How can continuing professional development better promote shared decision-making? Perspectives from an international collaboration.

ABSTRACT: BACKGROUND: Shared decision-making is not widely implemented in healthcare. We aimed to set a research agenda about promoting shared decision-making through continuing professional development. METHODS: Thirty-six participants met for two days. RESULTS: Participants suggested ways to improve an environmental scan that had inventoried 53 shared decision-making training programs from 14 countries. Their proposed research agenda included reaching an international consensus on shared decision-making competencies and creating a framework for accrediting continuing professional development initiatives in shared decision-making. CONCLUSIONS: Variability in shared decision-making training programs showcases the need for quality assurance frameworks.

Gap Tuition Program, FY2014,

The Gap Tuition program was established to provide funding to community colleges for need-based tuition assistance to applicants for completion of continuing education certificate training programs for in-demand occupations.

The double-edged sword of social capital: Three essays on entrepreneurship in developing nations

ABSTRACT My study seeks to answer the main question: "how does entrepreneurs' social capital positively and negatively affect their resource mobilization efforts, and exploitation of entrepreneurial opportunity?" To answer this question, I develop a model for examining positive and negative effects of social capital on resource accumulation by entrepreneurs, and the subsequent effect of resource accumulation on the exploitation of entrepreneurial opportunity, and utilize data from Africa to ëmpirically test the relationships in this model. Developing nations are a suitable context because: a) They require entrepreneurship for economic development, b) They have received less attention in management and entrepreneurship research, c) Because of inadequately-developed institutions, entrepreneurs from developing nations face major resource mobilization challenges hence they often turn to their social ties for resources, and d) The communalistic and collectivistic nature of most developing nations -encouraging support and sharing of resources- may help us better understand how society's values and structures may contribute and also deduct firm resources. My study reveals that social capital contributes resources to entrepreneurs in developing nations at a cost that takes away resources, and that more resources but lower costs facilitate entrepreneurial opportunity exploitation. For entrepreneurs in developing nations, large networks, greater shared identity, and more trust are beneficial. To increase chances of raising more resources, entrepreneurs from communalistic societies should include network members from outside their communities. Besides providing financial support, policy-makers should develop training programs and advisory services on configuration of entrepreneurs' networks so as to achieve more resources at a low cost. My study insights can help improve entrepreneurs' resource accumulation efforts and the subsequent growth of their firms, leading to the overall economic growth of developing nations.

Alteration of neuromuscular function in squash

The alteration in neuromuscular function of knee extensor muscles was characterised after a squash match in 10 trained players. Maximal voluntary contraction (MVC) and surface EMG activity of vastus lateralis (VL) and vastus medialis (VM) muscles were measured before and immediately after a 1-h squash match. M-wave and twitch contractile properties were analysed following single stimuli. MVC declined (280.5+/-46.8 vs. 233.6+/-35.4 Nm, -16%; P<0.001) after the exercise and this was accompanied by an impairment of central activation, as attested by decline in voluntary activation (76.7+/-10.4 vs. 71.3+/-9.6%, -7%; P<0.05) and raw EMG activity of the two vastii (-17%; P<0.05), whereas RMS/M decrease was lesser (VL: -5%; NS and VM: -12%; P=0.10). In the fatigued state, no significant changes in M-wave amplitude (VL: -9%; VM: -5%) or duration were observed. Following exercise, the single twitch was characterised by lower peak torque (-20%; P<0.001) as well as shorter half-relaxation time (-13%; P<0.001) and reduced maximal rate of twitch tension development (-23%; P<0.001) and relaxation (-17%; P<0.05). A 1-h squash match play caused peripheral fatigue by impairing excitation-contraction coupling, whereas sarcolemmal excitability seems well preserved. Our results also emphasise the role of central activation failure as a possible mechanism contributing to the torque loss observed in knee extensors. Physical conditioners should consider these effects when defining their training programs for squash players.

Current Issues in the Diagnosis and Classification of Peripheral T-Cell Lymphomas

Mature T-cell and T/NK-cell neoplasms are both uncommon and heterogeneous, among the broad category of non-Hodgkin's lymphomas. Due to the lack of specific genetic alterations in the vast majority of cases, most currently defined entities show overlapping morphologic and immunophenotypic features and therefore pose a challenge to the diagnostic pathologist. The goal of the symposium is to address current criteria for the recognition of specific subtypes of T-cell lymphoma, and to highlight new data regarding emerging immunophenotypic or molecular markers. This activity has been designed to meet the needs of practicing pathologists, and residents and fellows enrolled in training programs in anatomic and clinical pathology. It should be a particular benefit to those with an interest in hematopathology. Upon completion of this activity, participants should be better able to: -To be able to state the basis for the classification of mature T-cell malignancies involving nodal and extranodal sites. -To recognize and accurately diagnose the various subtypes of nodal and extranodal peripheral T-cell lymphomas. -To utilize immunohistochemical and molecular tests to characterize atypical T-cell proliferations. -To recognize and accurately diagnose T-cell lymphoproliferative lesions involving the skin and gastrointestinal tract, and be able to provide guidance regarding their clinical aggressiveness and management -To be able to utilize flow cytometric data to identify diverse functional T-cell subsets.

NURBS toolbox for Matlab

NURBS are widely used parametric approximation curves or surfaces. NURBS can be applied to the many applications. Examples of these applications are some computeraided design applications and some medical applications. Use of NURBS is very intuitive. The objective of this work was to implement the NURBS toolbox in the Matlab environment. Matlab is a program for many kinds of computational purposes. Matlab is also a programming language. NURBS toolbox implemented in this work offers a user an opportunity to use functions of this toolbox as parts of the user’s own programs. Current version of NURBS toolbox includes functions for NURBS curve and surface evaluation. The toolbox is designed such, that it allows extensions and enhancements in the future.

Química Sem Fronteiras: o desafio da energia

Coal, natural gas and petroleum-based liquid fuels are still the most widely used energy sources in modern society. The current scenario contrasts with the foreseen shortage of petroleum that was spread out in the beginning of the XXI century, when the concept of "energy security" emerged as an urgent agenda to ensure a good balance between energy supply and demand. Much beyond protecting refineries and oil ducts from terrorist attacks, these issues soon developed to a portfolio of measures related to process sustainability, involving at least three fundamental dimensions: (a) the need for technological breakthroughs to improve energy production worldwide; (b) the improvement of energy efficiency in all sectors of modern society; and (c) the increase of the social perception that education is a key-word towards a better use of our energy resources. Together with these technological, economic or social issues, "energy security" is also strongly influenced by environmental issues involving greenhouse gas emissions, loss of biodiversity in environmentally sensitive areas, pollution and poor solid waste management. For these and other reasons, the implementation of more sustainable practices in our currently available industrial facilities and the search for alternative energy sources that could partly replace the fossil fuels became a major priority throughout the world. Regarding fossil fuels, the main technological bottlenecks are related to the exploitation of less accessible petroleum resources such as those in the pre-salt layer, ranging from the proper characterization of these deep-water oil reservoirs, the development of lighter and more efficient equipment for both exploration and exploitation, the optimization of the drilling techniques, the achievement of further improvements in production yields and the establishment of specialized training programs for the technical staff. The production of natural gas from shale is also emerging in several countries but its production in large scale has several problems ranging from the unavoidable environmental impact of shale mining as well as to the bad consequences of its large scale exploitation in the past. The large scale use of coal has similar environmental problems, which are aggravated by difficulties in its proper characterization. Also, the mitigation of harmful gases and particulate matter that are released as a result of combustion is still depending on the development of new gas cleaning technologies including more efficient catalysts to improve its emission profile. On the other hand, biofuels are still struggling to fulfill their role in reducing our high dependence on fossil fuels. Fatty acid alkyl esters (biodiesel) from vegetable oils and ethanol from cane sucrose and corn starch are mature technologies whose market share is partially limited by the availability of their raw materials. For this reason, there has been a great effort to develop "second-generation" technologies to produce methanol, ethanol, butanol, biodiesel, biogas (methane), bio-oils, syngas and synthetic fuels from lower grade renewable feedstocks such as lignocellulosic materials whose consumption would not interfere with the rather sensitive issues of food security. Advanced fermentation processes are envisaged as "third generation" technologies and these are primarily linked to the use of algae feedstocks as well as other organisms that could produce biofuels or simply provide microbial biomass for the processes listed above. Due to the complexity and cost of their production chain, "third generation" technologies usually aim at high value added biofuels such as biojet fuel, biohydrogen and hydrocarbons with a fuel performance similar to diesel or gasoline, situations in which the use of genetically modified organisms is usually required. In general, the main challenges in this field could be summarized as follows: (a) the need for prospecting alternative sources of biomass that are not linked to the food chain; (b) the intensive use of green chemistry principles in our current industrial activities; (c) the development of mature technologies for the production of second and third generation biofuels; (d) the development of safe bioprocesses that are based on environmentally benign microorganisms; (e) the scale-up of potential technologies to a suitable demonstration scale; and (f) the full understanding of the technological and environmental implications of the food vs. fuel debate. On the basis of these, the main objective of this article is to stimulate the discussion and help the decision making regarding "energy security" issues and their challenges for modern society, in such a way to encourage the participation of the Brazilian Chemistry community in the design of a road map for a safer, sustainable and prosper future for our nation.

Osaamisen hallinta suurissa muutosprojekteissa

Ydinvoimatoiminta on muuta teollisuustoimintaa huomattavasti säädellympi alue, missä organisaatioiden riittävä osaaminen on ydinturvallisuuden kannalta tärkeää. Tästä syystä osaamisen riittävyyden takaamiseksi panostetaan tinkimättömästi. Etenkin prosessi- ja turvajärjestelmiin tehtävät muutos- modernisointityöt luovat haasteita organisaatioiden nykyosaamiselle, koska muutosten hallinta edellyttää organisaatioilta jatkuvaa oppimista ja osaamisen kehittämistä. Fortum Power & Heat Oy:n omistamalla ydinvoimalaitoksella käynnistettiin vuoden 2005 alussa laaja automaatiouusintaan tähtäävä projekti. Järjestelmien kokonaistoimittajaksi oli valittu ranskalais-saksalainen Areva NP GmbH – Siemens AG – konsortio. Konsortion kokonaistoimitukseen kuuluu automaatiojärjestelmien uusimisen lisäksi myösydinvoimalaitoksen henkilöstön kouluttaminen. Loviisa ydinvoimalaitoksen käyttöluvan haltijana Fortum Power & Heat Oy on kokonaisvastuullinen ydinvoimalaitoksen toiminnasta. Täten myös henkilöstön riittävä osaaminen ja pätevyys ovat Fortumin vastuulla. Toimittajan järjestämien koulutustilaisuuksien avulla hankittu uusi osaaminen on havaittu riittämättömäksi. Tämän on koettu johtuvan osittain teoriaan painottuvasta koulutusmateriaalista ja myös siitä, että käytännön tarjoamiin koulutustilaisuuksiin kuten esimerkiksi osallistuminen suunnittelutyöhön ei ole hakeuduttu. Lisäksi koulutus kaipaa kokonaisuudessaan kehittämistä. Tästä johtuen ydinvoimalaitosten muutostöihin liittyvän henkilöstön osaamisen ja pätevyyden selvittämiseksi käynnistettiin tämä tutkimus. Tutkimuksessa on tunnistettu useita sellaisia kehityskohteita, joita tehostamalla on mahdollista kehittää automaatioylläpitoryhmän osaamista. Lisäksi on esitetty menettelytapoja ja käytäntöjä, joilla ylläpidon koulutusta on mahdollista tehostaa. Tutkimuksen tuotokset toimivat suuntaviivoina organisaation kehittämisen toteutukselle.

Sähköisen itseopiskelutyökalun käyttö toiminnanohjausjärjestelmän loppukäyttäjien kouluttamisen tukena

Tutkimuksessa on tutkittu sähköisen itseopiskelutyökalun käyttöä toiminnanohjausjärjestelmän loppukäyttäjien kouluttamisen tukena. Tutkimuksen tavoitteina oli selvittää onko intra- tai internetin yli käytettävän sähköisen itseopiskeluympäristön käyttö organisaatiolle hyödyllistä ja kuinka nykyistä, sähköistä itseopiskelua hyödyntävää koulutusratkaisua voitaisiin kehittää edelleen. Tutkimus on toteutettu Liikennevirastossa syksyn 2010 ja kevään 2011 aikana. Tutkimus oli luonteeltaan laadullinen ja sen aineisto kerättiin haastatteluin, kirjallisena palautteena ja perehtymällä aiheeseen liittyviin tieteellisiin julkaisuihin. Tutkimuksen tuloksena todettiin luokkahuonekoulutuksen rinnalla käytetyn sähköisen itseopiskeluympäristön tukevan toiminnanohjausjärjestelmän järjestelmätoimintojen teknistä kouluttamista loppukäyttäjille, mutta käytettävien toimintatapojen ja kokonaiskuvan kouluttamiseen tarvitaan myös muuta tukimateriaalia. Kehitysehdotuksena nykyiseen ratkaisuun suositeltiin yksittäisiä järjestelmätoimintoja kouluttavien harjoitusten selkeämpään sijoittamiseen osaksi toiminnanohjauksen kokonaiskuvaa ja -prosessia. Näin loppukäyttäjät voisivat paremmin ymmärtää suorittamiensa toimintojen ja itsensä sijoittumisen osaksi toiminnanohjauksen liiketoimintaprosesseja.

Construction and validation of a surgical skills assessment tool for general surgery residency program

Objective: To develop and validate an instrument for measuring the acquisition of technical skills in conducting operations of increasing difficulty for use in General Surgery Residency (GSR) programs. Methods: we built a surgical skills assessment tool containing 11 operations in increasing levels of difficulty. For instrument validation we used the face validaity method. Through an electronic survey tool (Survey MonKey(r)) we sent a questionnaire to Full and Emeritus members of the Brazilian College of Surgeons - CBC - all bearers of the CBC Specialist Title. Results: Of the 307 questionnaires sent we received 100 responses. For the analysis of the data collected we used the Cronbach's alpha test. We observed that, in general, the overall alpha presented with values near or greater than 0.70, meaning good consistency to assess their points of interest. Conclusion: The evaluation instrument built was validated and can be used as a method of assessment of technical skill acquisition in the General Surgery Residency programs in Brazil.

Creating generation Y sources of motivation for enhanced performance

New challenges have been created in the modern work environment as the diversity of the workforce is greater than ever in terms of generations. There will become a large demand of generation Y employees as the baby boomer generation employees retire at an accelerated rate. The purpose of this study is to investigate Y generation specific characteristics and to identify motivational systems to enhance performance. The research questions are: 1. What are Y generation characteristics? 2. What motivational systems organizations can form to motivate Y generation employees and in turn, create better performance? The Y generation specific characteristics identified from the literature include; achievement oriented; confident; educated; multitasking; having a need for feedback; needing management support; sociable and tech savvy. The proposed motivational systems can be found in four areas of the organization; HRM, training and development, communication and decision making policies. Three focus groups were held to investigate what would motivate generation Y employees to achieve better performance. Two of these focus groups were Finnish natives and the third consisted of international students. The HRM systems included flexibility and a culture of fun. It was concluded that flexibility within the workplace and role was a great source of motivation. Culture of fun was not responded to as favorably although most focus group participants rated enjoyableness as one of their top motivating factors. Training and development systems include training programs and mentoring as sources of potential motivation. Training programs were viewed as a mode to gain a better position and were not necessarily seen as motivational systems. Mentoring programs were not concluded to have a significant effect on motivation. Communication systems included keeping up with technology, clarity and goals as well as feedback. Keeping up with technology was seen as an ineffective tool to motivate. Clarity and goal setting was seen as very important to be able to perform but not necessarily motivating. Feedback had a highly motivating effect on these focus groups. Decision making policies included collaboration and teamwork as well as ownership. Teams were familiar and meet the social needs of Y generation employees and are motivating. Ownership was equated with trust and responsibility and was highly valued as well as motivating to these focus group participants.

Self-directedness, personality type and success in self- employment

The new economy has spirited a transformation ofwork organizations from big business structures into smaller, more flexible enterprises, many of which are launched as self-employment initiatives. The growing trend towards increasing selfemployment in Canada demands aeritical review of how educational programs support and encourage entrepreneurship and self-employment opportunities for students ofpost-secondary and adult training programs. The focus ofthis study was threefold. First, the study examined whether a relationship exists between self-directedness and success in self-employment. Secondly, the purpose of this research was to determine whether a relationship exists between psychological type as defined by Jung and success in selfemployment. Finally, this research effort attempted to develop a model for identifying individual potential for self-employment based on combined factors of self-directedness and psychological type. Success was measured in three stages: 1) Did the subject start a selfemployment initiative? 2) Did the business survive six months? 3) Did the business survive one year? The research went beyond classroom training activities to determine whether individuals actually started a business enterprise while participating ina self-employment program designed for individuals who were unemployed. Given that many people initiate a self-employment venture.without actually operating the business beyond the initial start-up, this research effort measured success based on a commitment of at least one year to the selfemployment initiative. Results ofthe study revealed that individuals with a high level of selfdirected learning readiness tended to be more likely to succeed in business in terms ofbusiness starts, survival for six months, and survival for one year. In addition, it was discovered that individuals who were extraverted intuitive types succeeded more often in business at all three levels than any other type. These findings supported a model using the SDLRS and the PET Type Check as predictors for success in entrepreneurial ventures.

L’influence du développement durable à travers la formation universitaire en design industriel

Aujourd’hui, nous savons qu’environ 75 à 80% des impacts environnementaux des produits sont déterminés lors de la conception. Le rôle du designer industriel est donc crucial pour arriver à une forme de développement plus viable. Cette recherche tente de cibler les champs de connaissances qui devraient faire partie de la formation des professionnels du développement de produits pour y intégrer les aspects environnementaux. Après une recension de la littérature en design industriel, en pédagogie et en environnement, l’étude de terrain a été conduite en deux temps. Selon des critères prédéfinis, des programmes universitaires « spécialisés » en environnement/développement durable, au Québec, ainsi que des formations en éco-conception, offerts en France, ont été analysés. L’étude de terrain a été complétée par un entretien en profondeur semi-dirigé avec un consultant, qui aide des entreprises québécoises à intégrer l’environnement en développement de produits. L’analyse des informations recueillies met en évidence la nécessité de transformer rapidement les formations universitaires en conception de produits. Le nouveau cursus de design industriel devrait; 1. Intégrer les connaissances relatives aux impacts environnementaux; 2. Encourager le travail en équipes multidisciplinaires pour enrichir la collecte d’informations relative aux projets de développement; 3. Établir une collaboration étroite entre les établissements d’enseignement et les industries, ce qui est essentiel à la compréhension des enjeux de développement de produits et services (culture de l’entreprise, coût, délais, logistique, réglementation, etc.).

Le financement public de l’enseignement supérieur et ses impacts au Pérou : une analyse longitudinale (1993 – 2003)

Cette recherche porte sur le financement public de l’enseignement supérieur au Pérou et ses impacts dans une perspective longitudinale couvant la période 1993-2003. Cette période est importante parce qu’elle a été témoin, dans ce pays, de changements majeurs aux plans du financement public et de la configuration du système d’enseignement supérieur. La recherche consiste principalement dans des analyses secondaires de données pertinentes publiées par des organismes nationaux et internationaux. Les analyses sont structurées à partir d’un schéma d’inputs et outputs. On considère comme inputs les ressources financières et les ressources humaines, lesquelles comprennent les professeurs et les étudiants, et comme outputs les taux de diplomation (efficacité interne) et la demande de diplômés par le marché du travail (efficacité externe). La théorie de la dépendance de ressources sert de cadre pour interpréter les rapports entre le financement public et ses incidences sur les réponses institutionnels et ses conséquences. Dans la période retenue, le financement du secteur public a décru de 32% en raison d’un désengagement progressif de l’État. Une conséquence majeure de la diminution du financement public a été la croissance rapide du secteur privé de l’enseignement supérieur. En effet, alors qu’en 1993 il y avait 24 institutions privées d’enseignement supérieur, il y en avait, en 2003, 46 institutions. La baisse du financement public et la croissance du secteur privé d’enseignement supérieur ont eu des incidences sur la sélectivité des étudiants, sur le statut des professeurs, sur l’implication des universités en recherche et sur les taux de diplomation. Le taux de sélectivité dans le secteur public a augmenté entre 1993 et 2003, alors que ce taux a diminué, dans la même période, dans le secteur privé. Ainsi, le secteur public répond à la diminution du financement en restreignant l’accès à l’enseignement supérieur. Le secteur privé, par contre, diminue sa sélectivité compensant ainsi l’augmentation de la sélectivité dans le secteur public et, par le fait même, augmente sa part de marché. Également, tant dans le secteur public que dans le secteur privé, les professeurs sont engagés principalement sur une base temporaire, ce qui se traduit, particulièrement dans le secteur privé, dans un moindre engagement institutionnel. Enfin, les universités publiques et privées du Pérou font peu de recherche, car elles favorisent, pour balancer leurs budgets, la consultation et les contrats au détriment de la recherche fondamentale. Paradoxalement, alors que, dans le secteur privé, les taux de sélectivité des étudiants diminuent, leurs taux de diplomation augmentent plus que dans le secteur public. Enfin, les formations avec plus d’étudiants inscrits, tant dans le secteur public que privé, sont les moins coûteuses en infrastructure et équipements. Dès lors, la pertinence de la production universitaire devient problématique. Cette recherche révèle que les organisations universitaires, face à un environnement où les ressources financières deviennent de plus en plus rares, développent des stratégies de survie qui peuvent avoir des incidences sur la qualité et la pertinence de l’enseignement supérieur.

Développement de l'identité professionnelle d'enseignantes débutantes en contexte de relation mentorale

Entre 15% et 20% des enseignants du Québec abandonnent la profession avant d’atteindre cinq années d’expérience (Martel et Ouellette, 2003). Les difficultés rencontrées peuvent perturber leur insertion et freiner le développement de leur identité professionnelle (Baillauquès et Breuse, 1993). Pour les soutenir, des commissions scolaires offrent des mesures parmi lesquelles le mentorat est privilégié. La recherche visait à mieux comprendre le mentorat en enseignement pour en identifier des caractéristiques favorables au développement de l’identité professionnelle des enseignants débutants. Les deux concepts sont mis en relation, s’appuyant sur les travaux de Houde (1995) et de Gohier, Anadón, Bouchard, Charbonneau et Chevrier (2001). Les aspects retenus pour l’analyse sont : les caractéristiques de la relation mentorale, les fonctions du mentor et le développement des sentiments de compétence, de reconnaissance et d’appartenance à la profession. Cinq entrevues semi-dirigées ont été menées auprès d’enseignantes débutantes du primaire de la région de Montréal ayant vécu une relation mentorale d’un an. Les données ont été traitées qualitativement. Les résultats montrent que, selon les participantes, le mentorat peut favoriser le développement du sentiment de compétence. Toutefois, les sentiments de reconnaissance et d’appartenance sont attribuables à l’expérience et la sociabilité. Un portrait du mentor et des conditions de réussite de la relation mentorale sont aussi présentés. Le fait que seules des mentorées du primaire aient été interrogées constitue une limite. La généralisation est impossible, mais les résultats peuvent servir à d’autres études sur l’identité professionnelle ainsi qu’au développement de programmes d’insertion professionnelle et à la formation de mentors.