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Selected AbstractsComparing United States versus International Medical School Graduate Physicians Who Serve African- American and White ElderlyHEALTH SERVICES RESEARCH, Issue 6 2006Daniel L. Howard Objective. To examine the relationship that international medical school graduates (IMGs) in comparison with United States medical school graduates (USMGs) have on health care-seeking behavior and satisfaction with medical care among African-American and white elderly. Data Sources. Secondary data analysis of the 1986,1998 Piedmont Health Survey of the Elderly, Established Populations for the Epidemiological Study of the Elderly, a racially oversampled urban and rural cohort of elders in five North Carolina counties. Study Design. Primary focus of analyses examined the impact of the combination of elder race and physician graduate status across time using a linear model for repeated measures analyses and ,2 tests. Separate analyses using generalized estimating equations were conducted for each measure of elder characteristic and health behavior. The analytic cohort included 341 physicians and 3,250 elders (65 years old and older) in 1986; by 1998, 211 physicians and 1,222 elders. Data Collection/Extraction Methods. Trained personnel collected baseline measures on 4,162 elders (about 80 percent responses) through 90-minute in-home interviews. Principal Findings. Over time, IMGs treated more African-American elders, and those who had less education, lower incomes, less insurance, were in poorer health, and who lived in rural areas. White elders with IMGs delayed care more than those with USMGs. Both races indicated being unsure about where to go for medical care. White elders with IMGs were less satisfied than those with USMGs. Both races had perceptions of IMGs that relate to issues of communication, cultural competency, ageism, and unnecessary expenses. Conclusion. IMGs do provide necessary and needed access to medical care for underserved African Americans and rural populations. However, it is unclear whether concerns regarding cultural competency, communication and the quality of care undermine the contribution IMGs make to these populations. [source] The UK climate change levy: good intentions but potentially damaging to businessCORPORATE SOCIAL RESPONSIBILITY AND ENVIRONMENTAL MANAGEMENT, Issue 4 2004Ann Hansford The climate change levy (CCL) is an important part of the UK Government's response to being a signatory to the Kyoto agreement. Prior to the introduction of the levy there were sharply contrasting views, which ranged from Sir Robert May's view that it was ,an opportunity, not a threat' to the CBI's view that it should be an option of last resort. In order to consider the impact of the CCL on UK businesses, interviews were undertaken within one ,not for profit' and two commercial organizations to explore reactions to its introduction. The findings from the study suggest the primary foci of concerns are based upon increases to the cost base and threats to international competitiveness. Further, there is doubt that the ambitious targets signed up to by the UK Government are likely to be achieved, unless there are fundamental changes in support for businesses, or the targets are revised. Copyright © 2004 John Wiley & Sons, Ltd and ERP Environment. [source] An outcomes research perspective on medical education: the predominance of trainee assessment and satisfactionMEDICAL EDUCATION, Issue 4 2001Jay B Prystowsky Context A fundamental premise of medical education is that faculty should educate trainees, that is, students and residents, to provide high quality patient care. Yet, there is little research on the effect of medical education on patient outcomes. Objective A content analysis of leading medical education journals was performed to determine the primary foci of medical education research, using a three- dimensional outcomes research framework based on the paradigm of health services outcomes research. Data sources All articles in three medical education journals (Academic Medicine, Medical Education, and Teaching and Learning in Medicine) from 1996 to 1998 were reviewed. Papers presented at the Research in Medical Education conference at the Association of American Medical Colleges annual meeting during the same period, and published as Academic Medicine supplements, were also analysed. Study selection Only data-driven articles were selected for analysis; thus editorials and abstracts were excluded. Data extraction Each article was categorized according to primary participant (i.e. trainee, faculty, provider and patient), outcome (performance, satisfaction, professionalism and cost), and level of analysis (geographic, system, institution and individual(s)). Data synthesis A total of 599 articles were analysed. Trainees were the most frequent participants studied (68·9%), followed by faculty (19·4%), providers (8·1%) and patients (3·5%). Performance was the most common outcome measured (49·4%), followed by satisfaction (34·1%). Cost was the focus of only 2·3% of articles and patient outcomes accounted for only 0·7% of articles. Conclusions Medical education research is dominated by assessment of trainee performance followed by trainee satisfaction. Leading journals in medical education contain little information concerning the cost and products of medical education, that is, provider performance and patient outcomes. The study of these medical education outcomes represents an important challenge to medical education researchers. [source] Home and Away: The Grounding of New Football Teams in Perth, Western AustraliaTHE AUSTRALIAN JOURNAL OF ANTHROPOLOGY, Issue 3 2002Roy Jones Metropolitan sporting, and particularly football, competitions were established in all of Australia's colonial state capital cities about a century ago. Typically, they were comprised of teams from and were supported by the inhabitants of working-class, inner suburbs. These competitions were the primary foci of Australians' sporting interest and loyalty for almost a century. But, with the shift of public attention and private capital to national competitions, the former stadia of many local clubs have become redundant spaces in what are now gentrifying inner suburbs. Simultaneously new, and even old, national league teams have sought larger, more modern (near) city centre venues for their operations. In this context, two new national league teams in Perth,Fremantle Dockers and Perth Glory,have experienced considerable challenges in establishing both physical ,homes' and local identities. These have included both the supplanting of traditional local clubs and the placating of new kinds of inner suburban residents. [source] Mucoepidermoid/Adenosquamous Carcinoma of the Skin: Presentation of Two CasesDERMATOLOGIC SURGERY, Issue 12 2001Darlene S. Johnson MD Background. Mucoepidermoid carcinoma is a relatively common neoplasm of the major and minor salivary glands comprising 10,30% of primary carcinomas. They may involve the skin through direct extension, metastases, and rarely, as a primary focus (adenosquamous carcinoma). Objective. To discuss through case reports, the nomenclature, histology, clinical course, and treatment of mucoepidermoid/adenosquamous carcinoma. Methods. We present a case of mucoepidermoid carcinoma primary to an upper eyelid accessory lacrimal gland with direct cutaneous extension and a case of primary cutaneous adenosquamous carcinoma of the scalp. Results. An eyelid neoplasm of lacrimal origin was initially treated with Mohs micrographic surgery (MMS), requiring an orbital exenteration to achieve a tumorfree plane. In the second case, a primary scalp lesion was cleared with MMS. Neither patient has had local recurrence or metastases. Conclusion. Correct diagnosis is crucial to pursuing adequate treatment for this aggressive neoplasm. We support the use of MMS to achieve local control. [source] Refugee perceptions of the quality of healthcare: findings from a participatory assessment in Ngara, TanzaniaDISASTERS, Issue 4 2005Edmund Rutta Abstract This article describes the findings of a participatory assessment of Burundian and Rwandan refugees' perceptions of the quality of health services in camps in Ngara, Tanzania. Taking a beneficiary-centred approach, it examines a collaborative effort by several agencies to develop a generic field guide to analyse refugees' views of healthcare services. The objective was to gather information that would contribute to significant improvements in the care offered in the camps. Although the primary focus was on healthcare, several broader questions considered other general apprehensions that might influence the way refugees perceive their healthcare. Findings indicated that while refugees in Ngara were generally satisfied with the quality of healthcare provided and healthcare promotion activities, recognition of some key refugee concerns would assist healthcare providers in enhancing services. With increasing need for refugee community participation in evaluating humanitarian assistance, this assessment has relevance both in the context of Ngara and beyond. [source] Internet-based information-seeking behaviour amongst doctors and nurses: a short review of the literatureHEALTH INFORMATION & LIBRARIES JOURNAL, Issue 1 2010Paula Younger Background:, Reviews of how doctors and nurses search for online information are relatively rare, particularly where research examines how they decide whether to use Internet-based resources. Original research into their online searching behaviour is also rare, particularly in real world clinical settings. as is original research into their online searching behaviour. This review collates some of the existing evidence, from 1995 to 2009. Objectives:, To establish whether there are any significant differences in the ways and reasons why doctors and nurses seek out online information; to establish how nurses and doctors locate information online; to establish whether any conclusions can be drawn from the existing evidence that might assist health and medical libraries in supporting users. Methods:, An initial scoping literature search was carried out on PubMed and CINAHL to identify existing reviews of the subject area and relevant original research between 1995 and 2009. Following refinement, further searches were carried out on Embase (Ovid), LISA and LISTA. Following the initial scoping search, two journals were identified as particularly relevant for further table of contents searching. Articles were exclused where the main focus was on patients searching for information or where the focus was the evaluation of online-based educational software or tutorials. Articles were included if they were review or meta-analysis articles, where they reported original research, and where the primary focus of the online search was for participants' ongoing Continuing Professional Development (CPD). The relevant articles are outlined, with details of numbers of participants, response rates, and the user groups. Results:, There appear to be no significant differences between the reasons why doctors and nurses seek online Internet-based evidence, or the ways in which they locate that evidence. Reasons for searching for information online are broadly the same: primarily patient care and CPD (Continuing Professional Development). The perceived barriers to accessing online information are the same in both groups. There is a lack of awareness of the library as a potential online information enabler. Conclusions:, Libraries need to examine their policy and practice to ensure that they facilitate access to online evidence-based information, particularly where users are geographically remote or based in the community rather than in a hospital setting. Librarians also need to take into account the fact that medical professionals on duty may not be able to take advantage of the academic model of online information research. Further research is recommended into the difference between the idealised academic model of searching and real world practicalities; and how other user groups search, for example patients. [source] Nonoperative imaging techniques in suspected biliary tract obstructionHPB, Issue 6 2006Frances Tse Abstract Evaluation of suspected biliary tract obstruction is a common clinical problem. Clinical data such as history, physical examination, and laboratory tests can accurately identify up to 90% of patients whose jaundice is caused by extrahepatic obstruction. However, complete assessment of extrahepatic obstruction often requires the use of various imaging modalities to confirm the presence, level, and cause of obstruction, and to aid in treatment plan. In the present summary, the literature on competing technologies including endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic cholangiopancreatography (PTC), endoscopic ultrasound (EUS), intraductal ultrasonography (IDUS), magnetic resonance cholangiopancreatography (MRCP), helical CT (hCT) and helical CT cholangiography (hCTC) with regards to diagnostic performance characteristics, technical success, safety, and cost-effectiveness is reviewed. Patients with obstructive jaundice secondary to choledocholithiasis or pancreaticobiliary malignancies are the primary focus of this review. Algorithms for the management of suspected obstructive jaundice are put forward based on current evidence. Published data suggest an increasing role for EUS and other noninvasive imaging techniques such as MRCP, and hCT following an initial transabdominal ultrasound in the assessment of patients with suspected biliary obstruction to select candidates for surgery or therapeutic ERCP. The management of patients with a suspected pancreaticobiliary condition ultimately is dependent on local expertise, availability, cost, and the multidisciplinary collaboration between radiologists, surgeons, and gastroenterologists. [source] Fathers and families: Locating the ghost in the nurseryINFANT MENTAL HEALTH JOURNAL, Issue 5 2004Paul Barrows Infant mental-health clinicians and researchers have tended to focus particularly on the mother,infant dyad and, in Fraiberg's terms, on the "ghosts" that the mother brings to the nursery. This article begins by reiterating the case for paying as much attention to the "ghosts" that the father brings if we are to maximize our therapeutic impact. It is argued further, however, that over and above the father's individual role, what is more critical for the developing infant's future mental health is the nature of the parental couple that he/she encounters. That is, it is the relationship between the parents and their interactions that creates the emotional climate into which the infant is born and that determines the nature of the "internal" parental couple that they in turn will acquire. It is argued that the couple's relationship therefore needs to be the primary focus for our therapeutic interventions. Clinical material is presented to illustrate these points. [source] Men staying at home looking after their children: feminist linguistic reform and social changeINTERNATIONAL JOURNAL OF APPLIED LINGUISTICS, Issue 1 2006Jo Winter nicht-sexistische Sprache und Diskurse; Männlichkeit und Identität; Soziolinguistik und Ernennung; Englische Soziolinguistik; Berufsbezeichnungen The (mis)representation and stereotyping of gendered identities remain central concerns for applied linguistics and feminist linguistic reformers despite the history, since the 1970s, of promoting gender-fair or gender-inclusive language reform. To date, the primary focus has been the reform of linguistic discrimination against women. Here we examine the ,naming' of men who have entered the ,occupation', primary childcare provision , traditionally exclusively reserved for women. Drawing upon on-line survey and media data, we investigate the extent to which principles of feminist linguistic reform, equality, and inclusivity are evident in the labelling of, and media discourses about, these men. Regional variation in Englishes together with discourses of masculinity impact upon the implementation of linguistic reform. Normative meanings for masculinities and occupation construct a ,house father and working father' discourse context for men who are primary childcare providers. Die sprachliche Darstellung und Stereotypisierung der Geschlechter bleibt trotz der seit den siebziger Jahren eingeführten Maßnahmen zur Förderung nicht-sexistischen Sprachgebrauchs ein zentrales Anliegen der angewandten Sprachwissenschaft und der feministischen Sprachplanung/Politik. Bisher lag der Schwerpunkt auf der Reform der sprachlichen Diskriminierung gegen Frauen. In diesem Beitrag liegt der Akzent auf dem "Nennen" jener Männer, deren Hauptbeschäftigung die Betreuung der eigenen Kinder ist, eine Tätigkeit, die bis jetzt fast exklusiv mit Frauen verbunden war. Anhand einer on-line Datenerhebung und einer Analyse von Medientexten wird untersucht in wiefern die Prinzipien der feministischen Sprachreform , Gleichstellung und Inklusivität , in der Ernennung dieser Männer und deren Darstellung in Medientexten Anwendung finden. Festgestellt wird, daß das Ernennen solcher Männer regional gebunden ist und, daß der Einfluß der feministischen Sprachreform durch, dominante und normative' Diskurse der Männlichkeit gemäßigt wird. [source] Necessary conditions for the N -representability of pair distribution functionsINTERNATIONAL JOURNAL OF QUANTUM CHEMISTRY, Issue 7 2006Paul W. Ayers Abstract A necessary condition for the N -representability of the electron pair density proposed by one of the authors (E. R. D.) is generalized. This shows a link between this necessary condition and other, more widely known, N -representability conditions for the second-order density matrix. The extension to spin-resolved electron pair densities is considered, as is the extension to higher-order distribution functions. Although quantum mechanical systems are our primary focus, the results are also applicable to classical systems, where they reduce to an inequality originally derived by Garrod and Percus. As a simple application, bounds to the average angle between an electron pair are derived. It is shown that computational methods based on variational minimization of the energy with respect to the electron pair density can give extremely poor results unless robust N -representability constraints are considered. For reference, constraints for the N -representability of the pair density are summarized. © 2006 Wiley Periodicals, Inc. Int J Quantum Chem, 2006 [source] The evolution of black plumage from blue in Australian fairy-wrens (Maluridae): genetic and structural evidenceJOURNAL OF AVIAN BIOLOGY, Issue 5 2010Amy C. Driskell Genetic variation in the melanocortin-1 receptor (MC1R) locus is responsible for color variation, particularly melanism, in many groups of vertebrates. Fairy-wrens, Maluridae, are a family of Australian and New Guinean passerines with several instances of dramatic shifts in plumage coloration, both intra- and inter-specifically. A number of these color changes are from bright blue to black plumage. In this study, we examined sequence variation at the MC1R locus in most genera and species of fairy-wrens. Our primary focus was subspecies of the white-winged fairy-wren Malurus leucopterus in which two subspecies, each endemic to islands off the western Australian coast, are black while the mainland subspecies is blue. We found fourteen variable amino acid residues within M. leucopterus, but at only one position were alleles perfectly correlated with plumage color. Comparison with other fairy-wren species showed that the blue mainland subspecies, not the black island subspecies, had a unique genotype. Examination of MC1R protein sequence variation across our sample of fairy-wrens revealed no correlation between plumage color and sequence in this group. We thus conclude that amino acid changes in the MC1R locus are not directly responsible for the black plumage of the island subspecies of M. leucopterus. Our examination of the nanostructure of feathers from both black and blue subspecies of M. leucopterus and other black and blue fairy-wren species clarifies the evolution of black plumage in this family. Our data indicate that the black white-winged fairy-wrens evolved from blue ancestors because vestiges of the nanostructure required for the production of blue coloration exist within their black feathers. Based on our phylogeographic analysis of M. leucopterus, in which the two black subspecies do not appear to be each other's closest relatives, we infer that there have been two independent evolutionary transitions from blue to black plumage. A third potential transition from blue to black appears to have occurred in a sister clade. [source] CHARMM: The biomolecular simulation programJOURNAL OF COMPUTATIONAL CHEMISTRY, Issue 10 2009B. R. Brooks Abstract CHARMM (Chemistry at HARvard Molecular Mechanics) is a highly versatile and widely used molecular simulation program. It has been developed over the last three decades with a primary focus on molecules of biological interest, including proteins, peptides, lipids, nucleic acids, carbohydrates, and small molecule ligands, as they occur in solution, crystals, and membrane environments. For the study of such systems, the program provides a large suite of computational tools that include numerous conformational and path sampling methods, free energy estimators, molecular minimization, dynamics, and analysis techniques, and model-building capabilities. The CHARMM program is applicable to problems involving a much broader class of many-particle systems. Calculations with CHARMM can be performed using a number of different energy functions and models, from mixed quantum mechanical-molecular mechanical force fields, to all-atom classical potential energy functions with explicit solvent and various boundary conditions, to implicit solvent and membrane models. The program has been ported to numerous platforms in both serial and parallel architectures. This article provides an overview of the program as it exists today with an emphasis on developments since the publication of the original CHARMM article in 1983. © 2009 Wiley Periodicals, Inc.J Comput Chem, 2009. [source] Game theoretic approach to multiobjective designs: Focus on inherent safetyAICHE JOURNAL, Issue 1 2006Anjana Meel Abstract A method for designing processes that are inherently safer,with the primary focus on disturbances having the potential for unbounded hazardous responses,is introduced. In cases where safety is not threatened (as in isothermal fermentation reactors), but product quality can rapidly degrade, this method provides designs that ensure high product quality (as in pharmaceutical processes). Using game theory, the method accounts for the trade-offs in profitability, controllability, safety and/or product quality, and flexibility. For nonlinear processes that are hard to control; that is, have an unstable and/or nonminimum-phase steady state, over a wide range of operating conditions, extended bifurcation diagrams are introduced. When a steady state is nonminimum phase, the process may exhibit inverse response. The steady states of processes are classified on the basis of instability and nonminimum-phase behavior to segregate the operating regimes into distinct zones. Locally optimal designs, one corresponding to each zone, are obtained first. These are compared with other locally optimal designs at alternate operating conditions, and/or process reconfigurations, to obtain the globally optimal design using game theory. Four indices,profitability, controllability, safety and/or product quality, and flexibility,characterize the optimality of a design. A novel index for safe operation and/or product quality at a steady state is formulated as a function of the eigenvalues of the Jacobian of the process model and the Jacobian of the process zero dynamics, providing a quantitative measure of instability and nonminimum-phase behavior. The application of the proposed method to an isothermal, continuous stirred-tank reactor (CSTR) with van der Vusse reactions, an exothermic CSTR, and an anaerobic fermentor with substrate and product inhibition is presented. © 2005 American Institute of Chemical Engineers AIChE J, 2006 [source] Impact of Mental Health Training for Frontline Staff Working With Children With Severe Intellectual DisabilitiesJOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES, Issue 1 2008Teresa Whitehurst Abstract, The risk factors for young people with intellectual disabilities developing a mental health disorder are higher than those found in the general population, yet training is very rarely available to frontline staff. A recent study in the United Kingdom cited prevalence rates of mental ill health among adults with intellectual disabilities ranging from 35.2 to 40.9%, depending upon the sensitivity of the diagnostic tool used (Cooper et al., 2007). The ability to identify mental health problems is crucial to early intervention, but is particularly difficult when the symptoms of intellectual disability often mask emerging problems and confound differential diagnosis. The literature relating to mental health training focuses largely on changes in knowledge base and attitude, falling short of considering the primary focus of training,its impact upon practice and how this ultimately benefits people with intellectual disabilities. This study highlights the need for training, considers a training package provided to all frontline (direct care) staff in a residential school in the United Kingdom, catering to young people between the ages of 6 and 19 with severe intellectual disabilities, and investigates the impact of training upon practice and its influence upon the organization. [source] The determinants of corporate political strategy in Chinese transitionJOURNAL OF PUBLIC AFFAIRS, Issue 4 2007Zhilong Tian Corporate political strategy (CPS) formulation in Chinese transition is an area with little empirical work. We fill this gap validly and the primary focus of this study is to examine the firm- and industry-level factors influencing Chinese firms' political strategy choice. Empirical support is found for the taxonomy of corporate political strategies in Chinese transition,that is direct participation strategy, financial incentive strategy, prolocutor strategy, institution innovation strategy, government association strategy and government involvement strategy. The results indicate that there is no consistently significant firm- and industry-level predictor of all six political strategies and we explore what determinants are related to each specific decision independently. We also verify the random effects of industry-level variables and our hypotheses are tested through using general evaluation equations (GEEs). Our study aims to be helpful to point managers toward both industrial environments and internal resources to consider when making appropriate political strategy choices and thus improve Chinese firms' strategy management level. Some implications of findings are also discussed finally. Copyright © 2007 John Wiley & Sons, Ltd. [source] Strategic Alliance Success FactorsJOURNAL OF SUPPLY CHAIN MANAGEMENT, Issue 3 2000Judith M. Whipple SUMMARY There is recognition that competition is shifting from a "firm versus firm perspective" to a "supply chain versus supply chain perspective." In response to this shift, firms seeking competitive advantage are participating in cooperative supply chain arrangements, such as strategic alliances, which combine their individual strengths and unique resources. Buyer-supplier sourcing relationships are a primary focus of alliance improvement efforts. While interest in such arrangements remains strong, it is well accepted that creating, developing, and maintaining a successful alliance is a very daunting task. This research addresses several critical issues regarding that challenge. First, what factors contribute most to long-term alliance success? Second, what conditions define the presence of those success factors? Third, do buyers and suppliers in an alliance agree on those success factors and defining conditions? The research results demonstrate a remarkably consistent perspective among alliance partners regarding key success factors, despite the acknowledgment that the resultant success is based on a relatively even, but not equal, exchange of benefits and resources. Additionally, within an alliance's intended "win-win" foundation, suppliers must recognize their innate dependence on customers. Finally, significant opportunities for improvement exist with respect to alliance goal clarification, communication, and performance evaluation. [source] Policy on Acute Toxic Ingestion or Dermal or Inhalation ExposureJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 7 2003ANP-C FAANP, Mary Jo Goolsby EdD ABSTRACT Many nurse practitioners (NPs) practice in emergency and urgent-care settings, and fir more practical remote settings. NPs in each of these settings should be familiar with the assessment, stabilization, and treatment of patients who seek treatment for suspected intentional or accidental poisoning. This month's Clinical practice guideline (CPG) column reviews the "Clinical Policy for the Initial Approach to Patients Presenting With Acute Toxic Ingestion or Dermal or Inhalation Exposure." SUMMARY The ACEP "Clinical Policy for the Initial Approach to Patients Presenting With Acute Toxic Ingestion or Dermal or Inhalation Exposure" includes several helpful resources. In addition to recommending specific clinical actions in response to patient variables, the document includes a table identifying the antidote for many of the most commonly ingested drugs. These include digoxin, iron, opioids, salicylates, acetaminophen, and tricyclic antidepressants. The table also includes both the adult and pediatric dose of each listed antidote. A quick reference is included. This form can be used to guide the history, physical examination, and subsequent actions for treating patients with acute toxic ingestion or dermal or inhalation exposure. Finally, there is a quality assurance form to guide chart reviews. Many of the attributes of a well-developed guideline are identified in the report. The authors clearly identify the situations for which the recommendations are intended as well as those in which they do not apply. For instance, the guidance is not intended for use when patients are unstable and stabilization is the primary focus. It is also not intended for cases of radiation, parenteral, or eye exposure or of food poisoning. The authors describe the process used to develop the recommendations and identify the strength of the evidence on which each recommendation is based. The role of provider judgment in application of the guidance is addressed. Prior to its dissemination, the CPG was subjected to external review by dinical experts. This ACEP policy has applicability for the growing number of NPs working in emergency and urgent cafe settings as well as for those who must provide front line emergency care in remote settings. It provides a framework for responding to acute toxic exposures and provides several useful resources to assist the clinician in responding to situations in which accidental or intentional poisoning is suspected. [source] Introduction: Investigating Form-Focused InstructionLANGUAGE LEARNING, Issue 2001Rod Ellis The Introduction has three main aims. First, it provides a historical sketch of form-focused instruction research, documenting the origins of this branch of second language acquisition, the research questions that have been addressed, and current trends. Second, it seeks to define and conceptualize what is meant by "form-focused instruction" by distinguishing it from "meaning-focused instruction" and by describing three types of form-focused instruction in terms of whether the primary focus is on form or meaning and whether the instructional attention to target forms is intensive or extensive. Various instructional options relating to each type are also described. Third, the Introduction offers a discussion of the main research methods that have been used to investigate form-focused instruction in terms of a broad distinction between confirmatory and interpretative research. Methods of measuring "acquisition" in form-focused instruction research are also considered. [source] Training the ideal hospital doctor: the specialist registrars' perspectiveMEDICAL EDUCATION, Issue 10 2001N Khera Background When training for junior doctors is being planned, little discussion is focused on what outcomes hospitals are trying to achieve with regard to education/training, i.e. on what makes the ideal hospital doctor. Instead, the primary focus is on the requirements of the syllabi of the Royal Colleges (credentialing) and the requirements of service delivery (job description). Current literature has no qualitative studies of any longitude in which middle-grade doctors are asked about their vision of the ideal hospital doctor, what they feel can be done to help realize this vision, and how they feel about their own training. Methods This study examined data principally collected through a series of semistructured interviews conducted with eight specialist registrars (SpRs), four each from the North Trent and South Thames rotations over a period of 18 months. Additional information was taken from focus groups, interviews with programme directors, and questionnaires. Findings A model was created of the SpRs' perceptions of the key attributes of an ideal hospital doctor and of how these may be achieved in training. Eight broad areas were identified: clinical knowledge and skills; key clinically related generic/non-clinical skills; self-directed learning and medical education; implementing change management; applying strategic and organizational skills in career planning; consultation skills; research; and key personal attributes. Conclusions SpRs are articulate in expressing their own expectations of their training and have considerable insight into the components of good training. Further improvement could be made and will require significant commitment from both trainees and trainers. [source] Painful peripheral neuropathy and its nonsurgical treatmentMUSCLE AND NERVE, Issue 1 2004Gil I. Wolfe MD Abstract Treatment of neuropathic pain is the primary focus of management for many patients with painful peripheral neuropathy. Antidepressants and anticonvulsants are the two pharmacological classes most widely studied and represent first-line agents in the management of neuropathic pain. The number of pharmacological agents that have demonstrated effectiveness for neuropathic pain continues to expand. In the current review, we summarize data from randomized, controlled pharmacological trials in painful peripheral neuropathies. Although neuropathic pain management remains challenging because the response to therapy varies considerably between patients, and pain relief is rarely complete, a majority of patients can benefit from monotherapy using a well-chosen agent or polypharmacy that combines medications with different mechanisms of action. Muscle Nerve 30: 3,19, 2004 [source] Ports of Entry and Obstacles: Teenagers' Access to Volunteer ActivitiesNONPROFIT MANAGEMENT & LEADERSHIP, Issue 2 2000Richard A. Sundeen The recruitment of young people into volunteering activities is the primary focus of this article. We examine which teenagers volunteer, the ways that teenagers become involved in volunteer activities, and why teenagers do not volunteer. Teenagers who volunteer tend to have dominant status, that is, access to social power, high personal competency, and socialization into volunteer experiences through family, church, and school. Personal contact with family, friends, and teachers who are involved with service, prior participation in school- and church-based service, and personal initiative lead teenagers to learn about and engage in volunteering activities. Teenagers who do not volunteer often do not have sufficient time or interest. Differences exist among teenagers as to which factors prompt volunteering. For example, teenagers who are white, have parents who volunteer, and attend religious services are more likely than others to learn about volunteer activities through organizations, and teenagers with higher personal competency (grade point averages) are more likely than others to learn about volunteering activities at school. The article includes suggestions for recruitment policy and management of teenage volunteers. [source] Accommodation and resistance to the dominant cultural discourse on psychiatric mental health: oral history accounts of family membersNURSING INQUIRY, Issue 4 2007Geertje Boschma Oral history makes a critical contribution in articulating the perspectives of people often overlooked in histories written from the standpoint of dominating class, gender, ethnic or professional groups. Using three interrelated approaches , life stories, oral history, and narrative analysis , this paper analyzes family responses to psychiatric care and mental illness in oral history interviews with family members who experienced mental illness themselves or within their family between 1930 and 1975. Interviews with three family members in Alberta, Canada are the primary focus. These stories provide an important avenue to understand the meaning and transformations of mental health-care from the point of view of families. Family members' stories reveal contradictory responses to the dominant cultural discourse. Using a performative framework of interpretation, the narratives reveal a complex interplay between medical, social and cultural conceptions of mental illness, deepening our understanding of its meaning. The history of mental health-care can be substantially enriched by the analysis of family members' stories, not only revealing the constructed nature of mental illness, but also illustrating the family as a mediating context in which the meaning of mental illness is negotiated. [source] Interactions between habitat quality and connectivity affect immigration but not abundance or population growth of the butterfly, Parnassius smintheusOIKOS, Issue 10 2009Stephen F. Matter Habitat geometry has been a primary focus in studies of spatially structured systems. Recent studies have indicated that a more comprehensive approach including habitat quality may be needed, however most previous studies have neglected potential interactions between quality and geometry. We investigated the effects of habitat quality for the butterfly Parnassius smintheus among a series of 17 sub-populations. Specifically, we examined how habitat connectivity and local nectar flower density affect dispersal, and local population abundance and growth. We first determined which flower species were potentially important by examining nectar flower electivity and then quantified nectar flower density in meadows over a five year period (2003,2007). These data along with meadow connectivity were compared to local population statistics derived from mark,recapture over the same time period. The number of immigrants to a meadow increased as meadow connectivity increased, but showed no direct relationship with nectar flower density; however, there was a significant interaction between meadow connectivity and nectar flower density such that meadows with high connectivity and a high density of nectar flowers received the greatest number of immigrants. The number of emigrants from a meadow increased with increasing habitat quality and connectivity, but showed no interactive effect. The abundance of butterflies increased with meadow connectivity, but showed no relationship with habitat quality or any interactive effect. Separate experiments showed that access to nectar flowers significantly increased female reproductive output, but not lifespan. Despite the effects on immigration and reproductive output, local population growth rates also showed no relationship to nectar flower density. Our results indicate that habitat quality can be important for immigration in spatially structured populations; however, effects of habitat quality may not necessarily translate into higher abundance or population growth. Additionally, habitat quality should not be considered independently from habitat isolation, particularly if it directly affects dispersal. Preserving or augmenting habitat quality will do little to bolster immigration or colonization without adequate connectivity. [source] Mega thinking and planning: An introduction to defining and delivering individual and organizational successPERFORMANCE IMPROVEMENT QUARTERLY, Issue 2 2009Roger Kaufman All organizations are means to societal ends, and thus Mega thinking and planning starts with a primary focus on adding value for all stakeholders, including our shared society. It is pragmatic, realistic, practical, and ethical. Defining and achieving continual organizational success is possible. It relies on three basic elements: (1) a societal value-added "frame of mind" (your perspective and commitment about your organization, people, and our shared world), (2) shared determination and agreement on where to head and why (everyone who can or might be affected by the shared objectives must agree on purposes and results criteria), and (3) pragmatic and basic tools. The article presents the basic concepts for thinking and planning Mega to define and deliver value to internal and external partners, defining and delivering individual and organizational success. [source] Evolutionary adaptation to high altitude: A view from in utero,AMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 5 2009Colleen Glyde Julian A primary focus within biological anthropology has been to elucidate the processes of evolutionary adaptation. Frisancho helped to move anthropology towards more mechanistic explanations of human adaptation by drawing attention to the importance of the functional relevance of human variation. Using the natural laboratory of high altitude, he and others asked whether the unique physiology of indigenous high-altitude residents was the result of acclimatization, developmental plasticity, and/or genetic adaptation in response to the high-altitude environment. We approach the question of human adaptation to high altitude from a somewhat unique vantage point; namely, by examining physiological characteristics,pregnancy and pregnancy outcome,which are closely associated with reproductive fitness. Here we review the potent example of high-altitude native population's resistance to hypoxia-associated reductions in birth weight, which is often associated with higher infant morbidity and mortality at high altitude. With the exception of two recent publications, these comparative birth weight studies have utilized surnames, self-identification, and/or linguistic characteristics to assess ancestry, and none have linked ,advantageous' phenotypes to specific genetic variations. Recent advancements in genetic and statistical tools have enabled us to assess individual ancestry with higher resolution, identify the genetic basis of complex phenotypes and to infer the effect of natural selection on specific gene regions. Using these technologies our studies are now directed to determine the genetic variations that underlie the mechanisms by which high-altitude ancestry protects fetal growth and, in turn, to further our understanding of evolutionary processes involved in human adaptation to high altitude. Am. J. Hum. Biol., 2009. © 2009 Wiley-Liss, Inc. [source] Cattell,Horn,Carroll cognitive-achievement relations: What we have learned from the past 20 years of researchPSYCHOLOGY IN THE SCHOOLS, Issue 7 2010Kevin S. McGrew Contemporary Cattell,Horn,Carroll (CHC) theory of cognitive abilities has evolved over the past 20 years and serves as the theoretical foundation for a number of current cognitive ability assessments. CHC theory provides a means by which we can better understand the relationships between cognitive abilities and academic achievement, an important component of learning disabilities identification and instructional planning. A research synthesis of the extant CHC cognitive-achievement (COG-ACH) research literature is reported. Systematic and operationally defined research synthesis procedures were employed to address limitations present in the only prior attempted synthesis. Nineteen studies met the criteria for inclusion, which yielded 134 analyses. The 134 analyses were organized by three age groups (6,8, 9,13, and 14,19) and by four achievement domains (basic reading skills, reading comprehension, basic math skills, and math reasoning). The results reveal a much more nuanced set of CHC COG-ACH relations than was identified in the only prior review because of (a) breadth of cognitive abilities and measures (broad vs. narrow), (b) breadth of achievement domains (e.g., basic reading skills and reading comprehension vs. broad reading), and (c) developmental (age) status. The findings argue for selective, flexible, and referral-focused intelligence testing, particularly in the context of emerging Response to Intervention (RTI) assessment models. The results suggest that narrow CHC abilities should be the primary focus of instructionally relevant intelligence testing. Furthermore, the finding that more than 90% of the available research is based on the Woodcock,Johnson Battery argues for significant caution in generalizing the findings to other batteries. CHC-based COG-ACH research with other intelligence batteries is recommended. © 2010 Wiley Periodicals, Inc. [source] Children and traumatic events: Therapeutic techniques for psychologists working in the schoolsPSYCHOLOGY IN THE SCHOOLS, Issue 3 2009Steven G. Little It is clear that exposure to traumatic events is not uncommon in childhood and adolescence, and psychologists working in schools should have some training in meeting the needs of this segment of the population. One intervention that has been empirically supported in the trauma field is Trauma-Focused Cognitive Behavior Therapy (TF-CBT). This article seeks to provide an overview of research on the efficacy of TF-CBT with children and adolescents who have experienced trauma with a primary focus on psychologists working in the schools. © 2009 Wiley Periodicals, Inc. [source] The impact of childhood cancer on the family: a qualitative analysis of strains, resources, and coping behaviorsPSYCHO-ONCOLOGY, Issue 6 2004Joän M. Patterson Clinical research has led to tremendous improvements in treatment efficacy for most childhood cancers; overall 5-year survival is now greater than 75%. Long-term consequences of cure (i.e. adverse medical and psychosocial effects) have only recently begun to emerge as a primary focus of clinical research, including studies of health-related quality of life among survivors. Usually lacking in such efforts, however, is consideration of the impact of the cancer experience on the family, and the influence that the family's response to cancer has on quality of life in the child. From this qualitative analysis of seven focus groups with 45 parents of children a year or more out of cancer treatment, we report those aspects of a child's cancer diagnosis, treatment, and recovery that parents perceived as particularly difficult for their family, and the resources and coping behaviors parents perceived as helpful to their family in dealing with and managing the cancer experience. Using the Family Adjustment and Adaptation Response theoretical model to organize the data, the domains of strains and resources were delineated into themes and sub-themes related to the cancer, child, family, health-care system, and community. Within a third domain, coping, sub-themes were identified within the themes of appraisal-focused, problem-focused, and emotion-focused coping behaviors. Integration of this information should serve to improve future studies of health-related quality of life among children who survive cancer. Copyright © 2003 John Wiley & Sons, Ltd. [source] Feminist geography, the ,everyday', and local,global relations: hidden spaces of place-making,THE CANADIAN GEOGRAPHER/LE GEOGRAPHE CANADIEN, Issue 3 2005Isabel Dyck An interest in the taken-for-granted, mundane routine activities of women's lives has long been central to the production of knowledge in feminist geography. Here, I revisit the ,everyday' in relation to changing lines of inquiry as geographers work to capture the complexity of local,global relations in conceptualising an accelerated pace of the stretching of social relations over space. Through a primary focus on feminist work on care in the home, I explore the various ways in which the meanings and organisation of caregiving activity are intricately connected with the intertwining of globalisation, neoliberalism, social conservatism and a ,greying' population in the West. Foregrounding gender in my discussion, I review literature and draw on research examples to illustrate ways in which various types of ,hidden' caregiving contribute to contemporary place-making, and open up our understanding of the ,local'. Dans le domaine de la géographie féministe, la production de connaissances a longtemps été dépendante d'un intérêt particulier pour l'expérience vécue des femmes et de leurs activités routinières, mondaines et prises pour acquis. Je revisite le concept du ,quotidien, qui s'ouvre sur de nouvelles pistes de recherche pour les géographes qui tentent d'éclairer la complexité des rapports locaux-globaux à partir d'un cadre conceptuel du rythme accéléré de l'étendue des relations sociales dans l'espace. En portant une attention particulière aux travaux féministes sur les soins à domicile, j'explore de quelle façon les significations et l'organisation des activités entourant la prestation de soins sont subtilement liées aux notions entrelacées de la mondialisation, du néolibéralisme, du conservatisme social et du vieillissement de la population en Occident. Dans ma discussion, les questions relatives au sexe sont mises à l'avant-plan. Je procède à une recension de la littérature en reprenant quelques exemples de recherche pour illustrer comment les divers modes de prestation de soins ,cachés, peuvent créer le lieu contemporain et permettent de mieux comprendre le milieu local. [source] | |||||||||||||||||||||||||