by the overlap in the distribution of clinical outcomes in routine evaluation clinical scores in the two samples. The findings are discussed in terms of their implications for policy and service delivery of these two types of psychological therapy services.

  19. The use of Hall technique preformed metal crowns by specialist paediatric dentists in the UK


    Roberts, A; McKay, A; Albadri, S


    Examines treatment planning involving Hall technique preformed metal crowns by specialists in paediatric dentistry. Explores clinical situations in which specialists in paediatric dentistry feel it is appropriate or not to fit Hall technique preformed metal crowns. Investigates which types of carious lesions are being treated with Hall technique preformed metal crowns by specialists in paediatric dentistry.

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

    NARCIS (Netherlands)

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


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

  1. Perceptions of Information Technology Specialists Regarding Securing Re-Employment after Offshoring Displacement (United States)

    Gallaway, Ricky A.


    The purpose of this qualitative exploratory case study was to explore why some IT specialists, after experiencing unemployment because of corporate offshoring, acquired gainful re-employment, whereas other similarly unemployed IT specialists had not. To effectively address this case study, two cases were studied: (a) displaced IT specialists who…

  2. Legal Translator Training: Partnership between Teachers of English for Legal Purposes and Legal Specialists (United States)

    Northcott, Jill; Brown, Gillian


    Training legal English specialists is one area in which cooperation between discipline and language specialists is particularly valuable. Seven short excerpts from a short training course run jointly by teachers of English for legal purposes and legal specialists are presented and analysed to illustrate the contribution an ESP oriented approach,…

  3. Payload specialist station study. Volume 3: Program study cost estimates. Part 1: Work breakdown structure (United States)


    The work breakdown structure (WBS) for the Payload Specialist Station (PSS) is presented. The WBS is divided into two elements--PSS contractor and mission unique requirements. In accordance with the study ground rules, it is assumed that a single contractor, hereafter referred to as PSS Contractor will perform the following: (1) provide C and D hardware (MFDS and elements of MMSE), except for GFE; (2) identify software requirements; (3) provide GSE and ground test software; and (4) perform systems engineering and integration in support of the Aft Flight Deck (AFD) C and D concept. The PSS Contractor WBS element encompasses a core or standardized PSS concept. Payload peculiar C and D requirements identified by users will originate as a part of the WBS element mission unique requirements; these requirements will be provided to the PSS Contractor for implementation.

  4. Conceptualizing the impacts of dual practice on the retention of public sector specialists - evidence from South Africa. (United States)

    Ashmore, John; Gilson, Lucy


    'Dual practice', or multiple job holding, generally involves public sector-based health workers taking additional work in the private sector. This form of the practice is purported to help retain public health care workers in low and middle-income countries' public sectors through additional wage incentives. There has been little conceptual or empirical development of the relationship between dual practice and retention. This article helps begin to fill this gap, drawing on empirical evidence from a qualitative study focusing on South African specialists. Fifty-one repeat, in-depth interviews were carried out with 28 doctors (predominantly specialists) with more than one job, in one public and one private urban hospital. Findings suggest dual practice can impact both positively and negatively on specialists' intention to stay in the public sector. This is through multiple conceptual channels including those previously identified in the literature such as dual practice acting as a 'stepping stone' to private practice by reducing migration costs. Dual practice can also lead specialists to re-evaluate how they compare public and private jobs, and to overworking which can expedite decisions on whether to stay in the public sector or leave. Numerous respondents undertook dual practice without official permission. The idea that dual practice helps retain public specialists in South Africa may be overstated. Yet banning the practice may be ineffective, given many undertake it without permission in any case. Regulation should be better enforced to ensure dual practice is not abused. The conceptual framework developed in this article could form a basis for further qualitative and quantitative inquiry.

  5. Reconsidering the specialist-generalist paradigm in niche breadth dynamics: resource gradient selection by Canada lynx and bobcat. (United States)

    Peers, Michael J L; Thornton, Daniel H; Murray, Dennis L


    The long-standing view in ecology is that disparity in overall resource selection is the basis for identifying niche breadth patterns, with species having narrow selection being classified "specialists" and those with broader selection being "generalists". The standard model of niche breadth characterizes generalists and specialists as having comparable levels of overall total resource exploitation, with specialists exploiting resources at a higher level of performance over a narrower range of conditions. This view has gone largely unchallenged. An alternate model predicts total resource use being lower for the specialized species with both peaking at a comparable level of performance over a particular resource gradient. To reconcile the niche breadth paradigm we contrasted both models by developing range-wide species distribution models for Canada lynx, Lynx canadensis, and bobcat, Lynx rufus. Using a suite of environmental factors to define each species' niche, we determined that Canada lynx demonstrated higher total performance over a restricted set of variables, specifically those related to snow and altitude, while bobcat had higher total performance across most variables. Unlike predictions generated by the standard model, bobcat level of exploitation was not compromised by the trade-off with peak performance, and Canada lynx were not restricted to exploiting a narrower range of conditions. Instead, the emergent pattern was that specialist species have a higher total resource utilization and peak performance value within a smaller number of resources or environmental axes than generalists. Our results also indicate that relative differences in niche breadth are strongly dependent on the variable under consideration, implying that the appropriate model describing niche breadth dynamics between specialists and generalists may be more complex than either the traditional heuristic or our modified version. Our results demonstrate a need to re-evaluate traditional

  6. Reconsidering the specialist-generalist paradigm in niche breadth dynamics: resource gradient selection by Canada lynx and bobcat.

    Directory of Open Access Journals (Sweden)

    Michael J L Peers

    Full Text Available The long-standing view in ecology is that disparity in overall resource selection is the basis for identifying niche breadth patterns, with species having narrow selection being classified "specialists" and those with broader selection being "generalists". The standard model of niche breadth characterizes generalists and specialists as having comparable levels of overall total resource exploitation, with specialists exploiting resources at a higher level of performance over a narrower range of conditions. This view has gone largely unchallenged. An alternate model predicts total resource use being lower for the specialized species with both peaking at a comparable level of performance over a particular resource gradient. To reconcile the niche breadth paradigm we contrasted both models by developing range-wide species distribution models for Canada lynx, Lynx canadensis, and bobcat, Lynx rufus. Using a suite of environmental factors to define each species' niche, we determined that Canada lynx demonstrated higher total performance over a restricted set of variables, specifically those related to snow and altitude, while bobcat had higher total performance across most variables. Unlike predictions generated by the standard model, bobcat level of exploitation was not compromised by the trade-off with peak performance, and Canada lynx were not restricted to exploiting a narrower range of conditions. Instead, the emergent pattern was that specialist species have a higher total resource utilization and peak performance value within a smaller number of resources or environmental axes than generalists. Our results also indicate that relative differences in niche breadth are strongly dependent on the variable under consideration, implying that the appropriate model describing niche breadth dynamics between specialists and generalists may be more complex than either the traditional heuristic or our modified version. Our results demonstrate a need to re

  7. Economic modelling of telehealth substitution of face-to-face specialist outpatient consultations for Queensland correctional facilities. (United States)

    Taylor, Monica; Caffery, Liam J; Scuffham, Paul A; Smith, Anthony C


    Objective The provision of healthcare services to inmates in correctional facilities is costly and resource-intensive. This study aimed to estimate the costs of transporting prisoners from 11 Queensland correctional facilities to the Princess Alexandra Hospital Secure Unit (PAHSU) in Brisbane for non-urgent specialist outpatient consultations and identify the cost consequences that would result from the substitution of face-to-face visits with telehealth consultations.Methods A 12-month retrospective review of patient activity at the PAHSU was conducted to obtain the number of transfers per correctional facility. The total cost of transfers was calculated with estimates for transport vehicle costs and correctional staff escort wages, per diem and accommodation costs. A cost model was developed to estimate the potential cost savings from substituting face-to-face consultations with telehealth consultations. A sensitivity analysis on the cost variables was conducted. Costs are reported from a government funding perspective and presented in 2016 Australian dollars (A$).Results There were 3539 inmate appointments from July 2015 to June 2016 at the PAHSU, primarily for imaging, general practice, and orthopaedics. Telehealth may result in cost savings from negligible to A$969731, depending on the proportion, and travel distance, of face-to-face consultations substituted by telehealth. Wages of correctional staff were found to be the most sensitive variable.Conclusions Under the modelled conditions, telehealth may reduce the cost of providing specialist outpatient consultations to prisoners in Queensland correctional facilities. Telehealth may improve the timeliness of services to a traditionally underserved population.What is known about the topic? Specialist medical services are located in only a few metropolitan centres across Australia, which requires some populations to travel long distances to attend appointments. Some face-to-face specialist outpatient

  8. Scientific interests of petroleum specialists in the area of biodiversity

    Energy Technology Data Exchange (ETDEWEB)

    Wasserman, Julio C. [Universidade Federal Fluminense (UFF), Niteroi, RJ (Brazil). Inst. de Geociencias; Lima, Gilson Brito A.; Barros, Sergio R.S. [Universidade Federal Fluminense (UFF), Niteroi, RJ (Brazil). Escola de Engenharia


    The environmental risks of the petroleum industry have driven most of the companies to proceed for the mitigation of its impacts. In this sense, the choice of methods and processes that are better adapted to the petroleum business depends on the improving of the knowledge of most recent technologies. This article aims to identify the technological and knowledge needs of the petroleum industries in the area of biodiversity. For the last few years, the authors have been working with the biodiversity corporate department of a petroleum company and throughout this period, the researchers were able to identify the staff focus and interests for the generation of knowledge. The identification of the desired knowledge was constructed based on the selection of scientific papers that were sent to the company staff, who evaluated its concern. Over 400 articles were sent to the company staff that were published between 2004 and 2007 and about 190 were selected. From the selected pool of articles an analysis of the keywords, name of journals and most frequently selected authors. It is concluded that the petroleum company focused its scientific interests in applied subjects. It was further verified that a considerable amount of work has been carried out by petroleum companies that, sometimes make their reports available in their home pages, but it is probable that many works remain unpublished. (author)

  9. Are patients' and doctors' accounts of the first specialist consultation for chronic back pain in agreement?

    Directory of Open Access Journals (Sweden)

    White KB


    Full Text Available Kathy B White,1 John Lee,2 Amanda C de C Williams3 1Central and North West London NHS Foundation Trust, 2School of Life and Medical Sciences, University College London, 3Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, London, UK Introduction: The first consultation at a specialist pain clinic is potentially a pivotal event in a patient’s pain history, affecting treatment adherence and engagement with longer term self-management. What doctors communicate to patients about their chronic pain and how patients interpret doctors’ messages and explanations in pain consultations are under-investigated, particularly in specialist care. Yet, patients value personalized information about their pain problem.Patients and methods: Sixteen patients in their first specialist pain clinic consultation and the doctors they consulted were interviewed shortly after the consultation. Framework analysis, using patient themes, was used to identify full match, partial match, or mismatch of patient–doctor dyads’ understandings of the consultation messages.Results: Patients and doctors agreed, mainly implicitly, that medical treatment aiming at pain relief was primary and little time was devoted to discussion of self-management. Clinically relevant areas of mismatch included the explanation of pain, the likelihood of medical treatments providing relief, the long-term treatment plan, and the extent to which patients were expected to be active in achieving treatment goals.Discussion: Overall, there appears to be reasonable concordance between doctors and patients, and patients were generally satisfied with their first consultation with a specialist. Two topics showed substantial mismatch, the estimated likely outcome of the next planned intervention and, assuming (as doctors but not patients did that this was unsuccessful, the long-term treatment plan. It appeared that more complex issues

  10. Increasing the involvement of specialist physicians in chronic disease management. (United States)

    Taylor, Dylan; Lahey, Michele


    The Capital Health (CH) region in Alberta serves the population of the Edmonton area as well as a large referral population in western Canada. CH is responsible for the delivery of the spectrum of patient care, from inpatient to outpatient services. Growth in outpatient care, in particular, has led to the development of several ambulatory care facilities from which the delivery of care to several populations with a chronic disease will be coordinated. The traditional model of care delivery is unsuited to the management of chronic diseases. Physicians must be part of the planning and implementation of new models if they are to be successful and sustainable. The concept of integration into a delivery team is not well understood or practised. This is not conducive to the integration of specialist physicians into multidisciplinary teams in ambulatory care that serves the needs of patients from a large geographic area. Chronic disease management using the Chronic Care Model has proven to be an effective method of delivering care to this wide population. Specialist physicians have not always taken advantage of opportunities to be involved in the planning and development of such new health care projects. In CH, physician integration in the planning, development and implementation of this new model has proven vital to its success. We based our strategy for change on Wagner's Chronic Care Model. This involved eight steps, the first four of which have been completed and the fifth and sixth are underway. Five factors contributed to the successful integration of specialist physicians in chronic disease management: collaboration between disciplines and organizations; creating patient-centred services; organizational commitments; strong clinical leadership; and early involvement of clinicians.

  11. Medical student perceptions of plastic surgeons as hand surgery specialists. (United States)

    Agarwal, Jayant P; Mendenhall, Shaun D; Hopkins, Paul N


    Plastic surgeons are often not perceived as hand surgery specialists. Better educating medical students about the plastic surgeon's role in hand surgery may improve the understanding of the field for future referring physicians. The purposes of this study were to assess medical students' understanding of hand surgery specialists and to analyze the impact of prior plastic, orthopedic, and general surgery clinical exposure on this understanding. An online survey including 8 hand-related clinical scenarios was administered to students at a large academic medical center. After indicating training level and prior clinical exposure to plastic surgery or other surgical subspecialties, students selected one or more appropriate surgical subspecialists for management of surgical hand conditions. A response rate of 56.4% was achieved. Prior clinical exposure to plastic, orthopedic, and general surgery was reported by 29%, 43%, and 90% of fourth year students, respectively. Students generally chose at least 1 acceptable specialty for management of hand conditions with improvement over the course of their training (P = 0.008). Overall, students perceived orthopedic surgeons as hand specialists more so than plastic and general surgeons. Clinical exposure to plastic surgery increased the selection of this specialty for nearly all scenarios (22%-46%, P = 0.025). Exposure to orthopedic and general surgery was associated with a decrease in selection of plastic surgery for treatment of carpal tunnel and hand burns, respectively. Medical students have a poor understanding of the plastic surgeon's role in hand surgery. If plastic surgeons want to continue to be recognized as hand surgeons, they should better educate medical students about their role in hand surgery. This can be achieved by providing a basic overview of plastic surgery to all medical students with emphasis placed on hand and peripheral nerve surgery.

  12. STS-88 Mission Specialist Krikalev suits up for launch (United States)


    STS-88 Mission Specialist Sergei Konstantinovich Krikalev gets assistance from suit technician George Brittingham while donning his orange launch and entry suit in the Operations and Checkout Building. STS-88 will be Krikalev's fourth spaceflight, but only his second on the Space Shuttle. He also twice flew on long- duration missions aboard the Russian Space Station Mir. Krikalev and the five other STS-88 crew members will depart shortly for Launch Pad 39A where the Space Shuttle Endeavour is poised for liftoff on the first U.S. mission dedicated to the assembly of the International Space Station.

  13. STS-88 Mission Specialists Krikalev and Newman inside Endeavour (United States)


    STS-88 Mission Specialists Sergei Konstantinovich Krikalev (left) and James H. Newman (right) sit inside orbiter Endeavour during Terminal Countdown Demonstration Activities (TCDT). The TCDT includes mission familiarization activities, emergency egress training, and the simulated main engine cut-off exercise. Mission STS-88 is targeted for launch on Dec. 3, 1998. It is the first U.S. flight for the assembly of the International Space Station and will carry the Unity connecting module. Unity will be mated with the already orbiting Russian-built Zarya control module. The 12-day mission includes three planned spacewalks to connect power, data and utility lines and install exterior equipment.

  14. Column: The Consortium of Digital Forensics Specialists (CDFS

    Directory of Open Access Journals (Sweden)

    Christopher Kelley


    Full Text Available Digital forensic practitioners are faced with an extraordinary opportunity. In fact, we may never again be faced with such an opportunity, and this opportunity will challenge us in ways we may never again be challenged.At this point in the history of the Digital Forensics profession, digital forensic specialists have the unique opportunity to help this profession emerge from its infancy. But for this profession to mature -- and to flourish -- individuals and organizations integral to the practice must assemble and shape its future. This is our opportunity. In fact, this is our mandate.(see PDF for full column

  15. Regional trends amongst Danish specialist farmland breeding birds

    DEFF Research Database (Denmark)

    Heldbjerg, Henning; Fox, Anthony David


    be related to their respective specializations. Generally, few species showed differences in regional population trends, despite the increasing concentration of mixed (mainly pastoral) agriculture in the West and predominantly arable cultivation in the East. Most grassland and arable specialists were...... the period. Corn Bunting Emberiza calandra showed significant declines in the East of Denmark in contrast to stable trends in the Central and Western regions, but was declining everywhere since 2003. The results underline the need to understand how individual farmland species exploit specific crops and micro...

  16. Clinical molecular testing: subspecialty, entry-level or specialist certification? (United States)

    Lennon, Alan; Hu, Peter


    Some clinical laboratories require workers who have basic knowledge in molecular techniques (such as fluorescent in situ hybridization and polymerase chain reaction). Exclusively molecular diagnostic laboratories need workers to be competent in a variety of cutting edge molecular technologies, such as DNA sequencing, array-based comparative genomic hybridization, quantitative polymerase chain reaction, and many other techniques. Having only one certification for molecular biology at the entry level, as newly prescribed by the Board of Certification, doesn't accurately define the two very differently trained types of people these differing types of laboratories require. Creating a second molecular certification, at the specialist level, would address this issue positively.

  17. Development of a prototype specialist shuttle vehicle for chipped woodfuel

    Energy Technology Data Exchange (ETDEWEB)



    This report gives details of a project to develop and test a specialist chip shuttle vehicle for conveying woodchips out of the forest with the aim of reducing the cost of woodfuel production. The design objectives are described and include the need to allow easy transfer of the chips from the chipper to the shuttle and on into haulage units, good performance and manoeuvrability on and off roads, and high-tip capacity. Estimates of the improved production and reduced woodfuel production costs are discussed along with the anticipated satisfactory operation of the chipper-shuttle combination in a forestry site.

  18. Use of professional profiles in applications for specialist training positions

    DEFF Research Database (Denmark)

    Lundh, Andreas; Skjelsager, Karen; Wildgaard, Kim


    investigated use of professional profiles among the 38 Danish specialty societies in order to ascertain the use of the seven roles. MATERIAL AND METHODS: We used information from the websites of the Postgraduate Medical Training Secretariats in March 2012. For each profile, we extracted information on how......INTRODUCTION: The seven roles of the CanMEDS system have been implemented in Danish postgraduate medical training. For each medical specialty, a professional profile describes which elements of the seven roles the specialty deems important for applicants for a specialist training position. We...

  19. Peculiarities of self-regulation of extreme profile specialists

    Directory of Open Access Journals (Sweden)

    Kabanova T.N.


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

  20. Does the use of specialist palliative care services modify the effect of socioeconomic status on place of death? A systematic review. (United States)

    Chen, Hong; Nicolson, Donald J; Macleod, Una; Allgar, Victoria; Dalgliesh, Christopher; Johnson, Miriam


    Cancer patients in lower socioeconomic groups are significantly less likely to die at home and experience more barriers to access to palliative care. It is unclear whether receiving palliative care may mediate the effect of socioeconomic status on place of death. This review examines whether and how use of specialist palliative care may modify the effect of socioeconomic status on place of death. A systematic review was conducted. Eligible papers were selected and the quality appraised by two independent reviewers. Data were synthesised using a narrative approach. MEDLINE, Embase, CINAHL, PsycINFO and Web of Knowledge were searched (1997-2013). Bibliographies were scanned and experts contacted. Papers were included if they reported the effect of both socioeconomic status and use of specialist palliative care on place of death for adult cancer patients. Nine studies were included. All study subjects had received specialist palliative care. With regard to place of death, socioeconomic status was found to have (1) no effect in seven studies and (2) an effect in one study. Furthermore, one study found that the effect of socioeconomic status on place of death was only significant when patients received standard specialist palliative care. When patients received more intense care adapted to their needs, the effect of socioeconomic status on place of death was no longer seen. There is some evidence to suggest that use of specialist palliative care may modify the effect of socioeconomic status on place of death. © The Author(s) 2015.

  1. Microbial detoxification in the gut of a specialist avian herbivore, the Greater Sage-Grouse. (United States)

    Kohl, Kevin D; Connelly, John W; Dearing, M Denise; Forbey, Jennifer Sorensen


    One function of the gut microbiota gaining recent attention, especially in herbivorous mammals and insects, is the metabolism of plant secondary metabolites (PSMs). We investigated whether this function exists within the gut communities of a specialist avian herbivore. We sequenced the cecal metagenome of the Greater Sage-Grouse (Centrocercus urophasianus), which specializes on chemically defended sagebrush (Artemisia spp.). We predicted that the cecal metagenome of the sage-grouse would be enriched in genes associated with the metabolism of PSMs when compared to the metagenome of the domestic chicken. We found that representation of microbial genes associated with 'xenobiotic degradation and metabolism' was 3-fold higher in the sage-grouse cecal metagenomes when compared to that of the domestic chicken. Further, we identified a complete metabolic pathway for the degradation of phenol to pyruvate, which was not detected in the metagenomes of the domestic chicken, bovine rumen or 14 species of mammalian herbivores. Evidence of monoterpene degradation (a major class of PSMs in sagebrush) was less definitive, although we did detect genes for several enzymes associated with this process. Overall, our results suggest that the gut microbiota of specialist avian herbivores plays a similar role to the microbiota of mammalian and insect herbivores in degrading PSMs. © FEMS 2016. All rights reserved. For permissions, please e-mail:

  2. The clinical nurse specialist and essential genomic competencies: charting the course. (United States)

    Kelly, Patricia


    Forging new frontiers is one description for the completion of the Human Genome Project (HGP) in 2003. This project produced a human DNA blueprint that is revolutionalizing society, changing healthcare, and producing new practice standards. With the genome map, scientists are identifying DNA variations that transform traditional models of health promotion, disease prevention, disease classification, treatment, and symptom management. The HGP is shifting emphasis from traditional genetics to an expanded genomic message. Nursing has responded to the HGP completion by establishing genomic nursing competencies. In 2005, the American Nurses Association (ANA), along with 48 nursing organizations, including the National Association of Clinical Nurse Specialists (NACNS), endorsed minimum essential genetic/genomic nursing competencies for all registered nurses, regardless of education or specialty area. How does the clinical nurse specialist (CNS) explore the HGP frontier and integrate essential genomic nursing competencies into practice? This article discusses the HGP, the development of essential genetic/genomic nursing competencies, and the genomic role of the advanced practice CNS. A 1-day genomics program is described as a pilot project for integrating competencies in practice and education.

  3. Evaluation of PMBOK and scrum practices for software development in the vision of specialists

    Directory of Open Access Journals (Sweden)

    Elton Fernandes Gonçalves


    Full Text Available In project management, the challenge for software development is to achieve success for the proposed projects, using methods such as PMBOK and Scrum. Knowledge of the advantages of these methods are critical success factors for product development. Therefore, the proposal of this study was to verify the perception of specialists of the area of software development on practices of project management. The used methods in this study were the bibliographic, exploratory and qualitative research, with the construction of a questionnaire with 14 items on the advantages of project management practices of various natures, size and complexity, which were applied in 90 specialists. The results of the research demonstrated that all the experts agreed with the advantages of the project management practices, identified based on the literature review, for software development, thus validating the proposed items of the questionnaire. It is recommended for future researches the accomplishment of case studies that explore practical models of evaluation of the use of the practices studied in the scope of software development. It is important in these future studies that metrics and indicators are drawn for each of the advantages cited in the present study.

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

    Energy Technology Data Exchange (ETDEWEB)

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


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

  5. Psychological interventions on a specialist Early Intervention Inpatient Unit: An opportunity to engage? (United States)

    Reynolds, Nicola; Desai, Roopal; Zhou, Zheng; Fornells-Ambrojo, Miriam; Garden, Paul


    This study explored engagement with psychology on a specialist early intervention psychosis inpatient unit, with a focus on whether demographics or admission factors impacted on engagement. This was a retrospective cohort study using data extracted from patient notes for all service users who were admitted to an Early Intervention ward during a specified 6-month period. One hundred and one records were identified. Sixty-eight (67.3%) of the service users engaged in psychological therapy, 45.6% (n = 47) attended psychology groups and 58.4% (n = 59) engaged in individual psychology sessions. Service users admitted to the ward voluntarily were more likely to engage in individual psychology sessions in comparison to those admitted under section of the mental health act (β = -0.270, P < .005). Length of admission predicted engagement with groups (β = 0.38, P < .001) and individual psychology sessions (β = 0.408, P < .001). Ethnicity, gender and number of admissions did not predict engagement in psychology. Psychological interventions are acceptable on a specialist early intervention psychosis inpatient ward and offer an opportunity to engage service users. Engagement was not predicted by demographic factors typically seen in community settings. Implications arising from these differences are discussed. © 2017 John Wiley & Sons Australia, Ltd.

  6. Ten steps to establishing an e-consultation service to improve access to specialist care. (United States)

    Liddy, Clare; Maranger, Julie; Afkham, Amir; Keely, Erin


    There is dissatisfaction among primary care physicians, specialists, and patients with respect to the consultation process. Excessive wait times for receiving specialist services and inefficient communication between practitioners result in decreased access to care and jeopardize patient safety. We created and implemented an electronic consultation (e-consultation) system in Eastern Ontario to address these problems and improve the consultation process. The e-consultation system has passed through the proof-of-concept and pilot study stages and has effectively reduced unnecessary referrals while receiving resoundingly positive feedback from physician-users. Using our experience, we have outlined the 10 steps to developing an e-consultation service. We detail the technical, administrative, and strategic considerations with respect to (1) identifying your partners, (2) choosing your platform, (3) starting as a pilot project, (4) designing your product, (5) ensuring patient privacy, (6) thinking through the process, (7) fostering relationships with your participants, (8) being prepared to provide physician payment, (9) providing feedback, and (10) planning the transition from pilot to permanency. In following these 10 steps, we believe that the e-consultation system and its associated improvements on the consultation process can be effectively implemented in other healthcare settings.

  7. Nursing Morbidity and Mortality: The Clinical Nurse Specialist Role in Improving Patient Outcomes. (United States)

    Zavotsky, Kathleen Evanovich; Ciccarelli, Melissa; Pontieri-Lewis, Vicky; Royal, Sandia; Russer, Elizabeth


    The purpose of this article is to discuss the development and implementation of a nursing morbidity and mortality (M&M) monthly conference at an academic medical center. Nursing M&M was developed as a peer review process in which cases where clinical errors or misjudgments that have occurred are reviewed in a nonpunitive setting. The cases are selected based on the National Database for Nursing Quality Indicators and the implications they have for the quality of nursing practice. Morbidity and mortality conferences are well documented in the physician arena as an avenue to review and discuss adverse events. There is little published in the literature related to nursing using this peer review format and what impact this forum can have on clinical outcomes. Clinical nurse specialists and clinical nurse educators are oftentimes positioned to help implement this type of forum and evaluate the impact that it has for the staff and patients that they work with. The clinical nurse specialists/clinical nurse educators at this fourth-time designated Magnet® academic medical center facilitate the monthly M&M and select 4 to 5 cases to present. At the end of each brief presentation, the outcome is determined to be either preventable or unpreventable. Action items for educational needs are also identified. Nursing M&M has been well attended over the past year. Since its inception, multiple practice changes have been implemented. Based on the positive feedback from the evaluations, this monthly conference has become standing practice in the institution.

  8. What Proportion of Terminally Ill and Dying People Require Specialist Palliative Care Services?

    Directory of Open Access Journals (Sweden)

    Donna M. Wilson


    Full Text Available Currently, around 55 million people die each year worldwide. That number is expected to increase rapidly with accelerating population aging. Despite growth in the number of palliative care specialists and specialist services in most countries, the prospect of an increasing number of terminally ill and dying persons is daunting. This paper attempts to answer the question: what proportion of terminally ill and dying persons require specialist palliative care services? To address this question and highlight which persons require specialist palliative care, the current state of access to specialist palliative care services and specialists in Canada and other countries is highlighted, along with available evidence-based information on specialist services utilization and the care needs of terminally ill and dying persons. Current evidence and information gaps reveal that this question cannot be answered now, but it should be answered in advance of a crisis of unmet end-of-life care needs with the rising death toll.

  9. STS-103 Mission Specialist Clervoy DEPARTs PAFB for Houston (United States)


    STS-103 Mission Specialist Jean-Frangois Clervoy of France exhibits his holiday spirit on the runway at Patrick Air Force Base in Cocoa Beach, Fla. The STS-103 crew and their families are preparing to board an airplane that will return them to their home base at the Johnson Space Center in Houston following the successful completion of their mission. Discovery landed in darkness the previous evening, Dec. 27, on runway 33 at KSC's Shuttle Landing Facility at 7:00:47 p.m. EST. This was the first time that a Shuttle crew spent the Christmas holiday in space. The other STS-103 crew members are Commander Curtis L. Brown Jr.; Pilot Scott J. Kelly; and Mission Specialists Steven L. Smith, C. Michael Foale (Ph.D.), John M. Grunsfeld (Ph.D.), and Claude Nicollier of Switzerland. The STS-103 mission accomplished outfitting the Hubble Space Telescope with six new gyroscopes, six new voltage/temperature improvement kits, a new onboard computer, a new solid state recorder and new data transmitter, a new fine guidance sensor along with new insulation on parts of the orbiting telescope. This was the 96th flight in the Space Shuttle program and the 27th for the orbiter Discovery.

  10. Professional Training Of Specialists In International Marketing In Poland

    Directory of Open Access Journals (Sweden)

    Żukowski Wojciech


    Full Text Available Polish experience in training specialists in international marketing in the context of globalization and integration processes has been studied. A range of theoretical resources, namely Market Entry Strategy for Poland; the articles dedicated to international marketing and economy development (W. Grzegorczyk, M. Viachevskyi, M. Urbanetst; program specifications and structures at Polish universities, namely University of Lodz and Collegium Civitas, have been analyzed. It has been defined that marketing is one of the most important activities in all types of organizations since it is a link between customers and companies in the context of global changes in business environment. The need of leading companies for their staff to be highly qualified, open for new opportunities, ready to take an initiative and comprehend the global needs and values has been justified. It has been clarified that both higher education institutions have the same strategic aims, aimed at highly professional specialists’ training, the cultural-based education of youth, stimulating for critical reflection, lifelong learning, and professional development. Positive aspects in Polish experience of training future specialists in international marketing have been defined. Perspectives for further research have been considered.

  11. Opportunity Costs in Paediatric Training: The Specialist Registrars Experience.

    LENUS (Irish Health Repository)

    O’Neill, MB


    In the training process, there is a tension between the work life and home life of trainees. This study explored both the personal impact and the opportunity costs of training from the Specialist Paediatric Registrar (SPR) perspective. The survey explored 1) career progression2) perceived functional effectiveness at work 3) psychological impact of hospital based training and 4) the personal and social cost of training. Fifty-three (71%) SPRs responded of whom 47 (89%)were married or in long term relationships. Seventy-five percent of trainees had a definite career plan with 86% intending to undertake fellowship training. Seventy percent believed they were efficient time managers but 53% had difficulty in making time for academic pursuits and fifty percent experienced negative feelings, which lingered after work and interfered with their relationships at home. Seventy-four percent stated training was undertaken at significant personal cost with only 21% achieving a very satisfactory work\\/life balance. To address these difficulties trainee wellbeing should be addressed at the Basic Specialist Training (BST) level and the career path clearly explained outlining the challenges that are likely to be encountered.

  12. Professional standard of specialist of guardianship and custodianship agency

    Directory of Open Access Journals (Sweden)

    G.V. Semya


    Full Text Available We justified the introduction of the professional standard of specialist of guardianship and custodianship agency taking into consideration the psychological characteristics of the target group of customers. We describe the situation in our country with qualification of professionals, the international trends in the field of protection of the rights of minors in the countries – members of the Organization for Economic Cooperation and Development. We analyze the reflection of the theme of labor functions in the Russian legislation. We reveal the need for psychological and pedagogical knowledge for successful professional of guardianship authorities, compile a list of the necessary skills and knowledge. The main focus of the work of specialists is to maintain the child in the biological family at all stages of working with child and family problems. We characterize the trends in professional activities related to the development of the regional legislation in comparison with federal, increased number of international instruments to which Russia joined in the protection of children's rights. It is stressed that a requirement for education is additional retraining for new programs on the basis of higher education in the following professions and fields of study: law, pedagogy and psychology, social pedagogy and social work.

  13. Current nursing practice by hospital-based stoma specialist nurses. (United States)

    Burch, Jennie

    Nurses frequently care for patients who have stomas. A common complication is sore peristomal skin (skin around the stoma). The study aim was to answer the research question: what is the current nursing practice for peristomal skin problems among UK stoma specialist nurses? The question was explored through investigation of descriptions, treatments and opinions of peristomal skin problems. Results were examined to ascertain if practice reflects the literature and if care was evidence-based. A questionnaire was posted in September 2009 to the stoma care nurses in all UK NHS hospitals (n=596). The proportion of completed or partially completed questionnaires was 15% (89 of 596). Most of the responding nurses held a stoma-related qualification (86%), a degree (55%) and had specialised in stoma care for over 5 years (67%). Respondents used erythema to describe sore skin (80%). Stoma powder (98%) and convex appliances (98%) were the most commonly used treatments. The most common cause of sore skin was appliance leakage (61%). The study population was deemed suitably qualified and experienced to answer the research question. Many responses were reflected in the literature (predominantly opinion articles), reflecting a degree of reliability and validity. It could be concluded that stoma specialist nurses can accurately assess and use stoma accessories to treat sore skin, but due to the paucity of research, the care cannot be defined as evidence-based. More research is needed to determine universally accepted definitions and treatments for sore peristomal skin.

  14. [Education of clinical pharmacy specialists in critical care in Japan]. (United States)

    Maeda, Mikihiro


    In Japan, recent initiation of the reimbursement from the government to monitor patients in intensive care unit (ICU) and the foundation of certified emergency medicine and critical care specialist resulted in the increased number of ICU pharmacists. Because most pharmacy schools in Japan have provided few lectures or rotations related to critical care, pharmacy students may think critical care is a difficult field. Pharmacy students in the United States usually have basic didactic courses for critical care such as sepsis or sedation. They can also take critical care rotations as an elective advanced rotation. An organized postgraduate training programs, pharmacy practice residency programs (PGY1; post graduate year 1) and specialized pharmacy practice residency programs (PGY2), develop clinical knowledge and skills as clinical pharmacists. Critical care is one of the most popular areas in PGY2 specialty residency programs. Through three years pharmacy students and residents can develop required knowledge and skills in critical care such as patient monitoring skill. As a part of new pharmacists training, our institution provides a week of critical care rotation. The main objective is the introduction of critical care to be a pharmacy generalist and to develop patient monitoring skills. The critical care rotation is the first step to develop critical care clinical pharmacy specialists in the future.

  15. Professional communications of Russian technical and engineering specialists: empirical analysis

    Directory of Open Access Journals (Sweden)

    R N Abramov


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

  16. 3rd CEAS Specialist Conference on Guidance, Navigation and Control

    CERN Document Server

    Drouin, Antoine; Roos, Clément


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

  17. Isolated single umbilical artery: need for specialist fetal echocardiography? (United States)

    DeFigueiredo, D; Dagklis, T; Zidere, V; Allan, L; Nicolaides, K H


    To examine the association between single umbilical artery (SUA) and cardiac defects and to determine whether patients with SUA require specialist fetal echocardiography. Incidence and type of cardiac defects were determined in fetuses with SUA detected at routine second-trimester ultrasound examination. A routine second-trimester scan was performed in 46 272 singleton pregnancies at a median gestation of 22 (range, 18-25) weeks and an SUA was diagnosed in 246 (0.5%). Cardiac defects were diagnosed in 16 (6.5%) of these cases, including 10 (4.3%) in a subgroup of 233 with no other defects and in six (46.2%) of the 13 with multiple defects. In 11 (68.8%) of the 16 cases with cardiac defects the condition was readily diagnosable by evaluating the standard four-chamber view and the views of the great arteries. In the remaining cases there was left persistent superior vena cava or small ventricular septal defect, where prenatal diagnosis may not be important because they are not associated with adverse outcome. Although SUA is associated with an increased incidence of cardiac defects it may not be necessary to refer such patients for specialist fetal echocardiography because the defects are detectable by evaluating standard cardiac views that should be part of the routine second-trimester scan. Copyright © 2010 ISUOG. Published by John Wiley & Sons, Ltd.

  18. The Subject in Cognitive Psychotherapy

    Directory of Open Access Journals (Sweden)

    Isabel Caro-Gabalda


    Full Text Available This paper discusses the various subjects embedded in cognitive psychotherapy. The cognitive model developed by Beck, considered as a rationalist and modernist model, will exemplify these subjects. Cognitive therapy should be placed in the modernist historical context and related to a subject characterized as having rationality and the ability to observe and detect cognitions, emotions and behaviors. The paper develops this background introducing three main subject types. The first is the introspective and conscious subject, who is able to observe what is within oneself, has free access, and is conscious of one's cognitive world. The second is the cognitive miser that describes the subject who enters into therapy. The final subject identified, is the trained scientist who is able to develop a more objective knowledge, changing faulty schemas and cognitive distortions. This subject is the one most looked for in cognitive therapy. We could connect these subjects to some of the main elements of cognitive therapy such as the concept of ABC, assessment procedures, cognitive techniques or the relevance of schemas. Finally, the paper suggests some issues for study that could contribute to the theoretical and clinical evolution of cognitive psychotherapy.

  19. Art Appreciation as a Learned Competence: A Museum-Based Qualitative Study of Adult Art Specialist and Art Non-Specialist Visitors (United States)

    Bracun Sova, Rajka


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

  20. Redefining "Community" through Collaboration and Co-Teaching: A Case Study of an ESOL Specialist, a Literacy Specialist, and a Fifth-Grade Teacher (United States)

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


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

  1. Special Aspects of Specialist Training for Military Industrial Complex (Incentives, Conception, Integral Quality Indicator and Practical Recommendations

    Directory of Open Access Journals (Sweden)

    V. V. Ivanenkov


    Full Text Available The paper studies special concepts of so-called mentally structured approach to training the elite specialists of technical profile to be employed by the military industrial complex (MIC.Training of MIC-oriented specialists concerns specialties related to its special status of a dual technology “industrial locomotive”. This, in turn, requires specialized teaching aids, which in their harmonized body are capable to provide training the generalists (multi-discipline specialists to meet a number of specific requirements imposed by this status.One of the features of mentally structured approach that provides the maximum efficiency of training the MIC technical elite is a conceptual statement that it is not only a user or a student (the subjects of the cognitive process who needs to be fitted in the specialty content of a particular subject matter. The syllabus itself (i.e. the objects of a subject matter also needs to be finetuned or adapted to psychophysiological capabilities of users (students in accordance with entitative functioning principles of memory and thinking.In other words, the concept of mentally structured presentation of information materials is that they should not be a projection of subject matter logics only, but also a projection of logics of mental (psychophysiological capability of users or students being subjects of cognitive process. Stated differently, the bridge needs to be built from two harmoniously augmenting each other sides, both from the side of human mental capabilities and from the side of content complexity of the subject matter studied.For this purpose, a special analysis of the operation aspects of the human brain functional systems has been conducted. It was found that functional asymmetry of cerebral hemyspheres has a fractal-quantum logical structure for processing information arriving at the brain input.Dextrocerebral structural components form, primarily, a logical structure of so-called mental fractals


    Directory of Open Access Journals (Sweden)

    Yuriy G. Odegov


    Full Text Available The article deals with the stages of becoming and de-velopment the subject ща labor economy, the problem of training in the eld of labor relations associated with the formation of market relations in Russia, and as consequence, the allocation of separate independent direction of learning for higher education personnel management, the demand for it has been steadily in-creasing. The authors proved the inevitability oriented of learning specialists on the micro- and macrolevel and have offer to create new chairs

  3. [The concept of training anesthesia-resuscitation specialists for high-technology medical aid-delivering health care facilities]. (United States)

    Subbotin, V V; Sitnikov, A V; Il'in, S A


    The paper presents the concept of training specialists in anesthesia-resuscitation for high-technology-delivering facilities. This concept is based on the module-axial type of education based on two basic principles: from complex to simple (from general to particular) (the so-called axis) and the modular organization of an educational process. Education implies the obligatory teaching of the axis (the structuring of the already available knowledge) and specialized programs (modules) are incorporated into a course of subjects if there is a practical need, which permits a student to achieve the necessary level of knowledge and skills.

  4. A descriptive study of visits by animal health specialists in pig farming: type, frequency, and herd-health management factors. (United States)

    Enting, J; van de Laak, M J; Tielen, M J; Huirne, R B; Dijkhuizen, A A


    This research was carried out to analyse the visits specialists of the Dutch Animal Health Service made to growing and fattening pig farms. The type and frequency of the visits and identified herd-health management factors that did not meet accepted standards were investigated. In total 373 visit reports were studied. The majority of the visits (n = 306 of 373) were made to investigate the cause of health, welfare, and performance problems ('problem-solving visits'). Respiratory disorders were the main reason for requesting a specialist to assess farm conditions and management (n = 156). In the other 67 of 373 visit reports the specialists screened for herd-health management factors that did not meet standards for the prevention of disease ('screening visits'). For both types of visits, the main factors detected were abrupt changes in feeding regimens (e.g. changes in feed type, feed composition or feed supplier) (37%), inadequate measures to prevent introduction of pathogens by people and trucks (83%), and incorrect adjustment of the ventilation system (58-60%). The specialists focusing on housing-climate management, identified the majority of factors in an equal number irrespective of whether the visit was a problem-solving visit or a screening visit. This implies that even on farms that appear not to have health or performance problems, factors that relate to disease are present and may cause problems sooner or later. Although veterinary practitioners and other farm advisors assist farmers in their management to optimize herd health, the findings of the research suggest that advisors could provide additional support in situations where environmental and managerial factors play a role in pig health and performance. The knowledge of advisors about integrated herd-health management can be broadened by means of textbooks, courses, or computer programs.

  5. Periodontal maintenance following active specialist treatment: Should patients stay put or return to primary dental care for continuing care? A comparison of outcomes based on the literature. (United States)

    Leavy, P G; Robertson, D P


    To review the evidence for the efficacy of periodontal maintenance (PM) carried out in primary dental care (PDC) compared to the specialist setting for patients previously treated in a specialist setting for chronic (ChP) or aggressive (AgP) periodontitis. A focused PICO question and search protocol were developed. Online databases including MEDLINE, EMBASE, WEB OF SCIENCE™ and COCHRANE LIBRARY were searched along with specialist journals in the subject area of periodontal research. Selection criteria included studies that investigated delivery of PM in both specialist and PDC settings for patients with ChP or AgP over a minimum 12 months. We looked for studies that reported changes in clinical attachment levels (CAL), tooth loss, pocket probing depths (PPDs) and bleeding on probing (BoP) as outcome measures. Eight cohort studies were chosen for inclusion. There was considerable heterogeneity found between the eight studies, which did not allow for quantitative (meta) analysis and statistical testing of differences between groups. Clinical attachment levels remained relatively stable in patients who received specialist PM with mean changes of -0.42 mm to +0.2 mm, while for those enrolled in PDC-based PM for periods >12 months, mean CAL losses were between -0.13 mm and -2.80 mm. PPD reduction for those subjects receiving specialist PM was between 0.05 and 1.8 mm for five studies but two cohorts experienced increases of 0.32 and 0.80 mm, respectively. Increases of up to 2.90 mm (range: -0.1 to +2.90) and a higher proportion of deeper pockets were noted among PDC PM cohorts. Higher rates of BoP among those in receipt of PDC PM were reported in half of all studies. There were insufficient long-term data to make any firm conclusions about the effect of the delivery of PM on tooth loss. Within the limitations of the data available, it appears that specialist PM is effective in sustaining periodontal stability following active specialist intervention. There is

  6. Sensibility and Subjectivity: Levinas’ Traumatic Subject

    Directory of Open Access Journals (Sweden)

    Rashmika Pandya


    Full Text Available The importance of Levinas’ notions of sensibility and subjectivity are evident in the revision of phenomenological method by current phenomenologists such as Jean-Luc Marion and Michel Henry. The criticisms of key tenants of classical phenomenology, intentionality and reduction, are of a particular note. However, there are problems with Levinas’ characterization of subjectivity as essentially sensible. In “Totality and Infinity” and “Otherwise than Being”, Levinas criticizes and recasts a traditional notion of subjectivity, particularly the notion of the subject as the first and foremost rational subject. The subject in Levinas’ works is characterized more by its sensibility and affectedness than by its capacity to reason or affect its world. Levinas ties rationality to economy and suggests an alternative notion of reason that leads to his analysis of the ethical relation as the face-to-face encounter. The ‘origin’ of the social relation is located not in our capacity to know but rather in a sensibility that is diametrically opposed to the reason understood as economy. I argue that the opposition in Levinas’ thought between reason and sensibility is problematic and essentially leads to a self-conflicted subject. In fact, it would seem that violence characterizes the subject’s self-relation and, thus, is also inscribed at the base of the social relation. Rather than overcoming a problematic tendency to dualistic thought in philosophy Levinas merely reverses traditional hierarchies of reason/emotion, subject/object and self/other. 

  7. Roles, Titles and Opinions of Selected State Extension Sheep Specialists, A Partial Summary of a Nationwide Survey. A Research Summary of a Graduate Study. (United States)

    Kazzal, Najeeb T.; And Others

    This survey-type study had the following purposes: (1) to consider the sheep and Extension sheep situation and trends in the nation; (2) to gather information regarding titles and duties of sheep specialists; (3) to collect copies of available job descriptions; and (4) to identify some reasons why sheep numbers have continued to decline.…

  8. Certified peer specialist roles and activities: results from a national survey. (United States)

    Salzer, Mark S; Schwenk, Edward; Brusilovskiy, Eugene


    In 2001 Georgia became the first state to allow services provided by certified peer specialists (CPSs) to be reimbursed by Medicaid. Six other states have since followed Georgia's lead, with many others in the process of doing so. This study examined where CPSs work and what they do. CPSs (N=291) from 28 states completed an online survey. CPSs primarily did their work within the agency rather than in the community and worked most often with individuals rather than groups. CPSs frequently provided peer support and focus on self-determination, health and wellness, hope, communication with providers, illness management, and stigma. They spent the least amount of time supporting people's family, parenting, dating, or spiritual relationships. CPS work settings and modalities varied greatly, although a core set of activities was identified. Implications for developing and refining CPS roles in the system are discussed, along with suggestions for additional training and supervision.

  9. [Exercise-referral to a specialist in adapted physical activity (APA) : a pilot project]. (United States)

    Brugnerotto, Adeline; Cardinaux, Regula; Ueltschi, Yan; Bauwens, Marine; Nanchen, David; Cornuz, Jacques; Bize, Raphaël; Auer, Reto


    Family physicians have a key role in the promotion of physical activity, in particular in identifying and counseling persons who have a sedentary lifestyle. Some patients could benefit from intensive individual counseling. Physicians are often not aware of all physical activity promotion activities in the community that they could recommend their patients. In a pilot study, we have tested and adapted the referral of patients from family physicians to specialists in adapted physical activity (APAs). APAs are trained to assess and guide persons towards physical activities adapted to their needs and pathologies and thus towards an increase in physical activity. Pilot data suggest that, while few patients were oriented to the APAs in the pilot project, family physicians appreciate the possibility of collaborating with the APAs.

  10. Specialist/generalist division of responsibility for patients with mental disorders. (United States)

    Regier, D A; Goldberg, I D; Burns, B J; Hankin, J; Hoeper, E W; Nycz, G R


    The division of responsibility between general medical staff and mental specialists for care of persons with medical record diagnoses of mental disorders is documented in four organized health care settings. Rates of mental disorders identified in all departments ranged from 35.6 to 122.8 per 1,000 population. Specialty mental health departments treated most severe psychotic and personality disorders, plus transient situational disturbances, whereas neurotic, childhood behavior, and psychophysiological disorders received as much or greater attention in general medical departments. Mental disorder diagnoses were associated with greater patient use of general medical departments. However, joint specialty mental health/general medical treatment of these patients was associated with lower general medical department visit rates in all settings. Such joint care was facilitated by the low average visit frequency use of mental health departments. (2.2 to 8.9 visits per patient per year).

  11. Nursing and knowledge work: issues regarding workload measurement and the informatics nurse specialist. (United States)

    Windsor, Jason


    The profession of nursing has been faced with questions concerning workload measurement for decades, and those concerns continue to be relevant today. Traditionally, nursing has turned to time-motion studies to study this, but there is a debate about how relevant time-motion studies are to the profession of nursing when it is viewed as knowledge work. Healthcare workers, including the nursing profession, may be the single biggest group of knowledge workers. Knowledge workers today represent a significantly different workforce than are the workers of the past. Informatics, as a specialty, is relatively new to the nursing profession and continually evolving. As more nurses enter informatics and function as informatics nurse specialists, they will continue to be in the group of knowledge workers whose observable input and output is difficult to measure. Today's healthcare leaders, managers, and administrators need to identify an appropriate method of workload measurement for knowledge workers.

  12. An Inverse Method of Teaching Specialised Manufacturing Subjects: Decomposing a Focal Representative Product to Sustain Analysis and Interaction of Details (United States)

    Axinte, D. A.


    The paper presents an "inverse" method to teach specialist manufacturing processes by identifying a focal representative product (RP) from which, key specialist manufacturing (KSM) processes are analysed and interrelated to assess the capability of integrated manufacturing routes. In this approach, RP should: comprise KSM processes; involve…

  13. Recognition of lameness and decisions to catch for inspection among sheep farmers and specialists in GB

    Directory of Open Access Journals (Sweden)

    Green LE


    Full Text Available Abstract Background Epidemiological studies have used farmer estimates of the prevalence of lameness in their flocks. This assumes that farmers can identify lame sheep. Eight movie clips of sheep with locomotion from sound to moderately lame were used to investigate the ability of farmers and sheep specialists to recognise lame sheep. Each participant was asked to complete a form and indicate, for each movie clip, whether they thought the sheep was lame and whether they would catch it if it was the only lame sheep or if 2 – 5, 6 – 10 or > 10 sheep were equally lame. The farmers' responses were compared with their estimates of flock lameness prevalence and the interval between observing a lame sheep and catching it. Results 178 farmers and 54 sheep specialists participated. Participants could identify even mildly lame sheep but made a separate decision on whether to catch them. This decision was dependent on the severity of lameness and the number of sheep lame in a group. Those who said they would catch the first lame sheep in a group were significantly more likely to catch mildly lame sheep (farmer-reported median prevalence of lameness 5% (IQR: 2%–6%. In contrast, farmers who waited for several sheep to be lame indicated that they would only catch more severely lame sheep (farmer reported median flock lameness 11% (IQR: 9%–15%. Approximately 15% of farmers did not catch individual lame sheep (farmer reported median flock lameness 15% (IQR: 10%–15%. The flock prevalence of lameness increased as time to treatment increased and time to treatment was positively correlated with only catching more severely lame sheep. Conclusion If movie-clips are similar to the flock situation, farmers and specialists can recognise even mildly lame sheep but vary in their management from prompt treatment of the first lame sheep in a group to no individual sheep treatments. The former practices would be appropriate to minimise transmission of footrot, a

  14. [What is the subject of science "bioinformatics"?]. (United States)

    Chaĭlakhian, L M


    The paper is concerned with some problems of terminology, in particular the term "bioinformatics". In the last few years, the term "bioinformatics" has been intensively used among molecular biologists to indicate a subject that is only a constituent of genomics and is considered to involve a computer-assisted analysis of all data on nucleotide sequences of DNA. However, a wide circle of scientists, including biologists, physicists, mathematicians, and specialists in the field of cybernetics, informatics, and other disciplines have accepted and accept, as a rule, the "bioinformatics" as a synonym of science cybernetics and as a successor of this science. In this case, the subject of science "bioinformatics" should embrace not only genomics but practically all sections of the biological science. It should involve a study of information processes (storage, transfer, and processing of information, etc.) participating in the regulation and control at all levels of living systems, from macromolecules to the brain of higher animals and human.

  15. New study program: Interdisciplinary Postgraduate Specialist Study in Medical Informatics. (United States)

    Hercigonja-Szekeres, Mira; Simić, Diana; Božikov, Jadranka; Vondra, Petra


    Paper presents an overview of the EU funded Project of Curriculum Development for Interdisciplinary Postgraduate Specialist Study in Medical Informatics named MEDINFO to be introduced in Croatia. The target group for the program is formed by professionals in any of the areas of medicine, IT professionals working on applications of IT for health and researchers and teachers in medical informatics. In addition to Croatian students, the program will also provide opportunity for enrolling students from a wider region of Southeast Europe. Project partners are two faculties of the University of Zagreb - Faculty of Organization and Informatics from Varaždin and School of Medicine, Andrija Štampar School of Public Health from Zagreb with the Croatian Society for Medical Informatics, Croatian Chamber of Economy, and Ericsson Nikola Tesla Company as associates.

  16. An approach to mentoring healthcare play specialist students. (United States)

    Brown, Rachel; Jubb, Mags


    Healthcare play specialists (HPSs) provide therapeutic play programmes for children in healthcare settings. Each HPS student must have a mentor in practice, but most HPSs have received no formal training for their role. This article explores mentoring in the HPS service at Guy's and St Thomas' NHS Foundation Trust. A study day for HPSs was arranged to share best practice and discuss the challenges of mentoring students. Stronger links were built between the higher education institute that delivers the training to HPS students and the trust, and the HPSs were provided with a deeper understanding of what was required of them in their mentoring role. HPSs highlighted the importance of a yearly update on mentoring students.

  17. Professional applied physical training of future specialists of agricultural production

    Directory of Open Access Journals (Sweden)

    Karabanov Y.A.


    Full Text Available Purpose : develop and experimentally prove the contents, methods and forms of physical training of future specialists of agricultural production. This takes into account advanced course of professional applied physical preparation means kettlebell sport. Material : The study involved 141 students. Duration of study is 5 years. Results : It was found that a significant increase in indicators of flexibility, strength, coordination abilities of students promoted the use of exercises using weights of different weights. Confirmed the legitimacy of the use of such means of physical education for the development of muscle strength of the upper body, back, legs, abdominals. These muscles are the most loaded in the performance of professional activities of mechanical engineers. Conclusions : The program meets the basic criteria for the formation of curriculum for physical education. The program promotes the development of professional applications of physical qualities, motor skills and improve physical performance of students.

  18. 2nd CEAS Specialist Conference on Guidance, Navigation and Control

    CERN Document Server

    Mulder, Bob; Choukroun, Daniel; Kampen, Erik-Jan; Visser, Coen; Looye, Gertjan


    Following the successful 1st CEAS (Council of European Aerospace Societies) Specialist Conference on Guidance, Navigation and Control (CEAS EuroGNC) held in Munich, Germany in 2011, Delft University of Technology happily accepted the invitation of organizing the 2nd  CEAS EuroGNC in Delft, The Netherlands in 2013. The goal of the conference is to promote new advances in aerospace GNC theory and technologies for enhancing safety, survivability, efficiency, performance, autonomy and intelligence of aerospace systems using on-board sensing, computing and systems. A great push for new developments in GNC are the ever higher safety and sustainability requirements in aviation. Impressive progress was made in new research fields such as sensor and actuator fault detection and diagnosis, reconfigurable and fault tolerant flight control, online safe flight envelop prediction and protection, online global aerodynamic model identification, online global optimization and flight upset recovery. All of these challenges de...

  19. Andragogical Model in Language Training of Mining Specialists (United States)

    Bondareva, Evgeniya; Chistyakova, Galina; Kleshevskyi, Yury; Sergeev, Sergey; Stepanov, Aleksey


    Nowadays foreign language competence is one of the main professional skills of mining engineers. Modern competitive conditions require the ability for meeting production challenges in a foreign language from specialists and managers of mining enterprises. This is the reason of high demand on foreign language training/retraining courses. Language training of adult learners fundamentally differs from children and adolescent education. The article describes the features of andragogical learning model. The authors conclude that distance learning is the most productive education form having a number of obvious advantages over traditional (in-class) one. Interactive learning method that involves active engagement of adult trainees appears to be of the greatest interest due to introduction of modern information and communication technologies for distance learning.

  20. The clinical nurse specialist: from the outside looking in. (United States)

    Storr, G


    This paper considers the role of the clinical nurse specialist (CNS) as portrayed in the literature. The historical development of the role is highlighted, rationale for preparation at an advanced level presented and controversy regarding placement of the CNS in a line or staff position outlined. Also discussed are the five commonly accepted sub-roles of the CNS (practitioner, educator, consultant, researcher and change agent) as well as a new role (staff advocate) which can be seen to be emerging in the literature. The author presents some of her observations of the role of the CNS at a large urban teaching hospital and concludes that congruence between the ideal role portrayed in the literature and the actual practice of the role is possible.

  1. Scandinavian Nurse Specialist Group/Cystic Fibrosis (SNSG/CF)

    DEFF Research Database (Denmark)

    Bregnballe, Vibeke; Erwander, Inger


    Aims: SNSG/CF was established to stimulate and improve cooperation between CF nurses from Scandinavian CF centers. Methods: SNSG/CF includes all the CF centers in Norway (Oslo and Bergen), Sweden (Stockholm, Gothenburg, Lund and Uppsala) and Denmark (Copenhagen and Aarhus). The board of SNSG....../CF comprises one CF nurse from each of the centers. The board meets twice a year to plan workshops and courses. SNSG/CF is part of the International Nurse Specialist Group/Cystic Fibrosis (INSG/CF). Results: Within the framework of SNSG/CF a 2-day workshop is held every second year for approximately 40...... Scandinavian CF nurses. A twelve-day CF course equivalent to 5 ECTS has been held once. Twenty-one nurses, physiotherapists and dieticians attended the course and the course will be repeated. SNSG/CF plans to make a common Scandinavian database on nursing interventions in CE SNSG/CF aims to conduct common...

  2. Andragogical Model in Language Training of Mining Specialists

    Directory of Open Access Journals (Sweden)

    Bondareva Evgeniya


    Full Text Available Nowadays foreign language competence is one of the main professional skills of mining engineers. Modern competitive conditions require the ability for meeting production challenges in a foreign language from specialists and managers of mining enterprises. This is the reason of high demand on foreign language training/retraining courses. Language training of adult learners fundamentally differs from children and adolescent education. The article describes the features of andragogical learning model. The authors conclude that distance learning is the most productive education form having a number of obvious advantages over traditional (in-class one. Interactive learning method that involves active engagement of adult trainees appears to be of the greatest interest due to introduction of modern information and communication technologies for distance learning.

  3. Clinical nurse specialist leadership in computerized provider order entry design. (United States)

    Roggow, Darla J; Solie, Carol J; Tracy, Mary Fran; Gjere, Niki


    The purpose of this clinical project was to design and implement a computerized provider order entry system. Well-designed clinical computer systems can advance best practice and quality decision making, leading to improvements in patient and organizational outcomes. An Orders Design Group composed of clinical nurse specialists (CNSs), staff nurses, and information management personnel was formed. CNSs used competencies in the system sphere to lead the integration of the needs of patients, nurses, and organizations into new technologies. CNSs facilitated implementation of a collaboratively designed interdisciplinary computerized order entry process. Evaluation of the design and implementation process demonstrated greater success with the order entry system under the leadership of CNSs than past initiatives where CNSs were not in leadership roles. CNS competencies in designing and implementing innovative system-level solutions are key to clinical information systems design.

  4. STS-88 Mission Specialist Krikalev dons flight suit (United States)


    In the Operations and Checkout Building, STS-88 Mission Specialist Sergei Konstantinovich Krikalev, a Russian cosmonaut, gives a thumbs up during suit check before launch. Mission STS-88 is expected to lift off at 3:56 a.m. EST with the six-member crew aboard Space Shuttle Endeavour on Dec. 3. Endeavour carries the Unity connecting module, which the crew will be mating with the Russian-built Zarya control module already in orbit. In addition to Unity, two small replacement electronics boxes are on board for possible repairs to Zarya batteries. The mission is expected to last 11 days, 19 hours and 49 minutes, landing at 10:17 p.m. EST on Dec. 14.

  5. Professional socialization of students in clinical nurse specialist programs. (United States)

    Ares, Terri L


    Graduate nursing programs facilitate the transition of RNs to advanced roles through a complex process of professional socialization. The purpose of this study was to explore the professional socialization of clinical nurse specialist (CNS) students. Two hundred twenty-five students, representing 73 CNS programs, responded to an online survey. Both preprogram variables and educational experiences contributed to an adequate level of CNS socialization. Students' self-concept was strong, and they felt prepared to practice in the role, which was highly correlated with their perceptions of how well the program prepared them academically and experientially. Having a CNS mentor was positively associated with readiness to practice. Outcomes did not vary with cohort status, and online instruction did not impede socialization. These findings provide implications for CNS program advisement and design. Copyright 2014, SLACK Incorporated.

  6. STS-99 Mission Specialist Thiele returns to KSC for launch (United States)


    STS-99 Mission Specialist Gerhard P.J. Thiele (Ph.D.), with the European Space Agency, arrives at KSC aboard a T-38 jet aircraft eager to prepare for the second launch attempt of Endeavour Feb. 11 at 12:30 p.m. EST from Launch Pad 39A. The earlier launch scheduled for Jan. 31 was scrubbed due to poor weather and a faulty Enhanced Master Events Controller in the orbiter's aft compartment. Over the next few days, the crew will review mission procedures, conduct test flights in the Shuttle Training Aircraft and undergo routine preflight medical exams. STS-99 is the Shuttle Radar Topography Mission, which will produce unrivaled 3- D images of the Earth's surface. The result of the Shuttle Radar Topography Mission could be close to 1 trillion measurements of the Earth's topography. Landing is expected at KSC on Feb. 22 at 4:36 p.m. EST.


    Lingg, Myriam; Merida-Herrera, Everth; Wyss, Kaspar; Durán-Arenas, Luis


    The aim of this study was to assess viewpoints of end-users concerning the purchasing process of high-risk medical devices and to discuss the relevance of health technology assessments (HTAs) at the hospital level and other potential areas for improvement of purchasing processes. We used a cross-sectional study and assessed the attitudes and thoughts of orthopedic specialists. The study took place between June and October 2015 in Mexico. We collected data from 187 orthopedic surgeons. Involvement of orthopedic specialists in purchasing was reported by 86 percent. However, clinical practice was perceived as negatively influenced by purchasing outcomes by 92 percent. The problems were described as: material failure; effectiveness of medical devices; obsolete medical device technology; incomplete provision of implant / instrument sets; delayed provision of implants and instruments. To prevent sub-standard outcomes of purchasing decisions, this study and the current literature suggest that technologies should be assessed during the purchasing process, end-users should be adequately involved, and decisions should be based on multiple criteria including clinical impact in the short-term (e.g., primary stability of implant) and long-term (e.g., survival of implant). The focus on Mexico is particularly novel and provides insights into a health system where HTA is mainly present at the macro level and can be used for the listing of medical device technologies in the standard list. This study concludes that Mexican stakeholders of the purchasing process underestimate the contribution of HTAs at the level of purchasing decisions. HTA in Mexico has improved over the past years but still requires more advancement.

  8. Clinical nurse specialist assessment of nurses' knowledge of heart failure. (United States)

    Mahramus, Tara L; Penoyer, Daleen Aragon; Sole, Mary Lou; Wilson, Debra; Chamberlain, Lyne; Warrington, William


    Patients' self-management of heart failure (HF) is associated with improved adherence and reduced readmissions. Nurses' knowledge about self-management of HF may influence their ability to adequately perform discharge education. Inadequate nurse knowledge may lead to insufficient patient education, and insufficient education may decrease patients' ability to perform self-management. Prior to developing interventions to improve patient education, clinical nurse specialists should assess nurses' knowledge of HF. The purpose of this study was to determine nurses' knowledge of HF self-management principles. This was a prospective, exploratory, and descriptive online test. There were 3 patient care settings: tertiary care teaching hospital, community hospital, and home healthcare division. The sample was composed of 90 registered nurses who worked directly with patients with HF. Nurses completed an online test of knowledge using the Nurses' Knowledge of Heart Failure Education Principles instrument. Registered nurses (n = 90) completed the knowledge test instrument; their average score was 71% (SD, 10.8%) (range, 20%-90%). The percentage of correct items on each subscale ranged from 63.9% (SD, 30.0) for medications to 83.3% (SD, 25.0) for exercise. Only 8.9% of respondents achieved a passing score of greater than 85%, and a passing score was not associated with any demographic characteristics. Overall, nursing knowledge of HF self-management principles was low. Scores from our nurses were similar to those found in other studies. There is a need to develop interventions to improve nursing knowledge of HF self-management principles. Clinical nurse specialists can be instrumental in developing knowledge interventions for nurses.

  9. Neurophysiology training in the Neurology Specialist Education Program in Spain. (United States)

    Rodríguez-Antigüedad, A; Matías-Guiu, J; Hernández-Pérez, M A; Jiménez Hernández, M D; Martín González, M R; Morales Ortiz, A; Delgado, G; Frank, A; López de Silanes, C; Martínez-Vila, E


    The training period in neurophysiology is a substantial part of the Neurology Specialist Program in Spain. The National Neurology Committee (La Comisión Nacional de Neurología (CNN), which is the body reporting to the Ministries of Health and Education, must ensure compliance to the Program. During the first trimester of 2008, the CNN sent a questionnaire, in which there was a question asking about this training period, to each of the managers of the 69 teaching units accredited for neurology training in Spain, for them to answer. Of the 69 questionnaires issued, 49 were received completed, which was a response rate of 71%. The neurophysiology training period of the neurology specialist program in Spain was carried out in the same hospital in 44 teaching unit (90%): the remaining 5 sent their neurology trainees to 4 different hospitals. The Unit that carried out the neurophysiology training period was incorporated into the Neurology Department in 27 (55%) cases, and the formula was mixed in 3 (6%). A total of 69% of tutors were satisfied with the training, but was 90% in the hospitals where the unit was integrated into Neurology, and was 65% where this relationship did not exist. The neurologists in training were informed about EEG in 49% of education units, performed EMG/ENG 57%, and informed about evoked potentials in 35% after their training period. Although the level of satisfaction is high, the level of responsibility assumed by the neurologists in training during their rotation into neurophysiology does not appear to comply to the demands laid out in the training program, particularly in these units not integrated into Neurology Departments. Copyright © 2010 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  10. Revisioning a clinical nurse specialist curriculum in 3 specialty tracks. (United States)

    Arslanian-Engoren, Cynthia; Sullivan, Barbara-Jean; Struble, Laura


    The objective of the present study was to revise 3 clinical nurse specialist (CNS) educational tracks with current National Association of Clinical Nurse Specialist core competencies and educational expectations. National curricula recommendations include core competencies by the 3 spheres of influence. Advanced practice registered nurses consensus model educational requirements include a minimum of 500 faculty-supervised clinical hours; separate graduate courses in pharmacology, pathophysiology, and advanced physical assessment; and content in differential diagnosis disease management, decision making, and role preparation. This educational initiative was designed to (1) align with core competencies and advanced practice registered nurse consensus model recommendations, (2) create an innovative learning environment, (3) meet the needs of diverse student populations, (4) align with emerging doctor of nursing practice programs, (5) create a high-efficiency and high-quality environment to manage human and fiscal resources, and (6) reduce duplication of efforts. Courses were revised that did not meet current CNS educational preparation expectations. A total of 11 didactic and clinical sequences courses were developed for the 3 tracks to (1) ensure minimum numbers of clinical hours; (2) expand content on health promotion and risk reduction, advanced practice nurse role, and the healthcare delivery system; (3) consolidate clinical courses; and (4) resequence foundational content before beginning clinical courses. Revisioning a CNS curriculum in 3 specialty tracks is challenging but doable using innovative and creative approaches. The innovative process used to revise our CNS curriculum will assist nurse educators faced with similar program delivery challenges to meet future directions for educating CNS students in advanced nursing practice. Copyright © 2011 Lippincott Williams & Wilkins.

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

    DEFF Research Database (Denmark)

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


    Aim As in many countries, medical and surgical specialists in New Zealand have the opportunity of working in the public sector, the private sector or both. This study aimed to explore the level and sources of satisfaction and dissatisfaction of specialists in New Zealand with working in the two....... Results Completed surveys were received from 943 specialists (47% response rate). Overall mean levels of satisfaction were higher in the private sector than the public sector while levels of dissatisfaction were lower. While the public system is valued for its opportunities for further education...... and dissatisfaction amongst specialists are different for the public and private sectors. Allowing specialists more freedom to work independently and to apply their own ideas in the workplace may enhance recruitment and retention of specialists in the public health system....

  12. Scori: specialist of the thermal treatment of wastes in cement industry; Scori: specialiste du traitement thermique des dechets en cimenterie

    Energy Technology Data Exchange (ETDEWEB)



    Todays, the valorization in cement industry is an integral part of the treatment of industrial wastes in France. This solution, widely developed in other European countries, has been considered as an integral way of wastes elimination by the European directive on special industrial wastes incineration. In this context, with 460000 t processed in France and Belgium and a 600000 t capacity, the SCORI company is considered as the European specialist of the industrial wastes treatment in cement industry thanks to its know-how developed with its partners Ciment Calcia, Lafarge Ciments, Holderbank and Vicat. This paper describes the advantages of cement kilns for the destruction of organic compounds, the part of inorganic and mineral wastes introduced, the purification of combustion gases, the energy valorization of wastes, the pre-treatment of some special wastes before combustion, and the different types of wastes accepted in cement industry (selection, risk assessment, legal aspects and safety). (J.S.)

  13. Necesidades de aprendizaje del especialista en Medicina General Integral sobre síndrome demencial Needs of learning of specialist of Integral General Medicine on dementia syndrome

    Directory of Open Access Journals (Sweden)

    Víctor T. Pérez Martínez


    Full Text Available Introducción: las necesidades de aprendizaje o capacitación son la resultante de un proceso de comparación entre un patrón de conocimientos o habilidades y la realidad. Siempre resulta de contrastar un desempeño ideal o propuesto con el real, bien sea para un individuo o un grupo determinado. Objetivos: identificar las necesidades de aprendizaje que, sobre el síndrome demencial, tienen los médicos que laboran en los equipos de atención primaria de salud del municipio Playa. Métodos: se realizó la identificación de necesidades de aprendizaje mediante un cuestionario escrito, que se aplicó de forma colectiva y anónima a 20 especialistas de Medicina General Integral seleccionados al azar y que laboran en tres policlínicos del extremo este del municipio Playa. Resultados: se puntualizaron las deficiencias e insuficiencias de los conocimientos y habilidades profesionales sobre el síndrome demencial, fundamentalmente en lo referente al diagnóstico, y su terapéutica desactualizada. Conclusiones: a pesar de que la demencia senil constituye una entidad mayor en el orden geriátrico, psiquiátrico, epidemiológico y socioeconómico, la gran mayoría de los especialistas no la identifican debidamente, por lo que persiste como una entidad infradiagnosticada e infravalorada.Introduction: needs of learning or training are the result of a comparison process between the knowledges or abilities and the reality. Always it comes of to verify an ideal performance or the proposed compared to the real one, for a subject or a determined group. Objectives: to identify the needs of learning that on the dementia syndrome, have the physicians working in health primary care teams from Playa municipality. Methods: authors identified the needs of learning by a written questionnaire, applied in a collective or anonymous way in 20 specialists of Integral General Medicine working in three polyclinics from eastern extreme of Playa municipality. It was a random

  14. Current models of care for disorders of sex development - results from an International survey of specialist centres. (United States)

    Kyriakou, Andreas; Dessens, Arianne; Bryce, Jillian; Iotova, Violeta; Juul, Anders; Krawczynski, Maciej; Nordenskjöld, Agneta; Rozas, Marta; Sanders, Caroline; Hiort, Olaf; Ahmed, S Faisal


    To explore the current models of practice in centres delivering specialist care for children with disorders of sex development (DSD), an international survey of 124 clinicians, identified through DSDnet and the I-DSD Registry, was performed in the last quarter of 2014. A total of 78 (63 %) clinicians, in 75 centres, from 38 countries responded to the survey. A formal national network for managing DSD was reported to exist in 12 (32 %) countries. The paediatric specialists routinely involved in the initial evaluation of a newborn included: endocrinologist (99 %), surgeon/urologist (95 %), radiologist (93 %), neonatologist (91 %), clinical geneticist (81 %) and clinical psychologist (69 %). A team consisting of paediatric specialists in endocrinology, surgery/urology, clinical psychology, and nursing was only possible in 31 (41 %) centres. Of the 75 centres, 26 (35 %) kept only a local DSD registry and 40 (53 %) shared their data in a multicentre DSD registry. Attendance in local, national and international DSD-related educational programs was reported by 69, 78 and 84 % clinicians, respectively. Participation in audits/quality improvement exercises in DSD care was reported by 14 (19 %) centres. In addition to complex biochemistry and molecular genetic investigations, 40 clinicians (51 %) also had access to next generation sequencing. A genetic test was reported to be more preferable than biochemical tests for diagnosing 5-alpha reductase deficiency and 17-beta hydroxysteroid dehydrogenase 3 deficiency by 50 and 55 % clinicians, respectively. DSD centres report a high level of interaction at an international level, have access to specialist staff and are increasingly relying on molecular genetics for routine diagnostics. The quality of care provided by these centres locally requires further exploration.

  15. The ICT Level of Confidence of Course Specialists in Distance Education: The Polytechnic University of the Philippines Experience

    Directory of Open Access Journals (Sweden)

    Caroline T. SUMANDE


    Full Text Available This study intends to assess the ICT needs of the course specialists at Polytechnic University of the Philippines under the Open University System (PUP-OUS which may be the basis in conducting training on the different applications such as word processing, electronic spread sheet, presentation software, YouTube and etc. for the successful implementation of the community Learning Management System (LMS endeavor in the University. This is also a review of the current practices of the course specialists in the use of ICT to better facilitate teaching and learning process through the LMS or the PUP Open University eMabini Learning Portal. This particularly identifies various training programs that may be considered in order to successfully implement the system. Internally, the quality and success implementation of a certain program can be best determined if both of the faculty members and students had maximized its utility and made a gratifying experience afterwards. The overarching research questions – Are the Course Specialists (CS confident to utilize the LMS in teaching? Are they aware of various eLearning strategies that may help geographically dispersed learners? And what is the extent of eLearning utilization for instructions by the CS? Though a high percentage of course specialists are fully competent with computer applications such as word documents, PDF documents, email, multi-media presentations, e-learning tools for submission of requirements, assessment of students performance, and other systems integrated in handling OU Cyber classes, still the meager percentage of responses stating, “using these systems but need further practice/training” or “not aware of the application” can be alarming for PUP Open University’s goal to achieve pure online implementation in the next few years. This study concludes to create a long-term vision for the future of DE system in the University to best serve its clientele, “the DE students.”

  16. The Snowtweets Project: communicating snow depth measurements from specialists and non-specialists via mobile communication technologies and social networks (United States)

    King, J. M.; Cabrera, A. R.; Kelly, R. E.


    With the global decline of in situ snow measurements for hydrometeorological applications, there is an evolving need to find alternative ways to collect localized measurements of snow. The Snowtweets Project is an experiment aimed at providing a way for people interested in making snow measurements to quickly broadcast their measurements to the internet. The goal of the project is to encourage specialists and non-specialists alike to share simple snow depth measurements through widely available social networking sites. We are currently using the rapidly growing microblogging site Twitter ( as a broadcasting vehicle to collect the snow depth measurements. Using 140 characters or less, users "tweet" their snow depth from their location through the Twitter website. This can be done from a computer or smartphone with internet access or through SMS messaging. The project has developed a Snowtweets web application that interrogates Twitter by parsing the 140 character string to obtain a geographic position and snow depth. GeoRSS and KML feeds are available to visualize the tweets in GoogleEarth or they can be viewed in our own visualiser, Snowbird. The emphasis is on achieving wide coverage to increase the number of microblogs. Furthermore, after some quality control filters, the project is able to combine the broadcast snow depths with traditional and objective satellite remote sensing-based observations or hydrologic model estimates. Our site,, was launched in July 2009 and is ready for the 2009-2010 northern hemisphere winter. We invite comments from experienced community participation projects to help improve our product.

  17. Measurement and Improvement of Subject Specialists Performance Searching Chemical Abstracts Online as Available on SDC Search Systems. (United States)

    Copeland, Richard F.; And Others

    The first phase of a project to design a prompting system to help semi-experienced end users to search Chemical Abstracts online, this study focused on the differences and similarities in the search approaches used by experienced users and those with less expertise. Four online searches on topics solicited from chemistry professors in small…

  18. A retrospective population based cohort study of access to specialist palliative care in the last year of life: who is still missing out a decade on? (United States)

    Rosenwax, Lorna; Spilsbury, Katrina; McNamara, Beverley A; Semmens, James B


    Historically, specialist palliative care has been accessed by a greater proportion of people dying with cancer compared to people with other life-limiting conditions. More recently, a variety of measures to improve access to palliative care for people dying from non-cancer conditions have been implemented. There are few rigorous population-based studies that document changes in palliative care service delivery relative to the number of patients who could benefit from such services. A retrospective cohort study of the last year of life of persons with an underlying cause of death in 2009-10 from cancer, heart failure, renal failure, liver failure, chronic obstructive pulmonary disease, Alzheimer's disease, motor neurone disease, Parkinson's disease, Huntington's disease and/or HIV/AIDS. The proportion of decedents receiving specialist palliative care was compared to a 2000-02 cohort. Logistic regression models were used identify social and demographic factors associated with accessing specialist palliative care. There were 12,817 deaths included into the cohort; 7166 (56 %) from cancer, 527 (4 %) from both cancer and non-cancer conditions and 5124 (40 %) from non-cancer conditions. Overall, 46.3 % of decedents received community and/or hospital based specialist palliative care; a 3.5 % (95 % CI 2.3-4.7) increase on specialist palliative care access reported ten years earlier. The majority (69 %; n = 4928) of decedents with cancer accessed palliative care during the last year of life. Only 14 % (n = 729) of decedents with non-cancer conditions accessed specialist palliative care, however, this represented a 6.1 % (95 % CI 4.9-7.3) increase on the specialist palliative care access reported for the same decedent group ten years earlier. Compared to decedents with heart failure, increased odds of palliative care access was observed for decedents with cancer (OR 10.5; 95 % CI 9.1-12.2), renal failure (OR 1.5; 95 % CI 1.3-1.9), liver failure (OR 2.3; 95

  19. Requirements of Employers for Young Specialists and Issues of Their Training at the Educational Institutions: Regional Specificity of Moscow

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    Vyacheslav Nikolaevich Bobkov


    Full Text Available The subject-matter of the article is the study of the peculiarities of the youth labour market in such a specific region of Russia as the city of Moscow. The topic of the work is connected to the adaptation of young specialists training system to the regional requirements of the employers of Moscow. The main hypothesis of the research assumes that Moscow is the atypical region of Russia and it is inexpedient to apply criteria and methodological approaches, which are standard for our country, to its labour market. As a method of the research, a selective survey of key employers of Moscow and respondents aged from 14 till 30 years has been used. The data of the sociological survey conducted by the authors have allowed to establish the following features of the researched region: a respectively low level of youth unemployment compared with the whole Russia; focusing of employers on such features of personnel as a good communicative skills learning ability, professional knowledge and competences. Moscow employers don’t pay significant attention to such characteristics of young specialists as language and computer skills, computer knowledge and the diploma of a prestigious educational institution. The main difficulties in finding employment for young specialists in the city of Moscow are: overestimated salary expectations; the weak professional training level and unwillingness, in fact, to work. As a result of the survey, the practical offers have been formulated. There are two directions of their application: the offers focused on the behaviour of the youth at a stage of their training and those offers focused on the increase of a practical component of the activity of professional educational institutions. The authors came to conclusions about the need of a deep orientation of educational institutions to the applied training for specialists, of practical workers for teaching special disciplines, the development by future specialists their

  20. Specialist clinics in remote Australian Aboriginal communities: where rock art meets rocket science. (United States)

    Gruen, Russell; Bailie, Ross


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

  1. Attitudes, practices on allergic rhinitis of generalists and specialists in Philippine National Capital Region (United States)

    Romualdez, Joel A.


    Background Treatment of allergic rhinitis (AR) consistent with consensus guidelines is reported to result in better patient outcomes. However, physicians may manage patients independently of guidelines. Asian data on physician perspectives regarding AR diagnosis and management is limited. Objective The study objective is to assess attitudes and practices on AR of Filipino specialists and generalists. Methods A cross sectional survey of 100 specialists and 100 generalists was conducted from November 2014 to January 2015. A previously validated and pilot tested questionnaire was administered via structured face to face interviews. Results Specialists reported greater adequate knowledge of AR (specialists, 58%; generalists, 39%) and adherence to guidelines (specialists, 84%; generalists, 54%). Diagnostic tests were not routinely used (specialists, 81%; generalists, 92%). Monotherapy, specifically antihistamines, was preferred for mild AR. For moderate-severe AR, preference for monotherapy versus combination therapy (specialists, 49% vs. 51%; generalists, 44% vs. 56%) was similar. Both groups preferred intranasal corticosteroid spray (INCS) for monotherapy and antileukotrienes, antihistamines, INCS for combination therapy. For adjuvant therapy, specialists (82%) preferred nasal irrigation/douche. Primary consideration for choice of therapy was efficacy. Cost was the perceived reason for patients' noncompliance with treatment. Conclusion Despite differences in awareness of and adherence to guidelines, prescribing patterns on management of mild and moderate-severe AR are similar among Filipino specialists and generalists. This can be attributed to a shared perception of efficacy and cost as drivers for therapeutic choices. PMID:26539402

  2. Ankle fracture controversies: Do the foot and ankle specialists have a different vision? (United States)

    González-Lucena, G; Pérez-Prieto, D; López-Alcover, A; Ginés-Cespedosa, A

    To analyse the differences in the management of ankle fractures between orthopaedic/trauma surgeons and foot and ankle specialists. An e-mail survey was performed asking some of the country's orthopaedic surgeons controversial questions regarding the analysis of 5 clinical cases of different ankle fractures. Seventy-two surgeons responded to the questionnaire (response rate of 24.2%): 37 foot and ankle specialists and 35 non-specialist orthopaedic surgeons. For trimalleolar fracture, 40.5% of the specialists would request a computed tomography scan compared to 14% of the non-specialists (P=.01). Ninety-four percent of all the respondents would synthesise the posterior malleolus; 91% of the non-specialists would use an antero-posterior approach, either with a plate or with screws (P=.006). No differences were found between groups in the treatment of syndesmotic injuries (P>.05). For trans-syndesmotic fracture (Weber B) with signs of medial instability, 54% of the non-specialists would revise the internal lateral ligament compared to only 32% of the specialists (P=.06). The foot and ankle specialists ask for more complementary tests to diagnose ankle fractures. In turn, they use a greater diversity of surgical techniques in synthesis of the posterior malleolus (posterior plate) and the medial malleolus (cerclage wires). Finally, they indicated a lower revision rate of the internal lateral ligament. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.


    Directory of Open Access Journals (Sweden)

    Вікторія Пацюк


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

  4. Doctors applying for Danish postgraduate medical specialist training are getting younger

    DEFF Research Database (Denmark)

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


    INTRODUCTION: It was previously shown that applicants for postgraduate medical specialist training in Denmark were old. In order to prevent potential shortage of specialists, the Danish health authorities have passed legislation to speed up the output of new specialists. The aim of this study...... was to highlight the present characteristics of young doctors who entered specialist training. MATERIAL AND METHODS: Data include 443 doctors who were enrolled in a formalized postgraduate medical training programme in the Region of Southern Denmark from 2009 to 2011. RESULTS: 41% of the recruited young doctors...

  5. Substantiation of the necessity to develop a competency model of training specialist in pharmacy on the basis of intellectual educational system


    Demchenko, V. O.; Ryzhov, O. A.; Ivankova, N. A.


    The pharmaceutical market of Ukraine, in which various subjects of drug turnover operate, is gradually moving to basically new level. The development is taking place due tothe fundamental factors such as competence and the quality of pharmaceutical activities.The changes on the pharmaceutical market, tough competitive conditions, transforming of the managerial culture intensity, the problems of not always appropriate competence of specialists and require fundamental changes in the system of p...

  6. Retention of specialist physicians in Newfoundland and Labrador. (United States)

    Fleming, Patrick; Mathews, Maria


    Although specialist physicians comprise nearly half of the physician workforce in Newfoundland and Labrador (NL), relatively little is known about their retention patterns. We compared 2 cohorts of physicians who were initially licensed to practise in NL between 1993 and 1997 and between 2000 and 2004, to examine whether retention had changed over time. Additionally, we examined the retention of 4 groups of physicians in each cohort: (1) fully licensed medical graduates of Memorial University, (2) fully licensed medical graduates of other Canadian universities, (3) provisionally licensed international medical graduates (IMGs) and (4) fully licensed IMGs. Provisional licences allow physicians who have not received Canadian certification to practise while obtaining credentials. We hypothesized that fully licensed physicians (largely physicians who are locally trained) would remain in NL longer than provisionally licensed physicians (largely IMGs). Using data from the provincial medical registrar and Memorial University's office of postgraduate medical education, we used survival analysis (Cox regression) to compare the retention of the 2 cohorts and the 4 groups of physicians within each cohort. After 48 months, roughly 60% of the physicians in the 2000-04 cohort and 45% of the physicians in the 1993-97 cohort remained in NL. Medical graduates of Memorial University comprised 61/180 (33.9%) of the 2000-04 cohort and 38/211 (18.0%) of the 1993-97 cohort.Physicians in the 2000-04 cohort were 1.6 (95% confidence interval [CI] 1.23-2.08) times less likely to leave NL than physicians in the 1993-97 cohort. In the 2000-04 cohort, medical graduates of Canadian universities, provisionally licensed IMGs and fully licensed IMGs were 3.19 (95% CI 1.47-6.89), 1.85 (95% CI 1.09-3.17) and 4.39 (95% CI 1.91-10.10) times more likely to leave NL than medical graduates of Memorial University. In the 1993-97 cohort, IMGs with provisional licences were 2.16 (95% CI 1.37-3.42) times more

  7. Specialist advice may improve patient selection for decompression therapy following diving accidents: a retrospective observational study. (United States)

    Steffensmeier, Daniel; Albrecht, Roland; Wendling, Jürg; Melliger, Roger; Spahn, Donat R; Stein, Philipp; Wyss, Christophe


    Even in a landlocked country like Switzerland recreational diving is becoming more and more popular. Smaller lakes in the Alps are located at an altitude of 2500 m above sea level. The incidence of diving accidents among all helicopter emergency service missions and the consecutive medical knowledge about decompression injuries is low. Thus, a collaboration between the Swiss Air-Ambulance (Rega) and the divers alert network (DAN) was initiated to improve patient treatment and identification of decompression injury and necessity of hyperbaric oxygen therapy (HBO). Retrospective observational study that includes all patients treated by the Rega which have been classified to have had a diving accident from 2005 to 2014. Patient and diving epidemiology was assessed and the impact of DAN collaboration on patient selection and identification of patients needing transport to HBO facilities were analysed. In the 10-year observational period 116 patients with diving accidents were treated by Rega. Mean patient age was 40 (SD 11) years and 95 (82%) were male. If the Rega emergency physician suspected a decompression injury (DCI), without DAN contact 27/28 (96%) of these patients were transported directly to a HBO facility, whereas with DAN contact only 53/63 (84%) needed transport to a HBO facility. DAN was involved in 66/96 (69%) of the cases with suspected DCI on scene, with a significant increase over time (p = 0.001). Mean flight time to HBO facilities was significantly longer (28.9, SD 17.7 min.), compared to non-HBO facilities (7.1, SD 3.2 min., p therapy can be provided by HEMS within less than 30 min all over Switzerland. For diving accidents among HEMS missions, specialist advice by diving medicine specialists (DAN) appears mandatory to accurately identify and transport patients with decompression injury, as exposure of emergency physicians towards diving accidents and the diagnosis of DCI is low.

  8. Eavesdropping on plant volatiles by a specialist moth: significance of ratio and concentration.

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    Dong H Cha

    Full Text Available We investigated the role that the ratio and concentration of ubiquitous plant volatiles play in providing host specificity for the diet specialist grape berry moth Paralobesia viteana (Clemens in the process of locating its primary host plant Vitis sp. In the first flight tunnel experiment, using a previously identified attractive blend with seven common but essential components ("optimized blend", we found that doubling the amount of six compounds singly [(E- & (Z-linalool oxides, nonanal, decanal, β-caryophyllene, or germacrene-D], while keeping the concentration of other compounds constant, significantly reduced female attraction (average 76% full and 59% partial upwind flight reduction to the synthetic blends. However, doubling (E-4,8-dimethyl 1,3,7-nonatriene had no effect on female response. In the second experiment, we manipulated the volatile profile more naturally by exposing clonal grapevines to Japanese beetle feeding. In the flight tunnel, foliar damage significantly reduced female landing on grape shoots by 72% and full upwind flight by 24%. The reduction was associated with two changes: (1 more than a two-fold increase in total amount of the seven essential volatile compounds, and (2 changes in their relative ratios. Compared to the optimized blend, synthetic blends mimicking the volatile ratio emitted by damaged grapevines resulted in an average of 87% and 32% reduction in full and partial upwind orientation, respectively, and the level of reduction was similar at both high and low doses. Taken together, these results demonstrate that the specificity of a ubiquitous volatile blend is determined, in part, by the ratio of key volatile compounds for this diet specialist. However, P. viteana was also able to accommodate significant variation in the ratio of some compounds as well as the concentration of the overall mixture. Such plasticity may be critical for phytophagous insects to successfully eavesdrop on variable host plant

  9. Training oncology and palliative care clinical nurse specialists in psychological skills: evaluation of a pilot study. (United States)

    Clark, Jane E; Aitken, Susan; Watson, Nina; McVey, Joanne; Helbert, Jan; Wraith, Anita; Taylor, Vanessa; Catesby, Sarah


    National guidelines in the United Kingdom recommend training Clinical Nurse Specialists in psychological skills to improve the assessment and intervention with psychological problems experienced by people with a cancer diagnosis (National Institute for Health and Clinical Excellence, 2004). This pilot study evaluated a three-day training program combined with supervision sessions from Clinical Psychologists that focused on developing skills in psychological assessment and intervention for common problems experienced by people with cancer. Questionnaires were developed to measure participants' levels of confidence in 15 competencies of psychological skills. Participants completed these prior to the program and on completion of the program. Summative evaluation was undertaken and results were compared. In addition, a focus group interview provided qualitative data of participants' experiences of the structure, process, and outcomes of the program. Following the program, participants rated their confidence in psychological assessment and skills associated with providing psychological support as having increased in all areas. This included improved knowledge of psychological theories, skills in assessment and intervention and accessing and using supervision appropriately. The largest increase was in providing psycho-education to support the coping strategies of patients and carers. Thematic analysis of interview data identified two main themes including learning experiences and program enhancements. The significance of the clinical supervision sessions as key learning opportunities, achieved through the development of a community of practice, emerged. Although this pilot study has limitations, the results suggest that a combined teaching and supervision program is effective in improving Clinical Nurse Specialists' confidence level in specific psychological skills. Participants' experiences highlighted suggestions for refinement and development of the program

  10. Fetal alcohol spectrum disorder: development of consensus referral criteria for specialist diagnostic assessment in Australia (United States)


    Background Fetal alcohol spectrum disorder (FASD) is known to be under-recognised in Australia. The use of standard methods to identify when to refer individuals who may have FASD for specialist assessment could help improve the identification of this disorder. The purpose of this study was to develop referral criteria for use in Australia. Method An online survey about FASD screening and diagnosis in Australia, which included 23 statements describing criteria for referral for fetal alcohol syndrome (FAS) and FASD based on published recommendations for referral in North America, was sent to 139 health professionals who had expertise or involvement in FASD screening or diagnosis. Survey findings and published criteria for referral were subsequently reviewed by a panel of 14 investigators at a consensus development workshop where criteria for referral were developed. Results Among the 139 health professionals who were sent the survey, 103 (74%) responded, and 90 (65%) responded to the statements on criteria for referral. Over 80% of respondents agreed that referral for specialist evaluation should occur when there is evidence of significant prenatal alcohol exposure, defined as 7 or more standard drinks per week and at least 3 standard drinks on any one day, and more than 70% agreed with 13 of the 16 statements that described criteria for referral other than prenatal alcohol exposure. Workshop participants recommended five independent criteria for referral: confirmed significant prenatal alcohol exposure; microcephaly and confirmed prenatal alcohol exposure; 2 or more significant central nervous system (CNS) abnormalities and confirmed prenatal alcohol exposure; 3 characteristic FAS facial anomalies; and 1 characteristic FAS facial anomaly, growth deficit and 1 or more CNS abnormalities. Conclusion Referral criteria recommended for use in Australia are similar to those recommended in North America. There is a need to develop resources to raise awareness of these

  11. Intelligence obtained by applying data mining to a database of French theses on the subject of Brazil

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    Kira Tarapanoff


    Full Text Available The subject of Brazil was analyzed within the context of the French database DocThéses, comprising the years 1969 -1999. The data mining technique was used to obtain intelligence and infer knowledge. The objective was to identify indicators concerning: occurrence of thesis by subject areas; thesis supervisors identified with certain subject areas; geographical distribution of cities hosting institutions where the theses were defended; frequency by subject area in the period when the theses were defended. The technique of data mining is divided into stages which go from identification of the problem -object, through selection and preparation of data, and conclude with analysis of the latter. The software used to do the cleaning of the DocThéses database was Infotrans, and Dataview was used for the preparation of the data. It should be pointed out that the knowledge extracted is directly proportional to the value and validity of the information contained in the database. The results of the analysis were illustrated using the assumptions of Zipf's Law on bibliometrics, classifying the information as: trivial, interesting and 'noise', according to the distribution of frequency. It is concluded that the data mining technique associated with specialist software is a powerful ally when used with competitive intelligence applied at all levels of the decision -making process, including the macro level, since it can help the consolidation, investment and development of actions and policies.

  12. "Promoting continuity of care"-Specialist nurses' role experiences in gynaecological oncology: A qualitative study. (United States)

    Kobleder, Andrea; Mayer, Hanna; Gehrig, Larissa; Senn, Beate


    To investigate the experiences of specialist nurses in Switzerland concerning their role of caring for women with gynaecological cancer. Women with gynaecological cancer often face complex situations, which require an integrative and quality-assured approach by the healthcare system. Specialist nurses can play an important role in supporting these patients. However, in countries where the role of specialist nurses is at a developmental stage, their role lacks clarity. A qualitative descriptive design was chosen to gain insights into experiences of specialist nurses who care for women with gynaecological cancer. We conducted three focus groups with 12 specialist nurses to access their experiences with regard to their role. Thematic qualitative text analysis was used to interpret the results. Divided into six main themes, the study results describe specialist nurses' (1) current and (2) aspired role. (A) Counselling, (B) guidance, (C) key contact person and (D) team support are relevant themes in their current role. The themes (E) provision of resources and (F) extended knowledge are relevant to their aspired role. Within their current and aspired roles, the specialist nurses' scope of practice is defined as "promoting continuity of care." The results indicate aspects of specialist nurses' current and aspired roles. Detailed role descriptions and legal requirements are necessary to further support nurses towards an extended and specialised practice. In the context of gynaecological cancer survivors, services should be developed, where specialist nurses can play an important role in providing continuous care. To support implementation of specialist nursing in clinical practice, resources have to be mobilised and role descriptions should be provided. By creating an appropriate framework, the specialist nurse can turn into an important support for women with gynaecological cancer, in addition to current healthcare services. © 2017 John Wiley & Sons Ltd.

  13. Specialist nursing training in Poland: applications for neuroscience nursing. (United States)

    Slusarz, Robert; Ireland, Sandra; Green, Theresa


    Nurses have a pivotal role in providing facilitating, advocating and promoting the best possible care and outcome for the client. To ensure decisions and actions are based on current standards of practice, nurses must be accountable for participation in ongoing education in their area of practice. To present a description of the current state of Polish nursing education and specialized model for neurological and neurosurgical nursing that can be utilized for both undergraduate and postgraduate continuing education in Poland. The model of postgraduate training introduced in Poland in 2000 was taken into consideration in developing the framework for neuroscience nursing postgraduate continuing education presented here. The framework for neurological continuing education is also based on a review of the literature and is consistent with Poland's legally binding professional nursing regulations (normative and implementing regulations). The model demonstrates the need for the content of pre- and post-undergraduate degree education in neurological nursing to be graduated, based on the frameworks for undergraduate education (acquiring the knowledge and basic skills for performing the work of nurses) and postgraduate education (acquiring knowledge and specialist skills necessary for providing advanced nursing care including medical acts on patients with nervous system diseases). New and advanced skills gained in specialization training can be applied to complex functions, roles and professional tasks undertaken by nurses in relation to care of patients with neurological dysfunctions.


    Directory of Open Access Journals (Sweden)

    Ulyana Lyashenko


    Full Text Available The article represents main questions concerning usage of the newest information-communicative technologies of maritime educational establishments in the process of training specialists of corresponding specialities; reviews the problem of training cadets of Maritime educational institutions by means of information technologies while studying professionally focused disciplines; means of implementation information technologies into the educational process and their practical usage in future professional activity on board a ship are disclosed; the importance of online communications in teaching foreign language speaking, listening comprehension, writing and test tasks implementation to control forming of cadet’s lexical, phonetic and grammar skills are proved; presentations of authentic professionally oriented materials from the newest electronic sources on lectures on disciplines «Marine diesel installations», «Power management system», «Radio-navigational devices and systems». The author of the article grounds practicability of implementation of the newest information communicative technologies into educational process in classroom and extracurricular work, cadets are given an opportunity to get authentic professionally focused information on professional discipline, to extend knowledge on these disciplines and to realize control of formation corresponding competences.

  15. River Cetaceans and Habitat Change: Generalist Resilience or Specialist Vulnerability?

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    Brian D. Smith


    Full Text Available River dolphins are among the world’s most threatened mammals, and indeed the baiji (Lipotes vexillifer, a species endemic to China's Yangtze River, is likely extinct. Exploitation for products such as meat, oil, and skins has been a lesser feature in the population histories of river dolphins compared to most large mammals. Habitat factors are therefore of particular interest and concern. In this paper we attempt to describe the population-level responses of river dolphins to habitat transformation. We find circumstantial but compelling evidence supporting the view that, at a local scale, river dolphins are opportunists (generalists capable of adapting to a wide range of habitat conditions while, at a river basin scale, they are more appropriately viewed as vulnerable specialists. The same evidence implies that the distributional responses of river dolphins to basinwide ecological change can be informative about their extinction risk, while their local behaviour patterns may provide important insights about critical ecological attributes. Empirical studies are needed on the ecology of river cetaceans, both to inform conservation efforts on behalf of these threatened animals and to help address broader concerns related to biodiversity conservation and the sustainability of human use in several of the world's largest river systems.

  16. [Were there infection disease specialists in Ancient Rome?]. (United States)

    Ledermann D, Walter


    The existence of infectious diseases specialists in Ancient Rome is unlikely, but there were at least three authors able of keen observations on infectious matters, with enough merit to be considered our predecessors: Varro, Columella and Vitruvius, none of them physicians. Varro, in his first Book on Agriculture recommended, "Build the houses distant from swamps, because certain minute creatures are bred which cannot be followed with the eyes but which float in the air and enter the body through the mouth and nose, giving rise to severe diseases". Also in a text of agriculture and in the same sense, Columella says "that with heat a swamp releases a pestilential vapor and produces a very dense swarm of insects, which come flying over us armed with harmful stings Vitruvius, the great architect was worried about drinkable water: its sources and properties, how to obtain it and the methods for testing its quality. The concern on its distribution and disposal of sewage started on 614 B.C., little after the foundation of Rome, with the building of the first aqueduct, the Aqua Marcia. This aqueduct in Trajan's times (century II A.D.), reached a total of 443 km, with 49,500 meters of arcades, which were up to 32 meters high, plus 2.4 km of an underground net. This system released 947,200 m(3) of water per day, two thirds of which were for public use and one third for private customers.

  17. Mechanical diffraction in a sand-specialist snake (United States)

    Schiebel, Perrin E.; Rieser, Jennifer M.; Hubbard, Alex M.; Chen, Lillian; Goldman, Daniel I.

    Limbless locomotors such as snakes move by pressing the trunk against terrain heterogeneities. Our laboratory studies of the desert-dwelling Mojave Shovel-nosed snake (C. occipitalis, 40cm long, N=9) reveal that these animals use a stereotyped sinusoidal traveling wave of curvature. However, this snake also encounters rigid obstacles in its natural environment, and the tradeoff between using a cyclic, shape controlled gait versus one which changes shape in response to the terrain is not well understood. We challenged individuals to move across a model deformable substrate (carpet) through a row of 6.4 mm diameter force-sensitive pegs, a model of obstacles such as grass, oriented perpendicular to the direction of motion. Instead of forward-directed reaction forces, reaction forces generated by the pegs were more often perpendicular to the direction of motion. Distributions of post-peg travel angles displayed preferred directions revealing a diffraction-like pattern with a central peak at zero and symmetric peaks at 193 ° and 415 °. We observed similar dynamics in a robotic snake using shape-based control. This suggests that this sand-specialist snake adheres to its preferred waveform as opposed to changing in response to heterogeneity.

  18. Role clarity and role conflict among Swedish diabetes specialist nurses. (United States)

    Boström, Eva; Hörnsten, Asa; Lundman, Berit; Stenlund, Hans; Isaksson, Ulf


    To explore diabetes specialist nurses (DSNs)' perceptions of their role in terms of clarity, conflict and other psychosocial work aspects. A cross-sectional study was conducted among DSNs in a county in northern Sweden. The DSNs answered the Nordic Questionnaire of Psychological and Social Factors at Work (QPS Nordic) about psychosocial aspects of their work. Statistical analysis compared DSNs with a reference group of different health professionals. Correlations between role clarity, role conflict, and other variables were analysed. The DSNs perceived more, and higher, job demands, including quantitative, decision-making and learning demands, but also more positive challenges at work compared with the reference group. Role clarity correlated with experiences of health promotion, perception of mastery, co-worker support, and empowering leadership, while role conflict correlated with quantitative and learning demands. The DSNs perceived high demands but also positive challenges in their work. Their role expectations correlated with several psychosocial work aspects. It is important that DSNs should be presented with positive challenges as meaningful incentives for further role development and enhanced mastery of their work. Copyright © 2013 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  19. Bicuspid Aortic Valve: Unresolved Issues and Role of Imaging Specialists (United States)


    Bicuspid aortic valve (BAV) is the most common congenital heart disease with marked heterogeneity in many aspects. Fusion patterns of the aortic cusp are quite variable with different type and severity of valvular dysfunction. Moreover, non-valvular cardiovascular abnormalities are associated with BAV. Among them, aortic aneurysm/dissection is the most serious clinical condition with variable patterns of segmental aortic dilatation. Potential association between BAV phenotype and valvulopathy or aortopathy has been suggested, but needs to be tested further. A lack of long-term outcome data at this moment is responsible for unresolved debate regarding appropriate management of patients with BAV, specifically to prevent development of aortic dissection. Long-term follow-up data of a well-characterized cohort or registry based on standardized classification of BAV phenotype and aortopathy are necessary for evidence-based medical practice. Advanced imaging techniques such as computed tomography or magnetic resonance imaging offer better opportunities for accurate phenotype classification and imaging specialists should play a central role to establish a collaborative multicenter cohort or registry. PMID:25883749

  20. Randomised clinical trial of early specialist palliative care plus standard care versus standard care alone in patients with advanced cancer: The Danish Palliative Care Trial. (United States)

    Groenvold, Mogens; Petersen, Morten Aagaard; Damkier, Anette; Neergaard, Mette Asbjoern; Nielsen, Jan Bjoern; Pedersen, Lise; Sjøgren, Per; Strömgren, Annette Sand; Vejlgaard, Tove Bahn; Gluud, Christian; Lindschou, Jane; Fayers, Peter; Higginson, Irene J; Johnsen, Anna Thit


    Beneficial effects of early palliative care have been found in advanced cancer, but the evidence is not unequivocal. To investigate the effect of early specialist palliative care among advanced cancer patients identified in oncology departments. The Danish Palliative Care Trial (DanPaCT) ( NCT01348048) is a multicentre randomised clinical trial comparing early referral to a specialist palliative care team plus standard care versus standard care alone. The planned sample size was 300. At five oncology departments, consecutive patients with advanced cancer were screened for palliative needs. Patients with scores exceeding a predefined threshold for problems with physical, emotional or role function, or nausea/vomiting, pain, dyspnoea or lack of appetite according to the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) were eligible. The primary outcome was the change in each patient's primary need (the most severe of the seven QLQ-C30 scales) at 3- and 8-week follow-up (0-100 scale). Five sensitivity analyses were conducted. Secondary outcomes were change in the seven QLQ-C30 scales and survival. Totally 145 patients were randomised to early specialist palliative care versus 152 to standard care. Early specialist palliative care showed no effect on the primary outcome of change in primary need (-4.9 points (95% confidence interval -11.3 to +1.5 points); p = 0.14). The sensitivity analyses showed similar results. Analyses of the secondary outcomes, including survival, also showed no differences, maybe with the exception of nausea/vomiting where early specialist palliative care might have had a beneficial effect. We did not observe beneficial or harmful effects of early specialist palliative care, but important beneficial effects cannot be excluded.

  1. A subjective scheduler for subjective dedicated networks (United States)

    Suherman; Fakhrizal, Said Reza; Al-Akaidi, Marwan


    Multiple access technique is one of important techniques within medium access layer in TCP/IP protocol stack. Each network technology implements the selected access method. Priority can be implemented in those methods to differentiate services. Some internet networks are dedicated for specific purpose. Education browsing or tutorial video accesses are preferred in a library hotspot, while entertainment and sport contents could be subjects of limitation. Current solution may use IP address filter or access list. This paper proposes subjective properties of users or applications are used for priority determination in multiple access techniques. The NS-2 simulator is employed to evaluate the method. A video surveillance network using WiMAX is chosen as the object. Subjective priority is implemented on WiMAX scheduler based on traffic properties. Three different traffic sources from monitoring video: palace, park, and market are evaluated. The proposed subjective scheduler prioritizes palace monitoring video that results better quality, xx dB than the later monitoring spots.

  2. Naming the Ethological Subject. (United States)

    Benson, Etienne S


    Argument In recent decades, through the work of Jane Goodall and other ethologists, the practice of giving personal names to nonhuman animals who are the subjects of scientific research has become associated with claims about animal personhood and scientific objectivity. While critics argue that such naming practices predispose the researcher toward anthropomorphism, supporters suggest that it sensitizes the researcher to individual differences and social relations. Both critics and supporters agree that naming tends to be associated with the recognition of individual animal rights. The history of the naming of research animals since the late nineteenth century shows, however, that the practice has served a variety of purposes, most of which have raised few ethical or epistemological concerns. Names have been used to identify research animals who play dual roles as pets, workers, or patients, to enhance their market value, and to facilitate their identification in the field. The multifaceted history of naming suggests both that the use of personal names by Goodall and others is less of a radical break with previous practices than it might first appear to be and that the use of personal names to recognize the individuality, sentience, or rights of nonhuman animals faces inherent limits and contradictions.

  3. 29 CFR 1960.56 - Training of safety and health specialists. (United States)


    ..., DEPARTMENT OF LABOR (CONTINUED) BASIC PROGRAM ELEMENTS FOR FEDERAL EMPLOYEE OCCUPATIONAL SAFETY AND HEALTH PROGRAMS AND RELATED MATTERS Training § 1960.56 Training of safety and health specialists. (a) Each agency... 29 Labor 9 2010-07-01 2010-07-01 false Training of safety and health specialists. 1960.56 Section...

  4. Entomology Specialist 1-1. Military Curriculum Materials for Vocational and Technical Education. (United States)

    Jones, Jimmie L.

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

  5. The Instructional Role of the Library Media Specialist as Perceived by Elementary School Principals (United States)

    Church, Audrey P.


    This study explores Virginia elementary school principals' perceptions of the instructional role of the library media specialist and the origin of these perceptions. Principals who responded to the study strongly endorse the role of library media specialist as teacher of information literacy skills and as instructional partner. Respondents…

  6. Administrative Perceptions on the Role of the School Library Media Specialist (United States)

    Page, Kayla


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

  7. What Should a Teacher Expect a School Library Media Specialist to Be? (United States)

    Harvey, Carl A., II


    The importance and work of Library Media Specialists is discussed where they help teach students to be information literate. The Library Media Specialist also helps to find answers to questions and help find resources to support instruction in the classroom, working with students to use technology in the library media center, the computer lab, and…

  8. Fair Use Rights in the Digital World: A Phenomenological Study of Instructional Technology Specialists (United States)

    Alakur, Turgay


    The aim of this study is to reveal an insight into the awareness and experiences of IT specialists about fair use in Turkey. A phenomenological design was employed and the criterion sampling method was used in this study. A total of nine specialists volunteered to participate. The data were collected through semi-structured interviews. Information…

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

    NARCIS (Netherlands)

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


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

  10. Health Education Specialist Practice Analysis 2015 (HESPA 2015): Process and Outcomes (United States)

    McKenzie, James F.; Dennis, Dixie; Auld, M. Elaine; Lysoby, Linda; Doyle, Eva; Muenzen, Patricia M.; Caro, Carla M.; Kusorgbor-Narh, Cynthia S.


    The Health Education Specialist Practice Analysis 2015 (HESPA 2015) was conducted to update and validate the Areas of Responsibilities, Competencies, and Sub-competencies for Entry- and Advanced-Level Health Education Specialists. Two data collection instruments were developed--one was focused on Sub-competencies and the other on knowledge items…

  11. 78 FR 41993 - Transport Handling Specialists, Inc.-Continuance in Control Exemption-RSL Railroad, LLC (United States)


    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF TRANSPORTATION Surface Transportation Board Transport Handling Specialists, Inc.--Continuance in Control Exemption--RSL Railroad, LLC Transport Handling Specialists, Inc. (THS), has filed a verified notice of exemption (Notice...

  12. Legal Issues for Orientation and Mobility Specialists: Minimizing the Risks of Liability. (United States)

    Marsh, Ruth Ann; Hartmeister, Fred; Griffin-Shirley, Nora


    This article discusses the potential negligence-based liability risks that orientation and mobility (O&M) specialists often face when assisting students with visual impairments with independent travel in uncontrolled environments. It also presents strategies that may minimize the risks of O&M training for both students and specialists. (Contains…

  13. Media Skills for Middle Schools: Strategies for Library Media Specialists and Teachers. Second Edition. (United States)

    Van Vliet, Lucille W.

    Emphasizing the role of the library media specialist, this book provides a framework for collaboration among media specialists, teachers and administrators to help middle school students master the skills necessary for continued academic success and lifelong learning. The book reviews middle school philosophy and goals in light of recent…

  14. Pharmacovigilance training for specialist oncology nurses-a two way evaluation

    NARCIS (Netherlands)

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


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

  15. Idaho Marketing Education Core Curriculum. Career Sustaining Level, Specialist Level, Supervisory Level, Entrepreneurial Level. (United States)

    Allbright, Bruce; Holup, John

    This guide lists the competencies expected to be developed in four levels of the marketing education curriculum in Idaho: the career sustaining level, the specialist level, the supervisory level, and the entrepreneurial level. For the career sustaining and specialist levels, 15 competencies are listed: define and apply the role of marketing in the…

  16. 22 CFR 11.20 - Foreign Service specialist career candidate appointments. (United States)


    ... of specialist candidates are found in Volume 3 (Personnel), Foreign Affairs Manual, section 580. (4... (Personnel), Foreign Affairs Manual, section 580, may not be reappointed as a career candidate in the same... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Foreign Service specialist career candidate...

  17. Perception of drug teratogenicity among general practitioners and specialists in obstetrics/gynecology

    DEFF Research Database (Denmark)

    Gils, Charlotte; Pottegård, Anton; Ennis, Zandra Nymand


    the perception of the teratogenic risk of 9 commonly and 3 rarely prescribed drugs among general practitioners and specialists in obstetrics/gynecology. METHODS: All 811 general practitioners in the Region of Southern Denmark and all 502 specialist obstetricians/gynecologists in Denmark as a whole were invited...

  18. Families' perceptions of the contribution of intellectual disability clinical nurse specialists in Ireland. (United States)

    Doody, Owen; Slevin, Eamonn; Taggart, Laurence


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

  19. Not Enough Time in the Day: Media Specialists, Program Planning, and Time Management, Part I (United States)

    Fitzgerald, Mary Ann; Waldrip, Andrea


    Media specialists operate in an environment of challenge, controversy, and daily travail. A new and particularly challenging trend makes media specialists responsible for teaching classes, especially in reading, or to hold a spot on the so called "specials" rotation. [For Part II, see EJ717650.

  20. Personal view: randomized controlled trials in epilepsy specialist nursing: the seduction of content by form. (United States)

    Brown, Stephen


    Research into the effectiveness of epilepsy specialist nursing needs to take into account a number of factors, which have not been adequately addressed in previous studies. Nursing outcome measures are different to medical ones and it is inappropriate to confuse these. Specialist nurses affect the whole culture of a service, and their impact on service quality may go beyond that of their individual patient contacts. Thus randomized studies within a service that already has specialist nurses may not give valid results. Some service users will benefit more from direct contact with a specialist nurse than others, and people who give informed consent to take part in randomized controlled trials might not be representative of those who would benefit most from specialist nurse access. The stampede for level one evidence risks failing to address the issues properly by overvaluing research process (form) against its appropriateness (content), yet there remain great opportunities for good quality research in this area.

  1. Model training of future specialists in human health to strengthen the use of health technologies

    Directory of Open Access Journals (Sweden)

    O. I. Mikheenko


    Full Text Available Purpose : develop a model of scientific and methodological training of future specialists in human health to strengthen the use of health technologies. Material : processed more than 100 literary sources. Results : analyzed the methodological, organizational and educational and training aspects of the training of future specialists in human health. On the basis of scientific modeling, the basic structural components of the model of professional training of future specialists, are characterized by their nature and relationship. Theoretical basis to ensure a high level of training future specialist is an integral concept of professionalization based on the theoretical and methodological basis of its essence. Conclusions : it is proved that the effectiveness of training future specialist determined holistic concept of professionalization and relevant scientific and methodological support of the educational process.

  2. Utilization of stainless steel crowns by general dentists and pediatric dental specialists in Indiana. (United States)

    Kowolik, Joan; Kozlowski, Diana; Jones, James E


    The purpose of this study was to evaluate utilization of the stainless steel crown by both the general and pediatric dentists in Indiana. Although reports indicate that there has been a dramatic reduction in dental caries in the US, almost 20 percent of children have dental decay by age four, with almost 80 percent having a cavity by 17 years of age. After reviewing the literature, Seale has recommended that the stainless steel crown is the most successful restoration for children with a rate of high caries. All dental schools in North America teach the value of using stainless steel crowns and the method of tooth preparation. We hypothesized that greater use of the stainless steel crowns would be made by specialists than by general dentists. In this study, of the 200 questionnaires distributed, 62.5 percent were returned and analyzed. The results imply that stainless steel crowns are being significantly underutilized in general dental practice. It is interesting, and perhaps of concern, that the general dentists are not interested in continuing education courses about this subject. Over the next few years, with the aging of the pediatric dental community in Indiana, general (not specialty) dentists will treat most of the children. Because of this, pre-doctoral education needs to place more emphasis on preparation and utilization of the stainless steel crown.

  3. Childhood obesity in specialist care--searching for a healthy obese child. (United States)

    Dalla Valle, Marketta; Laatikainen, Tiina; Kalliokoski, Tomi; Nykänen, Päivi; Jääskeläinen, Jarmo


    One in three obese adults is classified as metabolically healthy, but there is less evidence in obese children. We studied the overall clinical presentation of Finnish obese children and the prevalence of cardiometabolic risk factors with child-specific cut-offs. This is a cross-sectional register-based study of 2-18-year-old children (n = 900) evaluated for obesity in three hospitals in 2005-2012. Clinical and metabolic data were related to sex, age, puberty, and obesity grade and analyzed using chi-square and non-parametric tests. In 80% of cases at least one cardiovascular risk factor was present. Only 3% of subjects for whom complete metabolic data were available (n = 360) had no metabolic disorder. Systolic blood pressure was hypertensive in 50.2% and diastolic in 14.5% of the children. The youngest children had highest body mass index SD score. Obesity was more severe in boys than girls (p obese children in specialist care have cardiovascular risk factors; this indicates that earlier intervention is needed.


    Directory of Open Access Journals (Sweden)

    Ol'ga L. Zadvornaya


    Full Text Available The article is devoted to the problem of development of professional-subjective position of managerial staff of health care in the system of continuous professional education in the conditions of optimization of activities of the health system. Professional and subject position reflects the position of individual managers in a professional environment, its relationship to the quality of professional activity, to himself, to patients and colleagues to level their skills.Purpose/objectives: analysis of core competencies, forming the professional and subject position of heads of medical organizations; identify possible ways of development of professional-subjective position of managerial staff of the public health based on the use of modern technologies and active methods of training in system of continuous professional education. Methodology. In conducting the present study used data from official sources, literature review, scientific methods of analysis and synthesis, comparative analysis and modeling. The results of the study indicate the necessity of actualization of the subject position of heads of medical organizations. Conclusions /Significance. The necessity of formation and development of professional subjective position of the heads due to the needs of society and the health care system with modern requirements for quality management training of health. Professional and subject position is a characteristic feature of a highly qualified specialist in the area of governance, reflecting its active attitude toward self and professional activity, factor of efficiency of activity of medical organizations. The real practice of activity of medical organizations requires improved approaches in the preparation of healthcare managers. Most of the leaders are having difficulties, associated not only with necessity of development of universal and professional competences, but also the necessity of development of professional-subjective position

  5. Subsidies to target specialist outreach services into more remote locations: a national cross-sectional study. (United States)

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


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

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

    Directory of Open Access Journals (Sweden)

    Slaets Joris PJ


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

  7. Geographic variation in resource use by specialist versus generalist butterflyfishes

    KAUST Repository

    Lawton, Rebecca J.


    Localised patterns of resource use can be constrained by multiple factors. Comparison of resource use at multiple locations with differing resource availability can allow fundamental specialists to be distinguished from species that simply feed predominantly on prey types that are locally abundant. This study investigates geographic variation in the feeding ecology of coral-feeding butterflyfishes to examine whether patterns of resource use and levels of dietary specialisation vary among distinct locations, corresponding with changes in resource availability. Our specific aims were to investigate whether the dietary niche breadth of four butterflyfishes varies among five geographically separated locations and assess whether each species utilises similar resources in each location. Resource availability and dietary composition of four butterflyfishes were quantified at three sites across each of five geographic locations throughout the Pacific. Niche breadth, niche overlap, and resource selection functions were calculated for each species at each site and compared among locations. Availability of dietary resources varied significantly among locations and sites. Chaetodon vagabundus, C. citrinellus and C. lunulatus had low levels of dietary specialisation and used different resources in each location. Chaetodon trifascialis had high levels of dietary specialisation and used the same few resources in each location. Our results indicate that relative levels of dietary specialisation among different butterflyfishes do hold at larger spatial scales, however, geographical variation in the dietary composition of all butterflyfishes indicates that prey availability has a fundamental influence on dietary composition. Highly specialised species such as C. trifascialis will be highly vulnerable to coral loss as they appear to be largely inflexible in their dietary composition. However, the increased feeding plasticity observed here for C. trifascialis suggests this species may

  8. How to be a specialist? Quantifying specialisation in pollination networks

    Directory of Open Access Journals (Sweden)

    Carsten F. Dormann


    Full Text Available The analysis of ecological networks has gained a very prominent foothold in ecology over the last years. While many publications try to elucidate patterns about the networks, others are primarily concerned with the role of specific species in the network. The core challenge here is to tell specialists from generalists. While field data and observations can be used to directly assess specialisation levels, the indirect way through networks is burdened with problems. Here, I review eight measures to quantify specialisation in pollination networks (degree, node specialisation, betweenness, closeness, strength, pollination support, Shannon's H and discrimination d', the first four being based on binary, the others on weighted network data. All data and R-code are available as supplement and can be applied beyond pollination networks. The indices convey different concepts of specialisation and hence quantify different aspects. Still, there is some redundancy, with node specialisation and closeness quantifying the same properties, as do degree, betweenness and Shannon's H. Using artificial and real network data, I illustrate the interpretation of the different indices and the importance of using a null model to correct for expectations given the different observed frequencies of interactions. For a well-described network the distributions of specialisation values do not differ from null model expectations for most indices. Finally, I investigate the effect of cattle grazing on the specialisation of an important pollinator in eight replicated pollination networks as an illustration of how to employ the specialisation indices, null models and permutation-based statistics in the analysis of specialisation in pollination networks.

  9. Personality types and specialist choices in medical students. (United States)

    Mehmood, Syed Imran; Khan, Muhammad Abid; Walsh, Kieran M; Borleffs, Jan C C


    Research on the correlation between personality and students' specialty choice is helpful in their career counselling process and in predicting the future distribution of the specialties in a country. This study is the first of its kind in the Arab world. The research questions were: (1) What is the influence of gender on the personality profiles of medical students? (2) What are the personality profiles of students categorized according to their preferred specialist choices? (3) What are the preferred career choices of students categorized according to the stage of their medical education? A cross-sectional study was performed at King Khalid University Medical School including 590 students during the academic year 2010-2011. A long version of the Zuckerman-Kuhlman personality questionnaire measuring five personality factors was used. Students were also asked for their specialty interests. Students were asked by means of a written questionnaire. Study response was 92.5%. Surgery was the single most popular specialty amongst both male and female students. Males had significantly higher scores on the 'impulsive sensation seeking' scale and students preferring a surgery specialty had the highest score on the 'impulsive sensation seeking', 'neuroticism-anxiety', 'aggression-hostility' and 'sociability' scales. Hospital-based, surgical and primary care specialties became more popular as students progressed through their undergraduate years. Different personality types have distinct preferences in medical students' choice of careers. Personality and specialty choice research can enhance career counselling of medical students and fresh graduates. This also has implications for predicting the specialty distribution of the future health careers.

  10. Engagement, workplace satisfaction, and retention of surgical specialists in academic medicine in the United States. (United States)

    Wai, Philip Y; Dandar, Valerie; Radosevich, David M; Brubaker, Linda; Kuo, Paul C


    Academic medical centers strive for clinical excellence with operational efficiency and financial solvency, which requires institutions to retain productive and skillful surgical specialists. Faculty workplace perceptions, overall satisfaction, and intent to leave are relationships that have not been examined previously among US surgeons in academic medicine. We hypothesize that critical factors related to workplace satisfaction and engagement could be identified as important for enhancing institutional retention of academic surgeons. The 2011-2012 Association of American Medical Colleges Faculty Forward Engagement Survey evaluated demographic variables, physician workplace satisfaction, and overall engagement among faculty subgroups, including comparison of surgical and nonsurgical clinicians. Multiple regression analysis (β = standard regression coefficient) was performed to identify critical factors most closely related to surgeon satisfaction and intent to leave their institutions. A total of 1,356 of 1,949 (70%) surgeons from 14 medical schools responded across different faculty subgroups, and comparisons were made with 1,105 nonsurgical clinicians. Multiple regression indicated that the strongest predictors of surgeons' overall satisfaction with their department included department governance (β = 0.36; p factors. Promotion equality (odds ratio = 0.62; p factors affecting surgical faculty satisfaction and intent to leave, we conclude that institutional understanding of, and improvement in, specific work environment factors can enhance recruitment and retention of academic surgeons. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  11. Professional Competencies of Cuban Specialists in Intensive Care and Emergency Medicine. (United States)

    Véliz-Martínez, Pedro L; Jorna-Calixto, Ana R; Oramas-González, René


    INTRODUCTION The quality of medical training and practice reflects the competency level of the professionals involved. The intensive care and emergency medicine specialty in Cuba has not defined its competencies. OBJECTIVE Identify the competencies required for specialty practice in intensive care and emergency medicine. METHODS The study was conducted from January 2014 to December 2015, using qualitative techniques; 48 professionals participated. We undertook functional occupational analysis, based on functions defined in a previous study. Three expert groups were utilized: the first used various group techniques; the second, the Delphi method; and the third, the Delphi method and a Likert questionnaire. RESULTS A total of 73 specific competencies were defined, grouped in 11 units: 44 in the patient care function, 16 in management, 7 in teaching and 6 in research. A competency map is provided. CONCLUSIONS The intensive care and emergency medicine specialty competencies identified will help improve professional standards, ensure health workforce quality, improve patient care and academic performance, and enable objective evaluation of specialists' competence and performance. KEYWORDS Clinical competency, competency-based education, professional education, intensive care, emergency medicine, urgent care, continuing medical education, curriculum, medical residency, Cuba.

  12. Civic Engagement Experiences of Students Preparing for Roles as Clinical Nurse Specialists. (United States)

    Embree, Jennifer L; Yueh-Feng Lu, Yvonne


    Clinical nurse specialist (CNS) students at an urban Midwestern university participated in a study to describe their satisfaction with civic engagement (CE) learning activities. A descriptive and cross-sectional study design housed a faculty-developed CE learning module with four learning activities: (a) gaining interprofessional collaborative practice leadership experience in a mock incident command experience; (b) identifying, researching, and writing a legislative letter about an area of public and/or health policy concern; and (c) developing a professional online network LinkedIn account with experienced CNSs; (d) identifying potential mechanisms for achieving board membership on a civic or professional nursing organization. Faculty developed an online survey to determine student satisfaction through quantitative and qualitative data. Participants completed the survey at the end of the course. Satisfaction with CE learning activities ranged from a mean of 6.07 to 6.75 on a 7-point Likert scale, with higher scores indicating more satisfaction. The overall mean score for CE activities was 6.27 (SD = 0.61) and mean score for course objectives' satisfaction was 6.55 (SE = 0.70). Students reported high satisfaction with their learning as a result of the CE activities. CNS students perceived high satisfaction with learning from the CE activities in this study. © 2016 Wiley Periodicals, Inc.

  13. Study of Selected Components of Architectural Environment of Primary Schools - Preferences of Adults and Analysis of the Specialist Literature (United States)

    Halarewicz, Aleksandra


    The school is one of the oldest social institutions designed to prepare a young man for an adult life. It performs a teaching and educational function in child’s life. It is a place where, apart from home, the child spends most of the time in a day, therefore it is one of the most important institutions in the life of a young person. The school environment has a direct impact on the student's personality and ambition, and it shapes an attitude of the young person. Therefore, the design process preceding the establishment of school facilities is extremely responsible and should be conducted in a conscious and thoughtful way. This article is a summary and an attempt to synthesize the data obtained from the survey carried out by the author in the context of the design guidelines contained in the specialist literature. The questionnaire survey was designed to make an attempt to determine adult’s preferences, opinions and perceptions about selected components of the primary school environment, including the factors which determine the choice of school for children, the priorities of architecture components made for early childhood use, also to specify the type and the scale of existing drawbacks and problems in the school construction industry, as well as expectations about the contemporary architecture of primary schools and its future changes. Moreover, in the article, based on the analysis of the available specialist’s literature, the following are broadly discussed: the general division and characterization of school spaces, issues related to the influence of selected components of the architectural environment on the physical, mental and psychological safety of children. Furthermore, the author raises the subject of the influence of the architectural interiors and furniture on the mood, emotions or comfort of children in the early school age, based on the anthropometric characteristics of children and issues related to the perception of space with an extra

  14. [Reproducibility of subjective refraction measurement]. (United States)

    Grein, H-J; Schmidt, O; Ritsche, A


    Reproducibility of subjective refraction measurement is limited by various factors. The main factors affecting reproducibility include the characteristics of the measurement method and of the subject and the examiner. This article presents the results of a study on this topic, focusing on the reproducibility of subjective refraction measurement in healthy eyes. The results of previous studies are not all presented in the same way by the respective authors and cannot be fully standardized without consulting the original scientific data. To the extent that they are comparable, the results of our study largely correspond largely with those of previous investigations: During repeated subjective refraction measurement, 95% of the deviation from the mean value was approximately ±0.2 D to ±0.65 D for the spherical equivalent and cylindrical power. The reproducibility of subjective refraction measurement in healthy eyes is limited, even under ideal conditions. Correct assessment of refraction results is only feasible after identifying individual variability. Several measurements are required. Refraction cannot be measured without a tolerance range. The English full-text version of this article is available at SpringerLink (under supplemental).

  15. The Main Determinants of Improvement of Model of Educational Training of Specialists in the Field of PR Based on Competency Approach

    Directory of Open Access Journals (Sweden)

    Andrii Kyrychok


    Full Text Available Modern approaches to the study of issue of PR-experts training require rethinking in order to identify new prospects of improvement and development in training of specialists in public relations. An important aspect is that Ukraine has recently moved to training format, based on acquiring of knowledge necessary for professional life by students. This applies, in particular, to specialists in public relations. The key aspect is to determine the set of skills of PR-specialist meant to be acquired by him during study. Another important point is the transition to the European three-level educational model, aimed at democratization and improvement of the process of acquiring of necessary skills by specialists. The essential transformation should be done in the field of PR-education in order to allow experts, at every level of education (Bachelor-Master-PhD, to receive only a clearly defined and systematic set of skills. The author carried out the content analysis of educational training programs in the field of PR for the purpose of discipline component, the principles of programming and knowledge, acquired at each educational level. Investigated data was systematized, analysed and recommendations on principles of development of effective three-level model of training for experts in public relations at the university were given.

  16. Impact of specialist palliative care on coping with Parkinson's disease: patients and carers. (United States)

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


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

  17. Giving and receiving of gifts between pharmaceutical companies and medical specialists in Australia. (United States)

    McNeill, P M; Kerridge, I H; Henry, D A; Stokes, B; Hill, S R; Newby, D; Macdonald, G J; Day, R O; Maguire, J; Henderson, K M


    This study investigated the 'gift-relationship' between pharmaceutical companies and doctors. The study was based on a survey questionnaire of 823 medical specialists from across Australia. The aim of this study was to investigate gifts offered to medical specialists in Australia by pharmaceutical companies, financial support actively sought by medical specialists for activities other than research and to consider what is ethically appropriate. A high percentage of specialists received offers of food (96%), items for the office (94%), personal gifts (51%) and journals or textbooks (50%). Most specialists were invited to product launches, symposia or educational events (75-84%) and 52% received offers of travel to conferences. A high proportion of offers were accepted (66-79%) except invitations to product launches (49%), sponsored symposia (53%) and offers of travel that included partners (27%). Fifteen per cent of specialists requested financial support from pharmaceutical companies for activities and items, including conferences, travel, educational activities, salaries and donations to specific funds. The study outlined guidelines on gifts from pharmaceutical companies and differing standards applying to gifts and grants for travel. We found that, although most gifts and requests for support complied with professional and pharmaceutical industry guidelines, some--including personal gifts, tickets to sporting events, entertainment and travel expenses for specialists' partners--did not. To ensure that physicians' judgements are free from real or perceived influence from industry and to maintain public trust, we support a shift towards more conservative standards on gifts and support for travel evident in recent guidelines.

  18. Embracing technology: patients', family members' and nurse specialists' experience of communicating using e-mail. (United States)

    Cornwall, Amanda; Moore, Sally; Plant, Hilary


    This paper reports on a study exploring the usefulness of e-mail as a means of communication between nurse specialists and patients with lung cancer and their families. The study involved two lung cancer nurse specialists and 16 patients and family members who used e-mail with them during the 6-month study period. Data were collected from three sources: (1) e-mail contact between the nurse specialists and patients/family members, (2) patient/family member questionnaire and (3) a focus group/reflective session with the nurse specialists. Quantitative data collected from the e-mails and the questionnaires were analysed descriptively and are presented as summary statistics. Text data from the questionnaires and e-mails were analysed using content analysis. Findings suggest that e-mail can be an effective and convenient means of communication between nurse specialists, and patients and family members. Patients and family members reported high levels of satisfaction with this method of communication. It was found to be quick and easy, and patients and family members were satisfied with both the response and the speed of response from the nurse specialists. Nurse specialists were also positive about e-mail use and found that the benefits of using e-mail with patients/family members outweighed any disadvantages. Further investigation is recommended involving other health care professionals and different patient groups to ensure the safe and appropriate use of e-mail within health care.

  19. Attitudes and Beliefs Toward Supportive and Palliative Care Referral Among Hematologic and Solid Tumor Oncology Specialists (United States)

    Park, Minjeong; Liu, Diane; Reddy, Akhila; Dalal, Shalini; Bruera, Eduardo


    Background. Palliative care (PC) referrals are often delayed for patients with hematologic malignancies. We examined the differences in attitudes and beliefs toward PC referral between hematologic and solid tumor specialists and how their perception changed with use of the service name “supportive care” (SC). Materials and Methods. We randomly surveyed 120 hematologic and 120 solid tumor oncology specialists at our tertiary care cancer center to examine their attitudes and beliefs toward PC and SC referral. Results. Of the 240 specialists, 182 (76%) responded. Compared with solid tumor specialists, hematologic specialists were less likely to report that they would refer symptomatic patients with newly diagnosed cancer to PC (solid tumor, 43% vs. hematology, 21%; p = .002). A significantly greater proportion of specialists expressed that they would refer a patient with newly diagnosed cancer to SC than PC (solid tumor specialists: SC, 81% vs. PC, 43%; p palliative care. However, both groups were significantly more willing to refer patients early in the disease trajectory if the service name “supportive care” were used instead of “palliative care.” These findings suggest that rebranding might help to overcome the stigma associated with palliative care and improve patient access to palliative care services. PMID:26417037

  20. Estimating Subjective Probabilities

    DEFF Research Database (Denmark)

    Andersen, Steffen; Fountain, John; Harrison, Glenn W.

    Subjective probabilities play a central role in many economic decisions, and act as an immediate confound of inferences about behavior, unless controlled for. Several procedures to recover subjective probabilities have been proposed, but in order to recover the correct latent probability one must...

  1. Estimating Subjective Probabilities

    DEFF Research Database (Denmark)

    Andersen, Steffen; Fountain, John; Harrison, Glenn W.


    Subjective probabilities play a central role in many economic decisions and act as an immediate confound of inferences about behavior, unless controlled for. Several procedures to recover subjective probabilities have been proposed, but in order to recover the correct latent probability one must ...

  2. Subjective meaning: an introduction

    NARCIS (Netherlands)

    van Wijnbergen-Huitink, Janneke; van Wijbergen-Huitink, Janneke; Meier, Cécile

    This introductory chapter traces some of the considerations on the basis of which relativistic approaches to subjective meaning became en vogue. In doing so, the chapter provides an overview of the relevant linguistic and philosophical issues when developing a treatment of subjectivity. In addition,

  3. Subjective safety in traffic.

    NARCIS (Netherlands)


    The term ‘subjective safety in traffic’ refers to people feeling unsafe in traffic or, more generally, to anxiety regarding being unsafe in traffic for oneself and/or others. Subjective safety in traffic can lead to road users limiting their mobility and social activities, which is one of the

  4. Subjective poverty line definitions

    NARCIS (Netherlands)

    J. Flik; B.M.S. van Praag (Bernard)


    textabstractIn this paper we will deal with definitions of subjective poverty lines. To measure a poverty threshold value in terms of household income, which separates the poor from the non-poor, we take into account the opinions of all people in society. Three subjective methods will be discussed

  5. It's more than just physical therapy: reported utilization of physiotherapy services for adults with neuromuscular disorders attending a specialist centre. (United States)

    Hartley, Sandra; Stockley, Rachel


    The purpose of this study is to evaluate service users' perceptions of their utilization of the physiotherapy service at a specialist Neuromuscular Centre and to identify their reasons for and barriers to attending. A prospective survey design, consisting of a 13-item questionnaire was completed by 104 registered users of a physiotherapy service at a Neuromuscular Centre in northwest England. Descriptive statistics was employed to analyse data from Likert style questions and thematic analysis conducted on responses to open-ended questions. Over 79% of respondents were satisfied with the frequency and duration of their treatment. Respondents attended physiotherapy to obtain physical therapy, for general wellbeing and to access specialized resources. Barriers to attendance included work commitments, travel cost and time, and lack of Centre resources. Clients attending physiotherapy valued the specialist service including advice from therapists, perceived benefit from social interaction with other clients and physical therapy. Adults with neuromuscular disorders identified psychosocial as well as physical benefits from attending physiotherapy at the Neuromuscular Centre. The findings highlight the importance of service users' views in service provision and suggest that a collaborative commitment to patient management could by advantageous when developing physiotherapy services.

  6. Specialist nurse key worker in children's cancer care: Professionals' perspectives on the core characteristics of the role. (United States)

    Martins, Ana; Aldiss, Susie; Gibson, Faith


    To describe the development and implementation of the specialist nurse key worker role across 18 children's cancer centres in the United Kingdom, and draw out significant factors for success to inform future development of the role across a range of specialities. Data were obtained through 42 semi-structured interviews and a focus group with 12 key workers. Framework analysis revealed two main themes: models of care and key workers' perspectives of the role. Four models of care were identified and described, roles were organised along a continuum of in reach and outreach with either the presence or absence of home visits and direct delivery of clinical care. Key workers' perspectives of the advantages of the role included: coordination of care (being the main point of contact for families/professionals), experience and expertise (communication/information) and the relationship with families. The main challenges identified were: time, caseload size, geographical area covered, staffing numbers and resources available in the hospital and community. The label 'key worker' was disliked by many participants, as the loss of 'specialist nurse' in the title failed to reflect professional group. Leaving aside terminology, key workers shared core role elements within a continuum of in reach and outreach work and their involvement in direct clinical care varied throughout the pathway. Irrespective of the model they worked in, the key worker provided clinical, emotional, educational, and practical support to families, through the coordination of care, experience and expertise and relationship with families and professionals. Copyright © 2016. Published by Elsevier Ltd.

  7. The role of child life in pediatric pain management: a survey of child life specialists. (United States)

    Bandstra, Nancy F; Skinner, Linda; Leblanc, Chantal; Chambers, Christine T; Hollon, Ellen C; Brennan, Debbie; Beaver, Chantal


    Pain management is often described as a component of child life specialists' work. No research has described the specific pain management strategies used by child life specialists. The objectives of this study were to determine child life specialists' use of nonpharmacological strategies, to describe the perceived efficacy of these strategies, to determine how much training child life specialists had in these various strategies, and to determine what demographic characteristics predict the use of evidence-based techniques. Six hundred seven child life specialists from hospitals and health centers across North America responded to an online survey (response rate: 85.4%). Results indicate that child life specialists use a variety of techniques with varying degrees of perceived efficacy. The most commonly endorsed techniques were providing information/preparation, comforting/reassurance, and positive reinforcement. Respondents reported receiving substantial training in some techniques (eg, providing information/preparation, medical play) and high interest in receiving additional training in all techniques. Certification status, the proportion of patients for whom participants reported providing pain management services, and participants' perceived levels of knowledge and skill emerged as significant predictors of the use of evidence-based strategies. The results of this survey suggest that child life specialists are actively involved in pediatric pain management. American and Canadian child life specialists were surveyed to assess their involvement in managing the pain of pediatric patients. Findings of the survey indicate that child life specialists are involved in the management of pediatric pain and are receptive to additional training in evidence-based techniques.

  8. Family medicine education in Singapore: a long-standing collaboration between specialists and family physicians. (United States)

    Wong, Teck Yee; Koh, Gerald Ch; Lee, Eng Hin; Cheong, Seng Kwing; Goh, Lee Gan


    In many countries, family medicine (FM) training has been conducted mainly by senior family physicians alone. However, FM training in Singapore in the last 30 years has involved specialists working in close collaboration with family physicians. The areas in which specialists are currently involved include the training of FM trainees in tertiary hospitals, the Master of Medicine in Family Medicine [MMed (FM)] and Graduate Diploma in Family Medicine (GDFM) programmes. This close relationship has been crucial in the continuing vocational and professional development of family physicians and in fostering closer collaboration between family physicians and specialists, thus ultimately benefiting patient care.

  9. Internal medicine specialists' attitudes towards working part-time: a comparison between 1996 and 2004. (United States)

    Lugtenberg, Marjolein; Heiligers, Phil J M; de Jong, Judith D; Hingstman, Lammert


    Although medical specialists traditionally hold negative views towards working part-time, the practice of medicine has evolved. Given the trend towards more part-time work and that there is no evidence that it compromises the quality of care, attitudes towards part-time work may have changed as well in recent years. The aim of this paper was to examine the possible changes in attitudes towards part-time work among specialists in internal medicine between 1996 and 2004. Moreover, we wanted to determine whether these attitudes were associated with individual characteristics (age, gender, investments in work) and whether attitudes of specialists within a partnership showed more resemblance than specialists' attitudes from different partnerships. Two samples were used in this study: data of a survey conducted in 1996 and in 2004. After selecting internal medicine specialists working in general hospitals in The Netherlands, the sample consisted of 219 specialists in 1996 and 363 specialists in 2004. They were sent a questionnaire, including topics on the attitudes towards part-time work. Internal medicine specialists' attitudes towards working part-time became slightly more positive between 1996 and 2004. Full-time working specialists in 2004 still expressed concerns regarding the investments of part-timers in overhead tasks, the flexibility of task division, efficiency, communication and continuity of care. In 1996 gender was the only predictor of the attitude, in 2004 being a full- or a part-timer, age and the time invested in work were associated with this attitude. Furthermore, specialists' attitudes were not found to cluster much within partnerships. In spite of the increasing number of specialists working or preferring to work part-time, part-time practice among internal medicine specialists seems not to be fully accepted. The results indicate that the attitudes are no longer gender based, but are associated with age and work aspects such as the number of hours

  10. Application of Professional Standards of the Specialists of the Sphere of Social Service


    Voloshina I.A.; Zaytseva O.M.; Goncharova A.A.


    The article reviews the first results of application of professional standards of the sphere of social service in the regions of the Russian Federation in accordance with legal requirements: “Psychologist in the social sphere”, “Head of the institution of medical and social expertise”, “Head of the social service organization”, “Social worker”, “Specialist of the guardianship agency for minors”, “Specialist in medical and social expertise”, “Specialist in the provision of public services in t...

  11. What are the views of hospital-based generalist palliative care professionals on what facilitates or hinders collaboration with in-patient specialist palliative care teams? A systematically constructed narrative synthesis. (United States)

    Firn, Janice; Preston, Nancy; Walshe, Catherine


    Hospital-based specialist palliative care services are common, yet existing evidence of inpatient generalist providers' perceptions of collaborating with hospital-based specialist palliative care teams has never been systematically assessed. To assess the existing evidence of inpatient generalist palliative care providers' perceptions of what facilitates or hinders collaboration with hospital-based specialist palliative care teams. Narrative literature synthesis with systematically constructed search. PsycINFO, PubMed, Web of Science, Cumulative Index of Nursing and Allied Health Literature and ProQuest Social Services databases were searched up to December 2014. Individual journal, citation and reference searching were also conducted. Papers with the views of generalist inpatient professional caregivers who utilised hospital-based specialist palliative care team services were included in the narrative synthesis. Hawker's criteria were used to assess the quality of the included studies. Studies included (n = 23) represented a variety of inpatient generalist palliative care professionals' experiences of collaborating with specialist palliative care. Effective collaboration is experienced by many generalist professionals. Five themes were identified as improving or decreasing effective collaboration: model of care (integrated vs linear), professional onus, expertise and trust, skill building versus deskilling and specialist palliative care operations. Collaboration is fostered when specialist palliative care teams practice proactive communication, role negotiation and shared problem-solving and recognise generalists' expertise. Fuller integration of specialist palliative care services, timely sharing of information and mutual respect increase generalists' perceptions of effective collaboration. Further research is needed regarding the experiences of non-physician and non-nursing professionals as their views were either not included or not explicitly reported.

  12. Quality of life and satisfaction of patients after nonsurgical primary root canal treatment provided by undergraduate students, graduate students and endodontic specialists. (United States)

    Hamasha, A A; Hatiwsh, A


    (i) To assess the impact of primary root canal treatment on the perceived quality of life amongst a cohort of Jordanian patients, (ii) to assess this cohort's satisfaction of their primary root canal treatment, and (iii) to evaluate the association of the level of training and experience of clinicians with these two parameters. A systematic random sample of 302 subjects was selected from patients who attended undergraduate, graduate and specialty clinics of Jordan University of Science and Technology. Participants were interviewed before and two weeks after completion of root canal treatment. The study instrument included the Oral Health Impact Profile questionnaire (Dugas et al. 2002) and seven semantic differential scales. Data analyses included descriptive statistics and nonparametric analyses. More than 90% of subjects reported improvements in the sense of taste, pain, eating, altering food temperature, self-consciousness, waking up during sleep, interruption of meals, difficulty to relax and difficulty to sleep after root canal treatment. There was no significant difference in terms of improvement amongst patients treated by specialists, graduate students or undergraduate students. The overall semantic differential score of intraoperative pain, pleasantness, chewing ability and general satisfaction was about 8. Satisfaction of root canal treatment by specialists was higher in terms of time involved, intraoperative pain, pleasantness and general satisfaction than those treatments by undergraduate students. Patients treated by specialist were least satisfied with the treatment cost compared to those patients treated by graduate or undergraduate students. The impact of root canal treatment on the quality of life was apparent. Satisfaction with root canal treatment approximates 8 on the semantic differential scale with preference for specialists over dental students. © 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd.

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

    DEFF Research Database (Denmark)

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


    BACKGROUND: Advances in mobile technology mean vets are now commonly presented with videos of paroxysmal events by clients, but the consistency of the interpretation of these videos has not been investigated. The objective of this study was to investigate the level of agreement between vets (both...... neurology specialists and non-specialists) on the description and classification of videos depicting paroxysmal events, without knowing any results of diagnostic workup. An online questionnaire study was conducted, where participants watched 100 videos of dogs and cats exhibiting paroxysmal events.......g. electroencephalogram) able to differentiate between epileptic and non-epileptic paroxysms....

  14. Who Teaches Primary Physical Education? Change and Transformation through the Eyes of Subject Leaders (United States)

    Jones, Luke; Green, Ken


    Primary physical education (PE) lessons tend to be taught by one, or a combination of, three different groups: generalist classroom teachers, specialist primary PE teachers and so-called adults other than teachers, who are almost exclusively sports coaches. Drawing upon data gathered from one-to-one interviews with 36 subject leaders (SLs), this…

  15. Unifying Subjectivity and Objectivity

    Directory of Open Access Journals (Sweden)

    Murugesan Chandrasekaran


    Full Text Available The contribution of modern science to the progress of civilization is immeasurable. Even its tendency toward exclusive concentration on the objective world has had salutary effects of great value. Modern science has wiped away much that was merely superstitious or speculative. Its rejection of unfounded opinions and prejudices has helped the thinking mind question conventional beliefs, shed preferences and prejudices, and challenge established authority. But modern systems thinking inherited from natural science is the suppression of the subjective dimension of reality. Many complex systems are an attempt to define and represent all subjective experience in physical terms. The modern man has a bias towards objectivity. The powerful influence of sense impressions on his mind and thinking makes him ignore the subjective experience and consider only objective facts as a valid, legitimate and representation of reality. Observing objective factors that are physical is easier than observing subjective factors that are subtle. The mechanistic view of reality has led to the rejection of the role of the individual in social development as insignificant. The individuals determine the development of society. Their social power has its roots both in subjective factors and objective factors. Economy, politics, society, and culture are inseparable dimensions of a single integrated reality. Subject and object constitute an integrated whole. The mind sees them as separate and independent. Or it views one as completely subordinate to the other. Unbiased approach to the study of all human experiences may prove that subject and object are interdependent dimensions or elements of reality.

  16. Plasma Zinc Levels of Pregnant Women Visiting Irrua Specialist ...

    African Journals Online (AJOL)

    Their plasma samples were analyzed using the Walsh method with alpha 4-type model of atomic absorption spectrophotometer. Results of the analyses were 17.113±1.600, 11.750±3.289, 9.246±4.739 and 17.350±0.504 μmol/L for the 1st trimester, 2nd trimester, 3rd trimester and control subjects respectively. There were ...

  17. Palliative medicine specialists' causal explanations for depression in the palliative care setting: a qualitative in-depth interview study. (United States)

    Ng, Felicity; Crawford, Gregory B; Chur-Hansen, Anna


    Medical practitioners have different causal explanations for depression, and may have greater difficulty in explaining causality of depression in the palliative care setting. The objective of this study was to investigate and describe the causal explanations of depression in the palliative care setting, from the perspective of palliative medicine specialists. Palliative medicine specialists practising in Australia were recruited and purposively sampled. Individual semistructured, in-depth interviews were conducted to explore their explanatory models of depression, including a focus on causal explanations. Nine participants were interviewed to reach data saturation. Interview transcripts were analysed for themes. Six themes for causal explanations of depression were identified: (1) Depression is inexplicable; (2) Biological explanations-primarily neurotransmitter depletion; (3) Psychological explanations-including reaction to circumstances, inability to accept illness and dying, diminished self, and coping mechanisms; (4) Social explanations-including inadequate social support, and contribution from modern medicine and societal norms; (5) Interrelationships between causal factors-mainly multifactoriality; (6) Different explanation for de novo and pre-existing depressions. Participants also articulated a link between causal explanations and clinical interventions. Palliative medicine specialists hold causal explanations of depression that align with the biopsychosocial and vulnerability-stress models. They use multiple individual explanations with diverse theoretical underpinnings, and largely view depression as multifactorial in causality. Given that causal explanations are linked to clinical interventions, these findings have implications for clinical practice and medical education. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to


    Directory of Open Access Journals (Sweden)

    D.N. Bakhrakh


    Full Text Available The question about the subjects of law branches is concerning the number of most important and difficult in law science. Its right decision influences on the subject of law regulation, precise definition of addressees of law norms, the volume of their rights and duties, the limits of action of norms of Main part of the branch, its principles. Scientific investigations, dedicated to law subjects system, promote the development of recommendations for the legislative and law applying activity; they are needed for scientific work organization and student training, for preparing qualified lawyers.


    Dovgalev, A S; Astanina, S Yu; Andreeva, N D


    The paper considers the functional aspects of a biological component in programs for training specialists in the area of Parasitology for accreditation within the current enactments, including those on modernization of public health and additional professional education. The working program of the module "Fundamental Disciplines" has been used as an example to outline approaches to molding a medical parasitologist's capacity and readiness to solve professional tasks on the basis of knowledge of fundamental disciplines: biology, immunology, and medical geography. Education fundamentalization is shown to suggest more unsupervised work of a learner in the teaching process. The fundamental constituent of a biological component of the 'programs for training learners in the specialty of Parasitology for accreditation is shown in the interaction of all sections of this area with special and allied subjects.

  20. Assessment With Children Who Need Augmentative and Alternative Communication (AAC): Clinical Decisions of AAC Specialists. (United States)

    Lund, Shelley K; Quach, Wendy; Weissling, Kristy; McKelvey, Miechelle; Dietz, Aimee


    The purpose of this study was to explore how speech-language pathologists (SLPs) who are augmentative and alternative communication (AAC) specialists approach the assessment process for 2 case studies, 1 child with cerebral palsy and 1 with autism spectrum disorder. The aim of the study was to answer the following questions: (a) How do clinicians with expertise approach the AAC assessment process for children with developmental disabilities? (b) Can any initial hypothesis be drawn about how SLPs approach the assessment of children with motor versus social interactive deficits? This study used a phenomenological qualitative design. The researchers conducted 2 in-depth, semistructured interviews with 8 SLPs who specialized in AAC and self-identified as primarily working with children. Four major themes emerged from the data: area of assessment, method of assessment, evaluation preparation, and parent education. Each major theme contained multiple subthemes and categories within those subthemes. Participants discussed similar areas of assessment for both cases, indicating that some aspects of AAC assessment are universal. However, the specific aspects of what they were assessing and how they went about assessing them differed between the 2 cases. The results of the current study provide an outline of an assessment protocol for children with complex communication needs.