Electronic health records: essential tools in integrating substance abuse treatment with primary care.

While substance use problems are considered to be common in medical settings, they are not systematically assessed and diagnosed for treatment management. Research data suggest that the majority of individuals with a substance use disorder either do not use treatment or delay treatment-seeking for over a decade. The separation of substance abuse services from mainstream medical care and a lack of preventive services for substance abuse in primary care can contribute to under-detection of substance use problems. When fully enacted in 2014, the Patient Protection and Affordable Care Act 2010 will address these barriers by supporting preventive services for substance abuse (screening, counseling) and integration of substance abuse care with primary care. One key factor that can help to achieve this goal is to incorporate the standardized screeners or common data elements for substance use and related disorders into the electronic health records (EHR) system in the health care setting. Incentives for care providers to adopt an EHR system for meaningful use are part of the Health Information Technology for Economic and Clinical Health Act 2009. This commentary focuses on recent evidence about routine screening and intervention for alcohol/drug use and related disorders in primary care. Federal efforts in developing common data elements for use as screeners for substance use and related disorders are described. A pressing need for empirical data on screening, brief intervention, and referral to treatment (SBIRT) for drug-related disorders to inform SBIRT and related EHR efforts is highlighted.

Participatory Methods for Climate Change and Mental Health Research: Photovoice in Nepal

Background: The relationship between mental health and climate change are poorly understood. Participatory methods represent ethical, feasible, and culturally-appropriate approaches to engage community members for mental health promotion in the context of climate change. Aim: Photovoice, a community-based participatory research methodology uses images as a tool to deconstruct problems by posing meaningful questions in a community to find actionable solutions. This community-enhancing technique was used to elicit experiences of climate change among women in rural Nepal and the association of climate change with mental health. Subjects and methods: Mixed-methods, including in-depth interviews and self-report questionnaires, were used to evaluate the experience of 10 women participating in photovoice. Quantitative tools included Nepali versions of Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) and a resilience scale. Results: In qualitative interviews after photovoice, women reported climate change adaptation and behavior change strategies including environmental knowledge-sharing, group mobilization, and increased hygiene practices. Women also reported beneficial effects for mental health. The mean BDI score prior to photovoice was 23.20 (SD=9.00) and two weeks after completion of photovoice, the mean BDI score was 7.40 (SD=7.93), paired t-test = 8.02, p<.001, n=10. Conclusion: Photovoice, as a participatory method, has potential to inform resources, adaptive strategies and potential interventions to for climate change and mental health.

A Framework to Support the Sharing and Reuse of Computable Phenotype Definitions Across Health Care Delivery and Clinical Research Applications.

INTRODUCTION: The ability to reproducibly identify clinically equivalent patient populations is critical to the vision of learning health care systems that implement and evaluate evidence-based treatments. The use of common or semantically equivalent phenotype definitions across research and health care use cases will support this aim. Currently, there is no single consolidated repository for computable phenotype definitions, making it difficult to find all definitions that already exist, and also hindering the sharing of definitions between user groups. METHOD: Drawing from our experience in an academic medical center that supports a number of multisite research projects and quality improvement studies, we articulate a framework that will support the sharing of phenotype definitions across research and health care use cases, and highlight gaps and areas that need attention and collaborative solutions. FRAMEWORK: An infrastructure for re-using computable phenotype definitions and sharing experience across health care delivery and clinical research applications includes: access to a collection of existing phenotype definitions, information to evaluate their appropriateness for particular applications, a knowledge base of implementation guidance, supporting tools that are user-friendly and intuitive, and a willingness to use them. NEXT STEPS: We encourage prospective researchers and health administrators to re-use existing EHR-based condition definitions where appropriate and share their results with others to support a national culture of learning health care. There are a number of federally funded resources to support these activities, and research sponsors should encourage their use.

Professional development programs in health promotion : tools and processes to favor new practices

Developing innovative interventions that are in sync with a health promotion paradigm often represents a challenge for professionals working in local public health organizations. Thus, it is critical to have both professional development programs that favor new practices and tools to examine these practices. In this case study, we analyze the health promotion approach used in a pilot intervention addressing children’s vulnerability that was developed and carried out by participants enrolled in a public health professional development program. More specifically, we use a modified version of Guichard and Ridde’s (Une grille d’analyse des actions pour lutter contre les inégalités sociales de santé. In Potvin, L., Moquet, M.-J. and Jones, C. M. (eds), Réduire les Inégalités Sociales en Santé. INPES, Saint-Denis Cedex, pp. 297– 312, 2010) analytical grid to assess deductively the program participants’ use of health promotion practices in the analysis and planning, implementation, evaluation, sustainability and empowerment phases of the pilot intervention. We also seek evidence of practices involving (empowerment, participation, equity, holism, an ecological approach, intersectorality and sustainability) in the intervention. The results are mixed: our findings reveal evidence of the application of several dimensions of health promotion (equity, holism, an ecological approach, intersectorality and sustainability), but also a lack of integration of two key dimensions; that is, empowerment and participation, during various phases of the pilot intervention. These results show that the professional development program is associated with the adoption of a pilot intervention integrating multiple but not all dimensions of health promotion. We make recommendations to facilitate a more complete integration. This research also shows that the Guichard and Ridde grid proves to be a thorough instrument to document the practices of participants.

Design and Implementation of Tools for STM Studies in UHV and at the Solid-Liquid Interface

This thesis presents details of the design and development of novel tools and instruments for scanning tunneling microscopy (STM), and may be considered as a repository for several years' worth of development work. The author presents design goals and implementations for two microscopes. First, a novel Pan-type STM was built that could be operated in an ambient environment as a liquid-phase STM. Unique features of this microscope include a unibody frame, for increased microscope rigidity, a novel slider component with large Z-range, a unique wiring scheme and damping mechanism, and a removable liquid cell. The microscope exhibits a high level of mechanical isolation at the tunnel junction, and operates excellently as an ambient tool. Experiments in liquid are on-going. Simultaneously, the author worked on designs for a novel low temperature, ultra-high vacuum (LT-UHV) instrument, and these are presented as well. A novel stick-slip vertical coarse approach motor was designed and built. To gauge the performance of the motor, an in situ motion sensing apparatus was implemented, which could measure the step size of the motor to high precision. A new driving circuit for stick-slip inertial motors is also presented, that o ffers improved performance over our previous driving circuit, at a fraction of the cost. The circuit was shown to increase step size performance by 25%. Finally, a horizontal sample stage was implemented in this microscope. The build of this UHV instrument is currently being fi nalized. In conjunction with the above design projects, the author was involved in a collaborative project characterizing N-heterocyclic carbene (NHC) self-assembled monolayers (SAMs) on Au(111) films. STM was used to characterize Au substrate quality, for both commercial substrates and those manufactured via a unique atomic layer deposition (ALD) process by collaborators. Ambient and UHV STM was then also used to characterize the NHC/Au(111) films themselves, and several key properties of these films are discussed. During this study, the author discovered an unexpected surface contaminant, and details of this are also presented. Finally, two models are presented for the nature of the NHC-Au(111) surface interaction based on the observed film properties, and some preliminary theoretical work by collaborators is presented.

An integrated psychology virtual research ethics committee

Research and professional ethics are an integral part of every Psychology degree, as this is seen as a key graduate learning outcome for students leaving to become clinicians working with clients and patients. The development of these skills is embedded in teaching, but they culminate in the final year of a degree when final year students must gain formal ethical approval for their final research project. Decision as to the ethical appropriateness of research are made by a Departmental Research Ethics Committee, which considers all research project proposals submitted by staff and students within the department. One of the challenges of this practice is the scale of work involved for committee members (Doyle & Buckley, 2014) who are all faculty members, and the tracking of applications and decisions, alongside the quality assurance required to ensure that all applications are treated fairly and equally. The time involved in performing this work is often underestimated by Universities, and the variety and complexity of decisions requires extensive discussion and negotiation. Traditionally, these decisions are reached by committee discussions, however this presents logistical difficulties as it requires meetings with quorate attendance. The University of Westminster launched a virtual tool in 2014 to facilitate the management of the Research Ethics Committee, to help track the progress of applications and to allow discussions to occur and be managed virtually. The Department of Psychology adopted the tools in September 2014 to deal with all ethics applications. Here we report on how this virtual committee has affected the role and practices of a working committee that deals with over 300 applications per year, and how an online ethics procedure has facilitated an integrated developmental approach to ethical education.

Almetrics: measuring the influence of the media on the social impact of research

Social media is changing the way we interact, present ideas and information and judge the quality of content and contributions. In recent years there have been hundreds of platforms to freely share all kinds of information and connect across networks. These new tools generate activity statistics and interactions among users such as mentions, retweets, conversations, comments on blogs or Facebook; managers references showing popularity ratings of more references shared by other researchers or repositories that generate statistics of visits or downloads of articles. This paper analyzes that have meaning and implications altmetrics, what are its advantages and critical platforms (Almetric.com, ImpactStory, Plos altmetrics, PlumX), reports progress and benefits for authors, publishers and librarians. It concluded that the value of alternative metrics as a complementary tool citation analysis is evident, although it is suggested that you should dig deeper into this issue to unravel the meaning and the potential value of these indicators to assess their potential.

Training proposal in the degree of Master of Early Childhood Education for working the method of historical research in the classroom

Future teachers must be competent in creating educational settings, which provide tools to their students future they can develop a conscious mind, able to interpret their experiences, to make decisions and imagine innovative solutions to help you participate autonomously and responsible in society. This requires an educational system that allows them to integrate the subjective into a broader spatial and temporal context. La patrimonializatión of “Cultural artefacts” and oral history, the basis of which, are found in the active mind and links both the personal and the group experience, don’t only serve as a catalyst to achieving this goal, but rather, they facilitate the implementation of established practice in infant education. To gain this experience we offer the opportunity for students of their degree in Infant Education in the Public University of Navarre, training within the framework of social didactics, allowing students to learn about established practice from iconic, materials and oral sources in the Archive of Intangible Cultural Heritage of Navarra. The vidences points to their effectiveness and presented in a work in progress.

The management of bone tools from the Bronze Age site of El Portalón of Cueva Mayor, Sierra de Atapuerca, Burgos

In this paper we analyze the set of Bronze Age bone tools recovered at the archaeological site of El Portalón of Cueva Mayor in the Sierra de Atapuerca (Burgos). The Bronze Age cultural period is the best represented in the cavity and its study has forced us to unify the different excavation and stratigraphical criteria undertaken from the earliest archaeological excavations developed by J.M. Apellániz during the 70s until the excavations of the current research team (EIA) since 2000. We propose here for the first time a relationship between the initial system of “beds” used by Apellániz and our recent sedimentary sequence that recognizes eleven stratigraphic levels radiometrically dated from the late Upper Pleistocene to the Middle Age. Within the bone industry assemblage we recognize a large variety of utensils and ornamental elements, with native and allochthonous features, that make evident a regional as well as long distance relationships of these populations of the interior of the Iberian Peninsula during the recent Prehistory.

An innovative electroforming process for oil heated rotational moulding tools

Rotational moulding is a method to produce hollow plastic articles. Heating is normally carried out by placing the mould into a hot air oven where the plastic material in the mould is heated. The most common cooling media are water and forced air. Due to the inefficient nature of conventional hot air ovens most of the energy supplied by the oven does not go to heat the plastic and as a consequence the procedure has very long cycle times. Direct oil heating is an effective alternative in order to achieve better energy efficiency and cycle times. This research work has combined this technology with new innovative design of mould, applying the advantages of electroforming and rapid prototyping. Complex cavity geometries are manufactured by electroforming from a rapid prototyping mandrel. The approach involves conformal heating and cooling channels , where the oil flows into a parallel channel to the electroformed cavity (nickel or copper). Because of this the mould enables high temperature uniformity with direct heating and cooling of the electroformed shell, Uniform heating and cooling is important not only for good quality parts but also for good uniform wall thickness distribution in the rotationally moulded part. The experimental work with the manufactured prototype mould has enabled analysis of the thermal uniformity in the cavity, under different temperatures. Copyright © 2008 by ASME.

A Systematic Review of Entrepreneurship Education Literature in Nigeria: Where is the Focus of Research?

Purpose- Entrepreneurship education (EEd) plays a crucial role in the development of entrepreneurs and the enhancement of entrepreneurial activities in every economy. This paper examined what Higher education Institutions (HEIs) do in learning and teaching of entrepreneurship in general and how entrepreneurship development takes place in Nigerian HEIs. The outcome from this study will enable a deeper understanding on what HEIs do EEd, with more exposure as to what the areas and focus of research is in the Nigerian context. Design/methodology/approach- The study adopted a systematic literature review approach- drawing from a computerized search of five selected data bases, using predetermined key words by the researchers. Findings: The main finding of this paper is that, related concepts like skills, intention, drive and attitude have been use in expounding discussions on the outcome of EEd, but very little has been written on entrepreneurial mind-set (EMS), of which other studies have suggested that it’s a crucial point in the journey of an entrepreneurs (Reed & Stoltz, 2011; Quality Assurance Agency for Higher Education (QAA), 2012; Neneh, 2012). Furthermore, learning and teaching of entrepreneurship in Nigerian HEIs seems to be more on creating awareness (about entrepreneurship) than actual preparation for entrepreneurship (For entrepreneurship). Research limitations/implications- The paper is limited since it is based on a review of literature from a selected databases- covering a specific time span. This potentially excludes other studies outside this time span. A more comprehensive overview of these contributions would benefit from employing tools such as Google Scholar, for an overview of the sub–domains online. Originality/value – There are limited studies that focus on the issue of entrepreneurial mind-set in entrepreneurship education in Africa, specifically Nigeria. This paper and its focus in particular, have laid down pioneering ground work for research on entrepreneurial mind-set development in Nigerian entrepreneurship education.

Tackling Ageing Continence through Theory, Tools & Technology (TACT3)

The complexity of issues surrounding continence management, have been investigated by a UK multi-disciplinary research team working under the project title Tackling Ageing Continence through Theory Tools and Technology (TACT3). The team comprising engineers, chemists, health researchers, designers and social anthropologists is funded by the New Dynamics of Ageing Programme, ‘a seven year multidisciplinary research initiative with the ultimate aim of improving quality of life of older people. The programme is a unique collaboration between five UK Research Councils , and is the largest and most ambitious research programme on ageing ever mounted in the UK’ (www.newdynamics.group.shef.ac.uk). The TACT3 project comprises four work packages that are individually managed by members of the research team. One work package focuses solely on knowledge transfer of the research outputs and the management of the overall project. Another work package, entitled ‘Challenging Environmental Barriers’ has focused on the barriers in the built environment that prevent older people with continence concerns from participating in wider social life, namely access to publicly available toilet facilities. We also have a work package entitled ‘Improving Continence Interventions and Services’ which is exploring patient, carer and service providers experiences in receiving and delivering National Health Service (NHS) continence management treatments. The fourth workpackage ‘Developing Assistive Technologies’ has worked with users to develop devices that promote confidence, improve health and therefore may facilitate greater social interaction for older people with continence management concerns.

Changes in biodiversity and trade-offs among ecosystem services, stakeholders, and components of well-being: the contribution of the International Long-Term Ecological Research network (ILTER) to Programme on Ecosystem Change and Society (PECS)

The International Long-Term Ecological Research (ILTER) network comprises > 600 scientific groups conducting site-based research within 40 countries. Its mission includes improving the understanding of global ecosystems and informs solutions to current and future environmental problems at the global scales. The ILTER network covers a wide range of social-ecological conditions and is aligned with the Programme on Ecosystem Change and Society (PECS) goals and approach. Our aim is to examine and develop the conceptual basis for proposed collaboration between ILTER and PECS. We describe how a coordinated effort of several contrasting LTER site-based research groups contributes to the understanding of how policies and technologies drive either toward or away from the sustainable delivery of ecosystem services. This effort is based on three tenets: transdisciplinary research; cross-scale interactions and subsequent dynamics; and an ecological stewardship orientation. The overarching goal is to design management practices taking into account trade-offs between using and conserving ecosystems toward more sustainable solutions. To that end, we propose a conceptual approach linking ecosystem integrity, ecosystem services, and stakeholder well-being, and as a way to analyze trade-offs among ecosystem services inherent in diverse management options. We also outline our methodological approach that includes: (i) monitoring and synthesis activities following spatial and temporal trends and changes on each site and by documenting cross-scale interactions; (ii) developing analytical tools for integration; (iii) promoting trans-site comparison; and (iv) developing conceptual tools to design adequate policies and management interventions to deal with trade-offs. Finally, we highlight the heterogeneity in the social-ecological setting encountered in a subset of 15 ILTER sites. These study cases are diverse enough to provide a broad cross-section of contrasting ecosystems with different policy and management drivers of ecosystem conversion; distinct trends of biodiversity change; different stakeholders’ preferences for ecosystem services; and diverse components of well-being issues.