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Systemic Approach (systemic + approach)
Selected AbstractsA Systemic Approach to Culturally Responsive Assessment Practices and EvaluationHIGHER EDUCATION QUARTERLY, Issue 3 2010June Slee In an earlier paper, Slee and Keenan demonstrated that it was possible for tertiary education institutions to design culturally responsive assessment procedures that complied with standardised assessment policy. The authors' paper described Growing Our Own, an initiative between Charles Darwin University and Northern Territory Catholic Education, which in 2009 began preparing in situ Indigenous teacher assistants for teacher qualification in very remote schools in the Northern Territory, Australia. The paper demonstrated that the university assessment policy accommodated Indigenous learning, reflecting students' culture, remote learning context, world experience, primary language, family and community values and entry-level competencies. This article is a systemic response to recommendations arising from a recent external evaluation of Growing Our Own and seeks to demonstrate how the project's approaches meet university assessment rules yet fit within a culturally valid framework. [source] Difference in physiogenomics between male and female infertilityANDROLOGIA, Issue 3 2008V. Wiwanitkit Summary Infertility is an important condition in reproductive medicine. According to this work, there is only one identified physiogenomic relationship on chromosome 5 (CAMK4) for male but there are four identified physiogenomic relationships on chromosome 12 (CD9), chromosome 19 (BSG), chromosome 2 (ADCY3) and chromosome 4 (AFP). Although it has been determined for a long time, there is no clear cut genetic difference between male and female infertility. Systemic approach on the pathophysiology and genomics might provide useful information to better understand the pathogenesis of infertility. In this work, physiogenomics analysis for infertility in male and female was performed. [source] Using the ,protective environment' framework to analyse children's protection needs in DarfurDISASTERS, Issue 4 2009Alastair Ager A major humanitarian concern during the continuing crisis in Darfur, Sudan, has been the protection of children, although there has been little in the way of comprehensive analysis to guide intervention. Founded on a situational analysis conducted between October 2005 and March 2006, this paper documents the significant threats to children's well-being directly linked to the political conflict. It demonstrates the role of non-conflict factors in exacerbating these dangers and in promoting additional protection violations, and it uses the ,protective environment' framework (UNICEF Sudan, 2006a) to identify systematic features of the current environment that put children at risk. This framework is shown to provide a coherent basis for assessment and planning, prompting broad, multidisciplinary analysis, concentrating on preventive and protective action, and fostering a systemic approach (rather than placing an undue focus on the discrete needs of ,vulnerable groups'). Constraints on its present utility in emergency settings are also noted. [source] Navigating Interdependence: How Adolescents Raised Solely by Grandparents Experience Their Family RelationshipsFAMILY RELATIONS, Issue 2 2009Megan L. Dolbin-MacNab This study examined how adolescents raised solely by grandparents navigated their relationships with their parents and grandparents and how these relationships were influenced by the caregiving context. Forty-one adolescents participated in qualitative, semistructured interviews. Findings suggest that relationships with parents were primarily companionate or marked by distance and distrust. Grandchildren had strong emotional bonds to their grandparents, although they also negotiated several sources of stress. Participants also reported feelings of gratitude because of the positive influence their grandparents had on their lives. Caregiving context shaped grandchildren's interdependence with their parents and grandparents in numerous ways. Findings highlight the complexity of grandchildren's family relationships and underscore the value of a systemic approach to understanding youth who are being raised by grandparents. [source] Innovation and Regional Growth in the Enlarged Europe: The Role of Local Innovative Capabilities, Peripherality, and EducationGROWTH AND CHANGE, Issue 4 2005RICCARDO CRESCENZI ABSTRACT In this paper, a formal model for the relationship between innovation and growth in European Union regions is developed drawing upon the theoretical contribution of the systems of innovation approach. The model combines the analytical approach of the regional growth models with the insights of the systemic approach. The cross-sectional analysis, covering all the Enlarged Europe (EU-25) regions (for which data are available), shows that regional innovative activities (for which a specific measure is developed) play a significant role in determining differential regional growth patterns. Furthermore, the model sheds light on how geographical accessibility and human capital accumulation, by shaping the regional system of innovation, interact (in a statistically significant way) with local innovative activities, thus allowing them to be more (or less) effectively translated into economic growth. The paper shows that an increase in innovative effort is not necessarily likely to produce the same effect in all EU-25 regions. Indeed, the empirical analysis suggests that in order to allow innovative efforts in peripheral regions to be as productive as in core areas, they need to be complemented by huge investments in human capital. [source] The acceptance of systemic thinking in various fields of technology and consequences on the respective safety philosophiesHUMAN FACTORS AND ERGONOMICS IN MANUFACTURING & SERVICE INDUSTRIES, Issue 3 2003Willy Geysen Systemic thinking aims to develop a common language that makes it possible for scientists of different disciplines and technologies to communicate with one another. The specific methodology of systemic thinking is a means of tackling complex, interrelated problems by applying a holistic approach that focuses on the interrelation of individual aspects. In this article, an attempt is made to show the impact of systemic thinking in different areas of science and technology. In particular, the authors argue that a multidisciplinary, systemic approach can play an important role in developing a general theory of safety science. © 2003 Wiley Periodicals, Inc. Hum Factors Man 13: 231,242, 2003. [source] Using the chronic care model to tackle depression among older adults who have long-term physical conditionsJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 3 2007P. MCEVOY phd bsc Effective psychological and pharmacological treatments are available, but for depressed older adults with long-term physical conditions, the outcome of routine care is generally poor. This paper introduces the chronic care model, a systemic approach to quality improvement and service redesign, which was developed by Ed Wagner and colleagues. The model highlights six key areas that need to be addressed, if depression is to be tackled more effectively in this neglected patient group: delivery system design, patient,provider relationships, decision support, clinical information systems, community resources and healthcare organization. Three influential programmes, the Improving Mood Promoting Access to Collaborative Treatment programme, the Prevention of Suicide in Primary Care Elderly Collaborative Trial, and the Program to Encourage Active, and Rewarding Lives for Seniors, have shown that when the model is adopted, significant improvements in outcomes can be achieved. The paper concludes with a case study, which illustrates the difference that adopting the chronic care model can make. Radical changes in working practices may be required, to implement the model in practice. However, Greg Simon, a leading researcher in the field of depression care, has suggested that there is already sufficient evidence to justify a shift in emphasis from research towards dissemination and implementation. [source] Risk Factors for Erectile Dysfunction in Patients with Urethral Strictures Secondary to Blunt TraumaTHE JOURNAL OF SEXUAL MEDICINE, Issue 11 2008Chao Feng PhD ABSTRACT Introduction., Erectile dysfunction (ED) is a well-known consequence of pelvic fracture, particularly in cases involving urethral injury. There are several risk factors that may be related to ED. However, no systemic approach is used to assess erectile function secondary to urethral trauma. Aim., To investigate ED associated with urethral injury secondary to pelvic fracture and perineal trauma. Methods., Forty patients with traumatic urethral strictures secondary to blunt traumatic impact episode to the pelvis or perineum were included in our study. Pelvic fractures and urethral strictures were categorized according to injury types and radiological findings. All patients underwent nocturnal penile tumescence (NPT) monitoring, dynamic color-duplex Doppler ultrasonography (D-CDDU) before surgery. NPT monitoring was conducted again after surgery. Main Outcome Measures., The events of NPT and D-CDDU were recorded. Results., In all patients, 11 had organic ED demonstrated by NPT. Vascular pathology was identified in three of 11 patients (27%). The peak systolic velocity of cavernosal artery was lower in patients with pubic diastasis in comparison to those without diastasis (P < 0.05). Significant changes in penile length and circumference were noted in posterior urethral injury compared with anterior urethral injury during erection (P < 0.05). The erectile duration time has a similar statistical difference in two groups mentioned above. However, no significant difference could be observed in the end-to-end anatomosis procedure before and after surgery (P > 0.05). Conclusions., The pelvic fracture type, especially pubic diastasis, is a risk factor for ED following urethral injury. Location of the stricture is also a risk factor for subsequent erectile dysfunction. Feng C, Xu Y-M, Yu J-J, Fei X-F, and Chen L. Risk factors for erectile dysfunction in patients with urethral strictures secondary to blunt trauma. J Sex Med 2008;5:2656,2661. [source] Rivers as living systemsAQUATIC CONSERVATION: MARINE AND FRESHWATER ECOSYSTEMS, Issue 4 2002Mark Everard Abstract 1.Fresh water and the ecosystem functions of catchments are essential to all life, and provide benefits upon which society depends. Yet there is widespread evidence of increasing degradation of river quality in many parts of the world. 2.Rivers are complex living systems, and must be managed on a systemic basis. Historic parochial approaches to management can exacerbate wider-scale problems by degrading ecosystem functions. 3.Reversal of long-term ecosystem degradation, not merely reducing the rate of ongoing damage to ecosystem functioning, is vital for achieving sustainability. In an already ecologically impoverished world, restoring ecosystem functions and the capacity of catchments to support human needs may be the only form of investment in a sustainable longer-term future. 4.A ,building block' approach can enable local issues to be addressed by technologies that protect or restore ecosystem functions at the catchment scale. They may also represent a cost-effective means for targeting investment. 5.Shifts in thinking and action are required if a move from a reactive to a systemic approach to the water environment is to be achieved. These shifts include acknowledgement of the central importance of ecosystem functions, protecting these functions through management action, valuing them appropriately, and taking longer-term and wider-scale perspectives in management decisions. A focus on restoration of function at the catchment scale, achieved through greater inclusion of all sectors of society in decision-making, is an essential element of this approach. Copyright © 2002 John Wiley & Sons, Ltd. [source] Comparison of static automated perimetry and semi-automated kinetic perimetry in patients with bilateral visible optic nerve head drusenACTA OPHTHALMOLOGICA, Issue 7 2009Katarzyna Nowomiejska Abstract. Purpose:, Until now there has been no standardized, systemic approach to diagnostics in patients with optic nerve head drusen (ONHD). This study compares visual field (VF) results obtained with static automated perimetry (SAP) and semi-automated kinetic perimetry (SKP) in patients with bilateral visible ONHD. Methods:, Visual fields in 26 eyes (13 patients) with ONHD were obtained by Humphrey Field Analyser II (SAP) and Octopus 101 (SKP) equipment and classified by three masked observers. Pairs of VFs were considered equivalent if the descriptions given by both methods matched. Individual reaction time (RT) was assessed during SKP. Fifteen healthy volunteers were examined as control material. Results:, Visual field pairs matched in 19 eyes (three normal VFs, 16 arcuate defects). In the remaining eight eyes SKP provided more information in concentric constriction of the VF (two eyes) and SAP provided more information on paracentral scotomas (five eyes). Sensitivity was 69% for SKP, 80% for SAP and 88% for both methods together. Mean RT assessed using SKP amounted to 909 ms in eyes with ONHD and 568 ms in normal subjects (p < 0.0003). The median examination duration was 13 mins with SKP and 11 mins with SAP (p = 0.05) in eyes with ONHD, and 8 mins in control eyes (p < 0.0001). Conclusions:, In clinical practice it is necessary to perform both SAP and SKP in patients with ONHD because the VF defects are diverse. In SKP, RT is prolonged in eyes with ONHD compared with normal eyes and SKP takes longer than SAP in ONHD eyes. [source] Mind the gap: the need for a generic bridge between psychoanalytic and systemic approachesJOURNAL OF FAMILY THERAPY, Issue 2 2003Mary Donovan The context for this paper is the ongoing systemic/psychoanalytic debate. It offers an alternative perspective to the recent contribution by Brodie and Wright (2002), in which they are concerned to underscore difference between the two therapeutic approaches. Here it is argued that the relationship is a great deal more complex than Brodie and Wright's analysis might suggest. Attention is focused on significant areas of commonality, in particular the impact of social constructionist thinking across the two therapies as well as current developments in technique. A case is made for the consolidation of generic space where there is opportunity for cross-fertilization and for integrative and combined systemic/psychoanalytic approaches to be nurtured and developed where appropriate. Case vignettes are used to highlight different aspects of the generic component in child and family therapy and to underline the need for bridge-building between these key therapeutic approaches in the field. [source] Current topical and systemic approaches to treatment of rosaceaJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 8 2009HC Korting Abstract Rosacea is a common, often overlooked, chronic facial dermatosis characterized by intermittent periods of exacerbation and remission. Clinical subtypes and grading of the disease have been defined in the literature. On the basis of a genetic predisposition, there are several intrinsic and extrinsic factors possibly correlating with the phenotypic expression of the disease. Although rosacea cannot be cured, there are several recommended treatment strategies appropriate to control the corresponding symptoms/signs. In addition to adequate skin care, these include topical and systemic medications particularly suitable for the papulopustular subtype of rosacea with moderate to severe intensity. The most commonly used and most established therapeutic regimens are topical metronidazole and topical azelaic acid as well as oral doxycycline. Conventionally, 100,200 mg per day have been used. Today also a controlled release formulation is available, delivering 40 mg per day using non-antibiotic, anti-inflammatory activities of the drug. Anti-inflammatory dose doxycycline in particular allows for a safe and effective short- and long-term therapy of rosacea. Topical metronidazole and topical azelaic acid also appear to be safe and effective for short-term use. There are indications that a combined therapy of anti-inflammatory dose doxycycline and topical metronidazole could possibly have synergy effects. Further interesting therapy options for the short- and long-term therapy of rosacea could be low-dose minocycline and isotretinoin; however, too little data are available with regard to the effectiveness, safety, optimal dosage and appropriate length of treatment for these medications to draw final conclusions. Conflicts of interest None declared. [source] New systemic treatment options for metastatic renal-cell carcinoma in the era of targeted therapiesASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, Issue 1 2010Thean Hsiang TAN Abstract Advances in understanding the biology and genetics of renal-cell carcinomas have led to the development of novel targeted therapies for the treatment of metastatic renal-cell cancer. Previously the systemic approaches were limited to cytokine therapies that were modest in their clinical benefits and at the expense of significant toxicities. Investigational treatments with allogeneic bone marrow transplantation were equally toxic and resulted in significant morbidity and mortality. The development of targeted therapy has revolutionized the treatment of metastatic renal-cell cancer with more meaningful outcomes. This review aims to provide a detailed discussion of the clinical benefits of targeted therapies such as sunitinib, sorafenib, temsirolimus, everolimus, bevacizumab, and some of the newer agents in clinical trial development. The efficacy of these compounds in terms of response, survival and clinical benefit are explored as well as their toxicities. The role of surgery in metastatic renal-cell carcinoma is reviewed in the context of cytoreductive therapy and resection of solitary and oligometastatic disease. Ongoing studies in the adjuvant setting following curative resection are also reviewed. The availability of targeted therapies has led to their rapid adoption as frontline therapy over traditional cytokine therapy, thus bringing more optimistic and hopeful therapeutic options in a condition where historically, systemic treatments have been relatively unsatisfactory and disappointing. [source] | |||||||||||||