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Sample records for variables practical implications

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

    Directory of Open Access Journals (Sweden)

    Stephanie J B Vos

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

  2. Psychological variables potentially implicated in opioid-related mortality as observed in clinical practice.

    Science.gov (United States)

    Passik, Steven D; Lowery, Amy

    2011-06-01

    Opioid-related deaths in the United States have become a public health problem, with accidental and unintended overdoses being especially troubling. Screening for psychological risk factors is an important first step in safeguarding against nonadherence practices and identifying patients who may be vulnerable to the risks associated with opioid therapy. Validated screening instruments can aid in this attempt as a complementary tool to clinicians' assessments. A structured screening is imperative as part of an assessment, as clinician judgment is not the most reliable method of identifying nonadherence. As a complement to formal screening, we present for discussion and possible future study certain psychological variables observed during years of clinical practice that may be linked to medication nonadherence and accidental overdose. These variables include catastrophizing, fear, impulsivity, attention deficit disorders, existential distress, and certain personality disorders. In our experience, chronic pain patients with dual diagnoses may become "chemical copers" as a way of coping with their negative emotion. For these patients, times of stress could lead to accidental overdose. Behavioral, cognitive-behavioral (acceptance and commitment, dialectical behavior), existential (meaning-centered, dignity), and psychotropic therapies have been effective in treating these high-risk comorbidities, while managing expectations of pain relief appears key to preventing accidental overdose. Wiley Periodicals, Inc.

  3. Mastication effects on the glycaemic index: impact on variability and practical implications.

    Science.gov (United States)

    Ranawana, V; Leow, M K-S; Henry, C J K

    2014-01-01

    Glycaemic variability challenges the accuracy and use of the glycaemic index (GI). The purpose of the current study was to determine the role of mastication on GI. Using a randomized, controlled, crossover, non-blind design, 15 healthy young subjects returned on 5 separate days for three glucose and two rice test sessions. At the rice sessions, subjects chewed each mouthful either 15 or 30 times. Rice chewed 15 times produced a total glycaemic response (GR; 155 mmol min/l), peak GR (2.4 mmol/l) and GI (68) significantly lower than when chewed for longer (30 times) (184 mmol min/l, 2.8 mmol/l and 88, respectively). The study shows that the GI of rice is affected by the degree of mastication. Chewing 15 times compared with 30 times significantly attenuates the GI, suggesting that mastication may potentially contribute to the glycaemic variability of rice. While future work must establish the extent and limits to which mastication affects glycaemia, it could also explore the potential of using mastication to reduce the glycaemic load of rice.

  4. Practical evaluation of action-angle variables

    International Nuclear Information System (INIS)

    Boozer, A.H.

    1984-02-01

    A practical method is described for establishing action-angle variables for a Hamiltonian system. That is, a given nearly integrable Hamiltonian is divided into an exactly integrable system plus a perturbation in action-angle form. The transformation of variables, which is carried out using a few short trajectory integrations, permits a rapid determination of trajectory properties throughout a phase space volume

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

    African Journals Online (AJOL)

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

  6. Practical implications of 'postmodern philosophy'

    Directory of Open Access Journals (Sweden)

    Savić Mile V.

    2002-01-01

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

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

    Science.gov (United States)

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

    2016-03-01

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

  8. Effects of practice variability on unimanual arm rotation.

    Science.gov (United States)

    James, Eric G; Conatser, Phillip

    2014-01-01

    High variability practice has been found to lead to a higher rate of motor learning than low variability practice in sports tasks. The authors compared the effects of low and high levels of practice variability on a simple unimanual arm rotation task. Participants performed rhythmic unimanual internal-external arm rotation as smoothly as possible before and after 2 weeks of low (LV) or high (HV) variability practice and after a 2-week retention interval. Compared to the pretest, the HV group significantly decreased hand, radioulnar, and shoulder rotation jerk on the retention test and shoulder jerk on the posttest. After training the LV group had lower radioulnar and shoulder jerk on the posttest but not the retention test. The results supported the hypothesis that high variability practice would lead to greater learning and reminiscence than low variability practice and the theoretical prediction of a bifurcation in the motor learning dynamics.

  9. Variable Speed Limit (VSL) - Best Management Practice

    Science.gov (United States)

    2012-07-01

    The Variable Speed Limit (VSL) system on the I-4 corridor in Orlando was implemented by Florida Department of Transportation in 2008, and since its deployment, it was revealed that the majority of traffic exceeds the speed limit by more mph when the ...

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

    African Journals Online (AJOL)

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

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

    African Journals Online (AJOL)

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

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

    Science.gov (United States)

    Sun, Miantao

    2010-01-01

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

  13. Some practical implications of source term reassessment

    International Nuclear Information System (INIS)

    1988-03-01

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

  14. Practical implications of neutron survey instrument performance

    International Nuclear Information System (INIS)

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

    2004-01-01

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

  15. Relative age effect: implications for effective practice.

    Science.gov (United States)

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

    2016-01-01

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

  16. Practical implications of the new risk perspectives

    International Nuclear Information System (INIS)

    Aven, Terje

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Adriana Benevides Soares

    2010-11-01

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

  18. Implementing Comprehensive Reform: Implications for Practice

    Science.gov (United States)

    Stout, Karen A.

    2016-01-01

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

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

    Science.gov (United States)

    Moller, Jorunn

    2006-01-01

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

  20. The problem of diagnostic variability in general practice.

    Science.gov (United States)

    Crombie, D L; Cross, K W; Fleming, D M

    1992-08-01

    The aim was to examine the scale, source, and relevance of variation between general practices in respect of the rates with which patients consulted with illnesses falling in each of several diagnostic groups. This study involved a general practice morbidity survey conducted over two years, 1970-72. All patients who consulted their general practitioners were identified and the number of these who consulted with diagnoses attributable to each of the 18 main chapters of the International classification of diseases were counted. Patients who consulted for more than one diagnosis within a chapter were counted once only; those who consulted for one or more diagnoses in each of several chapters were counted once for each chapter. This was a national survey involving general practitioners in England and Wales. The study involved 214,524 patients from 53 selected general practices (115 doctors) who were registered with their general practitioners for the whole of the year 1970-71 and for whom their morbidity data had been linked with their social data from the 1971 census. Using the numbers of patients on the practice lists as denominators, practice patient consulting rates (PPCR) were calculated for each practice and for each ICD chapter. Variability in chapter PPCR was examined by calculating coefficients of variation and, after allowance for random variation, coefficients of residual variation. There were large interpractice (doctor) variations in all chapter rates. These variations were only marginally attributable to: chance; different age, sex and social class mixes of practice populations; geographical locations; and practice organisation. The rates were, however, consistent from one year to the next for any one practice. Approximately half of the interpractice (doctor) diagnostic variability was associated with overall patient consulting behaviour. When the effects of this behaviour were discounted, any major residual diagnostic variability was confined largely to

  1. TECHNICAL AND PRACTICAL IMPLICATIONS OF SHORT SELLING

    Directory of Open Access Journals (Sweden)

    Radu BORES

    2016-07-01

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

  2. Medical Malpractice Implications of Clinical Practice Guidelines.

    Science.gov (United States)

    Ruhl, Douglas S; Siegal, Gil

    2017-08-01

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

  3. Age-Related Intraindividual Performance Variability with Practice

    Science.gov (United States)

    Miller, Suzanne Bonneau; Odell, Katharine H.

    2007-01-01

    Fluctuations in cognitive task performance in older individuals have been reported. To examine intraindividual variability as a function of practice, 34 younger and 34 older female participants, aged 20-30 years and 70-82 years, respectively, performed a reading span task 16 times over four sessions. Each individual's recall accuracy was analyzed…

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

    Science.gov (United States)

    Shanner, Laura

    2002-01-01

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

  5. Contemporary marketing practice : theoretical propositions and practical implications

    NARCIS (Netherlands)

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

    2004-01-01

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

  6. Implications of radiation risk for practical dosimetry

    International Nuclear Information System (INIS)

    Dennis, J.A.

    1984-01-01

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

  7. Reflective practice and its implications for pharmacy education.

    Science.gov (United States)

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

    2014-02-12

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

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

    International Nuclear Information System (INIS)

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

    1992-01-01

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

  9. Emergency department surge: models and practical implications.

    Science.gov (United States)

    Nager, Alan L; Khanna, Kajal

    2009-08-01

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

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

    Science.gov (United States)

    Lazenbatt, Anne; Greer, Jean

    2009-01-01

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

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

    African Journals Online (AJOL)

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

  12. Individual radiation sensitivity: implications in medical practice

    Energy Technology Data Exchange (ETDEWEB)

    Gisone, P.; Dubner, D.; Perez, M.D.R.; Michelin, S.; Di Giogio, M. [Autoridad Regulatoria Nuclear, Buenos Aires (Argentina); Bourguignon, M. [Direction Generale de la Surete Nucleaire et de la Radioprotection, Paris (France)

    2006-07-01

    Important advances in radiotherapy and nuclear medicine towards better treatment modalities and safer applications have taken place in recent years. Progress in medical imaging, better tumour targeting and optimization of radiation delivery have allowed for dose escalation and improved patient outcome. However, the tolerance of normal tissues constitutes the limiting factor for dose escalation in therapeutical uses of ionizing radiation (IR). Patients vary considerably in their normal tissue response to IR even after similar treatments. As many as 5% of cancer patients develop severe effects to external radiation therapy in normal tissues within the treatment field: they may include acute effects such as erythema and desquamation of the exposed skin and mucosa that appear during or directly after radiotherapy, late effects developed months or years later, such as fibrosis and telangiectasia and cancer induction. Several patient and treatment related factors are known to influence the variability of side effects, however up to a 70% of the total variance of normal tissue radiation response remained unexplained. Thus, individual sensitivity to IR, i.e. hypersensitivity to carcinogenic risks (stochastic effects) and hypersensitivity to deterministic effects, is becoming an important issue in oncology and raises questions regarding the underlying mechanisms. The mechanisms of DNA repair, the signalling pathways involved in radiation sensitivity and non-targeted effects are key aspects, essential to understanding radiation effects at genetic level. Moreover, human genetic diseases that combine higher incidence of cancer and hypersensitivity to IR are associated with defects in cell response to DNA damage. Therefore, much interest has raised during the last years in the developing of predictive tests capable to detect in advance such hypersensitive conditions. The goal of this presentation is to review the possible mechanisms involved in genetic and epigenetic

  13. Individual radiation sensitivity: implications in medical practice

    International Nuclear Information System (INIS)

    Gisone, P.; Dubner, D.; Perez, M.D.R.; Michelin, S.; Di Giogio, M.; Bourguignon, M.

    2006-01-01

    Important advances in radiotherapy and nuclear medicine towards better treatment modalities and safer applications have taken place in recent years. Progress in medical imaging, better tumour targeting and optimization of radiation delivery have allowed for dose escalation and improved patient outcome. However, the tolerance of normal tissues constitutes the limiting factor for dose escalation in therapeutical uses of ionizing radiation (IR). Patients vary considerably in their normal tissue response to IR even after similar treatments. As many as 5% of cancer patients develop severe effects to external radiation therapy in normal tissues within the treatment field: they may include acute effects such as erythema and desquamation of the exposed skin and mucosa that appear during or directly after radiotherapy, late effects developed months or years later, such as fibrosis and telangiectasia and cancer induction. Several patient and treatment related factors are known to influence the variability of side effects, however up to a 70% of the total variance of normal tissue radiation response remained unexplained. Thus, individual sensitivity to IR, i.e. hypersensitivity to carcinogenic risks (stochastic effects) and hypersensitivity to deterministic effects, is becoming an important issue in oncology and raises questions regarding the underlying mechanisms. The mechanisms of DNA repair, the signalling pathways involved in radiation sensitivity and non-targeted effects are key aspects, essential to understanding radiation effects at genetic level. Moreover, human genetic diseases that combine higher incidence of cancer and hypersensitivity to IR are associated with defects in cell response to DNA damage. Therefore, much interest has raised during the last years in the developing of predictive tests capable to detect in advance such hypersensitive conditions. The goal of this presentation is to review the possible mechanisms involved in genetic and epigenetic

  14. Global megatrends and their implications for environmental assessment practice

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-11-15

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

  15. Global megatrends and their implications for environmental assessment practice

    International Nuclear Information System (INIS)

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

    2016-01-01

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

  16. Clinical Implications of Glucose Variability: Chronic Complications of Diabetes

    Directory of Open Access Journals (Sweden)

    Hye Seung Jung

    2015-06-01

    Full Text Available Glucose variability has been identified as a potential risk factor for diabetic complications; oxidative stress is widely regarded as the mechanism by which glycemic variability induces diabetic complications. However, there remains no generally accepted gold standard for assessing glucose variability. Representative indices for measuring intraday variability include calculation of the standard deviation along with the mean amplitude of glycemic excursions (MAGE. MAGE is used to measure major intraday excursions and is easily measured using continuous glucose monitoring systems. Despite a lack of randomized controlled trials, recent clinical data suggest that long-term glycemic variability, as determined by variability in hemoglobin A1c, may contribute to the development of microvascular complications. Intraday glycemic variability is also suggested to accelerate coronary artery disease in high-risk patients.

  17. The relationship between selected variables and customer loyalty within an optometric practice environment

    Directory of Open Access Journals (Sweden)

    T. Van Vuuren

    2012-12-01

    Full Text Available Purpose: The purpose of the research that informed this article was to examine the relationship between customer satisfaction, trust, supplier image, commitment and customer loyalty within an optometric practice environment. Problem investigated: Optometric businesses need to adopt their strategies to enhance loyalty, as customer satisfaction is not enough to ensure loyalty and customer retention. An understanding of the variables influencing loyalty could help businesses within the optometric service environment to retain their customers and become more profitable. Methodology: The methodological approach followed was exploratory and quantitative in nature. The sample consisted of 357 customers who visited the practice twice or more over the previous six years. A structured questionnaire, with a five-point Likert scale, was fielded to gather the data. The descriptive and multiple regression analysis approach was used to analyse the results. Collinearity statistics and Pearson's correlation coefficient were also calculated to determine which independent variable has the largest influence on customer loyalty. Findings and implications: The main finding is that customer satisfaction had the highest correlation with customer loyalty. The other independent variables, however, also appear to significantly influence customer loyalty within an optometric practice environment. The implication is that optometric practices need to focus on customer satisfaction, trust, supplier image and commitment when addressing the improvement of customer loyalty. Originality and value of the research: The article contributes to the improvement of customer loyalty within a service business environment that could assist in facilitating larger market share, higher customer retention and greater profitability for the business over the long term.

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

    Science.gov (United States)

    Scheel, Matthew H

    2010-12-01

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

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

    Science.gov (United States)

    Weise, Kathryn L; Daly, Barbara J

    2014-01-01

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

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

    Science.gov (United States)

    Yavner, S B

    1989-01-01

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

  1. Sex as a Biological Variable in Emergency Medicine Research and Clinical Practice: A Brief Narrative Review

    Directory of Open Access Journals (Sweden)

    Alyson J. McGregor

    2017-10-01

    Full Text Available The National Institutes of Health recently highlighted the significant role of sex as a biological variable (SABV in research design, outcome and reproducibility, mandating that this variable be accounted for in all its funded research studies. This move has resulted in a rapidly increasing body of literature on SABV with important implications for changing the clinical practice of emergency medicine (EM. Translation of this new knowledge to the bedside requires an understanding of how sex-based research will ultimately impact patient care. We use three case-based scenarios in acute myocardial infarction, acute ischemic stroke and important considerations in pharmacologic therapy administration to highlight available data on SABV in evidence-based research to provide the EM community with an important foundation for future integration of patient sex in the delivery of emergency care as gaps in research are filled.

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

    Directory of Open Access Journals (Sweden)

    Bergin Michael

    2015-12-01

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

  3. Binge drinking among adolescents: prevalence, risk practices and related variables.

    Science.gov (United States)

    Golpe, Sandra; Isorna, Manuel; Barreiro, Carmen; Braña, Teresa; Rial, Antonio

    2017-09-29

    According to the last Survey on Drug Use among Secondary School Students (ESTUDES 2014-2015), consumption levels of alcohol and other substances have decreased in the last years in Spain. However, available data on binge drinking remain worrying, given the negative consequences related with this pattern. The aim of this paper is to analyse binge drinking among adolescents, providing updated data on prevalence in addition to information about the consequences and some predictive factors of binge drinking. A correlational method was used for this purpose, comprised of administering a survey to Compulsory Secondary School, High School and Vocational Training students. Based on a sample of 3,419 Galician adolescents aged between 12 and 18 years (M = 14.57; SD = 1.76), the results show that binge drinking is a common and global practice, with few socio-demographic differences but related with a wide range of risk practices. Furthermore, variables such as consumption expectancies, consumption by family and friends, as well as curfew time and allowance money have been identified as interesting predictive factors that should be taken into account at the preventive level.

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

    Science.gov (United States)

    Montenegro, Marisela

    2002-08-01

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

  5. Climate Change and Variability: Implications for Household Food ...

    African Journals Online (AJOL)

    These are drought, low annual rainfall, high temperature, and water shortage. The econometric model estimation result revealed the important factors determining household food security. These are household perception of climate change, use of soil and water conservation practices, use of livestock feed management ...

  6. Origins and implications of pluripotent stem cell variability and heterogeneity

    Science.gov (United States)

    Cahan, Patrick; Daley, George Q.

    2014-01-01

    Pluripotent stem cells constitute a platform to model disease and developmental processes and can potentially be used in regenerative medicine. However, not all pluripotent cell lines are equal in their capacity to differentiate into desired cell types in vitro. Genetic and epigenetic variations contribute to functional variability between cell lines and heterogeneity within clones. These genetic and epigenetic variations could ‘lock’ the pluripotency network resulting in residual pluripotent cells or alter the signalling response of developmental pathways leading to lineage bias. The molecular contributors to functional variability and heterogeneity in both embryonic stem (ES) cells and induced pluripotent stem (iPS) cells are only beginning to emerge, yet they are crucial to the future of the stem cell field. PMID:23673969

  7. Origins and implications of pluripotent stem cell variability and heterogeneity

    OpenAIRE

    Cahan, Patrick; Daley, George Q.

    2013-01-01

    Pluripotent stem cells constitute a platform to model disease and developmental processes and can potentially be used in regenerative medicine. However, not all pluripotent cell lines are equal in their capacity to differentiate into desired cell types in vitro. Genetic and epigenetic variations contribute to functional variability between cell lines and heterogeneity within clones. These genetic and epigenetic variations could ‘lock’ the pluripotency network resulting in residual pluripotent...

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

    Directory of Open Access Journals (Sweden)

    Zoran Milošević

    2010-09-01

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

  9. The implications of environmental variability on caribou demography: theoretical considerations

    Directory of Open Access Journals (Sweden)

    James A. Schaefer

    1991-10-01

    Full Text Available Random environmental influences, such as snow cover, are widely regarded as an integral feature of caribou population dynamics. We conducted computer simulations to explore the ramifications of such stochastic variability for caribou demography. We devised 4 models with increasing levels of complexity: Model 1, density-independence under different levels of stochasticity and r; Model 2, non-linear effect of snow cover on r; Model 3, non-linear effect of snow cover on r and stochasticity as a function of population size; and Model 4, non-linear effect of snow cover on r, stochasticity as a funciton of population size, and density-dependence according to the logistic equation. The results of Model 1 indicated that nearly all caribou populations subject only to environmental vagaries experienced either extincition or irruption. Model 2 revealed that non-linear effect of snow cover depressed the realised r as a function of population size. Finally, Model 4 suggested long-term population as previously reported in literature, but with reduced chance of overshooting K under moderate to high environmental variability.

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

    Science.gov (United States)

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

    2014-01-01

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

  11. Methods to quantify variable importance: implications for theanalysis of noisy ecological data

    OpenAIRE

    Murray, Kim; Conner, Mary M.

    2009-01-01

    Determining the importance of independent variables is of practical relevance to ecologists and managers concerned with allocating limited resources to the management of natural systems. Although techniques that identify explanatory variables having the largest influence on the response variable are needed to design management actions effectively, the use of various indices to evaluate variable importance is poorly understood. Using Monte Carlo simulations, we compared six different indices c...

  12. Heart rate variability and implication for sport concussion.

    Science.gov (United States)

    Bishop, Scott A; Dech, Ryan T; Guzik, Przemyslaw; Neary, J Patrick

    2017-11-16

    Finding sensitive and specific markers for sports-related concussion is both challenging and clinically important. Such biomarkers might be helpful in the management of patients with concussion (i.e. diagnosis, monitoring and risk prediction). Among many parameters, blood flow-pressure metrics and heart rate variability (HRV) have been used to gauge concussion outcomes. Reports on the relation between HRV and both acute and prolonged concussion recovery are conflicting. While some authors report on differences in the low-frequency (LF) component of HRV during postural manipulations and postexercise conditions, others observe no significant differences in various HRV measures. Despite the early success of using the HRV LF for concussion recovery, the interpretation of the LF is debated. Recent research suggests the LF power is a net effect of several intrinsic modulatory factors from both sympathetic and parasympathetic branches of the autonomic nervous system, vagally mediated baroreflex and even some respiratory influences at lower respiratory rate. There are only a few well-controlled concussion studies that specifically examine the contribution of the autonomic nervous system branches with HRV for concussion management. This study reviews the most recent HRV- concussion literature and the underlying HRV physiology. It also highlights cerebral blood flow studies related to concussion and the importance of multimodal assessment of various biological signals. It is hoped that a better understanding of the physiology behind HRV might generate cost-effective, repeatable and reliable protocols, all of which will improve the interpretation of HRV throughout concussion recovery. © 2017 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

  13. Interethnic variability and admixture in Latin America - social implications

    Directory of Open Access Journals (Sweden)

    Francisco M Salzano

    2004-09-01

    Full Text Available Past and present attempts to classify and characterize the human biological variability are examined, considering the race concept, ethnic identification problems, assortative mating based on ethnicity, and historical genetics. In relation to the latter, a review is made of the methods presently available for admixture quantification and of previous studies aimed at the characterization of the parental continental contributions to Latin American populations, with emphasis in global evaluations of the Costa Rican and Brazilian gene pools. Finally, the question of racism and discrimination is considered, including the relation between human rights and affirmative actions. The right to equal opportunity should be strictly respected. Biological inequality has nothing to do with the ethical principle that someone’s position in a given society should be an accurate reflection of her/his individual ability. Rev. Biol. Trop. 52(3: 405-415. Epub 2004 Dic 15Son examinados los intentos pasados y presentes de clasificar y caracterizar a la variabilidad biológica humana, considerando el concepto de raza, los problemas de identificación étnica, el matrimonio selectivo basado en la etnicidad, y la historia genética. En relación con la última, se hace una revisión de los métodos disponibles actualmente para la cuantificación de la mezcla y de los estudios previos enfocados en la caracterización de la contribuciones parentales de origen continental a las poblaciones Latinoamericanas, con énfasis en las evaluaciones globales de los acervos genéticos de de Brasil y Costa Rica. Finalmente, se considera el tema del racismo y la discriminación, incluyendo la relación entre los derechos humanos y las acciones afirmativas. El derecho a iguales oportunidades debe ser estrictamente respetado. La inequidad biológica no tiene nada que ver con el principio ético de que la posición de cualquiera en una sociedad dada debe ser un reflejo exacto de sus

  14. The effects of variable practice on locomotor adaptation to a novel asymmetric gait.

    Science.gov (United States)

    Hinkel-Lipsker, Jacob W; Hahn, Michael E

    2017-09-01

    Very little is known about the effects of specific practice on motor learning of predictive balance control during novel bipedal gait. This information could provide an insight into how the direction and magnitude of predictive errors during acquisition of a novel gait task influence transfer of balance control, as well as yield a practice protocol for the restoration of balance for those with locomotor impairments. This study examined the effect of a variable practice paradigm on transfer of a novel asymmetric gait pattern in able-bodied individuals. Using a split-belt treadmill, one limb was driven at a constant velocity (constant limb) and the other underwent specific changes in velocity (variable limb) during practice according to one of three prescribed practice paradigms: serial, where the variable limb velocity increased linearly; random blocked, where variable limb underwent random belt velocity changes every 20 strides; and random practice, where the variable limb underwent random step-to-step changes in velocity. Random practice showed the highest balance control variability during acquisition compared to serial and random blocked practice which demonstrated the best transfer of balance control on one transfer test. Both random and random blocked practices showed significantly less balance control variability during a second transfer test compared to serial practice. These results indicate that random blocked practice may be best for generalizability of balance control while learning a novel gait, perhaps, indicating that individuals who underwent this practice paradigm were able to find the most optimal balance control solution during practice.

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

    Science.gov (United States)

    Covell, Christine L; Sidani, Souraya

    2013-05-31

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

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

    Directory of Open Access Journals (Sweden)

    P. Gida

    2007-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Zoran Milošević

    2010-03-01

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

  18. Variable Speed Limit (VSL) - Best Management Practice [Summary

    Science.gov (United States)

    2012-01-01

    In variable speed limit (VSL) zones, the speed : limit changes in response to traffic congestion, : adverse weather, or road conditions. VSL zones are : often highly automated and have been employed : successfully in several U.S. and European : locat...

  19. Financial ratios in diagnostic radiology practices: variability and trends.

    Science.gov (United States)

    Hogan, Christopher; Sunshine, Jonathan H

    2004-03-01

    To evaluate variation in financial ratios for radiology practices nationwide and trends in these ratios and in payments. In 1999, the American College of Radiology surveyed radiology practices by mail. The final response rate was 66%. Weighting was used to make responses representative of all radiology practices in the United States. Self-reported financial ratios (payments, charges, accounts receivable turnover) were analyzed; 449 responses had usable data on these ratios. Comparison with results of a similar 1992 survey and combined analysis with Medicare data on billed charges provided information on trends. All measures of payment collections declined sharply from 1992 to 1999, with the gross collections rate (revenues as percentage of billed charges) decreasing from 71% to 55%. Average payment for a typical radiology service decreased approximately 4% in dollar terms or approximately 19% in inflation-adjusted terms. In 1999, nonmetropolitan practices appeared to fare better than others. Among insurers, Medicaid stood out as a low and slow payer, but neither managed care nor Medicare had a consistent effect on financial ratios. The gross collections rate varied substantially across geographic areas, as did, in an inverse pattern, the level of billed charges. One-quarter of practices had accounts receivable equal to 90 or more days of billings. The opposing geographic pattern of billed charges and gross collection rate suggests that geographic variation in the latter is driven more by variation in billed charges than by variation in payment levels. Radiologists saw a substantial decrease in the real (inflation-adjusted) value of payment per service during the 1990s. The large fraction of practices with accounts receivable of 90 or more days of billings-a level considered potentially imprudent by financial management advisors-suggests that many practices should improve financial management and that state prompt-payment laws have not had a substantial positive

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

    Science.gov (United States)

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

    2009-01-01

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

  1. Interactions In Online Education Implications For Theory & Practice

    Directory of Open Access Journals (Sweden)

    Askim KURT

    2007-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Jimmie Leppink, Ph.D.

    2017-10-01

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

  3. Practical implications of pre-employment nurse assessments.

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

    Vohra, Amit; Ladyshewsky, Richard; Trumble, Stephen

    2017-11-28

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

  5. Dissociable effects of practice variability on learning motor and timing skills.

    Science.gov (United States)

    Caramiaux, Baptiste; Bevilacqua, Frédéric; Wanderley, Marcelo M; Palmer, Caroline

    2018-01-01

    Motor skill acquisition inherently depends on the way one practices the motor task. The amount of motor task variability during practice has been shown to foster transfer of the learned skill to other similar motor tasks. In addition, variability in a learning schedule, in which a task and its variations are interweaved during practice, has been shown to help the transfer of learning in motor skill acquisition. However, there is little evidence on how motor task variations and variability schedules during practice act on the acquisition of complex motor skills such as music performance, in which a performer learns both the right movements (motor skill) and the right time to perform them (timing skill). This study investigated the impact of rate (tempo) variability and the schedule of tempo change during practice on timing and motor skill acquisition. Complete novices, with no musical training, practiced a simple musical sequence on a piano keyboard at different rates. Each novice was assigned to one of four learning conditions designed to manipulate the amount of tempo variability across trials (large or small tempo set) and the schedule of tempo change (randomized or non-randomized order) during practice. At test, the novices performed the same musical sequence at a familiar tempo and at novel tempi (testing tempo transfer), as well as two novel (but related) sequences at a familiar tempo (testing spatial transfer). We found that practice conditions had little effect on learning and transfer performance of timing skill. Interestingly, practice conditions influenced motor skill learning (reduction of movement variability): lower temporal variability during practice facilitated transfer to new tempi and new sequences; non-randomized learning schedule improved transfer to new tempi and new sequences. Tempo (rate) and the sequence difficulty (spatial manipulation) affected performance variability in both timing and movement. These findings suggest that there is a

  6. Demographic variables, clinical aspects, and medicolegal implications in a population of patients with adjustment disorder.

    Science.gov (United States)

    Anastasia, Annalisa; Colletti, Chiara; Cuoco, Valentina; Quartini, Adele; Urso, Stefania; Rinaldi, Raffaella; Bersani, Giuseppe

    2016-01-01

    Although adjustment disorder (AD) is considered as residual diagnosis and receives little attention in research, it plays an important role in clinical practice and also assumes an increasingly important role in the field of legal medicine, where the majority of diagnostic frameworks (eg, mobbing) often refer to AD. Our study aimed to look for specific stressor differences among demographic and clinical variables in a naturalistic setting of patients with AD. A restrospective statistical analysis of the data of patients diagnosed with AD from November 2009 to September 2012, identified via manual search from the archive of the outpatient setting at the University Unit of Psychiatry "A. Fiorini" Hospital, Terracina (Latina, Italy), was performed. The sample consisted of 93 patients (46 males and 47 females), aged between 26 and 85, with medium-high educational level who were mainly employed. In most cases (54.80%), a diagnosis of AD with mixed anxiety and depressed mood was made. In all, 72% of the sample reported a negative family history for psychiatric disorders. In 22.60%, a previous history of psychopathology, especially mood disorders (76.19%), was reported. The main stressors linked to the development of AD were represented by working problems (32.30%), family problems (23.70%), and/or somatic disease (22.60%) with significant differences with respect to age and sex. Half of the patients were subjected to a single first examination; 24.47% requested a copy of medical records. Confirming previous data from previous reports, our results suggest that AD may have a distinct profile in demographic and clinical terms. Increased scientific attention is hoped, particularly focused on addressing a better definition of diagnostic criteria, whose correctness and accuracy are critical, especially in situations with medicolegal implications.

  7. Arctic sea ice trends, variability and implications for seasonal ice forecasting.

    Science.gov (United States)

    Serreze, Mark C; Stroeve, Julienne

    2015-07-13

    September Arctic sea ice extent over the period of satellite observations has a strong downward trend, accompanied by pronounced interannual variability with a detrended 1 year lag autocorrelation of essentially zero. We argue that through a combination of thinning and associated processes related to a warming climate (a stronger albedo feedback, a longer melt season, the lack of especially cold winters) the downward trend itself is steepening. The lack of autocorrelation manifests both the inherent large variability in summer atmospheric circulation patterns and that oceanic heat loss in winter acts as a negative (stabilizing) feedback, albeit insufficient to counter the steepening trend. These findings have implications for seasonal ice forecasting. In particular, while advances in observing sea ice thickness and assimilating thickness into coupled forecast systems have improved forecast skill, there remains an inherent limit to predictability owing to the largely chaotic nature of atmospheric variability. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

  8. Within-otolith variability in chemical fingerprints: implications for sampling designs and possible environmental interpretation.

    Science.gov (United States)

    Di Franco, Antonio; Bulleri, Fabio; Pennetta, Antonio; De Benedetto, Giuseppe; Clarke, K Robert; Guidetti, Paolo

    2014-01-01

    Largely used as a natural biological tag in studies of dispersal/connectivity of fish, otolith elemental fingerprinting is usually analyzed by laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS). LA-ICP-MS produces an elemental fingerprint at a discrete time-point in the life of a fish and can generate data on within-otolith variability of that fingerprint. The presence of within-otolith variability has been previously acknowledged but not incorporated into experimental designs on the presumed, but untested, grounds of both its negligibility compared to among-otolith variability and of spatial autocorrelation among multiple ablations within an otolith. Here, using a hierarchical sampling design of spatial variation at multiple scales in otolith chemical fingerprints for two Mediterranean coastal fishes, we explore: 1) whether multiple ablations within an otolith can be used as independent replicates for significance tests among otoliths, and 2) the implications of incorporating within-otolith variability when assessing spatial variability in otolith chemistry at a hierarchy of spatial scales (different fish, from different sites, at different locations on the Apulian Adriatic coast). We find that multiple ablations along the same daily rings do not necessarily exhibit spatial dependency within the otolith and can be used to estimate residual variability in a hierarchical sampling design. Inclusion of within-otolith measurements reveals that individuals at the same site can show significant variability in elemental uptake. Within-otolith variability examined across the spatial hierarchy identifies differences between the two fish species investigated, and this finding leads to discussion of the potential for within-otolith variability to be used as a marker for fish exposure to stressful conditions. We also demonstrate that a 'cost'-optimal allocation of sampling effort should typically include some level of within-otolith replication in the

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

    Science.gov (United States)

    Jago, Suzanne; Radford, Julie

    2017-01-01

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

  10. Demographic variables, clinical aspects, and medicolegal implications in a population of patients with adjustment disorder

    Directory of Open Access Journals (Sweden)

    Anastasia A

    2016-04-01

    Full Text Available Annalisa Anastasia,1 Chiara Colletti,1 Valentina Cuoco,1 Adele Quartini,1 Stefania Urso,2 Raffaella Rinaldi,2 Giuseppe Bersani1 1Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Sapienza University of Rome, 2Department of Anatomical, Istological, Forensic and Locomotor System Sciences, Sapienza University of Rome, Rome, Italy Introduction: Although adjustment disorder (AD is considered as residual diagnosis and receives little attention in research, it plays an important role in clinical practice and also assumes an increasingly important role in the field of legal medicine, where the majority of diagnostic frameworks (eg, mobbing often refer to AD. Our study aimed to look for specific stressor differences among demographic and clinical variables in a naturalistic setting of patients with AD.Methods: A restrospective statistical analysis of the data of patients diagnosed with AD from November 2009 to September 2012, identified via manual search from the archive of the outpatient setting at the University Unit of Psychiatry “A. Fiorini” Hospital, Terracina (Latina, Italy, was performed.Results: The sample consisted of 93 patients (46 males and 47 females, aged between 26 and 85, with medium–high educational level who were mainly employed. In most cases (54.80%, a diagnosis of AD with mixed anxiety and depressed mood was made. In all, 72% of the sample reported a negative family history for psychiatric disorders. In 22.60%, a previous history of psychopathology, especially mood disorders (76.19%, was reported. The main stressors linked to the development of AD were represented by working problems (32.30%, family problems (23.70%, and/or somatic disease (22.60% with significant differences with respect to age and sex. Half of the patients were subjected to a single first examination; 24.47% requested a copy of medical records.Conclusion: Confirming previous data from previous reports, our results

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

    African Journals Online (AJOL)

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

  12. Recently studied sedimentary records from the eastern Arabian Sea: Implications to Holocene monsoonal variability

    Digital Repository Service at National Institute of Oceanography (India)

    Agnihotri, R.; Kurian, S.

    stream_size 72460 stream_content_type text/plain stream_name Earth_Sci_India_1_258.pdf.txt stream_source_info Earth_Sci_India_1_258.pdf.txt Content-Encoding UTF-8 Content-Type text/plain; charset=UTF-8 Agnihotri http://www....earthscienceindia.info/Agnihotri.htm 1 of 14 10/15/2008 9:41 AM Earth Science India Vol.1 (IV), October, 2008, pp. 258-287 http://www.earthscienceindia.info/ Recently studied sedimentary records from the eastern Arabian Sea: Implications to Holocene monsoonal variability Rajesh...

  13. Internal versus external controls on age variability: Definitions, origins and implications in a changing climate

    Science.gov (United States)

    Harman, C. J.

    2015-12-01

    The unsteadiness of stream water age is now well established, but the controls on the age dynamics, and the adequate representation and prediction of those dynamics, are not. A basic distinction can be made between internal variability that arises from changes in the proportions of flow moving through the diverse flow pathways of a hydrologic system, and external variability that arises from the stochasticity of inputs and outputs (such as precipitation and streamflow). In this talk I will show how these two types of age variability can be formally defined and distinguished within the framework of rank StorAge Selection (rSAS) functions. Internal variability implies variations in time in the rSAS function, while external variability does not. This leads naturally to the definition of several modes of internal variability, reflecting generic ways that system flowpaths may be rearranged. This rearrangement may be induced by fluctuations in the system state (such as catchment wetness), or by longer-term changes in catchment structure (such as land use change). One type of change, the 'inverse storage effect' is characterized by an increase in the release of young water from the system in response to an increase in overall system storage. This effect can be seen in many hydrologic settings, and has important implications for the effect of altered hydroclimatic conditions on solute transport through a landscape. External variability, such as increased precipitation, can induce a decrease in mean transit time (and vice versa), but this effect is greatly enhanced if accompanied by an internal shift in flow pathways that increases the relative importance of younger water. These effects will be illustrated using data from field and experimental studies.

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

    Science.gov (United States)

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

    2009-09-01

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

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

    Science.gov (United States)

    Hershenberg, Rachel; Goldfried, Marvin R

    2015-03-01

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

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

    Science.gov (United States)

    Ostrov, Jamie M.; Godleski, Stephanie A.

    2007-01-01

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

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

    Science.gov (United States)

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

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

    NARCIS (Netherlands)

    Scheerens, Jaap; Scheerens, Jaap

    2017-01-01

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

  19. Practical implications of empirically studying moral decision making

    NARCIS (Netherlands)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2009-01-01

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

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

    Science.gov (United States)

    Ehrlich, Alison; Kostecki, James; Olkaba, Helen

    2017-10-01

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

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

    Science.gov (United States)

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

    2018-02-01

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

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

    Science.gov (United States)

    Baker, C

    1997-09-01

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

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

    Science.gov (United States)

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

    1995-01-01

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

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

    Science.gov (United States)

    Moring, Camilla; Lloyd, Annemaree

    2013-01-01

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

  6. Within-otolith variability in chemical fingerprints: implications for sampling designs and possible environmental interpretation.

    Directory of Open Access Journals (Sweden)

    Antonio Di Franco

    Full Text Available Largely used as a natural biological tag in studies of dispersal/connectivity of fish, otolith elemental fingerprinting is usually analyzed by laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS. LA-ICP-MS produces an elemental fingerprint at a discrete time-point in the life of a fish and can generate data on within-otolith variability of that fingerprint. The presence of within-otolith variability has been previously acknowledged but not incorporated into experimental designs on the presumed, but untested, grounds of both its negligibility compared to among-otolith variability and of spatial autocorrelation among multiple ablations within an otolith. Here, using a hierarchical sampling design of spatial variation at multiple scales in otolith chemical fingerprints for two Mediterranean coastal fishes, we explore: 1 whether multiple ablations within an otolith can be used as independent replicates for significance tests among otoliths, and 2 the implications of incorporating within-otolith variability when assessing spatial variability in otolith chemistry at a hierarchy of spatial scales (different fish, from different sites, at different locations on the Apulian Adriatic coast. We find that multiple ablations along the same daily rings do not necessarily exhibit spatial dependency within the otolith and can be used to estimate residual variability in a hierarchical sampling design. Inclusion of within-otolith measurements reveals that individuals at the same site can show significant variability in elemental uptake. Within-otolith variability examined across the spatial hierarchy identifies differences between the two fish species investigated, and this finding leads to discussion of the potential for within-otolith variability to be used as a marker for fish exposure to stressful conditions. We also demonstrate that a 'cost'-optimal allocation of sampling effort should typically include some level of within

  7. Nursing practice implications of the year of ethics.

    Science.gov (United States)

    Harris, Karen T

    2015-01-01

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

  8. Survey of French spine surgeons reveals significant variability in spine trauma practices in 2013.

    Science.gov (United States)

    Lonjon, G; Grelat, M; Dhenin, A; Dauzac, C; Lonjon, N; Kepler, C K; Vaccaro, A R

    2015-02-01

    In France, attempts to define common ground during spine surgery meetings have revealed significant variability in clinical practices across different schools of surgery and the two specialities involved in spine surgery, namely, neurosurgery and orthopaedic surgery. To objectively characterise this variability by performing a survey based on a fictitious spine trauma case. Our working hypothesis was that significant variability existed in trauma practices and that this variability was related to a lack of strong scientific evidence in spine trauma care. We performed a cross-sectional survey based on a clinical vignette describing a 31-year-old male with an L1 burst fracture and neurologic symptoms (numbness). Surgeons received the vignette and a 14-item questionnaire on the management of this patient. For each question, surgeons had to choose among five possible answers. Differences in answers across surgeons were assessed using the Index of Qualitative Variability (IQV), in which 0 indicates no variability and 1 maximal variability. Surgeons also received a questionnaire about their demographics and surgical experience. Of 405 invited spine surgeons, 200 responded to the survey. Five questions had an IQV greater than 0.9, seven an IQV between 0.5 and 0.9, and two an IQV lower than 0.5. Variability was greatest about the need for MRI (IQV=0.93), degree of urgency (IQV=0.93), need for fusion (IQV=0.92), need for post-operative bracing (IQV=0.91), and routine removal of instrumentation (IQV=0.94). Variability was lowest for questions about the need for surgery (IQV=0.42) and use of the posterior approach (IQV=0.36). Answers were influenced by surgeon specialty, age, experience level, and type of centre. Clinical practice regarding spine trauma varies widely in France. Little published evidence is available on which to base recommendations that would diminish this variability. Copyright © 2015. Published by Elsevier Masson SAS.

  9. Improving statistical reasoning theoretical models and practical implications

    CERN Document Server

    Sedlmeier, Peter

    1999-01-01

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

  10. Probabilistic Requirements (Partial) Verification Methods Best Practices Improvement. Variables Acceptance Sampling Calculators: Empirical Testing. Volume 2

    Science.gov (United States)

    Johnson, Kenneth L.; White, K. Preston, Jr.

    2012-01-01

    The NASA Engineering and Safety Center was requested to improve on the Best Practices document produced for the NESC assessment, Verification of Probabilistic Requirements for the Constellation Program, by giving a recommended procedure for using acceptance sampling by variables techniques as an alternative to the potentially resource-intensive acceptance sampling by attributes method given in the document. In this paper, the results of empirical tests intended to assess the accuracy of acceptance sampling plan calculators implemented for six variable distributions are presented.

  11. Beat-to-beat variability of cardiac action potential duration: underlying mechanism and clinical implications.

    Science.gov (United States)

    Nánási, Péter P; Magyar, János; Varró, András; Ördög, Balázs

    2017-10-01

    Beat-to-beat variability of cardiac action potential duration (short-term variability, SV) is a common feature of various cardiac preparations, including the human heart. Although it is believed to be one of the best arrhythmia predictors, the underlying mechanisms are not fully understood at present. The magnitude of SV is basically determined by the intensity of cell-to-cell coupling in multicellular preparations and by the duration of the action potential (APD). To compensate for the APD-dependent nature of SV, the concept of relative SV (RSV) has been introduced by normalizing the changes of SV to the concomitant changes in APD. RSV is reduced by I Ca , I Kr , and I Ks while increased by I Na , suggesting that ion currents involved in the negative feedback regulation of APD tend to keep RSV at a low level. RSV is also influenced by intracellular calcium concentration and tissue redox potential. The clinical implications of APD variability is discussed in detail.

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Morgan S

    2013-06-01

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

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

    Science.gov (United States)

    Peca, Kathy

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

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

    Science.gov (United States)

    Gold, Joshua M.

    2012-01-01

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

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

    Science.gov (United States)

    Diemer, Matthew A.; Ali, Saba Rasheed

    2009-01-01

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

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

    Science.gov (United States)

    Awan, Muhammad Afzal

    2017-01-01

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

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

    Science.gov (United States)

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

    2012-10-01

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

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

    Science.gov (United States)

    Winston, Joe

    2011-01-01

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

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

    OpenAIRE

    Crosby, Neil; Lavers, Anthony; Foster , Henry

    1997-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Gry Cecilie Høiland

    2016-10-01

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

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

    OpenAIRE

    Zoran Milošević; Nebojša Maksimović; Nada Milošević; Borislav Obradović

    2010-01-01

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

  3. Adsorption properties of subtropical and tropical variable charge soils: Implications from climate change and biochar amendment

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Ren-Kou; Qafoku, Nikolla; Van Ranst, Eric; Li, Jiu-yu; Jiang, Jun

    2016-01-25

    This review paper attempts to summarize the progress made in research efforts conducted over the last years to study the surface chemical properties of the tropical and subtropical soils, usually called variable charge soils, and the way they response to different management practices. The paper is composed of an introductory section that provides a brief discussion on the surface chemical properties of these soils, and five other review sections. The focus of these sections is on the evolution of surface chemical properties during the development of the variable charge properties (second section), interactions between oppositely charged particles and the resulting effects on the soil properties and especially on soil acidity (third section), the surface effects of low molecular weight organic acids sorbed to mineral surfaces and the chemical behavior of aluminum (fourth section), and the crop straw derived biochar induced changes of the surface chemical properties of these soils (fifth section). A discussion on the effect of climate change variables on the properties of the variable charge soils is included at the end of this review paper (sixth section).

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

    Science.gov (United States)

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

    2014-01-01

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

  5. Informal Online Learning Practices: Implications for Distance Education

    Directory of Open Access Journals (Sweden)

    Fawn Winterwood

    2010-02-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-07-01

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

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

    Science.gov (United States)

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

    2016-11-01

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

  8. HIV-1 Genetic Variability in Cuba and Implications for Transmission and Clinical Progression.

    Science.gov (United States)

    Blanco, Madeline; Machado, Liuber Y; Díaz, Héctor; Ruiz, Nancy; Romay, Dania; Silva, Eladio

    2015-10-01

    INTRODUCTION Serological and molecular HIV-1 studies in Cuba have shown very low prevalence of seropositivity, but an increasing genetic diversity attributable to introduction of many HIV-1 variants from different areas, exchange of such variants among HIV-positive people with several coinciding routes of infection and other epidemiologic risk factors in the seropositive population. The high HIV-1 genetic variability observed in Cuba has possible implications for transmission and clinical progression. OBJECTIVE Study genetic variability for the HIV-1 env, gag and pol structural genes in Cuba; determine the prevalence of B and non-B subtypes according to epidemiologic and behavioral variables and determine whether a relationship exists between genetic variability and transmissibility, and between genetic variability and clinical disease progression in people living with HIV/AIDS. METHODS Using two molecular assays (heteroduplex mobility assay and nucleic acid sequencing), structural genes were characterized in 590 people with HIV-1 (480 men and 110 women), accounting for 3.4% of seropositive individuals in Cuba as of December 31, 2013. Nonrandom sampling, proportional to HIV prevalence by province, was conducted. Relationships between molecular results and viral factors, host characteristics, and patients' clinical, epidemiologic and behavioral variables were studied for molecular epidemiology, transmission, and progression analyses. RESULTS Molecular analysis of the three HIV-1 structural genes classified 297 samples as subtype B (50.3%), 269 as non-B subtypes (45.6%) and 24 were not typeable. Subtype B prevailed overall and in men, mainly in those who have sex with men. Non-B subtypes were prevalent in women and heterosexual men, showing multiple circulating variants and recombinant forms. Sexual transmission was the predominant form of infection for all. B and non-B subtypes were encountered throughout Cuba. No association was found between subtypes and

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

    Directory of Open Access Journals (Sweden)

    Fadzilah Abd Rahman

    2010-07-01

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

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

    DEFF Research Database (Denmark)

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

    2017-01-01

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

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

    Science.gov (United States)

    Durieux-Paillard, S; Loutan, L

    2005-09-28

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

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

    Science.gov (United States)

    Newton, Paul; Riveros, Augusto

    2015-01-01

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

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

    International Nuclear Information System (INIS)

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

    2016-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-08-15

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

  15. Practical Implications of Empirically Studying Moral Decision-Making

    Science.gov (United States)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2012-01-01

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

  17. Future Warming Increases Global Maize Yield Variability with Implications for Food Markets

    Science.gov (United States)

    Tigchelaar, M.; Battisti, D. S.; Naylor, R. L.; Ray, D. K.

    2017-12-01

    If current trends in population growth and dietary shifts continue, the world will need to produce about 70% more food by 2050, while earth's climate is rapidly changing. Rising temperatures in particular are projected to negatively impact agricultural production, as the world's staple crops perform poorly in extreme heat. Theoretical models suggest that as temperatures rise above plants' optimal temperature for performance, not only will mean yields decline rapidly, but the variability of yields will increase, even as interannual variations in climate remain unchanged. Here we use global datasets of maize production and climate variability combined with CMIP5 temperature projections to quantify how yield variability will change in major maize producing countries under 2°C and 4°C of global warming. Maize is the world's most produced crop, and is linked to other staple crops through substitution in consumption and production. We find that in warmer climates - absent any breeding gains in heat tolerance - the Coefficient of Variation (CV) of maize yields increases almost everywhere, to values much larger than present-day. This increase in CV is due both to an increase in the standard deviation of yields, and a decrease in mean yields. In locations where crop failures become the norm under high (4°C) warming (mostly in tropical, low-yield environments), the standard deviation of yields ultimately decreases. The probability that in any given year the most productive areas in the top three maize producing countries (United States, China, Brazil) have simultaneous production losses greater than 10% is virtually zero under present-day climate conditions, but increases to 12% under 2°C warming, and 89% under 4°C warming. This has major implications for global food markets and staple crop prices, affecting especially the 2.5 billion people that comprise the world's poor, who already spend the majority of their disposable income on food and are particularly vulnerable

  18. Stellar variability and its implications for photometric planet detection with Kepler

    Science.gov (United States)

    Batalha, N. M.; Jenkins, J.; Basri, G. S.; Borucki, W. J.; Koch, D. G.

    2002-01-01

    Kepler is one of three candidates for the next NASA Discovery Mission and will survey the extended solar neighborhood to detect and characterize hundreds of terrestrial (and larger) planets in or near the habitable zone. Its strength lies in its ability to detect large numbers of Earth-sized planets - planets which produced a 10-4 change in relative stellar brightness during a transit across the disk of a sun-like parent star. Such a detection requires high instrumental relative precision and is facilitated by observing stars which are photometrically quiet on hourly timescales. Probing stellar variability across the HR diagram, one finds that many of the photometrically quietest stars are the F and G dwarfs. The Hipparcos photometric database shows the lowest photometric variances among stars of this spectral class. Our own Sun is a prime example with RMS variations over a few rotational cycles of typically (3 - 4)×10-4 (computed from VIRGO/DIARAD data taken Jan-Mar 2001). And variability on the hourly time scales crucial for planet detection is significantly smaller: just (2 - 5)×10-5. This bodes well for planet detection programs such as Kepler and Eddington. With significant numbers of photometrically quiet solar-type stars, Earth-sized planets should be readily identified provided they are abundant in the solar neighborhood. In support of the Kepler science objectives, we have initiated a study of stellar variability and its implications for planet detection. Herein, we summarize existing observational and theoretrical work with the objective of determining the percentage of stars in the Kepler field of view expected to be photometrically stable at a level which allows for Earth-sized planet detection.

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

    Science.gov (United States)

    Thackeray, Rosemary; Neiger, Brad L

    2009-04-01

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

  20. Psychoacoustic entropy theory and its implications for performance practice

    Science.gov (United States)

    Strohman, Gregory J.

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

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

    Science.gov (United States)

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

    2017-03-01

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

  2. Semantic web implications for technologies and business practices

    CERN Document Server

    2016-01-01

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

  3. The implication of transcultural psychiatry for clinical practice.

    Science.gov (United States)

    Moldavsky, Daniel

    2003-01-01

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

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

    Science.gov (United States)

    Duteau, Jennifer

    2014-01-01

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

  5. PRACTICAL IMPLICATIONS OF USING INDUCED TRANSIENTS FOR LEAK DETECTION

    Directory of Open Access Journals (Sweden)

    Marko V. Ivetic

    2007-06-01

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

  6. PRACTICAL IMPLICATIONS OF USING INDUCED TRANSIENTS FOR LEAK DETECTION

    Directory of Open Access Journals (Sweden)

    Marko V. Ivetic

    2007-01-01

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

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

    Science.gov (United States)

    Georgiades, Savvas Daniel

    2015-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Niguse Fekadu

    2011-04-01

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

  9. Practical security analysis of continuous-variable quantum key distribution with jitter in clock synchronization

    Science.gov (United States)

    Xie, Cailang; Guo, Ying; Liao, Qin; Zhao, Wei; Huang, Duan; Zhang, Ling; Zeng, Guihua

    2018-03-01

    How to narrow the gap of security between theory and practice has been a notoriously urgent problem in quantum cryptography. Here, we analyze and provide experimental evidence of the clock jitter effect on the practical continuous-variable quantum key distribution (CV-QKD) system. The clock jitter is a random noise which exists permanently in the clock synchronization in the practical CV-QKD system, it may compromise the system security because of its impact on data sampling and parameters estimation. In particular, the practical security of CV-QKD with different clock jitter against collective attack is analyzed theoretically based on different repetition frequencies, the numerical simulations indicate that the clock jitter has more impact on a high-speed scenario. Furthermore, a simplified experiment is designed to investigate the influence of the clock jitter.

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

    Science.gov (United States)

    Parada, Filomena; Young, Richard A.

    2013-01-01

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

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

    Science.gov (United States)

    Penzo, Jeanine A.; Harvey, Pat

    2008-01-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

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

    Science.gov (United States)

    NOREEN, DAVID SHELDON

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

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

    Science.gov (United States)

    Levitt, Steven R.

    2016-01-01

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

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

    Science.gov (United States)

    Dong, Xin Qi

    2015-06-01

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

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

    DEFF Research Database (Denmark)

    Moring, Camilla Elisabeth; Lloyd, Annemaree

    2013-01-01

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

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

    Science.gov (United States)

    Peach, Brian C

    2017-04-01

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

  18. The impact of demographical variables on HRM practices in Saudi Telecom Company: An empirical exploration

    Directory of Open Access Journals (Sweden)

    Nasser S. Al-Kahtani

    2018-03-01

    Full Text Available Fair HRM practices are indispensable for the success of any company, especially the growing companies. The aim of this exploration is to understand the impact of certain personal characteris-tics of the employees of Telecommunication Company on HRM practices in the Kingdom of Saudi Arabia. A booklet consisted of HRM practices questionnaires along with personal characteristics blank sheet were used to gather the information of the respondents. A total of 210 sample collected from public and private sector Telecommunication Company existing in the Kingdom. The collected data was analyzed by inferential and descriptive statistics and the results were analyzed. The results revealed that married & unmarried, public & private sector, younger & older, high & low income and high & low experienced group of employees differ but in a varied degree on HRM practices in terms of performance appraisal, training and development, security and health, recruitment and se-lection, intention to stay in the company communication, working conditions, compensation and benefits, job analysis and co-worker relationships. The findings’ significances and implications were also elaborated at length and few suggestions were provided that could enhance the fair HRM practices in the telecommunication company in the Kingdom.

  19. Fine scale spatial variability of microbial pesticide degradation in soil: scales, controlling factors, and implications

    DEFF Research Database (Denmark)

    Dechesne, Arnaud; Badawi, N.; Aamand, Jens

    2014-01-01

    across pesticide classes: they include some soil characteristics (pH) and some agricultural management practices (pesticide application, tillage), while other potential controlling factors have more conflicting effects depending on the site or the pesticide. Evidence demonstrating the importance......Pesticide biodegradation is a soil microbial function of critical importance for modern agriculture and its environmental impact. While it was once assumed that this activity was homogeneously distributed at the field scale, mounting evidence indicates that this is rarely the case. Here, we...... critically examine the literature on spatial variability of pesticide biodegradation in agricultural soil. We discuss the motivations, methods, and main findings of the primary literature. We found significant diversity in the approaches used to describe and quantify spatial heterogeneity, which complicates...

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  1. Biofeedback on heart rate variability in cardiac rehabilitation: practical feasibility and psycho-physiological effects.

    Science.gov (United States)

    Climov, Daniela; Lysy, Camille; Berteau, Sylvain; Dutrannois, Jacques; Dereppe, Hubert; Brohet, Christian; Melin, Jacques

    2014-06-01

    Biofeedback is a self-regulation therapy by which the patient learns how to optimize the functioning of his autonomic nervous system. It has been applied to patients with various cardiovascular disorders. The purpose of this study was to investigate the practical feasibility and the psychophysiological effects of biofeedback applied to heart rate variability (HRV biofeedback) in order to increase cardiac coherence in coronary artery disease (CAD) patients participating in a cardiac rehabilitation programme. In this randomised and controlled study, 31 CAD patients were randomly assigned to an experimental or to a control group. The experimental group participated in a programme of 10 sessions of cardiac coherence biofeedback training, in addition to the rehabilitation programme. The control group participated in the usual cardiac rehabilitation programme only. Physiological variables (systolic and diastolic blood pressure, SDNN) and psychosocial variables (anxiety, depression, type D personality) were measured at the start and at the end of the programme in both groups. Statistical comparisons assessed the inter and intra group differences. The small sample size precludes any firm conclusions concerning the effect of cardiac coherence biofeedback on physiological or psychological variables. However, we observed a significant increase of the percentage of cardiac coherence, in relation with an increased SDNN index. Our study demonstrated the practical feasibility of cardiac coherence biofeedback training in CAD patients. Further research is desirable to investigate the potential benefit of cardiac coherence biofeedback as an adjunct to stress management in cardiac rehabilitation.

  2. Song practice promotes acute vocal variability at a key stage of sensorimotor learning.

    Directory of Open Access Journals (Sweden)

    Julie E Miller

    Full Text Available BACKGROUND: Trial by trial variability during motor learning is a feature encoded by the basal ganglia of both humans and songbirds, and is important for reinforcement of optimal motor patterns, including those that produce speech and birdsong. Given the many parallels between these behaviors, songbirds provide a useful model to investigate neural mechanisms underlying vocal learning. In juvenile and adult male zebra finches, endogenous levels of FoxP2, a molecule critical for language, decrease two hours after morning song onset within area X, part of the basal ganglia-forebrain pathway dedicated to song. In juveniles, experimental 'knockdown' of area X FoxP2 results in abnormally variable song in adulthood. These findings motivated our hypothesis that low FoxP2 levels increase vocal variability, enabling vocal motor exploration in normal birds. METHODOLOGY/PRINCIPAL FINDINGS: After two hours in either singing or non-singing conditions (previously shown to produce differential area X FoxP2 levels, phonological and sequential features of the subsequent songs were compared across conditions in the same bird. In line with our prediction, analysis of songs sung by 75 day (75d birds revealed that syllable structure was more variable and sequence stereotypy was reduced following two hours of continuous practice compared to these features following two hours of non-singing. Similar trends in song were observed in these birds at 65d, despite higher overall within-condition variability at this age. CONCLUSIONS/SIGNIFICANCE: Together with previous work, these findings point to the importance of behaviorally-driven acute periods during song learning that allow for both refinement and reinforcement of motor patterns. Future work is aimed at testing the observation that not only does vocal practice influence expression of molecular networks, but that these networks then influence subsequent variability in these skills.

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

    International Nuclear Information System (INIS)

    Gur, D.; Wald, N.

    1986-01-01

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

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

    Science.gov (United States)

    Milton, Constance L

    2016-07-01

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

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

    Science.gov (United States)

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

    2016-11-01

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

  6. Empirical Analysis of the Variability of Wind Generation in India: Implications for Grid Integration

    Energy Technology Data Exchange (ETDEWEB)

    Phadke, Amol; Abhyankar, NIkit; Rao, Poorvi

    2014-06-17

    We analyze variability in load and wind generation in India to assess its implications for grid integration of large scale wind projects using actual wind generation and load data from two states in India, Karnataka and Tamil Nadu. We compare the largest variations in load and net load (load ?wind, i.e., load after integrating wind) that the generation fleet has to meet. In Tamil Nadu, where wind capacity is about 53percent of the peak demand, we find that the additional variation added due to wind over the current variation in load is modest; if wind penetration reaches 15percent and 30percent by energy, the additional hourly variation is less than 0.5percent and 4.5percent of the peak demand respectively for 99percent of the time. For wind penetration of 15percent by energy, Tamil Nadu system is found to be capable of meeting the additional ramping requirement for 98.8percent of the time. Potential higher uncertainty in net load compared to load is found to have limited impact on ramping capability requirements of the system if coal plants can me ramped down to 50percent of their capacity. Load and wind aggregation in Tamil Nadu and Karnataka is found to lower the variation by at least 20percent indicating the benefits geographic diversification. These findings suggest modest additional flexible capacity requirements and costs for absorbing variation in wind power and indicate that the potential capacity support (if wind does not generate enough during peak periods) may be the issue that has more bearing on the economics of integrating wind

  7. Fine scale spatial variability of microbial pesticide degradation in soil: scales, controlling factors, and implications

    Directory of Open Access Journals (Sweden)

    Arnaud eDechesne

    2014-12-01

    Full Text Available Pesticide biodegradation is a soil microbial function of critical importance for modern agriculture and its environmental impact. While it was once assumed that this activity was homogeneously distributed at the field scale, mounting evidence indicates that this is rarely the case. Here, we critically examine the literature on spatial variability of pesticide biodegradation in agricultural soil. We discuss the motivations, methods, and main findings of the primary literature. We found significant diversity in the approaches used to describe and quantify spatial heterogeneity, which complicates inter-studies comparisons. However, it is clear that the presence and activity of pesticide degraders is often highly spatially variable with coefficients of variation often exceeding 50% and frequently displays nonrandom spatial patterns. A few controlling factors have tentatively been identified across pesticide classes: they include some soil characteristics (pH and some agricultural management practices (pesticide application, tillage, while other potential controlling factors have more conflicting effects depending on the site or the pesticide. Evidence demonstrating the importance of spatial heterogeneity on the fate of pesticides in soil has been difficult to obtain but modelling and experimental systems that do not include soil’s full complexity reveal that this heterogeneity must be considered to improve prediction of pesticide biodegradation rates or of leaching risks. Overall, studying the spatial heterogeneity of pesticide biodegradation is a relatively new field at the interface of agronomy, microbial ecology, and geosciences and a wealth of novel data is being collected from these different disciplinary perspectives. We make suggestions on possible avenues to take full advantage of these investigations for a better understanding and prediction of the fate of pesticides in soil.

  8. Assessing intraindividual variability in sustained attention: reliability, relation to speed and accuracy, and practice effects

    Directory of Open Access Journals (Sweden)

    HAGEN C. FLEHMIG

    2007-06-01

    Full Text Available We investigated the psychometric properties of competing measures of sustained attention. 179 subjects were assessed twice within seven day's time with a test designed to measure sustained attention, or concentration, respectively. In addition to traditional performance indices [i.e., speed (MRT and accuracy (E%], we evaluated two intraindividual response time (RT variability measures: standard deviation (SDRT and coefficient of variation (CVRT. For the overall test, both indices were reliable. SDRT showed good to acceptable retest reliability for all subtests. For CVRT, retest reliability coefficients ranged from very good to not satisfactory. While the reversed-word recognition test proved highly reliable, the mental calculation test and the arrows test were not sufficiently reliable. CVRT was only slightly correlated but SDRT was highly correlated with MRT. In contrast to substantial practice gains for MRT, SDRT and E%, only CVRT proved to be stable. In conclusion, CVRT appears to be a potential index for assessing performance variability: it is reliable for the overall test, only moderately correlated with speed, and virtually not affected by practice. However, before applying CVRT in practical assessment settings, additional research is required to elucidate the impact of task-specific factors on the reliability of this performance measure.

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

    Science.gov (United States)

    Daunhauer, Lisa A; Fidler, Deborah J

    2011-01-01

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

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

    International Nuclear Information System (INIS)

    Pacudan, Romeo

    2016-01-01

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

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

    Science.gov (United States)

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

    2011-10-01

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

  12. Practical continuous-variable quantum key distribution without finite sampling bandwidth effects.

    Science.gov (United States)

    Li, Huasheng; Wang, Chao; Huang, Peng; Huang, Duan; Wang, Tao; Zeng, Guihua

    2016-09-05

    In a practical continuous-variable quantum key distribution system, finite sampling bandwidth of the employed analog-to-digital converter at the receiver's side may lead to inaccurate results of pulse peak sampling. Then, errors in the parameters estimation resulted. Subsequently, the system performance decreases and security loopholes are exposed to eavesdroppers. In this paper, we propose a novel data acquisition scheme which consists of two parts, i.e., a dynamic delay adjusting module and a statistical power feedback-control algorithm. The proposed scheme may improve dramatically the data acquisition precision of pulse peak sampling and remove the finite sampling bandwidth effects. Moreover, the optimal peak sampling position of a pulse signal can be dynamically calibrated through monitoring the change of the statistical power of the sampled data in the proposed scheme. This helps to resist against some practical attacks, such as the well-known local oscillator calibration attack.

  13. Seasonal variability of mixed layer in the central Arabian Sea and its implication on nutrients and primary productivity

    Digital Repository Service at National Institute of Oceanography (India)

    PrasannaKumar, S.; Narvekar, J.

    -1 Seasonal variability of mixed layer in the central Arabian Sea and its implication on nutrients and primary productivity S. Prasanna Kumar and Jayu Narvekar National Institute of Oceanography, Dona Paula, Goa-403 004, India... on a 2? x 4? grids up to a depth of 500m. Monthly mean temperature and salinity data were used to calculate the sigma-t values (UNESCO, 1981). We also used nitrate, chlorophyll a and primary productivity data in the upper 120m water column...

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

    Science.gov (United States)

    Jiménez-Aleixandre, María Pilar

    2014-02-01

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

  15. Variability of LD50 Values from Rat Oral Acute Toxicity Studies: Implications for Alternative Model Development

    Science.gov (United States)

    Alternative models developed for estimating acute systemic toxicity are generally evaluated using in vivo LD50 values. However, in vivo acute systemic toxicity studies can produce variable results, even when conducted according to accepted test guidelines. This variability can ma...

  16. Using randomized variable practice in the treatment of childhood apraxia of speech.

    Science.gov (United States)

    Skelton, Steven L; Hagopian, Aubrie Lynn

    2014-11-01

    The purpose of this study was to determine if randomized variable practice, a central component of concurrent treatment, would be effective and efficient in treating childhood apraxia of speech (CAS). Concurrent treatment is a treatment program that takes the speech task hierarchy and randomizes it so that all tasks are worked on in one session. Previous studies have shown the treatment program to be effective and efficient in treating phonological and articulation disorders. The program was adapted to be used with children with CAS. A research design of multiple baselines across participants was used. Probes of generalization to untaught words were administered every fifth session. Three children, ranging in age from 4 to 6 years old, were the participants. Data were collected as percent correct productions during baseline, treatment, and probes of generalization of target sounds to untaught words and three-word phrases. All participants showed an increase in correct productions during treatment and during probes. Effect sizes (standard mean difference) for treatment were 3.61-5.00, and for generalization probes, they were 3.15-8.51. The results obtained from this study suggest that randomized variable practice as used in concurrent treatment can be adapted for use in treating children with CAS. Replication of this study with other children presenting CAS will be needed to establish generality of the findings.

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

    Science.gov (United States)

    Buck-McFadyen, Ellen; MacDonnell, Judith

    2017-07-27

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

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

    Science.gov (United States)

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

    2001-01-01

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

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

    Science.gov (United States)

    Clark, Phillip G

    2009-05-01

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

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

    Science.gov (United States)

    Petrini, Carlo

    2015-01-01

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

  1. Variability in the practice of fertility preservation for patients with cancer.

    Directory of Open Access Journals (Sweden)

    Kasey A Reynolds

    Full Text Available Fertility is important to women and men with cancer. While options for fertility preservation (FP are available, knowledge regarding the medical application of FP is lacking. Therefore we examined FP practices for cancer patients among reproductive endocrinologists (REs. A 36 item survey was sent to board-certified REs. 98% of respondents reported counseling women with cancer about FP options. Oocyte and embryo cryopreservation were universally offered by these providers, but variability was noted in reported management of these cases-particularly for women with breast cancer. 86% of the respondents reported using letrozole during controlled ovarian stimulation (COS in patients with estrogen receptor positive (ER+ breast cancer to minimize patient exposure to estrogen. 49% of respondents who reported using letrozole in COS for patients with ER+ breast cancer reported that they would also use letrozole in COS for women with ER negative breast cancer. Variability was also noted in the management of FP for men with cancer. 83% of participants reported counseling men about sperm banking with 22% recommending against banking for men previously exposed to chemotherapy. Overall, 79% of respondents reported knowledge of American Society for Clinical Oncology FP guidelines-knowledge that was associated with providers offering gonadal tissue cryopreservation (RR 1.82, 95% CI 1.14-2.90. These findings demonstrate that RE management of FP in cancer patients varies. Although some variability may be dictated by local resources, standardization of FP practices and communication with treating oncologists may help ensure consistent recommendations and outcomes for patients seeking FP.

  2. Variability in Institutional Screening Practices Related to Collegiate Student-Athlete Mental Health.

    Science.gov (United States)

    Kroshus, Emily

    2016-05-01

    Universal screening for mental health concerns, as part of the preparticipation examination in collegiate sports medicine settings, can be an important and feasible strategy for facilitating early detection of mental health disorders. To assess whether sports medicine departments at National Collegiate Athletic Association (NCAA) member colleges have policies related to identifying student-athlete mental health problems, the nature of preparticipation examination screening related to mental health, and whether other departmental or institutional screening initiatives are in place. I also aimed to characterize the variability in screening by institutional characteristics. Cross-sectional study. College sports medicine departments. Team physicians and head athletic trainers at NCAA member colleges (n = 365, 30.3% response rate). Electronic survey of departmental mental health screening activities. A total of 39% of respondents indicated that their institution had a written plan related to identifying student-athletes with mental health concerns. Fewer than half reported that their sports medicine department administers a written or verbal screening instrument for symptoms of disordered eating (44.5%), depression (32.3%), or anxiety (30.7%). The strongest predictors of mental health screening were the presence of a written plan related to identifying student-athlete mental health concerns and the employment of a clinical psychologist. Additionally, Division I institutions and institutions with a greater ratio of athletic trainers to student-athletes tended to engage in more screening. The substantial among-institutions variability in mental health screening suggests that opportunities exist to make these practices more widespread. To address this variability, recent NCAA mental health best-practice guidelines suggested that institutions should screen for a range of mental health disorders and risk behaviors. However, at some institutions, staffing deficits may need to

  3. Biological variability in biomechanical engineering research: Significance and meta-analysis of current modeling practices.

    Science.gov (United States)

    Cook, Douglas; Julias, Margaret; Nauman, Eric

    2014-04-11

    Biological systems are characterized by high levels of variability, which can affect the results of biomechanical analyses. As a review of this topic, we first surveyed levels of variation in materials relevant to biomechanics, and compared these values to standard engineered materials. As expected, we found significantly higher levels of variation in biological materials. A meta-analysis was then performed based on thorough reviews of 60 research studies from the field of biomechanics to assess the methods and manner in which biological variation is currently handled in our field. The results of our meta-analysis revealed interesting trends in modeling practices, and suggest a need for more biomechanical studies that fully incorporate biological variation in biomechanical models and analyses. Finally, we provide some case study example of how biological variability may provide valuable insights or lead to surprising results. The purpose of this study is to promote the advancement of biomechanics research by encouraging broader treatment of biological variability in biomechanical modeling. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Changes of heart rate variability and prefrontal oxygenation during Tai Chi practice versus arm ergometer cycling.

    Science.gov (United States)

    Lu, Xi; Hui-Chan, Christina Wan-Ying; Tsang, William Wai-Nam

    2016-11-01

    [Purpose] Exercise has been shown to improve cardiovascular fitness and cognitive function. Whether the inclusion of mind over exercise would increase parasympathetic control of the heart and brain activities more than general exercise at a similar intensity is not known. The aim of this study was to compare the effects of Tai Chi (mind-body exercise) versus arm ergometer cycling (body-focused exercise) on the heart rate variability and prefrontal oxygenation level. [Subjects and Methods] A Tai Chi master was invited to perform Tai Chi and arm ergometer cycling with similar exercise intensity on two separate days. Heart rate variability and prefrontal oxyhemoglobin levels were measured continuously by a RR recorder and near-infrared spectroscopy, respectively. [Results] During Tai Chi exercise, spectral analysis of heart rate variability demonstrated a higher high-frequency power as well as a lower low-frequency/high-frequency ratio than during ergometer cycling, suggesting increased parasympathetic and decreased sympathetic control of the heart. Also, prefrontal oxyhemoglobin and total hemoglobin levels were higher than those during arm ergometer exercise. [Conclusion] These findings suggest that increased parasympathetic control of the heart and prefrontal activities may be associated with Tai Chi practice. Having a "mind" component in Tai Chi could be more beneficial for older adults' cardiac health and cognitive function than body-focused ergometer cycling.

  5. Integrating Variable Renewable Energy in Electric Power Markets: Best Practices from International Experience

    Energy Technology Data Exchange (ETDEWEB)

    Cochran, J.; Bird, L.; Heeter, J.; Arent, D. A.

    2012-04-01

    Many countries -- reflecting very different geographies, markets, and power systems -- are successfully managing high levels of variable renewable energy on the electric grid, including that from wind and solar energy. This study documents the diverse approaches to effective integration of variable renewable energy among six countries -- Australia (South Australia), Denmark, Germany, Ireland, Spain, and the United States (Western region-Colorado and Texas)-- and summarizes policy best practices that energy ministers and other stakeholders can pursue to ensure that electricity markets and power systems can effectively coevolve with increasing penetrations of variable renewable energy. Each country has crafted its own combination of policies, market designs, and system operations to achieve the system reliability and flexibility needed to successfully integrate renewables. Notwithstanding this diversity, the approaches taken by the countries studied all coalesce around five strategic areas: lead public engagement, particularly for new transmission; coordinate and integrate planning; develop rules for market evolution that enable system flexibility; expand access to diverse resources and geographic footprint of operations; and improve system operations. The ability to maintain a broad ecosystem perspective, to organize and make available the wealth of experiences, and to ensure a clear path from analysis to enactment should be the primary focus going forward.

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

    Science.gov (United States)

    Loughlin, Michael; Lewith, George; Falkenberg, Torkel

    2013-06-01

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

  7. Quantum hacking on a practical continuous-variable quantum cryptosystem by inserting an external light

    Science.gov (United States)

    Qin, Hao; Kumar, Rupesh; Alleaume, Romain

    2015-10-01

    We report here a new side channel attack on a practical continuous-variable (CV) quantum key distribution (QKD) system. Inspired by blinding attack in discrete-variable QKD, we formalize an attack strategy by inserting an external light into a CV QKD system implemented Gaussian-modulated coherent state protocol and show that our attack can compromise its practical security. In this attack, we concern imperfections of a balanced homodyne detector used in CV QKD. According to our analysis, if one inserts an external light into Bob's signal port, due to the imperfect subtraction from the homodyne detector, the leakage of the external light contributes a displacement on the homodyne signal which causes detector electronics saturation. In consequence, Bob's quadrature measurement is not linear with the quadrature sent by Alice. By considering such vulnerability, a potential Eve can launch a full intercept-resend attack meanwhile she inserts an external light into Bob's signal port. By selecting proper properties of the external light, Eve actively controls the induced displacement value from the inserted light which results saturation of homodyne detection. In consequence, Eve can bias the excess noise due to the intercept-resend attack and the external light, such that Alice and Bob believe their excess noise estimation is below the null key threshold and they can still share a secret key. Our attack shows that the detector loopholes also exist in CV QKD, and it seems influence all the CV QKD systems using homodyne detection, since all the practical detectors have finite detection range.

  8. Association between education in EOL care and variability in EOL practice: a survey of ICU physicians.

    Science.gov (United States)

    Forte, Daniel Neves; Vincent, Jean Louis; Velasco, Irineu Tadeu; Park, Marcelo

    2012-03-01

    This study investigated the association between physician education in EOL and variability in EOL practice, as well as the differences between beliefs and practices regarding EOL in the ICU. Physicians from 11 ICUs at a university hospital completed a survey presenting a patient in a vegetative state with no family or advance directives. Questions addressed approaches to EOL care, as well physicians' personal, professional and EOL educational characteristics. The response rate was 89%, with 105 questionnaires analyzed. Mean age was 38 ± 8 years, with a mean of 14 ± 7 years since graduation. Physicians who did not apply do-not-resuscitate (DNR) orders were less likely to have attended EOL classes than those who applied written DNR orders [0/7 vs. 31/47, OR = 0.549 (0.356-0.848), P = 0.001]. Physicians who involved nurses in the decision-making process were more likely to be ICU specialists [17/22 vs. 46/83, OR = 4.1959 (1.271-13.845), P = 0.013] than physicians who made such decisions among themselves or referred to ethical or judicial committees. Physicians who would apply "full code" had less often read about EOL [3/22 vs. 11/20, OR = 0.0939 (0.012-0.710), P = 0.012] and had less interest in discussing EOL [17/22 vs. 20/20, OR = 0.210 (0.122-0.361), P EOL is associated with variability in EOL decisions in the ICU. Moreover, actual practice may differ from what physicians believe is best for the patient.

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

    LENUS (Irish Health Repository)

    2009-03-28

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

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

    Science.gov (United States)

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

    2016-09-01

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

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

    Science.gov (United States)

    Tavares, W; Boet, S

    2016-02-01

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

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

    Science.gov (United States)

    Cooper, Paul

    2011-01-01

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

  13. SU-E-J-176: Characterization of Inter-Fraction Breast Variability and the Implications On Delivered Dose

    Energy Technology Data Exchange (ETDEWEB)

    Sudhoff, M; Lamba, M; Kumar, N; Ward, A; Elson, H [University of Cincinnati, Cincinnati, OH (United States)

    2015-06-15

    Purpose: To systematically characterize inter-fraction breast variability and determine implications on delivered dose. Methods: Weekly port films were used to characterize breast setup variability. Five evenly spaced representative positions across the contour of each breast were chosen on the electronic port film in reference to graticule, and window and level was set such that the skin surface of the breast was visible. Measurements from the skin surface to treatment field edge were taken on each port film at each position and compared to the planning DRR, quantifying the variability. The systematic measurement technique was repeated for all port films for 20 recently treated breast cancer patients. Measured setup variability for each patient was modeled as a normal distribution. The distribution was randomly sampled from the model and applied as isocentric shifts in the treatment planning computer, representing setup variability for each fraction. Dose was calculated for each shifted fraction and summed to obtain DVHs and BEDs that modeled the dose with daily setup variability. Patients were categorized in to relevant groupings that were chosen to investigate the rigorousness of immobilization types, treatment techniques, and inherent anatomical difficulties. Mean position differences and dosimetric differences were evaluated between planned and delivered doses. Results: The setup variability was found to follow a normal distribution with mean position differences between the DRR and port film between − 8.6–3.5 mm with sigma range of 5.3–9.8 mm. Setup position was not found to be significantly different than zero. The mean seroma or whole breast PTV dosimetric difference, calculated as BED, ranged from a −0.23 to +1.13Gy. Conclusion: A systematic technique to quantify and model setup variability was used to calculate the dose in 20 breast cancer patients including variable setup. No statistically significant PTV or OAR BED differences were found between

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

    Directory of Open Access Journals (Sweden)

    Bhandesa Asthadi Mahendra

    2018-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Chris W Callaghan

    2016-10-01

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

  16. Implications of climate variability for the detection of multiple equilibria and for rapid transitions in the atmosphere-vegetation system

    Energy Technology Data Exchange (ETDEWEB)

    Bathiany, S. [Max Planck Institute for Meteorology, Hamburg (Germany); Claussen, M. [Max Planck Institute for Meteorology, Hamburg (Germany); Universitaet Hamburg, Meteorologisches Institut, Hamburg (Germany); Fraedrich, K. [Universitaet Hamburg, Meteorologisches Institut, Hamburg (Germany)

    2012-05-15

    Paleoclimatic records indicate a decline of vegetation cover in the Western Sahara at the end of the African Humid Period (about 5,500 years before present). Modelling studies have shown that this phenomenon may be interpreted as a critical transition that results from a bifurcation in the atmosphere-vegetation system. However, the stability properties of this system are closely linked to climate variability and depend on the climate model and the methods of analysis. By coupling the Planet Simulator (PlaSim), an atmosphere model of intermediate complexity, with the simple dynamic vegetation model VECODE, we assess previous methods for the detection of multiple equilibria, and demonstrate their limitations. In particular, a stability diagram can yield misleading results because of spatial interactions, and the system's steady state and its dependency on initial conditions are affected by atmospheric variability and nonlinearities. In addition, we analyse the implications of climate variability for the abruptness of a vegetation decline. We find that a vegetation collapse can happen at different locations at different times. These collapses are possible despite large and uncorrelated climate variability. Because of the nonlinear relation between vegetation dynamics and precipitation the green state is initially stabilised by the high variability. When precipitation falls below a critical threshold, the desert state is stabilised as variability is then also decreased. (orig.)

  17. Practices for Identifying and Rejecting Hemolyzed Specimens Are Highly Variable in Clinical Laboratories.

    Science.gov (United States)

    Howanitz, Peter J; Lehman, Christopher M; Jones, Bruce A; Meier, Frederick A; Horowitz, Gary L

    2015-08-01

    Hemolysis is an important clinical laboratory quality attribute that influences result reliability. To determine hemolysis identification and rejection practices occurring in clinical laboratories. We used the College of American Pathologists Survey program to distribute a Q-Probes-type questionnaire about hemolysis practices to Chemistry Survey participants. Of 3495 participants sent the questionnaire, 846 (24%) responded. In 71% of 772 laboratories, the hemolysis rate was less than 3.0%, whereas in 5%, it was 6.0% or greater. A visual scale, an instrument scale, and combination of visual and instrument scales were used to identify hemolysis in 48%, 11%, and 41% of laboratories, respectively. A picture of the hemolysis level was used as an aid to technologists' visual interpretation of hemolysis levels in 40% of laboratories. In 7.0% of laboratories, all hemolyzed specimens were rejected; in 4% of laboratories, no hemolyzed specimens were rejected; and in 88% of laboratories, some specimens were rejected depending on hemolysis levels. Participants used 69 different terms to describe hemolysis scales, with 21 terms used in more than 10 laboratories. Slight and moderate were the terms used most commonly. Of 16 different cutoffs used to reject hemolyzed specimens, moderate was the most common, occurring in 30% of laboratories. For whole blood electrolyte measurements performed in 86 laboratories, 57% did not evaluate the presence of hemolysis, but for those that did, the most common practice in 21 laboratories (24%) was centrifuging and visually determining the presence of hemolysis in all specimens. Hemolysis practices vary widely. Standard assessment and consistent reporting are the first steps in reducing interlaboratory variability among results.

  18. Implications of Wide-Area Geographic Diversity for Short- Term Variability of Solar Power

    Energy Technology Data Exchange (ETDEWEB)

    Mills, Andrew; Wiser, Ryan

    2010-08-23

    Worldwide interest in the deployment of photovoltaic generation (PV) is rapidly increasing. Operating experience with large PV plants, however, demonstrates that large, rapid changes in the output of PV plants are possible. Early studies of PV grid impacts suggested that short-term variability could be a potential limiting factor in deploying PV. Many of these early studies, however, lacked high-quality data from multiple sites to assess the costs and impacts of increasing PV penetration. As is well known for wind, accounting for the potential for geographic diversity can significantly reduce the magnitude of extreme changes in aggregated PV output, the resources required to accommodate that variability, and the potential costs of managing variability. We use measured 1-min solar insolation for 23 time-synchronized sites in the Southern Great Plains network of the Atmospheric Radiation Measurement program and wind speed data from 10 sites in the same network to characterize the variability of PV with different degrees of geographic diversity and to compare the variability of PV to the variability of similarly sited wind. The relative aggregate variability of PV plants sited in a dense 10 x 10 array with 20 km spacing is six times less than the variability of a single site for variability on time scales less than 15-min. We find in our analysis of wind and PV plants similarly sited in a 5 x 5 grid with 50 km spacing that the variability of PV is only slightly more than the variability of wind on time scales of 5-15 min. Over shorter and longer time scales the level of variability is nearly identical. Finally, we use a simple approximation method to estimate the cost of carrying additional reserves to manage sub-hourly variability. We conclude that the costs of managing the short-term variability of PV are dramatically reduced by geographic diversity and are not substantially different from the costs for managing the short-term variability of similarly sited wind in

  19. Practical way to avoid spurious geometrical contributions in Brillouin light scattering experiments at variable scattering angles.

    Science.gov (United States)

    Battistoni, Andrea; Bencivenga, Filippo; Fioretto, Daniele; Masciovecchio, Claudio

    2014-10-15

    In this Letter, we present a simple method to avoid the well-known spurious contributions in the Brillouin light scattering (BLS) spectrum arising from the finite aperture of collection optics. The method relies on the use of special spatial filters able to select the scattered light with arbitrary precision around a given value of the momentum transfer (Q). We demonstrate the effectiveness of such filters by analyzing the BLS spectra of a reference sample as a function of scattering angle. This practical and inexpensive method could be an extremely useful tool to fully exploit the potentiality of Brillouin acoustic spectroscopy, as it will easily allow for effective Q-variable experiments with unparalleled luminosity and resolution.

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

    Science.gov (United States)

    Blass, Rachel B

    2017-06-01

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

  1. Integrating Variable Renewable Energy in Electric Power Markets: Best Practices from International Experience, Summary for Policymakers

    Energy Technology Data Exchange (ETDEWEB)

    Cochran, J.; Bird, L.; Heeter, J.; Arent, D. A.

    2012-04-01

    Many countries -- reflecting very different geographies, markets, and power systems -- are successfully managing high levels of variable renewable energy on the electric grid, including that from wind and solar energy. This document summarizes policy best practices that energy ministers and other stakeholders can pursue to ensure that electricity markets and power systems can effectively coevolve with increasing penetrations of variable renewable energy. There is no one-size-fits-all approach; each country studied has crafted its own combination of policies, market designs, and system operations to achieve the system reliability and flexibility needed to successfully integrate renewables. Notwithstanding this diversity, the approaches taken by the countries studied all coalesce around five strategic areas: lead public engagement, particularly for new transmission; coordinate and integrate planning; develop rules for market evolution that enable system flexibility; expand access to diverse resources and geographic footprint of operations; and improve system operations. This study also emphatically underscores the value of countries sharing their experiences. The more diverse and robust the experience base from which a country can draw, the more likely that it will be able to implement an appropriate, optimized, and system-wide approach.

  2. Integrating Variable Renewable Energy in Electric Power Markets. Best Practices from International Experience, Summary for Policymakers

    Energy Technology Data Exchange (ETDEWEB)

    Cochran, Jaquelin [National Renewable Energy Lab. (NREL), Golden, CO (United States); Bird, Lori [National Renewable Energy Lab. (NREL), Golden, CO (United States); Heeter, Jenny [National Renewable Energy Lab. (NREL), Golden, CO (United States); Arent, Douglas J. [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2012-04-30

    Many countries - reflecting very different geographies, markets, and power systems - are successfully managing high levels of variable renewable energy on the electric grid, including that from wind and solar energy. This document summarizes policy best practices that energy ministers and other stakeholders can pursue to ensure that electricity markets and power systems can effectively coevolve with increasing penetrations of variable renewable energy. There is no one-size-fits-all approach; each country studied has crafted its own combination of policies, market designs, and system operations to achieve the system reliability and flexibility needed to successfully integrate renewables. Notwithstanding this diversity, the approaches taken by the countries studied all coalesce around five strategic areas: lead public engagement, particularly for new transmission; coordinate and integrate planning; develop rules for market evolution that enable system flexibility; expand access to diverse resources and geographic footprint of operations; and improve system operations. This study also emphatically underscores the value of countries sharing their experiences. The more diverse and robust the experience base from which a country can draw, the more likely that it will be able to implement an appropriate, optimized, and system-wide approach.

  3. Integrating Variable Renewable Energy in Electric Power Markets. Best Practices from International Experience

    Energy Technology Data Exchange (ETDEWEB)

    Cochran, Jaquelin [National Renewable Energy Lab. (NREL), Golden, CO (United States); Bird, Lori [National Renewable Energy Lab. (NREL), Golden, CO (United States); Heeter, Jenny [National Renewable Energy Lab. (NREL), Golden, CO (United States); Arent, Douglas J. [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2012-04-30

    Many countries—reflecting very different geographies, markets, and power systems—are successfully managing high levels of variable renewable energy on the electric grid, including that from wind and solar energy. This document summarizes policy best practices that energy ministers and other stakeholders can pursue to ensure that electricity markets and power systems can effectively coevolve with increasing penetrations of variable renewable energy. There is no one-size-fits-all approach; each country studied has crafted its own combination of policies, market designs, and system operations to achieve the system reliability and flexibility needed to successfully integrate renewables. Notwithstanding this diversity, the approaches taken by the countries studied all coalesce around five strategic areas: lead public engagement, particularly for new transmission; coordinate and integrate planning; develop rules for market evolution that enable system flexibility; expand access to diverse resources and geographic footprint of operations; and improve system operations. This study also emphatically underscores the value of countries sharing their experiences. The more diverse and robust the experience base from which a country can draw, the more likely that it will be able to implement an appropriate, optimized, and system-wide approach.

  4. Adaptive practices in heart failure care teams: implications for patient-centered care in the context of complexity

    Directory of Open Access Journals (Sweden)

    Tait GR

    2015-08-01

    member and could extend to other settings. Conclusion: Adaptive practices emerged unpredictably and were variably experienced by team members. Our study offers an empirically grounded explanation of how HF care teams self-organize and how adaptive practices emerge from nonlinear interdependencies among diverse agents. We use these insights to reframe the question of palliative care integration, to ask how best to foster palliative care-aligned adaptive practices in HF care. This work has implications for health care’s growing challenge of providing care to those with chronic medical illness in complex, team-based settings. Keywords: palliative care, qualitative, complex adaptive system, multimorbidity, health care teams

  5. Indian Summer Monsoon Rainfall: Implications of Contrasting Trends in the Spatial Variability of Means and Extremes

    Science.gov (United States)

    Ghosh, Subimal; Vittal, H.; Sharma, Tarul; Karmakar, Subhankar; Kasiviswanathan, K. S.; Dhanesh, Y.; Sudheer, K. P.; Gunthe, S. S.

    2016-01-01

    India’s agricultural output, economy, and societal well-being are strappingly dependent on the stability of summer monsoon rainfall, its variability and extremes. Spatial aggregate of intensity and frequency of extreme rainfall events over Central India are significantly increasing, while at local scale they are spatially non-uniform with increasing spatial variability. The reasons behind such increase in spatial variability of extremes are poorly understood and the trends in mean monsoon rainfall have been greatly overlooked. Here, by using multi-decadal gridded daily rainfall data over entire India, we show that the trend in spatial variability of mean monsoon rainfall is decreasing as exactly opposite to that of extremes. The spatial variability of extremes is attributed to the spatial variability of the convective rainfall component. Contrarily, the decrease in spatial variability of the mean rainfall over India poses a pertinent research question on the applicability of large scale inter-basin water transfer by river inter-linking to address the spatial variability of available water in India. We found a significant decrease in the monsoon rainfall over major water surplus river basins in India. Hydrological simulations using a Variable Infiltration Capacity (VIC) model also revealed that the water yield in surplus river basins is decreasing but it is increasing in deficit basins. These findings contradict the traditional notion of dry areas becoming drier and wet areas becoming wetter in response to climate change in India. This result also calls for a re-evaluation of planning for river inter-linking to supply water from surplus to deficit river basins. PMID:27463092

  6. Indian Summer Monsoon Rainfall: Implications of Contrasting Trends in the Spatial Variability of Means and Extremes.

    Directory of Open Access Journals (Sweden)

    Subimal Ghosh

    Full Text Available India's agricultural output, economy, and societal well-being are strappingly dependent on the stability of summer monsoon rainfall, its variability and extremes. Spatial aggregate of intensity and frequency of extreme rainfall events over Central India are significantly increasing, while at local scale they are spatially non-uniform with increasing spatial variability. The reasons behind such increase in spatial variability of extremes are poorly understood and the trends in mean monsoon rainfall have been greatly overlooked. Here, by using multi-decadal gridded daily rainfall data over entire India, we show that the trend in spatial variability of mean monsoon rainfall is decreasing as exactly opposite to that of extremes. The spatial variability of extremes is attributed to the spatial variability of the convective rainfall component. Contrarily, the decrease in spatial variability of the mean rainfall over India poses a pertinent research question on the applicability of large scale inter-basin water transfer by river inter-linking to address the spatial variability of available water in India. We found a significant decrease in the monsoon rainfall over major water surplus river basins in India. Hydrological simulations using a Variable Infiltration Capacity (VIC model also revealed that the water yield in surplus river basins is decreasing but it is increasing in deficit basins. These findings contradict the traditional notion of dry areas becoming drier and wet areas becoming wetter in response to climate change in India. This result also calls for a re-evaluation of planning for river inter-linking to supply water from surplus to deficit river basins.

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

    Science.gov (United States)

    Burns, L R; Robinson, J C

    1997-01-01

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

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

    Science.gov (United States)

    Spitzer, William J; Davidson, Kay W

    2013-01-01

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

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

    DEFF Research Database (Denmark)

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

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

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

    Science.gov (United States)

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

    2010-01-01

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

  11. Socioeconomic status and oppositional defiant disorder in preschoolers: parenting practices and executive functioning as mediating variables.

    Science.gov (United States)

    Granero, Roser; Louwaars, Leonie; Ezpeleta, Lourdes

    2015-01-01

    To investigate the mediating mechanisms of oppositional defiant disorder (ODD) in preschoolers through pathways analysis, considering the family socioeconomic status (SES) as the independent variable and the parenting style and the children's executive functioning (EF) as the mediating factors. The sample included 622 three-year-old children from the general population. Multi-informant reports from parents and teachers were analyzed. Structural Equation Modeling showed that the associations between SES, EF, parenting style and ODD levels differed by children's gender: (a) for girls, the association of low SES and high ODD scores was partially mediated by difficulties in EF inhibition, and parenting practices defined by corporal punishment and inconsistent discipline obtained a quasi-significant indirect effect into the association between SES and ODD; (b) for boys, SES and EF (inhibition and emotional control) had a direct effect on ODD with no mediation. SES seems a good indicator to identify children at high-risk for prevention and intervention programs for ODD. Girls with ODD in families of low SES may particularly benefit from parent training practices and training in inhibition control.

  12. Socioeconomic status and Oppositional Defiant Disorder in preschoolers: parenting practices and executive functioning as mediating variables

    Directory of Open Access Journals (Sweden)

    Roser eGranero

    2015-09-01

    Full Text Available Objectives. To investigate the mediating mechanisms of oppositional defiant disorder (ODD in preschoolers through pathways analysis, considering the family socioeconomic status (SES as the independent variable and the parenting style and the children’s executive functioning (EF as the mediating factors.Method. Sample included 622 three years-old children from the general population. Multi-informant reports from parents and teachers were analyzed.Results. Structural Equation Modeling showed that children’s gender achieved a moderating role into the pathways valuing the underlying process between SES, EF, parenting style and ODD levels: a for girls, the association of low SES and high ODD scores was mediated by parenting practices (punishment and inconsistent discipline and by difficulties in EF inhibition, and a direct predictive effect on ODD level was achieved for SES, punishment and inconsistence in rearing style and inhibition; b for boys, SES and EF (inhibition and emotional control had a direct effect on ODD with no mediation.Conclusion. SES seems a good indicator to identify at high-risk children for prevention and intervention programs for ODD. Girls with ODD in families of low SES may particularly benefit from parent training practices and training in inhibition control.

  13. Sources of Variability in Consonant Perception and Implications for Speech Perception Modeling

    DEFF Research Database (Denmark)

    Zaar, Johannes; Dau, Torsten

    2016-01-01

    The  present  study  investigated  the  influence  of  various  sources  of response  variability  in  consonant  perception.  A  distinction  was  made  between source­induced variability and receiver­related variability. The former refers to perceptual differences induced by differences in the ...

  14. Rowing, the ultimate challenge to the human body - implications for physiological variables

    DEFF Research Database (Denmark)

    Volianitis, S.; Secher, Niels H.

    2009-01-01

    Clinical diagnoses depend on a variety of physiological variables but the full range of these variables is seldom known. With the load placed on the human body during competitive rowing, the physiological range for several variables is illustrated. The extreme work produced during rowing...... is explained by the seated position and the associated ability to increase venous return and, thus, cardiac output. This review highlights experimental work on Olympic rowing that presents a unique challenge to the human capacities, including cerebral metabolism, to unprecedented limits, and provides a unique...

  15. Hypertension and blood pressure variability management practices among physicians in Singapore.

    Science.gov (United States)

    Setia, Sajita; Subramaniam, Kannan; Tay, Jam Chin; Teo, Boon Wee

    2017-01-01

    There are limited data on blood pressure variability (BPV) in Singapore. The absence of updated local guidelines might contribute to variations in diagnosis, treatment and control of hypertension and BPV between physicians. This study evaluated BPV awareness, hypertension management and associated training needs in physicians from Singapore. Physicians from Singapore were surveyed between September 8, 2016, and October 5, 2016. Those included were in public or private practice for ≥3 years, cared directly for patients ≥70% of the time and treated ≥30 patients for hypertension each month. The questionnaire covered 6 main categories: general blood pressure (BP) management, BPV awareness/diagnosis, home BP monitoring (HBPM), ambulatory BP monitoring (ABPM), BPV management and associated training needs. Responses from 60 physicians (30 general practitioners [GPs], 20 cardiologists, 10 nephrologists) were analyzed (77% male, 85% aged 31-60 years, mean 22 years of practice). Approximately 63% of physicians considered white-coat hypertension as part of BPV. The most common diagnostic tool was HBPM (overall 77%, GPs 63%, cardiologists 65%, nephrologists 70%), but ABPM was rated as the tool most valued by physicians (80% overall), especially specialists (97%). Withdrawn Singapore guidelines were still being used by 73% of GPs. Approximately 48% of physicians surveyed did not adhere to the BP cutoff recommended by most guidelines for diagnosing hypertension using HBPM (>135/85 mmHg). Hypertension treatment practices also varied from available guideline recommendations, although physicians did tend to use a lower BP target for patients with diabetes or kidney disease. There were a number of challenges to estimating BPV, the most common of which was patient refusal of ABPM/HBPM. The majority of physicians (82%) had no training on BPV, but stated that this would be useful. There appear to be gaps in knowledge and guideline adherence relating to the assessment and

  16. Variable relationships of DOC with oxygen in the northwestern Indian Ocean and their ecological implications

    Digital Repository Service at National Institute of Oceanography (India)

    Rajendran, A.; DileepKumar, M.; Ramaiah, N.; Ittekkot, V.; Desai, B.N.

    characterizEd. by the reducing environment, is found to outflux CO sub(2) much faster than the other regions. Considering the latitudinally variable relationships of DOC with oxidants, its different transport pathyways in the water column are discussed...

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

    Science.gov (United States)

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

    2017-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Maria Corazon Saturnina A Castro

    2017-10-01

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

  19. Variables Affecting a Level of Practice and Quality of Educational Quality Assurance in Basic Education Schools

    Directory of Open Access Journals (Sweden)

    Jakkapong Prongprommarat

    2016-10-01

    Full Text Available The purposes of this research were to study the Level of Practice and Quality of Educational Quality Assurance in Basic Education Schools of the Office of the Basic Education Commission. The sample consisted of 60 secondnary schools in Office of the basic Education Commission in the provinces of Chaiyaphum, Nakhon Ratchasima, Burirum, Surin and Khon Kaen were drawn by using proportionally with the number of teachers in each school. The data were collected by using (1 the questionnaire on the acting of educational quality assurance in basic education schools. (2 the record form the external assessment of the office for National Education Standards and Quality Assessment, (3 the questionnaire on the director leadership, (2 test of the directors and teachers attitudes towards educational quality assurance, (5 test of the directors and teachers inquirying motive, (6 test of the directors and teachers working responsibility, and (7 the questionnaire on the directors and teachers cooperative. The statistical methods used to analysis the data were mean, standard deviation, coefficient of variation and path analysis. The findings revealed that: 1. The level of acting of educational quality assurance in basic education schools was at a high level. There was just a fairly difference in acting of educational quality assurance in basic education schools. 2. The level of external quality assessment in basic education schools was at a good level. There was just a little difference in external quality assessment in basic education schools. 3. The variables affecting level of acting of educational quality assurance in basic education schools were the level of the school directors attitudes towards educational quality assurance (β = 0.10, the level of the school directors working responsibility (β = 0.13, the level of the teacher attitudes towards educational quality assurance (β = 0.23 and the level of the teachers inquirying motive (β = 0.49 These four

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

    Science.gov (United States)

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

    2012-01-01

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

  1. Prewhitening of hydroclimatic time series? Implications for inferred change and variability across time scales

    Science.gov (United States)

    Razavi, Saman; Vogel, Richard

    2018-02-01

    Prewhitening, the process of eliminating or reducing short-term stochastic persistence to enable detection of deterministic change, has been extensively applied to time series analysis of a range of geophysical variables. Despite the controversy around its utility, methodologies for prewhitening time series continue to be a critical feature of a variety of analyses including: trend detection of hydroclimatic variables and reconstruction of climate and/or hydrology through proxy records such as tree rings. With a focus on the latter, this paper presents a generalized approach to exploring the impact of a wide range of stochastic structures of short- and long-term persistence on the variability of hydroclimatic time series. Through this approach, we examine the impact of prewhitening on the inferred variability of time series across time scales. We document how a focus on prewhitened, residual time series can be misleading, as it can drastically distort (or remove) the structure of variability across time scales. Through examples with actual data, we show how such loss of information in prewhitened time series of tree rings (so-called "residual chronologies") can lead to the underestimation of extreme conditions in climate and hydrology, particularly droughts, reconstructed for centuries preceding the historical period.

  2. Impulse-variability theory: implications for ballistic, multijoint motor skill performance.

    Science.gov (United States)

    Urbin, M A; Stodden, David F; Fischman, Mark G; Weimar, Wendi H

    2011-01-01

    Impulse-variability theory (R. A. Schmidt, H. N. Zelaznik, B. Hawkins, J. S. Frank, & J. T. Quinn, 1979) accounts for the curvilinear relationship between the magnitude and resulting variability of the muscular forces that influence the success of goal-directed limb movements. The historical roots of impulse-variability theory are reviewed in the 1st part of this article, including the relationship between movement speed and spatial error. The authors then address the relevance of impulse-variability theory for the control of ballistic, multijoint skills, such as throwing, striking, and kicking. These types of skills provide a stark contrast to the relatively simple, minimal degrees of freedom movements that characterized early research. However, the inherent demand for ballistic force generation is a strong parallel between these simple laboratory tasks and multijoint motor skills. Therefore, the authors conclude by recommending experimental procedures for evaluating the adequacy of impulse variability as a theoretical model within the context of ballistic, multijoint motor skill performance. Copyright © Taylor & Francis Group, LLC

  3. Climate change and water table fluctuation: Implications for raised bog surface variability

    Science.gov (United States)

    Taminskas, Julius; Linkevičienė, Rita; Šimanauskienė, Rasa; Jukna, Laurynas; Kibirkštis, Gintautas; Tamkevičiūtė, Marija

    2018-03-01

    Cyclic peatland surface variability is influenced by hydrological conditions that highly depend on climate and/or anthropogenic activities. A low water level leads to a decrease of peatland surface and an increase of C emissions into the atmosphere, whereas a high water level leads to an increase of peatland surface and carbon sequestration in peatlands. The main aim of this article is to evaluate the influence of hydrometeorological conditions toward the peatland surface and its feedback toward the water regime. A regional survey of the raised bog water table fluctuation and surface variability was made in one of the largest peatlands in Lithuania. Two appropriate indicators for different peatland surface variability periods (increase and decrease) were detected. The first one is an 200 mm y- 1 average net rainfall over a three-year range. The second one is an average annual water depth of 25-30 cm. The application of these indicators enabled the reconstruction of Čepkeliai peatland surface variability during a 100 year period. Processes of peatland surface variability differ in time and in separate parts of peatland. Therefore, internal subbasins in peatland are formed. Subbasins involve autogenic processes that can later affect their internal hydrology, nutrient status, and vegetation succession. Internal hydrological conditions, surface fluctuation, and vegetation succession in peatland subbasins should be taken into account during evaluation of their state, nature management projects, and other peatland research works.

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

    Science.gov (United States)

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

    2006-07-01

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

  5. The association of heavy and light chain variable domains in antibodies: implications for antigen specificity.

    KAUST Repository

    Chailyan, Anna

    2011-06-28

    The antigen-binding site of immunoglobulins is formed by six regions, three from the light and three from the heavy chain variable domains, which, on association of the two chains, form the conventional antigen-binding site of the antibody. The mode of interaction between the heavy and light chain variable domains affects the relative position of the antigen-binding loops and therefore has an effect on the overall conformation of the binding site. In this article, we analyze the structure of the interface between the heavy and light chain variable domains and show that there are essentially two different modes for their interaction that can be identified by the presence of key amino acids in specific positions of the antibody sequences. We also show that the different packing modes are related to the type of recognized antigen.

  6. Understanding the relationship between the variability in agrometeorological indices and adaptation practices across the Canadian Prairies

    Science.gov (United States)

    Chipanshi, A.; Qi, D.; Zhang, Y.; Cherneski, P.

    2017-12-01

    In an attempt to understand how agriculture will adapt to the changing and variable climate, crop based agrometeorological indices including the Effective Growing Degree Days (EGDDs), Growing Season Length (GSL), Heat waves, Water Demand (Precipitation - Evapotranspiration) and the Standardized Precipitation Evapotranspiration Index (SPEI) were analyzed in terms of frequency, duration and trend over a 63-year timeframe (1950 to 2012) from the Canadian Prairies and related to crop production. The heat based indices (EGDD, GSL and Heat waves) increased over the analysis period due to an upward increase in the observed mean temperature. The change was most noticeable in the northern portion of the study area where agriculture is limited by insufficient heat units under the present climate. Heat waves became more frequent in the southern parts of the study area (there were more days above the 30oC threshold). Water availability as assessed from water demand (P-PE) and SPEI trended downward especially in Alberta and Saskatchewan. In spite of the increased severity and frequency in water deficits, there was a noticeable reduction in the variability of crop yield over time. This was attributed to the increased adaptive capacity that has been gained through the use of improved seed hybrids, fertilizer, the use of fungicides and adoption of best management practices such as zero till and direct seeding. After crop yields were de-trended to remove effects of technology, the cumulative precipitation during the growing season explained the majority of the variance in crop yield. This initial analysis has set the stage for analyzing the characteristics of agrometeorological indices under climate change scenarios and how accumulated precipitation during the growing season will affect crop yield and production.

  7. The association of heavy and light chain variable domains in antibodies: implications for antigen specificity.

    KAUST Repository

    Chailyan, Anna; Marcatili, Paolo; Tramontano, Anna

    2011-01-01

    of interaction between the heavy and light chain variable domains affects the relative position of the antigen-binding loops and therefore has an effect on the overall conformation of the binding site. In this article, we analyze the structure of the interface

  8. A review of factors explaining variability in fentanyl pharmacokinetics; focus on implications for cancer patients

    NARCIS (Netherlands)

    Kuip, E.J.M.; Zandvliet, M.L.; Koolen, S.L.; Mathijssen, R.H.; Rijt, C.C. van der

    2017-01-01

    Fentanyl is a strong opioid that is available for various administration routes, and which is widely used to treat cancer-related pain. Many factors influence the fentanyl pharmacokinetics leading to a wide inter- and intrapatient variability. This systematic review summarizes multiple studied

  9. ESA STSE “SST Diurnal Variability: Regional Extend - Implications in Atmospheric Modelling”

    DEFF Research Database (Denmark)

    Karagali, Ioanna

    The diurnal variability of SST, driven by the coincident occurrence of low enough wind and solar heating, has been observed in various regions of the global ocean [4, 5, 6]. Atmospheric, oceanic and climate models are not adequately resolving the daily SST cycle, resulting in biases of the total...

  10. Quantification of the variability of diaphragm motion and implications for treatment margin construction

    NARCIS (Netherlands)

    Rit, Simon; van Herk, Marcel; Zijp, Lambert; Sonke, Jan-Jakob

    2012-01-01

    To quantify the variability of diaphragm motion during free-breathing radiotherapy of lung patients and its effect on treatment margins to account for geometric uncertainties. Thirty-three lung cancer patients were analyzed. Each patient had 5-19 cone-beam scans acquired during different treatment

  11. Population dynamics under increasing environmental variability: implications of climate change for ecological network design criteria

    NARCIS (Netherlands)

    Verboom, J.; Schippers, P.; Cormont, A.; Sterk, M.; Vos, C.C.; Opdam, P.F.M.

    2010-01-01

    There is growing evidence that climate change causes an increase in variation in conditions for plant and animal populations. This increase in variation, e.g. amplified inter-annual variability in temperature and rainfall has population dynamical consequences because it raises the variation in vital

  12. The Implications of Demographic Variables as Related to Burnout among a Sample of Special Education Teachers

    Science.gov (United States)

    Williams, Joy; Dikes, Catherine

    2015-01-01

    The attrition rate of highly qualified special education teachers is a pervasive problem in the United States. This study investigated the association between the burnout subscales of emotional exhaustion, depersonalization, and personal accomplishment relative to 10 demographic variables. Sixty-five special education teachers constituted the…

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

    Science.gov (United States)

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

    2015-03-15

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

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

    Science.gov (United States)

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

    2018-05-10

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

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

    Science.gov (United States)

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

    2010-11-01

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

  16. [Variables involved in the individual and collective practice of healthy habits].

    Science.gov (United States)

    García-Ubaque, Juan C; García-Ubaque, César A; Vaca-Bohórquez, Martha L

    2014-01-01

    To conduct a descriptive review of the concepts related to the practice of healthy habits by identifying the main variables associated with their managment in terms of health promotion actions. In consultation with groups working in health promotion in the city of performed by consulting databases and documentary sources. The strategy and criteria for the selection of documents was previously defined. Finally, we proceeded to organizing and structuring the information. It was established that, to promote healthy habits, four groups of behavior are involved: a) consumption, b) phyisical activity and hygiene, c) safety, and d) social participation. All of these are reviewed in order to point out the main concepts contained in each. The promotion of healthy habits must involve not only the transmission of behaviors associated with them. It must also involve understanding and adapting these habits to the environments of life in which people operate, with consideration for the different roles that they perform and the psychological and cultural demands that each space implies.

  17. Ethical implications for clinical practice and future research in "at risk" individuals.

    Science.gov (United States)

    Singh, Fiza; Mirzakhanian, Heline; Fusar-Poli, Paolo; de la Fuente-Sandoval, Camilo; Cadenhead, Kristin S

    2012-01-01

    The last 15 years have witnessed a shift in schizophrenia research with increasing interest in earlier stages of illness with the hope of early intervention and ultimately prevention of psychotic illness. Large-scale longitudinal studies have identified clinical and biological risk factors associated with increased risk of psychotic conversion, which together with symptomatic and demographic risk factors may improve the power of prediction algorithms for psychotic transition. Despite these advances, 45-70% of at risk subjects in most samples do not convert to frank psychosis, but continue to function well below their age matched counterparts. The issue is of utmost importance in light of the upcoming DSM-V and the possible inclusion of the attenuated psychotic symptoms syndrome (APSS) diagnosis, with clinical and ethical implications. Clinical considerations include feasibility of reliably diagnosing the at risk state in non-academic medical centers, variable psychotic conversion rates, a non-uniform definition of conversion and extensive debate about treatment for individuals with an ill-defined outcome. On the ethical side, diagnosing APSS could lead to unnecessary prescribing of antipsychotics with long-term deleterious consequences, slow research by providing a false sense of comfort in the diagnosis, and have psychosocial implications for those who receive a diagnosis. Thus it may be prudent to engage at risk populations early and to use broad-spectrum treatments with low risk benefit ratios to relieve functional impairments, while simultaneously studying all subsets of the at risk population.

  18. Endodontic implications of the variability of the root canal systems of posterior teeth.

    Science.gov (United States)

    Biggs, J T; Benenati, F W

    1995-01-01

    Variations in the morphology of roots and root canal systems create challenges which the dental practitioner must be able to recognize. Endodontic therapy is predictable and successful only to the extent that the root canal system can be debrided, disinfected and sealed against future contamination. In order to accomplish these goals it is necessary to become familiar with the variability of the system we seek to treat.

  19. Intra-individual variability of ITS regions in entomopathogenic nematodes (Steinernematidae: Nematoda): implications for their taxonomy

    Czech Academy of Sciences Publication Activity Database

    Půža, Vladimír; Chundelová, Daniela; Nermuť, Jiří; Žurovcová, Martina; Mráček, Zdeněk

    2015-01-01

    Roč. 60, č. 4 (2015), s. 547-554 ISSN 1386-6141 R&D Projects: GA ČR GAP504/12/2352 Grant - others:GA JU(CZ) 052/2013/P Institutional support: RVO:60077344 Keywords : Steinernema * genetic diversity * intra-individual variability Subject RIV: EG - Zoology Impact factor: 1.767, year: 2015 http://link.springer.com/article/10.1007%2Fs10526-015-9664-5

  20. Video-assisted thoracic surgery lobectomy cost variability: implications for a bundled payment era.

    Science.gov (United States)

    Medbery, Rachel L; Perez, Sebastian D; Force, Seth D; Gillespie, Theresa W; Pickens, Allan; Miller, Daniel L; Fernandez, Felix G

    2014-05-01

    In 2013, the Centers for Medicare and Medicaid Services began its Bundled Payments for Care Improvement Initiative. If payments are to be bundled, surgeons must be able to predict which patients are at risk for more costly care. We aim to identify factors driving variability in hospital costs after video-assisted thoracic surgery (VATS) lobectomy for lung cancer. Our institutional Society of Thoracic Surgeons data were queried for patients undergoing VATS lobectomy for lung cancer during fiscal years 2010 to 2011. Clinical outcomes data were linked with hospital financial data to determine operative and postoperative costs. Linear regression models were created to identify the impact of preoperative risk factors and perioperative outcomes on cost. One hundred forty-nine VATS lobectomies for lung cancer were reviewed. The majority of patients had clinical stage IA lung cancer (67.8%). Median length of stay was 4 days, with 30-day mortality and morbidity rates of 0.7% and 37.6%, respectively. Mean operative and postoperative costs per case were $8,492.31 (±$2,238.76) and $10,145.50 (±$7,004.71), respectively, resulting in an average overall hospital cost of $18,637.81 (±$8,244.12) per patient. Patients with chronic obstructive pulmonary disease and coronary artery disease, as well as postoperative urinary tract infections and blood transfusions, were associated with statistically significant variability in cost. Variability in cost associated with VATS lobectomy is driven by assorted patient and clinical variables. Awareness of such factors can help surgeons implement quality improvement initiatives and focus resource utilization. Understanding risk-adjusted clinical-financial data is critical to designing payment arrangements that include financial and performance accountability, and thus ultimately increasing the value of health care. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  1. Variability of ferritin measurements in chronic kidney disease; implications for iron management.

    Science.gov (United States)

    Ford, Bradley A; Coyne, Daniel W; Eby, Charles S; Scott, Mitchell G

    2009-01-01

    Serum ferritin levels are a proxy measure of iron stores; and existing guidelines for managing anemia in hemodialysis patients suggest that serum ferritin concentrations should be maintained at >200 ng/ml. The KDOQI recommendations further state there is insufficient evidence advocating routine intravenous iron when ferritin levels exceed 500 ng/ml. Here we determined the interassay differences and short-term intraindividual variability of serum ferritin measurements in patients on chronic hemodialysis to illustrate how these variances may affect treatment decisions. Intermethod variations of up to 150 ng/ml were found comparing six commonly used ferritin assays that evaluated thirteen pools of serum from hemodialysis and nonhemodialysis patients. The intraindividual variability for ferritin in 60 stable hemodialysis patients ranged between 2-62% measured over an initial two-week period and from 3-52% when factored over a six-week period. Our results suggests that single serum ferritin values should not be used to guide clinical decisions regarding treatment of chronic hemodialysis patients with intravenous iron due to significant analytical and intraindividual variability.

  2. Walking to the beat of different drums: practical implications for the use of acoustic rhythms in gait rehabilitation.

    Science.gov (United States)

    Roerdink, Melvyn; Bank, Paulina J M; Peper, C Lieke E; Beek, Peter J

    2011-04-01

    Acoustic rhythms are frequently used in gait rehabilitation, with positive instantaneous and prolonged transfer effects on various gait characteristics. The gait modifying ability of acoustic rhythms depends on how well gait is tied to the beat, which can be assessed with measures of relative timing of auditory-motor coordination. We examined auditory-motor coordination in 20 healthy elderly individuals walking to metronome beats with pacing frequencies slower than, equal to, and faster than their preferred cadence. We found that more steps were required to adjust gait to the beat, the more the metronome rate deviated from the preferred cadence. Furthermore, participants anticipated the beat with their footfalls to various degrees, depending on the metronome rate; the faster the tempo, the smaller the phase advance or phase lead. Finally, the variability in the relative timing between footfalls and the beat was smaller for metronome rates closer to the preferred cadence, reflecting superior auditory-motor coordination. These observations have three practical implications. First, instantaneous effects of acoustic stimuli on gait characteristics may typically be underestimated given the considerable number of steps required to attune gait to the beat in combination with the usual short walkways. Second, a systematic phase lead of footfalls to the beat does not necessarily reflect a reduced ability to couple gait to the metronome. Third, the efficacy of acoustic rhythms to modify gait depends on metronome rate. Gait is coupled best to the beat for metronome rates near the preferred cadence. Copyright © 2011 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

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

    2011-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Pradeep Kumar Misra

    2015-12-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Science.gov (United States)

    Momper, Sandra L

    2010-04-01

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

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

    International Nuclear Information System (INIS)

    Tschurlovits, M

    1998-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Aditya Johri

    2011-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Jerneja Sveticic

    2012-07-01

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

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

    Science.gov (United States)

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

    1993-01-01

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

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

    Science.gov (United States)

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

    2018-04-01

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

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

    Science.gov (United States)

    Zapata, Mara; Gallard, Alejandro J.

    2007-10-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

    Wilson, Alyssa N; Grant, Tara

    2015-05-01

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

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

    Science.gov (United States)

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

    2018-04-02

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

  16. Variability in stream discharge and temperature: a preliminary assessment of the implications for juvenile and spawning Atlantic salmon

    Directory of Open Access Journals (Sweden)

    D. Tetzlaff

    2005-01-01

    Full Text Available This study focuses on understanding the temporal variability in hydrological and thermal conditions in a small mountain stream and its potential implication for two life stages of Atlantic salmon (Salmo salar – stream resident juveniles and returning adult spawners. Stream discharge and temperature in the Girnock Burn, NE Scotland, were characterised over ten hydrological years (1994/1995–2003/2004. Attention was focussed on assessing variations during particular ecologically 'sensitive' time periods when selected life-stages of salmon behaviour may be especially influenced by hydrological and thermal conditions. Empirical discharge data were used to derive hydraulic parameters to predict the Critical Displacement Velocity (CDV of juvenile salmon. This is the velocity above which fish may no longer be able to hold station in the water column and thus can be used as an index of time periods where feeding behaviour might be constrained. In the Girnock Burn, strong inter- and intra-annual variability in hydrological and thermal conditions may have important implications for feeding opportunities for juvenile fish; both during important growth periods in late winter and early spring, and the emergence of fry in the late spring. Time periods when foraging behaviour of juvenile salmon may be constrained by hydraulic conditions were assessed as the percentage time when CDV for 0+ and 1+ fish were exceeded by mean daily stream velocities. Clear seasonal patterns of CDV were apparent, with higher summer values driven by higher stream temperatures and fish length. Inter-annual variability in the time when mean stream velocity exceeded CDV for 0+ fish ranged between 29.3% (1997/1998 and 44.7% (2000/2001. For 1+ fish mean stream velocity exceeded CDV between 14.5% (1997/1998 and 30.7% (2000/2001 of the time. The movement of adult spawners into the Girnock Burn in preparation for autumn spawning (late October to mid-November exhibited a complex

  17. Hydrologic scales, cloud variability, remote sensing, and models: Implications for forecasting snowmelt and streamflow

    Science.gov (United States)

    Simpson, James J.; Dettinger, M.D.; Gehrke, F.; McIntire, T.J.; Hufford, Gary L.

    2004-01-01

    Accurate prediction of available water supply from snowmelt is needed if the myriad of human, environmental, agricultural, and industrial demands for water are to be satisfied, especially given legislatively imposed conditions on its allocation. Robust retrievals of hydrologic basin model variables (e.g., insolation or areal extent of snow cover) provide several advantages over the current operational use of either point measurements or parameterizations to help to meet this requirement. Insolation can be provided at hourly time scales (or better if needed during rapid melt events associated with flooding) and at 1-km spatial resolution. These satellite-based retrievals incorporate the effects of highly variable (both in space and time) and unpredictable cloud cover on estimates of insolation. The insolation estimates are further adjusted for the effects of basin topography using a high-resolution digital elevation model prior to model input. Simulations of two Sierra Nevada rivers in the snowmelt seasons of 1998 and 1999 indicate that even the simplest improvements in modeled insolation can improve snowmelt simulations, with 10%-20% reductions in root-mean-square errors. Direct retrieval of the areal extent of snow cover may mitigate the need to rely entirely on internal calculations of this variable, a reliance that can yield large errors that are difficult to correct until long after the season is complete and that often leads to persistent underestimates or overestimates of the volumes of the water to operational reservoirs. Agencies responsible for accurately predicting available water resources from the melt of snowpack [e.g., both federal (the National Weather Service River Forecast Centers) and state (the California Department of Water Resources)] can benefit by incorporating concepts developed herein into their operational forecasting procedures. ?? 2004 American Meteorological Society.

  18. Sex-Specific Effects of Unpredictable Variable Prenatal Stress: Implications for Mammalian Developmental Programming During Spaceflight

    Science.gov (United States)

    Talyansky, Y.; Moyer, E. L.; Oijala, E.; Baer, L. A.; Ronca, A. E.

    2016-01-01

    During adaptation to the microgravity environment, adult mammals experience stress mediated by the Hypothalamic-Pituitary-Adrenal axis. In our previous studies of pregnant rats exposed to 2-g hypergravity via centrifugation, we reported decreased corticosterone and increased body mass and leptin in adult male, but not female, offspring. In this study, we utilized Unpredictable Variable Prenatal Stress to simulate the stressors of spaceflight by exposing dams to different stressors. Stress response modulation occurs via both positive and negative feedback in the hypothalamus, anterior pituitary gland, and adrenal cortex resulting in the differential release of corticosterone (CORT), a murine analog to human cortisol.

  19. Interannual variability of the South Pacific Convergence Zone and implications for tropical cyclone genesis

    Energy Technology Data Exchange (ETDEWEB)

    Vincent, Emmanuel M. [IRD/UPMC/CNRS/MNHN, Laboratoire d' Oceanographie et du Climat: Experimentation et Approches Numeriques (LOCEAN), Paris (France); UPMC, LOCEAN/IPSL, Paris Cedex 05 (France); Lengaigne, Matthieu [IRD/UPMC/CNRS/MNHN, Laboratoire d' Oceanographie et du Climat: Experimentation et Approches Numeriques (LOCEAN), Paris (France); National Institute of Oceanography, Goa (India); Menkes, Christophe E. [IRD/UPMC/CNRS/MNHN, Laboratoire d' Oceanographie et du Climat: Experimentation et Approches Numeriques (LOCEAN), Paris (France); Institut de Recherche pour le Developpement, Noumea (New Caledonia); Jourdain, Nicolas C. [Institut de Recherche pour le Developpement, Noumea (New Caledonia); Marchesiello, Patrick [Institut de Recherche pour le Developpement, Noumea (New Caledonia); CNES/CNRS/UPS/IRD, Laboratoire d' Etudes en Geophysique et Oceanographie Spatiale (LEGOS), Toulouse (France); Madec, Gurvan [IRD/UPMC/CNRS/MNHN, Laboratoire d' Oceanographie et du Climat: Experimentation et Approches Numeriques (LOCEAN), Paris (France); National Oceanographic Centre, Southampton (United Kingdom)

    2011-05-15

    The interannual variability of the South Pacific Convergence Zone (SPCZ) and its influence on tropical cyclone (TC) genesis in the South Pacific are investigated using observations and ERA40 reanalysis over the 1979-2002 period. In austral summer, the SPCZ displays four typical structures at interannual timescales. The first three are characterized by a diagonal orientation of the SPCZ and account for 85% of the summer seasons. One is close to climatology and the other two exhibit a 3 northward or southward departure from the SPCZ climatological position. In contrast, the fourth one, that only encompasses three austral summer seasons (the extreme 1982/1983 and 1997/1998 El Nino events and the moderate 1991/1992 El Nino event), displays very peculiar behaviour where the SPCZ largely departs from its climatological position and is zonally oriented. Variability of the western/central Pacific equatorial sea surface temperature (SST) is shown to modulate moisture transport south of the equator, thereby strongly constraining the location of the SPCZ. The SPCZ location is also shown to strongly modulate the atmospheric circulation variability in the South Pacific with specific patterns for each class. However, independently of its wide year-to-year excursions, the SPCZ is always collocated with the zero relative vorticity at low levels while the maximum vorticity axis lies 6 to the south of the SPCZ position. This coherent atmospheric organisation in the SPCZ region is shown to constrain tropical cyclogenesis to occur preferentially within 10 south of the SPCZ location as this region combines all the large-scale atmospheric conditions that favour the breeding of TCs. This analysis also reveals that cyclogenesis in the central Pacific (in the vicinity of French Polynesia) only occurs when the SPCZ displays a zonal orientation while this observation was previously attributed to El Nino years in general. Different characteristics of El Nino Southern Oscillation (ENSO

  20. Mid-infrared interferometric variability of DG Tauri: Implications for the inner-disk structure

    Science.gov (United States)

    Varga, J.; Gabányi, K. É.; Ábrahám, P.; Chen, L.; Kóspál, Á.; Menu, J.; Ratzka, Th.; van Boekel, R.; Dullemond, C. P.; Henning, Th.; Jaffe, W.; Juhász, A.; Moór, A.; Mosoni, L.; Sipos, N.

    2017-08-01

    Context. DG Tau is a low-mass pre-main sequence star, whose strongly accreting protoplanetary disk exhibits a so-far enigmatic behavior: its mid-infrared thermal emission is strongly time-variable, even turning the 10 μm silicate feature from emission to absorption temporarily. Aims: We look for the reason for the spectral variability at high spatial resolution and at multiple epochs. Methods: Infrared interferometry can spatially resolve the thermal emission of the circumstellar disk, also giving information about dust processing. We study the temporal variability of the mid-infrared interferometric signal, observed with the VLTI/MIDI instrument at six epochs between 2011 and 2014. We fit a geometric disk model to the observed interferometric signal to obtain spatial information about the disk. We also model the mid-infrared spectra by template fitting to characterize the profile and time dependence of the silicate emission. We use physically motivated radiative transfer modeling to interpret the mid-infrared interferometric spectra. Results: The inner disk (r 1-3 au) spectra show a crystalline silicate feature in emission, similar to the spectra of comet Hale-Bopp. The striking difference between the inner and outer disk spectral feature is highly unusual among T Tauri stars. The mid-infrared variability is dominated by the outer disk. The strength of the silicate feature changed by more than a factor of two. Between 2011 and 2014 the half-light radius of the mid-infrared-emitting region decreased from 1.15 to 0.7 au. Conclusions: For the origin of the absorption we discuss four possible explanations: a cold obscuring envelope, an accretion heated inner disk, a temperature inversion on the disk surface and a misaligned inner geometry. The silicate emission in the outer disk can be explained by dusty material high above the disk plane, whose mass can change with time, possibly due to turbulence in the disk. Based on observations made with the ESO Very Large

  1. Interannual variability of the South Pacific Convergence Zone and implications for tropical cyclone genesis

    Digital Repository Service at National Institute of Oceanography (India)

    Vincent, E.M.; Lengaigne, M.; Menkes, C.E.; Jourdain, N.C.; Marchesiello, P.; Madec, G.

    SPCZ con- trols the large scale environment favouring cyclonic activity have not yet been investigated. In addition, the characteristics of El Nin˜o events vary widely from one event to another, and the influence of this diversity on the SPCZ location... which the classification is performed) accu- rately summarizes the large-scale precipitation variability in the tropical South Pacific (on which the EOFs are con- structed). The same AHC applied to PC1–PC2 coordinates instead of latW–latE indices gives...

  2. Impact of Climate Variability on Flowering Phenology and Its Implications for the Schedule of Blossom Festivals

    Directory of Open Access Journals (Sweden)

    Lu Wang

    2017-06-01

    Full Text Available Many tourism destinations characterized by spring blossom festivals (e.g., cherry blossom festival became increasingly popular around the world. Usually, spring blossom festivals should be planned within the flowering period of specific ornamental plants. In the context of climate and phenological change, whether the administrators of tourism destinations had perceived and responded to the flowering phenological variability is still unknown. Using the data of climate, blossom festival dates (BFD of three tourist attractions, and first flowering dates (FFD of specific species in Beijing, China, we analyzed the flowering phenological response to temperature and the impact of FFDs on BFDs from 1989 to 2016. It was shown that the flowering time of ornamental plants varied significantly among years in response to temperature variability. The administrators of Beijing Botanical Garden and Yuyuantan Park determined peach BFD and cherry BFD based on their experience rather than FFD of corresponding plants. Therefore, the mismatch between BFD and FFD occurred frequently at these two locations. However, the administrator of Jingshan Park scheduled the peony BFD following the variance of FFD of tree peony. These results revealed the various perceptions of climate change impacts for stakeholders of blossom festivals.

  3. The effect of biomechanical variables on force sensitive resistor error: Implications for calibration and improved accuracy.

    Science.gov (United States)

    Schofield, Jonathon S; Evans, Katherine R; Hebert, Jacqueline S; Marasco, Paul D; Carey, Jason P

    2016-03-21

    Force Sensitive Resistors (FSRs) are commercially available thin film polymer sensors commonly employed in a multitude of biomechanical measurement environments. Reasons for such wide spread usage lie in the versatility, small profile, and low cost of these sensors. Yet FSRs have limitations. It is commonly accepted that temperature, curvature and biological tissue compliance may impact sensor conductance and resulting force readings. The effect of these variables and degree to which they interact has yet to be comprehensively investigated and quantified. This work systematically assesses varying levels of temperature, sensor curvature and surface compliance using a full factorial design-of-experiments approach. Three models of Interlink FSRs were evaluated. Calibration equations under 12 unique combinations of temperature, curvature and compliance were determined for each sensor. Root mean squared error, mean absolute error, and maximum error were quantified as measures of the impact these thermo/mechanical factors have on sensor performance. It was found that all three variables have the potential to affect FSR calibration curves. The FSR model and corresponding sensor geometry are sensitive to these three mechanical factors at varying levels. Experimental results suggest that reducing sensor error requires calibration of each sensor in an environment as close to its intended use as possible and if multiple FSRs are used in a system, they must be calibrated independently. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Inter- and Intra-individual variability following intermittent theta burst stimulation: implications for rehabilitation and recovery.

    Science.gov (United States)

    Hinder, Mark R; Goss, Emily L; Fujiyama, Hakuei; Canty, Alison J; Garry, Michael I; Rodger, Jennifer; Summers, Jeffery J

    2014-01-01

    The continued refinement of non-invasive brain stimulation (NBS) techniques is indicative of promising clinical and rehabilitative interventions that are able to modulate cortical excitability. Intermittent theta burst stimulation (iTBS) is one such technique that can increase cortical excitability, purportedly via LTP-like mechanisms. While iTBS may have the capacity to promote recovery after neurological injury, and to combat cognitive and motor decline, recent reports observed highly variable effects across individuals, questioning the efficacy of iTBS as a clinical tool. The aim of this study was to examine intra-individual reliability and inter-individual variability in responses to iTBS. Thirty healthy participants completed two experimental sessions of the iTBS protocol 1-3 weeks apart. Motor evoked potentials in response to single pulse TMS were used to assess corticospinal excitability prior to, and up to 36 min following, iTBS. At the group level, iTBS evoked statistically significant increases in motor cortical excitability across both sessions (P iTBS is capable of inducing relatively robust and consistent effects within and between young individuals. As such, the capacity for iTBS to be exploited in clinical and rehabilitative interventions should continue to be explored. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Intra-individual gait pattern variability in specific situations: Implications for forensic gait analysis.

    Science.gov (United States)

    Ludwig, Oliver; Dillinger, Steffen; Marschall, Franz

    2016-07-01

    In this study, inter- and intra-individual gait pattern differences are examined in various gait situations by means of phase diagrams of the extremity angles (cyclograms). 8 test subjects walked along a walking distance of 6m under different conditions three times each: barefoot, wearing sneakers, wearing combat boots, after muscular fatigue, and wearing a full-face motorcycle helmet restricting vision. The joint angles of foot, knee, and hip were recorded in the sagittal plane. The coupling of movements was represented by time-adjusted cyclograms, and the inter- and intra-individual differences were captured by calculating the similarity between different gait patterns. Gait pattern variability was often greater between the defined test situations than between the individual test subjects. The results have been interpreted considering neurophysiological regulation mechanisms. Footwear, masking, and fatigue were interpreted as disturbance parameters, each being a cause for gait pattern variability and complicating the inference of identity of persons in video recordings. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. Variable Methylation Potential in Preterm Placenta: Implication for Epigenetic Programming of the Offspring.

    Science.gov (United States)

    Khot, Vinita V; Chavan-Gautam, Preeti; Mehendale, Savita; Joshi, Sadhana R

    2017-06-01

    Children born preterm are reported to be at increased risk of developing noncommunicable diseases in later life. Altered placental DNA methylation patterns are implicated in fetal programming of adult diseases. Our earlier animal studies focus on micronutrients (folic acid, vitamin B 12 ) and long-chain polyunsaturated fatty acids (LCPUFAs) that interact in the 1 carbon cycle, thereby influencing methylation reactions. Our previous studies in women delivering preterm show altered plasma levels of micronutrients and lower plasma LCPUFA levels. We postulate that alterations in the micronutrient metabolism may affect the regulation of enzymes, methionine adenosyltransferase ( MAT2A), and SAH-hydrolase ( AHCY), involved in the production of methyl donor S-adenosylmethionine (SAM), thereby influencing the methylation potential (MP) in the placenta of women delivering preterm. The present study, therefore, examines the mRNA, protein levels of enzymes ( MAT2A and AHCY), SAM, S-adenosylhomocysteine (SAH) levels, and global DNA methylation levels from preterm (n = 73) and term (n = 73) placentae. The enzyme messenger RNA (mRNA) levels were analyzed by real-time quantitative polymerase chain reaction, protein levels by enzyme-linked immunosorbent assay, and SAM-SAH levels by high-performance liquid chromatography. The mRNA levels for MAT2A and AHCY are higher ( P programming of the developing fetus.

  7. Offer acceptance practices and geographic variability in allocation model for end-stage liver disease at transplant.

    Science.gov (United States)

    Wey, Andrew; Pyke, Joshua; Schladt, David P; Gentry, Sommer E; Weaver, Tim; Salkowski, Nicholas; Kasiske, Bertram L; Israni, Ajay K; Snyder, Jon J

    2018-04-01

    Offer acceptance practices may cause geographic variability in allocation Model for End-Stage Liver Disease (aMELD) score at transplant and could magnify the effect of donor supply and demand on aMELD variability. To evaluate these issues, offer acceptance practices of liver transplant programs and donation service areas (DSAs) were estimated using offers of livers from donors recovered between January 1, 2016, and December 31, 2016. Offer acceptance practices were compared with liver yield, local placement of transplanted livers, donor supply and demand, and aMELD at transplant. Offer acceptance was associated with liver yield (odds ratio, 1.32; P offer acceptance (r = 0.09; P = 0.50). Additionally, the association between DSA-level donor-to-candidate ratios and aMELD at transplant did not change after adjustment for offer acceptance. The average squared difference in median aMELD at transplant across DSAs was 24.6; removing the effect of donor-to-candidate ratios reduced the average squared differences more than removing the effect of program-level offer acceptance (33% and 15% reduction, respectively). Offer acceptance practices and donor-to-candidate ratios independently contributed to geographic variability in aMELD at transplant. Thus, neither offer acceptance nor donor-to-candidate ratios can explain all of the geographic variability in aMELD at transplant. Liver Transplantation 24 478-487 2018 AASLD. © 2018 by the American Association for the Study of Liver Diseases.

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

    International Nuclear Information System (INIS)

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

    1982-01-01

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

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

    Science.gov (United States)

    Goekoop, R; Goekoop, J G

    2016-01-01

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

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

    Science.gov (United States)

    Clark, Phillip G

    2014-01-01

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

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

    Science.gov (United States)

    Skinner, Mark W; Winterton, Rachel

    2018-01-18

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

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

    Directory of Open Access Journals (Sweden)

    Rahul Mor

    2015-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Aleksandra Karovska Ristovska

    2017-12-01

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

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

    Science.gov (United States)

    Arber, Anne; Gallagher, Ann

    2003-04-01

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

  15. Pathogenic variability within race 65 of Colletotrichum lindemuthianum and its implications for common bean breeding

    Directory of Open Access Journals (Sweden)

    Livia Maria Chamma Davide

    2009-01-01

    Full Text Available The wide pathogenic variability among and within races of Colletotrichum lindemuthianum has complicated theprocess of obtaining cultivars of Phaseolus vulgaris that are resistant to anthracnose. Six isolates were inoculated into twelvedifferential cultivars and seven commercial cultivars of the common bean at concentrations in the range 102 to 106 sporesmL-1. Information concerning the vertical and horizontal resistance of hosts and the virulence of isolates was obtained fromdiallel analysis. It was clear that the set of differential cultivars recommended for the determination of races of C. lindemuthianumis inefficient in detecting differences within race 65, and it is suggested that new sources of resistance should be identified andadded to the cultivar set. There were significant differences in the virulence of isolates from race 65, with isolates CL 837 and CL844 being the most virulence. No horizontal resistance was detected in the C. lindemuthianum-common bean system.

  16. The Stock Market and Macroeconomic Variables in a BRICS Country and Policy Implications

    Directory of Open Access Journals (Sweden)

    Yu Hsing

    2011-01-01

    Full Text Available This paper examines the effects of selected macroeconomic variables on the stock market index in South Africa. The exponential GARCH (Nelson, 1991 model is applied. It finds that South Africa’s stock market index is positively influenced by the growth rate of real GDP, the ratio of the money supply to GDP and the U.S. stock market index and negatively affected by the ratio of the government deficit to GDP, the domestic real interest rate, the nominal effective exchange rate, the domestic inflation rate, and the U.S. government bond yield. Therefore, to maintain a robust stock market, the authorities are expected to pursue economic growth, fiscal prudence, a higher ratio of the money supply to GDP, a lower real interest rate, depreciation of the rand, and/or a lower inflation rate.

  17. Carpet-dust chemicals as measures of exposure: Implications of variability

    Directory of Open Access Journals (Sweden)

    Whitehead Todd P

    2012-03-01

    Full Text Available Abstract Background There is increasing interest in using chemicals measured in carpet dust as indicators of chemical exposures. However, investigators have rarely sampled dust repeatedly from the same households and therefore little is known about the variability of chemical levels that exist within and between households in dust samples. Results We analyzed 9 polycyclic aromatic hydrocarbons, 6 polychlorinated biphenyls, and nicotine in 68 carpet-dust samples from 21 households in agricultural communities of Fresno County, California collected from 2003-2005. Chemical concentrations (ng per g dust ranged from Conclusions Our findings suggest that attenuation bias should be relatively modest when using these semi-volatile carpet-dust chemicals as exposure surrogates in epidemiologic studies.

  18. Time variability of C-reactive protein: implications for clinical risk stratification.

    Directory of Open Access Journals (Sweden)

    Peter Bogaty

    Full Text Available C-reactive protein (CRP is proposed as a screening test for predicting risk and guiding preventive approaches in coronary artery disease (CAD. However, the stability of repeated CRP measurements over time in subjects with and without CAD is not well defined. We sought to determine the stability of serial CRP measurements in stable subjects with distinct CAD manifestations and a group without CAD while carefully controlling for known confounders.We prospectively studied 4 groups of 25 stable subjects each 1 a history of recurrent acute coronary events; 2 a single myocardial infarction ≥7 years ago; 3 longstanding CAD (≥7 years that had never been unstable; 4 no CAD. Fifteen measurements of CRP were obtained to cover 21 time-points: 3 times during one day; 5 consecutive days; 4 consecutive weeks; 4 consecutive months; and every 3 months over the year. CRP risk threshold was set at 2.0 mg/L. We estimated variance across time-points using standard descriptive statistics and Bayesian hierarchical models.Median CRP values of the 4 groups and their pattern of variability did not differ substantially so all subjects were analyzed together. The median individual standard deviation (SD CRP values within-day, within-week, between-weeks and between-months were 0.07, 0.19, 0.36 and 0.63 mg/L, respectively. Forty-six percent of subjects changed CRP risk category at least once and 21% had ≥4 weekly and monthly CRP values in both low and high-risk categories.Considering its large intra-individual variability, it may be problematic to rely on CRP values for CAD risk prediction and therapeutic decision-making in individual subjects.

  19. Depositional and diagenetic variability within the Cambrian Mount Simon Sandstone: Implications for carbon dioxide sequestration

    Science.gov (United States)

    Bowen, B.B.; Ochoa, R.I.; Wilkens, N.D.; Brophy, J.; Lovell, T.R.; Fischietto, N.; Medina, C.R.; Rupp, J.A.

    2011-01-01

    The Cambrian Mount Simon Sandstone is the major target reservoir for ongoing geologic carbon dioxide (CO2) sequestration demonstrations throughout the midwest United States. The potential CO2 reservoir capacity, reactivity, and ultimate fate of injected CO2 depend on textural and compositional properties determined by depositional and diagenetic histories that vary vertically and laterally across the formation. Effective and efficient prediction and use of the available pore space requires detailed knowledge of the depositional and diagenetic textures and mineralogy, how these variables control the petrophysical character of the reservoir, and how they vary spatially. Here, we summarize the reservoir characteristics of the Mount Simon Sandstone based on examination of geophysical logs, cores, cuttings, and analysis of more than 150 thin sections. These samples represent different parts of the formation and depth ranges of more than 9000 ft (>2743 m) across the Illinois Basin and surrounding areas. This work demonstrates that overall reservoir quality and, specifically, porosity do not exhibit a simple relationship with depth, but vary both laterally and with depth because of changes in the primary depositional facies, framework composition (i.e., feldspar concentration), and diverse diagenetic modifications. Diagenetic processes that have been significant in modifying the reservoir include formation of iron oxide grain coatings, chemical compaction, feldspar precipitation and dissolution, multiple generations of quartz overgrowth cementation, clay mineral precipitation, and iron oxide cementation. These variables provide important inputs for calculating CO2 capacity potential, modeling reactivity, and are also an important baseline for comparisons after CO2 injection. Copyright ??2011. The American Association of Petroleum Geologists/Division of Environmental Geosciences. All rights reserved.

  20. Abandoned mines, mountain sports, and climate variability: Implications for the Colorado tourism economy

    Science.gov (United States)

    Todd, Andrew; McKnight, Diane; Wyatt, Lane

    Until recently, the allure of the mountains in the American West was primarily extractive, for commodities like timber, water, and precious metals [Baron et. al., 2000]. Now, the effective marketing and management of the regions “white gold” by the ski industry has stimulated significant recreation-related growth and development in the last several decades. Under an uncertain climatic future, however, these burgeoning industries, and the communities that have grown up in relation to them, are facing water quality constraints inherited from historical mining practices, causing mountain water to become a limited resource more valuable than the precious metals of the past. Further, the current lack of proven, in-situ approaches for addressing distributed, mining waste pollution of fresh water complicates potential remediation efforts.

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

    Science.gov (United States)

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

    2005-08-01

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

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

    Science.gov (United States)

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

    2014-02-01

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

  3. Causes of Greenland temperature variability over the past 4000 yr: implications for northern hemispheric temperature changes

    Directory of Open Access Journals (Sweden)

    T. Kobashi

    2013-10-01

    Full Text Available Precise understanding of Greenland temperature variability is important in two ways. First, Greenland ice sheet melting associated with rising temperature is a major global sea level forcing, potentially affecting large populations in coming centuries. Second, Greenland temperatures are highly affected by North Atlantic Oscillation/Arctic Oscillation (NAO/AO and Atlantic multidecadal oscillation (AMO. In our earlier study, we found that Greenland temperature deviated negatively (positively from northern hemispheric (NH temperature trend during stronger (weaker solar activity owing to changes in atmospheric/oceanic changes (e.g. NAO/AO over the past 800 yr (Kobashi et al., 2013. Therefore, a precise Greenland temperature record can provide important constraints on the past atmospheric/oceanic circulation in the region and beyond. Here, we investigated Greenland temperature variability over the past 4000 yr reconstructed from argon and nitrogen isotopes from trapped air in a GISP2 ice core, using a one-dimensional energy balance model with orbital, solar, volcanic, greenhouse gas, and aerosol forcings. The modelled northern Northern Hemisphere (NH temperature exhibits a cooling trend over the past 4000 yr as observed for the reconstructed Greenland temperature through decreasing annual average insolation. With consideration of the negative influence of solar variability, the modelled and observed Greenland temperatures agree with correlation coefficients of r = 0.34–0.36 (p = 0.1–0.04 in 21 yr running means (RMs and r = 0.38–0.45 (p = 0.1–0.05 on a centennial timescale (101 yr RMs. Thus, the model can explain 14 to 20% of variance of the observed Greenland temperature in multidecadal to centennial timescales with a 90–96% confidence interval, suggesting that a weak but persistent negative solar influence on Greenland temperature continued over the past 4000 yr. Then, we estimated the distribution of multidecadal NH and northern high

  4. Conservation and variability of dengue virus proteins: implications for vaccine design.

    Directory of Open Access Journals (Sweden)

    Asif M Khan

    2008-08-01

    Full Text Available Genetic variation and rapid evolution are hallmarks of RNA viruses, the result of high mutation rates in RNA replication and selection of mutants that enhance viral adaptation, including the escape from host immune responses. Variability is uneven across the genome because mutations resulting in a deleterious effect on viral fitness are restricted. RNA viruses are thus marked by protein sites permissive to multiple mutations and sites critical to viral structure-function that are evolutionarily robust and highly conserved. Identification and characterization of the historical dynamics of the conserved sites have relevance to multiple applications, including potential targets for diagnosis, and prophylactic and therapeutic purposes.We describe a large-scale identification and analysis of evolutionarily highly conserved amino acid sequences of the entire dengue virus (DENV proteome, with a focus on sequences of 9 amino acids or more, and thus immune-relevant as potential T-cell determinants. DENV protein sequence data were collected from the NCBI Entrez protein database in 2005 (9,512 sequences and again in 2007 (12,404 sequences. Forty-four (44 sequences (pan-DENV sequences, mainly those of nonstructural proteins and representing approximately 15% of the DENV polyprotein length, were identical in 80% or more of all recorded DENV sequences. Of these 44 sequences, 34 ( approximately 77% were present in >or=95% of sequences of each DENV type, and 27 ( approximately 61% were conserved in other Flaviviruses. The frequencies of variants of the pan-DENV sequences were low (0 to approximately 5%, as compared to variant frequencies of approximately 60 to approximately 85% in the non pan-DENV sequence regions. We further showed that the majority of the conserved sequences were immunologically relevant: 34 contained numerous predicted human leukocyte antigen (HLA supertype-restricted peptide sequences, and 26 contained T-cell determinants identified by

  5. Observing Seasonal and Diurnal Hydrometeorological Variability Within a Tropical Alpine Valley: Implications for Evapotranspiration

    Science.gov (United States)

    Hellstrom, R. A.; Mark, B. G.

    2007-12-01

    Conditions of glacier recession in the seasonally dry tropical Peruvian Andes motivate research to better constrain the hydrological balance in alpine valleys. There is an outstanding need to better understand the impact of the pronounced tropical hygric seasonality on energy and water budgets within pro-glacial valleys that channel glacier runoff to stream flow. This paper presents a novel embedded network installed in the glacierized Llanganuco valley of the Cordillera Blanca (9°S) comprising eight low-cost, discrete temperature and humidity microloggers ranging from 3470 to 4740 masl and an automatic weather station at 3850 masl. Data are aggregated into distinct dry and wet periods sampled from two full annual cycles (2004-2006) to explore patterns of diurnal and seasonal variability. The magnitude of diurnal solar radiation varies little within the valley between the dry and wet periods, while wet season near-surface air temperatures are cooler. Seasonally characteristic diurnal fluctuations in lapse rate partially regulate convection and humidity. Steep lapse rates during the wet season afternoon promote up-slope convection of warm, moist air and nocturnal rainfall events. Standardized grass reference evapotranspiration (ET0) was estimated using the FAO-56 algorithm of the United Nations Food and Agriculture Organization and compared with estimates of actual ET from the process-based BROOK90 model that incorporates more realistic vegetation parameters. Comparisons of composite diurnal cycles of ET for the wet and dry periods suggest about twice the daily ET0 during the dry period, attributed primarily to the 500% higher vapor pressure deficit and 20% higher daily total solar irradiance. Conversely, the near absence of rainfall during the dry season diminishes actual ET below that of the wet season by two orders of magnitude. Nearly cloud-free daylight conditions are critical for ET during the wet season. We found significant variability of ET with elevation

  6. Influence of velocity on variability in gait kinematics: implications for recognition in forensic science.

    Science.gov (United States)

    Yang, Sylvia X M; Larsen, Peter K; Alkjaer, Tine; Lynnerup, Niels; Simonsen, Erik B

    2014-09-01

    Closed circuit television (CCTV) footage is often available from crime scenes and may be used to compare perpetrators with suspects. Usually, the footage comprises incomplete gait cycles at different velocities, making gait pattern identification from crimes difficult. This study investigated the concurrence of joint angles throughout a gait cycle at three different velocities (3.0, 4.5, 6.0 km/h). Six datasets at each velocity were collected from 16 men. A variability range VR throughout the gait cycle at each velocity for each joint angle for each person was calculated. The joint angles at each velocity were compared pairwise, and whenever this showed values within the VR of this velocity, the case was positive. By adding the positives throughout the gait cycle, phases with high and low concurrences were located; peak concurrence was observed at mid-stance phase. Striving for the same velocity for the suspect and perpetrator is recommended. © 2014 American Academy of Forensic Sciences.

  7. Parity implications for anthropometrical variables, lifestyle behaviors and dietary habits in pregnant women.

    Science.gov (United States)

    Goñi, L; Cuervo, M; Santiago, S; Zazpe, I; Martínez, J A

    2014-01-01

    Maintaining an adequate health status and appropriate lifestyles during pregnancy is of great importance to prevent adverse outcomes for both mother and baby. The present study aimed to assess the nutritional status, socio-demographic features, lifestyle behaviors and dietary habits of pregnant women in Spain, and to identify the influence of parity on these profiles. This cross-sectional study included pregnant women from regions all over Spain. The information was collected through a 40 item questionnaire, previously validated by community health professionals. The 5,087 pregnant women analyzed had an average age of 31.9 years with an adequate nutritional status. The distribution of the sample was 56% nulliparous and 44% multiparous. The nulliparous reported a better self-perceived health status and nutritional balance, and a lower incidence of gestational diabetes mellitus. However, the multiparous showed healthier lifestyle habits (lower rates of smoking and alcohol consumption) and more physically active patterns. Regarding diet, nulliparous pregnant women consumed more dairy products, fresh fruit and nuts, and less bread, rice/pasta/potatoes, meat, sausage and buns/pastries than multiparous pregnant women. Differences between analyzed patterns were observed in anthropometrical variables, lifestyle behaviors and dietary habits, which may require different nutritional messages to nulliparous as compared to multiparous from a public health point of view.

  8. Remote sensing and implications for variable-rate application using agricultural aircraft

    Science.gov (United States)

    Thomson, Steven J.; Smith, Lowrey A.; Ray, Jeffrey D.; Zimba, Paul V.

    2004-01-01

    Aircraft routinely used for agricultural spray application are finding utility for remote sensing. Data obtained from remote sensing can be used for prescription application of pesticides, fertilizers, cotton growth regulators, and water (the latter with the assistance of hyperspectral indices and thermal imaging). Digital video was used to detect weeds in early cotton, and preliminary data were obtained to see if nitrogen status could be detected in early soybeans. Weeds were differentiable from early cotton at very low altitudes (65-m), with the aid of supervised classification algorithms in the ENVI image analysis software. The camera was flown at very low altitude for acceptable pixel resolution. Nitrogen status was not detectable by statistical analysis of digital numbers (DNs) obtained from images, but soybean cultivar differences were statistically discernable (F=26, p=0.01). Spectroradiometer data are being analyzed to identify narrow spectral bands that might aid in selecting camera filters for determination of plant nitrogen status. Multiple camera configurations are proposed to allow vegetative indices to be developed more readily. Both remotely sensed field images and ground data are to be used for decision-making in a proposed variable-rate application system for agricultural aircraft. For this system, prescriptions generated from digital imagery and data will be coupled with GPS-based swath guidance and programmable flow control.

  9. Spatial variability of carbon dioxide in the urban canopy layer and implications for flux measurements

    Science.gov (United States)

    Crawford, B.; Christen, A.

    2014-12-01

    This contribution reports CO2 mixing ratios measured in the urban canopy layer (UCL) of a residential neighborhood in Vancouver, BC, Canada and discusses the relevance of UCL CO2 temporal and spatial variability to local-scale eddy covariance (EC) fluxes measured above the UCL. Measurements were conducted from a mobile vehicle-mounted platform over a continuous, 26-h period in the longterm turbulent flux source area of an urban EC tower. Daytime mixing ratios were highest along arterial roads and largely a function of proximity to vehicle traffic CO2 sources. At night, there was a distinct negative correlation between potential air temperature and CO2 mixing ratios. The spatial distribution of CO2 was controlled by topography and micro-scale advective processes (i.e. cold-air pooling). Mobile CO2 measurements were then used to calculate CO2 storage changes (FS) in the UCL volume and compared to single-layer FS estimates calculated from the EC system. In total, five variations of FS were calculated. On average, the choice of FS calculation method affected net measured hourly emissions (FC) by 5.2%. Analysis of FS using a four-year dataset measured at the EC tower show FS was 2.8% of hourly FC for this site on average. At this urban EC location, FS was relatively minor compared to FC and calculation of FS using a single-layer method was adequate, though FS still represents a potentially large uncertainty during individual hours.

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

    Science.gov (United States)

    Saçkes, Mesut

    2015-01-01

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

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

    Science.gov (United States)

    Jwan, Julius Ouma

    2011-01-01

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

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

    Science.gov (United States)

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

    2007-01-01

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

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

    Science.gov (United States)

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

    2003-01-01

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

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

    Science.gov (United States)

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

    2014-12-31

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

  15. On the use of Standardized Drought Indices under decadal climate variability: Critical assessment and drought policy implications

    Science.gov (United States)

    Núñez, J.; Rivera, D.; Oyarzún, R.; Arumí, J. L.

    2014-09-01

    Since the recent High Level Meeting on National Drought Policy held in Geneva in 2013, a greater concern about the creation and adaptation of national drought monitoring systems is expected. Consequently, backed by international recommendations, the use of Standardized Drought Indices (SDI), such as the Standardized Precipitation Index (SPI), as an operational basis of drought monitoring systems has been increasing in many parts of the world. Recommendations for the use of the SPI, and consequently, those indices that share its properties, do not take into account the limitations that this type of index can exhibit under the influence of multidecadal climate variability. These limitations are fundamentally related to the lack of consistency among the operational definition expressed by this type of index, the conceptual definition with which it is associated and the political definition it supports. Furthermore, the limitations found are not overcome by the recommendations for their application. This conclusion is supported by the long-term study of the Standardized Streamflow Index (SSI) in the arid north-central region of Chile, under the influence of multidecadal climate variability. The implications of the findings of the study are discussed with regard to their link to aspects of drought policy in the cases of Australia, the United States and Chile.

  16. Effect of personal and situational variables on noise annoyance: With special reference to implications for en route noise

    Science.gov (United States)

    Fields, James M.

    1992-08-01

    Over 680 publications from 282 social surveys of residents' reactions to environmental noise have been examined to locate 495 published findings on 26 topics concerning non-noise explanations for residents' reactions to environmental noise. This report (1) tabulates the evidence on the 26 response topics, (2) identifies the 495 findings, and (3) discusses the implications for en route noise assessment. After controlling for noise level, over half of the social survey evidence indicates that noise annoyance is not strongly affected by any of the nine demographic variables examined (age, sex, social status, income, education, homeownership, type of dwelling, length of residence, or receipt of benefits from the noise source), but is positively associated with each of the five attitudinal variables examined (a fear of danger from the noise source, a sensitivity towards noise generally, the belief that the authorities can control the noise, the awareness of non-noise impacts of the source, and the belief that the noise source is not important).

  17. Downscaled Climate Change Projections for the Southern Colorado Plateau: Variability and Implications for Vegetation Changes

    Science.gov (United States)

    Garfin, G. M.; Eischeid, J. K.; Cole, K. L.; Ironside, K.; Cobb, N. S.

    2008-12-01

    most striking aspect of projections of future precipitation is steadily decreasing May-June precipitation during the twenty-first century. Though absolute precipitation during this season is small, declining moisture during the arid pre-monsoon will likely decrease soil moisture, and increase drought stress - consequently, increasing vegetation susceptibility the insect outbreaks and disease. Summer precipitation projections show considerable multi-decade variability, but no substantial trends. Winter precipitation shows little interannual variability and no strong trends. By 2090, annual precipitation is projected to decline by 1-5% across much of the region, with greater declines in the southern part of the domain and increases of 1-5% in the northwestern and northeastern parts of the domain. As part of a National Institute for Climate Change Research project, these projected changes will be input into a USDA-FS vegetation response model, in order to estimate species-specific responses to projected climate changes. We expect increasing temperatures, declining annual precipitation, and extreme declines in pre-monsoon season precipitation to generate significant redistribution of some plant species in the Southern Colorado Plateau.

  18. ROTATIONAL VARIABILITY OF EARTH'S POLAR REGIONS: IMPLICATIONS FOR DETECTING SNOWBALL PLANETS

    International Nuclear Information System (INIS)

    Cowan, Nicolas B.; Robinson, Tyler; Agol, Eric; Meadows, Victoria S.; Shields, Aomawa L.; Livengood, Timothy A.; Deming, Drake; A'Hearn, Michael F.; Wellnitz, Dennis D.; Charbonneau, David; Lisse, Carey M.; Seager, Sara

    2011-01-01

    We have obtained the first time-resolved, disk-integrated observations of Earth's poles with the Deep Impact spacecraft as part of the EPOXI mission of opportunity. These data mimic what we will see when we point next-generation space telescopes at nearby exoplanets. We use principal component analysis (PCA) and rotational light curve inversion to characterize color inhomogeneities and map their spatial distribution from these unusual vantage points, as a complement to the equatorial views presented by Cowan et al. in 2009. We also perform the same PCA on a suite of simulated rotational multi-band light curves from NASA's Virtual Planetary Laboratory three-dimensional spectral Earth model. This numerical experiment allows us to understand what sorts of surface features PCA can robustly identify. We find that the EPOXI polar observations have similar broadband colors as the equatorial Earth, but with 20%-30% greater apparent albedo. This is because the polar observations are most sensitive to mid-latitudes, which tend to be more cloudy than the equatorial latitudes emphasized by the original EPOXI Earth observations. The cloudiness of the mid-latitudes also manifests itself in the form of increased variability at short wavelengths in the polar observations and as a dominant gray eigencolor in the south polar observation. We construct a simple reflectance model for a snowball Earth. By construction, our model has a higher Bond albedo than the modern Earth; its surface albedo is so high that Rayleigh scattering does not noticeably affect its spectrum. The rotational color variations occur at short wavelengths due to the large contrast between glacier ice and bare land in those wavebands. Thus, we find that both the broadband colors and diurnal color variations of such a planet would be easily distinguishable from the modern-day Earth, regardless of viewing angle.

  19. NON-THERMAL EMISSION FROM CATACLYSMIC VARIABLES: IMPLICATIONS ON ASTROPARTICLE PHYSICS

    Directory of Open Access Journals (Sweden)

    Vojtech Šimon

    2013-12-01

    Full Text Available We review the lines of evidence that some cataclysmic variables (CVs are the sources of non-thermal radiation. It was really observed in some dwarf novae in outburst, a novalike CV in the high state, an intermediate polar, polars, and classical novae (CNe during outburst. The detection of this radiation suggests the presence of highly energetic particles in these CVs. The conditions for the observability of this emission depend on the state of activity, and the system parameters. We review the processes and conditions that lead to the production of this radiation in various spectral bands, from gamma-rays including TeV emission to radio. Synchrotron and cyclotron emissions suggest the presence of strong magnetic fields in CV. In some CVs, e.g. during some dwarf nova outbursts, the magnetic field generated in the accretion disk leads to the synchrotron jets radiating in radio. The propeller effect or a shock in the case of the magnetized white dwarf (WD can lead to a strong acceleration of the particles that produce gamma-ray emission via pi0 decay; even Cherenkov radiation is possible. In addition, a gamma-ray production via pi0 decay was observed in the ejecta of an outburst of a symbiotic CN. Nuclear reactions during thermonuclear runaway in the outer layer of the WD undergoing CN outburst lead to the production of radioactive isotopes; their decay is the source of gamma-ray emission. The production of accelerated particles in CVs often has episodic character with a very small duty cycle; this makes their detection and establishing the relation of the behavior in various bands difficult.

  20. MGS Radio Science Electron Density Profiles: Interannual Variability and Implications for the Martian Neutral Atmosphere

    Science.gov (United States)

    Bougher, S. W.; Engel, S.; Hinson, D. P.; Murphy, J. R.

    2004-01-01

    Martian electron density profiles provided by the Mars Global Surveyor (MGS) Radio Science (RS) experiment over the 95-200 km altitude range indicate what the height of the electron peak and the longitudinal structure of the peak height are sensitive indicators of the physical state of the Mars lower and upper atmospheres. The present analysis is carried out on five sets of occultation profiles, all at high solar zenith angles (SZA). Variations spanning 2 Martian years are investigated near aphelion conditions at high northern latitudes (64.7 - 77.6 N) making use of four of these data sets. A mean ionospheric peak height of 133.5 - 135 km is obtained near SZA = 78 - 82 deg.; a corresponding mean peak density of 7.3 - 8.5 x l0(exp 4)/ qu cm is also measured during solar moderate conditions at Mars. Strong wave number 2 - 3 oscillations in peak heights are consistently observed as a function of longitude over the 2 Martian years. These observed ionospheric features are remarkably similar during aphelion conditions 1 Martian year apart. This year-to-year repeatability in the thermosphere-ionosphere structure is consistent with that observed in multiyear aphelion temperature data of the Mars lower atmosphere. Coupled Mars general circulation model (MGCM) and Mars thermospheric general circulation model (MTGCM) codes are run for Mars aphelion conditions, yielding mean and longitude variable ionospheric peak heights that reasonably match RS observations. A tidal decomposition of MTGCM thermospheric densities shows that observed ionospheric wave number 3 features are linked to a non-migrating tidal mode with semidiurnal period (sigma = 2) and zonal wave number 1 (s = -1) characteristics. The height of this photochemically determined ionospheric peak should be monitored regularly.

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

    Directory of Open Access Journals (Sweden)

    Huddleston, Lillie

    2011-07-01

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

  2. Contemporary internal auditing practices : (new) roles and influencing variables. Evidence from extended case studies

    OpenAIRE

    G. SARENS; I. DE BEELDE

    2004-01-01

    Following the recommendation made by Rittenberg (1999), this study encompasses the broader nature of internal auditing that is evolving in practice and confirmed by the revised definition of internal auditing and the new Professional Practices Framework, both issued by the IIA in 1999. This study, based on six extended case studies, attempts to contribute to the literature by studying contemporary internal auditing practices in Belgium (assurance and / or consulting oriented), refining the in...

  3. Mirror-drawing skill in children with specific language impairment: Improving generalization by incorporating variability into the practice session.

    Science.gov (United States)

    Desmottes, Lise; Maillart, Christelle; Meulemans, Thierry

    2017-05-01

    This study aimed to investigate the procedural deficit hypothesis (PDH) in children with specific language impairment (SLI) by using a mirror-drawing task, a sensorimotor adaptation paradigm that does not involve sequence learning and has never before been used in SLI. A total of 30 school-aged children with SLI matched to 30 typically developing (TD) control children had to trace several figures seen only in mirror-reversed view in two practice sessions separated by a one-week interval. Two practice conditions were compared: a constant condition in which children had to trace the same figure throughout the learning trials, and a variable one in which they had to trace different figures in each trial. The results revealed a similar learning pattern between SLI and TD children in both practice conditions, suggesting that initial learning for a non-sequential procedural task is preserved in SLI. However, the children with SLI generalized the mirror-drawing skill in the same way as the TD children only if there was variability in the way the material was trained (variable practice). No significant schedule effects were observed in the control group.

  4. Resting Heart Rate Variability, Facets of Rumination and Trait Anxiety: Implications for the Perseverative Cognition Hypothesis

    Directory of Open Access Journals (Sweden)

    DeWayne P. Williams

    2017-10-01

    Full Text Available The perseverative cognition hypothesis (PCH posits that perseveration, defined as the repetitive or sustained activation of cognitive representations of a real or imagined stressor, is a primary mechanism linking psychological (or stress vulnerability with poor health and disease. Resting vagally mediated heart rate variability (vmHRV is an important indicator of self-regulatory abilities, stress vulnerability and overall health. Those with lower resting vmHRV are more vulnerable to stress, and thus more likely to engage in perseverative cognition and experience subsequent negative mental health outcomes such as anxiety. Recent research suggests that rumination—one of the core mechanisms underlying perseveration—is a construct containing (at least two maladaptive (depressive and brooding and one adaptive (reflective types of rumination. However, to date, research has not examined how the association between resting vmHRV may differ between these three facets of rumination, in addition to these facets’ mechanistic role in linking lower resting vmHRV with greater trait anxiety. The current cross-sectional study explores these relationships in a sample of 203 participants (112 females, 76 ethnic minorities, mean age = 19.43, standard deviation = 1.87. Resting vmHRV was assessed during a 5-min-resting period using an Electrocardiogram (ECG. Both trait rumination (including the three facets and anxiety were assessed via self-report scales. Significant negative associations were found between resting vmHRV and maladaptive, but not adaptive, forms of perseveration. Similarly, mediation analyses showed a significant indirect relationship between resting vmHRV and anxiety through maladaptive, but not adaptive, facets of rumination. Our findings support the PCH such that those with stress vulnerability, as indexed by lower resting vmHRV, are more likely to engage in maladaptive perseverative cognition and thus experience negative outcomes such as

  5. Resting Heart Rate Variability, Facets of Rumination and Trait Anxiety: Implications for the Perseverative Cognition Hypothesis.

    Science.gov (United States)

    Williams, DeWayne P; Feeling, Nicole R; Hill, LaBarron K; Spangler, Derek P; Koenig, Julian; Thayer, Julian F

    2017-01-01

    The perseverative cognition hypothesis (PCH) posits that perseveration, defined as the repetitive or sustained activation of cognitive representations of a real or imagined stressor, is a primary mechanism linking psychological (or stress) vulnerability with poor health and disease. Resting vagally mediated heart rate variability (vmHRV) is an important indicator of self-regulatory abilities, stress vulnerability and overall health. Those with lower resting vmHRV are more vulnerable to stress, and thus more likely to engage in perseverative cognition and experience subsequent negative mental health outcomes such as anxiety. Recent research suggests that rumination-one of the core mechanisms underlying perseveration-is a construct containing (at least) two maladaptive (depressive and brooding) and one adaptive (reflective) types of rumination. However, to date, research has not examined how the association between resting vmHRV may differ between these three facets of rumination, in addition to these facets' mechanistic role in linking lower resting vmHRV with greater trait anxiety. The current cross-sectional study explores these relationships in a sample of 203 participants (112 females, 76 ethnic minorities, mean age = 19.43, standard deviation = 1.87). Resting vmHRV was assessed during a 5-min-resting period using an Electrocardiogram (ECG). Both trait rumination (including the three facets) and anxiety were assessed via self-report scales. Significant negative associations were found between resting vmHRV and maladaptive, but not adaptive, forms of perseveration. Similarly, mediation analyses showed a significant indirect relationship between resting vmHRV and anxiety through maladaptive, but not adaptive, facets of rumination. Our findings support the PCH such that those with stress vulnerability, as indexed by lower resting vmHRV, are more likely to engage in maladaptive perseverative cognition and thus experience negative outcomes such as anxiety. Our data

  6. Advective pathways near the tip of the Antarctic Peninsula: Trends, variability and ecosystem implications

    Science.gov (United States)

    Renner, Angelika H. H.; Thorpe, Sally E.; Heywood, Karen J.; Murphy, Eugene J.; Watkins, Jon L.; Meredith, Michael P.

    2012-05-01

    Pathways and rates of ocean flow near the Antarctic Peninsula are strongly affected by frontal features, forcings from the atmosphere and the cryosphere. In the surface mixed layer, the currents advect material from the northwestern Weddell Sea on the eastern side of the Peninsula around the tip of the Peninsula to its western side and into the Scotia Sea, connecting populations of Antarctic krill (Euphausia superba) and supporting the ecosystem of the region. Modelling of subsurface drifters using a particle tracking algorithm forced by the velocity fields of a coupled sea ice-ocean model (ORCA025-LIM2) allows analysis of the seasonal and interannual variability of drifter pathways over 43 years. The results show robust and persistent connections from the Weddell Sea both to the west into the Bellingshausen Sea and across the Scotia Sea towards South Georgia, reproducing well the observations. The fate of the drifters is sensitive to their deployment location, in addition to other factors. From the shelf of the eastern Antarctic Peninsula, the majority enter the Bransfield Strait and subsequently the Bellingshausen Sea. When originating further offshore over the deeper Weddell Sea, drifters are more likely to cross the South Scotia Ridge and reach South Georgia. However, the wind field east and southeast of Elephant Island, close to the tip of the Peninsula, is crucial for the drifter trajectories and is highly influenced by the Southern Annular Mode (SAM). Increased advection and short travel times to South Georgia, and reduced advection to the western Antarctic Peninsula can be linked to strong westerlies, a signature of the positive phase of the SAM. The converse is true for the negative phase. Strong westerlies and shifts of ocean fronts near the tip of the Peninsula that are potentially associated with both the SAM and the El Niño-Southern Oscillation restrict the connection from the Weddell Sea to the west, and drifters then predominantly follow the open

  7. Provider-agency fit in substance abuse treatment organizations: implications for learning climate, morale, and evidence-based practice implementation.

    Science.gov (United States)

    Ramsey, Alex T; van den Berk-Clark, Carissa

    2015-05-12

    Substance abuse agencies have been slow to adopt and implement evidence-based practices (EBPs), due in part to poor provider morale and organizational climates that are not conducive to successful learning and integration of these practices. Person-organization fit theory suggests that alignment, or fit, between provider- and agency-level characteristics regarding the implementation of EBPs may influence provider morale and organizational learning climate and, thus, implementation success. The current study hypothesized that discrepancies, or lack of fit, between provider- and agency-level contextual factors would negatively predict provider morale and organizational learning climate, outcomes shown to be associated with successful EBP implementation. Direct service providers (n = 120) from four substance abuse treatment agencies responded to a survey involving provider morale, organizational learning climate, agency expectations for EBP use, agency resources for EBP use, and provider attitudes towards EBP use. Difference scores between combinations of provider- and agency-level factors were computed to model provider-agency fit. Quadratic regression analyses were conducted to more adequately and comprehensively model the level of the dependent variables across the entire "fit continuum". Discrepancies, or misfit, between agency expectations and provider attitudes and between agency resources and provider attitudes were associated with poorer provider morale and weaker organizational learning climate. For all hypotheses, the curvilinear model of provider-agency discrepancies significantly predicted provider morale and organizational learning climate, indicating that both directions of misfit (provider factors more favorable than agency factors, and vice-versa) were detrimental to morale and climate. However, outcomes were most negative when providers viewed EBPs favorably, but perceived that agency expectations and resources were less supportive of EBP use. The

  8. Practical performance of real-time shot-noise measurement in continuous-variable quantum key distribution

    Science.gov (United States)

    Wang, Tao; Huang, Peng; Zhou, Yingming; Liu, Weiqi; Zeng, Guihua

    2018-01-01

    In a practical continuous-variable quantum key distribution (CVQKD) system, real-time shot-noise measurement (RTSNM) is an essential procedure for preventing the eavesdropper exploiting the practical security loopholes. However, the performance of this procedure itself is not analyzed under the real-world condition. Therefore, we indicate the RTSNM practical performance and investigate its effects on the CVQKD system. In particular, due to the finite-size effect, the shot-noise measurement at the receiver's side may decrease the precision of parameter estimation and consequently result in a tight security bound. To mitigate that, we optimize the block size for RTSNM under the ensemble size limitation to maximize the secure key rate. Moreover, the effect of finite dynamics of amplitude modulator in this scheme is studied and its mitigation method is also proposed. Our work indicates the practical performance of RTSNM and provides the real secret key rate under it.

  9. Childhood Adversities and Substance Misuse Among the Incarcerated: Implications for Treatment and Practice in Correctional Settings.

    Science.gov (United States)

    Marotta, Phillip L

    2017-05-12

    Incarcerated populations have high rates of childhood adversities and substance use problems. Moreover, childhood adversities are well-documented predictors of substance misuse. To investigate the impact of childhood sexual and physical abuse, caregiver abuse of drugs or alcohol, and time spent in foster care on several substance misuse outcomes. Data comes from a sample of 16,043 incarcerated men and women in the United States Survey of Inmates in State and Federal Facilities. Bivariate analyses revealed differences by sex in childhood adversities and socioeconomic characteristics. Logistic regression analyses assessed the data for a link between childhood adversities and substance misuse after adjusting for other variables. Analyses were stratified by sex to show differences in predictors of substance misuse between men and women. Childhood adversities increased the risk of many substance misuse outcomes. The prevalence of physical abuse, sexual abuse, foster care, and caretaker abuse of drugs or alcohol were greatest for inmates who reported injecting and sharing drugs. Growing up with a caregiver that used drugs or alcohol was a consistent predictor of increased risk of substance misuse for men and women. However, childhood sexual abuse increased risk for only women. Inmates who experience physical abuse, sexual abuse, foster care involvement and caretakers who use drugs and alcohol are at an increased risk of substance misuse, injecting drug use and syringe sharing. Implications suggest correctional HIV prevention and substance misuse programs must address unresolved trauma and important gender differences.

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

    Science.gov (United States)

    Koh, Kyungwon; Rubenstein, Ellen; White, Kelvin

    2015-01-01

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

  11. Age differences in coupling of intraindividual variability in mnemonic strategies and practice-related associative recall improvements.

    Science.gov (United States)

    Hertzog, Christopher; Lövdén, Martin; Lindenberger, Ulman; Schmiedek, Florian

    2017-09-01

    The importance of encoding strategies for associative recall is well established, but there have been no studies of aging and intraindividual variability (IAV) in strategy use during extended practice. We observed strategy use and cued-recall test performance over 101 days of practice in 101 younger adults (M = 25.6 years) and 103 older adults (M = 71.3 years) sandwiched by a pretest and posttest battery including an associative recall test. Each practice session included 2 lists of 12 number-noun paired-associate (PA) items (e.g., 23-DOGS), presented for brief exposures titrated to maintain below-ceiling performance throughout practice. Participants reported strategy use (e.g., rote repetition, imagery) after each test. Substantial IAV in strategy use was detected that was coupled with performance; lists studied with normatively effective strategies (e.g., imagery) generated higher PA recall than lists studied with less effective strategies (e.g., rote repetition). In comparison to younger adults, older adults' practice (a) relied more on repetition and less on effective strategies, (b) showed lower levels of IAV in effective strategy use, and (c) had lower within-person strategy-recall coupling, especially late in practice. Individual differences in pretest-posttest gains in PA recall were predicted by average level of effective strategy use in young adults but by strategy-recall coupling in older adults. Results are consistent with the hypothesis that experiencing variability in strategic outcomes during practice helps hone the effectiveness of strategic encoding behavior, and that older adults' reduced degree of pretest-posttest gains is influenced by lower likelihood of using and optimizing effective strategies through practice. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

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

    Science.gov (United States)

    Patterson, Fiona; Zibarras, Lara Dawn

    2017-05-01

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

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

    International Nuclear Information System (INIS)

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

    2015-01-01

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

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

    Science.gov (United States)

    Lee, Victor; Brain, Keira; Martin, Jenepher

    2017-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Maria Berghs

    2017-01-01

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

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

    Science.gov (United States)

    Berghs, Maria

    2017-01-01

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

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

    Science.gov (United States)

    Ewens, Beverley; Hendricks, Joyce; Sundin, Deb

    2017-01-23

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

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

    Science.gov (United States)

    Watson, Jeanne C

    2018-05-01

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

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

    Science.gov (United States)

    Bozzaro, Claudia; Schildmann, Jan

    2018-04-21

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

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

    Directory of Open Access Journals (Sweden)

    Janina Brutt-Griffler

    2017-11-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2008-01-01

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

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

    Science.gov (United States)

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

    2013-08-01

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

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

    Science.gov (United States)

    Idali Torres, M

    1998-06-01

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

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

    Science.gov (United States)

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

    2018-02-01

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

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

    Science.gov (United States)

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

    2018-02-01

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

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

    Science.gov (United States)

    Peel, Elizabeth; Taylor, Helen; Harding, Rosie

    2016-11-30

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

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

    Directory of Open Access Journals (Sweden)

    Miftahur Rohman

    2017-06-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

    Moule, Pam; Albarran, John W

    2002-09-01

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

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

    Science.gov (United States)

    Charville, Gregory W; Longacre, Teri A

    2017-11-01

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

  12. Quantifying the sources of variability in equine faecal egg counts: implications for improving the utility of the method.

    Science.gov (United States)

    Denwood, M J; Love, S; Innocent, G T; Matthews, L; McKendrick, I J; Hillary, N; Smith, A; Reid, S W J

    2012-08-13

    The faecal egg count (FEC) is the most widely used means of quantifying the nematode burden of horses, and is frequently used in clinical practice to inform treatment and prevention. The statistical process underlying the FEC is complex, comprising a Poisson counting error process for each sample, compounded with an underlying continuous distribution of means between samples. Being able to quantify the sources of variability contributing to this distribution of means is a necessary step towards providing estimates of statistical power for future FEC and FECRT studies, and may help to improve the usefulness of the FEC technique by identifying and minimising unwanted sources of variability. Obtaining such estimates require a hierarchical statistical model coupled with repeated FEC observations from a single animal over a short period of time. Here, we use this approach to provide the first comparative estimate of multiple sources of within-horse FEC variability. The results demonstrate that a substantial proportion of the observed variation in FEC between horses occurs as a result of variation in FEC within an animal, with the major sources being aggregation of eggs within faeces and variation in egg concentration between faecal piles. The McMaster procedure itself is associated with a comparatively small coefficient of variation, and is therefore highly repeatable when a sufficiently large number of eggs are observed to reduce the error associated with the counting process. We conclude that the variation between samples taken from the same animal is substantial, but can be reduced through the use of larger homogenised faecal samples. Estimates are provided for the coefficient of variation (cv) associated with each within animal source of variability in observed FEC, allowing the usefulness of individual FEC to be quantified, and providing a basis for future FEC and FECRT studies. Copyright © 2012 Elsevier B.V. All rights reserved.

  13. Intra-urban and street scale variability of BTEX, NO 2 and O 3 in Birmingham, UK: Implications for exposure assessment

    Science.gov (United States)

    Vardoulakis, Sotiris; Solazzo, Efisio; Lumbreras, Julio

    2011-09-01

    Automatic monitoring networks have the ability of capturing air pollution episodes, as well as short- and long-term air quality trends in urban areas that can be used in epidemiological studies. However, due to practical constraints (e.g. cost and bulk of equipment), the use of automatic analysers is restricted to a limited number of roadside and background locations within a city. As a result, certain localised air pollution hotspots may be overlooked or overemphasised, especially near heavily trafficked street canyons and intersections. This has implications for compliance with regulatory standards and may cause exposure misclassification in epidemiological studies. Apart from automatic analysers, low cost passive diffusion tubes can be used to characterise the spatial variability of air pollution in urban areas. In this study, BTEX, NO 2 and O 3 data from a one-year passive sampling survey were used to characterise the intra-urban and street scale spatial variability of traffic-related pollutants in Birmingham (UK). In addition, continuous monitoring of NO 2, NO x, O 3, CO, SO 2, PM 10 and PM 2.5 from three permanent monitoring sites was used to identify seasonal and annual pollution patterns. The passive sampling measurements allowed us to evaluate the representativeness of a permanent roadside monitoring site that has recorded some of the highest NO 2 and PM 10 concentrations in Birmingham in recent years. Dispersion modelling was also used to gain further insight into pollutant sources and dispersion characteristics at this location. The strong spatial concentration gradients observed in busy streets, as well as the differences between roadside and urban background levels highlight the importance of appropriate positioning of air quality monitoring equipment in cities.

  14. Climate variability and El Niño Southern Oscillation: implications for natural coastal resources and management

    Science.gov (United States)

    Thatje, Sven; Heilmayer, Olaf; Laudien, Jürgen

    2008-03-01

    The El Niño Southern Oscillation (ENSO) significantly influences marine ecosystems and the sustained exploitation of marine resources in the coastal zone of the Humboldt Current upwelling system. Both its warm (El Niño: EN) and cold (La Niña: LN) phase have drastic implications for the ecology, socio-economy and infrastructure along most of Pacific South America. Local artisanal fisheries, which especially suffer from the effects of EN, represent a major part for the domestic economy of Chile and Peru and in consequence a huge amount of published and unpublished studies exists aiming at identifying effects of EN and LN. However, most processes and underlying mechanisms fostering the ecology of organisms along Pacific South America have not been analyzed yet and for the marine realm most knowledge is traditionally based on rather descriptive approaches. We herein advocate that small-scale comparative and interdisciplinary process studies work as one possible solution to understand better the variability observed in EN/LN effects at local scale. We propose that differences in small-scale impacts of ENSO along the coast rather than the macro-ecological and oceanographic view are essential for the sustainable management of costal ecosystems and the livelihood of the people depending on it. Based on this, we summarize the conceptual approach from the EU-funded International Science and Technology Cooperation (INCO) project “Climate variability and El Niño Southern Oscillation: Implications for Natural Coastal Resources and Management (CENSOR)” that aims at enhancing the detection, compilation, and understanding of EN and LN effects on the coastal zone and its natural resources. We promote a multidisciplinary avenue within present international funding schemes, with the intention to bridge the traditional gap between basic and applied coastal research. The long-term aim is an increased mitigation of harm caused by EN as well as a better use of beneficial effects

  15. Probabilistic Requirements (Partial) Verification Methods Best Practices Improvement. Variables Acceptance Sampling Calculators: Derivations and Verification of Plans. Volume 1

    Science.gov (United States)

    Johnson, Kenneth L.; White, K, Preston, Jr.

    2012-01-01

    The NASA Engineering and Safety Center was requested to improve on the Best Practices document produced for the NESC assessment, Verification of Probabilistic Requirements for the Constellation Program, by giving a recommended procedure for using acceptance sampling by variables techniques. This recommended procedure would be used as an alternative to the potentially resource-intensive acceptance sampling by attributes method given in the document. This document contains the outcome of the assessment.

  16. Implementation of transverse variable asphalt rate seal coat practices in Texas.

    Science.gov (United States)

    2011-01-01

    An implementation project was performed to expand use of transversely varied asphalt rate (TVAR) seal : coat practices in all districts. The project included nine regional workshops, continued field texture testing of : test sites, provided one set o...

  17. The interface between research on individual difference variables and teaching practice: The case of cognitive factors and personality

    Directory of Open Access Journals (Sweden)

    Adriana Biedroń

    2016-09-01

    Full Text Available While a substantial body of empirical evidence has been accrued about the role of individual differences in second language acquisition, relatively little is still known about how factors of this kind can mediate the effects of instructional practices as well as how empirically-derived insights can inform foreign language pedagogy, both with respect to shaping certain variables and adjusting instruction to individual learner profiles. The present paper is an attempt to shed light on the interface between research on individual difference factors and teaching practice, focusing upon variables which do not easily lend themselves to external manipulation, namely intelligence, foreign language aptitude, working memory and personality, with the role of the last of these in language learning being admittedly the least obvious. In each case, the main research findings will briefly be outlined, their potential for informing instruction will be considered, and, in the final part, the caveats concerning practical applications of research on the variables in question will be spelled out.

  18. Preliminary results from the ESA STSE project on SST diurnal variability, its regional extent and implications in atmospheric modelling (SSTDV:R.EX.–IM.A.M.)

    DEFF Research Database (Denmark)

    Karagali, Ioanna; Hasager, Charlotte Bay; Høyer, Jacob L.

    2013-01-01

    This study presents some preliminary results of the ESA Support To Science Element (STSE) funded project on the Diurnal Variability of the Sea Surface Temperature, regarding its Regional Extend and Implications in Atmospheric Modelling (SSTDV:R.EX.–IM.A.M.). Comparisons of SEVIRI SST with AATSR...

  19. Variability of the reflectance coefficient of skylight from the ocean surface and its implications to ocean color.

    Science.gov (United States)

    Gilerson, Alexander; Carrizo, Carlos; Foster, Robert; Harmel, Tristan

    2018-04-16

    The value and spectral dependence of the reflectance coefficient (ρ) of skylight from wind-roughened ocean surfaces is critical for determining accurate water leaving radiance and remote sensing reflectances from shipborne, AERONET-Ocean Color and satellite observations. Using a vector radiative transfer code, spectra of the reflectance coefficient and corresponding radiances near the ocean surface and at the top of the atmosphere (TOA) are simulated for a broad range of parameters including flat and windy ocean surfaces with wind speeds up to 15 m/s, aerosol optical thicknesses of 0-1 at 440nm, wavelengths of 400-900 nm, and variable Sun and viewing zenith angles. Results revealed a profound impact of the aerosol load and type on the spectral values of ρ. Such impacts, not included yet in standard processing, may produce significant inaccuracies in the reflectance spectra retrieved from above-water radiometry and satellite observations. Implications for satellite cal/val activities as well as potential changes in measurement and data processing schemes are discussed.

  20. Effects of variability of practice in music: A pilot study on fast goal-directed movements in pianists

    Directory of Open Access Journals (Sweden)

    Marc eBangert

    2014-08-01

    Full Text Available Variability of Practice (VOP refers to the acquisition of a particular target movement by practicing a range of varying targets rather than by focusing on fixed repetitions of the target only. VOP has been demonstrated to have beneficial effects on transfer to a novel task and on skill consolidation. This study extends the line of research to musical practice. In a task resembling a barrier-knockdown paradigm, 36 music students trained to perform a wide left-hand interval leap on the piano. Performance at the target distance was tested before and after a 30-minute standardized training session. The high-variability group (VAR practiced 4 different intervals including the target. Another group (FIX practiced the target interval only. A third group (SPA performed spaced practice on the target only, interweaving with periods of not playing. Transfer was tested by introducing an interval novel to either group. After a 24-hour period with no further exposure to the instrument, performance was retested. All groups performed at comparable error levels before training, after training, and after the retention interval. At transfer, however, the FIX group, unlike the other groups, committed significantly more errors than in the target task. After the retention period, the effect was washed out for the FIX group but then was present for VAR. Thus, the results provide only partial support for the VOP hypothesis for the given setting. Additional exploratory observations suggest tentative benefits of VOP regarding execution speed, loudness, and performance confidence.We derive specific hypotheses and specific recommendations regarding sample selection and intervention duration for future investigations. Furthermore, the proposed leap task measurement is shown to be (a robust enough to serve as a standard framework for studies in the music domain, yet (b versatile enough to allow for a wide range of designs not previously investigated for music on a

  1. Effects of variability of practice in music: a pilot study on fast goal-directed movements in pianists.

    Science.gov (United States)

    Bangert, Marc; Wiedemann, Anna; Jabusch, Hans-Christian

    2014-01-01

    Variability of Practice (VOP) refers to the acquisition of a particular target movement by practicing a range of varying targets rather than by focusing on fixed repetitions of the target only. VOP has been demonstrated to have beneficial effects on transfer to a novel task and on skill consolidation. This study extends the line of research to musical practice. In a task resembling a barrier-knockdown paradigm, 36 music students trained to perform a wide left-hand interval leap on the piano. Performance at the target distance was tested before and after a 30-min standardized training session. The high-variability group (VAR) practiced four different intervals including the target. Another group (FIX) practiced the target interval only. A third group (SPA) performed spaced practice on the target only, interweaving with periods of not playing. Transfer was tested by introducing an interval novel to either group. After a 24-h period with no further exposure to the instrument, performance was retested. All groups performed at comparable error levels before training, after training, and after the retention (RET) interval. At transfer, however, the FIX group, unlike the other groups, committed significantly more errors than in the target task. After the RET period, the effect was washed out for the FIX group but then was present for VAR. Thus, the results provide only partial support for the VOP hypothesis for the given setting. Additional exploratory observations suggest tentative benefits of VOP regarding execution speed, loudness, and performance confidence. We derive specific hypotheses and specific recommendations regarding sample selection and intervention duration for future investigations. Furthermore, the proposed leap task measurement is shown to be (a) robust enough to serve as a standard framework for studies in the music domain, yet (b) versatile enough to allow for a wide range of designs not previously investigated for music on a standardized basis.

  2. Effect Of Variable Practice On The Motor Learning Process In Manual Wheelchair Propulsion

    NARCIS (Netherlands)

    Leving, Marika T; Vegter, Riemer J K; de Groot, Sonja; van der Woude, Lucas H V

    Handrim wheelchair propulsion is a cyclic skill that needs to be learned during rehabilitation. It has been suggested that a higher intra-individual variability benefits the motor learning process of wheelchair propulsion. PURPOSE: The goal of the current study was to determine the effect of

  3. Movement Variability in the Golf Swing: Theoretical, Methodological, and Practical Issues

    Science.gov (United States)

    Glazier, Paul

    2011-01-01

    Movement variability in the golf swing has recently been identified as a priority for future research in golf science. Although this ubiquitous aspect of golf performance has featured in previous empirical investigations of the golf swing, it has tended to be subordinate and studied as an adjunct to other more conventional research questions.…

  4. Quiet Eye Duration Is Responsive to Variability of Practice and to the Axis of Target Changes

    Science.gov (United States)

    Horn, Robert R.; Okumura, Michelle S.; Alexander, Melissa G. F.; Gardin, Fredrick A.; Sylvester, Curtis T.

    2012-01-01

    We tested the hypothesis that quiet eye, the final fixation before the initiation of a movement in aiming tasks, is used to scale the movement's parameters. Two groups of 12 participants (N = 24) threw darts to targets in the horizontal and vertical axes under conditions of higher (random) or lower (blocked) target variability. Supporting our…

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

    Directory of Open Access Journals (Sweden)

    Julia eMossbridge

    2014-03-01

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

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

    Science.gov (United States)

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

    2009-09-30

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

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

    Science.gov (United States)

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

    2015-12-01

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

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

    Science.gov (United States)

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

    2008-01-01

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

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

    Science.gov (United States)

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

    2018-01-01

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

  10. Sampling intraspecific variability in leaf functional traits: Practical suggestions to maximize collected information.

    Science.gov (United States)

    Petruzzellis, Francesco; Palandrani, Chiara; Savi, Tadeja; Alberti, Roberto; Nardini, Andrea; Bacaro, Giovanni

    2017-12-01

    The choice of the best sampling strategy to capture mean values of functional traits for a species/population, while maintaining information about traits' variability and minimizing the sampling size and effort, is an open issue in functional trait ecology. Intraspecific variability (ITV) of functional traits strongly influences sampling size and effort. However, while adequate information is available about intraspecific variability between individuals (ITV BI ) and among populations (ITV POP ), relatively few studies have analyzed intraspecific variability within individuals (ITV WI ). Here, we provide an analysis of ITV WI of two foliar traits, namely specific leaf area (SLA) and osmotic potential (π), in a population of Quercus ilex L. We assessed the baseline ITV WI level of variation between the two traits and provided the minimum and optimal sampling size in order to take into account ITV WI , comparing sampling optimization outputs with those previously proposed in the literature. Different factors accounted for different amount of variance of the two traits. SLA variance was mostly spread within individuals (43.4% of the total variance), while π variance was mainly spread between individuals (43.2%). Strategies that did not account for all the canopy strata produced mean values not representative of the sampled population. The minimum size to adequately capture the studied functional traits corresponded to 5 leaves taken randomly from 5 individuals, while the most accurate and feasible sampling size was 4 leaves taken randomly from 10 individuals. We demonstrate that the spatial structure of the canopy could significantly affect traits variability. Moreover, different strategies for different traits could be implemented during sampling surveys. We partially confirm sampling sizes previously proposed in the recent literature and encourage future analysis involving different traits.

  11. VARIABLES DOCENTES Y DE CENTRO QUE GENERAN BUENAS PRÁCTICAS CON TIC TEACHER AND SCHOOL VARIABLES THAT GENERATE GOOD PRACTICES WITH ICT

    Directory of Open Access Journals (Sweden)

    Pilar Colás Bravo

    2010-02-01

    Full Text Available En este artículo se presentan los resultados de un estudio de casos llevado a cabo mediante entrevistas narrativas, cuyo objetivo es identificar los factores condicionantes de las buenas prácticas con TIC. Las buenas prácticas con TIC están relacionadas con dos áreas científicas de estudio. Una referida a la integración de las TIC en los sistemas educativos y, otra ligada a procesos de innovación. En esta aportación se presenta el estado de la cuestión respecto a factores condicionantes de las buenas prácticas desde ambas perspectivas. A partir de ahí situamos el marco teórico de este trabajo desde la perspectiva del profesorado. El análisis cualitativo realizado mediante el software científico Atlas.Ti 5.0 saca a la luz variables personales y contextuales asociadas a los procesos de innovación. In this article the results of a case study carried out are presented by means of narrative interviews, whose objective is to identify the determining factors of the good practices with ICT. The good practices with ICT are related to two scientific areas of study. One, above mentioned, related to the integration of the ICT in the educational systems and, another, connected with processes of innovation. In this contribution we present the state of the question related to determining factors of the good practices from both points of view. From there we situate the theoretical framework of this work since the perspective of the teachers. The qualitative analysis carried out by means of the program AtlasTi identifies personal and contextual factors associated to the processes of innovation.

  12. The relationship between maternal self-efficacy and parenting practices: implications for parent training.

    Science.gov (United States)

    Sanders, M R; Woolley, M L

    2005-01-01

    The present study examined the relationship between maternal self-efficacy, dysfunctional discipline practices and child conduct problems. Specifically, three levels of self-efficacy, global, domain and task-specific self-efficacy, were assessed in mothers of 2- to 8-year-old children with conduct problems (clinic group, n=45) and non-clinic mothers from the community (non-clinic group, n=79). Measures of global, domain and task-specific self-efficacy were completed by mothers. Clinic mothers reported significantly lower self-efficacy than non-clinic mothers for all but one of the parenting tasks assessed. Both groups of mothers reported lowest self-efficacy for similar parenting tasks. In the sample as a whole self-efficacy measures were significant predictors of maternal discipline style after controlling for other parent, child and risk factors. Of the self-efficacy variables behavioural self-efficacy was the best predictor of mothers discipline style. The findings support the importance of developing parenting strategies that enable parents to generalize their parenting skills to a diverse range of diverse parenting contexts both in the home and in the community.

  13. Practical implications of procedures developed in IDEA project - Comparison with traditional methods

    International Nuclear Information System (INIS)

    Andrasi, A.; Bouvier, C.; Brandl, A.; De Carlan, L.; Fischer, H.; Franck, D.; Hoellriegl, V.; Li, W. B.; Oeh, U.; Ritt, J.; Roth, P.; Schlagbauer, M.; Schmitzer, Ch; Wahl, W.; Zombori, P.

    2007-01-01

    The idea of the IDEA project aimed to improve assessment of incorporated radionuclides through developments of more reliable and possibly faster in vivo and bioassay monitoring techniques and making use of such enhancements for improvements in routine monitoring. In direct in vivo monitoring technique the optimum choice of the detectors to be applied for different monitoring tasks has been investigated in terms of material, size and background in order to improve conditions namely to increase counting efficiency and reduce background. Detailed studies have been performed to investigate the manifold advantageous applications and capabilities of numerical simulation method for the calibration and optimisation of in vivo counting systems. This calibration method can be advantageously applied especially in the measurement of low-energy photon emitting radionuclides, where individual variability is a significant source of uncertainty. In bioassay measurements the use of inductively coupled plasma mass spectrometry (ICP-MS) can improve considerably both the measurement speed and the lower limit of detection currently achievable with alpha spectrometry for long-lived radionuclides. The work carried out in this project provided detailed guidelines for optimum performance of the technique of ICP-MS applied mainly for the determination of uranium and thorium nuclides in the urine including sampling procedure, operational parameters of the instruments and interpretation of the measured data. The paper demonstrates the main advantages of investigated techniques in comparison with the performances of methods commonly applied in routine monitoring practice. (authors)

  14. Biosimilars for psoriasis: worldwide overview of regulatory guidelines, uptake and implications for dermatology clinical practice.

    Science.gov (United States)

    Cohen, A D; Wu, J J; Puig, L; Chimenti, S; Vender, R; Rajagopalan, M; Romiti, R; de la Cruz, C; Skov, L; Zachariae, C; Young, H S; Foley, P; van der Walt, J M; Naldi, L; Prens, E P; Blauvelt, A

    2017-12-01

    The introduction of biological drugs for the treatment of patients with psoriasis has revolutionized treatment paradigms and enabled numerous patients to achieve disease control with an acceptable safety profile. However, the high cost of biologics limits access to these medications for the majority of patients worldwide. In recent years, the introduction of biosimilars for inflammatory diseases has become a fast evolving field. The future use of biosimilars offers the potential for decreased cost and increased access to biologics for patients with psoriasis. For approval of biosimilars, different regulatory agencies use highly variable methods for definition, production, approval, marketing and postmarketing surveillance. Due to potential interchangeability between biologics and biosimilars, traceability and pharmacovigilance are required to collect accurate data about adverse events in patients with psoriasis; spontaneous reporting, registries and use of 'big data' should facilitate this process on a global basis. The current article describes biosimilar regulatory guidelines and examples of biosimilar uptake in clinical practice in several countries around the world. As it is apparent that biological therapy treatment decisions may become more physician independent, the International Psoriasis Council recommends that dermatologists should take an active role in the development of biosimilar prescribing policies with their respective healthcare settings and government agencies. © 2017 British Association of Dermatologists.

  15. Investigating Grit Variables and Their Relations with Practice and Skill Groups in Developing Sport Experts

    Science.gov (United States)

    Tedesqui, Rafael A. B.; Young, Bradley W.

    2017-01-01

    Grit, the tendency to work hard toward long-term goals, maintaining effort and interest over years despite failure and adversity, has predicted several achievement outcomes. However, minimal work has examined grit within a sport expertise development framework, and specifically its association with deliberate practice (DP) in sport. Participants,…

  16. Short-term practice effects and variability in cognitive testing in a healthy elderly population

    DEFF Research Database (Denmark)

    Krenk, L.; Rasmussen, L.S.; Siersma, V.

    2012-01-01

    BACKGROUND: Cognitive decline in the elderly is a subject of intense focus. However, there is a lack of consensus regarding definition of significant decline in connection with repeated testing and the interpretation of cognitive tests results must take into account the practice effect...

  17. Changes of heart rate variability and prefrontal oxygenation during Tai Chi practice versus arm ergometer cycling

    OpenAIRE

    Lu, Xi; Hui-Chan, Christina Wan-Ying; Tsang, William Wai-Nam

    2016-01-01

    [Purpose] Exercise has been shown to improve cardiovascular fitness and cognitive function. Whether the inclusion of mind over exercise would increase parasympathetic control of the heart and brain activities more than general exercise at a similar intensity is not known. The aim of this study was to compare the effects of Tai Chi (mind-body exercise) versus arm ergometer cycling (body-focused exercise) on the heart rate variability and prefrontal oxygenation level. [Subjects and Methods] A T...

  18. Socioeconomic status and Oppositional Defiant Disorder in preschoolers: parenting practices and executive functioning as mediating variables

    OpenAIRE

    Roser eGranero; Roser eGranero; Leonie eLouwaars; Lourdes eEzpeleta; Lourdes eEzpeleta

    2015-01-01

    Objectives. To investigate the mediating mechanisms of oppositional defiant disorder (ODD) in preschoolers through pathways analysis, considering the family socioeconomic status (SES) as the independent variable and the parenting style and the children’s executive functioning (EF) as the mediating factors.Method. Sample included 622 three years-old children from the general population. Multi-informant reports from parents and teachers were analyzed.Results. Structural Equation Modeling showed...

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

    Science.gov (United States)

    Moore, Kimberly Sena

    2013-01-01

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

  20. Variability and practice load in motor learning. [Variabilidad y carga de práctica en el aprendizaje motor].

    Directory of Open Access Journals (Sweden)

    Francisco Javier Moreno

    2015-01-01

    Full Text Available Previous studies have pointed out the convenience of taking the characteristics of the skill to be learned and the intrinsic characteristics of the learners into account when designing practice tasks. Nevertheless, few studies have manipulated the amount of variable practice. The ability to adapt, as an inherent feature of biological systems, can be an adequate framework to explain and predict motor learning processes. This paper is based on adaption processes explained under the theory of allostasis and the general adaption syndrome and shares the background of the Dynamic Systems Theory, to propose the concept of practice load as a useful tool to quantify variability of practice in motor learning. From this standpoint, the conditions of variable practice are reviewed to be a stimulus in an adequate magnitude and direction to take the learner to a higher level of performance and hence to optimize motor learning. Resumen Muchos autores han recomendado la conveniencia de ajustar los niveles de práctica variable teniendo en cuenta las características de la tarea y la variabilidad intrínseca que muestra el aprendiz en la ejecución de la habilidad. Sin embargo, no son numerosos los trabajos que han manipulado varios niveles de cantidad de variabilidad al practicar. La capacidad de adaptación, como rasgo de los sistemas biológicos puede resultar un marco adecuado para afrontar esta cuestión. En este trabajo, apoyado en los procesos de adaptación explicados bajo las teorías de alostasis y el síndrome general de adaptación (GAS, y bajo presupuestos compartidos por la Teoría General de Sistemas Dinámicos, propondrá el concepto de carga de práctica como una herramienta para cuantificar la práctica en el aprendizaje motor. Bajo esta perspectiva se revisan las condiciones en las que la práctica en variabilidad debe modularse, para suponer una estimulación que facilite al aprendiz una adaptación a un nivel de rendimiento superior y con

  1. Fixed versus variable practice for teaching medical students the management of pediatric asthma exacerbations using simulation.

    Science.gov (United States)

    Drummond, David; Truchot, Jennifer; Fabbro, Eleonora; Ceccaldi, Pierre-François; Plaisance, Patrick; Tesnière, Antoine; Hadchouel, Alice

    2018-02-01

    Simulation-based trainings represent an interesting approach to teach medical students the management of pediatric asthma exacerbations (PAEs). In this study, we compared two pedagogical approaches, training students once on three different scenarios of PAEs versus training students three times on the same scenario of PAE. Eighty-five third-year medical students, novice learners for the management of PAEs, were randomized and trained. Students were assessed twice, 1 week and 4 months after the training, on a scenario of PAE new to both groups and on scenarios used during the training. The main outcome was the performance score on the new scenario of PAE at 1 week, assessed on a checklist custom-designed for the study. All students progressed rapidly and acquired excellent skills. One week after the training, there was no difference between the two groups on all the scenarios tested, including the new scenario of PAE (median performance score (IQR) of 8.3 (7.4-10.0) in the variation group versus 8.0 (6.0-10.0) in the repetition group (p = 0.16)). Four months later, the performance of the two groups remained similar. Varying practice with different scenarios was equivalent to repetitive practice on the same scenario for novice learners, with both methods leading to transfer and long-term retention of the skills acquired during the training. What is known: • Simulation-based trainings represent an interesting approach to teach medical students the management of pediatric asthma exacerbations. • It is unclear whether students would benefit more from repetitive practice on the same scenario of asthma exacerbation or from practice on different scenarios in terms of transfer of skills. What is new: • An individual 30-min training on the management of pediatric asthma exacerbations using simulation allows transfer and long-term retention of the skills acquired. • Varying practice with different scenarios is equivalent to repetitive practice on the same

  2. Parenting practices as mediating variables between parents' psychopathology and oppositional defiant disorder in preschoolers

    OpenAIRE

    Trepat de Ancos, Esther

    2014-01-01

    Background: Oppositional defiant disorder (ODD) is very frequent in preschoolers. The severity and the long-term negative outcomes make the understanding of this disorder a priority. The goal in this study was to assess the mediating role of parenting practices in the relationship between parents’ psychopathology and ODD in preschoolers. Method: A community sample of 622 children was assessed longitudinally at age 3 and age 5. Parents reported on children’s psychopathology through a diagnosti...

  3. Breastfeeding Practices, Demographic Variables, and Their Association with Morbidities in Children

    Directory of Open Access Journals (Sweden)

    Dipen V. Patel

    2015-01-01

    Full Text Available Appropriate feeding practices are the key contributor to reducing morbidities and mortalities in under-five children. A cross-sectional questionnaire based survey of mothers of children aged less than 5years was conducted in 781 mothers. More than half of mothers (57.5% started feeding within an hour of birth, 55.9% gave exclusive breastfeeding for six months, 89.1% of the mothers stopped breastfeeding before two years of age, 18.2% of the mothers bottle-fed the babies, and 15.6% had problems during breastfeeding in first 6 months. Early initiation of breastfeeding within one hour of birth promoted exclusive breastfeeding, and breastfeeding for longer duration. Exclusive breastfeeding increased frequency of feeds. Multivariable logistic regression showed that initiation of breastfeeding after an hour of birth (p = 0.035, not providing exclusive breastfeeding for 6 months (p < 0.0001, unemployed mothers (p = 0.035, having two or more kids (p = 0.001, and complementary feeds given by person other than mother (p = 0.007 increased hospitalization. Starting breastfeeding after an hour of birth (p = 0.045, severe malnutrition (p = 0.018, and breastfeeding for < two years (p = 0.026 increased rates of diarrhea. Breastfeeding practices were not optimum and interventions to improve these practices need to be strengthened.

  4. Depression, comorbid anxiety disorders, and heart rate variability in physically healthy, unmedicated patients: implications for cardiovascular risk.

    Science.gov (United States)

    Kemp, Andrew H; Quintana, Daniel S; Felmingham, Kim L; Matthews, Slade; Jelinek, Herbert F

    2012-01-01

    There is evidence that heart rate variability (HRV) is reduced in major depressive disorder (MDD), although there is debate about whether this effect is caused by medication or the disorder per se. MDD is associated with a two to fourfold increase in the risk of cardiac mortality, and HRV is a robust predictor of cardiac mortality; determining a direct link between HRV and not only MDD, but common comorbid anxiety disorders, will point to psychiatric indicators for cardiovascular risk reduction. To determine in physically healthy, unmedicated patients whether (1) HRV is reduced in MDD relative to controls, and (2) HRV reductions are driven by MDD alone, comorbid generalized anxiety disorder (GAD, characterized by anxious anticipation), or comorbid panic and posttraumatic stress disorders (PD/PTSD, characterized by anxious arousal). A case-control study in 2006 and 2007 on 73 MDD patients, including 24 without anxiety comorbidity, 24 with GAD, and 14 with PD/PTSD. Seventy-three MDD and 94 healthy age- and sex-matched control participants were recruited from the general community. Participants had no history of drug addiction, alcoholism, brain injury, loss of consciousness, stroke, neurological disorder, or serious medical conditions. There were no significant differences between the four groups in age, gender, BMI, or alcohol use. HRV was calculated from electrocardiography under a standardized short-term resting state condition. HRV was reduced in MDD relative to controls, an effect associated with a medium effect size. MDD participants with comorbid generalized anxiety disorder displayed the greatest reductions in HRV relative to controls, an effect associated with a large effect size. Unmedicated, physically healthy MDD patients with and without comorbid anxiety had reduced HRV. Those with comorbid GAD showed the greatest reductions. Implications for cardiovascular risk reduction strategies in otherwise healthy patients with psychiatric illness are discussed.

  5. Global Health Systems and Policy Development: Implications for Health Literacy Research, Theory and Practice.

    Science.gov (United States)

    Rowlands, Gillian; Dodson, Sarity; Leung, Angela; Levin-Zamir, Diane

    2017-01-01

    Accessible and responsive health systems are critical to population health and human development. While progress has been made toward global health and development targets, significant inequities remain within and between countries. Expanding health inequities suggest a widespread and systemic neglect of vulnerable citizens, and a failure to enshrine within policies a responsibility to tailor care to the variable capabilities of citizens. Implementation of health and social policies that drive the design of accessible health systems, services, products and infrastructure represents the next frontier for health reform. Within this chapter we argue the need to consider health and health literacy across policy domains, to operationalize the intent to address inequities in health in meaningful and pragmatic ways, and to actively monitor progress and impact within the context of the Sustainable Development Goals (SDGs). We contend that viewing and developing policies and systems within a health literacy framework will assist in placing citizens and equity considerations at the center of development efforts. In this chapter, we explore the relationship between health literacy and equitable access to health care, and the role of health system and policy reform. We first explore international policies, health literacy, and the SDGs. We then explore national policies and the role that national and local services and systems play in building health literacy, and responding to the health literacy challenges of citizens. We discuss the World Health Organization's (WHO) Framework for Integrated People-Centered Health Services and the way in which health services are being encouraged to understand and respond to citizen health literacy needs. Each section of the chapter ends with a summary and a review of health literacy research and practice. Throughout, we illustrate our points through 'vignettes' from around the world.

  6. Associations between the practice of bullying and individual and contextual variables from the aggressors' perspective

    Directory of Open Access Journals (Sweden)

    Wanderlei Abadio de Oliveira

    2016-02-01

    Full Text Available ABSTRACT OBJECTIVES: To estimate the prevalence of bullying among Brazilian students from the aggressor's perspective and to analyze its association with individual and contextual variables. METHODS: This was a cross-sectional population-based study carried out with data from the National Survey on Student Health. A total of 109,104 students attending eight grade in public and private schools were included. Data were collected through a self-applied questionnaire. A model of association between bullying and variables in the following domains was tested: sociodemographics, risk behaviors, mental health, and family context. Univariate and multivariate analyses were also performed. RESULTS: The prevalence of aggressors in bullying situations was 20.8%. The following variables remained associated in the final multivariate model: male gender (OR: 1.87; 95% CI: 1.79-1.94, lower participation of 16-year-old students (OR: 0.66; 95% CI: 0.53-0.82, and students from private schools (OR: 1.33; 95% CI: 1.27-1.39. Most aggressors reported feeling lonely (OR: 1.22; 95% CI: 1.16-1.28, insomnia episodes (OR: 1.21; 95% CI: 1.14-1.29, and a high prevalence of physical violence in the family (OR: 1.97 95% CI: 1.87-2.08. Aggressors missed classes more frequently (OR: 1.45; 95% CI: 1.40-1.51, and they regularly consumed more tobacco (OR: 1.21; 95% CI: 1.12-1.31, alcohol (OR: 1.85; 95% CI: 1.77-1.92, and illegal drugs (OR: 1.91; 95% CI: 1.79-2.04; they also demonstrated increased sexual intercourse (OR: 1.49 95% CI: 1.43-1.55 and regular exercise (OR: 1.20; 95% CI: 1.16-1.25. CONCLUSIONS: The data indicate that bullying is an important aspect that affects the learning-teaching process and the students' health.

  7. Temporal trends and variability of colonoscopy performance in a gastroenterology practice.

    Science.gov (United States)

    le Clercq, Chantal M C; Mooi, Rick J; Winkens, Bjorn; Salden, Bouke N H; Bakker, C Minke; van Nunen, Annick B; Keulen, Eric P T; de Ridder, Rogier J; Masclee, Ad A M; Sanduleanu, Silvia

    2016-03-01

    Quality measures for colonoscopy are operator dependent and vary. It is unclear whether quality measures change over time. In this study, time-dependent variation in colonoscopy performance was examined in a gastroenterology practice. Colonoscopy and histopathology records that were collected at three hospitals (one university and two non-university hospitals) over three time periods (2007, 2010, and 2013) were reviewed. Data from colonoscopists performing at least 100 procedures per year were analyzed. Inter-colonoscopist variation in performance (i. e. adjusted cecal intubation rate [aCIR], adenoma detection rate [ADR], advanced ADR, mean adenomas per procedure [MAP], proximal ADR, nonpolypoid ADR, and serrated polyp detection rate) were examined using coefficients of variation. Logistic regression analyses were also performed, adjusting for covariates. A total of 23 colonoscopists performing 6400 procedures were included. Overall, the mean aCIR, ADR, MAP, and proximal ADR improved significantly over time, from 91.9 %, 22.5 %, 0.37, and 10.2 % in 2007 to 95.3 %, 25.8 %, 0.45, and 13.4 %, respectively, in 2013 (P gastroenterology clinical practice. Core quality measures improved over time, mainly through improvement of the lower performers. Measurement of inter-colonoscopist variation in performance helps to identify factors that stimulate or hinder performance, and forms the basis for interventions. http://www.trialregister.nl. © Georg Thieme Verlag KG Stuttgart · New York.

  8. A multilevel variable neighborhood search heuristic for a practical vehicle routing and driver scheduling problem

    DEFF Research Database (Denmark)

    Wen, Min; Krapper, Emil; Larsen, Jesper

    2011-01-01

    in their fresh meat supply logistics system. The problem consists of a 1‐week planning horizon, heterogeneous vehicles, and drivers with predefined work regulations. These regulations include, among other things, predefined workdays, fixed starting time, maximum weekly working duration, and a break rule......The world's second largest producer of pork, Danish Crown, also provides a fresh meat supply logistics system within Denmark. This is used by the majority of supermarkets in Denmark. This article addresses an integrated vehicle routing and driver scheduling problem arising at Danish Crown....... The objective is to minimize the total delivery cost that is a weighted sum of two kinds of delivery costs. A multilevel variable neighborhood search heuristic is proposed for the problem. In a preprocessing step, the problem size is reduced through an aggregation procedure. Thereafter, the aggregated weekly...

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

    Science.gov (United States)

    Wei, Bing; Li, Xiaoxiao

    2017-09-01

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

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

    Science.gov (United States)

    Ade-Ojo, Gordon O.

    2012-01-01

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

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

    NARCIS (Netherlands)

    van Vugt, Marieke

    2014-01-01

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

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

    Science.gov (United States)

    Geake, John

    2011-01-01

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

  13. Quantum hacking: Saturation attack on practical continuous-variable quantum key distribution

    Science.gov (United States)

    Qin, Hao; Kumar, Rupesh; Alléaume, Romain

    2016-07-01

    We identify and study a security loophole in continuous-variable quantum key distribution (CVQKD) implementations, related to the imperfect linearity of the homodyne detector. By exploiting this loophole, we propose an active side-channel attack on the Gaussian-modulated coherent-state CVQKD protocol combining an intercept-resend attack with an induced saturation of the homodyne detection on the receiver side (Bob). We show that an attacker can bias the excess noise estimation by displacing the quadratures of the coherent states received by Bob. We propose a saturation model that matches experimental measurements on the homodyne detection and use this model to study the impact of the saturation attack on parameter estimation in CVQKD. We demonstrate that this attack can bias the excess noise estimation beyond the null key threshold for any system parameter, thus leading to a full security break. If we consider an additional criterion imposing that the channel transmission estimation should not be affected by the attack, then the saturation attack can only be launched if the attenuation on the quantum channel is sufficient, corresponding to attenuations larger than approximately 6 dB. We moreover discuss the possible countermeasures against the saturation attack and propose a countermeasure based on Gaussian postselection that can be implemented by classical postprocessing and may allow one to distill the secret key when the raw measurement data are partly saturated.

  14. The practical engineer-fine-tuning memory macros using variable internal delays

    CERN Document Server

    Gray, K

    1999-01-01

    Embedded memory blocks are extremely common in application-specific IC (ASIC) chips. In this era of design reuse, it is critical that these memory macros, as they are also called, should be as versatile as possible. Their $9 performance should be optimal, with adequate sense amplifier signal over the full manufacturing process range of the chip. Fortunately, several simple techniques exist for adapting memory macros to different applications running at $9 different speeds. The key is to design in delays that are variable and/or programmable. The approach is also helpful in debugging initial hardware where a memory macro is refusing to function because its timing is too fast and there $9 is insufficient internal delay for proper circuit operation. The techniques can also eliminate the process of redesigning and refabricating the initial hardware just to characterize it. A memory macro is made to function by internal $9 pulses, generated in the correct number, sequence and relationship by the internal timing ch...

  15. Ranking Practice Variability in the Medical Student Performance Evaluation: So Bad, It's "Good".

    Science.gov (United States)

    Boysen Osborn, Megan; Mattson, James; Yanuck, Justin; Anderson, Craig; Tekian, Ara; Fox, John Christian; Harris, Ilene B

    2016-11-01

    To examine the variability among medical schools in ranking systems used in medical student performance evaluations (MSPEs). The authors reviewed MSPEs from U.S. MD-granting medical schools received by the University of California, Irvine emergency medicine and internal medicine residency programs during 2012-2013 and 2014-2015. They recorded whether the school used a ranking system, the type of ranking system used, the size and description of student categories, the location of the ranking statement and category legend, and whether nonranking schools used language suggestive of rank. Of the 134 medical schools in the study sample, the majority (n = 101; 75%) provided ranks for students in the MSPE. Most of the ranking schools (n = 63; 62%) placed students into named category groups, but the number and size of groups varied. The most common descriptors used for these 63 schools' top, second, third, and lowest groups were "outstanding," "excellent," "very good," and "good," respectively, but each of these terms was used across a broad range of percentile ranks. Student ranks and school category legends were found in various locations. Many of the 33 schools that did not rank students included language suggestive of rank. There is extensive variation in ranking systems used in MSPEs. Program directors may find it difficult to use MSPEs to compare applicants, which may diminish the MSPE's value in the residency application process and negatively affect high-achieving students. A consistent approach to ranking students would benefit program directors, students, and student affairs officers.

  16. Comparing Absolute Error with Squared Error for Evaluating Empirical Models of Continuous Variables: Compositions, Implications, and Consequences

    Science.gov (United States)

    Gao, J.

    2014-12-01

    Reducing modeling error is often a major concern of empirical geophysical models. However, modeling errors can be defined in different ways: When the response variable is continuous, the most commonly used metrics are squared (SQ) and absolute (ABS) errors. For most applications, ABS error is the more natural, but SQ error is mathematically more tractable, so is often used as a substitute with little scientific justification. Existing literature has not thoroughly investigated the implications of using SQ error in place of ABS error, especially not geospatially. This study compares the two metrics through the lens of bias-variance decomposition (BVD). BVD breaks down the expected modeling error of each model evaluation point into bias (systematic error), variance (model sensitivity), and noise (observation instability). It offers a way to probe the composition of various error metrics. I analytically derived the BVD of ABS error and compared it with the well-known SQ error BVD, and found that not only the two metrics measure the characteristics of the probability distributions of modeling errors differently, but also the effects of these characteristics on the overall expected error are different. Most notably, under SQ error all bias, variance, and noise increase expected error, while under ABS error certain parts of the error components reduce expected error. Since manipulating these subtractive terms is a legitimate way to reduce expected modeling error, SQ error can never capture the complete story embedded in ABS error. I then empirically compared the two metrics with a supervised remote sensing model for mapping surface imperviousness. Pair-wise spatially-explicit comparison for each error component showed that SQ error overstates all error components in comparison to ABS error, especially variance-related terms. Hence, substituting ABS error with SQ error makes model performance appear worse than it actually is, and the analyst would more likely accept a

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

    International Nuclear Information System (INIS)

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

    2016-01-01

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

  18. Associations between the practice of bullying and individual and contextual variables from the aggressors’ perspective

    Directory of Open Access Journals (Sweden)

    Wanderlei Abadio de Oliveira

    2016-01-01

    Full Text Available Objectives: To estimate the prevalence of bullying among Brazilian students from the aggressor's perspective and to analyze its association with individual and contextual variables. Methods: This was a cross-sectional population-based study carried out with data from the National Survey on Student Health. A total of 109,104 students attending eight grade in public and private schools were included. Data were collected through a self-applied questionnaire. A model of association between bullying and variables in the following domains was tested: sociodemographics, risk behaviors, mental health, and family context. Univariate and multivariate analyses were also performed. Results: The prevalence of aggressors in bullying situations was 20.8%. The following variables remained associated in the final multivariate model: male gender (OR: 1.87; 95% CI: 1.79–1.94, lower participation of 16-year-old students (OR: 0.66; 95% CI: 0.53–0.82, and students from private schools (OR: 1.33; 95% CI: 1.27–1.39. Most aggressors reported feeling lonely (OR: 1.22; 95% CI: 1.16–1.28, insomnia episodes (OR: 1.21; 95% CI: 1.14–1.29, and a high prevalence of physical violence in the family (OR: 1.97 95% CI: 1.87–2.08. Aggressors missed classes more frequently (OR: 1.45; 95% CI: 1.40–1.51, and they regularly consumed more tobacco (OR: 1.21; 95% CI: 1.12–1.31, alcohol (OR: 1.85; 95% CI: 1.77–1.92, and illegal drugs (OR: 1.91; 95% CI: 1.79–2.04; they also demonstrated increased sexual intercourse (OR: 1.49 95% CI: 1.43–1.55 and regular exercise (OR: 1.20; 95% CI: 1.16–1.25. Conclusions: The data indicate that bullying is an important aspect that affects the learning-teaching process and the students’ health. Resumo: Objetivos: Estimar a prevalência de bullying, sob a perspectiva do agressor, em escolares brasileiros, e analisar sua associação com variáveis individuais e de contexto. Métodos: Estudo transversal, de base populacional, com dados

  19. How many replicate tests do I need?$-$ Variability of cookstove performance and emissions has implications for obtaining useful results

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Yungang [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division; Sohn, Michael D. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division; Gadgil, Ashok J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division; Wang, Yilun [ISO Innovative Analytics San Francisco, CA (United States); Lask, Kathleen M. [Univ. of California, Berkeley, CA (United States). College of Engineering Applied Science and Technology Program; Kirchstetter, Thomas W. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division

    2013-02-01

    Almost half of the world’s population still cooks on biomass cookstoves of poor efficiency and primitive design, such as three stone fires (TSF). Emissions from biomass cookstoves contribute to adverse health effects and climate change. A number of “improved cookstoves” with higher energy efficiency and lower emissions have been designed and promoted across the world. During the design development, and for selection of a stove for dissemination, the stove performance and emissions are commonly evaluated, communicated and compared using the arithmetic average of replicate tests made using a standardized laboratory-based test, commonly the water boiling test (WBT). However, published literature shows different WBT results reported from different laboratories for the same stove technology. Also, there is no agreement in the literature on how many replicate tests should be performed to ensure “significance” in the reported average performance. This matter has not received attention in the rapidly growing literature on stoves, and yet is crucial for estimating and communicating the performance of a stove, and for comparing the performance between stoves. We present results of statistical analyses using data from a number of replicate tests of performance and emission of the Berkeley-Darfur Stove (BDS) and the TSF under well-controlled laboratory conditions. We observed moderate variability in the test results for the TSF and BDS when measuring several characteristics. Here we focus on two as illustrative: time-to-boil and PM2.5 (particulate matter less than or equal to 2.5 micrometers in diameter) emissions. We demonstrate that interpretation of the results comparing these stoves could be misleading if only a small number of replicates had been conducted. We then describe a practical approach, useful to both stove testers and designers, to assess the number of replicates needed to obtain useful data. Caution should be exercised in attaching high credibility to

  20. Stigma modifies the association between social support and mental health among sexual violence survivors in the Democratic Republic of Congo: implications for practice.

    Science.gov (United States)

    Wachter, Karin; Murray, Sarah M; Hall, Brian J; Annan, Jeannie; Bolton, Paul; Bass, Judy

    2018-07-01

    The aim of this study was to further understanding of the relationship between social support, internalized and perceived stigma, and mental health among women who experienced sexual violence in the eastern Democratic Republic of Congo (DRC). Drawing from baseline survey data collected in eastern DRC, researchers conducted a secondary cross-sectional analysis using data from 744 participants. Regression and moderation analyses were conducted to examine associations between social support variables, felt stigma, and depression, anxiety and posttraumatic stress disorder (PTSD). Emotional support seeking and felt stigma were positively associated with increased symptom severity across all three mental health variables. Stigma modified associations between emotional support seeking and depression (t = -2.49, p = .013), anxiety (t = -3.08, p = .002), and PTSD (t = -2.94, p = .003). Increased frequency of emotional support seeking was associated with higher mental health symptoms of anxiety and PTSD among women experiencing all levels of stigma. Enhancing understanding of social support and stigma may inform research and intervention among Congolese forced migrant populations across circumstances and geographic locations. Implications for practice and research are discussed.

  1. The variability of practice in minimally invasive thoracic surgery for pulmonary resections.

    Science.gov (United States)

    Rocco, Gaetano; Internullo, Eveline; Cassivi, Stephen D; Van Raemdonck, Dirk; Ferguson, Mark K

    2008-08-01

    Thoracic surgeons participating in this survey seemed to have clearly indicated their perception of VATS major lung resections, in particular VATS lobectomy. 1. The acronym VATS as a short form of "video-assisted thoracic surgery" was the preferred terminology. 2. According to the respondents, the need or use of rib spreading served as the defining characteristic of "open" thoracic surgery. 3. It was most commonly suggested that VATS lobectomy is performed by means of two or three port incisions with the addition of a minithoracotomy or access incision. 4. Rib spreading (shearing) was not deemed acceptable as part of a strictly defined VATS procedure. 5. Although there was no general consensus, respondents suggested that the preferred approach for visualization in a VATS procedure was only through the video monitor. 6. Although minimally invasive procedures for lung resection are still mainly being used for diagnostic and minor therapeutic purposes, young surgeons seemed to be more likely to recommend VATS lung surgery for major pulmonary resections than their more senior colleagues. 7. The survey confirmed that the use of the standard posterolateral thoracotomy is still widespread. Almost 40% of the surgeons claimed to use the standard posterolateral thoracotomy for more than 50% of their cases and less than 30% use it for less than 5% of cases. 8. The major reasons to perform VATS lobectomy were perceived to be reduced pain and decreased hospitalization. 9. Approximately 60% of the surgeons claimed to perform VATS lobectomy in less than 5% of their lobectomy cases. Younger consultants reported using VATS lobectomy in up to 50% of their lobectomy cases. There was the suggestion that lack of resources could justify the minor impact of VATS lobectomy in the thoracic surgical practice in middle- to low-income countries. 10. The currently available scientific evidence on safety and effectiveness, and technologic advancements were emphasized as the two factors having a

  2. Tanker milk variability according to farm feeding practices: vitamins A and E, carotenoids, color, and terpenoids.

    Science.gov (United States)

    Agabriel, C; Cornu, A; Journal, C; Sibra, C; Grolier, P; Martin, B

    2007-10-01

    The aim of this work was to study the variability in the composition of bulk milk mixtures of fat-soluble compounds (vitamins A and E, carotenoids, and terpenoids) and assess the links with milk production conditions. Milk from 10 collection trips in the French department of the Haute-Loire (10 to 36 herds per trip) was sampled in the tanker twice during the winter period and 3 times during the grazing season. The collection trips differed in their altitude (440 to 1,150 m) and the forage system (grass or based on corn silage). Vitamins A and E, carotenoids, and terpenoids of the 50 tanker loads of milk were analyzed. Data of milk production conditions in the 204 farms made it possible to constitute indicators for the collection trip and to define 50 mean herds. The relationships between mean herd characteristics (breed, stage of lactation, and feed) and milk characteristics were investigated. The constituents of tanker loads of milk were comparable to those observed in milk produced by groups of animals receiving contrasting diets (rich in concentrate or corn silage vs. pasture). The characteristics of the milk differed according to the period; those produced at grazing were more yellow (1.02 +/- 0.4; mean of difference) and richer in beta-carotene, lutein, vitamin E (2.0 +/- 1.2, 0.23 +/- 0.12, and 6.1 +/- 5.0 mug/g of fat, respectively), and sesquiterpenes (2.7 +/- 2.5) than winter. The variations observed for beta-carotene, lutein, and vitamin E were linked to the proportion of grazed grass or grass silage in the forage (r = 0.66, 0.69, and 0.51, respectively), unlike the vitamin A content. During grazing, 20 of the 32 terpenoids identified were associated with the proportion of permanent grassland available for grazing or cut. These results show that feeding is an effective way to modify the quality of dairy products, even in the case of bulk tank milk mixtures. Dairy plants could market different milks, which would contain specific compositions.

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

    Science.gov (United States)

    Southern, Annie; Miller, Judi

    2012-01-01

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

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

    Science.gov (United States)

    Macmann, Gregg M.; Barnett, David W.

    1992-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Joanna Scurr

    2015-03-01

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

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

    Science.gov (United States)

    Farrell, Francis

    2016-01-01

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

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

    Science.gov (United States)

    Lomax, Helen Jayne

    2012-01-01

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

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

    Science.gov (United States)

    Grosland, Tanetha J.

    2013-01-01

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

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

    Science.gov (United States)

    Mathews, Rahel; Zachariah, Rachel

    2008-07-01

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

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

    Science.gov (United States)

    Reyna, Valerie F; Farley, Frank

    2006-09-01

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

  11. An Analysis of Programmatic Variables Relating to the Pass Rates on the Licensure Examination by Practical Nurses in Tennessee Technology Centers

    Science.gov (United States)

    Simpson, Janis Lee

    2013-01-01

    The purpose of this quantitative research study was to determine the degree to which Licensed Practical Nursing programmatic variables positively correlate with select Tennessee Technology Center institution pass rates on the licensure examination--NCLEX-PNRTM. This study investigated the relationship between the dependent variable of NCLEX-PNRTM…

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Science.gov (United States)

    Toddi A. Steelman; Sarah McCaffrey

    2013-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

    Jiménez-Aleixandre, María Pilar

    2014-01-01

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

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

    Science.gov (United States)

    Smith, Beatrice Quarshie

    2006-01-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    DEFF Research Database (Denmark)

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

    2006-01-01

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

  19. 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.

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

    Science.gov (United States)

    Kang-Yi, Christina D; Adams, Danielle R

    2017-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Graeme Pye

    2015-11-01

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

  2. Stereological estimates of nuclear volume and other quantitative variables in supratentorial brain tumors. Practical technique and use in prognostic evaluation

    DEFF Research Database (Denmark)

    Sørensen, Flemming Brandt; Braendgaard, H; Chistiansen, A O

    1991-01-01

    The use of morphometry and modern stereology in malignancy grading of brain tumors is only poorly investigated. The aim of this study was to present these quantitative methods. A retrospective feasibility study of 46 patients with supratentorial brain tumors was carried out to demonstrate...... the practical technique. The continuous variables were correlated with the subjective, qualitative WHO classification of brain tumors, and the prognostic value of the parameters was assessed. Well differentiated astrocytomas (n = 14) had smaller estimates of the volume-weighted mean nuclear volume and mean...... nuclear profile area, than those of anaplastic astrocytomas (n = 13) (2p = 3.1.10(-3) and 2p = 4.8.10(-3), respectively). No differences were seen between the latter type of tumor and glioblastomas (n = 19). The nuclear index was of the same magnitude in all three tumor types, whereas the mitotic index...

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

    Science.gov (United States)

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

    2012-03-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-03-15

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

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

    International Nuclear Information System (INIS)

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

    2012-01-01

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

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

    Science.gov (United States)

    Dunn, W; Cada, E

    1998-10-01

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

  7. Short-term to seasonal variability in factors driving primary productivity in a shallow estuary: Implications for modeling production

    Science.gov (United States)

    Canion, Andy; MacIntyre, Hugh L.; Phipps, Scott

    2013-10-01

    The inputs of primary productivity models may be highly variable on short timescales (hourly to daily) in turbid estuaries, but modeling of productivity in these environments is often implemented with data collected over longer timescales. Daily, seasonal, and spatial variability in primary productivity model parameters: chlorophyll a concentration (Chla), the downwelling light attenuation coefficient (kd), and photosynthesis-irradiance response parameters (Pmchl, αChl) were characterized in Weeks Bay, a nitrogen-impacted shallow estuary in the northern Gulf of Mexico. Variability in primary productivity model parameters in response to environmental forcing, nutrients, and microalgal taxonomic marker pigments were analysed in monthly and short-term datasets. Microalgal biomass (as Chla) was strongly related to total phosphorus concentration on seasonal scales. Hourly data support wind-driven resuspension as a major source of short-term variability in Chla and light attenuation (kd). The empirical relationship between areal primary productivity and a combined variable of biomass and light attenuation showed that variability in the photosynthesis-irradiance response contributed little to the overall variability in primary productivity, and Chla alone could account for 53-86% of the variability in primary productivity. Efforts to model productivity in similar shallow systems with highly variable microalgal biomass may benefit the most by investing resources in improving spatial and temporal resolution of chlorophyll a measurements before increasing the complexity of models used in productivity modeling.

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

    OpenAIRE

    Farrell, Kathleen

    2015-01-01

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

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

    OpenAIRE

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

    2010-01-01

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

  10. 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.

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

    Science.gov (United States)

    Park, Wonyong; Song, Jinwoong

    2018-03-01

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

  12. Quantification of the islet product: presentation of a standardized current good manufacturing practices compliant system with minimal variability.

    Science.gov (United States)

    Friberg, Andrew S; Brandhorst, Heide; Buchwald, Peter; Goto, Masafumi; Ricordi, Camillo; Brandhorst, Daniel; Korsgren, Olle

    2011-03-27

    Accurate islet quantification has proven difficult to standardize in a good manufacturing practices (GMP) approved manner. The influence of assessment variables from both manual and computer-assisted digital image analysis (DIA) methods were compared using calibrated, standardized microspheres or islets alone. Additionally, a mixture of microspheres and exocrine tissue was used to evaluate the variability of both the current, internationally recognized, manual method and a novel GMP-friendly purity- and volume-based method (PV) evaluated by DIA in a semiclosed, culture bag system. Computer-assisted DIA recorded known microsphere size distribution and quantities accurately. By using DIA to evaluate islets, the interindividual manually evaluated percent coefficients of variation (CV%; n=14) were reduced by almost half for both islet equivalents (IEs; 31% vs. 17%, P=0.002) and purity (20% vs. 13%, P=0.033). The microsphere pool mixed with exocrine tissue did not differ from expected IE with either method. However, manual IE resulted in a total CV% of 44.3% and a range spanning 258 k IE, whereas PV resulted in CV% of 10.7% and range of 60 k IE. Purity CV% for each method were similar approximating 10.5% and differed from expected by +7% for the manual method and +3% for PV. The variability of standard counting methods for islet samples and clinical quantities of microspheres mixed with exocrine tissue were reduced with DIA. They were reduced even further by use of a semiclosed bag system compared with standard manual counting, thereby facilitating the standardization of islet evaluation according to GMP standards.

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

    OpenAIRE

    Ye, J.

    2013-01-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2014-12-01

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

  16. An exploratory study of the influence of load and practice on segmental and articulatory variability in children with speech sound disorders.

    Science.gov (United States)

    Vuolo, Janet; Goffman, Lisa

    2017-01-01

    This exploratory treatment study used phonetic transcription and speech kinematics to examine changes in segmental and articulatory variability. Nine children, ages 4 to 8 years old, served as participants, including two with childhood apraxia of speech (CAS), five with speech sound disorder (SSD) and two who were typically developing. Children practised producing agent + action phrases in an imitation task (low linguistic load) and a retrieval task (high linguistic load) over five sessions. In the imitation task in session one, both participants with CAS showed high degrees of segmental and articulatory variability. After five sessions, imitation practice resulted in increased articulatory variability for five participants. Retrieval practice resulted in decreased articulatory variability in three participants with SSD. These results suggest that short-term speech production practice in rote imitation disrupts articulatory control in children with and without CAS. In contrast, tasks that require linguistic processing may scaffold learning for children with SSD but not CAS.

  17. Clinical Audit of the Radiotherapy Process in Rectal Cancer: Clinical Practice Guidelines and Quality Certification Do Not Avert Variability in Clinical Practice.

    Science.gov (United States)

    Torras, M G; Canals, E; Jurado-Bruggeman, D; Marín-Borras, S; Macià, M; Jové, J; Boladeras, A M; Muñoz-Montplet, C; Molero, J; Picón, C; Puigdemont, M; Aliste, L; Torrents, A; Guedea, F; Borras, J M

    2018-06-01

    The therapeutic approach to cancer is complex and multidisciplinary. Radiotherapy is among the essential treatments, whether used alone or in conjunction with other therapies. This study reports a clinical audit of the radiotherapy process to assess the process of care, evaluate adherence to agreed protocols and measure the variability to improve therapeutic quality for rectal cancer. Multicentre retrospective cohort study in a representative sample of patients diagnosed with rectal cancer in the Institut Català d'Oncologia, a comprehensive cancer centre with three different settings. We developed a set of indicators to assess the key areas of the radiotherapy process. The clinical audit consisted of a review of a random sample of 40 clinical histories for each centre. The demographic profile, histology and staging of patients were similar between centres. The MRI reports did not include the distance from tumour to mesorectal fascia (rCRM) in 38.3% of the cases. 96.7% of patients received the planned dose, and 57.4% received it at the planned time. Surgery followed neoadjuvant treatment in 96.7% of the patients. Among this group, postoperative CRM was recorded in 65.5% of the cases and was negative in 93.4% of these. With regard to the 34.5% (n = 40) of cases where no CRM value was stated, there were differences between the centres. Mean follow-up was 3.4 (SD 0.6) years, and overall survival at four years was 81.7%. The audit revealed a suboptimal degree of adherence to clinical practice guidelines. Significant variability between centres exists from a clinical perspective but especially with regard to organization and process. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2013-01-01

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

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

    OpenAIRE

    Farrell, Kathleen

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-12-01

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

  1. Interobserver variability in identification of breast tumors in MRI and its implications for prognostic biomarkers and radiogenomics

    Energy Technology Data Exchange (ETDEWEB)

    Saha, Ashirbani, E-mail: as698@duke.edu; Grimm, Lars J., E-mail: lars.grimm@duke.edu; Harowicz, Michael, E-mail: michael.harowicz@duke.edu; Ghate, Sujata V., E-mail: sujata.ghate@duke.edu; Kim, Connie, E-mail: connie.kim@duke.edu; Walsh, Ruth, E-mail: ruth.walsh@duke.edu; Mazurowski, Maciej A., E-mail: maciej.mazurowski@duke.edu [Department of Radiology, Duke University Medical Center, 2424 Erwin Road, Suite 302, Durham, North Carolina 27705 (United States)

    2016-08-15

    Purpose: To assess the interobserver variability of readers when outlining breast tumors in MRI, study the reasons behind the variability, and quantify the effect of the variability on algorithmic imaging features extracted from breast MRI. Methods: Four readers annotated breast tumors from the MRI examinations of 50 patients from one institution using a bounding box to indicate a tumor. All of the annotated tumors were biopsy proven cancers. The similarity of bounding boxes was analyzed using Dice coefficients. An automatic tumor segmentation algorithm was used to segment tumors from the readers’ annotations. The segmented tumors were then compared between readers using Dice coefficients as the similarity metric. Cases showing high interobserver variability (average Dice coefficient <0.8) after segmentation were analyzed by a panel of radiologists to identify the reasons causing the low level of agreement. Furthermore, an imaging feature, quantifying tumor and breast tissue enhancement dynamics, was extracted from each segmented tumor for a patient. Pearson’s correlation coefficients were computed between the features for each pair of readers to assess the effect of the annotation on the feature values. Finally, the authors quantified the extent of variation in feature values caused by each of the individual reasons for low agreement. Results: The average agreement between readers in terms of the overlap (Dice coefficient) of the bounding box was 0.60. Automatic segmentation of tumor improved the average Dice coefficient for 92% of the cases to the average value of 0.77. The mean agreement between readers expressed by the correlation coefficient for the imaging feature was 0.96. Conclusions: There is a moderate variability between readers when identifying the rectangular outline of breast tumors on MRI. This variability is alleviated by the automatic segmentation of the tumors. Furthermore, the moderate interobserver variability in terms of the bounding box

  2. Mixed Messages: Inconsistent Sexual Scripts in Australian Teenage Magazines and Implications for Sexual Health Practices

    Science.gov (United States)

    Burns, Melanie C.

    2018-01-01

    Condom use among Australian adolescents has been shown to be variable, despite good knowledge among this group about sexual health risks and the promotion of condoms as a simple way to reduce the spread of sexually transmitted infections. This study explores dominant constructions of condom use within two Australian lifestyle magazines targeted…

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

    Science.gov (United States)

    de-Graft Aikins, Ama

    2014-01-01

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

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Agunbiade Ojo M

    2012-04-01

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

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

    Science.gov (United States)

    Pickersgill, M D

    2009-11-01

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

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

    Science.gov (United States)

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

    2013-11-01

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

  8. Point-of-care testing for chlamydia and gonorrhoea: implications for clinical practice.

    Directory of Open Access Journals (Sweden)

    Lisa Natoli

    Full Text Available Point-of-care (POC testing for chlamydia (CT and gonorrhoea (NG offers a new approach to the diagnosis and management of these sexually transmitted infections (STIs in remote Australian communities and other similar settings. Diagnosis of STIs in remote communities is typically symptom driven, and for those who are asymptomatic, treatment is generally delayed until specimens can be transported to the reference laboratory, results returned and the patient recalled. The objective of this study was to explore the clinical implications of using CT/NG POC tests in routine clinical care in remote settings.In-depth qualitative interviews were conducted with a purposively selected group of 18 key informants with a range of sexual health and laboratory expertise.Participants highlighted the potential impact POC testing would have on different stages of the current STI management pathway in remote Aboriginal communities and how the pathway would change. They identified implications for offering a POC test, specimen collection, conducting the POC test, syndromic management of STIs, pelvic inflammatory disease diagnosis and management, interpretation and delivery of POC results, provision of treatment, contact tracing, management of client flow and wait time, and re-testing at 3 months after infection.The introduction of POC testing to improve STI service delivery requires careful consideration of both its advantages and limitations. The findings of this study will inform protocols for the implementation of CT/NG POC testing, and also STI testing and management guidelines.

  9. Point-of-Care Testing for Chlamydia and Gonorrhoea: Implications for Clinical Practice

    Science.gov (United States)

    Natoli, Lisa; Maher, Lisa; Shephard, Mark; Hengel, Belinda; Tangey, Annie; Badman, Steven G.; Ward, James; Guy, Rebecca J.

    2014-01-01

    Objectives Point-of-care (POC) testing for chlamydia (CT) and gonorrhoea (NG) offers a new approach to the diagnosis and management of these sexually transmitted infections (STIs) in remote Australian communities and other similar settings. Diagnosis of STIs in remote communities is typically symptom driven, and for those who are asymptomatic, treatment is generally delayed until specimens can be transported to the reference laboratory, results returned and the patient recalled. The objective of this study was to explore the clinical implications of using CT/NG POC tests in routine clinical care in remote settings. Methods In-depth qualitative interviews were conducted with a purposively selected group of 18 key informants with a range of sexual health and laboratory expertise. Results Participants highlighted the potential impact POC testing would have on different stages of the current STI management pathway in remote Aboriginal communities and how the pathway would change. They identified implications for offering a POC test, specimen collection, conducting the POC test, syndromic management of STIs, pelvic inflammatory disease diagnosis and management, interpretation and delivery of POC results, provision of treatment, contact tracing, management of client flow and wait time, and re-testing at 3 months after infection. Conclusions The introduction of POC testing to improve STI service delivery requires careful consideration of both its advantages and limitations. The findings of this study will inform protocols for the implementation of CT/NG POC testing, and also STI testing and management guidelines. PMID:24956111

  10. Late holocene primary productivity and sea surface temperature variations in the northeastern Arabian Sea: Implications for winter monsoon variability.

    Digital Repository Service at National Institute of Oceanography (India)

    Boll, A.; Luckge, A.; Munz, P.; Forke, S.; Schulz, H.; Ramaswamy, V.; Rixen, T.; Gaye, B.; Emeis, K.-C.

    changes in winter monsoon strength with winds from the northeast that drive convective mixing and high surface ocean productivity in the northeastern Arabian Sea. To establish a high-resolution record of winter monsoon variability for the late Holocene, we...

  11. A Generalized Stability Analysis of the AMOC in Earth System Models: Implication for Decadal Variability and Abrupt Climate Change

    Energy Technology Data Exchange (ETDEWEB)

    Fedorov, Alexey V. [Yale Univ., New Haven, CT (United States)

    2015-01-14

    The central goal of this research project was to understand the mechanisms of decadal and multi-decadal variability of the Atlantic Meridional Overturning Circulation (AMOC) as related to climate variability and abrupt climate change within a hierarchy of climate models ranging from realistic ocean models to comprehensive Earth system models. Generalized Stability Analysis, a method that quantifies the transient and asymptotic growth of perturbations in the system, is one of the main approaches used throughout this project. The topics we have explored range from physical mechanisms that control AMOC variability to the factors that determine AMOC predictability in the Earth system models, to the stability and variability of the AMOC in past climates.

  12. Effect of task-oriented training and high-variability practice on gross motor performance and activities of daily living in children with spastic diplegia.

    Science.gov (United States)

    Kwon, Hae-Yeon; Ahn, So-Yoon

    2016-10-01

    [Purpose] This study investigates how a task-oriented training and high-variability practice program can affect the gross motor performance and activities of daily living for children with spastic diplegia and provides an effective and reliable clinical database for future improvement of motor performances skills. [Subjects and Methods] This study randomly assigned seven children with spastic diplegia to each intervention group including that of a control group, task-oriented training group, and a high-variability practice group. The control group only received neurodevelopmental treatment for 40 minutes, while the other two intervention groups additionally implemented a task-oriented training and high-variability practice program for 8 weeks (twice a week, 60 min per session). To compare intra and inter-relationships of the three intervention groups, this study measured gross motor performance measure (GMPM) and functional independence measure for children (WeeFIM) before and after 8 weeks of training. [Results] There were statistically significant differences in the amount of change before and after the training among the three intervention groups for the gross motor performance measure and functional independence measure. [Conclusion] Applying high-variability practice in a task-oriented training course may be considered an efficient intervention method to improve motor performance skills that can tune to movement necessary for daily livelihood through motor experience and learning of new skills as well as change of tasks learned in a complex environment or similar situations to high-variability practice.

  13. The Radical Reform of Administrative Policies in New South Wales School Education: Practical and Theoretical Implications.

    Science.gov (United States)

    Macpherson, R. J. S.

    The government of New South Wales (Australia) is attempting to enhance the quality of public education by radically altering management structures and practices. Despite some popular objections, political intervention was mandated and warranted due to excessive centralization in administrative policy making, curriculum development, and resource…

  14. Consumer adoption of social networking sites: implications for theory and practice

    NARCIS (Netherlands)

    Lorenzo Romero, Carlota; Constantinides, Efthymios; Alarcon-del-Amo, Maria-del-Carmen

    2011-01-01

    Purpose – The purpose of this paper is to study factors affecting the acceptance of social networking sites (SNS), analyze users' practices and behavior in these environments and assess the degree of acceptance of SNS in The Netherlands. Design/methodology/approach – An extended technology

  15. Developmental Surveillance and Screening Practices by Pediatric Primary Care Providers: Implications for Early Intervention Professionals

    Science.gov (United States)

    Porter, Sallie; Qureshi, Rubab; Caldwell, Barbara Ann; Echevarria, Mercedes; Dubbs, William B.; Sullivan, Margaret W.

    2016-01-01

    This study used a survey approach to investigate current developmental surveillance and developmental screening practices by pediatric primary care providers in a diverse New Jersey county. A total of 217 providers were contacted with a final sample size of 57 pediatric primary care respondents from 13 different municipalities. Most providers…

  16. Comparing the Effects of Instructional and Transformational Leadership on Student Achievement: Implications for Practice

    Science.gov (United States)

    Shatzer, Ryan H.; Caldarella, Paul; Hallam, Pamela R.; Brown, Bruce L.

    2014-01-01

    The purpose of this study was to compare transformational and instructional leadership theories, examine the unique impact that school leaders have on student achievement, and determine which specific leadership practices are associated with increased student achievement. The sample for this study consisted of 590 teachers in 37 elementary schools…

  17. Exploring a Pluralist Understanding of Learning for Sustainability and Its Implications for Outdoor Education Practice

    Science.gov (United States)

    Paulus, Susanne C.

    2016-01-01

    This article explores a pluralist understanding of learning for sustainability in educational theory and relates it to outdoor education practice. In brief, this kind of learning can be described as a deep engagement with an individual's multiple identities and the personal location in diverse geo-physical and socio-cultural surroundings. I…

  18. Local Economic Trading Schemes and their implications for marketing assumptions, concepts, and practices

    NARCIS (Netherlands)

    Crowther, D.; Greene, A-M.; Hosking, D.M.

    2002-01-01

    This paper focuses on the relationship between a particular social practice - local exchange trading systems or schemes (LETS) - and what we here call the "mainstream" marketing paradigm. It begins by discussing some of the key principles that are thought to set LETS apart from other, "more

  19. Literacy in Cross-Cultural Perspective: Implications for Policy and Practice.

    Science.gov (United States)

    Street, B.

    This paper reviews some of the issues in the new literacy studies and the questions, from an anthropological perspective, of self, person, and identity that affect literacy practices. It is suggested that in discussing literacy, it is better to start from a cultural viewpoint rather than an educational one. The traditional autonomous model of…

  20. Implications of Online Learning for the Conceptual Development and Practice of Distance Education

    Science.gov (United States)

    Garrison, Randy

    2009-01-01

    The purpose of this article is to examine the foundational principles and practices of distance education for the purpose of understanding recent developments in the areas of online and blended learning. It is argued that mainstream distance education has not embraced the full collaborative potential of online learning. Distance education…

  1. Understanding Barriers to Safer Sex Practice in Zimbabwean Marriages: Implications for Future HIV Prevention Interventions

    Science.gov (United States)

    Mugweni, Esther; Omar, Mayeh; Pearson, Stephen

    2015-01-01

    Against the backdrop of high human immunodeficiency virus (HIV) prevalence in stable relationships in Southern Africa, our study presents sociocultural barriers to safer sex practice in Zimbabwean marriages. We conducted 36 in-depth interviews and four focus group discussions with married men and women in Zimbabwe in 2008. Our aim was to identify…

  2. The Use of Assessment Criteria to Ensure Consistency of Marking: Some Implications for Good Practice.

    Science.gov (United States)

    Saunders, Mark N. K.; Davis, Susan M.

    1998-01-01

    Lecturers at a British university participated in two workshops to examine the consistency of assessments of undergraduates' work. Use of both analytical and global quality measures, when clearly understood by the raters, improved assessment practices. Ongoing discussion of evaluation criteria was recommended. (SK)

  3. Children of Color and Parental Incarceration: Implications for Research, Theory, and Practice

    Science.gov (United States)

    Graham, James A.; Harris, Yvette R.

    2013-01-01

    Practical information about culturally appropriate interventions with children of incarcerated parents (CIPs) of color and their families is notably sparse. This study uses a cultural-ecological perspective to contextualize individual, family, and legal issues inherent in many intervention programs for CIPs of color. The authors highlight…

  4. The Social Psychology of Black-White Interracial Interactions: Implications for Culturally Competent Clinical Practice

    Science.gov (United States)

    Jordan, Alexander H.; Lovett, Benjamin J.; Sweeton, Jennifer L.

    2012-01-01

    Social psychological research suggests that because of concerns about being perceived in stereotypical ways, people may experience negative affect and diminished attention and cognitive capacity during interracial interactions. The authors discuss this research in relation to therapy and assessment and also offer practical suggestions for ensuring…

  5. Bourdieu's Habitus and Field: Implications on the Practice and Theory of Critical Action Learning

    Science.gov (United States)

    Warwick, Rob; McCray, Janet; Board, Douglas

    2017-01-01

    This paper considers the logic of practice of the French sociologist Pierre Bourdieu in relation to critical action learning: in particular "habitus" which is co-created with field and the interplay amongst the two in the form of misrecognition and risk. We draw on interviews with participants who have experienced action learning as part…

  6. Revisioning Assessment through a Children's Rights Approach: Implications for Policy, Process and Practice

    Science.gov (United States)

    Elwood, Jannette; Lundy, Laura

    2010-01-01

    The linkage between the impact of assessment and compliance with children's rights is a connection, which although seemingly obvious, is nonetheless rarely made, particularly by governments, which, as signatories to the relevant human rights treaties, have the primary responsibility for ensuring that educational practice is compatible with…

  7. The Implications of Autonomist Marxism for Research and Practice in Education and Technology

    Science.gov (United States)

    Hall, Richard

    2015-01-01

    This article considers the relevance of Autonomist Marxism for both research and practice in education and technology. The article situates the Autonomist perspective against that of traditional Marxist thought--illustrating how certain core Autonomist concepts enable a critical reading of developments in information and communication technology.…

  8. Contemplative Practices in Early Childhood: Implications for Self-Regulation Skills and School Readiness

    Science.gov (United States)

    Willis, Elizabeth; Dinehart, Laura H.

    2014-01-01

    This article examines the development of self-regulation skills in early childhood and the possibilities of children's contemplative practices as a viable tool to facilitate this development. Current research indicates that self-regulation skills in early childhood education make a significant contribution to school readiness, and long-term…

  9. The Socio-Materiality of Learning Practices and Implications for the Field of Learning Technology

    Science.gov (United States)

    Johri, Aditya

    2011-01-01

    Although the use of digital information technologies in education has become commonplace, there are few, if any, central guiding frameworks or theories that explicate the relationship between technology and learning practices. In this paper, I argue that such a theoretical framework can assist scholars and practitioners alike by working as a…

  10. Aging and Cognitive Performance: Challenges and Implications for Physicians Practicing in the 21st Century

    Science.gov (United States)

    Durning, Steven J.; Artino, Anthony R.; Holmboe, Eric; Beckman, Thomas J.; van der Vleuten, Cees; Schuwirth, Lambert

    2010-01-01

    The demands of physician practice are growing. Some specialties face critical shortages and a significant percentage of physicians are aging. To improve health care it is paramount to understand and address challenges, including cognitive issues, facing aging physicians. In this article, we outline several issues related to cognitive performance…

  11. Mathematics Reform Curricula and Special Education: Identifying Intersections and Implications for Practice

    Science.gov (United States)

    Sayeski, Kristin L.; Paulsen, Kim J.

    2010-01-01

    In many general education classrooms today, teachers are using "reform" mathematics curricula. These curricula emphasize the application of mathematics in real-life contexts and include such practices as collaborative, group problem solving and student-generated algorithms. Students with learning disabilities in the area of mathematics can…

  12. Material Enactments of Identities and Learning in Everyday Community Practices: Implications for Pedagogy

    Science.gov (United States)

    Aberton, Helen

    2012-01-01

    In recent years there has been an upsurge of interest in applying actor-network theory (ANT) to educational research and analysis. This article presents an account of how an ANT analysis of socio-material practices with a focus on objects can bring informal learning and identity formation to view. It is based on a doctoral study of the everyday…

  13. A Gendered Study of the Working Patterns of Classical Musicians: Implications for Practice

    Science.gov (United States)

    Bennett, Dawn

    2008-01-01

    Despite an increase in participation at all levels of the music profession, women continue to experience fewer opportunities to forge careers in music and are less likely than men to apply for leadership positions. This article presents results from a study in which 152 instrumental musicians reflected upon their professional practice and career…

  14. Surgical specialty procedures in rural surgery practices: implications for rural surgery training.

    Science.gov (United States)

    Sticca, Robert P; Mullin, Brady C; Harris, Joel D; Hosford, Clint C

    2012-12-01

    Specialty procedures constitute one eighth of rural surgery practice. Currently, general surgeons intending to practice in rural hospitals may not get adequate training for specialty procedures, which they will be expected to perform. Better definition of these procedures will help guide rural surgery training. Current Procedural Terminology codes for all surgical procedures for 81% of North Dakota and South Dakota rural surgeons were entered into the Dakota Database for Rural Surgery. Specialty procedures were analyzed and compared with the Surgical Council on Resident Education curriculum to determine whether general surgery training is adequate preparation for rural surgery practice. The Dakota Database for Rural Surgery included 46,052 procedures, of which 5,666 (12.3%) were specialty procedures. Highest volume specialty categories included vascular, obstetrics and gynecology, orthopedics, cardiothoracic, urology, and otolaryngology. Common procedures in cardiothoracic and vascular surgery are taught in general surgical residency, while common procedures in obstetrics and gynecology, orthopedics, urology, and otolaryngology are usually not taught in general surgery training. Optimal training for rural surgery practice should include experience in specialty procedures in obstetrics and gynecology, orthopedics, urology, and otolaryngology. Copyright © 2012 Elsevier Inc. All rights reserved.

  15. The attitudes and beliefs of a female science teacher: Implications in relation to gender and pedagogical practice

    Science.gov (United States)

    Zapata, Mara

    In this case study of a female science teacher named Laura, numerous observations, field notes, researcher interpretations, and assertions were developed. As meanings were negotiated, intent of actions was defined using significant statements, clustered to produce invariant meaning units. Both the participant's intents and how she interpreted her experiences were central to the understandings sought in this study. Whenever Laura planned for teaching science, taught, or otherwise interacted with students, the following four themes seemed to frame her actions: (1) Responsibility to Nurture/Mother/Mentor (2) Connecting to and Relating (3) Meeting Gender-Specific Expectations (4) Promoting the Fighter/Survivor Within. Each theme is examined in relation to attitudes and beliefs about teaching and learning science, and conclusions and assertions are expressed. The findings of this study point to the tensions between Laura's attitudes and beliefs and her pedagogical practices, disconfirming these as they pertain to gender in relation to teaching and learning science. It was not evident as part of her daily practice that student experiences were used in an attempt to create connections between their lives and science, although Laura always emphasized that science is a way of life. The findings support questioning the role of intentionality and a teacher's perceived ability to adhere to intentions while practicing within the norms established by the social institution of schools operating within the larger structures of society. The major findings and implications are relevant to the manner teachers are prepared and encouraged to enact their practice by departments and boards of education, prepared by institutions of higher education and subsequent participation in professional development. Specifically, calling attention to how these educational frameworks emphasize or de-emphasize the role of teachers and promote cognizance in terms of the culture of schools, reflective

  16. Sustainability of current agriculture practices, community perception, and implications for ecosystem health: an Indian study.

    Science.gov (United States)

    Sarkar, Atanu; Patil, Shantagouda; Hugar, Lingappa B; vanLoon, Gary

    2011-12-01

    In order to support agribusiness and to attain food security for ever-increasing populations, most countries in the world have embraced modern agricultural technologies. Ecological consequences of the technocentric approaches, and their sustainability and impacts on human health have, however, not received adequate attention particularly in developing countries. India is one country that has undergone a rapid transformation in the field of agriculture by adopting strategies of the Green Revolution. This article provides a comparative analysis of the effects of older and newer paradigms of agricultural practices on ecosystem and human health within the larger context of sustainability. The study was conducted in three closely situated areas where different agricultural practices were followed: (a) the head-end of a modern canal-irrigated area, (b) an adjacent dryland, and (c) an area (the ancient area) that has been provided with irrigation for some 800 years. Data were collected by in-depth interviews of individual farmers, focus-group discussions, participatory observations, and from secondary sources. The dryland, receiving limited rainfall, continues to practice diverse cropping centered to a large extent on traditional coarse cereals and uses only small amounts of chemical inputs. On the other hand, modern agriculture in the head-end emphasizes continuous cropping of rice supported by extensive and indiscriminate use of agrochemicals. Market forces have, to a significant degree, influenced the ancient area to abandon much of its early practices of organic farming and to take up aspects of modern agricultural practice. Rice cultivation in the irrigated parts has changed the local landscape and vegetation and has augmented the mosquito population, which is a potential vector for malaria, Japanese encephalitis and other diseases. Nevertheless, despite these problems, perceptions of adverse environmental effects are lowest in the heavily irrigated area.

  17. Learning from collaborative research on sustainably managing fresh water: implications for ethical research-practice engagement

    Directory of Open Access Journals (Sweden)

    Margaret L. Ayre

    2018-03-01

    Full Text Available Since the mid-2000s, there has been increasing recognition of the promise of collaborative research and management for addressing complex issues in sustainably managing fresh water. A large variety of collaborative freshwater research and management processes is now evident around the world. However, how collective knowledge development, coproduction, or cocreation is carried out in an ethical manner is less well known. From the literature and our experiences as applied, transdisciplinary researchers and natural resource management practitioners, we seek to describe and explore these aspects of empirical cases of collaborative freshwater research and management. Drawing on cases from Indigenous community-based natural resource management in northern Australia, flood and drought risk management in Bulgaria, water management and climate change adaptation in the Pacific, and regional catchment and estuary management in Victoria and New South Wales in Australia, we identify lessons to support improved collaborative sustainable freshwater management research and practice. Cocreation represents an emerging approach to participation and collaboration in freshwater management research-practice and can be seen to constitute four interlinked and iterative phases: coinitiation, codesign, coimplementation, and coevaluation. For freshwater researchers and managers and their collaborators, paying attention to these phases and the ethical dilemmas that arise within each phase will support the cocreation of more effective and ethical research-practice through: sensitizing collaborators to the need for reflexivity in research-practice, proposing action research codesign as a method for managing emergent questions and outcomes, and supporting more equitable outcomes for collaborators through an emphasis on coevaluation and collaborative articulation of the links between research outputs and practice outcomes.

  18. Awareness of food nutritive value and eating practices among Nigerian bank workers: Implications for nutritional counseling and education.

    Science.gov (United States)

    Eze, Ngozi M; Maduabum, Felicia O; Onyeke, Nkechi G; Anyaegunam, Ngozi J; Ayogu, Chinwe A; Ezeanwu, Bibian Amaka; Eseadi, Chiedu

    2017-03-01

    Adequate nutrition is an important aspect of a healthy lifestyle for all individuals, including bank staff. The objective of this study was to investigate the awareness of food nutritive value and eating practices among bank workers in Lagos State, Nigeria.The study adopted a cross-sectional descriptive survey design. A purposive sample of 250 bank workers took part in the study. Means and Student t tests were employed for data analysis.Results showed that bank workers were aware of the nutritive value of foods, and that eating practices commonly adopted included skipping breakfast, eating breakfast at work, buying food at work from the bank canteen, eating in between meals, buying snacks as lunch, and consuming soft drinks daily, among others. There were no significant differences between male and female bank workers in mean responses on food nutritive value or in eating practices adopted.Good eating habits will help bank workers not only to improve their nutritional well-being, but also to prevent nutrition-related diseases. The implications for nutritional counseling and education are discussed in the context of these findings.

  19. Privacy Practices of Health Social Networking Sites: Implications for Privacy and Data Security in Online Cancer Communities.

    Science.gov (United States)

    Charbonneau, Deborah H

    2016-08-01

    While online communities for social support continue to grow, little is known about the state of privacy practices of health social networking sites. This article reports on a structured content analysis of privacy policies and disclosure practices for 25 online ovarian cancer communities. All of the health social networking sites in the study sample provided privacy statements to users, yet privacy practices varied considerably across the sites. The majority of sites informed users that personal information was collected about participants and shared with third parties (96%, n = 24). Furthermore, more than half of the sites (56%, n = 14) stated that cookies technology was used to track user behaviors. Despite these disclosures, only 36% (n = 9) offered opt-out choices for sharing data with third parties. In addition, very few of the sites (28%, n = 7) allowed individuals to delete their personal information. Discussions about specific security measures used to protect personal information were largely missing. Implications for privacy, confidentiality, consumer choice, and data safety in online environments are discussed. Overall, nurses and other health professionals can utilize these findings to encourage individuals seeking online support and participating in social networking sites to build awareness of privacy risks to better protect their personal health information in the digital age.

  20. Procedural confidence in hospital based practitioners: implications for the training and practice of doctors at all grades

    Directory of Open Access Journals (Sweden)

    Tsagkaraki Petroula A

    2009-01-01

    Full Text Available Abstract Background Medical doctors routinely undertake a number of practical procedures and these should be performed competently. The UK Postgraduate Medical Education and Training Board (PMETB curriculum lists the procedures trainees should be competent in. We aimed to describe medical practitioner's confidence in their procedural skills, and to define which practical procedures are important in current medical practice. Methods A cross sectional observational study was performed measuring procedural confidence in 181 hospital practitioners at all grades from 2 centres in East Anglia, England. Results Both trainees and consultants provide significant service provision. SpR level doctors perform the widest range and the highest median number of procedures per year. Most consultants perform few if any procedures, however some perform a narrow range at high volume. Cumulative confidence for the procedures tested peaks in the SpR grade. Five key procedures (central line insertion, lumbar puncture, pleural aspiration, ascitic aspiration, and intercostal drain insertion are the most commonly performed, are seen as important generic skills, and correspond to the total number of procedures for which confidence can be maintained. Key determinants of confidence are gender, number of procedures performed in the previous year and total number of procedures performed. Conclusion The highest volume of service requirement is for six procedures. The procedural confidence is dependent upon gender, number of procedures performed in the previous year and total number of procedures performed. This has implications for those designing the training curriculum and with regards the move to shorten the duration of training.

  1. Infant and Young Child Feeding Behavior among Working Mothers in India: Implications for Global Health Policy and Practice

    Directory of Open Access Journals (Sweden)

    Vinay Kumar, MD, MPH

    2014-12-01

    Full Text Available Background: The National Guidelines on Infant and Young Child Feeding introduced in 2006 recommended the initiation of breastfeeding immediately after birth, preferably within one hour; exclusive breastfeeding for the first six months; appropriate and adequate complementary feeding from six months of age while continuing breastfeeding; and continued breastfeeding up to the age of two years or beyond. Working women in India constitute a dominant and expanding pool of mothers. There is paucity of research focused on feeding behavior within this group. Method: One hundred and fifty working women answered a structured questionnaire about their demographics, birth history, levels of awareness and practice of feeding guidelines, and perceptions about breastfeeding and counseling. Data analysis was carried out using Microsoft Excel and the Statistical Package for the Social Sciences. Results: Majority of participants belonged to 21-39 years age group, had nuclear families, received college education, and delivered in institutional setups. Gaps were observed between the mother’s levels of awareness and practice for different tenets of national guidelines. Higher education, longer maternity leave, higher income, and utilization of counseling services facilitated adoption of optimal feeding behavior. Most women perceived breast milk to be superior to any alternative and favored provision of counseling during last trimester. Conclusions and Global Health Implications: Counseling women on optimal feeding behavior is a potential intervention to convert its awareness into actual practice. The lessons learned from this study can help refine both national and global Mother and Child Health policies and programs.

  2. Relationship between variability of practice and variability of execution in flat tennis service Relación entre variabilidad de la práctica y variabilidad en la ejecución del servicio plano en tenis

    Directory of Open Access Journals (Sweden)

    R. Menayo

    2010-12-01

    Full Text Available This study analyzes the relationship between the variability in the performance of the flat tennis service and its practice under variable conditions, taking as a starting point a predictive analysis of the instantaneous kinematic variables of the hand that holds the racket. Seventeen tennis players performed services under 8 practice conditions (rackets and balls were modified, and pre-test and post-test were carried out. The players performed 120 services with the instruction to hit the ball powerfully and maintaining maximum efficiency. Data showed that two variables related to the speed and the acceleration of the hand will predict efficacy at 57.7%: both the time variation coefficients until we reach the speed peak and the final acceleration of the hand in the Y axis. Significant differences were also obtained between some instantaneous kinematic variables measured in the pre-test and the practice series, and also negative and significant correlations between these variables and the efficacy of the services.
    Key Words: variability, tennis, service

    Este estudio investiga acerca de la relación existente entre la variabilidad en la ejecución del servicio plano en tenis y la práctica variable del mismo, partiendo de un análisis predictivo de las variables cinemáticas instantáneas que definen el movimiento de la mano que sujeta la raqueta. 17 tenistas pasaron por 8 condiciones de práctica precedidas de un test inicial y finalizadas con un test final. En dichas series se variaron el implemento utilizado y la pelota. Cada jugador realizó 120 golpeos, con la instrucción de golpear a la máxima potencia manteniendo la eficacia. Los datos obtenidos identifican como variables predictoras de la eficacia en un 57.7 % a dos parámetros relacionados con la velocidad y con la aceleración de la mano: los coeficientes de variación del tiempo hasta el pico de velocidad lineal de la mano en el eje Y y la aceleraci

  3. A population-based audit of ethnicity and breast cancer risk in one general practice catchment area in North London, UK: implications for practice

    Directory of Open Access Journals (Sweden)

    Ferris Michelle

    2007-09-01

    Full Text Available Abstract Objectives To conduct a pilot population-based study within a general practice catchment area to determine whether the incidence of breast cancer was increased in the Ashkenazi population. Design Population-based cohort study. Setting A single general practice catchment area in North London. Participants 1947 women over the age of 16 who responded to a questionnaire about ethnicity and breast cancer. Main outcome measures Incidence of breast cancer, ethnicity. Results This study showed a 1.5-fold (95% CI 0.93–2.39 increase in breast cancer risk in the Ashkenazim compared with the non-Ashkenazi white population. The increased incidence was for both premenopausal and postmenopausal breast cancer (expected incidence pre:post is 1:4 whereas in the Ashkenazim it was 1:1; 51 and 52% of cases respectively. This increase was not shown in the Sephardim. Asians had a reduction in incidence (OR = 0.44; 95% CI 0.10–1.89. Results were adjusted for other risk factors for breast cancer. Conclusion This study showed a 1.5-fold increase in breast cancer rates in Ashkenazim compared with the non-Jewish white population when adjusted for age (i.e. corrections were made to allow comparison of age groups and this is not observed in the Sephardic population. The proportion of premenopausal breast cancer was just over double that of the general population. This is the first general practice population-based study in the UK to address this issue and has implications for general practitioners who care for patients from the Ashkenazi community.

  4. Restructuring patient flow logistics around patient care needs: implications and practicalities from three critical cases.

    Science.gov (United States)

    Villa, Stefano; Barbieri, Marta; Lega, Federico

    2009-06-01

    To make hospitals more patient-centered it is necessary to intervene on patient flow logistics. The study analyzes three innovative redesign projects implemented at three Italian hospitals. The three hospitals have reorganized patient flow logistics around patient care needs using, as proxies, the expected length of stay and the level of nursing assistance. In order to do this, they have extensively revised their logistical configuration changing: (1) the organization of wards, (2) the hospital's physical lay-out, (3) the capacity planning system, and (4) the organizational roles supporting the patient flow management. The study describes the changes implemented as well as the results achieved and draws some general lessons that provide useful hints for those other hospitals involved in such type of redesign projects. The paper ends by discussing some policy implications. In fact, the results achieved in the three cases investigated provide interesting material for further discussion on clinical, operational, and economic issues.

  5. Health and environmental implications of rural female entrepreneurship practices in osun state Nigeria.

    Science.gov (United States)

    Akinbami, Catherine A O; Momodu, Abiodun S

    2013-09-01

    In rural Nigeria, food processing is mostly engaged in by women and children. Most of these processes are done using outdated technologies that make use of traditional woodstoves. This article presents the health and environmental implications of the rural female entrepreneurs involved in food processing and proffer means of bettering the lot of these women to handle these hazards. A partially structured questionnaire and focus group discussion was used to capture data from respondents. The study revealed that about 73 % of women involved in direct production of garri and palm oil processing could be at risk of early death or disability-adjusted life years from the mentioned diseases. The article concludes that the rural female entrepreneur needs to be better positioned to handle these hazards, for her health, that of her children, as well as for the environment.

  6. No Fault Found events in maintenance engineering Part 1: Current trends, implications and organizational practices

    International Nuclear Information System (INIS)

    Khan, Samir; Phillips, Paul; Jennions, Ian; Hockley, Chris

    2014-01-01

    This paper presents the first part of a state of the art review on the No Fault Found (NFF) phenomenon. The aim has been to compile a systematic reference point for burgeoning NFF literature, and to provide a comprehensive overview for gaining an understanding of NFF knowledge and concepts. Increasing systems complexities have seen a rise in the number of unknown failures that are being reported during operational service. Units tagged as ‘NFF’ are evidence that a serviceable component was removed, and attempts to troubleshoot the root cause have been unsuccessful. There are many reasons on how these failures manifest themselves and these papers describe the prominent issues that have persisted across a variety of industrial applications and processes for decades. This article, in particular, deals with the impact of NFF from an organizational culture and human factors point of view. It also highlights recent developments in NFF standards, its financial implications and safety concerns

  7. Paradigm shift or annoying distraction: emerging implications of web 2.0 for clinical practice.

    Science.gov (United States)

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

    2010-01-01

    Web 2.0 technologies, known as social media, social technologies or Web 2.0, have emerged into the mainstream. As they grow, these new technologies have the opportunity to influence the methods and procedures of many fields. This paper focuses on the clinical implications of the growing Web 2.0 technologies. Five developing trends are explored: information channels, augmented reality, location-based mobile social computing, virtual worlds and serious gaming, and collaborative research networks. Each trend is discussed based on their utilization and pattern of use by healthcare providers or healthcare organizations. In addition to explorative research for each trend, a vignette is presented which provides a future example of adoption. Lastly each trend lists several research challenge questions for applied clinical informatics.

  8. A critical review of the implication of nanotechnology in modern dental practice

    Science.gov (United States)

    Verma, Sanjeev Kumar; Prabhat, K. C.; Goyal, Lata; Rani, Manita; Jain, Amit

    2010-01-01

    Curiosity has its own reason for existing. For thousands of years, mankind has been harnessing its curiosity into inquiry and the process of scientific methodology. If we consider technology as an engine, then science is its fuel. Science of miniaturization (nanotechnology) is manipulating matter at nanometer level and the application of the same to medicine is called nanomedicine. Nanotechnology holds promise for advanced diagnostics, targeted drug delivery, and biosensors. When we gain access to hold the nanorobots, we will be able to treat very rapidly a number of diseases that are a continuous threat for mankind today. The present article aims to provide an early glimpse on the impact and future implication of nanotechnology in dentistry, especially in oral surgery and orthodontics. PMID:22442549

  9. Trust in leadership: meta-analytic findings and implications for research and practice.

    Science.gov (United States)

    Dirks, Kurt T; Ferrin, Donald L

    2002-08-01

    In this study, the authors examined the findings and implications of the research on trust in leadership that has been conducted during the past 4 decades. First, the study provides estimates of the primary relationships between trust in leadership and key outcomes, antecedents, and correlates (k = 106). Second, the study explores how specifying the construct with alternative leadership referents (direct leaders vs. organizational leadership) and definitions (types of trust) results in systematically different relationships between trust in leadership and outcomes and antecedents. Direct leaders (e.g., supervisors) appear to be a particularly important referent of trust. Last, a theoretical framework is offered to provide parsimony to the expansive literature and to clarify the different perspectives on the construct of trust in leadership and its operation.

  10. Road safety practices among commercial motorcyclists in a rural town in Nigeria: implications for health education.

    Science.gov (United States)

    Amoran, O E; Eme, Owoaje; Giwa, O A; Gbolahan, O B

    This cross-sectional, community-based study was carried out among commercial motorcyclists in Igboora. All the commercial motor parks in Igboora were visited and all the commercial motorcyclists who consented to participate in the study were interviewed. Information on the respondents' socio-demographic characteristics, and the practice of road safety measures was collected using an interviewer administered questionnaire. A total of 299 motorcyclists were interviewed. All (100%) of them were males. The mean age of the respondents was 27.4 +/- 7.4 years. One hundred eighty-two (60.7%) of the motorcyclists had the correct knowledge of the purpose of Highway Code. Only 70 (23.3%) could recognize more than half of the currently used road safety codes and 47 (15.7%) obey these road safety codes more than half of the time they see it. Only 183 (61.2%) of them had a driving license and 72 (24.1%) were able to produce these licenses on demand. All (100%) of the respondents did not use any protective helmet. Those who have longer years of working experience, higher level of education and higher knowledge of the safety codes practice it more regularly (r = 0.198, p = 0.001, chi2= 9.31, p = 0.025, and r = 0.28, p = 0.001 respectively). One hundred thirty-six (45.5%) have been involved in at least one accident in the preceding year. The overall incidence of road traffic accident was 2.16 per 1,000. There was however on statistically significant association between the practice of road safety codes and the occurrence of road traffic accidents (chi2= 0.176, p = 0.916). The study shows that the practice of road safety measures was low in this rural Nigerian community and was not associated with the incidence of road traffic accidents. Introducing road safety education particularly targeted at educating the motorcyclists on the importance and practice of road safety measures would lead to an increase in the practice of the safety measures and hopefully a reduction in the incidence

  11. Acceptability of evidence-based neonatal care practices in rural Uganda – implications for programming

    Directory of Open Access Journals (Sweden)

    Kiguli Juliet

    2008-06-01

    Full Text Available Abstract Background Although evidence-based interventions to reach the Millennium Development Goals for Maternal and Neonatal mortality reduction exist, they have not yet been operationalised and scaled up in Sub-Saharan African cultural and health systems. A key concern is whether these internationally recommended practices are acceptable and will be demanded by the target community. We explored the acceptability of these interventions in two rural districts of Uganda. Methods We conducted 10 focus group discussions consisting of mothers, fathers, grand parents and child minders (older children who take care of other children. We also did 10 key informant interviews with health workers and traditional birth attendants. Results Most maternal and newborn recommended practices are acceptable to both the community and to health service providers. However, health system and community barriers were prevalent and will need to be overcome for better neonatal outcomes. Pregnant women did not comprehend the importance of attending antenatal care early or more than once unless they felt ill. Women prefer to deliver in health facilities but most do not do so because they cannot afford the cost of drugs and supplies which are demanded in a situation of poverty and limited male support. Postnatal care is non-existent. For the newborn, delayed bathing and putting nothing on the umbilical cord were neither acceptable to parents nor to health providers, requiring negotiation of alternative practices. Conclusion The recommended maternal-newborn practices are generally acceptable to the community and health service providers, but often are not practiced due to health systems and community barriers. Communities associate the need for antenatal care attendance with feeling ill, and postnatal care is non-existent in this region. Health promotion programs to improve newborn care must prioritize postnatal care, and take into account the local socio-cultural situation

  12. Acceptability of evidence-based neonatal care practices in rural Uganda - implications for programming.

    Science.gov (United States)

    Waiswa, Peter; Kemigisa, Margaret; Kiguli, Juliet; Naikoba, Sarah; Pariyo, George W; Peterson, Stefan

    2008-06-21

    Although evidence-based interventions to reach the Millennium Development Goals for Maternal and Neonatal mortality reduction exist, they have not yet been operationalised and scaled up in Sub-Saharan African cultural and health systems. A key concern is whether these internationally recommended practices are acceptable and will be demanded by the target community. We explored the acceptability of these interventions in two rural districts of Uganda. We conducted 10 focus group discussions consisting of mothers, fathers, grand parents and child minders (older children who take care of other children). We also did 10 key informant interviews with health workers and traditional birth attendants. Most maternal and newborn recommended practices are acceptable to both the community and to health service providers. However, health system and community barriers were prevalent and will need to be overcome for better neonatal outcomes. Pregnant women did not comprehend the importance of attending antenatal care early or more than once unless they felt ill. Women prefer to deliver in health facilities but most do not do so because they cannot afford the cost of drugs and supplies which are demanded in a situation of poverty and limited male support. Postnatal care is non-existent. For the newborn, delayed bathing and putting nothing on the umbilical cord were neither acceptable to parents nor to health providers, requiring negotiation of alternative practices. The recommended maternal-newborn practices are generally acceptable to the community and health service providers, but often are not practiced due to health systems and community barriers. Communities associate the need for antenatal care attendance with feeling ill, and postnatal care is non-existent in this region. Health promotion programs to improve newborn care must prioritize postnatal care, and take into account the local socio-cultural situation and health systems barriers including the financial burden. Male

  13. Secondary education student bodily practices: implications of gender in and outside physical education classes

    Directory of Open Access Journals (Sweden)

    Aline Fernanda Ferreira

    2016-03-01

    Full Text Available Abstract The present study aimed to analyze the bodily practices of high school students inside and outside of the physical education classes from the perspective of gender. A total of 426 students (63.7% girls and 36.3% boys enrolled in the 2nd year of public high schools in a municipality in the interior of São Paulo State participated in the study. To collect the data, a questionnaire was elaborated and analyzed based on categories of survey and systematic cross-gender comparisons. The results showed that, in general, boys are more physically active than girls, regarding practices inside and outside of physical education classes. Distinctions were found regarding the bodily manisfestations chosen by each group, the behavior associated with the social and the cultural contexts to which boys and girls are exposed from birth to adult life.

  14. Hysterectomy Pathway as the Global Engine of Practice Change: Implications for Value in Care

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    Amin Sanei-Moghaddam

    2017-09-01

    Results: Physician respondents found the clinical pathway to be practical, beneficial to patients, and up-to-date with the latest evidence-based literature. Key barriers to the use of the pathway that were identified by physicians included perceived waste of time, inappropriateness for some of the patient groups, improper incentive structure, and excessive bureaucracy surrounding the process.  Overall, patient respondents were satisfied with the tool and found it to be helpful with the decision-making process of choosing a hysterectomy route.  Conclusions: Physicians and patients found the developed tools to be practical and beneficial. Findings of this study will help to use pathways as a unifying framework to shape future care of patients needing hysterectomy and add value to their care.

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

    Science.gov (United States)

    Federer, Meghan Rector

    Assessment is a key element in the process of science education teaching and research. Understanding sources of performance bias in science assessment is a major challenge for science education reforms. Prior research has documented several limitations of instrument types on the measurement of students' scientific knowledge (Liu et al., 2011; Messick, 1995; Popham, 2010). Furthermore, a large body of work has been devoted to reducing assessment biases that distort inferences about students' science understanding, particularly in multiple-choice [MC] instruments. Despite the above documented biases, much has yet to be determined for constructed response [CR] assessments in biology and their use for evaluating students' conceptual understanding of scientific practices (such as explanation). Understanding differences in science achievement provides important insights into whether science curricula and/or assessments are valid representations of student abilities. Using the integrative framework put forth by the National Research Council (2012), this dissertation aimed to explore whether assessment biases occur for assessment practices intended to measure students' conceptual understanding and proficiency in scientific practices. Using a large corpus of undergraduate biology students' explanations, three studies were conducted to examine whether known biases of MC instruments were also apparent in a CR instrument designed to assess students' explanatory practice and understanding of evolutionary change (ACORNS: Assessment of COntextual Reasoning about Natural Selection). The first study investigated the challenge of interpreting and scoring lexically ambiguous language in CR answers. The incorporation of 'multivalent' terms into scientific discourse practices often results in statements or explanations that are difficult to interpret and can produce faulty inferences about student knowledge. The results of this study indicate that many undergraduate biology majors

  16. Traditional massage of newborns in Nepal: implications for trials of improved practice.

    Science.gov (United States)

    Mullany, Luke C; Darmstadt, Gary L; Khatry, Subarna K; Tielsch, James M

    2005-04-01

    Mustard oil massage of newborns is an integral component of traditional care practices in many communities. Recent evidence suggests that this practice may have detrimental effects, particularly for preterm infants or for those whose skin barrier function is otherwise sub-optimal. Other natural oils such as sunflower, sesame or safflower seed oil may have a beneficial impact on newborn health and survival. Little is known, however, about cultural and other factors related to the acceptance and uptake of alternative, more beneficial oils for massage of the newborn. A questionnaire concerning the usage and reasons for application of mustard and other oils to newborn skin was administered to the caretakers of 8580 newborns in Sarlahi district of rural Nepal. Four focus group discussions among representative groups were conducted to describe the perceived benefits of oil massage and the factors involved in the decision to apply oil. The potential for the introduction of alternative natural oils was explored. Approximately 99 per cent of newborns were massaged at least once with mustard oil in the 2 weeks after birth, and 80 per cent were massaged at least twice daily. Promotion of strength, maintenance of health, and provision of warmth were the most commonly cited reasons for application of mustard oil. Focus group discussion participants noted that smell, oiliness, mode of pre-massage preparation, and perceived absorptive potential on the skin are important contextual factors involved in the practice. Caretakers are willing to consider adaptation of established traditions for the promotion of positive health outcomes if essential contextual criteria are met. An understanding of cultural, social, and economic factors that shape the context of traditional healthcare practices is essential to the design and implementation of intervention trials examining the relative efficacy of application of oils in reducing neonatal mortality and morbidity.

  17. Managing health and safety risks: Implications for tailoring health and safety management system practices.

    Science.gov (United States)

    Willmer, D R; Haas, E J

    2016-01-01

    As national and international health and safety management system (HSMS) standards are voluntarily accepted or regulated into practice, organizations are making an effort to modify and integrate strategic elements of a connected management system into their daily risk management practices. In high-risk industries such as mining, that effort takes on added importance. The mining industry has long recognized the importance of a more integrated approach to recognizing and responding to site-specific risks, encouraging the adoption of a risk-based management framework. Recently, the U.S. National Mining Association led the development of an industry-specific HSMS built on the strategic frameworks of ANSI: Z10, OHSAS 18001, The American Chemistry Council's Responsible Care, and ILO-OSH 2001. All of these standards provide strategic guidance and focus on how to incorporate a plan-do-check-act cycle into the identification, management and evaluation of worksite risks. This paper details an exploratory study into whether practices associated with executing a risk-based management framework are visible through the actions of an organization's site-level management of health and safety risks. The results of this study show ways that site-level leaders manage day-to-day risk at their operations that can be characterized according to practices associated with a risk-based management framework. Having tangible operational examples of day-to-day risk management can serve as a starting point for evaluating field-level risk assessment efforts and their alignment to overall company efforts at effective risk mitigation through a HSMS or other processes.

  18. The optimisation principle and the new ICRP recommendations: practical implications on operational radiation protection

    International Nuclear Information System (INIS)

    Lochard, J.

    1992-01-01

    The formulation of the optimisation principle proposed by the International Commission of Radiological Protection in its new recommendations is largely oriented towards better control of individual doses. In this perspective, the concept of doe constraint and the reference to equity in dose distributions are becoming key elements within the optimisation process. This paper discusses some first reflexions regarding this new orientation and outlines the main impacts that must be forwarded to the practical level. (author)

  19. Partial and incremental PCMH practice transformation: implications for quality and costs.

    Science.gov (United States)

    Paustian, Michael L; Alexander, Jeffrey A; El Reda, Darline K; Wise, Chris G; Green, Lee A; Fetters, Michael D

    2014-02-01

    To examine the associations between partial and incremental implementation of the Patient Centered Medical Home (PCMH) model and measures of cost and quality of care. We combined validated, self-reported PCMH capabilities data with administrative claims data for a diverse statewide population of 2,432 primary care practices in Michigan. These data were supplemented with contextual data from the Area Resource File. We measured medical home capabilities in place as of June 2009 and change in medical home capabilities implemented between July 2009 and June 2010. Generalized estimating equations were used to estimate the mean effect of these PCMH measures on total medical costs and quality of care delivered in physician practices between July 2009 and June 2010, while controlling for potential practice, patient cohort, physician organization, and practice environment confounders. Based on the observed relationships for partial implementation, full implementation of the PCMH model is associated with a 3.5 percent higher quality composite score, a 5.1 percent higher preventive composite score, and $26.37 lower per member per month medical costs for adults. Full PCMH implementation is also associated with a 12.2 percent higher preventive composite score, but no reductions in costs for pediatric populations. Incremental improvements in PCMH model implementation yielded similar positive effects on quality of care for both adult and pediatric populations but were not associated with cost savings for either population. Estimated effects of the PCMH model on quality and cost of care appear to improve with the degree of PCMH implementation achieved and with incremental improvements in implementation. © Health Research and Educational Trust.

  20. Green Service Practices: Performance Implications and the Role of Environmental Management Systems

    OpenAIRE

    Christina W. Y. Wong; Chee Yew Wong; Sakun Boon-itt

    2013-01-01

    Research on the effects of environmental management has largely neglected the importance of green service practices and their impact on environmental protection and cost reduction. There is also little knowledge on how service-oriented firms may leverage their efforts in providing green services to achieve performance improvement through their existing environmental management system (EMS). Grounded in the natural resource-based view in conjunction with the contingency theory, we develop a mo...

  1. A randomized study of multimedia informational aids for research on medical practices: implications for informed consent

    Science.gov (United States)

    Kraft, Stephanie A; Constantine, Melissa; Magnus, David; Porter, Kathryn M.; Lee, Sandra Soo-Jin; Green, Michael; Kass, Nancy E; Wilfond, Benjamin S.; Cho, Mildred K

    2016-01-01

    Background/aims Participant understanding is a key element of informed consent for enrollment in research. However, participants often do not understand the nature, risks, benefits, or design of the studies in which they take part. Research on medical practices, which studies standard interventions rather than new treatments, has the potential to be especially confusing to participants because it is embedded within usual clinical care. Our objective in this randomized study was to compare the ability of a range of multimedia informational aids to improve participant understanding in the context of research on medical practices. Methods We administered a Web-based survey to members of a proprietary online panel sample selected to match national U.S. demographics. Respondents were randomized to one of five arms: four content-equivalent informational aids (animated videos, slideshows with voiceover, comics, and text), and one no-intervention control. We measured knowledge of research on medical practices using a summary knowledge score from 10 questions based on the content of the informational aids. We used ANOVA and paired t-tests to compare knowledge scores between arms. Results There were 1500 completed surveys (300 in each arm). Mean knowledge scores were highest for the slideshows with voiceover (65.7%), followed by the animated videos (62.7%), comics (60.7%), text (57.2%), and control (50.3%). Differences between arms were statistically significant except between the slideshows with voiceover and animated videos and between the animated videos and comics. Informational aids that included an audio component (animated videos and slideshows with voiceover) had higher knowledge scores than those without an audio component (64.2% versus 59.0%, peffectively than text alone. However, the relatively low knowledge scores suggest that targeted informational aids may be needed to teach some particularly challenging concepts. Nonetheless, our results demonstrate the

  2. NON-TERRITORIAL AUTONOMY IN RUSSIA: PRACTICAL IMPLICATIONS OF THEORETICAL APPROACHES

    Directory of Open Access Journals (Sweden)

    Tatiana RUDNEVA

    2012-06-01

    Full Text Available Despite the theoretical possibility to use non-territorial autonomy as a mechanism through which ethnic groups can fulfil their right to selfdetermination along with other minority rights, not many states have been willing to put theory into practice. The article offers an explanation why wider applicability of NTA is problematic by arguing that the theory itself is not yet polished enough to be implemented. The study includes examination of both theoretical approaches and empirical data from a case study of an attempt to establish NTAs in the Russian Federation. The findings suggest that inconsistencies and unclarities in the theory do correlate with practical flaws of NTAs, which allows to suggest that when the theory is tested empirically, the reality reveals all the flaws of the theory. The results indicate that the concept of NTA needs further refinement and development to make it more practice-oriented and applicable. As the problem of minority rights is still to be dealt with, we also propose a model of global union of NTAs where each ethnic group is represented by a non-governmental organisation, which seems to be more applicable than the others, alongside a number of other mechanisms that are even more essential and universal and focus on defending basic human rights

  3. Organizational climate in primary care settings: implications for nurse practitioner practice.

    Science.gov (United States)

    Poghosyan, Lusine; Nannini, Angela; Clarke, Sean

    2013-03-01

    The purpose of this review is to investigate literature related to organizational climate, define organizational climate, and identify its domains for nurse practitioner (NP) practice in primary care settings. A search was conducted using MEDLINE, PubMed, HealthSTAR/Ovid, ISI Web of Science, and several other health policy and nursingy databases. In primary care settings, organizational climate for NPs is a set of organizational attributes, which are perceived by NPs about their practice setting, emerge from the way the organization interacts with NPs, and affect NP behaviors and outcomes. Autonomy, NP-physician relations, and professional visibility were identified as organizational climate domains. NPs should be encouraged to assess organizational climate in their workplace and choose organizations that promote autonomy, collegiality between NPs and physicians, and encourage professional visibility. Organizational and NP awareness of qualities that foster NP practice will be a first step for developing strategies to creating an optimal organizational climate for NPs to deliver high-quality care. More research is needed to develop a comprehensive conceptual framework for organizational climate and develop new instruments to accurately measure organizational climate and link it to NP and patient outcomes. ©2012 The Author(s) Journal compilation ©2012 American Association of Nurse Practitioners.

  4. Microscope use in clinical veterinary practice and potential implications for veterinary school curricula.

    Science.gov (United States)

    Stewart, Sherry M; Dowers, Kristy L; Cerda, Jacey R; Schoenfeld-Tacher, Regina M; Kogan, Lori R

    2014-01-01

    Microscopy (skill of using a microscope) and the concepts of cytology (study of cells) and histology (study of tissues) are most often taught in professional veterinary medicine programs through the traditional method of glass slides and light microscopes. Several limiting factors in veterinary training programs are encouraging educators to explore innovative options for teaching microscopy skills and the concepts of cytology and histology. An anonymous online survey was administered through the Colorado Veterinary Medical Association to Colorado veterinarians working in private practice. It was designed to assess their current usage of microscopes for cytological and histological evaluation of specimens and their perceptions of microscope use in their veterinary education. The first part of the survey was answered by 183 veterinarians, with 104 indicating they had an onsite diagnostic lab. Analysis pertaining to the use of the microscope in practice and in veterinary programs was conducted on this subset. Most respondents felt the amount of time spent in the curriculum using a microscope was just right for basic microscope use and using the microscope for viewing and learning about normal and abnormal histological sections and clinical cytology. Participants felt more emphasis could be placed on clinical and diagnostic cytology. Study results suggest that practicing veterinarians frequently use microscopes for a wide variety of cytological diagnostics. However, only two respondents indicated they prepared samples for histological evaluation. Veterinary schools should consider these results against the backdrop of pressure to implement innovative teaching techniques to meet the changing needs of the profession.

  5. Knowledge, Attitudes, and Practices of Pediatric Dentists Regarding Speech Evaluation of Patients: Implications for Dental Education.

    Science.gov (United States)

    Van Eyndhoven, Lisa; Chussid, Steven; Yoon, Richard K

    2015-11-01

    The aim of this cross-sectional study was to determine pediatric dentists' attitudes about speech evaluation in the dental setting and assess their knowledge of speech development and pathology. In October 2013, members of the American Academy of Pediatric Dentistry were invited to participate in an electronic questionnaire. Categories of questions were demographics, attitudes and confidence in speech pathology, and theoretical and practical knowledge of speech development and speech pathology. Theoretical knowledge was assessed using questions about phonetics and speech milestones. Practical knowledge was determined with three 30-second interview-style video clips. A total of 539 responses were received for a response rate of 10.4%. The majority of respondents reported feeling that speech evaluation should be part of the pediatric dental visit (72.8%) and felt confident in their ability to detect speech issues (73.2%). However, they did poorly on the theoretical knowledge questions (41.9%) as well as the practical knowledge questions (8.5%). There was a statistically significant difference in theoretical score between gender and type of occupation (pspeech issues, they currently have insufficient training and knowledge to do so.

  6. Media, Technology Use, and Attitudes: Associations With Physical and Mental Well-Being in Youth With Implications for Evidence-Based Practice.

    Science.gov (United States)

    Zeeni, Nadine; Doumit, Rita; Abi Kharma, Joelle; Sanchez-Ruiz, Maria-Jose

    2018-05-15

    Previous research has shown that the use of technology and media, in their different available forms, may have detrimental effects on the physical and mental well-being of adolescents and young adults. The present study aimed to investigate the use of different types of technology and media, attitudes toward them, and how they relate to physical and mental well-being in Lebanese university students. A descriptive, correlational, cross-sectional design was used. A sample of 244 undergraduates completed a self-report measuring media and technology use and attitudes, eating-related variables (e.g., healthy eating, body image dissatisfaction [BID], and eating disorders [EDs] risk), trait emotional intelligence (TEI), and psychopathology indicators (stress, anxiety, and depression). The use of mobile phone multimedia (music, pictures, and videos) correlated with unhealthy eating and stress. Social media use was associated with BID, EDs risk, and the self-control construct of TEI. Anxiety of separation from technological devices and dependence on them was associated with increased BID, EDs risk, depression, and anxiety. Practical implications are discussed in terms of setting limits and boundaries on technology use during childhood and adolescence, and encouraging healthy eating and physical activity at home and on college campuses. Moreover, social media could be used as a platform for intervention and prevention programs to decrease BID, EDs, depression, and anxiety. © 2018 Sigma Theta Tau International.

  7. Empowerment and Social Support: Implications for Practice and Programming among Minority Women with Substance Abuse and Criminal Justice Histories

    Science.gov (United States)

    Barringer, Alexandra; Hunter, Bronwyn A.; Salina, Doreen; Jason, Leonard A.

    2016-01-01

    Programs for women with substance abuse and criminal justice histories often incorporate empowerment and social support into service delivery systems. Women’s empowerment research has focused on the relationship between women’s personal identities and the larger sociopolitical context, with an emphasis on how community based resources are critical for promoting well-being. Social support often protects against negative outcomes for individuals who live with chronic stress. However, few studies have evaluated community resource knowledge and empowerment among marginalized women or how social support might strengthen or weaken this relationship. This study investigated resource knowledge, social support and empowerment among 200 minority women in substance abuse recovery who had recent criminal justice involvement. Results indicated that resource knowledge was related to empowerment and belonging social support marginally moderated this relationship. In addition, education level increased and current involvement in the criminal justice system decreased empowerment. Implications for research, practice and policy are discussed. PMID:27084362

  8. The practice of marketing by dentists.

    Science.gov (United States)

    Chandler, E W; Weller, R B

    1994-01-01

    The attitudes and practices of dentists regarding the implementation of all the strategic variables in the marketing mix is examined. Factor analysis is used to reduce the data to five factors which are used to describe the attitudes and practices of dentists. The importance of using other marketing variables besides promotion is pointed out along with the implications for influencing dentists to take a broader strategic perspective in the development of their practice.

  9. A chironomid-based record of temperature variability during the past 4000 years in northern China and its possible societal implications

    Science.gov (United States)

    Wang, Haipeng; Chen, Jianhui; Zhang, Shengda; Zhang, David D.; Wang, Zongli; Xu, Qinghai; Chen, Shengqian; Wang, Shijin; Kang, Shichang; Chen, Fahu

    2018-03-01

    Long-term, high-resolution temperature records which combine an unambiguous proxy and precise dating are rare in China. In addition, the societal implications of past temperature change on a regional scale have not been sufficiently assessed. Here, based on the modern relationship between chironomids and temperature, we use fossil chironomid assemblages in a precisely dated sediment core from Gonghai Lake to explore temperature variability during the past 4000 years in northern China. Subsequently, we address the possible regional societal implications of temperature change through a statistical analysis of the occurrence of wars. Our results show the following. (1) The mean annual temperature (TANN) was relatively high during 4000-2700 cal yr BP, decreased gradually during 2700-1270 cal yr BP and then fluctuated during the last 1270 years. (2) A cold event in the Period of Disunity, the Sui-Tang Warm Period (STWP), the Medieval Warm Period (MWP) and the Little Ice Age (LIA) can all be recognized in the paleotemperature record, as well as in many other temperature reconstructions in China. This suggests that our chironomid-inferred temperature record for the Gonghai Lake region is representative. (3) Local wars in Shanxi Province, documented in the historical literature during the past 2700 years, are statistically significantly correlated with changes in temperature, and the relationship is a good example of the potential societal implications of temperature change on a regional scale.

  10. Knowledge, behavioral practices, and experiences of outdoor fallers: Implications for prevention programs.

    Science.gov (United States)

    Chippendale, Tracy; Raveis, Victoria

    2017-09-01

    Although the epidemiology and prevention of falls has been well studied, the focus has been on indoor rather than outdoor falls. Older adults' knowledge of outdoor risk factors and their outdoor fall prevention practices have not been examined. To fill this gap, and to inform the development of a prevention program, we sought to explore the experiences and fall prevention knowledge and practices of older adults who had sustained an outdoor fall. A cross-sectional study using random digit telephone dialing was used to survey community dwelling seniors (N=120) across the five boroughs of New York City. We used the Outdoor Falls Questionnaire (OFQ), a valid and reliable tool as the survey instrument. Perceived outdoor fall risks, strategies used for prevention, and outdoor fall experiences were examined. SPSS version 21 was used for descriptive analysis of participant characteristics and to determine frequencies of perceived outdoor fall risks and strategies used for prevention. Phenomenological analysis was used with the qualitative data. Qualitative and quantitative data were analyzed separately and a mixed methods matrix was used to interpret and integrate the findings. Analysis revealed diverse unmet education and training needs including the importance of using single vision glasses, understanding the fall risks associated with recreational areas and parking lots, safe outdoor walking strategies, safe carrying of items on level and uneven surfaces, as well as when walking up and down stairs, and safety in opening/closing doors. Study findings are informative for outdoor fall prevention programs as well as practice. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. An examination of current stroke rehabilitation practice in Peru: Implications for interprofessional education.

    Science.gov (United States)

    McDonald, Cody L; Fuhs, Amy K; Kartin, Deborah

    2018-05-01

    This study aimed to better understand current clinical practice of rehabilitation professionals in Lima, Peru, and to explore the existence of and potential for interprofessional collaboration. A secondary purpose was to assess rehabilitation professionals' agreement with evidence-based stroke rehabilitation statements and confidence performing stroke rehabilitation tasks prior to and following an interprofessional stroke rehabilitation training. Current clinical practice for rehabilitation professionals in Peru differs from high-income counties like the United States, as physical therapists work with dysphagia and feeding, prosthetist orthotists serve a strictly technical role, and nurses have a limited role in rehabilitation. Additionally, while opportunity for future interprofessional collaboration within stroke rehabilitation exists, it appears to be discouraged by current health system policies. Pre- and post-training surveys were conducted with a convenience sample of 107 rehabilitation professionals in Peru. Survey response options included endorsement of professionals for rehabilitation tasks and a Likert scale of agreement and confidence. Training participants largely agreed with evidence-based stroke rehabilitation statements. Differences in opinion remained regarding the prevalence of dysphagia and optimal frequency of therapy post-stroke. Substantially increased agreement post-training was seen in favour of early initiation of stroke rehabilitation and ankle foot orthosis use. Participants were generally confident performing traditional profession-specific interventions and educating patients and families. Substantial increases were seen in respondents' confidence to safely and independently conduct bed to chair transfers and determine physiological stability. Identification of key differences in rehabilitation professionals' clinical practice in Peru is a first step toward strengthening the development of sustainable rehabilitation systems and

  12. Health-Related Variables and Academic Performance among First-Year College Students: Implications for Sleep and Other Behaviors.

    Science.gov (United States)

    Trockel, Mickey T.; Barnes, Michael D.; Egget, Dennis L.

    2000-01-01

    Analyzed the effect of several health behaviors and health-related variables on college freshmen's grade point averages (GPAs). Survey data indicated that sleep habits, particularly wake-up time, accounted for the most variance in GPAs. Higher GPAs related to strength training and study of spiritually oriented material. Lower GPAs related to…

  13. Near-shore Antarctic pH variability has implications for the design of ocean acidification experiments

    Science.gov (United States)

    Kapsenberg, Lydia; Kelley, Amanda L.; Shaw, Emily C.; Martz, Todd R.; Hofmann, Gretchen E.

    2015-01-01

    Understanding how declining seawater pH caused by anthropogenic carbon emissions, or ocean acidification, impacts Southern Ocean biota is limited by a paucity of pH time-series. Here, we present the first high-frequency in-situ pH time-series in near-shore Antarctica from spring to winter under annual sea ice. Observations from autonomous pH sensors revealed a seasonal increase of 0.3 pH units. The summer season was marked by an increase in temporal pH variability relative to spring and early winter, matching coastal pH variability observed at lower latitudes. Using our data, simulations of ocean acidification show a future period of deleterious wintertime pH levels potentially expanding to 7–11 months annually by 2100. Given the presence of (sub)seasonal pH variability, Antarctica marine species have an existing physiological tolerance of temporal pH change that may influence adaptation to future acidification. Yet, pH-induced ecosystem changes remain difficult to characterize in the absence of sufficient physiological data on present-day tolerances. It is therefore essential to incorporate natural and projected temporal pH variability in the design of experiments intended to study ocean acidification biology.

  14. Turkish College Students' Subjective Wellbeing in Regard to Psychological Strengths and Demographic Variables: Implications for College Counseling

    Science.gov (United States)

    Sivis-Cetinkaya, Rahsan

    2013-01-01

    This study investigated Turkish college students' subjective wellbeing in regard to psychological strength and demographic variables. A sample of Turkish college students (N?=?1,052) aged 17-32 (mean age = 21, SD = 1.79) was administered various psychological strength instruments--the Gratitude Scale, the Rosenberg Self Esteem Inventory, the…

  15. Cancer pain management in China: current status and practice implications based on the ACHEON survey

    Directory of Open Access Journals (Sweden)

    Xia Z

    2017-08-01

    Full Text Available Zhongjun Xia Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, ChinaPurpose: Cancer pain can seriously impact the quality of life (QoL of patients, and optimal management practices are therefore of paramount importance. The ACHEON survey queried physicians and patients from 10 Asian countries/regions to assess current clinical practices in cancer pain management in Asia. This study presents the data obtained for cancer pain management in mainland China, with an emphasis on practices related to opioid drugs.Materials and methods: In several tertiary hospitals across China, 250 patients experiencing cancer pain and 100 physicians were surveyed on questions designed to assess current cancer pain management practices and cancer pain impact on QoL.Results: The patient survey showed that 88% of patients reported moderate-to-severe cancer pain, with a median duration of 6 months. The physician survey showed that medical school/residency training with regard to cancer pain management was inadequate in ~80% of physicians. A total of 80% of physicians and 67.2% of patients reported that pain scale was used during pain assessment; 84% of physicians expressed that physician-perceived pain severity was not completely consistent with actual pain the patient experienced. Of the 147 patients who recalled the medication received, 83.7% were administered opioid prescriptions. Of the 240 patients who received treatment, 43.8% perceived the inadequacy of controlling pain. The primary barriers from physicians perceived to optimal pain management included patients’ fear of side effects (58%, patients’ fear of addiction (53%, patients’ reluctance to report pain (43%, physicians’ reluctance to prescribe (29%, physicians’ inadequacy of pain assessment (27% and excessive regulation of opioid analgesics (47%.Conclusion: Knowledge of cancer pain management should be strengthened among physicians. Quantitative pain assessment and principle-based pain

  16. A randomized study of multimedia informational aids for research on medical practices: Implications for informed consent.

    Science.gov (United States)

    Kraft, Stephanie A; Constantine, Melissa; Magnus, David; Porter, Kathryn M; Lee, Sandra Soo-Jin; Green, Michael; Kass, Nancy E; Wilfond, Benjamin S; Cho, Mildred K

    2017-02-01

    Participant understanding is a key element of informed consent for enrollment in research. However, participants often do not understand the nature, risks, benefits, or design of the studies in which they take part. Research on medical practices, which studies standard interventions rather than new treatments, has the potential to be especially confusing to participants because it is embedded within usual clinical care. Our objective in this randomized study was to compare the ability of a range of multimedia informational aids to improve participant understanding in the context of research on medical practices. We administered a web-based survey to members of a proprietary online panel sample selected to match national US demographics. Respondents were randomized to one of five arms: four content-equivalent informational aids (animated videos, slideshows with voice-over, comics, and text) and one no-intervention control. We measured knowledge of research on medical practices using a summary knowledge score from 10 questions based on the content of the informational aids. We used analysis of variance and paired t-tests to compare knowledge scores between arms. There were 1500 completed surveys (300 in each arm). Mean knowledge scores were highest for the slideshows with voice-over (65.7%), followed by the animated videos (62.7%), comics (60.7%), text (57.2%), and control (50.3%). Differences between arms were statistically significant except between the slideshows with voice-over and animated videos and between the animated videos and comics. Informational aids that included an audio component (animated videos and slideshows with voice-over) had higher knowledge scores than those without an audio component (64.2% vs 59.0%, p informational aids with a character-driven story component (animated videos and comics) and those without. Our results show that simple multimedia aids that use a dual-channel approach, such as voice-over with visual reinforcement, can

  17. Cancer survivorship care-planning: Practice, research, and policy implications for social work.

    Science.gov (United States)

    Wagner, Richard W; Pritzker, Suzanne

    2016-01-01

    Increasing numbers of cancer survivors are living longer than 5 years from their diagnosis date. This has resulted in a growing population of cancer survivors, expected to reach 19 million by 2024. Survivors frequently experience late effects caused by cancer and its treatment, reducing survivors' quality of life in multiple domains. Survivorship care-plans may aid the many physical, psychosocial, and financial needs that emerge posttreatment. However, the lack of reimbursement mechanisms, the limited amount of effectiveness research, and minimal guidelines for content and delivery are barriers to the widespread provision of survivorship care-plans. Challenges and opportunities for social work practice, research, and policy are identified and discussed.

  18. Women's experiences of long term sickness absence: implications for rehabilitation practice and theory.

    Science.gov (United States)

    Ockander, Marlene K; Timpka, Toomas

    2003-01-01

    In most European countries, spells of long-term absence contribute the largest number of days that are reimbursed as a result of sickness absence. This group is growing and it is constituted mainly of women. The present study seeks further knowledge about what happens then and there, i.e. how women on long-term sickness absence handle and explain, for themselves and others, this interruption in their daily life. Semi-structured interviews were performed with 82 middle-aged women with personal experience of long-term sickness absence. The women's accounts of sickness absence contained interpretations of what had happened to them, how things were at present, and what they thought the future would bring. Three different accounts could be distinguished: crisis, breakpoint, and migration. The perception of their own situation and especially what they thought about their future was associated with their feeling of power to take the initiative, and their well-being. From this study the authors have found implications for central topics of importance: time elapse, sense of coherence, reorientation/adaptation, vital goals, and gender.

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

    Science.gov (United States)

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

    2014-01-01

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

  20. [Sexual health and intellectual disability: a narrative literature review and its implications for nursing practice.

    Science.gov (United States)

    Pariseau-Legault, Pierre; Holmes, Dave

    2017-09-01

    Issues associated with affectivity and sexuality in the context of intellectual disability have recently been the subject of various interdisciplinary discussions in academia. In nursing, interventions in sexual health are supported with hesitation and those issues constitute a marginal field of nursing research. A narrative literature review was realized in order to establish a portrait of the knowledge produced on this topic in the last decade. This paper illustrates three specific research areas recently developed, namely issues related to sexual autonomy, contextual factors positively or negatively contributing to emotional and sexual life, and the experiences of people identified as having an intellectual disability in this regard. On the basis of these results, different issues related to sexuality and intellectual disability are discussed, including those associated with the negotiation process of affective and sexual life, parenthood as a mediator of emotional and sexual expression, and the inclusiveness issues of sexual diversity in health interventions. Implications for nursing are finally discussed in light of the recent development of its role in sexual health.

  1. Genetic and epigenetic features in radiation sensitivity. Part II: implications for clinical practice and radiation protection

    International Nuclear Information System (INIS)

    Bourguignon, Michel H.; Gisone, Pablo A.; Perez, Maria R.; Michelin, Severino; Dubner, Diana; Giorgio, Marina di; Carosella, Edgardo D.

    2005-01-01

    Recent progress especially in the field of gene identification and expression has attracted greater attention to the genetic and epigenetic susceptibility to cancer, possibly enhanced by ionising radiation. This issue is especially important for radiation therapists since hypersensitive patients may suffer from adverse effects in normal tissues following standard radiation therapy, while normally sensitive patients could receive higher doses of radiation, offering a better likelihood of cure for malignant tumours. Although only a small percentage of individuals are ''hypersensitive'' to radiation effects, all medical specialists using ionising radiation should be aware of the aforementioned progress in medical knowledge. The present paper, the second of two parts, reviews human disorders known or strongly suspected to be associated with hypersensitivity to ionising radiation. The main tests capable of detecting such pathologies in advance are analysed, and ethical issues regarding genetic testing are considered. The implications for radiation protection of possible hypersensitivity to radiation in a part of the population are discussed, and some guidelines for nuclear medicine professionals are proposed. (orig.)

  2. Variability in soil-water retention properties and implications for physics-based simulation of landslide early warning criteria

    Science.gov (United States)

    Thomas, Matthew A.; Mirus, Benjamin B.; Collins, Brian D.; Lu, Ning; Godt, Jonathan W.

    2018-01-01

    Rainfall-induced shallow landsliding is a persistent hazard to human life and property. Despite the observed connection between infiltration through the unsaturated zone and shallow landslide initiation, there is considerable uncertainty in how estimates of unsaturated soil-water retention properties affect slope stability assessment. This source of uncertainty is critical to evaluating the utility of physics-based hydrologic modeling as a tool for landslide early warning. We employ a numerical model of variably saturated groundwater flow parameterized with an ensemble of texture-, laboratory-, and field-based estimates of soil-water retention properties for an extensively monitored landslide-prone site in the San Francisco Bay Area, CA, USA. Simulations of soil-water content, pore-water pressure, and the resultant factor of safety show considerable variability across and within these different parameter estimation techniques. In particular, we demonstrate that with the same permeability structure imposed across all simulations, the variability in soil-water retention properties strongly influences predictions of positive pore-water pressure coincident with widespread shallow landsliding. We also find that the ensemble of soil-water retention properties imposes an order-of-magnitude and nearly two-fold variability in seasonal and event-scale landslide susceptibility, respectively. Despite the reduced factor of safety uncertainty during wet conditions, parameters that control the dry end of the soil-water retention function markedly impact the ability of a hydrologic model to capture soil-water content dynamics observed in the field. These results suggest that variability in soil-water retention properties should be considered for objective physics-based simulation of landslide early warning criteria.

  3. Critical thinking, nurse education and universities: some thoughts on current issues and implications for nursing practice.

    Science.gov (United States)

    Morrall, Peter; Goodman, Benny

    2013-09-01

    When in the latter part of the 20th century nurse 'training' in the UK left the old schools of nursing (based within the health delivery system) and entered universities, the promise was not just a change of focus from training to education but an embracement of 'higher' education. Specifically, nurses were to be exposed to the demands of thinking rather than just doing - and critical thinking at that. However, despite a history of critical perspectives informing nursing theory, that promise may be turning sour. The insidious saturation of the university system in bureaucracy and managerialism has, we argue, undermined critical thinking. A major funding restructuring of higher education in the UK, coinciding with public concern about the state of nursing practice, is undermining further the viability of critical thinking in nursing and potentially the acceptability of university education for nurses. Nevertheless, while critical thinking in universities has decayed, there is no obvious educational alternative that can provide this core attribute, one that is even more necessary to understand health and promote competent nursing practice in an increasingly complex and globalising world. We propose that nurse academics and their colleagues from many other academic and professional disciplines engage in collegiate 'moral action' to re-establish critical thinking in UK universities. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. Race-Based Health Disparities and the Digital Divide: Implications for Nursing Practice.

    Science.gov (United States)

    Price, Zula

    2015-12-01

    Knowledge of the sources of race-based health disparities could improve nursing practice and education in minority underserved communities. This purpose of this paper was to consider if Black-nonBlack health disparities were at least in part explained by Black-nonBlack disparities in access to Internet-based health information. With data on the U.S. adult population from the 2012 General Social Survey, the parameters of a health production function in which computer usage as an input was estimated. It was found that while there are Black-nonBlack disparities in health, once computer usage was accounted for, Black-nonBlack health disparities disappeared. This suggests nursing and health interventions that improve Internet access for Black patients in underserved communities could improve the health of Black Americans and close the racial health disparities gap. These findings complement recent nursing researchfindings that suggest closing Black-nonBlack disparities in computer access, the "digital divide," can render nursing practice more effective in providing care to minority and underserved communities.

  5. New perspectives on the theory of justice: implications for physical therapy ethics and clinical practice.

    Science.gov (United States)

    Edwards, Ian; Delany, Clare M; Townsend, Anne F; Swisher, Laura Lee

    2011-11-01

    Recent revisions of physical therapy codes of ethics have included a new emphasis concerning health inequities and social injustice. This emphasis reflects the growing evidence regarding the importance of social determinants of health, epidemiological trends for health service delivery, and the enhanced participation of physical therapists in shaping health care reform in a number of international contexts. This perspective article suggests that there is a "disconnect" between the societal obligations and aspirations expressed in the revised codes and the individualist ethical frameworks that predominantly underpin them. Primary health care is an approach to health care arising from an understanding of the nexus between health and social disadvantage that considers the health needs of patients as expressive of the health needs of the communities of which they are members. It is proposed that re-thinking ethical frameworks expressed in codes of ethics can both inform and underpin practical strategies for working in primary health care. This perspective article provides a new focus on the ethical principle of justice: the ethical principle that arguably remains the least consensually understood and developed in the ethics literature of physical therapy. A relatively recent theory of justice known as the "capability approach to justice" is discussed, along with its potential to assist physical therapy practitioners to further develop moral agency in order to address situations of health inequity and social injustice in clinical practice.

  6. Clinical leadership in contemporary clinical practice: implications for nursing in Australia.

    Science.gov (United States)

    Davidson, P M; Elliott, D; Daly, J

    2006-04-01

    Leadership in the clinical practice environment is important to ensure both optimal patient outcomes and successive generations of motivated and enthusiastic clinicians. The present paper seeks to define and describe clinical leadership and identify the facilitators and barriers to clinical leadership. We also describe strategies to develop clinical leaders in Australia. Key drivers to the development of nursing leaders are strategies that recognize and value clinical expertise. These include models of care that highlight the importance of the nursing role; evidence-based practice and measurement of clinical outcomes; strategies to empower clinicians and mechanisms to ensure participation in clinical decision-making. Significant barriers to clinical leadership are organizational structures that preclude nurses from clinical decision making; the national shortage of nurses; fiscal constraints; absence of well evaluated models of care and trends towards less skilled clinicians. Systematic, strategic initiatives are required to nurture and develop clinical leaders. These strategies need to be collegial collaborations between the academic and health care sectors in order to provide a united voice for advancing the nursing profession.

  7. The prevalence and characteristics of homelessness in the NSW substance treatment population: implications for practice.

    Science.gov (United States)

    Allan, Julaine; Kemp, Michael

    2014-01-01

    This study examines the prevalence and characteristics of homelessness episodes in Australian substance misuse treatment. A dataset containing all closed substance treatment episodes in NSW, Australia from July 2006 to June 2011 was used. Statistical analysis was used to determine any relationships between demographic and treatment variables and homelessness. Of the 213, 129 treatment episodes in the dataset 12.8% have some form of homelessness. Non-government and residential services have the highest prevalence of homelessness. Sex, age, and drug type have weak relationships with homelessness. Leaving against the advice of the treatment provider is more common in episodes where homelessness is a factor. Homelessness is a problem experienced by a significant proportion of the substance treatment population and treatment providers have an opportunity and an obligation to address it in their treatment delivery.

  8. The importance, measurement and practical implications of worker's expectations for return to work.

    Science.gov (United States)

    Young, Amanda E; Besen, Elyssa; Choi, YoonSun

    2015-01-01

    Workers' own expectations for return to work consistently predict work status. To advance the understanding of the relationship between RTW expectations and outcomes, we reviewed existing measures to determine those which we felt were the most likely to capture the construct. A comprehensive search of the work-disability rehabilitation literature was undertaken. The review of the measures was conducted in three steps: first, a review of terminology; second, an examination of whether a time reference was included; third, an evaluation of ease of comprehension, and applicability across contexts. A total of 42 different measures were identified. One of the most striking findings was the inconsistency in terminology. Measures were also limited by not including a time reference. Problems were also identified with regards to ease of understanding, utility of response options, and applicability in a wide variety of research and applied settings. Most previously used measures contain elements that potentially limit utility. However, it would seem that further development can overcome these, resulting in a tool that provides risk prediction information, and an opportunity to start a conversation to help identify problems that might negatively impact a worker's movement through the RTW process and the outcomes achieved. Implications for Rehabilitation Return to work is an integral part of workplace injury management. The capture of RTW expectations affords a way to identify the potential for less than optimal RTW processes and outcomes. A mismatch between an injured worker's expectations and what other stakeholders might expect suggests that efforts could be made to determine what is causing the injured worker's concerns. Once underling issues are identified, work can be put into resolving these so that the worker's return to the workplace is not impeded.

  9. Framing Tobacco Dependence as a "Brain Disease": Implications for Policy and Practice.

    Science.gov (United States)

    Morphett, Kylie; Carter, Adrian; Hall, Wayne; Gartner, Coral

    2017-07-01

    Like other forms of drug dependence, tobacco dependence is increasingly being described as a "chronic brain disease." The potential consequences of this medical labelling have been examined in relation to other addictions, but the implications for tobacco control have been neglected. Some have posited that biomedical conceptions of addiction will reduce stigma and increase uptake of efficacious treatments. Others have countered that it could increase stigma, reduce treatment seeking, and deter unassisted quitting. We explored how smokers respond to the labelling of smoking as a brain disease. Semi-structured interviews with 29 Australian smokers recruited using purposive sampling. Thematic analysis was used to analyze the results. Most participants questioned the accuracy of the brain disease label as applied to smoking. They believed that smoking was not a chronic disease because they perceived smoking to be an individual's choice. In addition, many believed that this label would increase the stigma that they already felt and, did not want to adopt a "sick role" in relation to their smoking. Describing smoking as a brain disease is more likely to alienate smokers than to engage them in quitting. The application of overly medical labels of smoking are inconsistent with smokers own conceptualizations of their smoking, and may have unintended consequences if they are widely disseminated in healthcare settings or antismoking campaigns. The participants in this project believed that biomedical labels of smoking as a "brain disease" or a "chronic disease" were discordant their existing understandings of their smoking. Explanations of addiction that downplay or ignore the role of choice and autonomy risk being perceived as irrelevant by smokers, and could lead to suspicion of health professionals or an unwillingness to seek treatment. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights

  10. Yarning/Aboriginal storytelling: towards an understanding of an Indigenous perspective and its implications for research practice.

    Science.gov (United States)

    Geia, Lynore K; Hayes, Barbara; Usher, Kim

    2013-12-01

    There is increasing recognition of Indigenous perspectives from various parts of the world in relation to storytelling, research and its effects on practice. The recent emergence of storytelling or yarning as a research method in Australian Aboriginal and Torres Strait Island studies and other Indigenous peoples of the world is gaining momentum. Narratives, stories, storytelling and yarning are emerging methods in research and has wide ranging potential to shape conventional research discourse making research more meaningful and accessible for researchers. In this paper we argue for the importance of Indigenous research methods and Indigenous method(ology), within collaborative respectful partnerships with non-Indigenous researchers. It is imperative to take these challenging steps together towards better outcomes for Indigenous people and their communities. In the Australian context we as researchers cannot afford to allow the gap between Aboriginal and Torres Strait Islanders and mainstream Australia health outcomes to grow even wider. One such pathway is the inclusion of Aboriginal storytelling or yarning from an Aboriginal and Torres Strait perspective within Indigenous and non-Indigenous research paradigms. Utilising Aboriginal storytelling or yarning will provide deeper understanding; complementing a two-way research paradigm for collaborative research. Furthermore, it has significant social implications for research and clinical practice amongst Indigenous populations; thus complementing the biomedical medical paradigm.

  11. ESA STSE Project “Sea Surface Temperature Diurnal Variability: Regional Extend – Implications in Atmospheric Modelling”

    DEFF Research Database (Denmark)

    Karagali, Ioanna

    of the vertical extend of diurnal signals. Drifting buoys provide measurements close to the surface but are not always available. Moored buoys are generally not able to resolve the daily SST signal, which strongly weakens with depth within the upper water column. For such reasons, the General Ocean Turbulence......, atmospheric and oceanic modelling, bio-chemical processes and oceanic CO2 studies. The diurnal variability of SST, driven by the coincident occurrence of low enough wind and solar heating, is currently not properly understood. Atmospheric, oceanic and climate models are currently not adequately resolving...... the daily SST variability, resulting in biases of the total heat budget estimates and therefore, demised model accuracies. The ESA STSE funded project SSTDV:R.EX.-IM.A.M. aimed at characterising the regional extend of diurnal SST signals and their impact in atmospheric modelling. This study will briefly...

  12. Parenting, family life, and well-being among sexual minorities: nursing policy and practice implications.

    Science.gov (United States)

    Weber, Scott

    2008-06-01

    Parenting and family life are fundamental social constructs in human society and in law and public policy. Family structures and support systems provide important economic and psychological advantages for parents as well as for their children. Stigma toward lesbian and gay parents often marginalize individuals in these families and restrict family members' full expression of social citizenship, humanity, and personhood. Stigma directly contributes to increased risk for substance abuse, anxiety, and depressive illness among both parents and children. This article reviews the relevant policy literature to deconstruct the impacts of stigma on the psychological health and well-being of sexual minority parents so that psychiatric/mental health nurses and other health care providers can identify and counter these effects in their practices and advocate for policy improvements.

  13. Social Work Practice with Arab Families: The Implications of Spirituality vis-à-vis Islam

    Directory of Open Access Journals (Sweden)

    Ronald E. Hall

    2007-12-01

    Full Text Available In the aftermath of September 11, 2001, spiritualism has become apparent as critical to social work practice with Arab families. Regrettably, research on Arab families today is all but non-existent.Their belief in Islam is the fastest growing form of spirituality in Central Asia. Social workers who do not acknowledge this fact will be at a severe disadvantage in their attempts to treat Arab clientele. It is not compulsory that practitioners endorse client belief systems or other aspects of their spirituality, but practitioners should acknowledge said systems as a critical point in the client’s frame of reference. In the interest of social justice, social workers are thus challenged to develop creative treatment strategies less confined to Western bias.

  14. The long-term career outcome study: lessons learned and implications for educational practice.

    Science.gov (United States)

    Durning, Steven J; Dong, Ting; LaRochelle, Jeffrey L; Artino, Anthony R; Gilliland, William R; DeZee, Kent J; Saguil, Aaron; Cruess, David F; Picho, Katherine; McManigle, John E

    2015-04-01

    The work of the Long-Term Career Outcome Study has been a program of scholarship spanning 10 years. Borrowing from established quality assurance literature, the Long-Term Career Outcome Study team has organized its scholarship into three phases; before medical school, during medical school, and after medical school. The purpose of this commentary is to address two fundamental questions: (1) what has been learned? and (2) how does this knowledge translate to educational practice and policy now and into the future? We believe that answers to these questions are relevant not only to our institution but also to other educational institutions seeking to provide high-quality health professions education. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

  15. Never say die: death euphemisms, misunderstandings and their implications for practice.

    Science.gov (United States)

    Rawlings, Deborah; Tieman, Jennifer J; Sanderson, Christine; Parker, Deborah; Miller-Lewis, Lauren

    2017-07-02

    A Massive Open Online Course (MOOC) on death and dying was conducted to open the dialogue around death and dying. In one activity, participants were asked to engage with language and to think of alternative words (or euphemisms) that are used to describe death. To reflect from a nursing perspective how language enables and sometimes disguises important messages and conversations. Four hundred and seventy one participants provided 3053 euphemisms. Euphemisms were varied, with many providing commentary on their purpose and use. As a society we have become quite creative in the use of euphemisms, but need to be mindful of misunderstandings and misinterpretations which can cause embarrassment and distress in clinical situations. This paper describes some of the euphemisms that were provided, examining why they are used and how their use can be easily misconstrued in daily life and in clinical practice.

  16. Stakeholder perceptions of job stress in an industrialized country: implications for policy and practice.

    Science.gov (United States)

    Page, Kathryn M; LaMontagne, Anthony D; Louie, Amber M; Ostry, Aleck S; Shaw, Andrea; Shoveller, Jeannie A

    2013-08-01

    We used a secondary, qualitative analysis of stakeholder perceptions of work stress in Australia to characterize the context for policy and practice intervention. Themes included: Individual versus contextual descriptions of stress; perceived 'gender' differences in manifesting and reporting of stress; the work/home interface; and perceived sectoral and occupational differences in compensation claim rates. We found that people often still perceive stress as an individual rather than organizational problem and view work stress as a stereotypically feminine weakness that affects only certain people. Organizations downplay and overlook risks, increasing worker reluctance to report stressors, creating barriers to job stress interventions. Our study may be relevant to other industrial countries where researchers currently study job stress interventions to improve their effectiveness. Comprehensive approaches can increase knowledge and decrease stigma about job stress and mental illness, and target both work- and non-work-related influences on mental health.

  17. Knowledge, attitude, and practice about malaria: Socio-demographic implications for malaria control in rural Ghana.

    Science.gov (United States)

    Assan, Abraham; Takian, Amirhossein; Hanafi-Bojd, Ahmad Ali; Rahimiforoushani, Abbas; Nematolahi, Shahrzad

    2017-11-01

    Despite continuing international attention to malaria prevention, the disease remains a global public health problem. We investigated socio-demographic factors influencing knowledge, attitudes, and practices about malaria in rural Ghana. Our survey looked at 354 households. Mean knowledge score was higher among individuals with a history of volunteers having visited their households to educate them about malaria; families with 4-6 members; and males. Households with at least one under-five-aged child also had significantly higher knowledge scores. Households with at least one pregnant woman evinced a positive attitude towards malaria prevention. National malaria control strategies have achieved positive results in the fight against malaria. Nonetheless, multipronged community-based health strategies that integrate malaria programs and population growth control initiatives may be able to reach by 2030 the sustainable development goal of eliminating malaria.

  18. Authoritative parenting and drug-prevention practices: implications for antidrug ads for parents.

    Science.gov (United States)

    Stephenson, Michael T; Quick, Brian L; Atkinson, Joshua; Tschida, David A

    2005-01-01

    This research employed the theory of reasoned action to investigate the role of authoritative parenting in 3 drug-prevention behaviors: (a) parental monitoring, (b) parent-child discussions, and (c) awareness of the child's environment. A phone survey of 158 parents of adolescents in 7th, 9th, and 11th grades revealed that authoritative parenting was correlated with parenting practices that reduce the likelihood of adolescent drug use, including discussing family rules about drugs, discussing strategies to avoid drugs, discussing those in trouble with drugs, parental monitoring, knowing the child's plans for the coming day, and personally knowing the child's friends well. Additionally, authoritative parenting moderated the attitude-behavioral intention relation for parental monitoring and awareness of the child's environment, with the weakest relation detected for low-authoritative parents. The utility of these findings in helping design and target antidrug messages for parents more effectively is discussed.

  19. Social work and adverse childhood experiences research: implications for practice and health policy.

    Science.gov (United States)

    Larkin, Heather; Felitti, Vincent J; Anda, Robert F

    2014-01-01

    Medical research on "adverse childhood experiences" (ACEs) reveals a compelling relationship between the extent of childhood adversity, adult health risk behaviors, and principal causes of death in the United States. This article provides a selective review of the ACE Study and related social science research to describe how effective social work practice that prevents ACEs and mobilizes resilience and recovery from childhood adversity could support the achievement of national health policy goals. This article applies a biopsychosocial perspective, with an emphasis on mind-body coping processes to demonstrate that social work responses to adverse childhood experiences may contribute to improvement in overall health. Consistent with this framework, the article sets forth prevention and intervention response strategies with individuals, families, communities, and the larger society. Economic research on human capital development is reviewed that suggests significant cost savings may result from effective implementation of these strategies.

  20. Systematic Review of Cyberbullying Interventions for Youth and Parents With Implications for Evidence-Based Practice.

    Science.gov (United States)

    Hutson, Elizabeth; Kelly, Stephanie; Militello, Lisa K

    2018-02-01

    Cyberbullying is a new risk factor for the well-being of pediatric populations. Consequences of cyberbullying include both physical and mental health concerns such as depression, anxiety, and somatic concerns. Adolescents who have been victims of cyberbullying and developed secondary symptoms are often recommended to visit a healthcare provider to obtain effective, evidence-based treatment. To date, no interventions exist in the healthcare setting for adolescents who are victims of cyberbullying. The purpose of this project is to review interventional studies on cyberbullying that have components for adolescents who have been involved with cyberbullying and their parents and to provide recommendations on effective intervention components with the goal of guiding clinical practice. A systematic review was conducted using the Institute of Medicine guidelines. A comprehensive electronic literature search was completed targeting interventions of cyberbullying in any setting. No date limits were used. Literature was searched in MEDLINE, Cumulative Index of Nursing and Allied Health Literature (CINAHL), PubMed, Communication and Mass Media Complete, Education Information Resource Center (ERIC), and PsycINFO databases. The following search terms were applied "cyberbullying" + "intervention" or "treatment" or "therapy" or "program." Only articles with a pediatric population were selected for review. Seventeen cyberbullying intervention programs in 23 articles were found to meet the search criteria. The most frequently used intervention components included education on cyberbullying for the adolescent, coping skills, empathy training, communication and social skills, and digital citizenship. Parent education on cyberbullying was also found to be important and was included in programs with significant outcomes. As youth present to healthcare providers with symptoms related to cyberbullying, effective interventions are needed to guide evidence-based practice. This review