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At least 235 records · Page 13Linked to original sources
PubMed1990

A self-advocacy plan for high school students with learning disabilities: a comparative case study analysis of students', teachers', and parents' perceptions of program effects.

This qualitative study examined immediate perceived effects of a self-advocacy plan for students with learning disabilities (LD) in a 4-year comprehensive high school. The study's design was based on information-processing theory and qualitative research techniques, such as participant/observation and interviews. Subjects were 15 ninth- and tenth-grade students with LD, their parents, and their resource teachers. Participants responded to standardized open-ended interview questions upon completing the first step of the Self-Advocacy Plan. The study suggests that the Self-Advocacy Plan is an effective program increasing students' awareness of the vocational and academic services they qualify for, clarifying their perceptions of their roles as learners and individuals with LD, increasing their understanding of LD as a condition that has certain general characteristics, and developing their awareness of career and educational opportunities. The study provides suggestions for future self-advocacy research and for special educators who wish to design programs for students with LD incorporating the concepts of psychosocial development of the individual, information-processing theory, and self-advocacy.

Adolescent↗
PubMed2005

A computer services program for residents of a continuing care retirement community: needs assessment and program design.

Preparatory to establishing a computer services program for residents, Presbyterian Homes, a multi-campus continuing care retirement community, conducted an assessment of residents' computer needs, ownership, and usage. Based on the results of the needs assessment, computer resource rooms were established at each facility, with computer hardware and software adapted for the use of seniors. We also deliver adapted computer education for residents, including small-group training in basic software skills; classes on software for computer accessibility; and workshops on themes motivating computer use. Ongoing evaluation shows that half of residents make use of computer resources, and that their computer skills have opened the door to other educational opportunities.

Aged↗
PubMed2025

A large-scale study across the avian clade identifies ecological drivers of neophobia.

Neophobia, or aversion to novelty, is important for adaptability and survival as it influences the ways in which animals navigate risk and interact with their environments. Across individuals, species and other taxonomic levels, neophobia is known to vary considerably, but our understanding of the wider ecological drivers of neophobia is hampered by a lack of comparative multispecies studies using standardized methods. Here, we utilized the ManyBirds Project, a Big Team Science large-scale collaborative open science framework, to pool efforts and resources of 129 collaborators at 77 institutions from 24 countries worldwide across six continents. We examined both difference scores (between novel object test and control conditions) and raw data of latency to touch familiar food in the presence (test) and absence (control) of a novel object among 1,439 subjects from 136 bird species across 25 taxonomic orders incorporating lab, field, and zoo sites. We first demonstrated that consistent differences in neophobia existed among individuals, among species, and among other taxonomic levels in our dataset, rejecting the null hypothesis that neophobia is highly plastic at all taxonomic levels with no evidence for evolutionary divergence. We then tested for effects of ecological factors on neophobia, including diet, sociality, habitat, and range, while accounting for phylogeny. We found that (i) species with more specialist diets were more neophobic than those with more generalist diets, providing support for the Neophobia Threshold Hypothesis; (ii) migratory species were also more neophobic than nonmigratory species, which supports the Dangerous Niche Hypothesis. Our study shows that the evolution of avian neophobia has been shaped by ecological drivers and demonstrates the potential of Big Team Science to advance our understanding of animal behavior.

Animals↗
PubMed1995

Rationing health care and the need for credible scarcity: why Americans can't say no.

With adequate cost containment unlikely in the foreseeable future, health care use will have to be curtailed, ideally with open and explicit criteria for equitably allocating resources or rationing. Yet, consensus on any such criteria appears remote because Americans cannot say no to health care. Americans may refuse to accept rationing for two reasons. The absence of any global limitation on health care resources may encourage patients to believe that health care resources are not scarce and do not need to be rationed. A belief in vitalism--that everyone is morally entitled to unlimited longevity and good health--may discourage setting limits on one's own care. Together, these characteristics may foster the belief that denials of health care services, especially by health insurers, are arbitrary or unfair refusals to pay for existing resources and not a necessary method of rationing scarce resources. If this hypothesis is true, Americans are unlikely to achieve consensus on any equitable allocation of health care unless they face an actual shortage (credible scarcity) of health care resources that makes it necessary to ration care.

Attitude to Health↗
PubMed1981

Performance appraisal: one company's experience.

In many corporations the installation of a performance appraisal program is a necessary step to opening the door to other key human resource development activities. Implementing a performance appraisal program that works and convincing managers to use the program are essential if other human resource development programs are to succeed. This article describes the characteristics of the performance appraisal process used at Glendale Federal Savings and Loan Association, Glendale, California, and how data generated by the program was used to facilitate other employee development programs.

California↗
PubMed2003

How to access online research reviews to inform nursing practice.

Government recognition of the fact that the NHS needs a service-wide strategy on information technology has opened up access to a many online resources. This article explains how nurses can access and use electronically stored material, such as that held by the Cochrane Library.

Clinical Nursing Research↗
PubMed1993

Cardiac surgery--challenges and surprises in a country at war.

The challenges and results of cardio-vascular surgery at the American University of Beirut Medical Center (AUBMC) during the civil strife in Lebanon are presented. Dependence on local resources is emphasized. Temporary interruption of open-heart surgery in a university setting may be the product of absence of essential materials and/or personnel. Ingenuity and team approach have contributed to the success and survival of the open-heart program. The operative results and mortality rate were indirectly related to the intensity of fighting in the vicinity of a Medical Center that served as a field hospital.

Academic Medical Centers↗
PubMed1995

Concern, continuity, and choice: a health promotion formula for advanced practice nurses.

Promoting health in a newly established nurse practitioner family practice was a major undertaking for one advanced practice nurse (APN) in a semi-rural community in southern California. The alignment of the resources necessary to begin such a practice opened many doors not previously traversed by nurses in this community. Likewise, the development of a formula and model for health promotion came about as a result of overcoming the obstacles to starting this private practice as well as the positive rewards of patient encounters over time. Episodes of concern for patients, continuous care, and choices in health care decisions come together to illustrate this formula. The research data supporting the practice further demonstrate the plausibility of the APN becoming a provider of health promotion in the primary care setting.

Adolescent↗
PubMedDate not supplied

Case management: unraveling the confusion.

I'm going to close with some of my ideas about the characteristics that case managers exhibit. I have a great deal of professional respect for case managers. I think that you are a tenacious lot. One of the major things that case managers do is help create new alternatives to problems. You open doors; no ... you first build the door and then you open it. You're creative, persistent, and resourceful. You are sometimes asked to solve all of an organization's problems. I think that is a tremendous burden, and that you can get confused because of that role conflict and confusion. What model is best for my organization? Within that is my patient population. What is it that they need? What are the current issues that you are seeing? How is my case management role different from other roles? How large a scope of practice can I handle and be reasonably successful with the patients with whom I'm dealing? How many different kinds of approaches and models are needed within my organization? Look toward the future; think about the future in terms of your crystal balls. What trends do you see building in either the demographics or the health and social environments that are going to influence health care in the future? What effect will the aging of our population have on you and your case management practice? What issues are going to be related to those trends? How many more people do we have living in fragmented families? What's going to happens in terms of resources available for patients? How can case management influence those changes? I don't think we're going to see the pace of change in the health care industry slow down. We will continue to have health care organizations address social issues in addition to pathophysiologic ones. No matter what the role and how it evolves, case management will always be at the junction of change in health care. This will be difficult at times to deal with. It will also be a source of satisfaction for those in the role because of the tremendously positive effect case managers have on the lives of patients and their families.

Case Management↗
PubMed1996

Organizational models of medical school relationships to the clinical enterprise.

The authors analyzed existing relationships between medical schools and clinical enterprises in order to develop models of these relationships. The conceptual framework for the models uses three variables to assess the nature of the relationships: (1) high academic control-high clinical enterprise control; (2) high academic influence-low academic influence; and (3) self-contained system-open system (i.e., the extent to which the resources needed for clinical education are provided by the relationship between the clinical enterprise and the medical school). The authors present four conceptual models of the relationship between the medical school and the clinical enterprise: (1) The "single ownership; owned integrated system" is characterized by a closed clinical delivery system owned or controlled by the academic institution. (2) The "general partner" organization emphasizes an open clinical environment in which the medical school forms alliances with clinical entities, and the school is a dominant partner. (3) The "limited partner" organization operates with an open clinical delivery system that the school relates to through affiliations and contractual relationships, and the school is a less dominant partner. (4) The "wholly owned, subsidiary" organization operates in a controlled clinical environment in which the medical school is a subsidiary of the larger integrated delivery system. Each model is presented in its pure organizational form, then augmented with descriptions of the different ways that the medical school and other components may relate to each other. Also, the advantages and disadvantages of each model for the medical school are discussed. The authors emphasize that no model is superior to the others; instead, the best choice for a medical school depends on the history, local circumstances, and leadership of the school and other organizations. The authors' intent is to assist the leaders of medical schools as they design strategies for the future relationships of their institutions.

Interinstitutional Relations↗
PubMed2004

Public evaluation of open space in Illinois: citizen support for natural area acquisition.

Numerous studies have indicated a broad-based support for open space preservation and protection. Research also has characterized the public values and rationale that underlie the widespread support for open space. In recognition of the widespread public support for open space, various levels of government have implemented programs to provide public access to open space. There are many different types of open space, ranging from golf courses, ball parks, wildlife areas, and prairies, to name a few. This paper addresses questions related to the types of open space that should be prioritized by planners and natural resource managers. The results of this study are based on a stratified random sample of 5000 households in Illinois that were sent a questionnaire related to their support for various types of open space. Through a comparatively simple action grid analysis, the open space types that should be prioritized for public access include forest areas, stream corridors, wildlife habitat, and lakes/ponds. These were the open space types rated of the highest importance, yet were also the open space types rated the lowest in respondent satisfaction. This kind of analysis does not require the technical expertise of other options for land-use prioritizations (e.g., conjoint analysis, contingent valuation), yet provides important policy directives for planners. Although open space funds often allow for purchase of developed sites such as golf courses, ball parks, and community parks, this study indicates that undeveloped (or nature-based) open space lands are most needed in Illinois.

Adult↗
PubMedDate not supplied

Effects of organizational change in the medical intensive care unit of a teaching hospital: a comparison of 'open' and 'closed' formats.

OBJECTIVE: To compare the effects of change from an open to a closed intensive care unit (ICU) format on clinical outcomes, resource utilization, teaching, and perceptions regarding quality of care. DESIGN: Prospective cohort study; prospective economic evaluation. SETTING: Medical ICU at a university-based tertiary care center. For the open ICU, primary admitting physicians direct care of patients with input from critical care specialists via consultation. For the closed ICU, critical care specialists direct patient care. PATIENTS: Consecutive samples of 124 patients admitted under an open ICU format and 121 patients admitted after changing to a closed ICU format. Readmissions were excluded. MAIN OUTCOME MEASURES: Comparison of hospital mortality with mortality predicted by the Acute Physiology and Chronic Health Evaluation II (APACHE II) system; duration of mechanical ventilation; length of stay; patient charges for radiology, laboratory, and pharmacy departments; vascular catheter use; number of interruptions of formal teaching rounds; and perceptions of patients, families, physicians, and nurses regarding quality of care and ICU function. RESULTS: Mean +/- SD APACHE II scores were 15.4 +/- 8.3 in the open ICU and 20.6 +/- 8.6 in the closed ICU (P=.001). In the closed ICU, the ratio of actual mortality (31.4 percent) to predicted mortality (40.1 percent) was 0.78. In the open ICU, the ratio of actual mortality (22.6 percent) to predicted mortality (25.2 percent) was 0.90. Mean length of stay for survivors in the open ICU was 3.9 days, and mean length of stay for survivors in the closed ICU was 3.7 days (P=.79). There were no significant differences between periods in patient charges for radiology, laboratory, or pharmacy resources. Nurses were more likely to say that they were very confident in the clinical judgment of the physician primarily responsible for patient care in the closed ICU compared with the open ICU (41 percent vs 7 percent; P<.Ol), and nurses were the group most supportive of changing to a closed ICU format before and after the study. CONCLUSIONS: Based on comparison of actual to predicted mortality, changing from an open to a closed ICU format improved clinical outcome. Although patients in the closed ICU had greater severity of illness, resource utilization did not increase.

APACHE↗
PubMed2000

An open standard platform for interoperability of medical devices.

Patient care in Intensive Care Units and Operating Rooms requires sophisticated instrumentation for monitoring, treatment and control. A major technical problem is the communication between devices, since the connection of medical devices from different manufacturers has similar problems to the communication between people from different countries who do not share a common language. Several proprietary solutions have been developed by initiatives from well-known international companies. These proprietary, non-open solutions have not gained general acceptability and have failed to draw upon the immense resources for instrumentation development which are available in the industry. Consequently, a set of open European standards for Medical Device Intercommunication has recently been created (ratified 1999) to provide the ability to connect devices to each other freely and to exchange data between them. The development of such standards has lead to the design and implementation of a network platform over which those standards could be tested and validated. At the same time guidelines have been defined for the development and deployment of open solutions for any kind of medical device, including existing legacy devices. The design and testing of this open standards implementation is described in this paper.

Computer Communication Networks↗
PubMed2005

An Improved Publication Process for the UMVF.

The "Université Médicale Virtuelle Francophone" (UMVF) is a federation of French medical schools. Its main goal is to share the production and use of pedagogic medical resources generated by academic medical teachers. We developed an Open-Source application based upon a workflow system which provides an improved publication process for the UMVF. For teachers, the tool permits easy and efficient upload of new educational resources. For web masters it provides a mechanism to easily locate and validate the resources. For both the teachers and the web masters, the utility provides the control and communication functions that define a workflow system.For all users, students in particular, the application improves the value of the UMVF repository by providing an easy way to find a detailed description of a resource and to check any resource from the UMVF to ascertain its quality and integrity, even if the resource is an old deprecated version. The server tier of the application is used to implement the main workflow functionalities and is deployed on certified UMVF servers using the PHP language, an LDAP directory and an SQL database. The client tier of the application provides both the workflow and the search and check functionalities and is implemented using a Java applet through a W3C compliant web browser. A unique signature for each resource, was needed to provide security functionality and is implemented using the MD5 Digest algorithm. The testing performed by Rennes and Lille verified the functionality and conformity with our specifications.

Education, Medical↗
PubMed2005

Arthroscopic versus open Bankart repair: analysis of patient subjective outcome and cost.

PURPOSE: Although the comparative efficacy of open and arthroscopic Bankart repair remains a matter of debate, little data exist on relative costs. We analyzed the patient outcomes, cost, and resource utilization of both procedures to determine if differences exist between open versus arthroscopic Bankart repair. TYPE OF STUDY: Retrospective case-control study. METHODS: We compared 22 patients who had open Bankart repair with 20 patients who had arthroscopic Bankart repair. Total operating times and all charges were obtained from records. Patients were evaluated using the American Shoulder and Elbow Surgeons (ASES) shoulder score, and any recurrence of dislocation was noted at minimum 24-month follow-up. RESULTS: For arthroscopic Bankart repairs, operating times were shorter, but operating room equipment charges were greater. Overall charges were greater for open repairs as all open repair patients were admitted postoperatively. ASES shoulder scores were not significantly different between treatment groups. Four of 17 evaluable patients with open Bankart repair (including 1 shoulder in a patient who underwent bilateral repairs) had recurrent dislocation. One of the 18 evaluable patients with arthroscopic Bankart repair had recurrent dislocation. CONCLUSIONS: Arthroscopic Bankart repair as same-day surgery has lower overall charges than open repair, although this difference would be negligible if all patients went home immediately after surgery. LEVEL OF EVIDENCE: Level III, therapeutic, retrospective cohort study.

Adolescent↗
PubMed2001

Laboratory diagnosis of mycobacterial infections: new tools and lessons learned.

Even in the 21st century, tuberculosis continues to be a problem. Although the number of cases continues gradually to decrease in the United States, cases get more difficult to treat, specifically those that are multiple-drug resistant. Infection of one-third of the world's population ensures that tuberculosis will not disappear in the near future. In light of this, it will be useful to know the goals for the health care system and how these goals may be accomplished. Laboratory testing in the mycobacteriology field is experiencing more changes today than ever before. Determining what assays will be most useful to the clinician is a challenge, and acceptance of the new technology by the medical community an even greater one. Clinicians must use the best available resources to determine the most appropriate care for their patients and work together with the laboratory to ensure that the communication channels are open. This review focuses on current state-of-the-art resources useful for accurate and rapid laboratory diagnosis of mycobacterial infections.

Bacteriological Techniques↗
PubMed2004

Families in home care--a resource or a burden? District nurses' beliefs.

BACKGROUND: Caring for families in home care is a growing part of Swedish district nurses' professional work. District nurses' facilitative and constraining beliefs about families guide the extent to which families are acknowledged and engaged in the care. AIMS AND OBJECTIVES: The aim of the study was to explore district nurses' beliefs about families in home care. DESIGN: Explorative, descriptive. METHODS: Five district nurses participated in focus group interviews on three separate occasions. Each interview lasted approximately 90 minutes, was audio taped and transcribed verbatim. A thematic content analysis was used for analyses of the data. RESULTS: The result revealed two underpinning beliefs held by the district nurses towards families in home care: families are a resource and Families are a burden. Families could be a resource for the patient, for the other family members as well as for the district nurses themselves. Families could be a resource for the patient both practically and emotionally by e.g. being present and listening. Being open in communication with other family members and district nurses was also considered as a resource. The district nurses considered families as a burden when they were experienced as demanding in various ways, for example, when family members did not act in a way that pleased the district nurses or when family members showed their suffering. CONCLUSIONS: This study highlight some facilitating and constraining beliefs held by district nurses: families can be both a resource and a burden. RELEVANCE TO CLINICAL PRACTICE: It is important that district nurses are aware of what beliefs they hold as their beliefs guide their actions towards the families.

Attitude of Health Personnel↗