Prescribing practices in German and Swiss psychiatric university and in non-university hospitals : national differences

RÉSUMÉ Il existe dans la pratique de prescription des médicaments de grandes variations entre les hôpitaux. Ces variations sont d'origines multifactorielles, comme par exemple des traditions de prescriptions locales, des considérations pharmato-économiques, la disponibilité d'un médicament, des différences de population, la prévalence d'une maladie, etc. Les études disponibles sur les pratiques de prescription sont souvent réduites à un centre unique, à une région ou à un pays. L'emploi de méthodes et de définitions particulières a jusqu'à pressent limité des comparaisons plus étendues entre les pays et régions. Le but de cette étude est de comparer la pratique de prescription de nouveaux médicaments psychotropes dans des cliniques suisses et allemandes. Cinq hôpitaux psychiatriques ont été sélectionnés, faisant tous partie du projet AMSP, et représentant des cliniques suisses, allemandes, de niveau universitaire ou non. Des données sur 572 patients et 1745 prescriptions ont été collectées durant un jour précis. Les comparaisons ont été ajustées pour l'âge et le sexe. Une différence significative (p <0.001) a été trouvée dans la prescription de nouveaux médicaments antidépresseurs, les cliniciens suisses en donnant en moyenne plus (65.2%) que les allemands (48.3%). Aucune différence significative n'a été démontrée dans la prescription des nouveaux médicaments antipsychotiques atypiques. Il semble en conséquence que les psychiatres suisses ont une propension plus élevée à prescrire des nouveaux médicaments antidépresseurs. Cela semble être dû à des différences de traditions de prescriptions nationales ou régionales. D'autres études sont nécessaires pour investiguer les influences économiques sur la pratique de prescription dans des cliniques suisses et allemandes. SUMMARY Obiective: There are great variations between hospitals in the way drugs are prescribed and these variations may be due to multiple factors such as local prescribing traditions, pharmacoeconomic considerations, drug availability; regional differences of population, disease prevalence etc. Available studies on prescribing habits have, besides studies performed in a unique centre, until now often been restricted to single countries or regions and the comparisons across countries or regions have often been limited by the use of diverse methodologies and definitions. The aim of the present study was to compare drug prescriptions between German and Swiss psychiatric services with regard to their preference of newer psychotropics. Material, method: Five psychiatric hospitals, associated to the AMSP-project, were chosen to represent Swiss and German clinics, university and non-university settings. Data were available from one index day on 572 patients and 1745 prescriptions. The comparisons were adjusted for age and gender. Results: There was a significant difference (p < 0.001) with regard to the prescription of newer antidepressants (NAD), Swiss clinicians giving proportionally more (65.2 %) than the German psychiatrists (48.3 %). No significant difference was, on the other hand, found as to the proportion of atypical antipsychotics, the lack of difference being due to the higher proportion of clozapine among the atypical antipsychotics in Germany. Conclusion: There seems therefore to be a higher propensity for Swiss hospital psychiatrists to prescribe newer antidepressants. This seems to be due to national or regional prescribing traditions. Further studies are needed to investigate the economical influences on antidepressant prescribing in Swiss and German clinics.)

Broadcast Yourself! Internet and playful media practices

In this paper we want to present a work- in-progress research about video self production on the Internet that is part of a broader research project which explores the ways current media practices convey a 'playful' relationship with digital technologies in popular culture.

Cropping Practices Baseline Data, 2002

Crooping practices produced by Iowa Departmment of Agriculture and Land Stewardship

Main results of the Monte Carlo studies carried out for nuclear medicine practices within the ORAMED project

The aim of ORAMED work package 4 was the optimization of the medical practices in nuclear medicine during the preparation of radiopharmaceuticals and their administration to the patient. During the project a wide campaign of measurements was performed in the nuclear medicine departments of the collaborating hospitals. Such data were intrinsically characterized by a large variability that depended on the procedure, the employed techniques and the operator's habits. That variability could easily hide some important parameter, for example, the effectiveness of the adopted shielding (for syringe and vial) or the effect of the distances from the source. This information is necessary for a valuable optimization purpose of radiation protection. To this end a sensitivity analysis was carried out through Monte Carlo simulations employing voxel models, representing operator's hand during the considered practices. Such analysis allowed understanding at what extent the range of personal dose equivalent evaluated during measurements can be considered intrinsically related to the procedures. Furthermore, with the Monte Carlo simulations it was possible to study the appropriateness of the shielding usually utilized in these practices.

Identification of the Best Practices for Design, Construction, and Repair of Bridge Approches, 2005

Bridge approach settlement and the formation of the bump is a common problem in Iowa that draws upon considerable resources for maintenance and creates a negative perception in the minds of transportation users. This research study was undertaken to investigate bridge approach problems and develop new concepts for design, construction, and maintenance that will reduce this costly problem. As a result of the research described in this report, the following changes are suggested for implementation on a pilot test basis: • Use porous backfill behind the abutment and/or geocomposite drainage systems to improve drainage capacity and reduce erosion around the abutment. • On a pilot basis, connect the approach slab to the bridge abutment. Change the expansion joint at the bridge to a construction joint of 2 inch. Use a more effective joint sealing system at the CF joint. Change the abutment wall rebar from #5 to #7 for non-integral abutments. • For bridges with soft foundation or embankment soils, implement practices of better compaction, preloading, ground improvement, soil removal and replacement, or soil reinforcement that reduce time-dependent post construction settlements.

Reusing IMS-LD formalized best practices in collaborative learning structuring

Designs of CSCL (Computer Supported Collaborative Learning)activities should be flexible, effective and customizable toparticular learning situations. On the other hand, structureddesigns aim to create favourable conditions for learning. Thus,this paper proposes the collection of representative and broadlyaccepted (best practices) structuring techniques in collaborative learning. With the aim of establishing a conceptual common ground among collaborative learning practitioners and softwaredevelopers, and reusing the expertise that best practicesrepresent, the paper also proposes the formulation of these techniques as patterns: the so-called CLFPs (CollaborativeLearning Flow Patterns). To formalize these patterns, we havechosen the educational modelling language IMS Learning Design (IMS-LD). IMS-LD has the capability to specify many of the collaborative characteristics of the CLFPs. Nevertheless, the language bears limited capability for describing the services that mediate interactions within a learning activity and the specification of temporal or rotated roles. This analysis isdiscussed in the paper, as well as our approaches towards thedevelopment of a system capable of integrating tools using IMSLDscripts and a CLFP-based Learning Design authoring tool.

Welcoming New Iowans: A Guide for Managers and Supervisors; The Best Practices of Iowa Employers with Immigrants and efugees in the Workplace, 2002

This guidebook has been published by the University of Northern Iowa New Iowans Program to assist employers, managers and supervisors with the unique challenges associated with hiring, training and integrating immigrant and refugee workers. Its purpose is to promote proactive engagement of newcomer workers to assure the vitality of Iowa businesses. Successful integration of immigrants and refugees in our workplaces and communities is essential to insure Iowa’s long-term economic and social health. This book provides essential information for human resource directors, trainers, supervisors and others as they meet the challenges and rewards of hiring immigrants and refugees. Of course, no guidebook can provide simple solutions to complex issues in a great variety if workplaces. This is not a “cookbook” with recipes that provide easy answers to challenges facing every company and worker. All employers are unique and approach problems differently. What works in one company might not work as well in another.

Doing Intersectionality: Repertoires of Feminist Practices in France and Canada

Intersectionality has been adopted as the preferred term to refer to and to analyze multiple axes of oppression in feminist theory. However, less research examines if this term, and the political analyses it carries, has been adopted by women's rights organizations in various contexts and to what effect. Drawing on interviews with activists working in a variety of women's rights organizations in France and Canada, I show that intersectionality is only one of the repertoires that a women's rights organization might use to analyze the social experience and the political interests of women situated at the intersection of several axes of domination. I propose a typology of four repertoires that activists use to reflect on intersectionality and inclusiveness. Drawing on a quantitative and qualitative analysis of the interview data, I show that hegemonic repertoires about racial or religious identity in one national context shape the way activists and organizations understand intersectionality and its challenges. The identity of organizations, as well as their main function (advocacy or providing service), also shape their understanding of intersectional issues.

Identification of the Best Practices for Design, Construction, and Repair of Bridge Approaches, January 2005

Bridge approach settlement and the formation of the bump is a common problem in Iowa that draws upon considerable resources for maintenance and creates a negative perception in the minds of transportation users. This research study was undertaken to investigate bridge approach problems and develop new concepts for design, construction, and maintenance that will reduce this costly problem. As a result of the research described in this report, the following changes are suggested for implementation on a pilot test basis: • Use porous backfill behind the abutment and/or geocomposite drainage systems to improve drainage capacity and reduce erosion around the abutment. • On a pilot basis, connect the approach slab to the bridge abutment. Change the expansion joint at the bridge to a construction joint of 2 inch. Use a more effective joint sealing system at the CF joint. Change the abutment wall rebar from #5 to #7 for non-integral abutments. • For bridges with soft foundation or embankment soils, implement practices of better compaction, preloading, ground improvement, soil removal and replacement, or soil reinforcement that reduce time-dependent post construction settlements.

Argumentation and education. Theoretical foundations and practices

During the last decade, argumentation has attracted growing attention as a means to elicit processes (linguistic, logical, dialogical, psychological, etc.) that can sustain or provoke reasoning and learning. Constituting an important dimension of daily life and of professional activities, argumentation plays a special role in democracies and is at the heart of philosophical reasoning and scientific inquiry. Argumentation, as such, requires specific intellectual and social skills. Hence, argumentation will have an increasing importance in education, both because it is a critical competence that has to be learned, and because argumentation can be used to foster learning in philosophy, history, sciences and in many other domains. Argumentation and Education answers these and other questions by providing both theoretical backgrounds, in psychology, education and theory of argumentation, and concrete examples of experiments and results in school contexts in a range of domains. It reports on existing innovative practices in education settings at various levels.

IOWA Principles and Practices for Charitable Nonprofit Excellence, 2006

Task Force members formulated these principles and practices as a way to promote good management practices, ethical conduct, and public accountability. By compiling the information in this guide, we hope to provide a valuable tool for organizations and individuals as they go about the work of building better Iowa communities.

Field Experiments of Current Concrete Pavement Surface Characteristics Practices: Iowa Data Collection and Analysis, December 2005

One of the most important issues in portland cement concrete pavement research today is surface characteristics. The issue is one of balancing surface texture construction with the need for durability, skid resistance, and noise reduction. The National Concrete Pavement Technology Center at Iowa State University, in conjunction with the Federal Highway Administration, American Concrete Pavement Association, International Grinding and Grooving Association, Iowa Highway Research Board, and other states, have entered into a three-part National Surface Characteristics Program to resolve the balancing problem. As a portion of Part 2, this report documents the construction of 18 separate pavement surfaces for use in the first level of testing for the national project. It identifies the testing to be done and the limitations observed in the construction process. The results of the actual tests will be included in the subsequent national study reports.

Problematizing the multidisciplinary residency in oncology: a practical teaching protocol from the perspective of nurse residents

Objective: To investigate practical teaching of nurse residents in a multidisciplinary residency in oncology. Method: A qualitative descriptive study grounded in the problematization methodology and its steps, represented by the Maguerez Arch. Data were analyzed using content analysis. Results: Potentiating and limiting elements of the residency guided the design of a practical teaching protocol from the perspective of residents, structured in three stages: Welcoming and ambience; Nursing care for problem situations; and, Evaluation process. Conclusion: Systematization of practical teaching promoted the autonomy of individuals and the approximation of teaching to reality, making residency less strenuous, stressful and distressing.