Using 'Generic Abilities' to Foster Professionalism in a Post-Professional Program

Introduction To be successful in a profession, persons must have mastery of professional affective behaviors in addition to that profession’s core knowledge base. Health care delivery is more than just developing a good plan of care. The effective health care provider also will have good interpersonal and communication skills, have a commitment to learning, act professionally and responsibly, and have abilities in problem solving and critical thinking. But, these behaviors and characteristics are not taught directly in a professional program. This presentation will demonstrate how these ‘generic abilities’ have been incorporated in a post-professional program and how they can be used in other professional health care, professional development, and leadership programs. [See PDF for complete abstract]

Physician perceptions of risk regarding mood disorders and pharmacological management during pregnancy: What is current practice?

Mood disorders are the most common form of mental illness and one of the leading causes of morbidity worldwide. Major depressive disorder and bipolar disorder have a lifetime prevalence of 16.2% and 4.4%, respectively. Women comprise a substantial proportion of this population, and an estimated 500,000 pregnancies each year involve women with a psychiatric condition. Management with psychotropic medications is considered standard of care for most patients with mood disorders. However, many of these medications are known human teratogens. Because pregnant women with mood disorders face a high risk of relapse if unmanaged, the obstetrician faces a unique challenge in providing the best care to both mother and baby. It has been suggested that many obstetricians overestimate the teratogenic risks associated with psychotropic medications, while concurrently underestimating the risks associated with unmanaged mood disorders. This may be due a knowledge gap regarding the most current teratogen information, and lack of official management guidelines. Therefore, the purpose of this study is to determine the current knowledge base of obstetricians regarding the teratogenic effects of common psychotropic medications, as wells as to capture current management practices for pregnant women with mood disorders. A total of 117 Texas obstetricians responded to a survey regarding teratogen knowledge and management practice. It was common for respondents to encounter women who disclose both having a mood disorder and taking a psychotropic medication during pregnancy. Many respondents did not utilize up-to-date drug counseling resources, and were unaware of or over-estimated the teratogenic risks of common medications used to treat mood disorders. Finally, many respondents reported wanting to refer pregnant patients with mood disorders to psychiatrists for co-management, but are reportedly restricted in doing so due to accessibility or insurance issues. This study demonstrates that there is a knowledge gap among obstetricians regarding the teratogenicity of common psychotropic medications utilized to manage a patient population they frequently encounter. Further, obstetricians have vastly different risk perceptions of these medications, resulting in various management approaches and recommendations. Future research should focus on establishing standard practice guidelines, as well as better accessibility to psychiatric services for pregnant women.

A Research Roadmap for Complementary and Alternative Medicine – What We Need to Know by 2020

Background: The CAMbrella coordination action was funded within the Framework Programme 7. Its aim is to provide a research roadmap for clinical and epidemiological research for complementary and alternative medicine (CAM) that is appropriate for the health needs of European citizens and acceptable to their national research institutes and healthcare providers in both public and private sectors. One major issue in the European research agenda is the demographic change and its impact on health care. Our vision for 2020 is that there is an evidence base that enables European citizens to make informed decisions about CAM, both positive and negative. This roadmap proposes a strategic research agenda for the field of CAM designed to address future European health care challenges. This roadmap is based on the results of CAMbrella’s several work packages, literature reviews and expert discussions including a consensus meeting. Methods: We first conducted a systematic literature review on key issues in clinical and epidemiological research in CAM to identify the general concepts, methods and the strengths and weaknesses of current CAM research. These findings were discussed in a workshop (Castellaro, Italy, September 7–9th 2011) with international CAM experts and strategic and methodological recommendations were defined in order to improve the rigor and relevance of CAM research. These recommendations provide the basis for the research roadmap, which was subsequently discussed in a consensus conference (Järna, Sweden, May 9–11th 2012) with all CAMbrella members and the CAMbrella advisory board. The roadmap was revised after this discussion in CAMbrella Work Package (WP) 7 and finally approved by CAMbrella’s scientific steering committee on September 26th 2012. Results: Our main findings show that CAM is very heterogenous in terms of definitions and legal regulations between the European countries. In addition, citizens’ needs and attitudes towards CAM as well as the use and provision of CAM differ significantly between countries. In terms of research methodology, there was consensus that CAM researchers should make use of all the commonly accepted scientific research methods and employ those with utmost diligence combined in a mixed methods framework. Conclusions: We propose 6 core areas of research that should be investigated to achieve a robust knowledge base and to allow stakeholders to make informed decisions. These are: Research into the prevalence of CAM in Europe: Reviews show that we do not know enough about the circumstances in which CAM is used by Europeans. To enable a common European strategic approach, a clear picture of current use is of the utmost importance. Research into differences regarding citizens’ attitudes and needs towards CAM: Citizens are the driver for CAM utilization. Their needs and views on CAM are a key priority, and their interests must be investigated and addressed in future CAM research. Research into safety of CAM: Safety is a key issue for European citizens. CAM is considered safe, but reliable data is scarce although urgently needed in order to assess the risk and cost-benefit ratio of CAM. Research into the comparative effectiveness of CAM: Everybody needs to know in what situation CAM is a reasonable choice. Therefore, we recommend a clear emphasis on concurrent evaluation of the overall effectiveness of CAM as an additional or alternative treatment strategy in real-world settings. Research into effects of context and meaning: The impact of effects of context and meaning on the outcome of CAM treatments must be investigated; it is likely that they are significant. Research into different models of CAM health care integration: There are different models of CAM being integrated into conventional medicine throughout Europe, each with their respective strengths and limitations. These models should be described and concurrently evaluated; innovative models of CAM provision in health care systems should be one focus for CAM research. We also propose a methodological framework for CAM research. We consider that a framework of mixed methodological approaches is likely to yield the most useful information. In this model, all available research strategies including comparative effectiveness research utilising quantitative and qualitative methods should be considered to enable us to secure the greatest density of knowledge possible. Stakeholders, such as citizens, patients and providers, should be involved in every stage of developing the specific and relevant research questions, study design and the assurance of real-world relevance for the research. Furthermore, structural and sufficient financial support for research into CAM is needed to strengthen CAM research capacity if we wish to understand why it remains so popular within the EU. In order to consider employing CAM as part of the solution to the health care, health creation and self-care challenges we face by 2020, it is vital to obtain a robust picture of CAM use and reliable information about its cost, safety and effectiveness in real-world settings. We need to consider the availability, accessibility and affordability of CAM. We need to engage in research excellence and utilise comparative effectiveness approaches and mixed methods to obtain this data. Our recommendations are both strategic and methodological. They are presented for the consideration of researchers and funders while being designed to answer the important and implicit questions posed by EU citizens currently using CAM in apparently increasing numbers. We propose that the EU actively supports an EUwide strategic approach that facilitates the development of CAM research. This could be achieved in the first instance through funding a European CAM coordinating research office dedicated to foster systematic communication between EU governments, public, charitable and industry funders as well as researchers, citizens and other stakeholders. The aim of this office would be to coordinate research strategy developments and research funding opportunities, as well as to document and disseminate international research activities in this field. With the aim to develop sustainability as second step, a European Centre for CAM should be established that takes over the monitoring and further development of a coordinated research strategy for CAM, as well as it should have funds that can be awarded to foster high quality and robust independent research with a focus on citizens health needs and pan-European collaboration. We wish to establish a solid funding for CAM research to adequately inform health care and health creation decision-making throughout the EU. This centre would ensure that our vision of a common, strategic and scientifically rigorous approach to CAM research becomes our legacy and Europe’s reality. We are confident that our recommendations will serve these essential goals for EU citizens.

Impact of a modified dietary plan on the health related quality of life of minority participants in the Women's Healthy Eating and Living (WHEL) Study

Advances in medical technology, in genetics, and in clinical research have led to early detection of cancer, precise diagnosis, and effective treatment modalities. Decline in cancer incidence and mortality due to cancer has led to increased number of long-term survivors. However, the ethnic minority population has not experienced this decline and still continues to carry a disparate proportion of the cancer burden. Majority of the clinical research including survivorship studies have recruited and continue to recruit a convenient sample of middle- to upper-class Caucasian survivors. Thus, minorities are underrepresented in cancer research in terms of both clinical studies and in health related quality of life (HRQOL) studies. ^ Life style and diet have been associated with increased risk of breast cancer. High vegetable low fat diet has been shown to reduce recurrence of breast cancer and early death. The Women's Healthy Eating and Living Study is an ongoing multi-site randomized controlled trial that is evaluating the high-vegetable low fat diet in reducing the recurrence of breast cancer and early death. The purpose of this dissertation was to (1) compare the impact of the modified diet on the HRQOL during the first 12-month period on specific Minorities and matched Caucasians; (2) identify predictors that significantly impact the HRQOL of the study participants; and (3) using the structural equation modeling assess the impact of nutrition on the HRQOL of the intervention group participants. Findings suggest that there are no significant differences in change in HRQOL between Minorities and Caucasians; between Minorities in the intervention group and those in the comparison group; and between women in the intervention group and those in the comparison group. Minority indicator variable and Intervention/Comparison group indicator variable were not found to be good predictors of HRQOL. Although the structural equation models suggested viable representation of the relationship between the antecedent variables, the mediating variables and the two outcome variables, the impact of nutrition was not statistically significant to be included in the model. This dissertation, by analyzing the HRQOL of minorities in the WHEL Study, attempted to add to the knowledge base specific to minority cancer survivors. ^

African American and Hispanic adolescent STI and pregnancy prevention: Whose responsibility is it, anyway?

This dissertation utilized quantitative and qualitative methods to examine the role of responsibility in the prevention of sexually transmitted infections (STIs) and pregnancy through condom use and other sexual behaviors among young adolescents. Data were analyzed across race and gender and three papers were developed. The quantitative portion used logistic regression to assess associations between personal responsibility, as well as other know correlates, and reported condom use and condom use intentions as a means of STI and pregnancy prevention among 445 inner-city, high school adolescents. Responsibility to prevent pregnancy by providing the condom was associated with condom use at last sex and consistent condom use. Responsibility to prevent acquiring a STI by using a condom was significantly associated with consistent condom use. No significant associations were found between responsibility and condom use intentions. ^ The qualitative section of the dissertation project involved conducting 28 in-depth interviews among 9th and 10th grade, African American and Hispanic students who attended a large urban school district in South Central Texas. Perceptions of responsibility for preventing STIs and unintended pregnancy, as well as for condom use, were explored. Male and female adolescents expressed joint responsibility to prevent a STI or pregnancy. Perceptions of responsibility for providing and using the condoms were mixed. Despite the indication of both partners, mostly all participants implied that females, more so than the males, had the final responsibility to prevent contracting a STI, a pregnancy, to provide a condom, and to make sure a condom was used. Participants expressed the role of parents' involvement for preventing these outcomes as well as the need for more sexual health education and access to preventative methods. ^ The last section of this dissertation involved qualitative inquiry to ascertain perceptions of reasons why adolescents engage in anal and oral (non-coital) sex. Pleasure-seeking and giving as well social influence and pressure were described as the main reasons why teenagers have non-coital sex. Other reasons included conveniences of participating in these behaviors such as ease of performing oral sex and anal sex as a convenient alternative to vaginal sex. Sexual inexperience was an indicator for why anal sex occurs. Many of the reasons involved misperceptions and adolescents who practice these sexual behaviors place themselves at-risk for contracting a STI. ^ This dissertation increased the current knowledge base about adolescent sexual responsibility and non-coital behaviors. Future studies should explore perceptions of responsibility and actual sexual activity practices among adolescents to reduce the burden of STIs and pregnancy as well as help public health professionals develop programs for adolescent populations, schools, and communities where these issues persist.^

Benvenuto Terracini y Demetrio Gazdaru : Dos lecturas desplazadas del archivo glotológico de Graziadio Isaia Ascoli

En este trabajo proponemos centrarnos en dos intervenciones de lectura sobre la obra del lingüista italiano Graziadio Isaia Ascoli, producidas por lingüistas europeos instalados en la Argentina: el italiano Benvenuto Terracini, que ejerció como profesor de Lingüística en la Universidad de Tucumán entre 1941 y 1946, y el rumano Demetrio Gazdaru, que fue docente de materias lingüísticas en diferentes universidades del país desde 1949 hasta 1973. Entendemos esas relecturas como un momento sustancial en los respectivos diseños de la historia de los estudios sobre el lenguaje que ambos especialistas llevan adelante en ámbito argentino. Asimismo, interrogamos esas relecturas como dos intervenciones por la definición de un saber lingüístico legítimo desde lugares periféricos, en la medida en que apuntalan una tradición romanista alternativa a las diferentes inscripciones hispanistas hegemónicas en los discursos académicos sobre el lenguaje en la Argentina

Tratamiento de resultados en diseños cualitativos : La aplicación del Análisis Descriptivo

Este artículo presenta el Análisis Descriptivo como una estrategia del tratamiento de la información durante el proceso de investigación y su posible uso en estudios de diseño cualitativo. Muchas investigaciones en Ciencias Sociales y Humanas no contemplan la importancia de explicitar los soportes teórico-metodológicos de las inferencias explicativas o interpretación/es a la/s que se arriba, es decir, cómo es que se ha pasado del referente seleccionado (unidad de referencia), al argumento (modelo explicativo o interpretativo) con el que se lo pretende representar. De este modo, se suele ignorar el problema de la representación del referente en un dato tratable y la necesaria transformación del lenguaje natural (LN) en lenguaje descriptivo (LD). Se desarrollan dos ejemplos del campo de la Etología y de la Psicología, aplicando la estrategia metodológica del Análisis Descriptivo. En ellos se demuestra que la codificación que permite realizar este método toma en cuenta por un lado, la base de conocimientos e informaciones relativas a un dominio disciplinar particular y, por otro, permite evidenciar las inferencias seguidas en el razonamiento y las reglas de interpretación utilizadas para arribar a nuevos conocimientos

Benvenuto Terracini y Demetrio Gazdaru : Dos lecturas desplazadas del archivo glotológico de Graziadio Isaia Ascoli

En este trabajo proponemos centrarnos en dos intervenciones de lectura sobre la obra del lingüista italiano Graziadio Isaia Ascoli, producidas por lingüistas europeos instalados en la Argentina: el italiano Benvenuto Terracini, que ejerció como profesor de Lingüística en la Universidad de Tucumán entre 1941 y 1946, y el rumano Demetrio Gazdaru, que fue docente de materias lingüísticas en diferentes universidades del país desde 1949 hasta 1973. Entendemos esas relecturas como un momento sustancial en los respectivos diseños de la historia de los estudios sobre el lenguaje que ambos especialistas llevan adelante en ámbito argentino. Asimismo, interrogamos esas relecturas como dos intervenciones por la definición de un saber lingüístico legítimo desde lugares periféricos, en la medida en que apuntalan una tradición romanista alternativa a las diferentes inscripciones hispanistas hegemónicas en los discursos académicos sobre el lenguaje en la Argentina

Tratamiento de resultados en diseños cualitativos : La aplicación del Análisis Descriptivo

Este artículo presenta el Análisis Descriptivo como una estrategia del tratamiento de la información durante el proceso de investigación y su posible uso en estudios de diseño cualitativo. Muchas investigaciones en Ciencias Sociales y Humanas no contemplan la importancia de explicitar los soportes teórico-metodológicos de las inferencias explicativas o interpretación/es a la/s que se arriba, es decir, cómo es que se ha pasado del referente seleccionado (unidad de referencia), al argumento (modelo explicativo o interpretativo) con el que se lo pretende representar. De este modo, se suele ignorar el problema de la representación del referente en un dato tratable y la necesaria transformación del lenguaje natural (LN) en lenguaje descriptivo (LD). Se desarrollan dos ejemplos del campo de la Etología y de la Psicología, aplicando la estrategia metodológica del Análisis Descriptivo. En ellos se demuestra que la codificación que permite realizar este método toma en cuenta por un lado, la base de conocimientos e informaciones relativas a un dominio disciplinar particular y, por otro, permite evidenciar las inferencias seguidas en el razonamiento y las reglas de interpretación utilizadas para arribar a nuevos conocimientos

Benvenuto Terracini y Demetrio Gazdaru : Dos lecturas desplazadas del archivo glotológico de Graziadio Isaia Ascoli

En este trabajo proponemos centrarnos en dos intervenciones de lectura sobre la obra del lingüista italiano Graziadio Isaia Ascoli, producidas por lingüistas europeos instalados en la Argentina: el italiano Benvenuto Terracini, que ejerció como profesor de Lingüística en la Universidad de Tucumán entre 1941 y 1946, y el rumano Demetrio Gazdaru, que fue docente de materias lingüísticas en diferentes universidades del país desde 1949 hasta 1973. Entendemos esas relecturas como un momento sustancial en los respectivos diseños de la historia de los estudios sobre el lenguaje que ambos especialistas llevan adelante en ámbito argentino. Asimismo, interrogamos esas relecturas como dos intervenciones por la definición de un saber lingüístico legítimo desde lugares periféricos, en la medida en que apuntalan una tradición romanista alternativa a las diferentes inscripciones hispanistas hegemónicas en los discursos académicos sobre el lenguaje en la Argentina

Tratamiento de resultados en diseños cualitativos : La aplicación del Análisis Descriptivo

Este artículo presenta el Análisis Descriptivo como una estrategia del tratamiento de la información durante el proceso de investigación y su posible uso en estudios de diseño cualitativo. Muchas investigaciones en Ciencias Sociales y Humanas no contemplan la importancia de explicitar los soportes teórico-metodológicos de las inferencias explicativas o interpretación/es a la/s que se arriba, es decir, cómo es que se ha pasado del referente seleccionado (unidad de referencia), al argumento (modelo explicativo o interpretativo) con el que se lo pretende representar. De este modo, se suele ignorar el problema de la representación del referente en un dato tratable y la necesaria transformación del lenguaje natural (LN) en lenguaje descriptivo (LD). Se desarrollan dos ejemplos del campo de la Etología y de la Psicología, aplicando la estrategia metodológica del Análisis Descriptivo. En ellos se demuestra que la codificación que permite realizar este método toma en cuenta por un lado, la base de conocimientos e informaciones relativas a un dominio disciplinar particular y, por otro, permite evidenciar las inferencias seguidas en el razonamiento y las reglas de interpretación utilizadas para arribar a nuevos conocimientos

Pollen analysis of a sediment profile from Gabelsee in Germany

The article shows that pollen analysis plays an important role in the prediction of potential settlement areas and, furthermore, can offer a crude determination of settlement duration. Especially when the archaeological data fails to offer a possibility of dating, pollen analysis in connection with 14C can importantly broaden the knowledge base. As in the present case, the results of the Archaeo-Prognosis mapping and the pollen analysis of the Gabelsee are compared and, within this vicinity, confirmend. = Der Beitrag zeigt, dass die Pollenanalyse eine wichtige Rolle für die Vorhersage von potenziellen Siedlungsflächen spielen und darüber hinaus eine grobe Berechnung der Siedlungsdauer bieten kann. Insbesondere wenn die archäologische Datenbasis keine genaue Datierung zulässt, ermöglicht die Pollenanalyse in Verbindung mit der 14C-Datierung eine wichtige Erweiterung der Kenntnisse. Im vorliegenden Fall konnten die Ergebnisse der Archäoprognosekarte mit denjenigen der Pollenanalyse des Gabelsees verglichen und für diesen lokalen Raum bestätigt werden.

Multipedia: Enriching DBpedia with Multimedia Information

Enriching knowledge bases with multimedia information makes it possible to complement textual descriptions with visual and audio information. Such complementary information can help users to understand the meaning of assertions, and in general improve the user experience with the knowledge base. In this paper we address the problem of how to enrich ontology instances with candidate images retrieved from existing Web search engines. DBpedia has evolved into a major hub in the Linked Data cloud, interconnecting millions of entities organized under a consistent ontology. Our approach taps into the Wikipedia corpus to gather context information for DBpedia instances and takes advantage of image tagging information when this is available to calculate semantic relatedness between instances and candidate images. We performed experiments with focus on the particularly challenging problem of highly ambiguous names. Both methods presented in this work outperformed the baseline. Our best method leveraged context words from Wikipedia, tags from Flickr and type information from DBpedia to achieve an average precision of 80%.

A Multi-Agent System for the Solution of Fuzzy Incidents in Telecommunications

This article presents a multi-agent expert system (SMAF) , that allows the input of incidents which occur in different elements of the telecommunications area. SMAF interacts with experts and general users, and each agent with all the agents? community, recording the incidents and their solutions in a knowledge base, without the analysis of their causes. The incidents are expressed using keywords taken from natural language (originally Spanish) and their main concepts are recorded with their severities as the users express them. Then, there is a search of the best solution for each incident, being helped by a human operator using a distancenotions between them.

A Multiagent system model which suggests solutions to fuzzy incidents in the field of telecommunications

This article presents the model of a multi-agent system (SMAF), which objectives are the input of fuzzy incidents as the human experts express them with different severities degrees and the further search and suggestion of solutions. The solutions will be later confirm or not by the users. This model was designed, implemented and tested in the telecommunications field, with heterogeneous agents in a cooperative model. In the design, different abstract levels where considered, according to the agents? objectives, their ways to carry it out and the environment in which they act. Each agent is modeled with different spectrum of the knowledge base