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

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Schmidt, Lasse M; Foli-Andersen, Nina J

2017-02-01

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

The Perceived Effectiveness of Supervision In Cognitive Behavioral Therapy Training

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Erkan Kuru

2016-12-01

Full Text Available Psychotherapy is a general name for the problem solving techniques to address mental disorders or struggles through verbal interaction. Cognitive Behavioral Therapy (CBT is one of the leading approaches in psychotherapy field. The first aim of this study; to evaluate the contribution of theoretical and supervision trainings perceived by mental health professionals to their CBT skills and personal development. The second one was to evaluate the CBT training process in psychotherapy training. To this end, 54 mental health professionals who agree to participate the study were given questionnaires each consisting of 18 items. This questionnaire was created by three supervisors who have been certified by the Academy of Cognitive Therapy (ACT. Mean duration of work as a mental health professional were 7.6 years. Mean duration of using psychotherapy in their clinical practice were 4,8 years. Mean duration of application of CBT as a psychotherapy modality were 3,2 years. Mean durations of theoretical and supervision trainings the participants had participated were 55,4 hours and 69,1 respectively. Seventy-nine point six of the participants reported that the theoretical training had contributed to their CBT practice at “quite” to “too much” levels. Fifty-nine point two of the participants reported that the same training contributed to their personal development at “quiet” to “too much” levels. For the supervision traning these perceived contributions were 92,6 % and 70,4% respectively. That the therapists reported high degree of satisfaction with the theoretical and supervision trainings they need to accomplish is promising about the psychotherapy training in Turkey. Besides, results of this study suggests that although theoretical training is of perceived value, supervision has been perceived as had given extra contribution. [JCBPR 2016; 5(3.000: 119-124

Twelve tips on how to set up postgraduate training via remote clinical supervision

DEFF Research Database (Denmark)

Wearne, Susan; Dornan, Tim; Teunissen, Pim W.

2013-01-01

Doctors-in-training can now be supervised remotely by specialist clinicians using information and communication technology. This provides an intermediate stage of professional development between on-site supervision and independent medical practice. Remote supervision could increase training capa...

Caregivers' satisfaction and supervision of primary health care ...

African Journals Online (AJOL)

Caregivers' satisfaction and supervision of primary health care services in Nnewi, ... made in the reduction of childhood health indicators in the previous decade, ... supervision of PHCs should also improve the quality of child health services.

Nurses’ perceptions on nursing supervision in Primary Health Care

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Beatriz Francisco Farah

2016-01-01

Full Text Available Objective: to understand the perceptions of nurses on nursing supervision in the work process. Methods: this is a qualitative research, with a semi-structured interview, performed with 16 nurses. Data analysis was performed through content analysis. Results: two meanings topics emerged from the speeches of the participants: Nurses´ activities in Primary Health Care Units and Nurses´ perceptions about nursing supervision. In the first category, the actions listed were filling out forms and reports under the supervision of the nursing service. In the second category, supervision was perceived as a function of management and follow-up of the activities planned by the team, in opposition to the classical supervision concept, which is inspecting. Conclusion: nursing supervision has been configured for primary care nurses as an administrative function that involves planning, organization, coordination, evaluation, follow-up and support for the health team.

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

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2016-12-01

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

Improving quality of reproductive health care in Senegal through formative supervision: results from four districts.

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Suh, Siri; Moreira, Philippe; Ly, Moussa

2007-11-29

In Senegal, traditional supervision often focuses more on collection of service statistics than on evaluation of service quality. This approach yields limited information on quality of care and does little to improve providers' competence. In response to this challenge, Management Sciences for Health (MSH) has implemented a program of formative supervision. This multifaceted, problem-solving approach collects data on quality of care, improves technical competence, and engages the community in improving reproductive health care. This study evaluated changes in service quality and community involvement after two rounds of supervision in 45 health facilities in four districts of Senegal. We used checklists to assess quality in four areas of service delivery: infrastructure, staff and services management, record-keeping, and technical competence. We also measured community involvement in improving service quality using the completion rates of action plans. The most notable improvement across regions was in infection prevention.Management of staff, services, and logistics also consistently improved across the four districts. Record-keeping skills showed variable but lower improvement by region. The completion rates of action plans suggest that communities are engaged in improving service quality in all four districts. Formative supervision can improve the quality of reproductive health services, especially in areas where there is on-site skill building and refresher training. This approach can also mobilize communities to participate in improving service quality.

Improving quality of reproductive health care in Senegal through formative supervision: results from four districts

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Moreira Philippe

2007-11-01

Full Text Available Abstract Background In Senegal, traditional supervision often focuses more on collection of service statistics than on evaluation of service quality. This approach yields limited information on quality of care and does little to improve providers' competence. In response to this challenge, Management Sciences for Health (MSH has implemented a program of formative supervision. This multifaceted, problem-solving approach collects data on quality of care, improves technical competence, and engages the community in improving reproductive health care. Methods This study evaluated changes in service quality and community involvement after two rounds of supervision in 45 health facilities in four districts of Senegal. We used checklists to assess quality in four areas of service delivery: infrastructure, staff and services management, record-keeping, and technical competence. We also measured community involvement in improving service quality using the completion rates of action plans. Results The most notable improvement across regions was in infection prevention. Management of staff, services, and logistics also consistently improved across the four districts. Record-keeping skills showed variable but lower improvement by region. The completion rates of action plans suggest that communities are engaged in improving service quality in all four districts. Conclusion Formative supervision can improve the quality of reproductive health services, especially in areas where there is on-site skill building and refresher training. This approach can also mobilize communities to participate in improving service quality.

Pervasive Sound Sensing: A Weakly Supervised Training Approach.

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Kelly, Daniel; Caulfield, Brian

2016-01-01

Modern smartphones present an ideal device for pervasive sensing of human behavior. Microphones have the potential to reveal key information about a person's behavior. However, they have been utilized to a significantly lesser extent than other smartphone sensors in the context of human behavior sensing. We postulate that, in order for microphones to be useful in behavior sensing applications, the analysis techniques must be flexible and allow easy modification of the types of sounds to be sensed. A simplification of the training data collection process could allow a more flexible sound classification framework. We hypothesize that detailed training, a prerequisite for the majority of sound sensing techniques, is not necessary and that a significantly less detailed and time consuming data collection process can be carried out, allowing even a nonexpert to conduct the collection, labeling, and training process. To test this hypothesis, we implement a diverse density-based multiple instance learning framework, to identify a target sound, and a bag trimming algorithm, which, using the target sound, automatically segments weakly labeled sound clips to construct an accurate training set. Experiments reveal that our hypothesis is a valid one and results show that classifiers, trained using the automatically segmented training sets, were able to accurately classify unseen sound samples with accuracies comparable to supervised classifiers, achieving an average F -measure of 0.969 and 0.87 for two weakly supervised datasets.

A Good Supervisor--Ten Facts of Caring Supervision

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Määttä, Kaarina

2015-01-01

This article describes the elements of caring supervision of doctoral theses. The purpose was to describe the best practices as well as challenges of supervision especially from the supervisor's perspective. The analysis is based on the author's extensive experience as a supervisor and related data obtained for research and developmental purposes.…

The Spiritual Genogram in Training and Supervision.

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Frame, Marsha Wiggins

2001-01-01

Describes the spiritual genogram, a blueprint of family members' multigenerational religious and spiritual affiliations, events, and conflicts. Used as a tool in both training and supervision, the spiritual genogram enables students and supervisees to make sense of their own religious and spiritual heritage and to explore the ways in which their…

Learning outcomes using video in supervision and peer feedback during clinical skills training

DEFF Research Database (Denmark)

Lauridsen, Henrik Hein; Toftgård, Rie Castella; Nørgaard, Cita

supervision of clinical skills (formative assessment). Demonstrations of these principles will be presented as video podcasts during the session. The learning outcomes of video supervision and peer-feedback were assessed in an online questionnaire survey. Results Results of the supervision showed large self......Objective New technology and learning principles were introduced in a clinical skills training laboratory (iLab). The intension was to move from apprenticeship to active learning principles including peer feedback and supervision using video. The objective of this study was to evaluate student...... learning outcomes in a manual skills training subject using video during feedback and supervision. Methods The iLab classroom was designed to fit four principles of teaching using video. Two of these principles were (a) group work using peer-feedback on videos produced by the students and, (b) video...

Informal sources of supervision in clinical training.

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Farber, Barry A; Hazanov, Valery

2014-11-01

Although formal, assigned supervision is a potent source of learning and guidance for psychotherapy trainees, many beginning psychotherapists use other, informal sources of supervision or consultation for advice and support. Results of an online survey of beginning trainees (N = 146) indicate that other than their formally assigned supervisor, trainees most often consult with colleagues in their program, their own psychotherapist, and their significant other; that they're most likely to seek these other sources of help when they're feeling stuck or feel they've made a clinical mistake; that they do so because they need extra reassurance and suggestions; that they feel the advice given from these sources is helpful; and that they don't especially regret sharing this information. Several case examples are used to illustrate these points. Discussing clinical material with informal sources is, apparently, a great deal more common than typically acknowledged, and as such, has implications for training programs (including discussions of ethics) and formal supervision. © 2014 Wiley Periodicals, Inc.

Transfer of communication skills training from workshop to workplace: the impact of clinical supervision.

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Heaven, Cathy; Clegg, Jenny; Maguire, Peter

2006-03-01

Recent studies have recognised that the communication skills learned in the training environment are not always transferred back into the clinical setting. This paper reports a study which investigated the potential of clinical supervision in enhancing the transfer process. A randomised controlled trial was conducted involving 61 clinical nurse specialists. All attended a 3-day communication skills training workshop. Twenty-nine were then randomised to 4 weeks of clinical supervision, aimed at facilitating transfer of newly acquired skills into practice. Assessments, using real and simulated patients, were carried out before the course, immediately after the supervision period and 3 months later. Interviews were rated objectively using the Medical Interview Aural Rating Scale (MIARS) to assess nurses' ability to use key skills, respond to patient cues and identify patient concerns. Assessments with simulated patients showed that the training programme was extremely effective in changing competence in all three key areas. However, only those who experienced supervision showed any evidence of transfer. Improvements were found in the supervised groups' use of open questions, negotiation and psychological exploration. Whilst neither group facilitated more disclosure of cues or concerns, those in the experimental group responded more effectively to the cues disclosed, reduced their distancing behaviour and increasing their exploration of cues. The study has shown that whilst training enhances skills, without intervention, it may have little effect on clinical practice. The potential role of clinical supervision as one way of enhancing the clinical effectiveness of communication skills training programmes has been demonstrated. PRACTISE IMPLICATIONS: This study raises questions about the effectiveness of training programmes which do not incorporate a transfer element, and provides evidence to support the need for clinical supervision for clinical nurse specialist.

A Novel Semi-Supervised Electronic Nose Learning Technique: M-Training

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Pengfei Jia

2016-03-01

Full Text Available When an electronic nose (E-nose is used to distinguish different kinds of gases, the label information of the target gas could be lost due to some fault of the operators or some other reason, although this is not expected. Another fact is that the cost of getting the labeled samples is usually higher than for unlabeled ones. In most cases, the classification accuracy of an E-nose trained using labeled samples is higher than that of the E-nose trained by unlabeled ones, so gases without label information should not be used to train an E-nose, however, this wastes resources and can even delay the progress of research. In this work a novel multi-class semi-supervised learning technique called M-training is proposed to train E-noses with both labeled and unlabeled samples. We employ M-training to train the E-nose which is used to distinguish three indoor pollutant gases (benzene, toluene and formaldehyde. Data processing results prove that the classification accuracy of E-nose trained by semi-supervised techniques (tri-training and M-training is higher than that of an E-nose trained only with labeled samples, and the performance of M-training is better than that of tri-training because more base classifiers can be employed by M-training.

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

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Puffett, Nick; Perkins, Paul

2017-11-02

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

Utilizing technological innovations to enhance psychotherapy supervision, training, and outcomes.

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Barnett, Jeffrey E

2011-06-01

Recent technological advances in the use of the Internet and video technologies has greatly impacted the provision of psychotherapy and other clinical services as well as how the training of psychotherapists may be conducted. When utilized appropriately these technologies may provide greater access to needed services to include treatment, consultation, supervision, and training. Specific ethical challenges and pitfalls are discussed and recommendations are made for the ethical use of these technologies. Additionally, innovative practices from the seven articles in the special section that follows are highlighted and reviewed. These articles present a number of innovations that can take psychotherapy training, research, supervision, and treatment forward toward increased effectiveness. Recommendations for integrating these innovations into ongoing practices are provided and for additional research to build on the important work of the authors in this special section are provided.

Communication training improves sense of performance expectancy of public health nurses engaged in long-term elderly prevention care program.

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Tanabe, Motoko; Suzukamo, Yoshimi; Tsuji, Ichiro; Izumi, Sin-Ichi

2012-01-01

This study examines the effectiveness of a communication skill training based on a coaching theory for public health nurses (PHNs) who are engaged in Japan's long-term care prevention program. The participants in this study included 112 PHNs and 266 service users who met with these PHNs in order to create a customized care plan within one month after the PHNs' training. The participants were divided into three groups: a supervised group in which the PHNs attended the 1-day training seminar and the follow-up supervision; a seminar group attended only the 1-day training seminar; a control group. The PHNs' sense of performance expectancy, and user's satisfaction, user's spontaneous behavior were evaluated at the baseline (T1), at one month (T2), and at three months (T3) after the PHNs' training. At T3, the PHNs performed a recalled evaluation (RE) of their communication skills before the training. The PHNs' sense of performance expectancy increased significantly over time in the supervised group and the control group (F = 11.28, P < 0.001; F = 4.03, P < 0.05, resp.). The difference score between T3-RE was significantly higher in the supervised group than the control group (P < 0.01). No significant differences in the users' outcomes were found.

Does training frequency and supervision affect compliance, performance and muscular health? A cluster randomized controlled trial.

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Dalager, Tina; Bredahl, Thomas G V; Pedersen, Mogens T; Boyle, Eleanor; Andersen, Lars L; Sjøgaard, Gisela

2015-10-01

The aim was to determine the effect of one weekly hour of specific strength training within working hours, performed with the same total training volume but with different training frequencies and durations, or with different levels of supervision, on compliance, muscle health and performance, behavior and work performance. In total, 573 office workers were cluster-randomized to: 1 WS: one 60-min supervised session/week, 3 WS: three 20-min supervised sessions/week, 9 WS: nine 7-min supervised sessions/week, 3 MS: three 20-min sessions/week with minimal supervision, or REF: a reference group without training. Outcomes were diary-based compliance, total training volume, muscle performance and questionnaire-based health, behavior and work performance. Comparisons were made among the WS training groups and between 3 WS and 3 MS. If no difference, training groups were collapsed (TG) and compared with REF. Results demonstrated similar degrees of compliance, mean(range) of 39(33-44)%, and total training volume, 13.266(11.977-15.096)kg. Musculoskeletal pain in neck and shoulders were reduced with approx. 50% in TG, which was significant compared with REF. Only the training groups improved significantly their muscle strength 8(4-13)% and endurance 27(12-37)%, both being significant compared with REF. No change in workability, productivity or self-rated health was demonstrated. Secondary analysis showed exercise self-efficacy to be a significant predictor of compliance. Regardless of training schedule and supervision, similar degrees of compliance were shown together with reduced musculoskeletal pain and improved muscle performance. These findings provide evidence that a great degree of flexibility is legitimate for companies in planning future implementation of physical exercise programs at the workplace. ClinicalTrials.gov, number NCT01027390. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Effects of Simulation-based Transvaginal Ultrasound Training on Quality and Efficiency of Care

DEFF Research Database (Denmark)

Tolsgaard, Martin Grønnebæk; Ringsted, Charlotte; Rosthøj, Susanne

2017-01-01

, but no studies have examined its effects on quality and efficiency of care. METHODS: Trainees from 4 University Hospitals in East Denmark were included (N = 54). Participants were randomized to either simulation-based ultrasound training and clinical training (intervention group, n = 28), or to clinical training......, 33.5-55.1) and 19.8% (95% CI, 4.1-32.9) in the intervention and control group, respectively (P = 0.005). CONCLUSIONS: Simulation-based ultrasound training improved quality of care and reduced the need for repeated patient examination and trainee supervision.......OBJECTIVE: To explore the effect of adding simulation-based transvaginal ultrasound training to trainees' clinical training compared with only clinical training on quality of and efficiency of care. BACKGROUND: Simulation-based ultrasound training may be an effective adjunct to clinical training...

Using patient experiences on Dutch social media to supervise health care services: exploratory study.

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van de Belt, Tom H; Engelen, Lucien J L P G; Verhoef, Lise M; van der Weide, Marian J A; Schoonhoven, Lisette; Kool, Rudolf B

2015-01-15

Social media has become mainstream and a growing number of people use it to share health care-related experiences, for example on health care rating sites. These users' experiences and ratings on social media seem to be associated with quality of care. Therefore, information shared by citizens on social media could be of additional value for supervising the quality and safety of health care services by regulatory bodies, thereby stimulating participation by consumers. The objective of the study was to identify the added value of social media for two types of supervision by the Dutch Healthcare Inspectorate (DHI), which is the regulatory body charged with supervising the quality and safety of health care services in the Netherlands. These were (1) supervision in response to incidents reported by individuals, and (2) risk-based supervision. We performed an exploratory study in cooperation with the DHI and searched different social media sources such as Twitter, Facebook, and healthcare rating sites to find additional information for these incidents and topics, from five different sectors. Supervision experts determined the added value for each individual result found, making use of pre-developed scales. Searches in social media resulted in relevant information for six of 40 incidents studied and provided relevant additional information in 72 of 116 cases in risk-based supervision of long-term elderly care. The results showed that social media could be used to include the patient's perspective in supervision. However, it appeared that the rating site ZorgkaartNederland was the only source that provided information that was of additional value for the DHI, while other sources such as forums and social networks like Twitter and Facebook did not result in additional information. This information could be of importance for health care inspectorates, particularly for its enforcement by risk-based supervision in care of the elderly. Further research is needed to determine

A qualitative investigation of the nature of "informal supervision" among therapists in training.

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Coren, Sidney; Farber, Barry A

2017-11-29

This study investigated how, when, why, and with whom therapists in training utilize "informal supervision"-that is, engage individuals who are not their formally assigned supervisors in significant conversations about their clinical work. Participants were 16 doctoral trainees in clinical and counseling psychology programs. Semi-structured interviews were conducted and analyzed using the Consensual Qualitative Research (CQR) method. Seven domains emerged from the analysis, indicating that, in general, participants believe that informal and formal supervision offer many of the same benefits, including validation, support, and reassurance; freedom and safety to discuss doubts, anxieties, strong personal reactions to patients, clinical mistakes and challenges; and alternative approaches to clinical interventions. However, several differences also emerged between these modes of learning-for example, formal supervision is seen as more focused on didactics per se ("what to do"), whereas informal supervision is seen as providing more of a "holding environment." Overall, the findings of this study suggest that informal supervision is an important and valuable adjunctive practice by which clinical trainees augment their professional competencies. Recommendations are proposed for clinical practice and training, including the need to further specify the ethical boundaries of this unique and essentially unregulated type of supervision.

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

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

2018-03-21

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

Nonsuicidal Self-Injury among Adolescents: A Training Priority for Primary Care Providers

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Taliaferro, Lindsay A.; Muehlenkamp, Jennifer J.; Hetler, Joel; Edwall, Glenace; Wright, Catherine; Edwards, Anne; Borowsky, Iris W.

2013-01-01

Primary care providers were surveyed to determine how prepared they feel to address nonsuicidal self-injury (NSSI) among adolescents, their interest in training on NSSI, and factors associated with routinely asking about NSSI when providing health supervision. Participants included family medicine physicians ("n" = 260), pediatricians…

A semi-supervised classification algorithm using the TAD-derived background as training data

Science.gov (United States)

Fan, Lei; Ambeau, Brittany; Messinger, David W.

2013-05-01

In general, spectral image classification algorithms fall into one of two categories: supervised and unsupervised. In unsupervised approaches, the algorithm automatically identifies clusters in the data without a priori information about those clusters (except perhaps the expected number of them). Supervised approaches require an analyst to identify training data to learn the characteristics of the clusters such that they can then classify all other pixels into one of the pre-defined groups. The classification algorithm presented here is a semi-supervised approach based on the Topological Anomaly Detection (TAD) algorithm. The TAD algorithm defines background components based on a mutual k-Nearest Neighbor graph model of the data, along with a spectral connected components analysis. Here, the largest components produced by TAD are used as regions of interest (ROI's),or training data for a supervised classification scheme. By combining those ROI's with a Gaussian Maximum Likelihood (GML) or a Minimum Distance to the Mean (MDM) algorithm, we are able to achieve a semi supervised classification method. We test this classification algorithm against data collected by the HyMAP sensor over the Cooke City, MT area and University of Pavia scene.

Nuclear safety culture and nuclear safety supervision

International Nuclear Information System (INIS)

Chai Jianshe

2013-01-01

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

Care to pregnant women in primary care: report of activities in supervised training

Directory of Open Access Journals (Sweden)

Mayckel da Silva Barreto

2013-07-01

Full Text Available This is an experience report that describes an academic activity during Interdisciplinary In-training course, which is part of curricular program of the 4th year of the Nursing undergraduate course at a public university of the Paraná Northwest. As evaluation of the internship was elaborated an Action Plan based on the Altadir Method of Popular Planning, about prenatal care, focusing on the most common pregnancy complications. After researching the literature, observations during the internship, study in documents and reports of the health team, revealed was that anemia, followed by urinary complications, gastric and gynecological were pregnancy complications more frequent at the health unit. As a result of acquired knowledge together, several actions were undertaken, with professionals and pregnant women. The activities evidenced the relevance of Interdisciplinary In-training as an agent of the competences consolidation and technical abilities, providing the academic identify problems, develop intervention strategies and operational demands of the action.

Efficacy of clinical supervision: influence on job satisfaction, burnout and quality of care.

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Hyrkäs, Kristiina; Appelqvist-Schmidlechner, Kaija; Haataja, Riina

2006-08-01

This paper reports a study to determine how supervisees' backgrounds and surrounding infrastructure predict the efficacy of clinical supervision among Finnish nursing staff, their job satisfaction, levels of burnout and perceptions of the quality of care. Several studies have described the effects of clinical supervision, but few have focused on evaluating it. Until recently, no studies have examined how clinical supervision evaluations are related to supervisees' backgrounds, surrounding infrastructure or respondents' levels of burnout, job satisfaction and perceptions of the quality of care. The survey involved supervisees completing a range of standardized and validated evaluation measures. The respondents were identified from 12 regional, central and university hospitals across Finland (n = 799). The data collection took place from October 2000 to February 2001. The evaluations varied statistically significantly and were associated with statistically significant variations in the respondents' backgrounds. Clinical supervision infrastructure was also strongly related to evaluation scores. Supervisees' age, education, gender, employment status, area of specialty, working hours, work experience and experience as a supervisor were statistically significant predictors for evaluations of the efficacy of clinical supervision. These evaluations of clinical supervision were also found to predict the respondents' job satisfaction, levels of burnout and assessments of good nursing. Nursing staff, especially those who have over 10 years' work experience, work in general care, have a nursing diploma, are non-tenured, work part-time and work 24-hour rotating shifts can benefit from clinical supervision. However, resources need to be invested in supervisor education and nursing staff need to be encouraged to start working in both supervisor and supervisee roles because of the positive effects on job satisfaction and quality of care.

Supervising Family Therapy Trainees in Primary Care Medical Settings: Context Matters

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Edwards, Todd M.; Patterson, Jo Ellen

2006-01-01

The purpose of this article is to identify and describe four essential skills for effective supervision of family therapy trainees in primary care medical settings. The supervision skills described include: (1) Understand medical culture; (2) Locate the trainee in the treatment system; (3) Investigate the biological/health issues; and (4) Be…

Does clinical supervision of healthcare professionals improve effectiveness of care and patient experience? A systematic review.

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

2017-11-28

To ensure quality of care delivery clinical supervision has been implemented in health services. While clinical supervision of health professionals has been shown to improve patient safety, its effect on other dimensions of quality of care is unknown. The purpose of this systematic review is to determine whether clinical supervision of health professionals improves effectiveness of care and patient experience. Databases MEDLINE, PsychINFO, CINAHL, EMBASE and AMED were searched from earliest date available. Additional studies were identified by searching of reference lists and citation tracking. Two reviewers independently applied inclusion and exclusion criteria. The quality of each study was rated using the Medical Education Research Study Quality Instrument. Data were extracted on effectiveness of care (process of care and patient health outcomes) and patient experience. Seventeen studies across multiple health professions (medical (n = 4), nursing (n = 7), allied health (n = 2) and combination of nursing, medical and/or allied health (n = 4)) met the inclusion criteria. The clinical heterogeneity of the included studies precluded meta-analysis. Twelve of 14 studies investigating 38,483 episodes of care found that clinical supervision improved the process of care. This effect was most predominant in cardiopulmonary resuscitation and African health settings. Three of six studies investigating 1756 patients found that clinical supervision improved patient health outcomes, namely neurological recovery post cardiopulmonary resuscitation (n = 1) and psychological symptom severity (n = 2). None of three studies investigating 1856 patients found that clinical supervision had an effect on patient experience. Clinical supervision of health professionals is associated with effectiveness of care. The review found significant improvement in the process of care that may improve compliance with processes that are associated with enhanced patient health

Effects of Supervised vs. Unsupervised Training Programs on Balance and Muscle Strength in Older Adults: A Systematic Review and Meta-Analysis.

Science.gov (United States)

Lacroix, André; Hortobágyi, Tibor; Beurskens, Rainer; Granacher, Urs

2017-11-01

Balance and resistance training can improve healthy older adults' balance and muscle strength. Delivering such exercise programs at home without supervision may facilitate participation for older adults because they do not have to leave their homes. To date, no systematic literature analysis has been conducted to determine if supervision affects the effectiveness of these programs to improve healthy older adults' balance and muscle strength/power. The objective of this systematic review and meta-analysis was to quantify the effectiveness of supervised vs. unsupervised balance and/or resistance training programs on measures of balance and muscle strength/power in healthy older adults. In addition, the impact of supervision on training-induced adaptive processes was evaluated in the form of dose-response relationships by analyzing randomized controlled trials that compared supervised with unsupervised trials. A computerized systematic literature search was performed in the electronic databases PubMed, Web of Science, and SportDiscus to detect articles examining the role of supervision in balance and/or resistance training in older adults. The initially identified 6041 articles were systematically screened. Studies were included if they examined balance and/or resistance training in adults aged ≥65 years with no relevant diseases and registered at least one behavioral balance (e.g., time during single leg stance) and/or muscle strength/power outcome (e.g., time for 5-Times-Chair-Rise-Test). Finally, 11 studies were eligible for inclusion in this meta-analysis. Weighted mean standardized mean differences between subjects (SMD bs ) of supervised vs. unsupervised balance/resistance training studies were calculated. The included studies were coded for the following variables: number of participants, sex, age, number and type of interventions, type of balance/strength tests, and change (%) from pre- to post-intervention values. Additionally, we coded training according

On-the-job training makes the difference: healthcare assistants' perceived competence and responsibility in the care of patients with home mechanical ventilation.

Science.gov (United States)

Swedberg, Lena; Michélsen, Hans; Chiriac, Eva Hammar; Hylander, Ingrid

2015-06-01

To describe and analyse perceived competence and perceived responsibility among healthcare assistants (HC assistants), caring for patients with home mechanical ventilation (HMV) and other advanced caring needs, adjusted for socio-demographic and workplace background factors. A cross-sectional study was conducted including 128 HC assistants employed in Stockholm County, Sweden. The HC assistants responded to a study-specific questionnaire on perceived competence and perceived responsibility, provided socio-demographic and workplace background data, as well as information on the patient characteristics for the understanding of their work situations. Descriptive statistics and logistic regression analyses were performed. Eighty per cent of the HC assistants rated their perceived competence as high, and fifty-nine per cent rated their perceived responsibility as high. Fifty-five per cent lacked formal healthcare training, and only one in five of the HC assistants had a formal training equivalent with a licensed practical nurse (LPN) examination. Males lacked formal training to a greater extent than females and rated their competence accordingly. On-the-job training was significantly associated with high ratings on both perceived competence and perceived responsibility, and clinical supervision was associated with high rating on perceived responsibility. HC assistants with limited formal training self-reported their competence as high, and on-the-job training was found to be important. Also, clinical supervision was found important for their perception of high responsibility. In Sweden, HC assistants have a 24-hour responsibility for the care and safety of their patient with HMV and other advanced caring needs. The study results point out important issues for further research regarding formal training requirements as well as the needs for standardised workplace training and supervision of HC assistants. The consequences of transfer of responsibility by delegation from

Training Level, Acculturation, Role Ambiguity, and Multicultural Discussions in Training and Supervising International Counseling Students in the United States

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Ng, Kok-Mun; Smith, Shannon D.

2012-01-01

This research partially replicated Nilsson and Anderson's "Professional Psychology: Research and Practice" (2004) study on training and supervising international students. It investigated the relationships among international counseling students' training level, acculturation, supervisory working alliance (SWA), counseling self-efficacy (COSE),…

Cultivating Self-Awareness in Counselors-in-Training through Group Supervision

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Del Moro, Ronald R.

2012-01-01

This study investigated processes, strategies, and frameworks that took place during group supervision classes, which best cultivate the self-awareness of Mental Health and Marriage and Family Counselors-in-Training (CITs). It was designed to explore factors across multiple theoretical models, which contributed to the cultivation of self-awareness…

SUPPORTIVE SUPERVISION AS A TECHNOLOGY OF IMPROVING THE QUALITY OF HOSPITAL CARE DELIVERY

Directory of Open Access Journals (Sweden)

Svetlana A. Mukhortova

2017-01-01

Full Text Available Improving the quality of medical care is a priority in countries with developed and developing health care system. There are various approaches to improve the quality and safety of patient’s care, as well as various strategies to encourage hospitals to achieve this goal. The purpose of the presented literature review was to analyze existing experience of the implementation of technology of supportive supervision in health care facilities to improve the quality of hospital care delivery. The data sources for publication were obtained from the following medical databases: PubMed, Cochrane Library, Medscape, e-library, and books on the topic of the review written by experts. The article discusses the results of the research studies demonstrating the successes and failures of supportive supervision technology application. Implementation of supportive supervision in medical facilities based on generalized experience of different countries is a promising direction in improving the quality of medical care delivery. This technology opens up opportunities to improve skills and work quality of the staff at pediatric hospitals in the Russian Federation.

Internet and video technology in psychotherapy supervision and training.

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Wolf, Abraham W

2011-06-01

The seven articles in this special section on the use of Internet and video technology represent the latest growth on one branch of the increasingly prolific and differentiated work in the technology of psychotherapy. In addition to the work presented here on video and the Internet applications to supervision and training, information technology is changing the field of psychotherapy through computer assisted therapies and virtual reality interventions.

Food hygiene training in small to medium-sized care settings.

Science.gov (United States)

Seaman, Phillip; Eves, Anita

2008-10-01

Adoption of safe food handling practices is essential to effectively manage food safety. This study explores the impact of basic or foundation level food hygiene training on the attitudes and intentions of food handlers in care settings, using questionnaires based on the Theory of Planned Behaviour. Interviews were also conducted with food handlers and their managers to ascertain beliefs about the efficacy of, perceived barriers to, and relevance of food hygiene training. Most food handlers had undertaken formal food hygiene training; however, many who had not yet received training were preparing food, including high risk foods. Appropriate pre-training support and on-going supervision appeared to be lacking, thus limiting the effectiveness of training. Findings showed Subjective Norm to be the most significant influence on food handlers' intention to perform safe food handling practices, irrespective of training status, emphasising the role of important others in determining desirable behaviours.

SUPERVISED PHYSICAL TRAINING IMPROVES FINE MOTOR SKILLS OF 5-YEAR-OLD CHILDREN

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Yugang Qi

Full Text Available ABSTRACT Introduction: Fine motor skills are important for children not only in the activities of daily living, but also for learning activities. In the present study, the effects of supervised physical training were investigated in normal children. Objective: To evaluate the effects of supervised training by combining full-body exercise and the eye-hand coordination activities to improve fine motor skills in a group of five-year-old normal children. Methods: Fifty-two children were selected and randomized in exercise and control groups. The exercise group participated in three 30-minute training sessions per week for 24 weeks. Results: The fine motor skills and hand grip strength of the exercise group were significantly increased, while there was no significant change in the control group during the experimental period. Conclusion: The results indicate that the current exercise training program is effective and can be applied to 5-year-old normal children to improve their fine motor skills. In addition, this program has simple physical activities that are appropriate to the physical and mental level of child development. The 30-minute training session would be easily implemented in the kindergarten program. Level of Evidence I; High quality randomized trial with statistically significant difference or no statistically significant difference but narrow confidence intervals.

Protocols and Results of Resident Neurosurgeon's Transfemoral Catheter Angiography Training Supervised by Neuroendovascular Specialists

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Shin, Dong-Seong; Yeo, Dong-Kyu; Hwang, Sun-Chul; Park, Sukh-Que

2013-01-01

Objective Transfemoral catheter angiography (TFCA) is a basic procedure in neurovascular surgery with increasing importance in surgical and non-invasive treatments. Unfortunately, resident neurosurgeons have relatively few opportunities to perform TFCA in most institutions. We report a method developed in our hospital for training resident neurosurgeons to perform TFCA and evaluate the efficacy of this training. Methods From May 2011 to September 2011, a total of 112 consecutive patients underwent TFCA by one resident neurosurgeon supervised by two neuroendovascular specialists. Patients who underwent elective diagnostic procedures were included in this study. Patients who underwent endovascular treatment were excluded. Demographic data, indications for TFCA, side of approach, number of selected arteries, and complications were analyzed. Results This study included 64 males and 48 females with a mean age of 51.6 (12-81) years. All procedures were performed in the angiography suite. Common indications for procedures were as follows: stroke-induced symptoms in 61 patients (54.5%), Moyamoya disease and arteriovenous malformation in 13 patients (11.6%), and unruptured intracranial aneurysm in eight patients (7.1%). Right and left femoral puncture was performed in 98.2% and 1.8% of patients, respectively. A total of 465 selective angiographies were performed without complications. Angiographic examination was performed on 4.15 vessels per patient. Conclusion TFCA can be performed safely by resident neurosurgeons based on anatomical study and a meticulous protocol under the careful supervision of neuroendovascular specialists. PMID:24175020

Improvement program of state supervision system for radioactive and nuclear installations

International Nuclear Information System (INIS)

Cardenas, J.

1993-01-01

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

Supervision of the thermal performance of heat exchanger trains

Energy Technology Data Exchange (ETDEWEB)

Negrao, C.O.R.; Tonin, P.C.; Madi, M. [Federal University of Technology Parana UTFPR, Post-graduate Program in Mechanical and Materials Engineering PPGEM, Thermal Science Laboratory LACIT, Av. Sete de Setembro, 3165, CEP 80230-901, Curitiba, Parana (Brazil)

2007-02-15

In oil refining, heat exchanger networks are employed to recover heat and therefore save energy of the plant. However, many heat exchangers in crude oil pre-heat trains are under high risk of fouling. Under fouling conditions, the thermal performance of heat exchangers is continuously reduced and its supervision becomes an important task. The large number of heat exchangers in pre-heat trains and the change of operation conditions and feedstock charges make the daily supervision a difficult task. This work applies an approach to follow the performance of heat exchangers [M.A.S. Jeronimo, L.F. Melo, A.S. Braga, P.J.B.F. Ferreira, C. Martins, Monitoring the thermal efficiency of fouled heat exchangers - A simplified method, Experimental Thermal and Fluid Science 14 (1997) 455-463] and extends it to monitor the whole train. The approach is based on the comparison of measured and predicted heat exchanger effectiveness. The measured value is computed from the four inlet and outlet temperatures of a heat exchanger unit. The predicted clean and dirty values of effectiveness are calculated from classical literature relations as a function of NTU and of heat capacity ratio (R). NTU and R are continuously adjusted according to mass flow rate changes. An index of fouling is defined for the whole network and the results show the performance degradation of the network with time. The work also suggests that Jeronimo's index of fouling can be used to estimate the fouling thermal resistance of heat exchangers. (author)

Medical-pedagogical supervisions for sportsmen short-trek in a period of еducational and trainings employments

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Zaycev V.P.

2010-04-01

Full Text Available The results of inspection of sportsmen are generalized. 8 highly skilled sportsmen were inspected. A method is presented medical-pedagogical supervisions. Age of sportsmen: 16-18 years - 2 sportsmen, 19-20 years - 3 sportsmen, 22-25 years - 3 sportsmen. The results of the use of clinical inspection and visual supervisions are rotined. Frequency of heart-throbs and arteriotony is certain. Information of pulsator is resulted, functional tests and tests, dynamometer. For renewal of organism after educational and training employment employment it is recommended to accept water procedures, vitaminized food, autogenic training, active and passive rest.

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

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Tatiana V. Kulichenko

2017-01-01

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

Supervised Versus Home Exercise Training Programs on Functional Balance in Older Subjects.

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Youssef, Enas Fawzy; Shanb, Alsayed Abd Elhameed

2016-11-01

Aging is associated with a progressive decline in physical capabilities and a disturbance of both postural control and daily living activities. The aim of this study was to evaluate the effects of supervised versus home exercise programs on muscle strength, balance and functional activities in older participants. Forty older participants were equally assigned to a supervised exercise program (group-I) or a home exercise program (group-II). Each participant performed the exercise program for 35-45 minutes, two times per week for four months. Balance indices and isometric muscle strength were measured with the Biodex Balance System and Hand-Held Dynamometer. Functional activities were evaluated by the Berg Balance Scale (BBS) and the timed get-up-and-go test (TUG). The mean values of the Biodex balance indices and the BBS improved significantly after both the supervised and home exercise programs ( P training programs significantly increased balance performance. The supervised program was superior to the home program in restoring functional activities and isometric muscle strength in older participants.

Wibangbe: the making of a documentary about the training and supervision of traditional birth attendants in Zaire.

Science.gov (United States)

Vansintejan, G A; Glaser, W A

1988-01-01

During the 1980's in Karawa, Northwestern Zaire, a motion picture was produced which showed the interaction of the modern and traditional systems. The maternity center of the Karawa hospital was central to this effort. Traditional birth attendants (TBAs) became leading participants. Locally trained midwives were key trainers. The training and supervision programs had been ongoing for 2 years when Karawa was chosen as the movie site in 1986. The script was written by a midwife who had trained trainers of TBAs and TBAs themselves. All the steps in the selection, training, supervision, and supplying of TBAs in Karawa and its neighboring villages are included in the script. A Zairian team shot the script. The 5-member crew were employees of the Office Zairois de la Radio-Television (OZRT), the country's official television, radio, and film service. "Wibange" has separate sound tracks in French and English. Costs of the movie were met by contributions from both the US Agency for International Development and from Zaire. "Wibange--Traditional Birth Attendants: Their Training and Supervision" was developed in New York City. There are 2 final productions, a French and an English version. Running time is 23 minutes.

Semi-supervised adaptation in ssvep-based brain-computer interface using tri-training

DEFF Research Database (Denmark)

Bender, Thomas; Kjaer, Troels W.; Thomsen, Carsten E.

2013-01-01

This paper presents a novel and computationally simple tri-training based semi-supervised steady-state visual evoked potential (SSVEP)-based brain-computer interface (BCI). It is implemented with autocorrelation-based features and a Naïve-Bayes classifier (NBC). The system uses nine characters...

Supervised Balance Training and Wii Fit-Based Exercises Lower Falls Risk in Older Adults With Type 2 Diabetes.

Science.gov (United States)

Morrison, Steven; Simmons, Rachel; Colberg, Sheri R; Parson, Henri K; Vinik, Aaron I

2018-02-01

This study examined the benefits of and differences between 12 weeks of thrice-weekly supervised balance training and an unsupervised at-home balance activity (using the Nintendo Wii Fit) for improving balance and reaction time and lowering falls risk in older individuals with type 2 diabetes mellitus (T2DM). Before-after trial. University research laboratory, home environment. Sixty-five older adults with type 2 diabetes were recruited for this study. Participants were randomly allocated to either supervised balance training (mean age 67.8 ± 5.2) or unsupervised training using the Nintendo Wii Fit balance board (mean age 66.1 ± 5.6). The training period for both groups lasted for 12 weeks. Individuals were required to complete three 40-minute sessions per week for a total of 36 sessions. The primary outcome measure was falls risk, which was as derived from the physiological profile assessment. In addition, measures of simple reaction time, lower limb proprioception, postural sway, knee flexion, and knee extension strength were also collected. Persons also self-reported any falls in the previous 6 months. Both training programs resulted in a significant lowering of falls risk (P general balance ability. Interestingly, the reduced falls risk occurred without significant changes in leg strength, suggesting that interventions to reduce falls risk that target intrinsic risk factors related to balance control (over muscle strength) may have positive benefits for the older adult with T2DM at risk for falls. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Guess Where? Actor-Supervision for Spatiotemporal Action Localization

KAUST Repository

Escorcia, Victor

2018-04-05

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

Guess Where? Actor-Supervision for Spatiotemporal Action Localization

KAUST Repository

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

2018-01-01

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

A Device for Automatically Measuring and Supervising the Critical Care Patient’S Urine Output

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Roemi Fernández

2010-01-01

Full Text Available Critical care units are equipped with commercial monitoring devices capable of sensing patients’ physiological parameters and supervising the achievement of the established therapeutic goals. This avoids human errors in this task and considerably decreases the workload of the healthcare staff. However, at present there still is a very relevant physiological parameter that is measured and supervised manually by the critical care units’ healthcare staff: urine output. This paper presents a patent-pending device capable of automatically recording and supervising the urine output of a critical care patient. A high precision scale is used to measure the weight of a commercial urine meter. On the scale’s pan there is a support frame made up of Bosch profiles that isolates the scale from force transmission from the patient’s bed, and guarantees that the urine flows properly through the urine meter input tube. The scale’s readings are sent to a PC via Bluetooth where an application supervises the achievement of the therapeutic goals. The device is currently undergoing tests at a research unit associated with the University Hospital of Getafe in Spain.

Weighting training images by maximizing distribution similarity for supervised segmentation across scanners

DEFF Research Database (Denmark)

van Opbroek, Annegreet; Vernooij, Meike W; Ikram, M.Arfan

2015-01-01

Many automatic segmentation methods are based on supervised machine learning. Such methods have proven to perform well, on the condition that they are trained on a sufficiently large manually labeled training set that is representative of the images to segment. However, due to differences between...... scanners, scanning parameters, and patients such a training set may be difficult to obtain. We present a transfer-learning approach to segmentation by multi-feature voxelwise classification. The presented method can be trained using a heterogeneous set of training images that may be obtained with different...... scanners than the target image. In our approach each training image is given a weight based on the distribution of its voxels in the feature space. These image weights are chosen as to minimize the difference between the weighted probability density function (PDF) of the voxels of the training images...

Task sharing in rural Haiti: Qualitative assessment of a brief, structured training with and without apprenticeship supervision for community health workers

Science.gov (United States)

McLean, Kristen E; Kaiser, Bonnie N; Hagaman, Ashley K; Wagenaar, Bradley H; Therosme, Tatiana P; Kohrt, Brandon A

2015-01-01

Despite growing support for supervision after task sharing trainings in humanitarian settings, there is limited research on the experience of trainees in apprenticeship and other supervision approaches. Studying apprenticeships from trainees’ perspectives is crucial to refine supervision and enhance motivation for service implementation. The authors implemented a multi-stage, transcultural adaptation for a pilot task sharing training in Haiti entailing three phases: 1) literature review and qualitative research to adapt a mental health and psychosocial support training; 2) implementation and qualitative process evaluation of a brief, structured group training; and 3) implementation and qualitative evaluation of an apprenticeship training, including a two year follow-up of trainees. Structured group training revealed limited knowledge acquisition, low motivation, time and resource constraints on mastery, and limited incorporation of skills into practice. Adding an apprenticeship component was associated with subjective clinical competency, increased confidence regarding utilising skills, and career advancement. Qualitative findings support the added value of apprenticeship according to trainees. PMID:26190953

Artificial neural network classification using a minimal training set - Comparison to conventional supervised classification

Science.gov (United States)

Hepner, George F.; Logan, Thomas; Ritter, Niles; Bryant, Nevin

1990-01-01

Recent research has shown an artificial neural network (ANN) to be capable of pattern recognition and the classification of image data. This paper examines the potential for the application of neural network computing to satellite image processing. A second objective is to provide a preliminary comparison and ANN classification. An artificial neural network can be trained to do land-cover classification of satellite imagery using selected sites representative of each class in a manner similar to conventional supervised classification. One of the major problems associated with recognition and classifications of pattern from remotely sensed data is the time and cost of developing a set of training sites. This reseach compares the use of an ANN back propagation classification procedure with a conventional supervised maximum likelihood classification procedure using a minimal training set. When using a minimal training set, the neural network is able to provide a land-cover classification superior to the classification derived from the conventional classification procedure. This research is the foundation for developing application parameters for further prototyping of software and hardware implementations for artificial neural networks in satellite image and geographic information processing.

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

Science.gov (United States)

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

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

Effect of training supervision on effectiveness of strength training for reducing neck/shoulder pain and headache in office workers

DEFF Research Database (Denmark)

Gram, Bibi; Andersen, Christoffer; Zebis, Mette Kreutzfeldt

2014-01-01

Objective. To investigate the effect of workplace neck/shoulder strength training with and without regular supervision on neck/shoulder pain and headache among office workers. Method. A 20-week cluster randomized controlled trial among 351 office workers was randomized into three groups: two trai...

Skærpet bevidsthed om supervision

DEFF Research Database (Denmark)

Pedersen, Inge Nygaard

2002-01-01

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

Drivers of prenatal care quality and uptake of supervised delivery ...

African Journals Online (AJOL)

Background: In spite of the introduction of free maternal healthcare in Ghana, utilization of supervised delivery services continues to be low due partly to poor quality of antenatal care (ANC). Aim: The study sought to identify the determinants of perceived quality of ANC and uptake of skilled delivery services. Subjects and ...

Group supervision for healthcare professionals within primary care for patients with psychosomatic health problems: a pilot intervention study.

Science.gov (United States)

Bullington, Jennifer; Cronqvist, Agneta

2018-03-01

In primary health care, efficacious treatment strategies are lacking for these patients, although the most prominent symptoms accounting for consultation in primary care often cannot be related to any biological causes. The aim was to explore whether group supervision from a specific phenomenological theory of psychosomatics could provide healthcare professionals treating patients with psychosomatic health issues within primary care a deeper understanding of these conditions and stimulate profession-specific treatment strategies. Our research questions were as follows: (i) What is the healthcare professionals' understanding of psychosomatics before and after the intervention? (ii) What are the treatment strategies for this group of patients before and after the intervention? The study was an explorative qualitative intervention pilot study. The six participants from a primary healthcare setting in a medium-sized city in Sweden participated in the study. A supervision group was formed, based on a mix of professions, age, gender and years of clinical experience. Supervision consisted of one 75-minutes meeting every month during the course of 6 months. Participants were interviewed before and after the supervision intervention. The study showed two distinct categories emerged from the data. One category of healthcare professionals espoused a psycho-educative approach, while the other lacked a cohesive approach. The supervision improved the second category of healthcare professionals' understanding of psychosomatics. The psycho-educative group did not change their understanding of psychosomatics, although they felt strengthened in their approach by the supervision. Profession-specific strategies were not developed. This pilot study indicates that a relatively short supervision intervention can aid clinicians in their clinical encounters with these patients; however, further research is necessary to ascertain the value of the specific phenomenologically based

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

Science.gov (United States)

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

2016-06-01

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

Providing effective supervision in clinical neuropsychology.

Science.gov (United States)

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

2010-01-01

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

Clinical Supervision in Denmark

DEFF Research Database (Denmark)

Jacobsen, Claus Haugaard

2011-01-01

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

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

Science.gov (United States)

1993-01-01

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

The efficacy of early initiated, supervised, progressive resistance training compared to unsupervised, home-based exercise after unicompartmental knee arthroplasty

DEFF Research Database (Denmark)

Jørgensen, Peter Bo; Bogh, Søren B; Kierkegaard, Signe

2017-01-01

OBJECTIVE: To examine if supervised progressive resistance training was superior to home-based exercise in rehabilitation after unicompartmental knee arthroplasty. DESIGN: Single blinded, randomized clinical trial. SETTING: Surgery, progressive resistance training and testing was carried out...

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

Science.gov (United States)

Ogren, Marie-Louise; Sundin, Eva C.

2009-01-01

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

Gymnasium-based unsupervised exercise maintains benefits in oxygen uptake kinetics obtained following supervised training in type 2 diabetes.

Science.gov (United States)

Macananey, Oscar; O'Shea, Donal; Warmington, Stuart A; Green, Simon; Egaña, Mikel

2012-08-01

Supervised exercise (SE) in patients with type 2 diabetes improves oxygen uptake kinetics at the onset of exercise. Maintenance of these improvements, however, has not been examined when supervision is removed. We explored if potential improvements in oxygen uptake kinetics following a 12-week SE that combined aerobic and resistance training were maintained after a subsequent 12-week unsupervised exercise (UE). The involvement of cardiac output (CO) in these improvements was also tested. Nineteen volunteers with type 2 diabetes were recruited. Oxygen uptake kinetics and CO (inert gas rebreathing) responses to constant-load cycling at 50% ventilatory threshold (V(T)), 80% V(T), and mid-point between V(T) and peak workload (50% Δ) were examined at baseline (on 2 occasions) and following each 12-week training period. Participants decided to exercise at a local gymnasium during the UE. Thirteen subjects completed all the interventions. The time constant of phase 2 of oxygen uptake was significantly faster (p exercise maintained benefits in oxygen uptake kinetics obtained during a supervised exercise in subjects with diabetes, and these benefits were associated with a faster dynamic response of heart rate after training.

A SURVEY OF SEMI-SUPERVISED LEARNING

OpenAIRE

Amrita Sadarangani *, Dr. Anjali Jivani

2016-01-01

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

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

Science.gov (United States)

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

2018-01-01

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

Educational Supervision Appropriate for Psychiatry Trainee's Needs

Science.gov (United States)

Rele, Kiran; Tarrant, C. Jane

2010-01-01

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

Optimistic semi-supervised least squares classification

DEFF Research Database (Denmark)

Krijthe, Jesse H.; Loog, Marco

2017-01-01

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

Paid carers' experiences of caring for mechanically ventilated children at home: implications for services and training.

Science.gov (United States)

Maddox, Christina; Pontin, David

2013-06-01

UK survival rates for long-term mechanically ventilated children have increased and paid carers are trained to care for them at home, however there is limited literature on carers' training needs and experience of sharing care. Using a qualitative abductive design, we purposively sampled experienced carers to generate data via diaries, semi-structured interviews, and researcher reflexive notes. Research ethics approval was granted from NHS and University committees. Five analytical themes emerged - Parent as expert; Role definition tensions; Training and Continuing Learning Needs; Mixed Emotions; Support Mechanisms highlighting the challenges of working in family homes for carers and their associated learning needs. Further work on preparing carers to share feelings with parents, using burnout prevention techniques, and building confidence is suggested. Carers highlight the lack of clinical supervision during their night-working hours. One solution may be to provide access to registered nurse support when working out-of-office hours.

Supervised Exercise Training Counterbalances the Adverse Effects of Insulin Therapy in Overweight/Obese Subjects With Type 2 Diabetes

OpenAIRE

Balducci, Stefano; Zanuso, Silvano; Cardelli, Patrizia; Salerno, Gerardo; Fallucca, Sara; Nicolucci, Antonio; Pugliese, Giuseppe

2011-01-01

OBJECTIVE To examine the effect of supervised exercise on traditional and nontraditional cardiovascular risk factors in sedentary, overweight/obese insulin-treated subjects with type 2 diabetes from the Italian Diabetes Exercise Study (IDES). RESEARCH DESIGN AND METHODS The study randomized 73 insulin-treated patients to twice weekly supervised aerobic and resistance training plus structured exercise counseling (EXE) or to counseling alone (CON) for 12 months. Clinical and laboratory paramete...

Academic Writing in Reflexive Professional Writing: Citations of Scientific Literature in Supervised Pre-Service Training Reports

Directory of Open Access Journals (Sweden)

Lívia Chaves de Melo

2013-06-01

Full Text Available In this paper we investigate citation practices of scientific literature in reflexive writing from the genre of supervised pre-service training report produced by pre-service teachers enrolled in the mandatory pre-service training subject of English Language Teaching, at an undergraduate language teaching course. The aim of this research is to analyze how these pre-services teacher represent themselves based on citation practices of scientific literature, and characterize some of the functions deployed by the citations in the reflexive writing emerging in the academic sphere. We use the dialogic approach to language from Bakhtinian studies as a theoretical base, as well as theoretical and methodological contributions regarding types of sequences and of discourse proposed by Adam and Bronckart. The results of this research show that the practice of citation of scientific literature is an invocation of authority as a form of erudition, amplification and ornamentation of the discourse produced. This practice can also guide pedagogical action developed by pre-service teachers in their supervised training.

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

Science.gov (United States)

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

2015-01-01

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

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

Science.gov (United States)

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

2013-11-01

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

Mentoring, coaching and supervision

OpenAIRE

McMahon, Samantha; Dyer, Mary; Barker, Catherine

2016-01-01

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

Evaluation of Semi-supervised Learning for Classification of Protein Crystallization Imagery.

Science.gov (United States)

Sigdel, Madhav; Dinç, İmren; Dinç, Semih; Sigdel, Madhu S; Pusey, Marc L; Aygün, Ramazan S

2014-03-01

In this paper, we investigate the performance of two wrapper methods for semi-supervised learning algorithms for classification of protein crystallization images with limited labeled images. Firstly, we evaluate the performance of semi-supervised approach using self-training with naïve Bayesian (NB) and sequential minimum optimization (SMO) as the base classifiers. The confidence values returned by these classifiers are used to select high confident predictions to be used for self-training. Secondly, we analyze the performance of Yet Another Two Stage Idea (YATSI) semi-supervised learning using NB, SMO, multilayer perceptron (MLP), J48 and random forest (RF) classifiers. These results are compared with the basic supervised learning using the same training sets. We perform our experiments on a dataset consisting of 2250 protein crystallization images for different proportions of training and test data. Our results indicate that NB and SMO using both self-training and YATSI semi-supervised approaches improve accuracies with respect to supervised learning. On the other hand, MLP, J48 and RF perform better using basic supervised learning. Overall, random forest classifier yields the best accuracy with supervised learning for our dataset.

Multicultural Supervision: What Difference Does Difference Make?

Science.gov (United States)

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

2014-01-01

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

Supervised pelvic floor muscle training versus attention-control massage treatment in patients with faecal incontinence

DEFF Research Database (Denmark)

Ussing, Anja; Dahn, Inge; Due, Ulla

2017-01-01

supplements is recommended as first-line treatment for faecal incontinence. Despite this, the effect of pelvic floor muscle training for faecal incontinence is unclear. No previous trials have investigated the efficacy of supervised pelvic floor muscle training in combination with conservative treatment...... treatment and conservative treatment. The primary outcome is participants' rating of symptom changes after 16 weeks of treatment using the Patient Global Impression of Improvement Scale. Secondary outcomes are the Vaizey Incontinence Score, the Fecal Incontinence Severity Index, the Fecal Incontinence...

Extended apprenticeship learning in doctoral training and supervision - moving beyond 'cookbook recipes'

DEFF Research Database (Denmark)

Tanggaard, Lene; Wegener, Charlotte

An apprenticeship perspective on learning in academia sheds light on the potential for mutual learning and production, and also reveals the diverse range of learning resources beyond the formal novice-–expert relationship. Although apprenticeship is a well-known concept in educational research......, in this case apprenticeship offers an innovative perspective on future practice and research in academia allowing more students access to high high-quality research training and giving supervisors a chance to combine their own research with their supervision obligations....

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

Science.gov (United States)

Hall, Ian

2018-03-02

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

QUEST: Eliminating Online Supervised Learning for Efficient Classification Algorithms.

Science.gov (United States)

Zwartjes, Ardjan; Havinga, Paul J M; Smit, Gerard J M; Hurink, Johann L

2016-10-01

In this work, we introduce QUEST (QUantile Estimation after Supervised Training), an adaptive classification algorithm for Wireless Sensor Networks (WSNs) that eliminates the necessity for online supervised learning. Online processing is important for many sensor network applications. Transmitting raw sensor data puts high demands on the battery, reducing network life time. By merely transmitting partial results or classifications based on the sampled data, the amount of traffic on the network can be significantly reduced. Such classifications can be made by learning based algorithms using sampled data. An important issue, however, is the training phase of these learning based algorithms. Training a deployed sensor network requires a lot of communication and an impractical amount of human involvement. QUEST is a hybrid algorithm that combines supervised learning in a controlled environment with unsupervised learning on the location of deployment. Using the SITEX02 dataset, we demonstrate that the presented solution works with a performance penalty of less than 10% in 90% of the tests. Under some circumstances, it even outperforms a network of classifiers completely trained with supervised learning. As a result, the need for on-site supervised learning and communication for training is completely eliminated by our solution.

Reflecting reflection in supervision

DEFF Research Database (Denmark)

Lystbæk, Christian Tang

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

Impact of Family Planning and Business Trainings on Private-Sector Health Care Providers in Nigeria.

Science.gov (United States)

Ugaz, Jorge; Leegwater, Anthony; Chatterji, Minki; Johnson, Doug; Baruwa, Sikiru; Toriola, Modupe; Kinnan, Cynthia

2017-06-01

Private health care providers are an important source of modern contraceptives in Sub-Saharan Africa, yet they face many challenges that might be addressed through targeted training. This study measures the impact of a package of trainings and supportive supervision activities targeted to private health care providers in Lagos State, Nigeria, on outcomes including range of contraceptive methods offered, providers' knowledge and quality of counseling, recordkeeping practices, access to credit and revenue. A total of 965 health care facilities were randomly assigned to treatment and control groups. Facilities in the treatment group-but not those in the control group-were offered a training package that included a contraceptive technology update and interventions to improve counseling and clinical skills and business practices. Multivariate regression analysis of data collected through facility and mystery client surveys was used to estimate effects. The training program had a positive effect on the range of contraceptive methods offered, with facilities in the treatment group providing more methods than facilities in the control group. The training program also had a positive impact on the quality of counseling services, especially on the range of contraceptive methods discussed by providers, their interpersonal skills and overall knowledge. Facilities in the treatment group were more likely than facilities in the control group to have good recordkeeping practices and to have obtained loans. No effect was found on revenue generation. Targeted training programs can be effective tools to improve the provision of family planning services through private providers.

Cliché, Gossip, and Anecdote as Supervision Training

Science.gov (United States)

Grealy, Liam

2016-01-01

This article expands on a co-authored project with Timothy Laurie on the practices and ethics of higher degree research (HDR) supervision (or advising): "What does good HDR supervision look like?" in contemporary universities. It connects that project with scholarship on the relevance of "common sense" to questions of…

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

Science.gov (United States)

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

2016-10-03

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

SemiBoost: boosting for semi-supervised learning.

Science.gov (United States)

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

2009-11-01

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

46 CFR 131.420 - Manning and supervision.

Science.gov (United States)

2010-10-01

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

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

Science.gov (United States)

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

2011-01-01

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

QUEST: Eliminating Online Supervised Learning for Efficient Classification Algorithms

Directory of Open Access Journals (Sweden)

Ardjan Zwartjes

2016-10-01

Full Text Available In this work, we introduce QUEST (QUantile Estimation after Supervised Training, an adaptive classification algorithm for Wireless Sensor Networks (WSNs that eliminates the necessity for online supervised learning. Online processing is important for many sensor network applications. Transmitting raw sensor data puts high demands on the battery, reducing network life time. By merely transmitting partial results or classifications based on the sampled data, the amount of traffic on the network can be significantly reduced. Such classifications can be made by learning based algorithms using sampled data. An important issue, however, is the training phase of these learning based algorithms. Training a deployed sensor network requires a lot of communication and an impractical amount of human involvement. QUEST is a hybrid algorithm that combines supervised learning in a controlled environment with unsupervised learning on the location of deployment. Using the SITEX02 dataset, we demonstrate that the presented solution works with a performance penalty of less than 10% in 90% of the tests. Under some circumstances, it even outperforms a network of classifiers completely trained with supervised learning. As a result, the need for on-site supervised learning and communication for training is completely eliminated by our solution.

Educational Technology and Distance Supervision in Counselor Education

Science.gov (United States)

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

2017-01-01

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

Deconstructing Risk Management in Psychotherapy Supervision.

Science.gov (United States)

Kroll, Jerome; Radden, Jennifer

2017-12-01

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

Requirements for nurse supervisor training: A qualitative content analysis.

Science.gov (United States)

Dehghani, Khadijeh; Nasiriani, Khadijeh; Salimi, Tahere

2016-01-01

Supervisors should have certain characteristics and adequate preparation for their roles. Yet, there are no well-educated experts knowing about the supervisor's role and responsibilities and how to train them. So, this research was conducted with the purpose of finding the factors affecting nursing supervisor training. This research is an inductive content analysis. Participants were 25 in number, consisting of nurses and supervisors in Shahid Sadoughi University hospitals. The participants were chosen by a purposive sampling method. Data collection was done by semi-structured interviews and reviewing documents. Data were analyzed using conventional content analysis. Findings included two main themes: Firstly, establishment of a supervisory infrastructure that includes "making the appointments and retention of supervisors, clarifying the duties and authority of supervisor, developing supervisory culture, specializing supervision, and conducting practice-based training" and secondly, comprehensive supervisory competencies that include "acquiring scientific, managing, communicative, professional, ethical, pedagogical, and supporting adequacy." Clinical supervisor has a major role in ensuring the quality of nursing care. This leads to improvements in patient care and nurses' personal and professional development. So, it is necessary that for effective supervision in nursing, first an infrastructure is provided for supervision and then the comprehensive competency of a supervisor is enhanced to apply effective supervision.

Developing a Strong Direct Care Workforce.

Science.gov (United States)

Stear, Lynda A

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

Clinical Supervision of International Supervisees: Suggestions for Multicultural Supervision

Science.gov (United States)

Lee, Ahram

2018-01-01

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

Teaching teamwork: an evaluation of an interprofessional training ward placement for health care students.

Science.gov (United States)

Morphet, Julia; Hood, Kerry; Cant, Robyn; Baulch, Julie; Gilbee, Alana; Sandry, Kate

2014-01-01

The establishment of interprofessional teamwork training in the preprofessional health care curriculum is a major challenge for teaching faculties. Interprofessional clinical placements offer an opportunity for teamwork education, as students in various professions can work and learn together. In this sequential, mixed-method study, focus group and survey techniques were used to evaluate students' educational experiences after 2-week ward-based interprofessional clinical placements. Forty-five senior nursing, medicine, and other health care students cared for patients in hospital wards under professional supervision, with nursing-medicine student "teams" leading care. Thirty-six students attended nine exit focus groups. Five central themes that emerged about training were student autonomy and workload, understanding of other professional roles, communication and shared knowledge, interprofessional teamwork/collaboration, and the "inner circle", or being part of the unit team. The learning environment was described as positive. In a postplacement satisfaction survey (n=38), students likewise rated the educational experience highly. In practicing teamwork and collaboration, students were able to rehearse their future professional role. We suggest that interprofessional clinical placements be regarded as an essential learning experience for senior preprofessional students. More work is needed to fully understand the effect of this interactive program on students' clinical learning and preparation for practice.

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

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Jaggi, Namita; Sissodia, Pushpa

2012-10-01

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

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

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

2013-09-30

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

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

Science.gov (United States)

Xakellis, George C.; And Others

1996-01-01

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

Transfer learning improves supervised image segmentation across imaging protocols.

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van Opbroek, Annegreet; Ikram, M Arfan; Vernooij, Meike W; de Bruijne, Marleen

2015-05-01

The variation between images obtained with different scanners or different imaging protocols presents a major challenge in automatic segmentation of biomedical images. This variation especially hampers the application of otherwise successful supervised-learning techniques which, in order to perform well, often require a large amount of labeled training data that is exactly representative of the target data. We therefore propose to use transfer learning for image segmentation. Transfer-learning techniques can cope with differences in distributions between training and target data, and therefore may improve performance over supervised learning for segmentation across scanners and scan protocols. We present four transfer classifiers that can train a classification scheme with only a small amount of representative training data, in addition to a larger amount of other training data with slightly different characteristics. The performance of the four transfer classifiers was compared to that of standard supervised classification on two magnetic resonance imaging brain-segmentation tasks with multi-site data: white matter, gray matter, and cerebrospinal fluid segmentation; and white-matter-/MS-lesion segmentation. The experiments showed that when there is only a small amount of representative training data available, transfer learning can greatly outperform common supervised-learning approaches, minimizing classification errors by up to 60%.

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

Directory of Open Access Journals (Sweden)

Eilish McAuliffe

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

Effects of a Supervised versus an Unsupervised Combined Balance and Strength Training Program on Balance and Muscle Power in Healthy Older Adults: A Randomized Controlled Trial.

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Lacroix, André; Kressig, Reto W; Muehlbauer, Thomas; Gschwind, Yves J; Pfenninger, Barbara; Bruegger, Othmar; Granacher, Urs

2016-01-01

Losses in lower extremity muscle strength/power, muscle mass and deficits in static and particularly dynamic balance due to aging are associated with impaired functional performance and an increased fall risk. It has been shown that the combination of balance and strength training (BST) mitigates these age-related deficits. However, it is unresolved whether supervised versus unsupervised BST is equally effective in improving muscle power and balance in older adults. This study examined the impact of a 12-week BST program followed by 12 weeks of detraining on measures of balance and muscle power in healthy older adults enrolled in supervised (SUP) or unsupervised (UNSUP) training. Sixty-six older adults (men: 25, women: 41; age 73 ± 4 years) were randomly assigned to a SUP group (2/week supervised training, 1/week unsupervised training; n = 22), an UNSUP group (3/week unsupervised training; n = 22) or a passive control group (CON; n = 22). Static (i.e., Romberg Test) and dynamic (i.e., 10-meter walk test) steady-state, proactive (i.e., Timed Up and Go Test, Functional Reach Test), and reactive balance (e.g., Push and Release Test), as well as lower extremity muscle power (i.e., Chair Stand Test; Stair Ascent and Descent Test) were tested before and after the active training phase as well as after detraining. Adherence rates to training were 92% for SUP and 97% for UNSUP. BST resulted in significant group × time interactions. Post hoc analyses showed, among others, significant training-related improvements for the Romberg Test, stride velocity, Timed Up and Go Test, and Chair Stand Test in favor of the SUP group. Following detraining, significantly enhanced performances (compared to baseline) were still present in 13 variables for the SUP group and in 10 variables for the UNSUP group. Twelve weeks of BST proved to be safe (no training-related injuries) and feasible (high attendance rates of >90%). Deficits of balance and lower extremity muscle power can be

Wellness Model of Supervision: A Comparative Analysis

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

2012-01-01

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

Effects of gastric bypass surgery followed by supervised physical training on inflammation and endothelial function

DEFF Research Database (Denmark)

Stolberg, Charlotte Røn; Mundbjerg, Lene Hymøller; Funch-Jensen, Peter

2018-01-01

Background and aims: Obesity and physical inactivity are both associated with low-grade inflammation and endothelial dysfunction. Bariatric surgery improves markers of inflammation and endothelial function, but it is unknown if physical training after bariatric surgery can improve these markers...... even further. Therefore, we aimed to investigate the effects of Roux-en-Y gastric bypass (RYGB) followed by physical training on markers of low-grade inflammation and endothelial function. Methods: Sixty patients approved for RYGB underwent examinations pre-surgery, 6, 12, and 24 months post......-surgery. Six months post-surgery, they were randomized 1:1 to an intervention group or a control group. The interventions consisted of two weekly sessions of supervised moderate intensity physical training for a period of 26 weeks. Fasting blood samples were analyzed for concentrations of interleukin 6 (IL-6...

Projected estimators for robust semi-supervised classification

DEFF Research Database (Denmark)

Krijthe, Jesse H.; Loog, Marco

2017-01-01

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

[Feedback on the training and supervision of student nurses].

Science.gov (United States)

Papas, Anne; Bourgois, Monique

2015-03-01

In order to harmonise the supervision of student nurses in the different departments of the same unit, a Parisian hospital team has created a working group. An IT tool for supervising the students to be used by the whole unit is also under development. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Current trauma care system and trauma care training in China

Directory of Open Access Journals (Sweden)

Lian-Yang Zhang

2018-04-01

Full Text Available Trauma is a life-threatening “modern disease”. The outcomes could only be optimized by cost-efficient and prompt trauma care, which embarks on the improvement of essential capacities and conceptual revolution in addition to the disruptive innovation of the trauma care system. According to experiences from the developed countries, systematic trauma care training is the cornerstone of the generalization and the improvement on the trauma care, such as the Advance Trauma Life Support (ATLS. Currently, the pre-hospital emergency medical services (EMS has been one of the essential elements of infrastructure of health services in China, which is also fundamental to the trauma care system. Hereby, the China Trauma Care Training (CTCT with independent intellectual property rights has been initiated and launched by the Chinese Trauma Surgeon Association to extend the up-to-date concepts and techniques in the field of trauma care as well to reinforce the generally well-accepted standardized protocols in the practices. This article reviews the current status of the trauma care system as well as the trauma care training. Keywords: Trauma care system, Trauma care training, China

Cross-Domain Semi-Supervised Learning Using Feature Formulation.

Science.gov (United States)

Xingquan Zhu

2011-12-01

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

Discriminative Localization in CNNs for Weakly-Supervised Segmentation of Pulmonary Nodules.

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Feng, Xinyang; Yang, Jie; Laine, Andrew F; Angelini, Elsa D

2017-09-01

Automated detection and segmentation of pulmonary nodules on lung computed tomography (CT) scans can facilitate early lung cancer diagnosis. Existing supervised approaches for automated nodule segmentation on CT scans require voxel-based annotations for training, which are labor- and time-consuming to obtain. In this work, we propose a weakly-supervised method that generates accurate voxel-level nodule segmentation trained with image-level labels only. By adapting a convolutional neural network (CNN) trained for image classification, our proposed method learns discriminative regions from the activation maps of convolution units at different scales, and identifies the true nodule location with a novel candidate-screening framework. Experimental results on the public LIDC-IDRI dataset demonstrate that, our weakly-supervised nodule segmentation framework achieves competitive performance compared to a fully-supervised CNN-based segmentation method.

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

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

2015-01-01

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

Current Risk Management Practices in Psychotherapy Supervision.

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

2017-12-01

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

Genetic Counseling Supervisors' Self-Efficacy for Select Clinical Supervision Competencies.

Science.gov (United States)

Finley, Sabra Ledare; Veach, Pat McCarthy; MacFarlane, Ian M; LeRoy, Bonnie S; Callanan, Nancy

2016-04-01

Supervision is a primary instructional vehicle for genetic counseling student clinical training. Approximately two-thirds of genetic counselors report teaching and education roles, which include supervisory roles. Recently, Eubanks Higgins and colleagues published the first comprehensive list of empirically-derived genetic counseling supervisor competencies. Studies have yet to evaluate whether supervisors possess these competencies and whether their competencies differ as a function of experience. This study investigated three research questions: (1) What are genetic counselor supervisors' perceptions of their capabilities (self-efficacy) for a select group of supervisor competencies?, (2) Are there differences in self-efficacy as a function of their supervision experience or their genetic counseling experience, and 3) What training methods do they use and prefer to develop supervision skills? One-hundred thirty-one genetic counselor supervisors completed an anonymous online survey assessing demographics, self-efficacy (self-perceived capability) for 12 goal setting and 16 feedback competencies (Scale: 0-100), competencies that are personally challenging, and supervision training experiences and preferences (open-ended). A MANOVA revealed significant positive effects of supervision experience but not genetic counseling experience on participants' self-efficacy. Although mean self-efficacy ratings were high (>83.7), participant comments revealed several challenging competencies (e.g., incorporating student's report of feedback from previous supervisors into goal setting, and providing feedback about student behavior rather than personal traits). Commonly preferred supervision training methods included consultation with colleagues, peer discussion, and workshops/seminars.

Supervised learning with restricted training sets: a generating functional analysis

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Heimel, J.A.F.; Coolen, A.C.C. [Department of Mathematics, King' s College London, Strand, London (United Kingdom)

2001-10-26

We study the dynamics of supervised on-line learning of realizable tasks in feed-forward neural networks. We focus on the regime where the number of examples used for training is proportional to the number of input channels N. Using generating functional techniques from spin glass theory, we are able to average over the composition of the training set and transform the problem for N{yields}{infinity} to an effective single pattern system described completely by the student autocovariance, the student-teacher overlap and the student response function with exact closed equations. Our method applies to arbitrary learning rules, i.e., not necessarily of a gradient-descent type. The resulting exact macroscopic dynamical equations can be integrated without finite-size effects up to any degree of accuracy, but their main value is in providing an exact and simple starting point for analytical approximation schemes. Finally, we show how, in the region of absent anomalous response and using the hypothesis that (as in detailed balance systems) the short-time part of the various operators can be transformed away, one can describe the stationary state of the network successfully by a set of coupled equations involving only four scalar order parameters. (author)

Supervised exercise training counterbalances the adverse effects of insulin therapy in overweight/obese subjects with type 2 diabetes.

Science.gov (United States)

Balducci, Stefano; Zanuso, Silvano; Cardelli, Patrizia; Salerno, Gerardo; Fallucca, Sara; Nicolucci, Antonio; Pugliese, Giuseppe

2012-01-01

To examine the effect of supervised exercise on traditional and nontraditional cardiovascular risk factors in sedentary, overweight/obese insulin-treated subjects with type 2 diabetes from the Italian Diabetes Exercise Study (IDES). The study randomized 73 insulin-treated patients to twice weekly supervised aerobic and resistance training plus structured exercise counseling (EXE) or to counseling alone (CON) for 12 months. Clinical and laboratory parameters were assessed at baseline and at the end of the study. The volume of physical activity was significantly higher in the EXE versus the CON group. Values for hemoglobin A(1c), BMI, waist circumference, high-sensitivity C-reactive protein, blood pressure, LDL cholesterol, and the coronary heart disease risk score were significantly reduced only in the EXE group. No major adverse events were observed. In insulin-treated subjects with type 2 diabetes, supervised exercise is safe and effective in improving glycemic control and markers of adiposity and inflammation, thus counterbalancing the adverse effects of insulin on these parameters.

Paediatric trainee supervision: management changes and perceived education value.

Science.gov (United States)

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

2012-07-01

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

A Delphi Study and Initial Validation of Counselor Supervision Competencies

Science.gov (United States)

Neuer Colburn, Anita A.; Grothaus, Tim; Hays, Danica G.; Milliken, Tammi

2016-01-01

The authors addressed the lack of supervision training standards for doctoral counseling graduates by developing and validating an initial list of supervision competencies. They used content analysis, Delphi polling, and content validity methods to generate a list, vetted by 2 different panels of supervision experts, of 33 competencies grouped…

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

Science.gov (United States)

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

2012-10-01

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

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

Science.gov (United States)

Gönen, Mehmet

2014-03-01

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

Supervised pelvic floor muscle training versus attention-control massage treatment in patients with faecal incontinence: Statistical analysis plan for a randomised controlled trial.

Science.gov (United States)

Ussing, Anja; Dahn, Inge; Due, Ulla; Sørensen, Michael; Petersen, Janne; Bandholm, Thomas

2017-12-01

Faecal incontinence affects approximately 8-9% of the adult population. The condition is surrounded by taboo; it can have a devastating impact on quality of life and lead to major limitations in daily life. Pelvic floor muscle training in combination with information and fibre supplements is recommended as first-line treatment for faecal incontinence. Despite this, the effect of pelvic floor muscle training for faecal incontinence is unclear. No previous trials have investigated the efficacy of supervised pelvic floor muscle training in combination with conservative treatment and compared this to an attention-control massage treatment including conservative treatment. The aim of this trial is to investigate if 16 weeks of supervised pelvic floor muscle training in combination with conservative treatment is superior to attention-control massage treatment and conservative treatment in patients with faecal incontinence. Randomised, controlled, superiority trial with two parallel arms. 100 participants with faecal incontinence will be randomised to either (1) individually supervised pelvic floor muscle training and conservative treatment or (2) attention-control massage treatment and conservative treatment. The primary outcome is participants' rating of symptom changes after 16 weeks of treatment using the Patient Global Impression of Improvement Scale. Secondary outcomes are the Vaizey Incontinence Score, the Fecal Incontinence Severity Index, the Fecal Incontinence Quality of Life Scale, a 14-day bowel diary, anorectal manometry and rectal capacity measurements. Follow-up assessment at 36 months will be conducted. This paper describes and discusses the rationale, the methods and in particular the statistical analysis plan of this trial.

The supervisions in the field develop nuclear professionals

International Nuclear Information System (INIS)

Fernandez de la Casa, M.; Buedo, J. L.; Gonzalez, F.

2015-01-01

In 2011 Cofrentes Nuclear Power Plants began a training program for improving the supervision of managers in the field: the effort done not only has improved the quality of supervisions but also has defined a way to reinforce behavior expectations of Cofrentes Nuclear Power Plant. (Author)

Guidelines for the training, credentialing, use, and supervision of speech-language pathology assistants. Task Force on Support Personnel.

Science.gov (United States)

1996-01-01

These guidelines are an official statement of the American Speech-Language-Hearing Association. They provide guidance on the training, credentialing, use, and supervision of one category of support personnel in speech-language pathology: speech-language pathology assistants. Guidelines are not official standards of the Association. They were developed by the Task Force on Support Personnel: Dennis J. Arnst, Kenneth D. Barker, Ann Olsen Bird, Sheila Bridges, Linda S. DeYoung, Katherine Formichella, Nena M. Germany, Gilbert C. Hanke, Ann M. Horton, DeAnne M. Owre, Sidney L. Ramsey, Cathy A. Runnels, Brenda Terrell, Gerry W. Werven, Denise West, Patricia A. Mercaitis (consultant), Lisa C. O'Connor (consultant), Frederick T. Spahr (coordinator), Diane Paul-Brown (associate coordinator), Ann L. Carey (Executive Board liaison). The 1994 guidelines supersede the 1981 guidelines entitled, "Guidelines for the Employment and Utilization of Supportive Personnel" (Asha, March 1981, 165-169). Refer to the 1995 position statement on the "Training, Credentialing, Use, and Supervision of Support Personnel in Speech-Language Pathology" (Asha, 37 [Suppl. 14], 21).

The feasibility of a train-the-trainer approach to end of life care training in care homes: an evaluation.

Science.gov (United States)

Mayrhofer, Andrea; Goodman, Claire; Smeeton, Nigel; Handley, Melanie; Amador, Sarah; Davies, Sue

2016-01-22

The ABC End of Life Education Programme trained approximately 3000 care home staff in End of Life (EoL) care. An evaluation that compared this programme with the Gold Standards Framework found that it achieved equivalent outcomes at a lower cost with higher levels of staff satisfaction. To consolidate this learning, a facilitated peer education model that used the ABC materials was piloted. The goal was to create a critical mass of trained staff, mitigate the impact of staff turnover and embed EoL care training within the organisations. The aim of the study was to evaluate the feasibility of using a train the trainer (TTT) model to support EoL care in care homes. A mixed method design involved 18 care homes with and without on-site nursing across the East of England. Data collection included a review of care home residents' characteristics and service use (n = 274), decedents' notes n = 150), staff interviews (n = 49), focus groups (n = 3), audio diaries (n = 28) and observations of workshops (n = 3). Seventeen care homes participated. At the end of the TTT programme 28 trainers and 114 learners (56% of the targeted number of learners) had been trained (median per home 6, range 0-13). Three care homes achieved or exceeded the set target of training 12 learners. Trainers ranged from senior care staff to support workers and administrative staff. Results showed a positive association between care home stability, in terms of leadership and staff turnover, and uptake of the programme. Care home ownership, type of care home, size of care home, previous training in EoL care and resident characteristics were not associated with programme completion. Working with facilitators was important to trainers, but insufficient to compensate for organisational turbulence. Variability of uptake was also linked to management support, programme fit with the trainers' roles and responsibilities and their opportunities to work with staff on a daily basis. When

Weakly supervised semantic segmentation using fore-background priors

Science.gov (United States)

Han, Zheng; Xiao, Zhitao; Yu, Mingjun

2017-07-01

Weakly-supervised semantic segmentation is a challenge in the field of computer vision. Most previous works utilize the labels of the whole training set and thereby need the construction of a relationship graph about image labels, thus result in expensive computation. In this study, we tackle this problem from a different perspective. We proposed a novel semantic segmentation algorithm based on background priors, which avoids the construction of a huge graph in whole training dataset. Specifically, a random forest classifier is obtained using weakly supervised training data .Then semantic texton forest (STF) feature is extracted from image superpixels. Finally, a CRF based optimization algorithm is proposed. The unary potential of CRF derived from the outputting probability of random forest classifier and the robust saliency map as background prior. Experiments on the MSRC21 dataset show that the new algorithm outperforms some previous influential weakly-supervised segmentation algorithms. Furthermore, the use of efficient decision forests classifier and parallel computing of saliency map significantly accelerates the implementation.

QUEST : Eliminating online supervised learning for efficient classification algorithms

NARCIS (Netherlands)

Zwartjes, Ardjan; Havinga, Paul J.M.; Smit, Gerard J.M.; Hurink, Johann L.

2016-01-01

In this work, we introduce QUEST (QUantile Estimation after Supervised Training), an adaptive classification algorithm for Wireless Sensor Networks (WSNs) that eliminates the necessity for online supervised learning. Online processing is important for many sensor network applications. Transmitting

Semi-supervised prediction of gene regulatory networks using machine learning algorithms.

Science.gov (United States)

Patel, Nihir; Wang, Jason T L

2015-10-01

Use of computational methods to predict gene regulatory networks (GRNs) from gene expression data is a challenging task. Many studies have been conducted using unsupervised methods to fulfill the task; however, such methods usually yield low prediction accuracies due to the lack of training data. In this article, we propose semi-supervised methods for GRN prediction by utilizing two machine learning algorithms, namely, support vector machines (SVM) and random forests (RF). The semi-supervised methods make use of unlabelled data for training. We investigated inductive and transductive learning approaches, both of which adopt an iterative procedure to obtain reliable negative training data from the unlabelled data. We then applied our semi-supervised methods to gene expression data of Escherichia coli and Saccharomyces cerevisiae, and evaluated the performance of our methods using the expression data. Our analysis indicated that the transductive learning approach outperformed the inductive learning approach for both organisms. However, there was no conclusive difference identified in the performance of SVM and RF. Experimental results also showed that the proposed semi-supervised methods performed better than existing supervised methods for both organisms.

Adequate supervision for children and adolescents.

Science.gov (United States)

Anderst, James; Moffatt, Mary

2014-11-01

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

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

Directory of Open Access Journals (Sweden)

Kern KU

2013-07-01

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

EQUIP training the trainers: an evaluation of a training programme for service users and carers involved in training mental health professionals in user-involved care planning.

Science.gov (United States)

Fraser, C; Grundy, A; Meade, O; Callaghan, P; Lovell, K

2017-08-01

alongside ongoing support and supervision. Mental health nurses (and other health professionals) will be better able to involve service users and carers in care planning. Service users and carers may feel more involved in care planning in future. Introduction Limited evidence exists on service user and carer perceptions of undertaking a training course for delivering care planning training to qualified mental health professionals. We know little about trainee motivations for engaging with such train the trainers courses, experiences of attending courses and trainees' subsequent experiences of codelivering training to health professionals, hence the current study. Aim To obtain participants' views on the suitability and acceptability of a training programme that aimed to prepare service users and carers to codeliver training to health professionals. Method Semi-structured interviews with nine service users and carers attending the training programme. Transcripts were analysed using inductive thematic analysis. Results Participants' reasons for attending training included skill development and making a difference to mental health practice. Course content was generally rated highly but may benefit from review and/or extension to allow the range of topics and resulting professional training programme to be covered in more depth. Trainees who delivered the care planning training reported a mix of expectations, support experiences, preparedness and personal impacts. Implications for Practice Mental health nurses are increasingly coproducing and delivering training with service users and carers. This study identifies possibilities and pitfalls in this endeavour, highlighting areas where user and carer involvement and support structures might be improved in order to fully realize the potential for involvement in training. © 2017 The Authors. Journal of Psychiatric and Mental Health Nursing Published by John Wiley & Sons Ltd.

Computerised training improves cognitive performance in chronic pain: a participant-blinded randomised active-controlled trial with remote supervision.

Science.gov (United States)

Baker, Katharine S; Georgiou-Karistianis, Nellie; Lampit, Amit; Valenzuela, Michael; Gibson, Stephen J; Giummarra, Melita J

2018-04-01

Chronic pain is associated with reduced efficiency of cognitive performance, and few studies have investigated methods of remediation. We trialled a computerised cognitive training protocol to determine whether it could attenuate cognitive difficulties in a chronic pain sample. Thirty-nine adults with chronic pain (mean age = 43.3, 61.5% females) were randomised to an 8-week online course (3 sessions/week from home) of game-like cognitive training exercises, or an active control involving watching documentary videos. Participants received weekly supervision by video call. Primary outcomes were a global neurocognitive composite (tests of attention, speed, and executive function) and self-reported cognition. Secondary outcomes were pain (intensity; interference), mood symptoms (depression; anxiety), and coping with pain (catastrophising; self-efficacy). Thirty participants (15 training and 15 control) completed the trial. Mixed model intention-to-treat analyses revealed significant effects of training on the global neurocognitive composite (net effect size [ES] = 0.43, P = 0.017), driven by improved executive function performance (attention switching and working memory). The control group reported improvement in pain intensity (net ES = 0.65, P = 0.022). Both groups reported subjective improvements in cognition (ES = 0.28, P = 0.033) and catastrophising (ES = 0.55, P = 0.006). Depression, anxiety, self-efficacy, and pain interference showed no change in either group. This study provides preliminary evidence that supervised cognitive training may be a viable method for enhancing cognitive skills in persons with chronic pain, but transfer to functional and clinical outcomes remains to be demonstrated. Active control results suggest that activities perceived as relaxing or enjoyable contribute to improved perception of well-being. Weekly contact was pivotal to successful program completion.

Training the Millennial learner through experiential evolutionary scaffolding: implications for clinical supervision in graduate education programs.

Science.gov (United States)

Venne, Vickie L; Coleman, Darrell

2010-12-01

They are the Millennials--Generation Y. Over the next few decades, they will be entering genetic counseling graduate training programs and the workforce. As a group, they are unlike previous youth generations in many ways, including the way they learn. Therefore, genetic counselors who teach and supervise need to understand the Millennials and explore new ways of teaching to ensure that the next cohort of genetic counselors has both skills and knowledge to represent our profession well. This paper will summarize the distinguishing traits of the Millennial generation as well as authentic learning and evolutionary scaffolding theories of learning that can enhance teaching and supervision. We will then use specific aspects of case preparation during clinical rotations to demonstrate how incorporating authentic learning theory into evolutionary scaffolding results in experiential evolutionary scaffolding, a method that potentially offers a more effective approach when teaching Millennials. We conclude with suggestions for future research.

Semi-supervised detection of intracranial pressure alarms using waveform dynamics

International Nuclear Information System (INIS)

Scalzo, Fabien; Hu, Xiao

2013-01-01

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

Communication skills training in dementia care: a systematic review of effectiveness, training content, and didactic methods in different care settings.

Science.gov (United States)

Eggenberger, Eva; Heimerl, Katharina; Bennett, Michael I

2013-03-01

Caring for and caring about people with dementia require specific communication skills. Healthcare professionals and family caregivers usually receive little training to enable them to meet the communicative needs of people with dementia. This review identifies existent interventions to enhance communication in dementia care in various care settings. We searched MEDLINE, AMED, EMBASE, PsychINFO, CINAHL, The Cochrane Library, Gerolit, and Web of Science for scientific articles reporting interventions in both English and German. An intervention was defined as communication skills training by means of face-to-face interaction with the aim of improving basic communicative skills. Both professional and family caregivers were included. The effectiveness of such training was analyzed. Different types of training were defined. Didactic methods, training content, and additional organizational features were qualitatively examined. This review included 12 trials totaling 831 persons with dementia, 519 professional caregivers, and 162 family caregivers. Most studies were carried out in the USA, the UK, and Germany. Eight studies took place in nursing homes; four studies were located in a home-care setting. No studies could be found in an acute-care setting. We provide a list of basic communicative principles for good communication in dementia care. Didactic methods included lectures, hands-on training, group discussions, and role-play. This review shows that communication skills training in dementia care significantly improves the quality of life and wellbeing of people with dementia and increases positive interactions in various care settings. Communication skills training shows significant impact on professional and family caregivers' communication skills, competencies, and knowledge. Additional organizational features improve the sustainability of communication interventions.

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

Science.gov (United States)

2010-01-01

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

Effects of Supervised vs. Unsupervised Training Programs on Balance and Muscle Strength in Older Adults : A Systematic Review and Meta-Analysis

NARCIS (Netherlands)

Lacroix, Andre; Hortobagyi, Tibor; Beurskens, Rainer; Granacher, Urs

Background Balance and resistance training can improve healthy older adults' balance and muscle strength. Delivering such exercise programs at home without supervision may facilitate participation for older adults because they do not have to leave their homes. To date, no systematic literature

Effects of Supervised vs. Unsupervised Training Programs on Balance and Muscle Strength in Older Adults : A Systematic Review and Meta-Analysis

NARCIS (Netherlands)

Lacroix, Andre; Hortobagyi, Tibor; Beurskens, Rainer; Granacher, Urs

2017-01-01

Background Balance and resistance training can improve healthy older adults' balance and muscle strength. Delivering such exercise programs at home without supervision may facilitate participation for older adults because they do not have to leave their homes. To date, no systematic literature

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

Science.gov (United States)

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

2005-09-01

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

Supervised Learning for Visual Pattern Classification

Science.gov (United States)

Zheng, Nanning; Xue, Jianru

This chapter presents an overview of the topics and major ideas of supervised learning for visual pattern classification. Two prevalent algorithms, i.e., the support vector machine (SVM) and the boosting algorithm, are briefly introduced. SVMs and boosting algorithms are two hot topics of recent research in supervised learning. SVMs improve the generalization of the learning machine by implementing the rule of structural risk minimization (SRM). It exhibits good generalization even when little training data are available for machine training. The boosting algorithm can boost a weak classifier to a strong classifier by means of the so-called classifier combination. This algorithm provides a general way for producing a classifier with high generalization capability from a great number of weak classifiers.

The efficacy of unsupervised home-based exercise regimens in comparison to supervised lab-based exercise training upon cardio-respiratory health facets

OpenAIRE

Blackwell, J.; Atherton, Philip J.; Smith, Kenneth; Doleman, Brett; Williams, John P.; Lund, Jonathan N.; Phillips, Bethan E.

2017-01-01

Abstract Supervised high?intensity interval training (HIIT) can rapidly improve cardiorespiratory fitness (CRF). However, the effectiveness of time?efficient unsupervised home?based interventions is unknown. Eighteen volunteers completed either: laboratory?HIIT (L?HIIT); home?HIIT (H?HIIT) or home?isometric hand?grip training (H?IHGT). CRF improved significantly in L?HIIT and H?HIIT groups, with blood pressure improvements in the H?IHGT group only. H?HIIT offers a practical, time?efficient ex...

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

Science.gov (United States)

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

2017-08-01

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

Impact of a provider training program on the treatment of children with autism spectrum disorder at psychosocial care units in Brazil.

Science.gov (United States)

Silva, Luciana C; Teixeira, Maria C T V; Ribeiro, Edith L; Paula, Cristiane S

2017-12-18

To develop, implement, and verify the impact of a training program for health care providers working with children with autism spectrum disorder (ASD) in psychosocial care centers for children and adolescents (Centro de Atenção Psicossocial à Infância e à Adolescência - CAPSi) in São Paulo, Brazil. This quasi-experimental study was conducted with 14 professionals from four CAPSi units. The training program consisted of six phases: 1) pre-intervention observation; 2) meeting with staff to assess the main needs of the training program; 3) developing materials for training and evaluation; 4) meetings to discuss program implementation; 5) a final meeting for case discussion and evaluation; and 6) distance supervision. Three measures were used to evaluate the training program: i) the Knowledge, Attitudes, and Practices (KAP) questionnaire; ii) videos containing questions designed to assess program comprehension; and iii) a satisfaction survey. Thirteen videos were produced to as visual aids for use during the training program, and a further 26 videos were developed to evaluate it. The program was well evaluated by the participants. The video responses and KAP questionnaire scores suggest that staff knowledge and attitudes improved after training. The positive findings of this study suggest that the tested training program is feasible for use with multidisciplinary teams working in the CAPSi environment.

Impact of a provider training program on the treatment of children with autism spectrum disorder at psychosocial care units in Brazil

Directory of Open Access Journals (Sweden)

Luciana C. Silva

2017-12-01

Full Text Available Objective: To develop, implement, and verify the impact of a training program for health care providers working with children with autism spectrum disorder (ASD in psychosocial care centers for children and adolescents (Centro de Atenção Psicossocial à Infância e à Adolescência – CAPSi in São Paulo, Brazil. Methods: This quasi-experimental study was conducted with 14 professionals from four CAPSi units. The training program consisted of six phases: 1 pre-intervention observation; 2 meeting with staff to assess the main needs of the training program; 3 developing materials for training and evaluation; 4 meetings to discuss program implementation; 5 a final meeting for case discussion and evaluation; and 6 distance supervision. Three measures were used to evaluate the training program: i the Knowledge, Attitudes, and Practices (KAP questionnaire; ii videos containing questions designed to assess program comprehension; and iii a satisfaction survey. Results: Thirteen videos were produced to as visual aids for use during the training program, and a further 26 videos were developed to evaluate it. The program was well evaluated by the participants. The video responses and KAP questionnaire scores suggest that staff knowledge and attitudes improved after training. Conclusion: The positive findings of this study suggest that the tested training program is feasible for use with multidisciplinary teams working in the CAPSi environment.

Self-supervised, mobile-application based cognitive training of auditory attention: A behavioral and fMRI evaluation

Directory of Open Access Journals (Sweden)

Josef J. Bless

2014-07-01

Full Text Available Emerging evidence of the validity of collecting data in natural settings using smartphone applications has opened new possibilities for psychological assessment, treatment, and research. In this study we explored the feasibility and effectiveness of using a mobile application for self-supervised training of auditory attention. In addition, we investigated the neural underpinnings of the training procedure with functional magnetic resonance imaging (fMRI, as well as possible transfer effects to untrained cognitive interference tasks. Subjects in the training group performed the training task on an iPod touch two times a day (morning/evening for three weeks; subjects in the control group received no training, but were tested at the same time interval as the training group. Behavioral responses were measured before and after the training period in both groups, together with measures of task-related neural activations by fMRI. The results showed an expected performance increase after training that corresponded to activation decreases in brain regions associated with selective auditory processing (left posterior temporal gyrus and executive functions (right middle frontal gyrus, indicating more efficient processing in task-related neural networks after training. Our study suggests that cognitive training delivered via mobile applications is feasible and improves the ability to focus attention with corresponding effects on neural plasticity. Future research should focus on the clinical benefits of mobile cognitive training. Limitations of the study are discussed including reduced experimental control and lack of transfer effects.

The implementation of the case assignment method of patient care at the Dr. A.J. Stals care and rehabilitation centre

Directory of Open Access Journals (Sweden)

N.L. Daniels

1980-09-01

Full Text Available The modern approach to the care of the mentally retarded in institutional settings is no longer to provide only custiodial care, but to train and rehabilitate each patient to be able to function at his maximal potential. This requires that each resident must have his abilities assessed and a programme implemented for his training, according to his particular needs and capabilities. Residents requiring similar training programmes are therefore grouped together under the care of one nurse, the number of residents in each group depending upon their selfcare skills. The nurse is assigned the responsibility of carrying out the training programme under the supervision of the Ward Sister and with the guidance of the multidisciplinary team under the leadership of the psychiatrist.

Feature-space transformation improves supervised segmentation across scanners

DEFF Research Database (Denmark)

van Opbroek, Annegreet; Achterberg, Hakim C.; de Bruijne, Marleen

2015-01-01

Image-segmentation techniques based on supervised classification generally perform well on the condition that training and test samples have the same feature distribution. However, if training and test images are acquired with different scanners or scanning parameters, their feature distributions...

Effects of 12-week supervised treadmill training on spatio-temporal gait parameters in patients with claudication.

Science.gov (United States)

Konik, Anita; Kuklewicz, Stanisław; Rosłoniec, Ewelina; Zając, Marcin; Spannbauer, Anna; Nowobilski, Roman; Mika, Piotr

2016-01-01

The purpose of the study was to evaluate selected temporal and spatial gait parameters in patients with intermittent claudication after completion of 12-week supervised treadmill walking training. The study included 36 patients (26 males and 10 females) aged: mean 64 (SD 7.7) with intermittent claudication. All patients were tested on treadmill (Gait Trainer, Biodex). Before the programme and after its completion, the following gait biomechanical parameters were tested: step length (cm), step cycle (cycle/s), leg support time (%), coefficient of step variation (%) as well as pain-free walking time (PFWT) and maximal walking time (MWT) were measured. Training was conducted in accordance with the current TASC II guidelines. After 12 weeks of training, patients showed significant change in gait biomechanics consisting in decreased frequency of step cycle (p gait was more regular, which was expressed via statistically significant decrease of coefficient of variation (p 0.05). Twelve-week treadmill walking training programme may lead to significant improvement of temporal and spatial gait parameters in patients with intermittent claudication. Twelve-week treadmill walking training programme may lead to significant improvement of pain-free walking time and maximum walking time in patients with intermittent claudication.

An empirical study of ensemble-based semi-supervised learning approaches for imbalanced splice site datasets.

Science.gov (United States)

Stanescu, Ana; Caragea, Doina

2015-01-01

Recent biochemical advances have led to inexpensive, time-efficient production of massive volumes of raw genomic data. Traditional machine learning approaches to genome annotation typically rely on large amounts of labeled data. The process of labeling data can be expensive, as it requires domain knowledge and expert involvement. Semi-supervised learning approaches that can make use of unlabeled data, in addition to small amounts of labeled data, can help reduce the costs associated with labeling. In this context, we focus on the problem of predicting splice sites in a genome using semi-supervised learning approaches. This is a challenging problem, due to the highly imbalanced distribution of the data, i.e., small number of splice sites as compared to the number of non-splice sites. To address this challenge, we propose to use ensembles of semi-supervised classifiers, specifically self-training and co-training classifiers. Our experiments on five highly imbalanced splice site datasets, with positive to negative ratios of 1-to-99, showed that the ensemble-based semi-supervised approaches represent a good choice, even when the amount of labeled data consists of less than 1% of all training data. In particular, we found that ensembles of co-training and self-training classifiers that dynamically balance the set of labeled instances during the semi-supervised iterations show improvements over the corresponding supervised ensemble baselines. In the presence of limited amounts of labeled data, ensemble-based semi-supervised approaches can successfully leverage the unlabeled data to enhance supervised ensembles learned from highly imbalanced data distributions. Given that such distributions are common for many biological sequence classification problems, our work can be seen as a stepping stone towards more sophisticated ensemble-based approaches to biological sequence annotation in a semi-supervised framework.

Semi-supervised sparse coding

KAUST Repository

Wang, Jim Jing-Yan; Gao, Xin

2014-01-01

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

Semi-supervised sparse coding

KAUST Repository

Wang, Jim Jing-Yan

2014-07-06

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

The Phelophepa Health Care Train: a pharmacoepidemiological ...

African Journals Online (AJOL)

2009-11-19

Nov 19, 2009 ... Background: The Phelophepa Health Care Train is the only primary healthcare train in the world. Phelophepa is an ... history of caring.3. The Phelophepa .... Skin conditions were, according to the pharmacists, common in the ...

Supervised spike-timing-dependent plasticity: a spatiotemporal neuronal learning rule for function approximation and decisions.

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Franosch, Jan-Moritz P; Urban, Sebastian; van Hemmen, J Leo

2013-12-01

How can an animal learn from experience? How can it train sensors, such as the auditory or tactile system, based on other sensory input such as the visual system? Supervised spike-timing-dependent plasticity (supervised STDP) is a possible answer. Supervised STDP trains one modality using input from another one as "supervisor." Quite complex time-dependent relationships between the senses can be learned. Here we prove that under very general conditions, supervised STDP converges to a stable configuration of synaptic weights leading to a reconstruction of primary sensory input.

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

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

2016-08-26

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

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

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Berney, Alexandre; Bourquin, Céline

2017-12-22

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

Postgraduate research training: the PhD and MD thesis.

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Higginson, I; Corner, J

1996-04-01

Higher research degrees, such as the PhD, MPhil and MD, have existed within universities for 80 years or more, although the differences between the MD and PhD remain confused. A higher research degree training provides individuals with greater research knowledge and skills, and benefits the specialty. Concern exists about the levels of supervision sometimes provided, failure to complete degrees, and the variable levels of research knowledge and skills attained. We propose that higher research degrees in palliative care have four functions: extending personal scholarship, generating knowledge, training for the individual and contributing to the growth of the specialty. Such an approach may include: a formalised first year with taught components such as in research MSc programmes, formal supervision and progress assessment. In palliative care, clinical and academic approaches need greater integration. Multiprofessional learning is essential. To allow individuals to undertake higher research degree programmes, fellowships or specific funding are needed.

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

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Bendix Tom

2010-02-01

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

Emergency Medical Care Training and Adolescents.

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Topham, Charles S.

1982-01-01

Describes an 11-week emergency medical care training program for adolescents focusing on: pretest results; factual emergency instruction and first aid; practical experience training; and assessment. (RC)

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

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Ducat WH

2015-08-01

of an agreed upon definition and functions of supervision when supervisors from diverse allied health disciplines were surveyed. While methodologically weak, all studies reported positive perceptions of supervision across professionals, supervisors, and managers. This is in accordance with previous research in the wider supervision literature. Discussion: Considering the large pool of studies retrieved for further investigation, few of these met inclusion criteria demonstrating the paucity of primary research in this area. Increased training, policies, and implementation frameworks to ensure the definition and functions of supervision are agreed upon across the allied health disciplines in non-metropolitan areas is needed. Furthermore, systematic evaluation of supervision implementation in non-metropolitan settings, investigation of the experience and effects of distance based supervision (versus face-to-face, and increased rigor in research studies investigating non-metropolitan allied health profession supervision is needed. Keywords: clinical supervision, allied health, professional development

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

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Gemma Stacey

2017-11-01

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

Late group-based rehabilitation has no advantages compared with supervised home-exercises after total knee arthroplasty

DEFF Research Database (Denmark)

Madsen, Majbritt; Larsen, Kristian; Madsen, Inger Kirkegård

2013-01-01

This study aimed to test whether group-based rehabilitation focusing on strength training, education and self-management is more effective than individual, supervised home-training after fast-track total knee arthroplasty (TKA).......This study aimed to test whether group-based rehabilitation focusing on strength training, education and self-management is more effective than individual, supervised home-training after fast-track total knee arthroplasty (TKA)....

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

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Yaghouby, Farid; Sunderam, Sridhar

2015-04-01

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

Generative Adversarial Networks-Based Semi-Supervised Learning for Hyperspectral Image Classification

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Zhi He

2017-10-01

Full Text Available Classification of hyperspectral image (HSI is an important research topic in the remote sensing community. Significant efforts (e.g., deep learning have been concentrated on this task. However, it is still an open issue to classify the high-dimensional HSI with a limited number of training samples. In this paper, we propose a semi-supervised HSI classification method inspired by the generative adversarial networks (GANs. Unlike the supervised methods, the proposed HSI classification method is semi-supervised, which can make full use of the limited labeled samples as well as the sufficient unlabeled samples. Core ideas of the proposed method are twofold. First, the three-dimensional bilateral filter (3DBF is adopted to extract the spectral-spatial features by naturally treating the HSI as a volumetric dataset. The spatial information is integrated into the extracted features by 3DBF, which is propitious to the subsequent classification step. Second, GANs are trained on the spectral-spatial features for semi-supervised learning. A GAN contains two neural networks (i.e., generator and discriminator trained in opposition to one another. The semi-supervised learning is achieved by adding samples from the generator to the features and increasing the dimension of the classifier output. Experimental results obtained on three benchmark HSI datasets have confirmed the effectiveness of the proposed method , especially with a limited number of labeled samples.

46 CFR 199.100 - Manning of survival craft and supervision.

Science.gov (United States)

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Manning of survival craft and supervision. 199.100....100 Manning of survival craft and supervision. (a) There must be a sufficient number of trained... craft and launching arrangements required for abandonment by the total number of persons on board. (c...

Consultative Instructor Supervision and Evaluation

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Lee, William W.

2010-01-01

Organizations vary greatly in how they monitor training instructors. The methods used in monitoring vary greatly. This article presents a systematic process for improving instructor skills that result in better teaching and better learning, which results in better-prepared employees for the workforce. The consultative supervision and evaluation…

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

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Marcos Martínez-Romero

2013-01-01

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

On being supervised: getting value from a clinical supervisor and making the relationship work when it is not.

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Parker, Stephen; Suetani, Shuichi; Motamarri, Balaji

2017-12-01

The importance of clinical supervision is emphasised in psychiatric training programs. Despite this, the purpose and processes of supervision are often poorly defined. There is limited guidance available for trainees about their role in making supervision work. This paper considers the nature of supervision in psychiatric training and provides practical advice to help supervisees take active steps to make supervision work. In obtaining value from supervision, the active role of the supervisee in seeking feedback, finding value in criticism and building autonomy is emphasised. Additionally, the importance of exploring what value a supervisor can offer and maintaining realistic expectations is considered. Trainees can benefit from taking an active role in planning and managing their supervision to maximise their learning.

Virtual reality training for health-care professionals.

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Mantovani, Fabrizia; Castelnuovo, Gianluca; Gaggioli, Andrea; Riva, Giuseppe

2003-08-01

Emerging changes in health-care delivery are having a significant impact on the structure of health-care professionals' education. Today it is recognized that medical knowledge doubles every 6-8 years, with new medical procedures emerging everyday. While the half-life of medical information is so short, the average physician practices 30 years and the average nurse 40 years. Continuing education thus represents an important challenge to face. Recent advances in educational technology are offering an increasing number of innovative learning tools. Among these, Virtual Reality represents a promising area with high potential of enhancing the training of health-care professionals. Virtual Reality Training can provide a rich, interactive, engaging educational context, thus supporting experiential learning-by-doing; it can, in fact, contribute to raise interest and motivation in trainees and to effectively support skills acquisition and transfer, since the learning process can be settled within an experiential framework. Current virtual training applications for health-care differ a lot as to both their technological/multimedia sophistication and to the types of skills trained, varying for example from telesurgical applications to interactive simulations of human body and brain, to virtual worlds for emergency training. Other interesting applications include the development of immersive 3D environments for training psychiatrists and psychologists in the treatment of mental disorders. This paper has the main aim of discussing the rationale and main benefits for the use of virtual reality in health-care education and training. Significant research and projects carried out in this field will also be presented, followed by discussion on key issues concerning current limitations and future development directions.

Preparing supervisors to provide safeguarding supervision for healthcare staff.

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Smikle, Marcia

2017-11-28

This paper outlines why experienced supervisors at a London healthcare provider received skills training so they could offer safeguarding supervision to front-line colleagues with case management responsibilities for vulnerable children and young people. It examines how supervisors use the main functions of supervision and a cycle of reflection in clinical practice with supervisees. As well as the professional issues encountered by supervisors in relation to the benefits, the challenges of providing supervision and the action required to make safeguarding supervision a part of the organisational culture are also explored. ©2017 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

Supervision to Enhance Educational and Vocational Guidance Practice: A Review

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Reid, Hazel L.

2010-01-01

Supervision to support the work of career practitioners is evident in many countries, but is not universal. This author presents a literature review, intending to emphasise the prime importance of developing supervision for guidance work. The author also considers the issues facing those training to develop the role of supervisors in southeast…

46 CFR 109.323 - Manning of survival craft and supervision.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Manning of survival craft and supervision. 109.323... DRILLING UNITS OPERATIONS Operation and Stowage of Safety Equipment § 109.323 Manning of survival craft and supervision. (a) There must be a sufficient number of trained persons on board the survival craft for...

Primary care training and the evolving healthcare system.

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Peccoralo, Lauren A; Callahan, Kathryn; Stark, Rachel; DeCherrie, Linda V

2012-01-01

With growing numbers of patient-centered medical homes and accountable care organizations, and the potential implementation of the Patient Protection and Affordable Care Act, the provision of primary care in the United States is expanding and changing. Therefore, there is an urgent need to create more primary-care physicians and to train physicians to practice in this environment. In this article, we review the impact that the changing US healthcare system has on trainees, strategies to recruit and retain medical students and residents into primary-care internal medicine, and the preparation of trainees to work in the changing healthcare system. Recruitment methods for medical students include early preclinical exposure to patients in the primary-care setting, enhanced longitudinal patient experiences in clinical clerkships, and primary-care tracks. Recruitment methods for residents include enhanced ambulatory-care training and primary-care programs. Financial-incentive programs such as loan forgiveness may encourage trainees to enter primary care. Retaining residents in primary-care careers may be encouraged via focused postgraduate fellowships or continuing medical education to prepare primary-care physicians as both teachers and practitioners in the changing environment. Finally, to prepare primary-care trainees to effectively and efficiently practice within the changing system, educators should consider shifting ambulatory training to community-based practices, encouraging resident participation in team-based care, providing interprofessional educational experiences, and involving trainees in quality-improvement initiatives. Medical educators in primary care must think innovatively and collaboratively to effectively recruit and train the future generation of primary-care physicians. © 2012 Mount Sinai School of Medicine.

Self-supervised Chinese ontology learning from online encyclopedias.

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Hu, Fanghuai; Shao, Zhiqing; Ruan, Tong

2014-01-01

Constructing ontology manually is a time-consuming, error-prone, and tedious task. We present SSCO, a self-supervised learning based chinese ontology, which contains about 255 thousand concepts, 5 million entities, and 40 million facts. We explore the three largest online Chinese encyclopedias for ontology learning and describe how to transfer the structured knowledge in encyclopedias, including article titles, category labels, redirection pages, taxonomy systems, and InfoBox modules, into ontological form. In order to avoid the errors in encyclopedias and enrich the learnt ontology, we also apply some machine learning based methods. First, we proof that the self-supervised machine learning method is practicable in Chinese relation extraction (at least for synonymy and hyponymy) statistically and experimentally and train some self-supervised models (SVMs and CRFs) for synonymy extraction, concept-subconcept relation extraction, and concept-instance relation extraction; the advantages of our methods are that all training examples are automatically generated from the structural information of encyclopedias and a few general heuristic rules. Finally, we evaluate SSCO in two aspects, scale and precision; manual evaluation results show that the ontology has excellent precision, and high coverage is concluded by comparing SSCO with other famous ontologies and knowledge bases; the experiment results also indicate that the self-supervised models obviously enrich SSCO.

Clinical supervision reflected in a Danish DPCCQ sample

DEFF Research Database (Denmark)

Nielsen, Jan; Jacobsen, Claus Haugaard

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

Challenges for Better thesis supervision.

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

2014-01-01

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

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

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

2017-08-07

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

A Comparison of Surgery and Family Medicine Residents' Perceptions of Cross-Cultural Care Training of Cross-Cultural Care Training

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Jackson, David S; Lin, Susan Y; Park, Elyse R

2010-01-01

The need for physicians formally trained to deliver care to diverse patient populations has been widely advocated. Utilizing a validated tool, Weissman and Betancourt's Cross-Cultural Care Survey, the aim of this current study was to compare surgery and family medicine residents' perceptions of their preparedness and skillfulness to provide high quality cross-cultural care. Past research has documented differences between the two groups' reported impressions of importance and level of instruction received in cross-cultural care. Twenty surgery and 15 family medicine residents participated in the study. Significant differences were found between surgery and family medicine residents on most ratings of the amount of training they received in cross-cultural skills. Specifically, family medicine residents reported having received more training on: 1) determining how patients want to be addressed, 2) taking a social history, 3) assessing their understanding of the cause of illness, 4) negotiating their treatment plan, 5) assessing whether they are mistrustful of the health care system and/or doctor, 6) identifying cultural customs, 7) identifying how patients make decisions within the family, and 8) delivering services through a medical interpreter. One unexpected finding was that surgery residents, who reported not receiving much formal cultural training, reported higher mean scores on perceived skillfulness (i.e. ability) than family medicine residents. The disconnect may be linked to the family medicine residents' training in cultural humility — more knowledge and understanding of cross-cultural care can paradoxically lead to perceptions of being less prepared or skillful in this area. PMID:21225585

Self-reflection in cognitive behavioural therapy and supervision.

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Prasko, Jan; Mozny, Petr; Novotny, Miroslav; Slepecky, Milos; Vyskocilova, Jana

2012-12-01

Supervision is a basic part of training and ongoing education in cognitive behavioural therapy. Self-reflection is an important part of supervision. The conscious understanding of one's own emotions, feelings, thoughts, and attitudes at the time of their occurrence, and the ability to continuously follow and recognize them are among the most important abilities of both therapists and supervisors. The objective of this article is to review aspects related to supervision in cognitive behavioural therapy and self-reflection in the literature. This is a narrative review. A literature review was performed using the PubMed, SciVerse Scopus, and Web of Science databases; additional references were found through bibliography reviews of relevant articles published prior to July 2011. The databases were searched for articles containing the following keywords: cognitive behavioural therapy, self-reflection, therapeutic relationship, training, supervision, transference, and countertransference. The review also includes information from monographs referred to by other reviews. We discuss conceptual aspects related to supervision and the role of self-reflection. Self-reflection in therapy is a continuous process which is essential for the establishment of a therapeutic relationship, the professional growth of the therapist, and the ongoing development of therapeutic skills. Recognizing one's own emotions is a basic skill from which other skills necessary for both therapy and emotional self-control stem. Therapists who are skilled in understanding their inner emotions during their encounters with clients are better at making decisions, distinguishing their needs from their clients' needs, understanding transference and countertransference, and considering an optimal response at any time during a session. They know how to handle their feelings so that these correspond with the situation and their response is in the client's best interest. The ability to self-reflect increases the

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

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

2015-01-01

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

Semi-Supervised Multiple Feature Analysis for Action Recognition

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2013-11-26

in saving la- beling costs while simultaneously achieving good performance. Most semi-supervised learning methods assume that nearby points are likely...3, 5, 10 and 15) per category in the training set, thus resulting in , , , and randomly la- beled videos, with the remaining training videos unlabeled...with the increase of la- beled training samples, the performance of all algorithms rises. Meanwhile, the performance differences between our method and

Distant Supervision for Relation Extraction with Ranking-Based Methods

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Yang Xiang

2016-05-01

Full Text Available Relation extraction has benefited from distant supervision in recent years with the development of natural language processing techniques and data explosion. However, distant supervision is still greatly limited by the quality of training data, due to its natural motivation for greatly reducing the heavy cost of data annotation. In this paper, we construct an architecture called MIML-sort (Multi-instance Multi-label Learning with Sorting Strategies, which is built on the famous MIML framework. Based on MIML-sort, we propose three ranking-based methods for sample selection with which we identify relation extractors from a subset of the training data. Experiments are set up on the KBP (Knowledge Base Propagation corpus, one of the benchmark datasets for distant supervision, which is large and noisy. Compared with previous work, the proposed methods produce considerably better results. Furthermore, the three methods together achieve the best F1 on the official testing set, with an optimal enhancement of F1 from 27.3% to 29.98%.

Strengthening health facilities for maternal and newborn care: experiences from rural eastern Uganda

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Gertrude Namazzi

2015-03-01

Full Text Available Background: In Uganda maternal and neonatal mortality remains high due to a number of factors, including poor quality of care at health facilities. Objective: This paper describes the experience of building capacity for maternal and newborn care at a district hospital and lower-level health facilities in eastern Uganda within the existing system parameters and a robust community outreach programme. Design: This health system strengthening study, part of the Uganda Newborn Study (UNEST, aimed to increase frontline health worker capacity through district-led training, support supervision, and mentoring at one district hospital and 19 lower-level facilities. A once-off supply of essential medicines and equipment was provided to address immediate critical gaps. Health workers were empowered to requisition subsequent supplies through use of district resources. Minimal infrastructure adjustments were provided. Quantitative data collection was done within routine process monitoring and qualitative data were collected during support supervision visits. We use the World Health Organization Health System Building Blocks to describe the process of district-led health facility strengthening. Results: Seventy two per cent of eligible health workers were trained. The mean post-training knowledge score was 68% compared to 32% in the pre-training test, and 80% 1 year later. Health worker skills and competencies in care of high-risk babies improved following support supervision and mentoring. Health facility deliveries increased from 3,151 to 4,115 (a 30% increase in 2 years. Of 547 preterm babies admitted to the newly introduced kangaroo mother care (KMC unit, 85% were discharged alive to continue KMC at home. There was a non-significant declining trend for in-hospital neonatal deaths across the 2-year study period. While equipment levels remained high after initial improvement efforts, maintaining supply of even the most basic medications was a challenge, with

Assessment of a Statewide Palliative Care Team Training Course: COMFORT Communication for Palliative Care Teams.

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Wittenberg, Elaine; Ferrell, Betty; Goldsmith, Joy; Ragan, Sandra L; Paice, Judith

2016-07-01

Despite increased attention to communication skill training in palliative care, few interprofessional training programs are available and little is known about the impact of such training. This study evaluated a communication curriculum offered to interprofessional palliative care teams and examined the longitudinal impact of training. Interprofessional, hospital-based palliative care team members were competitively selected to participate in a two-day training using the COMFORT(TM SM) (Communication, Orientation and options, Mindful communication, Family, Openings, Relating, Team) Communication for Palliative Care Teams curriculum. Course evaluation and goal assessment were tracked at six and nine months postcourse. Interprofessional palliative care team members (n = 58) representing 29 teams attended the course and completed course goals. Participants included 28 nurses, 16 social workers, 8 physicians, 5 chaplains, and one psychologist. Precourse surveys assessed participants' perceptions of institution-wide communication performance across the continuum of care and resources supporting optimum communication. Postcourse evaluations and goal progress monitoring were used to assess training effectiveness. Participants reported moderate communication effectiveness in their institutions, with the weakest areas being during bereavement and survivorship care. Mean response to course evaluation across all participants was greater than 4 (scale of 1 = low to 5 = high). Participants taught an additional 962 providers and initiated institution-wide training for clinical staff, new hires, and volunteers. Team member training improved communication processes and increased attention to communication with family caregivers. Barriers to goal implementation included a lack of institutional support as evidenced in clinical caseloads and an absence of leadership and funding. The COMFORT(TM SM) communication curriculum is effective palliative care communication

Effective use of technology in clinical supervision

Directory of Open Access Journals (Sweden)

Priya Martin

2017-06-01

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

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

NARCIS (Netherlands)

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

2016-01-01

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

Clinical Supervision in Alcohol and Drug Abuse Counseling: Principles, Models, Methods.

Science.gov (United States)

Powell, David J.

A case is made for professionalism in clinical training as substance abuse counseling becomes a unique field. Part 1, "Principles," includes: (1) "A Historical Review of Supervision"; (2) "A Working Definition of Supervision"; (3) "Leadership Principles for Supervisors" and; (4) "Traits of an Effective Clinical Supervisor." Part 2, "Models,"…

Teacher training: challenges and possibilities of teaching of reproduction and sexuality in supervised curricular stage

Directory of Open Access Journals (Sweden)

Mayara Lustosa de Oliveira

2012-02-01

Full Text Available This work has its origins in a survey conducted during the supervised curricular stage of Biological Sciences course at Federal University of Goiás. The article describes critically and analytically every step of the curricular stage, especially the classes with the themes: reproduction and sexuality. The classes were taught to elementary students in State College St. Bernadete in Goiânia-GO. To facilitate the process of teaching and learning the trainees divided the themes into subtopics, and several teaching resources were developed for each subtopic. The research was descriptive and exploratory, using interviews with school students, teachers, supervisors and college students to collect data that allowed assessing the success of the teaching methodologies applied by the teachers in training. The field diaries of the trainees were also used to compose the analysis. Through the statements of the participants, it is considered that the methods achieved their goal in clarifying the issues. The resources used not only brought understanding, but encouraged the participation of the students. The article has been organized according to the steps of the curricular stage and it exposes all the impressions of the supervising teachers, school students and undergraduates during the internship, highlighting, comments, concerns, planning and execution process of the activities.

The Impact of the School Counselor Supervision Model on the Self-Efficacy of School Counselor Site Supervisors

Science.gov (United States)

Brown, Carleton H.; Olivárez, Artura, Jr.; DeKruyf, Loraine

2018-01-01

Supervision is a critical element in the professional identity development of school counselors; however, available school counseling-specific supervision training is lacking. The authors describe a 4-hour supervision workshop based on the School Counselor Supervision Model (SCSM; Luke & Bernard, 2006) attended by 31 school counselors from…

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

Science.gov (United States)

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

2016-02-01

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

Therapeutic validity and effectiveness of supervised physical exercise training on exercise capacity in patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis

NARCIS (Netherlands)

Vooijs, M.; Siemonsma, P.C.; Heus, I.; Sont, J.K.; Rövekamp, T.A.; Meeteren, N.L. van

2016-01-01

Objective: Our aim was to determine the effectiveness of supervised physical exercise training on exercise capacity in patients with chronic obstructive pulmonary disease taken into consideration indices such as therapeutic validity of interventions, methodological quality of studies, and exercise

Miles Apart: Two Art Therapists' Experience of Distance Supervision

Science.gov (United States)

Brandoff, Rachel; Lombardi, Reina

2012-01-01

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

Teaching teamwork: an evaluation of an interprofessional training ward placement for health care students

Directory of Open Access Journals (Sweden)

Morphet J

2014-06-01

Full Text Available Julia Morphet,1 Kerry Hood,2 Robyn Cant,2 Julie Baulch,3 Alana Gilbee,3 Kate Sandry4 1School of Nursing and Midwifery, Monash University, Frankston, Victoria, Australia; 2School of Nursing and Midwifery, Monash University, Clayton, Victoria, Australia; 3Southern Clinical School, Monash University, Monash Health, Clayton, Victoria, Australia; 4Dandenong Emergency Department, Monash Health, David St, Dandenong, Victoria, Australia Abstract: The establishment of interprofessional teamwork training in the preprofessional health care curriculum is a major challenge for teaching faculties. Interprofessional clinical placements offer an opportunity for teamwork education, as students in various professions can work and learn together. In this sequential, mixed-method study, focus group and survey techniques were used to evaluate students' educational experiences after 2-week ward-based interprofessional clinical placements. Forty-five senior nursing, medicine, and other health care students cared for patients in hospital wards under professional supervision, with nursing-medicine student "teams" leading care. Thirty-six students attended nine exit focus groups. Five central themes that emerged about training were student autonomy and workload, understanding of other professional roles, communication and shared knowledge, interprofessional teamwork/collaboration, and the "inner circle", or being part of the unit team. The learning environment was described as positive. In a postplacement satisfaction survey (n=38, students likewise rated the educational experience highly. In practicing teamwork and collaboration, students were able to rehearse their future professional role. We suggest that interprofessional clinical placements be regarded as an essential learning experience for senior preprofessional students. More work is needed to fully understand the effect of this interactive program on students' clinical learning and preparation for practice

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

Science.gov (United States)

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

2011-01-01

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

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

Science.gov (United States)

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

2016-01-01

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

The Juggling Act of Supervision in Community Mental Health: Implications for Supporting Evidence-Based Treatment.

Science.gov (United States)

Dorsey, Shannon; Pullmann, Michael D; Kerns, Suzanne E U; Jungbluth, Nathaniel; Meza, Rosemary; Thompson, Kelly; Berliner, Lucy

2017-11-01

Supervisors are an underutilized resource for supporting evidence-based treatments (EBTs) in community mental health. Little is known about how EBT-trained supervisors use supervision time. Primary aims were to describe supervision (e.g., modality, frequency), examine functions of individual supervision, and examine factors associated with time allocation to supervision functions. Results from 56 supervisors and 207 clinicians from 25 organizations indicate high prevalence of individual supervision, often alongside group and informal supervision. Individual supervision serves a wide range of functions, with substantial variation at the supervisor-level. Implementation climate was the strongest predictor of time allocation to clinical and EBT-relevant functions.

A new supervised learning algorithm for spiking neurons.

Science.gov (United States)

Xu, Yan; Zeng, Xiaoqin; Zhong, Shuiming

2013-06-01

The purpose of supervised learning with temporal encoding for spiking neurons is to make the neurons emit a specific spike train encoded by the precise firing times of spikes. If only running time is considered, the supervised learning for a spiking neuron is equivalent to distinguishing the times of desired output spikes and the other time during the running process of the neuron through adjusting synaptic weights, which can be regarded as a classification problem. Based on this idea, this letter proposes a new supervised learning method for spiking neurons with temporal encoding; it first transforms the supervised learning into a classification problem and then solves the problem by using the perceptron learning rule. The experiment results show that the proposed method has higher learning accuracy and efficiency over the existing learning methods, so it is more powerful for solving complex and real-time problems.

Working in the Field of Complex Psychological Trauma: A Framework for Personal and Professional Growth, Training, and Supervision.

Science.gov (United States)

Coleman, Anne Marie; Chouliara, Zoë; Currie, Kay

2018-03-01

The aim of this article is to explore the positive and negative impacts of working therapeutically in complex psychological trauma (CPT), particularly the field of gender-based violence (GBV) and childhood sexual abuse (CSA), from the clinicians' perspective. The focus was on the prospect of positive gains and growth for therapists. Twenty-one clinicians ( n = 21; counselors/psychotherapists and psychologists) from National Health Service (NHS) specialist trauma services, a community mental health team, and specialist sexual assault counseling organization participated. Interpretative phenomenological analysis (IPA) was utilized to conduct single one-off interviews and analysis. Six themes were identified: Called to the work; Connection, Separation, and Oneness; Into and out of the darkness; Chaos into meaning; Reparation not repetition; and Expansion and growth. The first "Therapist Led Framework of Growth in Trauma Work" is presented. Vicarious posttraumatic growth (VPTG) was a key finding, with CPT therapists experiencing a "challenge/benefit/change" growth process. Adoption of actively relational strategies to enhance clinicians' growth process through trauma work is being proposed. The benefits of conceptualizing both the positive and negative impacts of such work for supervision, training, shaping the formal curricula, service management, and continuing professional development (CPD) are being discussed. The need for good practice guidelines on self-care internationally is highlighted.

Impact of data transformation and preprocessing in supervised ...

African Journals Online (AJOL)

Impact of data transformation and preprocessing in supervised learning ... Nowadays, the ideas of integrating machine learning techniques in power system has ... The proposed algorithm used Python-based split train and k-fold model ...

Introduction to the Special Section on Teaching, Training, and Supervision in Personality and Psychological Assessment.

Science.gov (United States)

Smith, Justin D

2017-01-01

This special section contains empirical and conceptual articles pertaining to the broad topic of teaching, training, and supervision of assessment. Despite some evidence of a decline in recent decades, assessment remains a defining practice of professional psychologists in many subfields, including clinical, counseling, school, and neuropsychology, that consumes a consequential proportion of their time. To restore assessment to its rightful place of prominence, a clear agenda needs to be developed for advancing teaching and training methods, increasing instruction to state-of-the-art methods, and defining aims that could be elucidated through empirical inquiry. The 7 articles in this special section provide a developmental perspective of these issues that collectively provide practical tools for instructors and begin to set the stage for a research agenda in this somewhat neglected area of study that is vital to the identity of professional psychology. Additionally, 2 comments are provided by distinguished figures in the field concerning the implications of the articles in the special section to health services psychology and the competencies-based movement in applied psychology.

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

Science.gov (United States)

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

2015-06-01

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

Supervised Transfer Sparse Coding

KAUST Repository

Al-Shedivat, Maruan

2014-07-27

A combination of the sparse coding and transfer learn- ing techniques was shown to be accurate and robust in classification tasks where training and testing objects have a shared feature space but are sampled from differ- ent underlying distributions, i.e., belong to different do- mains. The key assumption in such case is that in spite of the domain disparity, samples from different domains share some common hidden factors. Previous methods often assumed that all the objects in the target domain are unlabeled, and thus the training set solely comprised objects from the source domain. However, in real world applications, the target domain often has some labeled objects, or one can always manually label a small num- ber of them. In this paper, we explore such possibil- ity and show how a small number of labeled data in the target domain can significantly leverage classifica- tion accuracy of the state-of-the-art transfer sparse cod- ing methods. We further propose a unified framework named supervised transfer sparse coding (STSC) which simultaneously optimizes sparse representation, domain transfer and classification. Experimental results on three applications demonstrate that a little manual labeling and then learning the model in a supervised fashion can significantly improve classification accuracy.

Customer care a training manual for library staff

CERN Document Server

Gannon-Leary, Pat

2010-01-01

Customer Care provides a detailed course suitable for delivery to library staff at all levels. It can be used as a stand-alone reference work for customer care processes and procedures or, alternatively, it can be used by library staff to tailor a customer care course to suit the requirements and training needs of their own staff.Dual use - reference work and/or training manualPotential as a text bookApplicable to a wider context than LIS - could be used for a whole HEI institutional approach to customer care or in local authorities/public services

Supervisor training

DEFF Research Database (Denmark)

Pedersen, Inge Nygaard

2015-01-01

on the experience of an integrated supervisor training programme offered in Aalborg, Denmark in 2009/2010. In this programme general issues of professional supervision and the application of artistic media as a core element in the supervisory process were Integrated. It is the hope of the author that this article...... will inspire other music therapists to develop supervisor training programmes for professional music therapists and also to undertake further research into professional supervision....

Telemedicine Based Ultrasound for Detecting Neonatal Heart Disease in Babies at Remote Military or Native American Health Care Facilities

National Research Council Canada - National Science Library

Sahn, David J; Kinney, James; Puntel, Robert

2007-01-01

... & Science University in Portland will test the hypothesis that trained primary care practitioners or nurses can with telemedicine supervision perform cardiac ultrasound exams on neonates at risk...

Telemedicine Based Ultrasound for Detecting Neonatal Heart Disease in Babies at Remote Military of Native American Health Care Facilities

National Research Council Canada - National Science Library

Sahn, David J

2006-01-01

... & Science University in Portland, will test the hypothesis that trained primary care practitioners or nurses can, with telemedicine supervision, perform cardiac ultrasound exams on neonates at risk...

Telemedicine Based Ultrasound for Detecting Neonatal Heart Disease in Babies at Remote Military or Native American Health Care Facilities

National Research Council Canada - National Science Library

Sahn, David J; Kinney, James; Puntel, Robert

2008-01-01

... & Science University in Portland will test the hypothesis that trained primary care practitioners or nurses can with telemedicine supervision perform cardiac ultrasound exams on neonates at risk...

Health care leadership development and training: progress and pitfalls

Directory of Open Access Journals (Sweden)

Sonnino RE

2016-02-01

Full Text Available Roberta E Sonnino1,2 1Department of Surgery, Division of Pediatric Surgery, Wayne State University School of Medicine, Detroit, MI, USA; 2RES Coaching LLC, Locust Hill, VA, USA Abstract: Formal training in the multifaceted components of leadership is now accepted as highly desirable for health care leaders. Despite natural leadership instincts, some core leadership competencies (“differentiating competencies” must be formally taught or refined. Leadership development may begin at an early career stage. Despite the recognized need, the number of comprehensive leadership development opportunities is still limited. Leadership training programs in health care were started primarily as internal institutional curricula, with a limited scope, for the development of faculty or practitioners. More comprehensive national leadership programs were developed in response to the needs of specific cohorts of individuals, such as programs for women, which are designed to increase the ranks of senior women leaders in the health sciences. As some programs reach their 20th year of existence, outcomes research has shown that health care leadership training is most effective when it takes place over time, is comprehensive and interdisciplinary, and incorporates individual/institutional projects allowing participants immediate practical application of their newly acquired skills. The training should envelop all the traditional health care domains of clinical practice, education, and research, so the leader may understand all the activities taking place under his/her leadership. Early career leadership training helps to develop a pipeline of leaders for the future, setting the foundation for further development of those who may chose to pursue significant leadership opportunities later in their career. A combination of early and mid-to-late career development may represent the optimal training for effective leaders. More training programs are needed to make

Semi-supervised Learning for Phenotyping Tasks.

Science.gov (United States)

Dligach, Dmitriy; Miller, Timothy; Savova, Guergana K

2015-01-01

Supervised learning is the dominant approach to automatic electronic health records-based phenotyping, but it is expensive due to the cost of manual chart review. Semi-supervised learning takes advantage of both scarce labeled and plentiful unlabeled data. In this work, we study a family of semi-supervised learning algorithms based on Expectation Maximization (EM) in the context of several phenotyping tasks. We first experiment with the basic EM algorithm. When the modeling assumptions are violated, basic EM leads to inaccurate parameter estimation. Augmented EM attenuates this shortcoming by introducing a weighting factor that downweights the unlabeled data. Cross-validation does not always lead to the best setting of the weighting factor and other heuristic methods may be preferred. We show that accurate phenotyping models can be trained with only a few hundred labeled (and a large number of unlabeled) examples, potentially providing substantial savings in the amount of the required manual chart review.

Magazine Picture Collage in Group Supervision

Science.gov (United States)

Shepard, Blythe C.; Guenette, Francis L.

2010-01-01

A magazine picture collage activity was used with three female counsellor education students as a vehicle to support them in processing their experience as counsellors in training. The use of magazine picture collage in group supervision is described, and the benefits and challenges are presented. The collages served as jumping-off points for…

Transfer learning improves supervised image segmentation across imaging protocols

DEFF Research Database (Denmark)

van Opbroek, Annegreet; Ikram, M. Arfan; Vernooij, Meike W.

2015-01-01

with slightly different characteristics. The performance of the four transfer classifiers was compared to that of standard supervised classification on two MRI brain-segmentation tasks with multi-site data: white matter, gray matter, and CSF segmentation; and white-matter- /MS-lesion segmentation......The variation between images obtained with different scanners or different imaging protocols presents a major challenge in automatic segmentation of biomedical images. This variation especially hampers the application of otherwise successful supervised-learning techniques which, in order to perform...... well, often require a large amount of labeled training data that is exactly representative of the target data. We therefore propose to use transfer learning for image segmentation. Transfer-learning techniques can cope with differences in distributions between training and target data, and therefore...

A survey of wound care knowledge in South Africa

African Journals Online (AJOL)

2010-12-09

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

Chapter 9. Managing Occupational Stress for Group Care Personnel

Science.gov (United States)

Mattingly, Martha A.

2006-01-01

Traditional clinical professions, as well as the emerging child and youth care profession, have focused primarily on the welfare of identified clients. While the personal and professional well-being of practitioners has long been addressed in the training and supervision of human service workers, serious efforts to identify problems confronting…

A retrospective evaluation of the Perfecting Patient Care University training program for health care organizations.

Science.gov (United States)

Morganti, Kristy Gonzalez; Lovejoy, Susan; Beckjord, Ellen Burke; Haviland, Amelia M; Haas, Ann C; Farley, Donna O

2014-01-01

This study evaluated how the Perfecting Patient Care (PPC) University, a quality improvement (QI) training program for health care leaders and clinicians, affected the ability of organizations to improve the health care they provide. This training program teaches improvement methods based on Lean concepts and principles of the Toyota Production System and is offered in several formats. A retrospective evaluation was performed that gathered data on training, other process factors, and outcomes after staff completed the PPC training. A majority of respondents reported gaining QI competencies and cultural achievements from the training. Organizations had high average scores for the success measures of "outcomes improved" and "sustainable monitoring" but lower scores for diffusion of QI efforts. Total training dosage was significantly associated with the measures of QI success. This evaluation provides evidence that organizations gained the PPC competencies and cultural achievements and that training dosage is a driver of QI success.

Health care leadership development and training: progress and pitfalls

Science.gov (United States)

Sonnino, Roberta E

2016-01-01

Formal training in the multifaceted components of leadership is now accepted as highly desirable for health care leaders. Despite natural leadership instincts, some core leadership competencies (“differentiating competencies”) must be formally taught or refined. Leadership development may begin at an early career stage. Despite the recognized need, the number of comprehensive leadership development opportunities is still limited. Leadership training programs in health care were started primarily as internal institutional curricula, with a limited scope, for the development of faculty or practitioners. More comprehensive national leadership programs were developed in response to the needs of specific cohorts of individuals, such as programs for women, which are designed to increase the ranks of senior women leaders in the health sciences. As some programs reach their 20th year of existence, outcomes research has shown that health care leadership training is most effective when it takes place over time, is comprehensive and interdisciplinary, and incorporates individual/institutional projects allowing participants immediate practical application of their newly acquired skills. The training should envelop all the traditional health care domains of clinical practice, education, and research, so the leader may understand all the activities taking place under his/her leadership. Early career leadership training helps to develop a pipeline of leaders for the future, setting the foundation for further development of those who may chose to pursue significant leadership opportunities later in their career. A combination of early and mid-to-late career development may represent the optimal training for effective leaders. More training programs are needed to make comprehensive leadership development widely accessible to a greater number of potential health care leaders. This paper addresses the skills that health care leaders should develop, the optimal leadership

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

Science.gov (United States)

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

2011-01-01

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

Primary health care and public policy.

Science.gov (United States)

Mangelsdorf, K L; Luna, J; Smith, H L

1988-01-01

The health problems of Ecuador are similar to those in other developing countries where the standard of living is low, and housing and sanitation are inadequate. Women, children, and those living in rural areas are those most severely affected. National policy has been to attempt to increase access to health care in rural areas through the construction of new facilities and the appointment of highly paid medical staff. However, little attention was paid to sociocultural factors, which caused the peasantry to reject the medical care system, or to problems of internal efficiency which inhibited utilization. Since the 1970s various national and international organizations have attempted to implement primary health care (PHC) through the use of trained community health workers (CHWs). The primary problems faced by the CHWs were shortages of medicines and supplies, an almost total lack of supervision, and lack of transportation available to take staff to isolated villages. The poor supervision is blamed for the 17% drop out rate among CHWs since 1980. Independent PHC programs have also been established in Ecuador by voluntary organizations. These work best when coordinated with governmental programs, in order to allow monitoring and to avoid the duplication of services. Problems with the establishment of PHC programs in Ecuador will continue, as the government has no clear cut policy, and difficulties financing on a broad national scale. Other problems include the absence of effective supervision and logistical support for even small pilot programs, and inconsistencies in the training and role definition for CHWs. These problems need to be met in the implementation of a national PHC policy.

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

Directory of Open Access Journals (Sweden)

Johanna Enö Persson

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

Constrained Deep Weak Supervision for Histopathology Image Segmentation.

Science.gov (United States)

Jia, Zhipeng; Huang, Xingyi; Chang, Eric I-Chao; Xu, Yan

2017-11-01

In this paper, we develop a new weakly supervised learning algorithm to learn to segment cancerous regions in histopathology images. This paper is under a multiple instance learning (MIL) framework with a new formulation, deep weak supervision (DWS); we also propose an effective way to introduce constraints to our neural networks to assist the learning process. The contributions of our algorithm are threefold: 1) we build an end-to-end learning system that segments cancerous regions with fully convolutional networks (FCNs) in which image-to-image weakly-supervised learning is performed; 2) we develop a DWS formulation to exploit multi-scale learning under weak supervision within FCNs; and 3) constraints about positive instances are introduced in our approach to effectively explore additional weakly supervised information that is easy to obtain and enjoy a significant boost to the learning process. The proposed algorithm, abbreviated as DWS-MIL, is easy to implement and can be trained efficiently. Our system demonstrates the state-of-the-art results on large-scale histopathology image data sets and can be applied to various applications in medical imaging beyond histopathology images, such as MRI, CT, and ultrasound images.

Spiritual care in the training of hospice volunteers in Germany.

Science.gov (United States)

Gratz, Margit; Paal, Piret; Emmelmann, Moritz; Roser, Traugott

2016-10-01

Hospice volunteers often encounter questions related to spirituality. It is unknown whether spiritual care receives a corresponding level of attention in their training. Our survey investigated the current practice of spiritual care training in Germany. An online survey sent to 1,332 hospice homecare services for adults in Germany was conducted during the summer of 2012. We employed the SPSS 21 software package for statistical evaluation. All training programs included self-reflection on personal spirituality as obligatory. The definitions of spirituality used in programs differ considerably. The task of defining training objectives is randomly delegated to a supervisor, a trainer, or to the governing organization. More than half the institutions work in conjunction with an external trainer. These external trainers frequently have professional backgrounds in pastoral care/theology and/or in hospice/palliative care. While spiritual care receives great attention, the specific tasks it entails are rarely discussed. The response rate for our study was 25.0% (n = 332). A need exists to develop training concepts that outline distinct contents, methods, and objectives. A prospective curriculum would have to provide assistance in the development of training programs. Moreover, it would need to be adaptable to the various concepts of spiritual care employed by the respective institutions and their hospice volunteers.

Extracting microRNA-gene relations from biomedical literature using distant supervision.

Directory of Open Access Journals (Sweden)

Andre Lamurias

Full Text Available Many biomedical relation extraction approaches are based on supervised machine learning, requiring an annotated corpus. Distant supervision aims at training a classifier by combining a knowledge base with a corpus, reducing the amount of manual effort necessary. This is particularly useful for biomedicine because many databases and ontologies have been made available for many biological processes, while the availability of annotated corpora is still limited. We studied the extraction of microRNA-gene relations from text. MicroRNA regulation is an important biological process due to its close association with human diseases. The proposed method, IBRel, is based on distantly supervised multi-instance learning. We evaluated IBRel on three datasets, and the results were compared with a co-occurrence approach as well as a supervised machine learning algorithm. While supervised learning outperformed on two of those datasets, IBRel obtained an F-score 28.3 percentage points higher on the dataset for which there was no training set developed specifically. To demonstrate the applicability of IBRel, we used it to extract 27 miRNA-gene relations from recently published papers about cystic fibrosis. Our results demonstrate that our method can be successfully used to extract relations from literature about a biological process without an annotated corpus. The source code and data used in this study are available at https://github.com/AndreLamurias/IBRel.

Supervising away from home: clinical, cultural and professional challenges.

Science.gov (United States)

Abramovitch, Henry; Wiener, Jan

2017-02-01

This paper explores some challenges of supervising clinical work of trainees, known as 'routers', who live in countries with diverse cultural, social and political traditions, and the analysts who travel to supervise them. It is written as an evolving dialogue between the authors, who explore together the effects of their own culture of origin, and in particular the legacy and values of their own training institutes on the styles and models of analytic supervision. Their dialogue is framed around the meaning of home and experiences of homesickness for analysts working away from home in an interactive field of strangeness in countries where analytical psychology is a relatively new discipline. The authors outline the findings from their own qualitative survey, where other supervisors working abroad, and those they have supervised, describe their experiences and their encounters with difference. The dialogue ends with both authors discussing what they have learned about teaching and supervising abroad, the implications for more flexible use of Jungian concepts, and how such visits have changed their clinical practice in their home countries. © 2017, The Society of Analytical Psychology.

Intensive care unit nurses' evaluation of simulation used for team training.

Science.gov (United States)

Ballangrud, Randi; Hall-Lord, Marie Louise; Hedelin, Birgitta; Persenius, Mona

2014-07-01

To implement a simulation-based team training programme and to investigate intensive care nurses' evaluations of simulation used for team training. Simulation-based training is recommended to make health care professionals aware of and understand the importance of teamwork related to patient safety. The study was based on a questionnaire evaluation design. A total of 63 registered nurses were recruited: 53 from seven intensive care units in four hospitals in one hospital trust and 10 from an intensive care postgraduate education programme. After conducting a simulation-based team training programme with two scenarios related to emergency situations in the intensive care, the participants evaluated each simulation activity with regard to: (i) outcome of satisfaction and self-confidence in learning, (ii) implementation of educational practice and (iii) simulation design/development. Intensive care nurses were highly satisfied with their simulation-based learning, and they were mostly in agreement with the statements about self-confidence in learning. They were generally positive in their evaluation of the implementation of the educational practice and the simulation design/development. Significant differences were found with regard to scenario roles, prior simulation experience and area of intensive care practice. The study indicates a positive reception of a simulation-based programme with regard to team training in emergency situations in an intensive care unit. The findings may motivate and facilitate the use of simulation for team training to promote patient safety in intensive care and provide educators with support to develop and improve simulation-based training programmes. © 2013 British Association of Critical Care Nurses.

Remotely-Supervised Transcranial Direct Current Stimulation (tDCS for Clinical Trials: Guidelines for Technology and Protocols

Directory of Open Access Journals (Sweden)

Leigh E Charvet

2015-03-01

Full Text Available The effect of transcranial direct current stimulation (tDCS is cumulative. Treatment protocols typically require multiple consecutive sessions spanning weeks or months. However, traveling to clinic for a tDCS session can present an obstacle to subjects and their caregivers. With modified devices and headgear, tDCS treatment can be administered remotely under clinical supervision, potentially enhancing recruitment, throughput, and convenience. Here we propose standards and protocols for clinical trials utilizing remotely-supervised tDCS with the goal of providing safe, reproducible and well-tolerated stimulation therapy outside of the clinic. The recommendations include: 1 training of staff in tDCS treatment and supervision, 2 assessment of the user’s capability to participate in tDCS remotely, 3 ongoing training procedures and materials including assessments of the user and/or caregiver, 4 simple and fail-safe electrode preparation techniques and tDCS headgear, 5 strict dose control for each session, 6 ongoing monitoring to quantify compliance (device preparation, electrode saturation/placement, stimulation protocol, with corresponding corrective steps as required, 7 monitoring for treatment-emergent adverse effects, 8 guidelines for discontinuation of a session and/or study participation including emergency failsafe procedures tailored to the treatment population’s level of need. These guidelines are intended to provide a minimal level of methodological rigor for clinical trials seeking to apply tDCS outside a specialized treatment center. We outline indication-specific applications (Attention Deficit Hyperactivity Disorder, Depression, Multiple Sclerosis, Palliative Care following these recommendations that support a standardized framework for evaluating the tolerability and reproducibility of remote-supervised tDCS that, once established, will allow for translation of tDCS clinical trials to a greater size and range of patient populations.

Functional measures show improvements after a home exercise program following supervised balance training in older adults with elevated fall risk.

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Tisher, Kristen; Mann, Kimberly; VanDyke, Sarah; Johansson, Charity; Vallabhajosula, Srikant

2018-03-05

Supervised balance training shows immediate benefit for older adults at fall risk. The long-term effectiveness of such training can be enhanced by implementing a safe and simple home exercise program (HEP). We investigated the effects of a12-week unsupervised HEP following supervised clinic-based balance training on functional mobility, balance, fall risk, and gait. Six older adults with an elevated fall risk obtained an HEP and comprised the HEP group (HEPG) and five older adults who were not given an HEP comprised the no HEP group (NoHEPG). The HEP consisted of three static balance exercises: feet-together, single-leg stance, and tandem. Each exercise was to be performed twice for 30-60 s, once per day, 3 days per week for 12 weeks. Participants were educated on proper form, safety, and progression of exercises. Pre- and post-HEP testing included Berg Balance Scale (BBS), Timed Up and Go, Short Physical Performance Battery (SPPB) assessments, Activities-Balance Confidence, Late-Life Functional Disability Instrument and instrumented assessments of balance and gait (Limits of Stability, modified Clinical Test of Sensory Interaction on Balance, Gait). A healthy control group (HCG; n = 11) was also tested. For most of the measures, the HEPG improved to the level of HCG. Though task-specific improvements like BBS and SPPB components were seen, the results did not carry over to more dynamic assessments. Results provide proof of concept that a simple HEP can be independently implemented and effective for sustaining and/or improving balance in older adults at elevated fall-risk after they have undergone a clinic-based balance intervention.

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

Science.gov (United States)

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

2014-08-30

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

A paediatric cardiopulmonary resuscitation training project in Honduras.

Science.gov (United States)

Urbano, Javier; Matamoros, Martha M; López-Herce, Jesús; Carrillo, Angel P; Ordóñez, Flora; Moral, Ramón; Mencía, Santiago

2010-04-01

It is possible that the exportation of North American and European models has hindered the creation of a structured cardiopulmonary resuscitation (CPR) training programme in developing countries. The objective of this paper is to describe the design and present the results of a European paediatric and neonatal CPR training programme adapted to Honduras. A paediatric CPR training project was set up in Honduras with the instructional and scientific support of the Spanish Group for Paediatric and Neonatal CPR. The programme was divided into four phases: CPR training and preparation of instructors; training for instructors; supervised teaching; and independent teaching. During the first phase, 24 Honduran doctors from paediatric intensive care, paediatric emergency and anaesthesiology departments attended the paediatric CPR course and 16 of them the course for preparation as instructors. The Honduran Paediatric and Neonatal CPR Group was formed. In the second phase, workshops were given by Honduran instructors and four of them attended a CPR course in Spain as trainee instructors. In the third phase, a CPR course was given in Honduras by the Honduran instructors, supervised by the Spanish team. In the final phase of independent teaching, eight courses were given, providing 177 students with training in CPR. The training of independent paediatric CPR groups with the collaboration and scientific assessment of an expert group could be a suitable model on which to base paediatric CPR training in Latin American developing countries. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

Improving Semi-Supervised Learning with Auxiliary Deep Generative Models

DEFF Research Database (Denmark)

Maaløe, Lars; Sønderby, Casper Kaae; Sønderby, Søren Kaae

Deep generative models based upon continuous variational distributions parameterized by deep networks give state-of-the-art performance. In this paper we propose a framework for extending the latent representation with extra auxiliary variables in order to make the variational distribution more...... expressive for semi-supervised learning. By utilizing the stochasticity of the auxiliary variable we demonstrate how to train discriminative classifiers resulting in state-of-the-art performance within semi-supervised learning exemplified by an 0.96% error on MNIST using 100 labeled data points. Furthermore...

Processes that Inform Multicultural Supervision: A Qualitative Meta-Analysis.

Science.gov (United States)

Tohidian, Nilou B; Quek, Karen Mui-Teng

2017-10-01

As the fields of counseling and psychotherapy have become more cognizant that individuals, couples, and families bring with them a myriad of diversity factors into therapy, multicultural competency has also become a crucial component in the development of clinicians during clinical supervision and training. We employed a qualitative meta-analysis to provide a detailed and comprehensive description of similar themes identified in primary qualitative studies that have investigated supervisory practices with an emphasis on diversity. Findings revealed six meta-categories, namely: (a) Supervisor's Multicultural Stances; (b) Supervisee's Multicultural Encounters; (c) Competency-Based Content in Supervision; (d) Processes Surrounding Multicultural Supervision; (e) Culturally Attuned Interventions; and (f) Multicultural Supervisory Alliance. Implications for practice are discussed. © 2017 American Association for Marriage and Family Therapy.

Supervision--growing and building a sustainable general practice supervisor system.

Science.gov (United States)

Thomson, Jennifer S; Anderson, Katrina J; Mara, Paul R; Stevenson, Alexander D

2011-06-06

This article explores various models and ideas for future sustainable general practice vocational training supervision in Australia. The general practitioner supervisor in the clinical practice setting is currently central to training the future general practice workforce. Finding ways to recruit, retain and motivate both new and experienced GP teachers is discussed, as is the creation of career paths for such teachers. Some of the newer methods of practice-based teaching are considered for further development, including vertically integrated teaching, e-learning, wave consulting and teaching on the run, teaching teams and remote teaching. Approaches to supporting and resourcing teaching and the required infrastructure are also considered. Further research into sustaining the practice-based general practice supervision model will be required.

Determining effects of non-synonymous SNPs on protein-protein interactions using supervised and semi-supervised learning.

Directory of Open Access Journals (Sweden)

Nan Zhao

2014-05-01

Full Text Available Single nucleotide polymorphisms (SNPs are among the most common types of genetic variation in complex genetic disorders. A growing number of studies link the functional role of SNPs with the networks and pathways mediated by the disease-associated genes. For example, many non-synonymous missense SNPs (nsSNPs have been found near or inside the protein-protein interaction (PPI interfaces. Determining whether such nsSNP will disrupt or preserve a PPI is a challenging task to address, both experimentally and computationally. Here, we present this task as three related classification problems, and develop a new computational method, called the SNP-IN tool (non-synonymous SNP INteraction effect predictor. Our method predicts the effects of nsSNPs on PPIs, given the interaction's structure. It leverages supervised and semi-supervised feature-based classifiers, including our new Random Forest self-learning protocol. The classifiers are trained based on a dataset of comprehensive mutagenesis studies for 151 PPI complexes, with experimentally determined binding affinities of the mutant and wild-type interactions. Three classification problems were considered: (1 a 2-class problem (strengthening/weakening PPI mutations, (2 another 2-class problem (mutations that disrupt/preserve a PPI, and (3 a 3-class classification (detrimental/neutral/beneficial mutation effects. In total, 11 different supervised and semi-supervised classifiers were trained and assessed resulting in a promising performance, with the weighted f-measure ranging from 0.87 for Problem 1 to 0.70 for the most challenging Problem 3. By integrating prediction results of the 2-class classifiers into the 3-class classifier, we further improved its performance for Problem 3. To demonstrate the utility of SNP-IN tool, it was applied to study the nsSNP-induced rewiring of two disease-centered networks. The accurate and balanced performance of SNP-IN tool makes it readily available to study the

Determining Effects of Non-synonymous SNPs on Protein-Protein Interactions using Supervised and Semi-supervised Learning

Science.gov (United States)

Zhao, Nan; Han, Jing Ginger; Shyu, Chi-Ren; Korkin, Dmitry

2014-01-01

Single nucleotide polymorphisms (SNPs) are among the most common types of genetic variation in complex genetic disorders. A growing number of studies link the functional role of SNPs with the networks and pathways mediated by the disease-associated genes. For example, many non-synonymous missense SNPs (nsSNPs) have been found near or inside the protein-protein interaction (PPI) interfaces. Determining whether such nsSNP will disrupt or preserve a PPI is a challenging task to address, both experimentally and computationally. Here, we present this task as three related classification problems, and develop a new computational method, called the SNP-IN tool (non-synonymous SNP INteraction effect predictor). Our method predicts the effects of nsSNPs on PPIs, given the interaction's structure. It leverages supervised and semi-supervised feature-based classifiers, including our new Random Forest self-learning protocol. The classifiers are trained based on a dataset of comprehensive mutagenesis studies for 151 PPI complexes, with experimentally determined binding affinities of the mutant and wild-type interactions. Three classification problems were considered: (1) a 2-class problem (strengthening/weakening PPI mutations), (2) another 2-class problem (mutations that disrupt/preserve a PPI), and (3) a 3-class classification (detrimental/neutral/beneficial mutation effects). In total, 11 different supervised and semi-supervised classifiers were trained and assessed resulting in a promising performance, with the weighted f-measure ranging from 0.87 for Problem 1 to 0.70 for the most challenging Problem 3. By integrating prediction results of the 2-class classifiers into the 3-class classifier, we further improved its performance for Problem 3. To demonstrate the utility of SNP-IN tool, it was applied to study the nsSNP-induced rewiring of two disease-centered networks. The accurate and balanced performance of SNP-IN tool makes it readily available to study the rewiring of

Antenatal care strengthening for improved quality of care in Jimma, Ethiopia

DEFF Research Database (Denmark)

Villadsen, Sarah Fredsted; Negussie, Dereje; GebreMariam, Abebe

2015-01-01

and assess the implementation process and effectiveness on quality of ANC in Jimma, Ethiopia. METHODS: The intervention comprised trainings, supervisions, equipment, development of health education material, and adaption of guidelines. It was implemented at public facilities and control sites were included...... in the evaluation. Improved content of care (physical examinations, laboratory testing, tetanus toxoid (TT)-immunization, health education, conduct of health professionals, and waiting time) were defined as proximal project outcomes and increased quality of care (better identification of health problems....... The effect of the intervention was assessed by comparing the change in quality of care from before to after the intervention period at intervention sites, relative to control sites, using logistic mixed effect regression. RESULTS: The continued attention to the ANC provision during implementation stimulated...

ACGME core competency training, mentorship, and research in surgical subspecialty fellowship programs.

Science.gov (United States)

Francesca Monn, M; Wang, Ming-Hsien; Gilson, Marta M; Chen, Belinda; Kern, David; Gearhart, Susan L

2013-01-01

To determine the perceived effectiveness of surgical subspecialty training programs in teaching and assessing the 6 ACGME core competencies including research. Cross-sectional survey. ACGME approved training programs in pediatric urology and colorectal surgery. Program Directors and recent trainees (2007-2009). A total of 39 program directors (60%) and 57 trainees (64%) responded. Both program directors and recent trainees reported a higher degree of training and mentorship (75%) in patient care and medical knowledge than the other core competencies (pinterpersonal and communication, and professionalism training were perceived effective to a lesser degree. Specifically, in the areas of teaching residents and medical students and team building, program directors, compared with recent trainees, perceived training to be more effective, (p = 0.004, p = 0.04). Responses to questions assessing training in systems based practice ubiquitously identified a lack of training, particularly in financial matters of running a practice. Although effective training in research was perceived as lacking by recent trainees, 81% reported mentorship in this area. According to program directors and recent trainees, the most effective method of teaching was faculty supervision and feedback. Only 50% or less of the recent trainees reported mentorship in career planning, work-life balance, and job satisfaction. Not all 6 core competencies and research are effectively being taught in surgery subspecialty training programs and mentorship in areas outside of patient care and research is lacking. Emphasis should be placed on faculty supervision and feedback when designing methods to better incorporate all 6 core competencies, research, and mentorship. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Generalization of Supervised Learning for Binary Mask Estimation

DEFF Research Database (Denmark)

May, Tobias; Gerkmann, Timo

2014-01-01

This paper addresses the problem of speech segregation by es- timating the ideal binary mask (IBM) from noisy speech. Two methods will be compared, one supervised learning approach that incorporates a priori knowledge about the feature distri- bution observed during training. The second method...

A new corps of trained Grand-Aides has the potential to extend reach of primary care workforce and save money.

Science.gov (United States)

Garson, Arthur; Green, Donna M; Rodriguez, Lia; Beech, Richard; Nye, Christopher

2012-05-01

Because the Affordable Care Act will expand health insurance to cover an estimated thirty-two million additional people, new approaches are needed to expand the primary care workforce. One possible solution is Grand-Aides®, who are health care professionals operating under the direct supervision of nurses, and who are trained and equipped to conduct telephone consultations or make primary care home visits to patients who might otherwise be seen in emergency departments and clinics. We conducted pilot tests with Grand-Aides in two pediatric Medicaid settings: an urban federally qualified health center in Houston, Texas, and a semi-rural emergency department in Harrisonburg, Virginia. We estimated that Grand-Aides and their supervisors averted 62 percent of drop-in visits at the Houston clinic and would have eliminated 74 percent of emergency department visits at the Virginia test site. We calculated the cost of the Grand-Aides program to be $16.88 per encounter. That compares with current Medicaid payments of $200 per clinic visit in Houston and $175 per emergency department visit in Harrisonburg. In addition to reducing health care costs, Grand-Aides have the potential to make a substantial impact in reducing congestion in primary care practices and emergency departments.

Impact of Health Care Provider's Training on Patients ...

African Journals Online (AJOL)

Material and Methods: A situation analysis was done before training to assess existing practice of providers' communication skills and patient's satisfaction. All care providers in labour ward were trained and their practice was assessed before and after training. A ten percent sample of patients delivered in hospital before ...

Building capacity in implementation science research training at the University of Nairobi.

Science.gov (United States)

Osanjo, George O; Oyugi, Julius O; Kibwage, Isaac O; Mwanda, Walter O; Ngugi, Elizabeth N; Otieno, Fredrick C; Ndege, Wycliffe; Child, Mara; Farquhar, Carey; Penner, Jeremy; Talib, Zohray; Kiarie, James N

2016-03-08

Health care systems in sub-Saharan Africa, and globally, grapple with the problem of closing the gap between evidence-based health interventions and actual practice in health service settings. It is essential for health care systems, especially in low-resource settings, to increase capacity to implement evidence-based practices, by training professionals in implementation science. With support from the Medical Education Partnership Initiative, the University of Nairobi has developed a training program to build local capacity for implementation science. This paper describes how the University of Nairobi leveraged resources from the Medical Education Partnership to develop an institutional program that provides training and mentoring in implementation science, builds relationships between researchers and implementers, and identifies local research priorities for implementation science. The curriculum content includes core material in implementation science theory, methods, and experiences. The program adopts a team mentoring and supervision approach, in which fellows are matched with mentors at the University of Nairobi and partnering institutions: University of Washington, Seattle, and University of Maryland, Baltimore. A survey of program participants showed a high degree satisfaction with most aspects of the program, including the content, duration, and attachment sites. A key strength of the fellowship program is the partnership approach, which leverages innovative use of information technology to offer diverse perspectives, and a team model for mentorship and supervision. As health care systems and training institutions seek new approaches to increase capacity in implementation science, the University of Nairobi Implementation Science Fellowship program can be a model for health educators and administrators who wish to develop their program and curricula.

Supervised exercise reduces cancer-related fatigue: a systematic review

Directory of Open Access Journals (Sweden)

José F Meneses-Echávez

2015-01-01

Full Text Available Question: Does supervised physical activity reduce cancer-related fatigue? Design: Systematic review with meta-analysis of randomised trials. Participants: People diagnosed with any type of cancer, without restriction to a particular stage of diagnosis or treatment. Intervention: Supervised physical activity interventions (eg, aerobic, resistance and stretching exercise, defined as any planned or structured body movement causing an increase in energy expenditure, designed to maintain or enhance health-related outcomes, and performed with systematic frequency, intensity and duration. Outcome measures: The primary outcome measure was fatigue. Secondary outcomes were physical and functional wellbeing assessed using the Functional Assessment of Cancer Therapy Fatigue Scale, European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire, Piper Fatigue Scale, Schwartz Cancer Fatigue Scale and the Multidimensional Fatigue Inventory. Methodological quality, including risk of bias of the studies, was evaluated using the PEDro Scale. Results: Eleven studies involving 1530 participants were included in the review. The assessment of quality showed a mean score of 6.5 (SD 1.1, indicating a low overall risk of bias. The pooled effect on fatigue, calculated as a standardised mean difference (SMD using a random-effects model, was –1.69 (95% CI –2.99 to –0.39. Beneficial reductions in fatigue were also found with combined aerobic and resistance training with supervision (SMD = –0.41, 95% CI –0.70 to –0.13 and with combined aerobic, resistance and stretching training with supervision (SMD = –0.67, 95% CI –1.17 to –0.17. Conclusion: Supervised physical activity interventions reduce cancer-related fatigue. These findings suggest that combined aerobic and resistance exercise regimens with or without stretching should be included as part of rehabilitation programs for people who have been diagnosed with cancer

Intensive care nurses' perceptions of simulation-based team training for building patient safety in intensive care: a descriptive qualitative study.

Science.gov (United States)

Ballangrud, Randi; Hall-Lord, Marie Louise; Persenius, Mona; Hedelin, Birgitta

2014-08-01

To describe intensive care nurses' perceptions of simulation-based team training for building patient safety in intensive care. Failures in team processes are found to be contributory factors to incidents in an intensive care environment. Simulation-based training is recommended as a method to make health-care personnel aware of the importance of team working and to improve their competencies. The study uses a qualitative descriptive design. Individual qualitative interviews were conducted with 18 intensive care nurses from May to December 2009, all of which had attended a simulation-based team training programme. The interviews were analysed by qualitative content analysis. One main category emerged to illuminate the intensive care nurse perception: "training increases awareness of clinical practice and acknowledges the importance of structured work in teams". Three generic categories were found: "realistic training contributes to safe care", "reflection and openness motivates learning" and "finding a common understanding of team performance". Simulation-based team training makes intensive care nurses more prepared to care for severely ill patients. Team training creates a common understanding of how to work in teams with regard to patient safety. Copyright © 2014 Elsevier Ltd. All rights reserved.

CANDiS: Coupled & Attention-Driven Neural Distant Supervision

OpenAIRE

Nagarajan, Tushar; Sharmistha; Talukdar, Partha

2017-01-01

Distant Supervision for Relation Extraction uses heuristically aligned text data with an existing knowledge base as training data. The unsupervised nature of this technique allows it to scale to web-scale relation extraction tasks, at the expense of noise in the training data. Previous work has explored relationships among instances of the same entity-pair to reduce this noise, but relationships among instances across entity-pairs have not been fully exploited. We explore the use of inter-ins...

What are the critical success factors for team training in health care?

Science.gov (United States)

Salas, Eduardo; Almeida, Sandra A; Salisbury, Mary; King, Heidi; Lazzara, Elizabeth H; Lyons, Rebecca; Wilson, Katherine A; Almeida, Paula A; McQuillan, Robert

2009-08-01

Ineffective communication among medical teams is a leading cause of preventable patient harm throughout the health care system. A growing body of literature indicates that medical teamwork improves the quality, safety, and cost-effectiveness of health care delivery, and expectations for teamwork in health care have increased. Yet few health care professions' curricula include teamwork training, and few medical practices integrate teamwork principles. Because of this knowledge gap, growing numbers of health care systems are requiring staff to participate in formal teamwork training programs. Seven evidence-based, practical, systematic success factors for preparing, implementing, and sustaining a team training and performance improvement initiative were identified. Each success factor is accompanied by tips for deployment and a real-world example of application. (1) Align team training objectives and safety aims with organizational goals, (2) provide organizational support for the team training initiative, (3) get frontline care leaders on board, (4) prepare the environment and trainees for team training, (5) determine required resources and time commitment and ensure their availability, (6) facilitate application of trained teamwork skills on the job; and (7) measure the effectiveness of the team training program. Although decades of research in other high-risk organizations have clearly demonstrated that properly designed team training programs can improve team performance, success is highly dependent on organizational factors such as leadership support, learning climate, and commitment to data-driven change. Before engaging in a teamwork training initiative, health care organizations should have a clear understanding of these factors and the strategies for their establishment.

GMDH-Based Semi-Supervised Feature Selection for Electricity Load Classification Forecasting

Directory of Open Access Journals (Sweden)

Lintao Yang

2018-01-01

Full Text Available With the development of smart power grids, communication network technology and sensor technology, there has been an exponential growth in complex electricity load data. Irregular electricity load fluctuations caused by the weather and holiday factors disrupt the daily operation of the power companies. To deal with these challenges, this paper investigates a day-ahead electricity peak load interval forecasting problem. It transforms the conventional continuous forecasting problem into a novel interval forecasting problem, and then further converts the interval forecasting problem into the classification forecasting problem. In addition, an indicator system influencing the electricity load is established from three dimensions, namely the load series, calendar data, and weather data. A semi-supervised feature selection algorithm is proposed to address an electricity load classification forecasting issue based on the group method of data handling (GMDH technology. The proposed algorithm consists of three main stages: (1 training the basic classifier; (2 selectively marking the most suitable samples from the unclassified label data, and adding them to an initial training set; and (3 training the classification models on the final training set and classifying the test samples. An empirical analysis of electricity load dataset from four Chinese cities is conducted. Results show that the proposed model can address the electricity load classification forecasting problem more efficiently and effectively than the FW-Semi FS (forward semi-supervised feature selection and GMDH-U (GMDH-based semi-supervised feature selection for customer classification models.

Training community mental health staff in Guangzhou, China: evaluation of the effect of a new training model.

Science.gov (United States)

Li, Jie; Li, Juan; Thornicroft, Graham; Yang, Hui; Chen, Wen; Huang, Yuanguang

2015-10-26

Increasing numbers of people with mental disorders receive services at primary care in China. The aims of this study are to evaluate impact of a new training course and supervision for community mental health staff to enhance their levels of mental health knowledge and to reduce their stigmatization toward people with mental illness. A total of 77 community mental health staff from eight regions in Guangzhou in China were recruited for the study.4 regions were randomly allocated to the new training model group, and 4 to the old training model group. Levels of mental health knowledge were measured by purpose-made assessment schedule and by the Mental Health Knowledge Schedule (MAKS). Stigma was evaluated by the Mental Illness: Clinicians' Attitudes Scale (MICA) and the Reported and Intended Behavior Scale (RIBS). Evaluation questionnaires were given at the beginning of course, at the end, and at 6 month and at 12 month follow-up. After the training period, the 6-month, and the 12-month, knowledge scores of the intervention group were higher than the control group. At 6-month and 12-month follow-up, means scores of MAKS of the intervention group increased more than the control group (both p training, at 6-months, and at 12-months, mean scores of RIBS of the intervention group increased more than the control (p training course and supervision, the new course improved community mental health staff knowledge of mental disorders, improving their attitudes toward people with mental disorder, and increasing their willingness to have contact with people with mental disorder.

The efficacy of unsupervised home-based exercise regimens in comparison to supervised laboratory-based exercise training upon cardio-respiratory health facets.

Science.gov (United States)

Blackwell, James; Atherton, Philip J; Smith, Kenneth; Doleman, Brett; Williams, John P; Lund, Jonathan N; Phillips, Bethan E

2017-09-01

Supervised high-intensity interval training (HIIT) can rapidly improve cardiorespiratory fitness (CRF). However, the effectiveness of time-efficient unsupervised home-based interventions is unknown. Eighteen volunteers completed either: laboratory-HIIT (L-HIIT); home-HIIT (H-HIIT) or home-isometric hand-grip training (H-IHGT). CRF improved significantly in L-HIIT and H-HIIT groups, with blood pressure improvements in the H-IHGT group only. H-HIIT offers a practical, time-efficient exercise mode to improve CRF, away from the laboratory environment. H-IHGT potentially provides a viable alternative to modify blood pressure in those unable to participate in whole-body exercise. © 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

Alzheimer's Association Quality Care Campaign and professional training initiatives: improving hands-on care for people with dementia in the U.S.A.

Science.gov (United States)

Gould, Elizabeth; Reed, Peter

2009-04-01

In the U.S.A., direct care workers and licensed practical nurses are the professionals who provide the most hands-on care to people with dementia in nursing homes and residential care facilities--yet they do not receive adequate training in dementia care. Dementia care training needs to be universal with all disciplines at all levels of care. Even though there is variability on recommended hours and content, most studies emphasize the importance of dementia care training as a distinct component of required training for any professional or paraprofessional working in long-term care. In 2005, the Alzheimer's Association launched its Quality Care Campaign to improve dementia care through state and federal advocacy; consumer education and empowerment; and staff training. This paper describes the effectiveness of Alzheimer's Association training as measured by knowledge gained and providers' intention to change their behavior immediately after attending the training.Overall, findings indicated that the participants responded positively to evidence-based training in dementia care that emphasized the importance of (i) leadership, (ii) team communication and collaboration, (iii) support and empowerment of direct care staff, (iv) awareness and practice of specific dementia care issues, (v) resident and family involvement in care, and (vi) professional self-care.

The supervisions in the field develop nuclear professionals; Las supervisiones en campo desarrollan profesionales nucleares

Energy Technology Data Exchange (ETDEWEB)

Fernandez de la Casa, M.; Buedo, J. L.; Gonzalez, F.

2015-07-01

In 2011 Cofrentes Nuclear Power Plants began a training program for improving the supervision of managers in the field: the effort done not only has improved the quality of supervisions but also has defined a way to reinforce behavior expectations of Cofrentes Nuclear Power Plant. (Author)

Supervised Gaussian mixture model based remote sensing image ...

African Journals Online (AJOL)

Using the supervised classification technique, both simulated and empirical satellite remote sensing data are used to train and test the Gaussian mixture model algorithm. For the purpose of validating the experiment, the resulting classified satellite image is compared with the ground truth data. For the simulated modelling, ...

Impact of training of traditional birth attendants on the newborn care.

Science.gov (United States)

Satishchandra, D M; Naik, V A; Wantamutte, A S; Mallapur, M D

2009-01-01

To study the impact of training of Traditional Birth Attendants (TBAs) on the Newborn care in resource poor setting in rural area. A community based study in the Primary Health Center (PHC) area was conducted over one year period between March 2006 to February 2007. The study participants were 50 Traditional Birth Attendants (TBAs)who conduct home deliveries in the PHC area. Training was conducted for two days which included topics on techniques of conducting safe delivery and newborn care practices. Pre-test evaluation regarding knowledge and practices about newborn care was done. Post-test evaluation was done at first month (early) and at fifth month (late) after the training. Analysis was done by using Mc. Nemer's test, Chi- square test with Yates's correction and Fischer's exact test. Pre-test evaluation showed that, knowledge and practices about newborn care services provided by the previously trained TBAs and untrained TBAs were poor. Early and late post-test evaluation showed that, there was a progressive improvement in the newborn care provided by both the groups. Preintervention period (one year prior to the training) and postintervention period (one year after the training) showed that, there was a statistically significant (p<0.05) reduction in the perinatal deaths (11 to 3) and neonatal deaths (10 to 2) among the deliveries conducted by TBAs after the training. Training programme for TBAs with regular reinforcements in the resource poor setting will not only improve the quality of newborn care but also reduces perinatal deaths.

Culturally Competent Palliative and Hospice Care Training for Ethnically Diverse Staff in Long-Term Care Facilities.

Science.gov (United States)

Kataoka-Yahiro, Merle R; McFarlane, Sandra; Koijane, Jeannette; Li, Dongmei

2017-05-01

Between 2013 and 2030, older adults 65 years and older of racial/ethnic populations in the U.S. is projected to increase by 123% in comparison to the Whites (Non-Hispanics). To meet this demand, training of ethnically diverse health staff in long-term care facilities in palliative and hospice care is imperative. The purpose of this study was to evaluate a palliative and hospice care training of staff in two nursing homes in Hawaii - (a) to evaluate knowledge and confidence over three time periods, and (b) to compare staff and family caregiver satisfaction at end of program. The educational frameworks were based on cultural and communication theories. Fifty-two ethnically diverse staff, a majority being Asian (89%), participated in a 10-week module training and one 4 hour communication skills workshop. Staff evaluation included knowledge and confidence surveys, pre- and post-test knowledge tests, and FAMCARE-2 satisfaction instrument. There were nine Asian (89%) and Pacific Islander (11%) family caregivers who completed the FAMCARE-2 satisfaction instrument. The overall staff knowledge and confidence results were promising. The staff rated overall satisfaction of palliative care services lower than the family caregivers. Implications for future research, practice, and education with palliative and hospice care training of ethnically diverse nursing home staff is to include patient and family caregiver satisfaction of palliative and hospice care services, evaluation of effectiveness of cross-cultural communication theories in palliative and hospice care staff training, and support from administration for mentorship and development of these services in long term care facilities.

The effectiveness of Technology-assisted Cascade Training and Supervision of community health workers in delivering the Thinking Healthy Program for perinatal depression in a post-conflict area of Pakistan - study protocol for a randomized controlled trial.

Science.gov (United States)

Zafar, Shamsa; Sikander, Siham; Hamdani, Syed Usman; Atif, Najia; Akhtar, Parveen; Nazir, Huma; Maselko, Joanna; Rahman, Atif

2016-04-06

Rates of perinatal depression in low and middle income countries are reported to be very high. Perinatal depression not only has profound impact on women's health, disability and functioning, it is associated with poor child health outcomes such as pre-term birth, under-nutrition and stunting, which ultimately have an adverse trans-generational impact. There is strong evidence in the medical literature that perinatal depression can be effectively managed with psychological treatments delivered by non-specialists. Our previous research in Pakistan led to the development of a successful perinatal depression intervention, the Thinking Healthy Program (THP). The THP is a psychological treatment delivered by community health workers. The burden of perinatal depression can be reduced through scale-up of this proven intervention; however, training of health workers at scale is a major barrier. To enhance access to such interventions there is a need to look at technological solutions to training and supervision. This is a non-inferiority, single-blinded randomized controlled trial. Eighty community health workers called Lady Health Workers (LHWs) working in a post-conflict rural area in Pakistan (Swat) will be recruited through the LHW program. LHWs will be randomly allocated to Technology-assisted Cascade Training and Supervision (TACTS) or to specialist-delivered training (40 in each group). The TACTS group will receive training in THP through LHW supervisors using a tablet-based training package, whereas the comparison group will receive training directly from mental health specialists. Our hypothesis is that both groups will achieve equal competence. Primary outcome measure will be competence of health workers at delivering THP using a modified ENhancing Assessment of Common Therapeutic factors (ENACT) rating scale immediately post training and after 3 months of supervision. Independent assessors will be blinded to the LHW allocation status. Women living in post

Short and long-term effects of supervised versus unsupervised exercise training on health-related quality of life and functional outcomes following lung cancer surgery - a randomized controlled trial.

Science.gov (United States)

Brocki, Barbara Cristina; Andreasen, Jane; Nielsen, Lene Rodkjaer; Nekrasas, Vytautas; Gorst-Rasmussen, Anders; Westerdahl, Elisabeth

2014-01-01

Surgical resection enhances long-term survival after lung cancer, but survivors face functional deficits and report on poor quality of life long time after surgery. This study evaluated short and long-term effects of supervised group exercise training on health-related quality of life and physical performance in patients, who were radically operated for lung cancer. A randomized, assessor-blinded, controlled trial was performed on 78 patients undergoing lung cancer surgery. The intervention group (IG, n=41) participated in supervised out-patient exercise training sessions, one hour once a week for ten weeks. The sessions were based on aerobic exercises with target intensity of 60-80% of work capacity, resistance training and dyspnoea management. The control group (CG, n=37) received one individual instruction in exercise training. Measurements consisted of: health-related quality of life (SF36), six minute walk test (6MWT) and lung function (spirometry), assessed three weeks after surgery and after four and twelve months. Both groups were comparable at baseline on demographic characteristic and outcome values. We found a statistically significant effect after four months in the bodily pain domain of SF36, with an estimated mean difference (EMD) of 15.3 (95% CI:4 to 26.6, p=0.01) and a trend in favour of the intervention for role physical functioning (EMD 12.04, 95% CI: -1 to 25.1, p=0.07) and physical component summary (EMD 3.76, 95% CI:-0.1 to 7.6, p=0.06). At 12 months, the tendency was reversed, with the CG presenting overall slightly better measures. We found no effect of the intervention on 6MWT or lung volumes at any time-point. Supervised compared to unsupervised exercise training resulted in no improvement in health-related quality of life, except for the bodily pain domain, four months after lung cancer surgery. No effects of the intervention were found for any outcome after one year. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Spiritual Care Training for Mothers of Children with Cancer: Effects on Quality of Care and Mental Health of Caregivers.

Science.gov (United States)

Borjalilu, Somaieh; Shahidi, Shahriar; Mazaheri, Mohammad Ali; Emami, Amir Hossein

2016-01-01

The purpose of this study was to explore the effectiveness of a spiritual care training package in maternal caregivers of children with cancer. This study was a quasi-experimental study with pretest and posttest design consisting of a sample of 42 mothers of children diagnosed as having cancer. Participants were randomly assigned to either an experimental or a control group. The training package consisted of seven group training sessions offered in a children's hospital in Tehran. All mothers completed the Spirituality and Spiritual Care Rating Scale (SSCRS) and the Depression, Anxiety and Stress Scale (DASS-21) at pre and post test and after a three month follow up. There was significant difference between anxiety and spiritual, religious, Personalized care and total scores spiritual care between the intervention and control groups at follow-up (Pspiritual care training program promotes spirituality, personalized care, religiosity and spiritual care as well as decreasing anxiety in mothers of children with cancer and decreases anxiety. It may be concluded that spiritual care training could be used effectively in reducing distressful spiritual challenges in mothers of children with cancer.

Changes in Perceived Supervision Quality After Introduction of Competency-Based Orthopedic Residency Training: A National 6-Year Follow-Up Study.

Science.gov (United States)

van Vendeloo, Stefan N; Brand, Paul L P; Kollen, Boudewijn J; Verheyen, Cees C P M

2018-04-27

To evaluate the perceived quality of the learning environment, before and after introduction of competency-based postgraduate orthopedic education. From 2009 to 2014, we conducted annual surveys among Dutch orthopedic residents. The validated Dutch Residency Educational Climate Test (D-RECT, 50 items on 11 subscales) was used to assess the quality of the learning environment. Scores range from 1 (poor) to 5 (excellent). Dynamic cohort follow-up study. All Dutch orthopedic residents were surveyed during annual compulsory courses. Over the 6-year period, 641 responses were obtained (response rate 92%). Scores for "supervision" (95% CI for difference 0.06-0.28, p = 0.002) and "coaching and assessment" (95% CI 0.11-0.35, p < 0.001) improved significantly after introduction of competency-based training. There was no significant change in score on the other subscales of the D-RECT. After the introduction of some of the core components of competency-based postgraduate orthopedic education the perceived quality of "supervision" and "coaching and assessment" improved significantly. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Effects of a spiritual care training for nurses

NARCIS (Netherlands)

Vlasblom, J.P.; Steen, van der J.T.; Knol, D.L.; Jochemsen, H.

2011-01-01

Despite the fact that spiritual care is an essential part of nursing care according to many nursing definitions, it appears to be quite different in practice. A spirituality training for nurses may be necessary to give spiritual care the attention it deserves. In a trial a pre-tested “spirituality

[Compassionate care for student nurses].

Science.gov (United States)

Cann, Lisa

2016-05-01

Nurses are practising in a work environment which is sometimes difficult and which can affect their capacity to supervise students. They may sometimes find themselves taking out their frustration on these students. By being better trained in the specificities of adult learning, frontline professionals and tutors could find it easier to adopt a compassionate care attitude towards nursing students, an essential condition for the development of their skills. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Effect of Comprehensive Geriatric Training for The Long-term Care Insurance user.

OpenAIRE

磯崎, 弘司; 石井, 佐和子; 高橋, 美千子

2007-01-01

Comprehensive geriatric training (CGT) is training devised for the elderly persons which uses exercise therapy together with instrumental training. The comprehensive geriatric training was provided to a Long-term Care Insurance user group in order to evaluate the effect of the training. The subjects of the training include 12 Long-term Care Insurance users (mean 80.9 age, SD 7.6 years). Physical strength examinations were made before and after the training and their results were used to evalu...

A diagnostic study of Department of Health training courses for family planning providers.

Science.gov (United States)

Rood, S; Raquepo, M; Ladia, M A

1993-01-01

A study in the Philippines sought to observe and describe the family planning (FP) training program in two regions. This program trains physicians, nurses, and midwives as a team and includes a Basic/Comprehensive (B/C) course in FP with didactic and practicum elements, training in interpersonal communication skills (ICS) for those who have completed with B/C course, and a Preceptors Course for those who will supervise the practicum phase of the B/C course. The study gathered specific information on 1) trainee absenteeism and drop-out rates, 2) course content and effects, 3) the trainee selection process, 4) the practicum requirement for the B/C course, and 5) service delivery values and quality of care. Data were collected through observations, questionnaires, exit interviews with clients during the practicum phase, interviews with supervisors and public officials (mayors), and focus group discussions with regional trainers. This assessment led to the following recommendations: 1) maintain the current team approach; 2) reserve basic orientation-type subjects for office-based training to allow more time for FP topics in the training programs; 3) use caution in making a switch to "competency-based" training because of the possibility that supervision is inadequate for such a training method; 4) improve scheduling; 5) enforce the prerequisites for participation in the ICS and Preceptors Courses; 6) assign only one trainee to a preceptor area during the practicum and reduce the quota of IUD insertions to reduce pressure to obtain IUD acceptors; 7) create a "model" FP clinic each time a preceptor is trained; 8) pay more attention to natural FP methods; and 9) maintain an emphasis on quality of care.

Communication skills training for health care professionals improves the adult orthopaedic patient's experience of quality of care

DEFF Research Database (Denmark)

Nørgaard, Birgitte; Kofoed, Poul-Erik; Ohm Kyvik, Kirsten

2012-01-01

Scand J Caring Sci; 2012; Communication skills training for health care professionals improves the adult orthopaedic patient's experience of quality of care Rationale:  Despite the fact that communication has become a core topic in health care, patients still experience the information provided...... as insufficient or incorrect and a lack of involvement. Objective:  To investigate whether adult orthopaedic patients' evaluation of the quality of care had improved after a communication skills training course for healthcare professionals. Design and methods:  The study was designed as an intervention study...... offering professionals training in communicating with patients and colleagues. The outcome was measured by assessing patients' experience of quality of care. Data were collected by means of a questionnaire and analysed using a linear regression model. Approval was obtained from the Danish Data Protection...

Improving family medicine resident training in dementia care: an experiential learning opportunity in Primary Care Collaborative Memory Clinics.

Science.gov (United States)

Lee, Linda; Weston, W Wayne; Hillier, Loretta; Archibald, Douglas; Lee, Joseph

2018-06-21

Family physicians often find themselves inadequately prepared to manage dementia. This article describes the curriculum for a resident training intervention in Primary Care Collaborative Memory Clinics (PCCMC), outlines its underlying educational principles, and examines its impact on residents' ability to provide dementia care. PCCMCs are family physician-led interprofessional clinic teams that provide evidence-informed comprehensive assessment and management of memory concerns. Within PCCMCs residents learn to apply a structured approach to assessment, diagnosis, and management; training consists of a tutorial covering various topics related to dementia followed by work-based learning within the clinic. Significantly more residents who trained in PCCMCs (sample = 98), as compared to those in usual training programs (sample = 35), reported positive changes in knowledge, ability, and confidence in ability to assess and manage memory problems. The PCCMC training intervention for family medicine residents provides a significant opportunity for residents to learn about best clinical practices and interprofessional care needed for optimal dementia care integrated within primary care practice.

Predicting protein complexes using a supervised learning method combined with local structural information.

Science.gov (United States)

Dong, Yadong; Sun, Yongqi; Qin, Chao

2018-01-01

The existing protein complex detection methods can be broadly divided into two categories: unsupervised and supervised learning methods. Most of the unsupervised learning methods assume that protein complexes are in dense regions of protein-protein interaction (PPI) networks even though many true complexes are not dense subgraphs. Supervised learning methods utilize the informative properties of known complexes; they often extract features from existing complexes and then use the features to train a classification model. The trained model is used to guide the search process for new complexes. However, insufficient extracted features, noise in the PPI data and the incompleteness of complex data make the classification model imprecise. Consequently, the classification model is not sufficient for guiding the detection of complexes. Therefore, we propose a new robust score function that combines the classification model with local structural information. Based on the score function, we provide a search method that works both forwards and backwards. The results from experiments on six benchmark PPI datasets and three protein complex datasets show that our approach can achieve better performance compared with the state-of-the-art supervised, semi-supervised and unsupervised methods for protein complex detection, occasionally significantly outperforming such methods.

Identifying an Education Gap in Wound Care Training in United States Dermatology.

Science.gov (United States)

Ruiz, Emily Stamell; Ingram, Amber; Landriscina, Angelo; Tian, Jiaying; Kirsner, Robert S; Friedman, Adam

2015-07-01

As restoration of the integument is paramount to wound healing, dermatologists should be central to managing wounds; yet this is often not the case. If a training gap exists during residency training, this may account for the observed discrepancy. To identify United States (US) dermatology residents' impressions regarding their preparedness to care for wounds, and to assess the amount and type of training devoted to wound care during residency. An online survey among current US dermatology residents enrolled in a residency training program. The primary goal was to determine whether dermatology residents believe more wound care education is needed, evaluate preparedness to care for wounds, and identify future plans to manage wounds. Responses were received from 175 of 517 (33.8%) US Dermatology residents contacted. The majority of residents did not feel prepared to manage acute (78.3%) and chronic (84.6%) wounds. Over three quarters (77.1%) felt that more education is needed. Fewer than half (49.1% and 35.4%) of residents planned to care for acute and chronic wounds, respectively, when in practice. There is a gap in wound care education in US dermatology residency training. This translates to a low percentage of dermatology residents planning to care for wounds in future practice. Dermatology residents need to receive focused wound care training in order to translate the underpinnings of wound healing biology and ultimately better serve patients.

Training oncology and palliative care clinical nurse specialists in psychological skills: evaluation of a pilot study.

Science.gov (United States)

Clark, Jane E; Aitken, Susan; Watson, Nina; McVey, Joanne; Helbert, Jan; Wraith, Anita; Taylor, Vanessa; Catesby, Sarah

2015-06-01

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

Race in Supervision: Let's Talk About It.

Science.gov (United States)

Schen, Cathy R; Greenlee, Alecia

2018-01-01

Addressing race and racial trauma within psychotherapy supervision is increasingly important in psychiatry training. A therapist's ability to discuss race and racial trauma in psychotherapy supervision increases the likelihood that these topics will be explored as they arise in the therapeutic setting. The authors discuss the contextual and sociocultural dynamics that contributed to their own avoidance of race and racial trauma within the supervisory relationship. The authors examine the features that eventually led to a robust discussion of race and culture within the supervisory setting and identify salient themes that occurred during three phases of the conversation about race: pre-dialogue, the conversation, and after the conversation. These themes include building an alliance, supercompetence, avoidance, shared vulnerability, "if I speak on this, I own it," closeness versus distance, and speaking up. This article reviews the key literature in the field of psychiatry and psychology that has shaped how we understand race and racial trauma and concludes with guidelines for supervisors on how to facilitate talking about race in supervision.

Deep Web Search Interface Identification: A Semi-Supervised Ensemble Approach

Directory of Open Access Journals (Sweden)

Hong Wang

2014-12-01

Full Text Available To surface the Deep Web, one crucial task is to predict whether a given web page has a search interface (searchable HyperText Markup Language (HTML form or not. Previous studies have focused on supervised classification with labeled examples. However, labeled data are scarce, hard to get and requires tediousmanual work, while unlabeled HTML forms are abundant and easy to obtain. In this research, we consider the plausibility of using both labeled and unlabeled data to train better models to identify search interfaces more effectively. We present a semi-supervised co-training ensemble learning approach using both neural networks and decision trees to deal with the search interface identification problem. We show that the proposed model outperforms previous methods using only labeled data. We also show that adding unlabeled data improves the effectiveness of the proposed model.

Caring to learn, learning to care: Inmate Hospice Volunteers and the Delivery of Prison End-of-Life Care

Science.gov (United States)

Cloyes, Kristin G.; Rosenkranz, Susan J.; Supiano, Katherine P.; Berry, Patricia H.; Routt, Meghan; Llanque, Sarah M.; Shannon-Dorcy, Kathleen

2017-01-01

The increasing numbers of aging and chronically ill prisoners incarcerated in Western nations is well documented, as is the growing need for prison-based palliative and end-of-life care. Less often discussed is specifically how end-of-life care can and should be provided, by whom, and with what resources. One strategy incorporates prisoner volunteers into end-of-life services within a peer care program. This article reports on one such program based on focused ethnographic study including in-depth interviews with inmate hospice volunteers, nursing staff, and corrections officers working in the hospice program. We describe how inmate volunteers learn hospice care through formal education and training, supervised practice, guidance from more experienced inmates, and support from correctional staff. We discuss how emergent values of mentorship and stewardship are seen by volunteers and staff as integral to prison hospice sustainability and discuss implications of this volunteer-centric model for response-ability for the end-of-life care of prisoners. PMID:28100141

Physical health care for people with mental illness: training needs for nurses.

Science.gov (United States)

Happell, Brenda; Platania-Phung, Chris; Scott, David

2013-04-01

People diagnosed with serious mental illness have higher rates of physical morbidity and decreased longevity, yet these people are not adequately served by health care systems. Nurses may provide improved physical health support to consumers with serious mental illness but this is partly dependent on nurses having necessary skills and interest in training opportunities for this component of their work. This survey investigated Australian nurses' interest in training across areas of physical health care including lifestyle factors, cardiovascular disease, and identifying health risks. A nation-wide online survey of nurse members of the Australian College of Mental Health Nurses. The survey included an adapted version of a sub-section of the Physical Health Attitudes Scale. Participants were asked to indicate their interest in various aspects of physical health care training. Most (91.6%) participants viewed educating nurses in physical health care as of moderate or significant value in improving the physical health of people with serious mental illness. Interest in training in all areas of physical health care was over 60% across the health care settings investigated (e.g. public, private, primary care). Forty-two percent sought training in all nine areas of physical health care, from supporting people with diabetes, to assisting consumers with sexually-related and lifestyle issues. The findings suggest that nurses in mental health services in Australia acknowledge the importance of training to improve physical health care of consumers with serious mental illness. Training programs and learning opportunities for nurses are necessary to reduce inequalities in health of people with serious mental illness. Copyright © 2013. Published by Elsevier Ltd.

Primary care resident perceived preparedness to deliver cross-cultural care: an examination of training and specialty differences.

Science.gov (United States)

Greer, Joseph A; Park, Elyse R; Green, Alexander R; Betancourt, Joseph R; Weissman, Joel S

2007-08-01

Previous research has shown that resident physicians report differences in training across primary care specialties, although limited data exist on education in delivering cross-cultural care. The goals of this study were to identify factors that relate to primary care residents' perceived preparedness to provide cross-cultural care and to explore the extent to which these perceptions vary across primary care specialties. Cross-sectional, national mail survey of resident physicians in their last year of training. Eleven hundred fifty primary care residents specializing in family medicine (27%), internal medicine (23%), pediatrics (26%), and obstetrics/gynecology (OB/GYN) (24%). Male residents as well as those who reported having graduated from U.S. medical schools, access to role models, and a greater cross-cultural case mix during residency felt more prepared to deliver cross-cultural care. Adjusting for these demographic and clinical factors, family practice residents were significantly more likely to feel prepared to deliver cross-cultural care compared to internal medicine, pediatric, and OB/GYN residents. Yet, when the quantity of instruction residents reported receiving to deliver cross-cultural care was added as a predictor, specialty differences became nonsignificant, suggesting that training opportunities better account for the variability in perceived preparedness than specialty. Across primary care specialties, residents reported different perceptions of preparedness to deliver cross-cultural care. However, this variation was more strongly related to training factors, such as the amount of instruction physicians received to deliver such care, rather than specialty affiliation. These findings underscore the importance of formal education to enhance residents' preparedness to provide cross-cultural care.

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

Science.gov (United States)

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

2018-01-01

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

Semi-Supervised Generation with Cluster-aware Generative Models

DEFF Research Database (Denmark)

Maaløe, Lars; Fraccaro, Marco; Winther, Ole

2017-01-01

Deep generative models trained with large amounts of unlabelled data have proven to be powerful within the domain of unsupervised learning. Many real life data sets contain a small amount of labelled data points, that are typically disregarded when training generative models. We propose the Clust...... a log-likelihood of −79.38 nats on permutation invariant MNIST, while also achieving competitive semi-supervised classification accuracies. The model can also be trained fully unsupervised, and still improve the log-likelihood performance with respect to related methods.......Deep generative models trained with large amounts of unlabelled data have proven to be powerful within the domain of unsupervised learning. Many real life data sets contain a small amount of labelled data points, that are typically disregarded when training generative models. We propose the Cluster...

A Comparison of Surgery and Family Medicine Residents' Perceptions of Cross-Cultural Care Training of Cross-Cultural Care Training

OpenAIRE

Chun, Maria BJ; Jackson, David S; Lin, Susan Y; Park, Elyse R

2010-01-01

The need for physicians formally trained to deliver care to diverse patient populations has been widely advocated. Utilizing a validated tool, Weissman and Betancourt's Cross-Cultural Care Survey, the aim of this current study was to compare surgery and family medicine residents' perceptions of their preparedness and skillfulness to provide high quality cross-cultural care. Past research has documented differences between the two groups' reported impressions of importance and level of instruc...

Speech reconstruction using a deep partially supervised neural network.

Science.gov (United States)

McLoughlin, Ian; Li, Jingjie; Song, Yan; Sharifzadeh, Hamid R

2017-08-01

Statistical speech reconstruction for larynx-related dysphonia has achieved good performance using Gaussian mixture models and, more recently, restricted Boltzmann machine arrays; however, deep neural network (DNN)-based systems have been hampered by the limited amount of training data available from individual voice-loss patients. The authors propose a novel DNN structure that allows a partially supervised training approach on spectral features from smaller data sets, yielding very good results compared with the current state-of-the-art.

Meeting the milestones. Strategies for including high-value care education in pulmonary and critical care fellowship training.

Science.gov (United States)

Courtright, Katherine R; Weinberger, Steven E; Wagner, Jason

2015-04-01

Physician decision making is partially responsible for the roughly 30% of U.S. healthcare expenditures that are wasted annually on low-value care. In response to both the widespread public demand for higher-quality care and the cost crisis, payers are transitioning toward value-based payment models whereby physicians are rewarded for high-value, cost-conscious care. Furthermore, to target physicians in training to practice with cost awareness, the Accreditation Council for Graduate Medical Education has created both individual objective milestones and institutional requirements to incorporate quality improvement and cost awareness into fellowship training. Subsequently, some professional medical societies have initiated high-value care educational campaigns, but the overwhelming majority target either medical students or residents in training. Currently, there are few resources available to help guide subspecialty fellowship programs to successfully design durable high-value care curricula. The resource-intensive nature of pulmonary and critical care medicine offers unique opportunities for the specialty to lead in modeling and teaching high-value care. To ensure that fellows graduate with the capability to practice high-value care, we recommend that fellowship programs focus on four major educational domains. These include fostering a value-based culture, providing a robust didactic experience, engaging trainees in process improvement projects, and encouraging scholarship. In doing so, pulmonary and critical care educators can strive to train future physicians who are prepared to provide care that is both high quality and informed by cost awareness.

Trends in Psychotherapy Training: A National Survey of Psychiatry Residency Training

Science.gov (United States)

Sudak, Donna M.; Goldberg, David A.

2012-01-01

Objective: The authors sought to determine current trends in residency training of psychiatrists. Method: The authors surveyed U.S. general-psychiatry training directors about the amount of didactic training, supervised clinical experience, and numbers of patients treated in the RRC-mandated models of psychotherapy (psychodynamic,…

A Training Intervention to Improve Information Management in Primary Care

Science.gov (United States)

Schifferdecker, Karen E.; Reed, Virginia A.; Homa, Karen

2010-01-01

Background and Objectives Training programs designed to improve information management have been implemented but not adequately tested. Three critical components for information management were tested in a randomized control study: (1) knowledge of valid, synthesized summary information, (2) skills to use Web-based resources that provide access to these summaries, and (3) use of Web-based resources in clinical practice. Methods Twenty-four primary care practices were provided with computers and high-speed Internet access and then matched, with half randomly assigned to receive training and half to receive training at a later date. Training was designed to address knowledge, skills, and use of Web-based information. Outcomes were assessed by comparing baseline and follow-up questionnaires that focused on five conceptual domains related to Web-based resource use for patient care decisions and patient education. Results Compared to the delayed training group, the initial training group increased their knowledge and skill of Web-based resources and use for patient care decisions. Some measures of communication with patients about using Web-based resources and of incorporating use of Web-based resources into daily practice increased from baseline to follow-up for all participants. Conclusions Our findings suggest that training and providing computers and Internet connections have measurable effects on information management behaviors. PMID:18773781

Diversity and cultural competence training in health care organizations: hallmarks of success.

Science.gov (United States)

Curtis, Ellen Foster; Dreachslin, Janice L; Sinioris, Marie

2007-01-01

The authors reviewed recent literature on diversity training interventions and identified effective practices for health care organizations. Self-reported satisfaction was especially likely to be found as a result of training, whereas attitude change measured by standardized instruments was mixed. Although those responsible for diversity training in the workplace agree that behavioral change is key, awareness building and associated attitude change remain the focus of most diversity training in the workplace. Consequently, the authors recommend a systems approach to diversity training interventions wherein training is a key component of a health care organization's strategic approach to organizational performance, and diversity training is linked to the organizations' strategic goals for improved quality of care. The systems approach requires these steps: determine diversity and cultural competence goals in the context of strategy, measure current performance against needs, design training to address the gap, implement the training, assess training effectiveness, and strive for continuous improvement. Higher level evaluations measuring whether employees have transferred learning from training to their jobs are paramount to the systems approach to diversity training interventions. Measuring other positive changes in a "return on investment" format can be used to convince stakeholders of training's value.

Effectiveness of Group Supervision versus Combined Group and Individual Supervision.

Science.gov (United States)

Ray, Dee; Altekruse, Michael

2000-01-01

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

Primary Care Resident Perceived Preparedness to Deliver Cross-cultural Care: An Examination of Training and Specialty Differences

Science.gov (United States)

Park, Elyse R.; Green, Alexander R.; Betancourt, Joseph R.; Weissman, Joel S.

2007-01-01

Objective Previous research has shown that resident physicians report differences in training across primary care specialties, although limited data exist on education in delivering cross-cultural care. The goals of this study were to identify factors that relate to primary care residents’ perceived preparedness to provide cross-cultural care and to explore the extent to which these perceptions vary across primary care specialties. Design Cross-sectional, national mail survey of resident physicians in their last year of training. Participants Eleven hundred fifty primary care residents specializing in family medicine (27%), internal medicine (23%), pediatrics (26%), and obstetrics/gynecology (OB/GYN) (24%). Results Male residents as well as those who reported having graduated from U.S. medical schools, access to role models, and a greater cross-cultural case mix during residency felt more prepared to deliver cross-cultural care. Adjusting for these demographic and clinical factors, family practice residents were significantly more likely to feel prepared to deliver cross-cultural care compared to internal medicine, pediatric, and OB/GYN residents. Yet, when the quantity of instruction residents reported receiving to deliver cross-cultural care was added as a predictor, specialty differences became nonsignificant, suggesting that training opportunities better account for the variability in perceived preparedness than specialty. Conclusions Across primary care specialties, residents reported different perceptions of preparedness to deliver cross-cultural care. However, this variation was more strongly related to training factors, such as the amount of instruction physicians received to deliver such care, rather than specialty affiliation. These findings underscore the importance of formal education to enhance residents’ preparedness to provide cross-cultural care. PMID:17516107

Classification of gene expression data: A hubness-aware semi-supervised approach.

Science.gov (United States)

Buza, Krisztian

2016-04-01

Classification of gene expression data is the common denominator of various biomedical recognition tasks. However, obtaining class labels for large training samples may be difficult or even impossible in many cases. Therefore, semi-supervised classification techniques are required as semi-supervised classifiers take advantage of unlabeled data. Gene expression data is high-dimensional which gives rise to the phenomena known under the umbrella of the curse of dimensionality, one of its recently explored aspects being the presence of hubs or hubness for short. Therefore, hubness-aware classifiers have been developed recently, such as Naive Hubness-Bayesian k-Nearest Neighbor (NHBNN). In this paper, we propose a semi-supervised extension of NHBNN which follows the self-training schema. As one of the core components of self-training is the certainty score, we propose a new hubness-aware certainty score. We performed experiments on publicly available gene expression data. These experiments show that the proposed classifier outperforms its competitors. We investigated the impact of each of the components (classification algorithm, semi-supervised technique, hubness-aware certainty score) separately and showed that each of these components are relevant to the performance of the proposed approach. Our results imply that our approach may increase classification accuracy and reduce computational costs (i.e., runtime). Based on the promising results presented in the paper, we envision that hubness-aware techniques will be used in various other biomedical machine learning tasks. In order to accelerate this process, we made an implementation of hubness-aware machine learning techniques publicly available in the PyHubs software package (http://www.biointelligence.hu/pyhubs) implemented in Python, one of the most popular programming languages of data science. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Training providers on issues of race and racism improve health care equity.

Science.gov (United States)

Nelson, Stephen C; Prasad, Shailendra; Hackman, Heather W

2015-05-01

Race is an independent factor in health disparity. We developed a training module to address race, racism, and health care. A group of 19 physicians participated in our training module. Anonymous survey results before and after the training were compared using a two-sample t-test. The awareness of racism and its impact on care increased in all participants. White participants showed a decrease in self-efficacy in caring for patients of color when compared to white patients. This training was successful in deconstructing white providers' previously held beliefs about race and racism. © 2015 Wiley Periodicals, Inc.

A semi-supervised learning approach for RNA secondary structure prediction.

Science.gov (United States)

Yonemoto, Haruka; Asai, Kiyoshi; Hamada, Michiaki

2015-08-01

RNA secondary structure prediction is a key technology in RNA bioinformatics. Most algorithms for RNA secondary structure prediction use probabilistic models, in which the model parameters are trained with reliable RNA secondary structures. Because of the difficulty of determining RNA secondary structures by experimental procedures, such as NMR or X-ray crystal structural analyses, there are still many RNA sequences that could be useful for training whose secondary structures have not been experimentally determined. In this paper, we introduce a novel semi-supervised learning approach for training parameters in a probabilistic model of RNA secondary structures in which we employ not only RNA sequences with annotated secondary structures but also ones with unknown secondary structures. Our model is based on a hybrid of generative (stochastic context-free grammars) and discriminative models (conditional random fields) that has been successfully applied to natural language processing. Computational experiments indicate that the accuracy of secondary structure prediction is improved by incorporating RNA sequences with unknown secondary structures into training. To our knowledge, this is the first study of a semi-supervised learning approach for RNA secondary structure prediction. This technique will be useful when the number of reliable structures is limited. Copyright © 2015 Elsevier Ltd. All rights reserved.

Kollegial supervision

DEFF Research Database (Denmark)

Andersen, Ole Dibbern; Petersson, Erling

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

Accelerated Training of Skilled Birth Attendants in a Marginalized Population on the Thai-Myanmar Border: A Multiple Methods Program Evaluation.

Science.gov (United States)

White, Adrienne Lynne; Min, Thaw Htwe; Gross, Mechthild M; Kajeechiwa, Ladda; Thwin, May Myo; Hanboonkunupakarn, Borimas; Than, Hla Hla; Zin, Thet Wai; Rijken, Marcus J; Hoogenboom, Gabie; McGready, Rose

2016-01-01

To evaluate a skilled birth attendant (SBA) training program in a neglected population on the Thai-Myanmar border, we used multiple methods to show that refugee and migrant health workers can be given effective training in their own environment to become SBAs and teachers of SBAs. The loss of SBAs through resettlement to third countries necessitated urgent training of available workers to meet local needs. All results were obtained from student records of theory grades and clinical log books. Qualitative evaluation of both the SBA and teacher programs was obtained using semi-structured interviews with supervisors and teachers. We also reviewed perinatal indicators over an eight-year period, starting prior to the first training program until after the graduation of the fourth cohort of SBAs. Four SBA training programs scheduled between 2009 and 2015 resulted in 79/88 (90%) of students successfully completing a training program of 250 theory hours and 625 supervised clinical hours. All 79 students were able to: achieve pass grades on theory examination (median 80%, range [70-89]); obtain the required clinical experience within twelve months; achieve clinical competence to provide safe care during childbirth. In 2010-2011, five experienced SBAs completed a train-the-trainer (TOT) program and went on to facilitate further training programs. Perinatal indicators within Shoklo Malaria Research Unit (SMRU), such as place of birth, maternal and newborn outcomes, showed no significant differences before and after introduction of training or following graduate deployment in the local maternity units. Confidence, competence and teamwork emerged from qualitative evaluation by senior SBAs working with and supervising students in the clinics. We demonstrate that in resource-limited settings or in marginalized populations, it is possible to accelerate training of skilled birth attendants to provide safe maternity care. Education needs to be tailored to local needs to ensure

Trainees' use of supervision for therapy with sexual minority clients: A qualitative study.

Science.gov (United States)

Chui, Harold; McGann, Kevin J; Ziemer, Kathryn S; Hoffman, Mary Ann; Stahl, Jessica

2018-01-01

In the supervision literature, research on sexual orientation considerations often focuses on sexual minority supervisees and less often on their work with sexual minority clients. Yet both heterosexual and sexual minority supervisees serve sexual minority clients and may have different supervision needs. Twelve predoctoral interns from 12 APA-accredited counseling center internships were interviewed about how they made use of supervision for their work with a sexual minority client. The sample consisted of 6 heterosexual-identified supervisees and 6 supervisees who identified as lesbian, gay, or queer (LGQ). Data were analyzed using consensual qualitative research. All participants reported positive gains from supervision that carried over to their work with heterosexual and sexual minority clients, even when not all supervisors disclosed or discussed their own sexual orientation. Heterosexual supervisees used supervision to ensure that their heterosexuality does not interfere with an affirmative experience for their sexual minority client, whereas LGQ supervisees used supervision to explore differences in sexual identity development between themselves and their client to minimize the negative impact of overidentification. Thus, affirmative supervision may unfold with different foci depending on supervisees' sexual identity. Implications for training and supervision are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Communication skills training increases self-efficacy of health care professionals

DEFF Research Database (Denmark)

Nørgaard, Birgitte; Ammentorp, Jette; Ohm Kyvik, Kirsten

2012-01-01

Despite the knowledge of good communication as a precondition for optimal care and treatment in health care, serious communication problems are still experienced by patients as well as by health care professionals. An orthopedic surgery department initiated a 3-day communication skills training...... course for all staff members expecting an increase in patient-centeredness in communication and more respectful intercollegial communication. The aim of this study was to investigate the impact of this training course on participants' self-efficacy with a focus on communication with both colleagues...

Semi-Supervised Classification for Fault Diagnosis in Nuclear Power Plants

International Nuclear Information System (INIS)

Ma, Jian Ping; Jiang, Jin

2014-01-01

Pattern classification methods have become important tools for fault diagnosis in industrial systems. However, it is normally difficult to obtain reliable labeled data to train a supervised pattern classification model for applications in a nuclear power plant (NPP). However, unlabeled data easily become available through increased deployment of supervisory, control, and data acquisition (SCADA) systems. In this paper, a fault diagnosis scheme based on semi-supervised classification (SSC) method is developed with specific applications for NPP. In this scheme, newly measured plant data are treated as unlabeled data. They are integrated with selected labeled data to train a SSC model which is then used to estimate labels of the new data. Compared to exclusive supervised approaches, the proposed scheme requires significantly less number of labeled data to train a classifier. Furthermore, it is shown that higher degree of uncertainties in the labeled data can be tolerated. The developed scheme has been validated using the data generated from a desktop NPP simulator and also from a physical NPP simulator using a graph-based SSC algorithm. Two case studies have been used in the validation process. In the first case study, three faults have been simulated on the desktop simulator. These faults have all been classified successfully with only four labeled data points per fault case. In the second case, six types of fault are simulated on the physical NPP simulator. All faults have been successfully diagnosed. The results have demonstrated that SSC is a promising tool for fault diagnosis

Improving the potential of pixel-based supervised classification in ...

African Journals Online (AJOL)

The goal of this paper was to describe the impact of various parameters when applying a supervised Maximum Likelihood Classifier (MLC) to SPOT 5 image analysis in a remote savanna biome. Pair separation indicators and probability thresholds were used to analyse the effect of training area size and heterogeneity as ...

The complexities of power in feminist multicultural psychotherapy supervision.

Science.gov (United States)

Arczynski, Alexis V; Morrow, Susan L

2017-03-01

The goal of the present study was to understand how current feminist multicultural supervisors understand and implement their feminist multicultural principles into clinical supervision. We addressed this aim by answering the following research question: How do self-identified feminist multicultural psychotherapy supervisors conceptualize and practice feminist supervision that is explicitly multicultural? The perspectives of 14 participant supervisors were obtained by using semistructured initial interviews, follow-up interviews, and feedback interviews and were investigated via a feminist constructivist grounded theory design and analysis. Most participants identified as counseling psychologists (n = 12), women (n = 11) and temporarily able-bodied (n = 11); but they identified with diverse racial/ethnic, sexual, spiritual/religious, generational, and nationality statuses. A 7-category empirical framework emerged that explained how the participants anticipated and managed power in supervision. The core category, the complexities of power in supervision, explained how participants conceptualized power in supervisory relationships. The 6 remaining categories were bringing history into the supervision room, creating trust through openness and honesty, using a collaborative process, meeting shifting developmental (a)symmetries, cultivating critical reflexivity, and looking at and counterbalancing the impact of context. Limitations of the study, implications for research, and suggestions to use the theoretical framework to transform supervisory practice and training are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Curing and caring competences in the skills training of physiotherapy students.

Science.gov (United States)

Dahl-Michelsen, Tone

2015-01-01

This article explores the significance of curing and caring competences in physiotherapy education, as well as how curing and caring competences intersect within the professional training of physiotherapy students. The empirical data include participant observations and interviews with students attending skills training in the first year of a bachelor's degree program in Norway. Curing and caring are conceptualized as gender-coded competences. That is, curing and caring are viewed as historical and cultural constructions of masculinities and femininities within the physiotherapy profession, as well as performative actions. The findings illuminate the complexity of curing and caring competences in the skills training of physiotherapy students. Curing and caring are both binary and intertwined competences; however, whereas binary competences are mostly concerned with contextual frames, intertwined competences are mostly concerned with performative aspects. The findings also point to how female and male students attend to curing and caring competences in similar ways; thus, the possibilities of transcending traditional gender norms turn out to be significant in this context. The findings suggest that, although curing somehow remains hegemonic to caring, the future generation of physiotherapists seemingly will be able to use their skills for both caring and curing.

Supervised Cross-Modal Factor Analysis for Multiple Modal Data Classification

KAUST Repository

Wang, Jingbin; Zhou, Yihua; Duan, Kanghong; Wang, Jim Jing-Yan; Bensmail, Halima

2015-01-01

. In this paper, we improve CFA by incorporating the supervision information to represent and classify both image and text modals of documents. We project both image and text data to a shared data space by factor analysis, and then train a class label predictor

A supervised contextual classifier based on a region-growth algorithm

DEFF Research Database (Denmark)

Lira, Jorge; Maletti, Gabriela Mariel

2002-01-01

A supervised classification scheme to segment optical multi-spectral images has been developed. In this classifier, an automated region-growth algorithm delineates the training sets. This algorithm handles three parameters: an initial pixel seed, a window size and a threshold for each class. A su...

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

African Journals Online (AJOL)

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

Perspectives on enhancing international practical training of students in health and social care study programs - A qualitative descriptive case study.

Science.gov (United States)

Hvalič-Touzery, Simona; Hopia, Hanna; Sihvonen, Sanna; Diwan, Sadhna; Sen, Soma; Skela-Savič, Brigita

2017-01-01

Internationalization of practical training in health and social care study programs is an important aspect of higher education. However, field mentors' and classroom teachers' competence in guiding culturally diverse students varies widely in European countries, and the majority does not have enough training in guiding foreign students. This study aimed to examine which factors enhance the efficacy of international practical placement experiences in health and social care study programs. A qualitative descriptive case study design was used. The study was conducted at six higher education institutions-two in Finland and one in Croatia, Estonia, the Netherlands and Slovenia. A convenience sample of 14 mentors, 15 teachers and 14 students with international experiences from six higher education institutions which are part of the Bologna Process was recruited. The data were collected from six focus groups using a semi-structured questionnaire based on a literature review. Each higher education institution conducted one group interview that was tape-recorded, transcribed and analysed for themes. Participants made several recommendations for enhancing the practical placement experience of students, teachers, and mentors. Most recommendations dealt with practical supervision of students. Three major themes noted were: 'Attitudes towards internationalization of practical placements', 'Factors impacting the international placement experience', and 'Pedagogical methods used and structural support available for internationalization.' The study highlights the need for strengthening the multicultural knowledge and skills of mentors and teachers. The findings provide practical guidelines for improving the international placement experience across health and social care fields. Copyright © 2016 Elsevier Ltd. All rights reserved.

Educating Occupational Therapists in the Use of Theory and Evidence to Enhance Supervision Practice

Directory of Open Access Journals (Sweden)

Melanie J. Roberts

2017-10-01

Full Text Available This paper describes the implementation of a unique learning experience aimed at enhancing the quality of supervision practice in occupational therapy at the Gold Coast Hospital and Health Service. The package was designed by experienced occupational therapy educators based on adult, blended, and flipped learning approaches with content developed following administration of a standardized tool and semi-structured interviews. The learning package focused particularly on the logistics of supervision and the use of occupational therapy theory and evidence with supervision. The training for supervising therapists included a workshop and pre and post workshop learning activities. This collaborative research approach to designing and implementing a learning package as well as the specific content of the ongoing education opportunities could also be transferred to other services.

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

Science.gov (United States)

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

2018-01-01

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

Outreach training model for accredited colorectal specialists in laparoscopic colorectal surgery: feasibility and evaluation of challenges.

Science.gov (United States)

Hamdan, M F; Day, A; Millar, J; Carter, F J C; Coleman, M G; Francis, N K

2015-07-01

The aim of this study was to explore the feasibility and safety of an outreach model of laparoscopic colorectal training of accredited specialists in advanced laparoscopic techniques and to explore the challenges of this model from the perspective of a National Training Programme (NTP) trainer. Prospective data were collected for unselected laparoscopic colorectal training procedures performed by five laparoscopic colorectal NTP trainees supervised by a single NTP trainer with an outreach model between 2009 and 2012. The operative and postoperative outcomes were compared with standard laparoscopic colorectal training procedures performed by six senior colorectal trainees under the supervision of the same NTP trainer within the same study period. The primary outcome was 30-day mortality. The Mann-Whitney test was used to compare continuous variables and the Chi squared or Fisher's exact tests were applied for the analysis of categorical variables. The level of statistical significance was set at P groups. Seventy-eight per cent of the patients operated on by the NTP trainees had had no previous abdominal surgery, compared with 50% in the supervised trainees' group (P = 0.0005). There were no significant differences in 30-day mortality or the operative and postoperative outcome between both groups. There were, however, difficulties in training an already established consultant in his or her own hospital and these were overcome by certain adjustments to the programme. Outreach laparoscopic training of colorectal surgeons is a feasible and safe model of training accredited specialists and does not compromise patient care. The challenges encountered can be overcome with optimum training and preparation. Colorectal Disease © 2015 The Association of Coloproctology of Great Britain and Ireland.

Webly-Supervised Fine-Grained Visual Categorization via Deep Domain Adaptation.

Science.gov (United States)

Xu, Zhe; Huang, Shaoli; Zhang, Ya; Tao, Dacheng

2018-05-01

Learning visual representations from web data has recently attracted attention for object recognition. Previous studies have mainly focused on overcoming label noise and data bias and have shown promising results by learning directly from web data. However, we argue that it might be better to transfer knowledge from existing human labeling resources to improve performance at nearly no additional cost. In this paper, we propose a new semi-supervised method for learning via web data. Our method has the unique design of exploiting strong supervision, i.e., in addition to standard image-level labels, our method also utilizes detailed annotations including object bounding boxes and part landmarks. By transferring as much knowledge as possible from existing strongly supervised datasets to weakly supervised web images, our method can benefit from sophisticated object recognition algorithms and overcome several typical problems found in webly-supervised learning. We consider the problem of fine-grained visual categorization, in which existing training resources are scarce, as our main research objective. Comprehensive experimentation and extensive analysis demonstrate encouraging performance of the proposed approach, which, at the same time, delivers a new pipeline for fine-grained visual categorization that is likely to be highly effective for real-world applications.

The effects of emotional intelligence training on the job performance of Australian aged care workers.

Science.gov (United States)

Karimi, Leila; Leggat, Sandra G; Bartram, Timothy; Rada, Jiri

2018-05-09

Emotional intelligence (EI) training is popular among human resource practitioners, but there is limited evidence of the impact of such training on health care workers. In the current article, we examine the effects of EI training on quality of resident care and worker well-being and psychological empowerment in an Australian aged care facility. We use Bar-On's (1997) conceptualization of EI. We used a quasiexperimental design in 2014-2015 with experimental (training) and control (nontraining) groups of 60 participants in each group in two geographically separate facilities. Our final poststudy sample size was 27 participants for the training group and 17 participants for the control group. Over a 6-month period, we examined whether staff improved their well-being, psychological empowerment, and job performance measured as enhanced quality of care (self-rated and client-rated) by applying skills in EI. The results showed significant improvement among workers in the training group for EI scores, quality of care, general well-being, and psychological empowerment. There were no significant differences for the control group. Through examining the impact of EI training on staff and residents of an aged care facility, we demonstrate the benefits of EI training for higher quality of care delivery. This study demonstrates the practical process through which EI training can improve the work experiences of aged care workers, as well as the quality of care for residents.

The effects of clinical supervision on supervisees and patients in cognitive behavioral therapy: a systematic review.

Science.gov (United States)

Alfonsson, Sven; Parling, Thomas; Spännargård, Åsa; Andersson, Gerhard; Lundgren, Tobias

2018-05-01

Clinical supervision is a central part of psychotherapist training but the empirical support for specific supervision theories or features is unclear. The aims of this study were to systematically review the empirical research literature regarding the effects of clinical supervision on therapists' competences and clinical outcomes within Cognitive Behavior Therapy (CBT). A comprehensive database search resulted in 4103 identified publications. Of these, 133 were scrutinized and in the end 5 studies were included in the review for data synthesis. The five studies were heterogeneous in scope and quality and only one provided firm empirical support for the positive effects of clinical supervision on therapists' competence. The remaining four studies suffered from methodological weaknesses, but provided some preliminary support that clinical supervision may be beneficiary for novice therapists. No study could show benefits from supervision for patients. The research literature suggests that clinical supervision may have some potential effects on novice therapists' competence compared to no supervision but the effects on clinical outcomes are still unclear. While bug-in-the-eye live supervision may be more effective than standard delayed supervision, the effects of specific supervision models or features are also unclear. There is a continued need for high-quality empirical studies on the effects of clinical supervision in psychotherapy.

Legislation and supervision

International Nuclear Information System (INIS)

1998-01-01

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

Good Undergraduate Dissertation Supervision: Perspectives of Supervisors and Dissertation Coordinators

Science.gov (United States)

Roberts, Lynne D.; Seaman, Kristen

2018-01-01

There is a paucity of research, training, and material available to support supervisors of undergraduate dissertation students. This article explores what "good" supervision might look like at this level. Interviews were conducted with eight new supervisors and six dissertation coordinators using a critical incident methodology. Thematic…

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

Science.gov (United States)

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

2014-12-08

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

A review of supervised object-based land-cover image classification

Science.gov (United States)

Ma, Lei; Li, Manchun; Ma, Xiaoxue; Cheng, Liang; Du, Peijun; Liu, Yongxue

2017-08-01

Object-based image classification for land-cover mapping purposes using remote-sensing imagery has attracted significant attention in recent years. Numerous studies conducted over the past decade have investigated a broad array of sensors, feature selection, classifiers, and other factors of interest. However, these research results have not yet been synthesized to provide coherent guidance on the effect of different supervised object-based land-cover classification processes. In this study, we first construct a database with 28 fields using qualitative and quantitative information extracted from 254 experimental cases described in 173 scientific papers. Second, the results of the meta-analysis are reported, including general characteristics of the studies (e.g., the geographic range of relevant institutes, preferred journals) and the relationships between factors of interest (e.g., spatial resolution and study area or optimal segmentation scale, accuracy and number of targeted classes), especially with respect to the classification accuracy of different sensors, segmentation scale, training set size, supervised classifiers, and land-cover types. Third, useful data on supervised object-based image classification are determined from the meta-analysis. For example, we find that supervised object-based classification is currently experiencing rapid advances, while development of the fuzzy technique is limited in the object-based framework. Furthermore, spatial resolution correlates with the optimal segmentation scale and study area, and Random Forest (RF) shows the best performance in object-based classification. The area-based accuracy assessment method can obtain stable classification performance, and indicates a strong correlation between accuracy and training set size, while the accuracy of the point-based method is likely to be unstable due to mixed objects. In addition, the overall accuracy benefits from higher spatial resolution images (e.g., unmanned aerial

Effects of online palliative care training on knowledge, attitude and satisfaction of primary care physicians.

Science.gov (United States)

Pelayo, Marta; Cebrián, Diego; Areosa, Almudena; Agra, Yolanda; Izquierdo, Juan Vicente; Buendía, Félix

2011-05-23

The Spanish Palliative Care Strategy recommends an intermediate level of training for primary care physicians in order to provide them with knowledge and skills. Most of the training involves face-to-face courses but increasing pressures on physicians have resulted in fewer opportunities for provision of and attendance to this type of training. The effectiveness of on-line continuing medical education in terms of its impact on clinical practice has been scarcely studied. Its effect in relation to palliative care for primary care physicians is currently unknown, in terms of improvement in patient's quality of life and main caregiver's satisfaction. There is uncertainty too in terms of any potential benefits of asynchronous communication and interaction among on-line education participants, as well as of the effect of the learning process.The authors have developed an on-line educational model for palliative care which has been applied to primary care physicians in order to measure its effectiveness regarding knowledge, attitude towards palliative care, and physician's satisfaction in comparison with a control group.The effectiveness evaluation at 18 months and the impact on the quality of life of patients managed by the physicians, and the main caregiver's satisfaction will be addressed in a different paper. Randomized controlled educational trial to compared, on a first stage, the knowledge and attitude of primary care physicians regarding palliative care for advanced cancer patients, as well as satisfaction in those who followed an on-line palliative care training program with tutorship, using a Moodle Platform vs. traditional education. 169 physicians were included, 85 in the intervention group and 84 in the control group, of which five were excluded. Finally 82 participants per group were analyzed. There were significant differences in favor of the intervention group, in terms of knowledge (mean 4.6; CI 95%: 2.8 to 6.5 (p = 0.0001), scale range 0-33), confidence

Effects of online palliative care training on knowledge, attitude and satisfaction of primary care physicians

Directory of Open Access Journals (Sweden)

Agra Yolanda

2011-05-01

Full Text Available Abstract Background The Spanish Palliative Care Strategy recommends an intermediate level of training for primary care physicians in order to provide them with knowledge and skills. Most of the training involves face-to-face courses but increasing pressures on physicians have resulted in fewer opportunities for provision of and attendance to this type of training. The effectiveness of on-line continuing medical education in terms of its impact on clinical practice has been scarcely studied. Its effect in relation to palliative care for primary care physicians is currently unknown, in terms of improvement in patient's quality of life and main caregiver's satisfaction. There is uncertainty too in terms of any potential benefits of asynchronous communication and interaction among on-line education participants, as well as of the effect of the learning process. The authors have developed an on-line educational model for palliative care which has been applied to primary care physicians in order to measure its effectiveness regarding knowledge, attitude towards palliative care, and physician's satisfaction in comparison with a control group. The effectiveness evaluation at 18 months and the impact on the quality of life of patients managed by the physicians, and the main caregiver's satisfaction will be addressed in a different paper. Methods Randomized controlled educational trial to compared, on a first stage, the knowledge and attitude of primary care physicians regarding palliative care for advanced cancer patients, as well as satisfaction in those who followed an on-line palliative care training program with tutorship, using a Moodle Platform vs. traditional education. Results 169 physicians were included, 85 in the intervention group and 84 in the control group, of which five were excluded. Finally 82 participants per group were analyzed. There were significant differences in favor of the intervention group, in terms of knowledge (mean 4.6; CI

Training of midwives in advanced obstetrics in Liberia.

Science.gov (United States)

Dolo, Obed; Clack, Alice; Gibson, Hannah; Lewis, Naomi; Southall, David P

2016-05-01

The shortage of doctors in Liberia limits the provision of comprehensive emergency obstetric and neonatal care. In a pilot project, two midwives were trained in advanced obstetric procedures and in the team approach to the in-hospital provision of advanced maternity care. The training took two years and was led by a Liberian consultant obstetrician with support from international experts. The training took place in CB Dunbar Maternity Hospital. This rural hospital deals with approximately 2000 deliveries annually, many of which present complications. In February 2015 there were just 117 doctors available in Liberia. In the first 18 months of training, the trainees were involved with 236 caesarean sections, 35 manual evacuations of products of conception, 25 manual removals of placentas, 21 vaginal breech deliveries, 14 vacuum deliveries, four repairs of ruptured uteri, the management of four cases of shoulder dystocia, three hysterectomies, two laparotomies for ruptured ectopic pregnancies and numerous obstetric ultrasound examinations. The trainees also managed 41 cases of eclampsia or severe pre-eclampsia, 25 of major postpartum haemorrhage and 21 of shock. Although, initially they only assisted senior doctors, the trainees subsequently progressed from direct to indirect supervision and then to independent management. To compensate for a shortage of doctors able to undertake comprehensive emergency obstetric and neonatal care, experienced midwives can be taught to undertake advanced obstetric care and procedures. Their team work with doctors can be particularly valuable in rural hospitals in resource-poor countries.

A pilot training programme for health and social care professionals providing oncological and palliative care to lesbian, gay and bisexual patients in Ireland.

LENUS (Irish Health Repository)

Reygan, Finn C G

2012-05-09

OBJECTIVE: The international literature points to the specific cancer risks and palliative care needs of lesbian, gay and bisexual (LGB) populations. However, with the exception of a programme in the USA, there is a lack of training internationally for health and social care professionals providing oncological and palliative care to LGB patients. In Ireland, a training project funded by the Irish Cancer Society, the Irish Hospice Foundation and the Health Service Executive developed a training pilot programme for health and social care professionals providing oncological and palliative care to LGB patients. METHODS: Over 200 (N = 201) oncology and palliative care staff participated in 17 brief, 50-min trainings in pilot sites. Evaluation of the training included self-report questionnaires at the end of each training and an evaluation interview with one participant from each of the four sites. RESULTS: The majority of participants reported that they would recommend the training to their colleagues, were interested in further training in the area and found the training useful for their practice. They also reported becoming more familiar with LGB-related language and terminology, became more knowledgeable of LGB health issues and reported becoming more confident in providing care to LGB patients. CONCLUSIONS: Recommendations are that the training be made available across the health services in Ireland and included in postgraduate courses for trainee health and social care professionals. Copyright © 2012 John Wiley & Sons, Ltd.

Collective academic supervision

DEFF Research Database (Denmark)

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

2013-01-01

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

Competencies and Training Guidelines for Behavioral Health Providers in Pediatric Primary Care.

Science.gov (United States)

Njoroge, Wanjiku F M; Williamson, Ariel A; Mautone, Jennifer A; Robins, Paul M; Benton, Tami D

2017-10-01

This article focuses on the cross-discipline training competencies needed for preparing behavioral health providers to implement integrated primary care services. After a review of current competencies in the disciplines of child and adolescent psychiatry, psychology, and social work, cross-cutting competencies for integrated training purposes are identified. These competencies are comprehensive and broad and can be modified for use in varied settings and training programs. An existing and successful integrated care training model, currently implemented at Children's Hospital of Philadelphia, is described. This model and the training competencies are discussed in the context of recommendations for future work and training. Copyright © 2017 Elsevier Inc. All rights reserved.

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

Science.gov (United States)

Hair, Heather J; Fine, Marshall

2012-10-01

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

Security system signal supervision

International Nuclear Information System (INIS)

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

1991-09-01

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

32 CFR 634.33 - Training of law enforcement personnel.

Science.gov (United States)

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Training of law enforcement personnel. 634.33 Section 634.33 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS MOTOR VEHICLE TRAFFIC SUPERVISION Traffic Supervision § 634.33 Training of law enforcement personnel. (a) A...

Treatment Foster Care Pre-Service Trainings: Changes in Parenting Attitudes and Fostering Readiness

Science.gov (United States)

Strickler, Amy; Trunzo, Annette C.; Kaelin, Michael S.

2018-01-01

Background: Pre-service training of treatment parents is a requirement for all foster care models to ensure safety and well-being of children in care. Researchers theorize treatment parents benefit more from enhanced pre-service trainings; however, no rigorous studies exist indicating the effectiveness of these trainings for treatment parents.…

Staff members' perceived training needs regarding sexuality in residential aged care facilities.

Science.gov (United States)

Villar, Feliciano; Celdrán, Montserrat; Fabà, Josep; Serrat, Rodrigo

2017-01-01

The purpose of the article is to ascertain if staff members of residential aged care facilities (RACF) perceive the need for training regarding residents' sexuality, and what, if any, benefits from the training were perceived, and to compare perceived benefits of training between care assistants and professional/managerial staff. Interviews were conducted with 53 staff members of five different RACF in Spain. Their responses to two semistructured questions were transcribed verbatim and submitted to content analysis. Results show that most interviewees said they lacked training about sexuality and aging. Two potential highlighted benefits of the training are knowledge/attitudinal (countering negative attitudes regarding sexuality) and procedural (developing common protocols and tools to manage situations related to sexuality). Care assistants and professional staff agreed on the need for training, though the former emphasized the procedural impact and the latter the knowledge/attitudinal benefits. The results suggest that RACF staff should have an opportunity to receive training on residents' sexuality, as sexual interest and behavior is a key dimension of residents' lives.

A Strength Training Program for Primary Care Patients, Central Pennsylvania, 2012

Science.gov (United States)

Patel, Vijay A.; Kraschnewski, Jennifer L.; Rovniak, Liza S.; Messina, Dino A.; Stuckey, Heather L.; Curry, William J.; Chuang, Cynthia H.; Sherwood, Lisa L.; Hess, Stacy L.

2014-01-01

Introduction Primary care providers can recommend strength training programs to use “Exercise as Medicine,” yet few studies have examined the interest of primary care patients in these programs. Methods We conducted a cross-sectional survey of primary care patients in central Pennsylvania. Interest in participating in free group-based strength training and weight control programs was assessed, in addition to patient demographics, medical history, and quality of life. Results Among 414 patients, most (61.0%) were aged 54 or older, and 64.0% were female. More patients were interested in a strength training program (55.3%) than in a weight control program (45.4%). Nearly three-quarters (72.8%) of those reporting 10 or more days of poor physical health were interested in a strength training program compared with 49.5% of those reporting no days of poor physical health. After adjusting for potential confounders, those reporting poorer physical health had 2.7 greater odds (95% confidence interval, 1.4–5.1) of being interested in a strength training program compared with those reporting better physical health. Patients with hypertension, diabetes, or high cholesterol were not more interested in a strength training program than those without these conditions. Conclusion Primary care practices may consider offering or referring patients to community-based strength training programs. This study observed high levels of interest in these widely available programs. Practices may also consider screening and referring those with poorer physical health, as they may be the most interested and have the most to gain from participating. PMID:24967829

Training community matrons in basic cognitive behavioural therapy-based techniques for patients with COPD.

Science.gov (United States)

Barker, David; Davies, Caroline; Dixon, Brendan; Hodgson, Amanda; Reay, Simon; Barclay, Nicola

2014-06-01

People with chronic obstructive pulmonary disease (COPD) experience anxiety and depression with a higher prevalence than the general population. Despite this, they are under-represented in mental health services on a national scale, but do regularly have contact with health-care professionals such as community matrons. We aimed to explore the process of CBT-based skills supervision and the practical implications for community matrons using CBT-based techniques with COPD clients as part of their standard practice. Twenty community matrons took part in a 2-day CBT-based skills training programme. Measurements of their knowledge and understanding of CBT-based skills were taken before and following the training. Additionally, they completed written feedback relating to the training. They were then supervised by CBT therapists for 6 months. Written feedback was obtained following this and some supervisors participated in a 1-hour focus group to discuss the process. Community matrons' knowledge and understanding of CBT-based techniques significantly improved following training, although findings did indicate that merely training did not always seamlessly translate into effective practice. Supervisor feedback suggested that it would be beneficial for community matrons to share positive practice of their use of basic CBT-based techniques among peers to maximise the perceived value of this approach.

A Supervised Classification Algorithm for Note Onset Detection

Directory of Open Access Journals (Sweden)

Douglas Eck

2007-01-01

Full Text Available This paper presents a novel approach to detecting onsets in music audio files. We use a supervised learning algorithm to classify spectrogram frames extracted from digital audio as being onsets or nononsets. Frames classified as onsets are then treated with a simple peak-picking algorithm based on a moving average. We present two versions of this approach. The first version uses a single neural network classifier. The second version combines the predictions of several networks trained using different hyperparameters. We describe the details of the algorithm and summarize the performance of both variants on several datasets. We also examine our choice of hyperparameters by describing results of cross-validation experiments done on a custom dataset. We conclude that a supervised learning approach to note onset detection performs well and warrants further investigation.

Man-machine supervision; Supervision homme-machine

Energy Technology Data Exchange (ETDEWEB)

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

2005-05-01

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

An evaluation of the 18- and 12-month basic postgraduate training programmes in Denmark

DEFF Research Database (Denmark)

Kjaer, Niels Kristian; Qvesel, Dorte; Kodal, Troels

2010-01-01

equipped and less ready for continued specialisation than doctors of the 18-month programme and they requested a downward adjustment of the learning objectives associated with the educational positions which follow their basic training. Physicians do not expect the increased focus on learning...... and new programmes evaluate their training, and it explores their attitudes towards the new postgraduate training programme. MATERIAL AND METHODS: We developed a questionnaire by which quantitative and qualitative data were collected. The questionnaire was sent to all physicians following basic...... and supervision to compensate for the six-month reduction of the training period. Internal medicine should be included in the basic postgraduate training of all physicians. Training in secondary as well as primary health care was requested. CONCLUSION: The young physicians were reluctant towards the new basic...

Seizure Classification From EEG Signals Using Transfer Learning, Semi-Supervised Learning and TSK Fuzzy System.

Science.gov (United States)

Jiang, Yizhang; Wu, Dongrui; Deng, Zhaohong; Qian, Pengjiang; Wang, Jun; Wang, Guanjin; Chung, Fu-Lai; Choi, Kup-Sze; Wang, Shitong

2017-12-01

Recognition of epileptic seizures from offline EEG signals is very important in clinical diagnosis of epilepsy. Compared with manual labeling of EEG signals by doctors, machine learning approaches can be faster and more consistent. However, the classification accuracy is usually not satisfactory for two main reasons: the distributions of the data used for training and testing may be different, and the amount of training data may not be enough. In addition, most machine learning approaches generate black-box models that are difficult to interpret. In this paper, we integrate transductive transfer learning, semi-supervised learning and TSK fuzzy system to tackle these three problems. More specifically, we use transfer learning to reduce the discrepancy in data distribution between the training and testing data, employ semi-supervised learning to use the unlabeled testing data to remedy the shortage of training data, and adopt TSK fuzzy system to increase model interpretability. Two learning algorithms are proposed to train the system. Our experimental results show that the proposed approaches can achieve better performance than many state-of-the-art seizure classification algorithms.

Good supervision and PBL

DEFF Research Database (Denmark)

Otrel-Cass, Kathrin

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

Supervision for School Psychologists in Training: Developing a Framework from Empirical Findings

Science.gov (United States)

Gibbs, Simon; Atkinson, Cathy; Woods, Kevin; Bond, Caroline; Hill, Vivian; Howe, Julia; Morris, Sue

2016-01-01

Similar to other professional disciplines, the importance of supervision within school psychology has attracted considerable attention within recent years. Despite this, systematic review of current literature reveals a dearth of empirical literature proposing underlying theoretical structures. This study extends recent qualitative research by…

Training hospital staff on spiritual care in palliative care influences patient-reported outcomes: Results of a quasi-experimental study.

Science.gov (United States)

van de Geer, Joep; Groot, Marieke; Andela, Richtsje; Leget, Carlo; Prins, Jelle; Vissers, Kris; Zock, Hetty

2017-09-01

Spiritual care is reported to be important to palliative patients. There is an increasing need for education in spiritual care. To measure the effects of a specific spiritual care training on patients' reports of their perceived care and treatment. A pragmatic controlled trial conducted between February 2014 and March 2015. The intervention was a specific spiritual care training implemented by healthcare chaplains to eight multidisciplinary teams in six hospitals on regular wards in which patients resided in both curative and palliative trajectories. In total, 85 patients were included based on the Dutch translation of the Supportive and Palliative Care Indicators Tool. Data were collected in the intervention and control wards pre- and post-training using questionnaires on physical symptoms, spiritual distress, involvement and attitudes (Spiritual Attitude and Involvement List) and on the perceived focus of healthcare professionals on patients' spiritual needs. All 85 patients had high scores on spiritual themes and involvement. Patients reported that attention to their spiritual needs was very important. We found a significant ( p = 0.008) effect on healthcare professionals' attention to patients' spiritual and existential needs and a significant ( p = 0.020) effect in favour of patients' sleep. No effect on the spiritual distress of patients or their proxies was found. The effects of spiritual care training can be measured using patient-reported outcomes and seemed to indicate a positive effect on the quality of care. Future research should focus on optimizing the spiritual care training to identify the most effective elements and developing strategies to ensure long-term positive effects. This study was registered at the Dutch Trial Register: NTR4559.

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

Directory of Open Access Journals (Sweden)

Wamae Annah

2009-07-01

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

A roadmap for acute care training of frontline Healthcare workers in LMICs.

Science.gov (United States)

Shah, Nirupa; Bhagwanjee, Satish; Diaz, Janet; Gopalan, P D; Appiah, John Adabie

2017-10-01

This 10-step roadmap outlines explicit procedures for developing, implementing and evaluating short focused training programs for acute care in low and middle income countries (LMICs). A roadmap is necessary to develop resilient training programs that achieve equivalent outcomes despite regional variability in human capacity and infrastructure. Programs based on the roadmap should address shortfalls in human capacity and access to care in the short term and establish the ground work for health systems strengthening in the long term. The primary targets for acute care training are frontline healthcare workers at the clinic level. The programs will differ from others currently available with respect to the timelines, triage method, therapeutic interventions and potential for secondary prevention. The roadmap encompasses multiple iterative cycles of the Plan-Do-Study-Act framework. Core features are integration of frontline trainees with the referral system while promoting research, quality improvement and evaluation from the bottom-up. Training programs must be evidence based, developed along action timelines and use adaptive training methods. A systems approach is essential because training programs that take cognizance of all factors that influence health care delivery have the potential to produce health systems strengthening (HSS). Copyright © 2017 Elsevier Inc. All rights reserved.

Optimizing lay counsellor services for chronic care in South Africa: a qualitative systematic review.

Science.gov (United States)

Petersen, Inge; Fairall, Lara; Egbe, Catherine O; Bhana, Arvin

2014-05-01

To conduct a qualitative systematic review on the use of lay counsellors in South Africa to provide lessons on optimizing their use for psychological and behavioural change counselling for chronic long-term care in scare-resource contexts. A qualitative systematic review of the literature on lay counsellor services in South Africa. Twenty-nine studies met the inclusion criteria. Five randomized control trials and two cohort studies reported that lay counsellors can provide behaviour change counselling with good outcomes. One multi-centre cohort study provided promising evidence of improved anti-retroviral treatment adherence and one non-randomized controlled study provided promising results for counselling for depression. Six studies found low fidelity of lay counsellor-delivered interventions in routine care. Reasons for low fidelity include poor role definition, inconsistent remuneration, lack of standardized training, and poor supervision and logistical support. Within resource-constrained settings, adjunct behaviour change and psychological services provided by lay counsellors can be harnessed to promote chronic care at primary health care level. Optimizing lay counsellor services requires interventions at an organizational level that provide a clear role definition and scope of practice; in-service training and formal supervision; and sensitization of health managers to the importance and logistical requirements of counselling. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Deployment of an in-house designed training process in a quaternary care hospital.

Science.gov (United States)

Kumar, Ajit; Bhatia, Saurabh; Chiang, I-Jen

2013-01-01

Healthcare providers, such as doctors and nurses, have been famous for high resistance to change. A careful change management plan, particularly training process, is utmost necessary. A quaternary care hospital in India changed its system, from manual to Electronic Medical Record/Health Information System (EMR/HIS). The hospital management wanted to train its 4000 diverse end-users on the EMR/HIS in two months' time. This paper describes an in-house designed training process and its deployment in the given healthcare organizational settings. We designed a training process named DRIPDA. The training process was deployed to train 4000 end-users of EMR/HIS, in the quaternary care hospital. Various factors, such as methods and tools of training, constraints of trainees, trainers, and organization were considered while deploying the training process. The effectiveness of the DRIPDA was assessed using the Kirkpatrick model. End-users received training on the new system only in 25% of estimated time and 28% of the projected expense, without having any distraction in their usual workflow, or any productivity loss. We found that the DRIPDA training process could train all employees effectively and efficiently. A decent training process can help in managing the change, thereby reduce the training time and cost.

Palliative Care Training in Cardiology Fellowship: A National Survey of the Fellows.

Science.gov (United States)

Dabbouseh, Noura M; Kaushal, Shivtej; Peltier, Wendy; Johnston, Fabian M

2018-02-01

To address perspectives of cardiology fellows on the current state of palliative education and palliative and hospice resource utilization within their fellowship experiences. We conducted an online national survey of cardiology fellows during the 2015 to 2016 academic year. Survey questions aimed to assess perceived importance of palliative care education, level of palliative care education during fellowship, and the structure of palliative care support at respondent institutions. Responses were collected anonymously. A total of 519 programs, including subspecialty programs, were contacted. We received 365 responses, a number that represents roughly 14% of all cardiology fellows nationwide during the 2015 to 2016 academic year. Fellows reported discordance in the quality of education between general cardiology and palliative care principles as it relates to care of the patient approaching the end of life. Fellows infrequently received explicit training nor were observed or mentored in delivering end-of-life discussions. Respondents reported an underutilization of palliative care and hospice resources during fellowship training and also a perception that attending faculty were not routinely addressing goals of care. Our survey results highlight a need for enhanced palliative care and end-of-life training experiences for cardiology fellows and also suggest underutilization of hospice and palliative care resources for patients with advanced cardiac diseases. These findings create a platform for future work that might: (1) confirm this training deficit, (2) lead to exploration of educational models that could reconcile this deficit, and (3) potentially help improve palliative care support for patients and families facing advanced heart disease.

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

Science.gov (United States)

McKellar, Lois; Graham, Kristen

2017-05-01

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

Participatory action research in the training of primary health care ...

African Journals Online (AJOL)

Participatory action research in the training of primary health care nurses in Venda. ... who had been part of the nurse training programme with clinic attenders. ... enough access to financial decision making and were therefore powerless to ...

Target discrimination method for SAR images based on semisupervised co-training

Science.gov (United States)

Wang, Yan; Du, Lan; Dai, Hui

2018-01-01

Synthetic aperture radar (SAR) target discrimination is usually performed in a supervised manner. However, supervised methods for SAR target discrimination may need lots of labeled training samples, whose acquirement is costly, time consuming, and sometimes impossible. This paper proposes an SAR target discrimination method based on semisupervised co-training, which utilizes a limited number of labeled samples and an abundant number of unlabeled samples. First, Lincoln features, widely used in SAR target discrimination, are extracted from the training samples and partitioned into two sets according to their physical meanings. Second, two support vector machine classifiers are iteratively co-trained with the extracted two feature sets based on the co-training algorithm. Finally, the trained classifiers are exploited to classify the test data. The experimental results on real SAR images data not only validate the effectiveness of the proposed method compared with the traditional supervised methods, but also demonstrate the superiority of co-training over self-training, which only uses one feature set.

Whither Supervision?

Directory of Open Access Journals (Sweden)

Duncan Waite

2006-11-01

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

[Training of health-care employees in crisis resource management].

Science.gov (United States)

Spanager, Lene; Østergaard, Doris; Lippert, Anne; Nielsen, Kurt; Dieckmann, Peter

2013-03-25

Studies show that human errors contribute to up to 70% of mistakes and mishaps in health care. Crisis resource management, CRM, is a conceptual framework for analysing and training individual and team skills in order to prevent and manage errors. Different CRM training methods, e.g. simulation, are in use and the literature emphasises the need of training the full team or organisation for maximal effect. CRM training has an effect on skill improvement, but few studies have shown an effect on patient outcome. However, these studies show great variability of quality.

Caring for older people with dementia: an exploratory study of staff knowledge and perception of training in three Australian dementia care facilities.

Science.gov (United States)

Jones, Cindy; Moyle, Wendy; Stockwell-Smith, Gillian

2013-03-01

To ascertain care staff's knowledge of dementia relating to aetiology and/or pathology, symptoms and care/treatment; and explore their perceptions of the importance and adequacy of dementia education and training opportunities. Thirty-five care staff working in three secure dementia care facilities were recruited. Dementia knowledge was surveyed using the Staff Knowledge of Dementia Test (SKDT). Perceptions of dementia education and training were examined via semi-structured individual interviews. An average of 21 out of 33 SKDT questions (SD = 4.0) was correctly answered. Knowledge discrepancy was attributed to participants' cultural and ethnic origin and the length of residency in Australia of migrant care staff. Participants acknowledged the importance of dementia education and training but were critical of the content relevancy to direct care practices. There is a need to improve care staff knowledge of dementia, and dementia education and training should include direct practical competencies required for effective care delivery. © 2012 The Authors. Australasian Journal on Ageing © 2012 ACOTA.

Automatic Classification Using Supervised Learning in a Medical Document Filtering Application.

Science.gov (United States)

Mostafa, J.; Lam, W.

2000-01-01

Presents a multilevel model of the information filtering process that permits document classification. Evaluates a document classification approach based on a supervised learning algorithm, measures the accuracy of the algorithm in a neural network that was trained to classify medical documents on cell biology, and discusses filtering…

The State of Neurocritical Care Fellowship Training and Attitudes toward Accreditation and Certification: A Survey of Neurocritical Care Fellowship Program Directors

Directory of Open Access Journals (Sweden)

Rajat Dhar

2017-11-01

Full Text Available Neurocritical care as a recognized and distinct subspecialty of critical care has grown remarkably since its inception in the 1980s. As of 2016, there were 61 fellowship training programs accredited by the United Council for Neurologic Subspecialties (UCNS in the United States and more than 1,000 UCNS-certified neurointensivists from diverse medical backgrounds. In late 2015, the Program Accreditation, Physician Certification, and Fellowship Training (PACT Committee of the Neurocritical Care Society (NCS was convened to promote and support excellence in the training and certification of neurointensivists. One of the first tasks of the committee was to survey neurocritical care fellowship training program directors to ascertain the current state of fellowship training and attitudes regarding transition to Accreditation Council for Graduate Medical Education (ACGME accreditation of training programs and American Board of Medical Specialties (ABMS certification of physicians. First, the survey revealed significant heterogeneities in the manner of neurocritical care training and a lack of consistency in requirements for fellow procedural competency. Second, although a majority of the 33 respondents indicated that a move toward ACGME accreditation/ABMS certification would facilitate further growth and mainstreaming of training in neurocritical care, many programs do not currently meet administrative requirements and do not receive the level of institutional support that would be needed for such a transition. In summary, the results revealed that there is an opportunity for future harmonization of training standards and that a transition to ACGME accreditation/ABMS certification is preferred. While the results reflect the opinions of more than half of the survey respondents, they represent only a small sample of neurointensivists.

Fellowship Training in the Emerging Fields of Fetal-Neonatal Neurology and Neonatal Neurocritical Care.

Science.gov (United States)

Smyser, Christopher D; Tam, Emily W Y; Chang, Taeun; Soul, Janet S; Miller, Steven P; Glass, Hannah C

2016-10-01

Neonatal neurocritical care is a growing and rapidly evolving medical subspecialty, with increasing numbers of dedicated multidisciplinary clinical, educational, and research programs established at academic institutions. The growth of these programs has provided trainees in neurology, neonatology, and pediatrics with increased exposure to the field, sparking interest in dedicated fellowship training in fetal-neonatal neurology. To meet this rising demand, increasing numbers of training programs are being established to provide trainees with the requisite knowledge and skills to independently deliver care for infants with neurological injury or impairment from the fetal care center and neonatal intensive care unit to the outpatient clinic. This article provides an initial framework for standardization of training across these programs. Recommendations include goals and objectives for training in the field; core areas where clinical competency must be demonstrated; training activities and neuroimaging and neurodiagnostic modalities which require proficiency; and programmatic requirements necessary to support a comprehensive and well-rounded training program. With consistent implementation, the proposed model has the potential to establish recognized standards of professional excellence for training in the field, provide a pathway toward Accreditation Council for Graduate Medical Education certification for program graduates, and lead to continued improvements in medical and neurological care provided to patients in the neonatal intensive care unit. Copyright © 2016 Elsevier Inc. All rights reserved.

Communication Skills Training Increases Self-Efficacy of Health Care Professionals

Science.gov (United States)

Norgaard, Birgitte; Ammentorp, Jette; Kyvik, Kirsten Ohm; Kofoed, Poul-Erik

2012-01-01

Introduction: Despite the knowledge of good communication as a precondition for optimal care and treatment in health care, serious communication problems are still experienced by patients as well as by health care professionals. An orthopedic surgery department initiated a 3-day communication skills training course for all staff members expecting…

Resistance to group clinical supervision

DEFF Research Database (Denmark)

Buus, Niels; Delgado, Cynthia; Traynor, Michael

2018-01-01

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

Analysis of safety supervision effect on coal mine using game theory

Energy Technology Data Exchange (ETDEWEB)

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

2006-07-01

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

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

Science.gov (United States)

Chen, Ke; Wang, Shihai

2011-01-01

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

A supervised learning rule for classification of spatiotemporal spike patterns.

Science.gov (United States)

Lilin Guo; Zhenzhong Wang; Adjouadi, Malek

2016-08-01

This study introduces a novel supervised algorithm for spiking neurons that take into consideration synapse delays and axonal delays associated with weights. It can be utilized for both classification and association and uses several biologically influenced properties, such as axonal and synaptic delays. This algorithm also takes into consideration spike-timing-dependent plasticity as in Remote Supervised Method (ReSuMe). This paper focuses on the classification aspect alone. Spiked neurons trained according to this proposed learning rule are capable of classifying different categories by the associated sequences of precisely timed spikes. Simulation results have shown that the proposed learning method greatly improves classification accuracy when compared to the Spike Pattern Association Neuron (SPAN) and the Tempotron learning rule.

Resist diabetes: A randomized clinical trial for resistance training maintenance in adults with prediabetes.

Science.gov (United States)

Davy, Brenda M; Winett, Richard A; Savla, Jyoti; Marinik, Elaina L; Baugh, Mary Elizabeth; Flack, Kyle D; Halliday, Tanya M; Kelleher, Sarah A; Winett, Sheila G; Williams, David M; Boshra, Soheir

2017-01-01

To determine whether a social cognitive theory (SCT)-based intervention improves resistance training (RT) maintenance and strength, and reduces prediabetes prevalence. Sedentary, overweight/obese (BMI: 25-39.9 kg/m2) adults aged 50-69 (N = 170) with prediabetes participated in the 15-month trial. Participants completed a supervised 3-month RT (2×/wk) phase and were randomly assigned (N = 159) to one of two 6-month maintenance conditions: SCT or standard care. Participants continued RT at a self-selected facility. The final 6-month period involved no contact. Assessments occurred at baseline and months 3, 9, and 15. The SCT faded-contact intervention consisted of nine tailored transition (i.e., supervised training to training alone) and nine follow-up sessions. Standard care involved six generic follow-up sessions. Primary outcomes were prevalence of normoglycemia and muscular strength. The retention rate was 76%. Four serious adverse events were reported. After 3 months of RT, 34% of participants were no longer prediabetic. This prevalence of normoglycemia was maintained through month 15 (30%), with no group difference. There was an 18% increase in the odds of being normoglycemic for each % increase in fat-free mass. Increases in muscular strength were evident at month 3 and maintained through month 15 (Pprediabetes prevalence in the SCT condition. Resistance training is an effective, maintainable strategy for reducing prediabetes prevalence and increasing muscular strength. Future research which promotes RT initiation and maintenance in clinical and community settings is warranted. ClinicalTrials.gov NCT01112709.

Care staff training based on person-centered care and dementia care mapping, and its effects on the quality of life of nursing home residents with dementia.

Science.gov (United States)

Yasuda, Mami; Sakakibara, Hisataka

2017-09-01

To assess the effects of care staff training based on person-centered care (PCC) and dementia care mapping (DCM) on the quality of life (QOL) of residents with dementia in a nursing home. An intervention of staff training based on PCC and DCM was conducted with 40 care staff members at a geriatric nursing home. The effects of the staff training on the QOL of residents with dementia were evaluated by the DCM measurements of 40 residents with dementia three times at about one-month intervals (first, baseline; second, pre-intervention; third, post-intervention). The well-being and ill-being values (WIB values) of the residents with dementia measured by DCM were not different between the first and second rounds before the staff training (p = 0.211). Meanwhile, the WIB values increased from the first and second rounds to the third post-intervention round (p = 0.035 and p Staff training based on PCC and DCM could effectively improve the QOL of residents with dementia.

Optimal preventive bank supervision

OpenAIRE

Belhaj, Mohamed; Klimenko, Nataliya

2012-01-01

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

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

Science.gov (United States)

Bondas, Terese

2010-05-01

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

Impact of communication skills training on parents perceptions of care: intervention study

DEFF Research Database (Denmark)

Ammentorp, Jette; Kofoed, Poul-Erik; Laulund, Lone W

2011-01-01

This paper is a report of a study of the effects of communication-skills training for healthcare professionals on parents' perceptions of information, care and continuity.......This paper is a report of a study of the effects of communication-skills training for healthcare professionals on parents' perceptions of information, care and continuity....

Self-Supervised Video Representation Learning With Odd-One-Out Networks : CVPR 2017 : 21-26 July 2016, Honolulu, Hawaii : proceedings

NARCIS (Netherlands)

Fernando, B.; Bilen, H.; Gavves, E.; Gould, S.

2017-01-01

We propose a new self-supervised CNN pre-training technique based on a novel auxiliary task called odd-one-out learning. In this task, the machine is asked to identify the unrelated or odd element from a set of otherwise related elements. We apply this technique to self-supervised video

Accelerated Training of Skilled Birth Attendants in a Marginalized Population on the Thai-Myanmar Border: A Multiple Methods Program Evaluation.

Directory of Open Access Journals (Sweden)

Adrienne Lynne White

Full Text Available To evaluate a skilled birth attendant (SBA training program in a neglected population on the Thai-Myanmar border, we used multiple methods to show that refugee and migrant health workers can be given effective training in their own environment to become SBAs and teachers of SBAs. The loss of SBAs through resettlement to third countries necessitated urgent training of available workers to meet local needs.All results were obtained from student records of theory grades and clinical log books. Qualitative evaluation of both the SBA and teacher programs was obtained using semi-structured interviews with supervisors and teachers. We also reviewed perinatal indicators over an eight-year period, starting prior to the first training program until after the graduation of the fourth cohort of SBAs.Four SBA training programs scheduled between 2009 and 2015 resulted in 79/88 (90% of students successfully completing a training program of 250 theory hours and 625 supervised clinical hours. All 79 students were able to: achieve pass grades on theory examination (median 80%, range [70-89]; obtain the required clinical experience within twelve months; achieve clinical competence to provide safe care during childbirth. In 2010-2011, five experienced SBAs completed a train-the-trainer (TOT program and went on to facilitate further training programs. Perinatal indicators within Shoklo Malaria Research Unit (SMRU, such as place of birth, maternal and newborn outcomes, showed no significant differences before and after introduction of training or following graduate deployment in the local maternity units. Confidence, competence and teamwork emerged from qualitative evaluation by senior SBAs working with and supervising students in the clinics.We demonstrate that in resource-limited settings or in marginalized populations, it is possible to accelerate training of skilled birth attendants to provide safe maternity care. Education needs to be tailored to local needs to

Supervised Learning

Science.gov (United States)

Rokach, Lior; Maimon, Oded

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

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

Science.gov (United States)

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

2013-04-01

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

Supervised machine learning and active learning in classification of radiology reports.

Science.gov (United States)

Nguyen, Dung H M; Patrick, Jon D

2014-01-01

This paper presents an automated system for classifying the results of imaging examinations (CT, MRI, positron emission tomography) into reportable and non-reportable cancer cases. This system is part of an industrial-strength processing pipeline built to extract content from radiology reports for use in the Victorian Cancer Registry. In addition to traditional supervised learning methods such as conditional random fields and support vector machines, active learning (AL) approaches were investigated to optimize training production and further improve classification performance. The project involved two pilot sites in Victoria, Australia (Lake Imaging (Ballarat) and Peter MacCallum Cancer Centre (Melbourne)) and, in collaboration with the NSW Central Registry, one pilot site at Westmead Hospital (Sydney). The reportability classifier performance achieved 98.25% sensitivity and 96.14% specificity on the cancer registry's held-out test set. Up to 92% of training data needed for supervised machine learning can be saved by AL. AL is a promising method for optimizing the supervised training production used in classification of radiology reports. When an AL strategy is applied during the data selection process, the cost of manual classification can be reduced significantly. The most important practical application of the reportability classifier is that it can dramatically reduce human effort in identifying relevant reports from the large imaging pool for further investigation of cancer. The classifier is built on a large real-world dataset and can achieve high performance in filtering relevant reports to support cancer registries. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Psykoterapi og supervision

DEFF Research Database (Denmark)

Jacobsen, Claus Haugaard

2014-01-01

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

Participation in Training for Depression Care Quality Improvement: A Randomized Trial of Community Engagement or Technical Support.

Science.gov (United States)

Chung, Bowen; Ngo, Victoria K; Ong, Michael K; Pulido, Esmeralda; Jones, Felica; Gilmore, James; Stoker-Mtume, Norma; Johnson, Megan; Tang, Lingqi; Wells, Kenneth Brooks; Sherbourne, Cathy; Miranda, Jeanne

2015-08-01

Community engagement and planning (CEP) could improve dissemination of depression care quality improvement in underresourced communities, but whether its effects on provider training participation differ from those of standard technical assistance, or resources for services (RS), is unknown. This study compared program- and staff-level participation in depression care quality improvement training among programs enrolled in CEP, which trained networks of health care and social-community agencies jointly, and RS, which provided technical support to individual programs. Matched programs from health care and social-community service sectors in two communities were randomly assigned to RS or CEP. Data were from 1,622 eligible staff members from 95 enrolled programs. Primary outcomes were any staff trained (for programs) and total hours of training (for staff). Secondary staff-level outcomes were hours of training in specific depression collaborative care components. CEP programs were more likely than RS programs to participate in any training (p=.006). Within health care sectors, CEP programs were more likely than RS programs to participate in training (p=.016), but within social-community sectors, there was no difference in training by intervention. Among staff who participated in training, mean training hours were greater among CEP programs versus RS programs for any type of training (ptraining related to each component of depression care (p<.001) except medication management. CEP may be an effective strategy to promote staff participation in depression care improvement efforts in underresourced communities.

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

Science.gov (United States)

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

2017-09-01

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

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

Directory of Open Access Journals (Sweden)

Mireia Peláez

2013-07-01

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

The impact of emergency obstetric care training in Somaliland, Somalia.

Science.gov (United States)

Ameh, Charles; Adegoke, Adetoro; Hofman, Jan; Ismail, Fouzia M; Ahmed, Fatuma M; van den Broek, Nynke

2012-06-01

To provide and evaluate in-service training in "Life Saving Skills - Emergency Obstetric and Newborn Care" in order to improve the availability of emergency obstetric care (EmOC) in Somaliland. In total, 222 healthcare providers (HCPs) were trained between January 2007 and December 2009. A before-after study was conducted using quantitative and qualitative methods to evaluate trainee reaction and change in knowledge, skills, and behavior, in addition to functionality of healthcare facilities, during and immediately after training, and at 3 and 6 months post-training. The HCPs reacted positively to the training, with a significant improvement in 50% of knowledge and 100% of skills modules assessed. The HCPs reported improved confidence in providing EmOC. Basic and comprehensive EmOC healthcare facilities provided 100% of expected signal functions-compared with 43% and 56%, respectively, at baseline-with trained midwives performing skills usually performed by medical doctors. Lack of drugs, supplies, medical equipment, and supportive policy were identified as barriers that could contribute to nonuse of new skills and knowledge acquired. The training impacted positively on the availability and quality of EmOC and resulted in "up-skilling" of midwives. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Mental health nurses' diabetes care skills - a training needs analysis.

Science.gov (United States)

Nash, Michael

2009-05-28

This article explores mental health nurses' diabetes training needs. A survey of inpatient and community mental health nurses was undertaken using a 16-item self-reporting questionnaire. Two hundred and twenty questionnaires were sent out and 138 returned, providing a response rate of 63%. Analysis shows that mental health nurses are currently involved in a range of diabetes care activities, however, their knowledge and skills may not be up to date. Mental health nurses also report the growing impact of diabetes care on their workload. Areas of identified training needs include taking blood glucose readings, giving dietary advice, liaison with diabetes nurse specialists and weight management. Mental health services and education providers need to consider developing specific training courses for mental health nurses.

75 FR 69686 - Advisory Committee on Training in Primary Care Medicine and Dentistry

Science.gov (United States)

2010-11-15

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Advisory Committee on Training in Primary Care Medicine and Dentistry AGENCY: Health Resources and Services... of the Advisory Committee on Training in Primary Care Medicine and Dentistry, November 15, 2010, 8:30...

Rethinking Educational Supervision

OpenAIRE

Burhanettin DÖNMEZ; Kadir BEYCİOĞLU

2009-01-01

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

A medical student in private practice for a 1-month clerkship: a qualitative exploration of the challenges for primary care clinical teachers

Directory of Open Access Journals (Sweden)

Muller-Juge V

2017-12-01

Full Text Available Virginie Muller-Juge, Anne Catherine Pereira Miozzari, Arabelle Rieder, Jennifer Hasselgård-Rowe, Johanna Sommer, Marie-Claude Audétat Unit of Primary Care, Faculty of Medicine, University of Geneva, Geneva, Switzerland Purpose: The predicted shortage of primary care physicians emphasizes the need to increase the family medicine workforce. Therefore, Swiss universities develop clerkships in primary care physicians’ private practices. The objective of this research was to explore the challenges, the stakes, and the difficulties of clinical teachers who supervised final year medical students in their primary care private practice during a 1-month pilot clerkship in Geneva.Methods: Data were collected via a focus group using a semistructured interview guide. Participants were asked about their role as a supervisor and their difficulties and positive experiences. The text of the focus group was transcribed and analyzed qualitatively, with a deductive and inductive approach.Results: The results show the nature of pressures felt by clinical teachers. First, participants experienced the difficulty of having dual roles: the more familiar one of clinician, and the new challenging one of teacher. Second, they felt compelled to fill the gap between the academic context and the private practice context. Clinical teachers were surprised by the extent of the adaptive load, cognitive load, and even the emotional load involved when supervising a trainee in their clinical practice. The context of this rotation demonstrated its utility and its relevance, because it allowed the students to improve their knowledge about the outpatient setting and to develop their professional autonomy and their maturity by taking on more clinical responsibilities.Conclusion: These findings show that future training programs will have to address the needs of clinical teachers as well as bridge the gap between students’ academic training and the skills needed for

Attitudes of anesthesiology residents toward critical care medicine training.

Science.gov (United States)

Durbin, C G; McLafferty, C L

1993-09-01

The number of anesthesiology residents pursuing critical care medicine (CCM) fellowship training has been decreasing in recent years. A significant number of training positions remain unfilled each year. Possible causes of this decline were evaluated by surveying residents regarding their attitudes toward practice and training in CCM. All 38 anesthesiology programs having accredited CCM fellowships were surveyed. Four of these and one program without CCM fellowships were used to develop the survey instrument. Four programs without CCM fellowships and 34 programs with CCM fellowships make up the survey group. Returned were 640 surveys from 37 (97%) programs accounting for over 30% of the possible residents. Resident interest in pursuing CCM training decreased as year of residency increased (P questions suggested resident concerns with the following: stress of chronic care, financial consequences of additional year of training, ICU call frequency and load, ICU role ambiguity, and shared decision-making in the ICU. A recurring question was, "Are there jobs (outside of academics) for anesthesiologist intensivists?" Most residents knew a CCM anesthesiologist they admired and knew that there were unfilled fellowship positions available. Defining the job market, improving curriculum and teaching, supporting deferment of student loans, and introducing residents and medical students to the ICU earlier may increase the interest in CCM practice among anesthesiology residents.

Sparse supervised principal component analysis (SSPCA) for dimension reduction and variable selection

DEFF Research Database (Denmark)

Sharifzadeh, Sara; Ghodsi, Ali; Clemmensen, Line H.

2017-01-01

Principal component analysis (PCA) is one of the main unsupervised pre-processing methods for dimension reduction. When the training labels are available, it is worth using a supervised PCA strategy. In cases that both dimension reduction and variable selection are required, sparse PCA (SPCA...

A blended design in acute care training: similar learning results, less training costs compared with a traditional format.

Science.gov (United States)

Dankbaar, Mary E W; Storm, Diana J; Teeuwen, Irene C; Schuit, Stephanie C E

2014-09-01

Introduction There is a demand for more attractive and efficient training programmes in postgraduate health care training. This retrospective study aims to show the effectiveness of a blended versus traditional face-to-face training design. For nurses in postgraduate Acute and Intensive Care training, the effectiveness of a blended course design was compared with a traditional design. Methods In a first pilot study 57 students took a traditional course (2-h lecture and 2-h workshop) and 46 students took a blended course (2-h lecture and 2-h online self-study material). Test results were compared for both groups. After positive results in the pilot study, the design was replicated for the complete programme in Acute and Intensive Care. Now 16 students followed the traditional programme (11 days face-to-face education) and 31 students did the blended programme (7 days face-to-face and 40 h online self-study). An evaluation was done after the pilot and course costs were calculated. Results Results show that the traditional and blended groups were similar regarding the main characteristics and did not differ in learning results for both the pilot and the complete programme. Student evaluations of both designs were positive; however, the blended group were more confident that they had achieved the learning objectives. Training costs were reduced substantially. Conclusion The blended training design offers an effective and attractive training solution, leading to a significant reduction in costs.

[Analysis of interventions designed to improve clinical supervision of student nurses in Benin].

Science.gov (United States)

Otti, André; Pirson, Magali; Piette, Danielle; Coppieters T Wallant, Yves

2017-12-05

The absence of an explicit and coherent conception of the articulation between theory and practice in the reform of nursing training in Benin has resulted in poor quality clinical supervision of student nurses. The objective of this article is to analyze two interventions designed to improve the quality of supervision. A student welcome booklet developed by means of a consultative and provocative participatory approach was tested with twelve student nurses versus a control group. Content analysis of the data collected by individual semi-directed interviews and during two focus groups demonstrated the value of this tool. Student nurses were also taught to use to training diaries inspired by the ?experiential learning? Training diaries were analysed using a grid based on the descriptive elements of the five types of Scheepers training diaries (2008). According to the student nurses, the welcome booklet provided them with structured information to be used as a reference during their training and a better understanding of their teachers, and allowed them to situate the resources of the training course with a lower level of stress. Fifty-eight per cent of the training diaries were are mosaics, reflecting the reflective practice and self-regulated learning of student nurses. This activity also promoted metacognitive dialogue with their supervisors. The student welcome booklet appeared to facilitate integration of student nurses into the clinical setting and promoted professional and organizational socialization. The training diary improved the quality of clinical learning by repeated reflective observation of student nurses and helped to maintain permanent communication with the supervisors.

Nonparametric Mixture Models for Supervised Image Parcellation.

Science.gov (United States)

Sabuncu, Mert R; Yeo, B T Thomas; Van Leemput, Koen; Fischl, Bruce; Golland, Polina

2009-09-01

We present a nonparametric, probabilistic mixture model for the supervised parcellation of images. The proposed model yields segmentation algorithms conceptually similar to the recently developed label fusion methods, which register a new image with each training image separately. Segmentation is achieved via the fusion of transferred manual labels. We show that in our framework various settings of a model parameter yield algorithms that use image intensity information differently in determining the weight of a training subject during fusion. One particular setting computes a single, global weight per training subject, whereas another setting uses locally varying weights when fusing the training data. The proposed nonparametric parcellation approach capitalizes on recently developed fast and robust pairwise image alignment tools. The use of multiple registrations allows the algorithm to be robust to occasional registration failures. We report experiments on 39 volumetric brain MRI scans with expert manual labels for the white matter, cerebral cortex, ventricles and subcortical structures. The results demonstrate that the proposed nonparametric segmentation framework yields significantly better segmentation than state-of-the-art algorithms.

Introduction of Syphilis Point-of-Care Tests, from Pilot Study to National Programme Implementation in Zambia: A Qualitative Study of Healthcare Workers' Perspectives on Testing, Training and Quality Assurance.

Directory of Open Access Journals (Sweden)

Éimhín M Ansbro

Full Text Available Syphilis affects 1.4 million pregnant women globally each year. Maternal syphilis causes congenital syphilis in over half of affected pregnancies, leading to early foetal loss, pregnancy complications, stillbirth and neonatal death. Syphilis is under-diagnosed in pregnant women. Point-of-care rapid syphilis tests (RST allow for same-day treatment and address logistical barriers to testing encountered with standard Rapid Plasma Reagin testing. Recent literature emphasises successful introduction of new health technologies requires healthcare worker (HCW acceptance, effective training, quality monitoring and robust health systems. Following a successful pilot, the Zambian Ministry of Health (MoH adopted RST into policy, integrating them into prevention of mother-to-child transmission of HIV clinics in four underserved Zambian districts. We compare HCW experiences, including challenges encountered in scaling up from a highly supported NGO-led pilot to a large-scale MoH-led national programme. Questionnaires were administered through structured interviews of 16 HCWs in two pilot districts and 24 HCWs in two different rollout districts. Supplementary data were gathered via stakeholder interviews, clinic registers and supervisory visits. Using a conceptual framework adapted from health technology literature, we explored RST acceptance and usability. Quantitative data were analysed using descriptive statistics. Key themes in qualitative data were explored using template analysis. Overall, HCWs accepted RST as learnable, suitable, effective tools to improve antenatal services, which were usable in diverse clinical settings. Changes in training, supervision and quality monitoring models between pilot and rollout may have influenced rollout HCW acceptance and compromised testing quality. While quality monitoring was integrated into national policy and training, implementation was limited during rollout despite financial support and mentorship. We

Introduction of Syphilis Point-of-Care Tests, from Pilot Study to National Programme Implementation in Zambia: A Qualitative Study of Healthcare Workers’ Perspectives on Testing, Training and Quality Assurance

Science.gov (United States)

Ansbro, Éimhín M.; Gill, Michelle M.; Reynolds, Joanna; Shelley, Katharine D.; Strasser, Susan; Sripipatana, Tabitha; Ncube, Alexander Tshaka; Tembo Mumba, Grace; Terris-Prestholt, Fern; Peeling, Rosanna W.; Mabey, David

2015-01-01

Syphilis affects 1.4 million pregnant women globally each year. Maternal syphilis causes congenital syphilis in over half of affected pregnancies, leading to early foetal loss, pregnancy complications, stillbirth and neonatal death. Syphilis is under-diagnosed in pregnant women. Point-of-care rapid syphilis tests (RST) allow for same-day treatment and address logistical barriers to testing encountered with standard Rapid Plasma Reagin testing. Recent literature emphasises successful introduction of new health technologies requires healthcare worker (HCW) acceptance, effective training, quality monitoring and robust health systems. Following a successful pilot, the Zambian Ministry of Health (MoH) adopted RST into policy, integrating them into prevention of mother-to-child transmission of HIV clinics in four underserved Zambian districts. We compare HCW experiences, including challenges encountered in scaling up from a highly supported NGO-led pilot to a large-scale MoH-led national programme. Questionnaires were administered through structured interviews of 16 HCWs in two pilot districts and 24 HCWs in two different rollout districts. Supplementary data were gathered via stakeholder interviews, clinic registers and supervisory visits. Using a conceptual framework adapted from health technology literature, we explored RST acceptance and usability. Quantitative data were analysed using descriptive statistics. Key themes in qualitative data were explored using template analysis. Overall, HCWs accepted RST as learnable, suitable, effective tools to improve antenatal services, which were usable in diverse clinical settings. Changes in training, supervision and quality monitoring models between pilot and rollout may have influenced rollout HCW acceptance and compromised testing quality. While quality monitoring was integrated into national policy and training, implementation was limited during rollout despite financial support and mentorship. We illustrate that new

Introduction of Syphilis Point-of-Care Tests, from Pilot Study to National Programme Implementation in Zambia: A Qualitative Study of Healthcare Workers' Perspectives on Testing, Training and Quality Assurance.

Science.gov (United States)

Ansbro, Éimhín M; Gill, Michelle M; Reynolds, Joanna; Shelley, Katharine D; Strasser, Susan; Sripipatana, Tabitha; Tshaka Ncube, Alexander; Tembo Mumba, Grace; Terris-Prestholt, Fern; Peeling, Rosanna W; Mabey, David

2015-01-01

Syphilis affects 1.4 million pregnant women globally each year. Maternal syphilis causes congenital syphilis in over half of affected pregnancies, leading to early foetal loss, pregnancy complications, stillbirth and neonatal death. Syphilis is under-diagnosed in pregnant women. Point-of-care rapid syphilis tests (RST) allow for same-day treatment and address logistical barriers to testing encountered with standard Rapid Plasma Reagin testing. Recent literature emphasises successful introduction of new health technologies requires healthcare worker (HCW) acceptance, effective training, quality monitoring and robust health systems. Following a successful pilot, the Zambian Ministry of Health (MoH) adopted RST into policy, integrating them into prevention of mother-to-child transmission of HIV clinics in four underserved Zambian districts. We compare HCW experiences, including challenges encountered in scaling up from a highly supported NGO-led pilot to a large-scale MoH-led national programme. Questionnaires were administered through structured interviews of 16 HCWs in two pilot districts and 24 HCWs in two different rollout districts. Supplementary data were gathered via stakeholder interviews, clinic registers and supervisory visits. Using a conceptual framework adapted from health technology literature, we explored RST acceptance and usability. Quantitative data were analysed using descriptive statistics. Key themes in qualitative data were explored using template analysis. Overall, HCWs accepted RST as learnable, suitable, effective tools to improve antenatal services, which were usable in diverse clinical settings. Changes in training, supervision and quality monitoring models between pilot and rollout may have influenced rollout HCW acceptance and compromised testing quality. While quality monitoring was integrated into national policy and training, implementation was limited during rollout despite financial support and mentorship. We illustrate that new

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

Science.gov (United States)

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

2008-01-01

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

MULTIPERIOD BANKING SUPERVISION

OpenAIRE

KARL-THEODOR EISELE; PHILIPPE ARTZNER

2013-01-01

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

The impact of staff training on staff outcomes in dementia care: a systematic review.

Science.gov (United States)

Spector, Aimee; Revolta, Catherine; Orrell, Martin

2016-11-01

Caring for people with dementia can be emotionally challenging and is often linked to low job satisfaction and burnout in care staff. Staff training within care settings is potentially valuable in improving well-being and quality of care. This review aimed to (i) establish the impact of training on staff outcomes; (ii) compare the impact of different training approaches; (iii) explore the influence of training intensity; and (iv) explore potential barriers to success. A database search of staff training interventions revealed 207 papers, 188 of which were excluded based on prespecified criteria. Nineteen studies were included and appraised using a quality rating tool. Overall, the studies were found to be of variable quality; however, 16 studies found a significant change following training in at least one staff domain, with knowledge improving most frequently. Approaches focusing on managing challenging behaviours appeared to be the most effective. Training staff can be an effective method of improving well-being, and programmes helping staff to manage challenging behaviour appear to be the most beneficial. There is no clear relationship between training intensity and outcome. Most studies point to the importance of addressing organisational factors as a barrier to change. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Clinical staff perceptions of palliative care-related quality of care, service access, education and training needs and delivery confidence in an acute hospital setting.

Science.gov (United States)

Frey, Rosemary; Gott, Merryn; Raphael, Deborah; O'Callaghan, Anne; Robinson, Jackie; Boyd, Michal; Laking, George; Manson, Leigh; Snow, Barry

2014-12-01

Central to appropriate palliative care management in hospital settings is ensuring an adequately trained workforce. In order to achieve optimum palliative care delivery, it is first necessary to create a baseline understanding of the level of palliative care education and support needs among all clinical staff (not just palliative care specialists) within the acute hospital setting. The objectives of the study were to explore clinical staff: perceptions concerning the quality of palliative care delivery and support service accessibility, previous experience and education in palliative care delivery, perceptions of their own need for formal palliative care education, confidence in palliative care delivery and the impact of formal palliative care training on perceived confidence. A purposive sample of clinical staff members (598) in a 710-bed hospital were surveyed regarding their experiences of palliative care delivery and their education needs. On average, the clinical staff rated the quality of care provided to people who die in the hospital as 'good' (x̄=4.17, SD=0.91). Respondents also reported that 19.3% of their time was spent caring for end-of-life patients. However, only 19% of the 598 respondents reported having received formal palliative care training. In contrast, 73.7% answered that they would like formal training. Perceived confidence in palliative care delivery was significantly greater for those clinical staff with formal palliative care training. Formal training in palliative care increases clinical staff perceptions of confidence, which evidence suggests impacts on the quality of palliative care provided to patients. The results of the study should be used to shape the design and delivery of palliative care education programmes within the acute hospital setting to successfully meet the needs of all clinical staff. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Are Undergraduate Nurses Taught Palliative Care during Their Training?

Science.gov (United States)

Lloyd-Williams, Mari; Field, David

2002-01-01

Responses from 46 of 108 nurse educators in the United Kingdom indicated that diploma students received a mean of 7.8 hours and degree students 12.2 hours of palliative care training. Although 82% believed it should be a core component, 67% had difficulty finding qualified teachers. Palliative care knowledge was not formally assessed in most…

A Supervision of Solidarity

Science.gov (United States)

Reynolds, Vikki

2010-01-01

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

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

Science.gov (United States)

Oktay, J S; Palley, H A

1991-05-01

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

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

African Journals Online (AJOL)

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

TRADE instructional materials for SARA/OSHA training. Volume 2, Managers and supervisors training

Energy Technology Data Exchange (ETDEWEB)

1989-03-01

This document provides instructional materials for an eight-hour training course for managers and supervisors of hazardous waste sites. It is one of three volumes of course materials TRADE is preparing to help DOE contractor training staff comply with 29 CFR 1910.120, the Occupational Health and Safety Administration (OSHA) rule that implements Title I of the Superfund Amendments and Reauthorization Act (SARA) of 1986. OSHA`s final rule for hazardous waste operators was published in the Federal Register of March 6, 1989 (54 FR 9294). Combined with the materials in Volumes I and III and with appropriate site-specific information, these materials will help DOE contractors to meet the requirements of 1910.120 (e) that ``on-site management and supervisors directly responsible for, or who supervise employees engaged in, hazardous waste operations`` receive the same initial training as that of the employees they supervise and at least eight additional hours of specialized training in managing hazardous waste operations.

Improving head and body pose estimation through semi-supervised manifold alignment

KAUST Repository

Heili, Alexandre

2014-10-27

In this paper, we explore the use of a semi-supervised manifold alignment method for domain adaptation in the context of human body and head pose estimation in videos. We build upon an existing state-of-the-art system that leverages on external labelled datasets for the body and head features, and on the unlabelled test data with weak velocity labels to do a coupled estimation of the body and head pose. While this previous approach showed promising results, the learning of the underlying manifold structure of the features in the train and target data and the need to align them were not explored despite the fact that the pose features between two datasets may vary according to the scene, e.g. due to different camera point of view or perspective. In this paper, we propose to use a semi-supervised manifold alignment method to bring the train and target samples closer within the resulting embedded space. To this end, we consider an adaptation set from the target data and rely on (weak) labels, given for example by the velocity direction whenever they are reliable. These labels, along with the training labels are used to bias the manifold distance within each manifold and to establish correspondences for alignment.

A National Survey of School Counselor Supervision Practices: Administrative, Clinical, Peer, and Technology Mediated Supervision

Science.gov (United States)

Perera-Diltz, Dilani M.; Mason, Kimberly L.

2012-01-01

Supervision is vital for personal and professional development of counselors. Practicing school counselors (n = 1557) across the nation were surveyed to explore current supervision practices. Results indicated that 41.1% of school counselors provide supervision. Although 89% receive some type of supervision, only 10.3% of school counselors receive…

Stochastic microstructure characterization and reconstruction via supervised learning

International Nuclear Information System (INIS)

Bostanabad, Ramin; Bui, Anh Tuan; Xie, Wei; Apley, Daniel W.; Chen, Wei

2016-01-01

Microstructure characterization and reconstruction have become indispensable parts of computational materials science. The main contribution of this paper is to introduce a general methodology for practical and efficient characterization and reconstruction of stochastic microstructures based on supervised learning. The methodology is general in that it can be applied to a broad range of microstructures (clustered, porous, and anisotropic). By treating the digitized microstructure image as a set of training data, we generically learn the stochastic nature of the microstructure via fitting a supervised learning model to it (we focus on classification trees). The fitted supervised learning model provides an implicit characterization of the joint distribution of the collection of pixel phases in the image. Based on this characterization, we propose two different approaches to efficiently reconstruct any number of statistically equivalent microstructure samples. We test the approach on five examples and show that the spatial dependencies within the microstructures are well preserved, as evaluated via correlation and lineal-path functions. The main advantages of our approach stem from having a compact empirically-learned model that characterizes the stochastic nature of the microstructure, which not only makes reconstruction more computationally efficient than existing methods, but also provides insight into morphological complexity.

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

Science.gov (United States)

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

Clinical neuropsychology practice and training in Canada.

Science.gov (United States)

Janzen, Laura A; Guger, Sharon

2016-11-01

This invited paper provides information about professional neuropsychology issues in Canada and is part of a special issue addressing international perspectives on education, training, and practice in clinical neuropsychology. Information was gathered from literature searches and personal communication with other neuropsychologists in Canada. Canada has a rich neuropsychological history. Neuropsychologists typically have doctoral-level education including relevant coursework and supervised practical experience. Licensure requirements vary across the 10 provinces and there are regional differences in salary. While training at the graduate and internship level mirrors that of our American colleagues, completion of a two-year postdoctoral fellowship in neuropsychology is not required to obtain employment in many settings and there are few postdoctoral training programs in this country. The majority of neuropsychologists are employed in institutional settings (e.g. hospitals, universities, rehabilitation facilities), with a growing number entering private practice or other settings. There are challenges in providing neuropsychological services to the diverse Canadian population and a need for assessment measures and normative data in multiple languages. Canadian neuropsychologists face important challenges in defining ourselves as distinct from other professions and other psychologists, in maintaining funding for high-quality training and research, in establishing neuropsychology-specific training and practice standards at the provincial or national level, and ensuring the clinical care that we provide is efficient and effective in meeting the needs of our patient populations and consumers, both within and outside of the publically funded health care system.

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

Science.gov (United States)

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

2013-01-01

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

Effects of supervised slackline training on postural instability, freezing of gait, and falls efficacy in people with Parkinson's disease.

Science.gov (United States)

Santos, Luis; Fernandez-Rio, Javier; Winge, Kristian; Barragán-Pérez, Beatriz; Rodríguez-Pérez, Vicente; González-Díez, Vicente; Blanco-Traba, Miguel; Suman, Oscar E; Philip Gabel, Charles; Rodríguez-Gómez, Javier

2017-08-01

The aim of this study was to assess whether supervised slackline training reduces the risk of falls in people with Parkinson's disease (PD). Twenty-two patients with idiopathic PD were randomized into experimental (EG, N = 11) and control (CG, N = 11) groups. Center of Pressure (CoP), Freezing of Gait (FOG), and Falls Efficacy Scale (FES) were assessed at pre-test, post-test and re-test. Rate perceived exertion (RPE, Borg's 6-20 scale) and local muscle perceived exertion (LRPE) were also assessed at the end of the training sessions. The EG group showed significant improvements in FOG and FES scores from pre-test to post-test. Both decreased at re-test, though they did not return to pre-test levels. No significant differences were detected in CoP parameters. Analysis of RPE and LRPE scores revealed that slackline was associated with minimal fatigue and involved the major lower limb and lumbar muscles. These findings suggest that slacklining is a simple, safe, and challenging training and rehabilitation tool for PD patients. It could be introduced into their physical activity routine to reduce the risk of falls and improve confidence related to fear of falling. Implications for Rehabilitation Individuals with Parkinson's disease (PD) are twice as likely to have falls compared to patients with other neurological conditions. This study support slackline as a simple, safe, and challenging training and rehabilitation tool for people with PD, which reduce their risk of falls and improve confidence related to fear of falling. Slackline in people with PD yields a low tiredness or fatigue impact and involves the major lower limb and lumbar muscles.

Evaluation of Multidisciplinary Tobacco Cessation Training Program in a Large Health Care System