scholarly journals What Makes Stroke Rehabilitation Patients Complex? Clinician Perspectives and the Role of Discharge Pressure

2016 ◽  
Vol 6 (2) ◽  
pp. 35-41 ◽  
Author(s):  
Michelle L.A. Nelson ◽  
Elizabeth Hanna ◽  
Stephen Hall ◽  
Michael Calvert
Keyword(s):  
Stroke Rehabilitation ◽  
Personal Characteristics ◽  
Inpatient Rehabilitation ◽  
Community Services ◽  
Social Determinant ◽  
Structural Element ◽  
Wide Range ◽  
Patient Complexity ◽  
Definition Of ◽  
Discharge Pressure

Background Approximately 80% of people who survive a stroke have on average five other conditions and a wide range of psychosocial issues. Attention to biopsychosocial issues has led to the identification of ‘complex patients’. No single definition of ‘patient complexity’ exists; therefore, applied health researchers seek to understand ‘patient complexity’ as it relates to a specific clinical context. Objective To understand how ‘patient complexity’ is conceptualized by clinicians, and to position the findings within the existing literature on patient complexity. Methods A qualitative descriptive approach was utilized. Twenty-three stroke rehabilitation clinicians participated in four focus groups. Results Five elements of patient complexity were identified: medical/functional issues, social determinant factors, social/family support, personal characteristics, and health system factors. Using biopsychosocial factors to identify complexity results in all patients being complex; operationalization of the definition led to the identification of systemic elements. A disconnect between acute, inpatient rehabilitation and community services was identified as a trigger for increased complexity. Conclusions Patient complexity is not a dichotomous state. If applying existing complexity definitions, all patients are complex. This study extends the understanding by suggesting a structural element of complexity from manageable to less manageable complexity based on ability to discharge.

scholarly journals Redefining the concept of professionalism in nursing: an integrative review

2021 ◽  
Vol 8 (4) ◽  
pp. 327-340
Author(s):  
Azadeh Azemian ◽  
Abbas Ebadi ◽  
Leila Afshar
Keyword(s):  
Self Regulation ◽  
Cost Benefit ◽  
Personal Characteristics ◽  
Legal Responsibility ◽  
Professional Status ◽  
Individual Factors ◽  
Scientific Databases ◽  
Wide Range ◽  
Comprehensive Search ◽  
Definition Of

Abstract Objective In today's world with sweeping changes, nurses are responsible for providing high-quality and cost-benefit care, which would almost be impossible unless they achieve their high professional status. To date, no precise and comprehensive definition of professionalism in nursing has been evidently proposed. In fact, many of the previously proposed definitions are either complicated or ambiguous. Moreover, there is no consensus in the literature on an exhaustive definition for “a professional nurse.” The present study aimed to illustrate the concept of professionalism in nursing and identify its defining characteristics. Methods In this study, concept analysis was conducted using Whittemore et al.'s method for the integrated review. A comprehensive search of electronic, scientific databases including Eric, PubMed, Scopus, Web of Science, EBSCO, PsychoINFO, Embass, MagIran, IranDoc, SID, and IRANMEDEX was carried out using the keywords such as professionalism, professional behavior, nursing professionalism (NP), professional attribute, and nursing. Results In the present study, a comprehensive search of 11 electronic databases retrieved 5738 articles. Then, 2837 duplicate articles were removed by endnote (version 8). Based on a preliminary examination of the titles and abstracts as well as the inclusion and exclusion criteria, 1517 articles were excluded. In addition, 137 articles were removed for scientific reasons. Finally, 52 articles in English and Persian were selected. Content analysis of the articles revealed four major themes, namely, individual prerequisite, professional prerequisite, appropriate structure, and socio-individual factors. Conclusions Professionalism in nursing is a major, multidimensional concept according to the literature that included individual prerequisites, professional prerequisites, appropriate structures, and socio-individual factors. In fact, professionalism in nursing comprises a wide range of personal characteristics, self-regulation, professional values, striving to acquire and enhance professional expertise, professional interactions, social, professional, and legal responsibility, and creation of a sense of belonging, and professional development.

Theoretical Basis for Creation of a Model of Potential for Entrepreneurship Competencies

2017 ◽  
Vol 7 (1) ◽  
pp. 7-31
Author(s):  
Lucie Křeménková ◽  
Jan Sebastian Novotný ◽  
Hana Marešová
Keyword(s):  
Theoretical Basis ◽  
Current Knowledge ◽  
Personal Characteristics ◽  
Entrepreneurship Education ◽  
New Wave ◽  
Management Skills ◽  
Educational Facilities ◽  
Wide Range ◽  
Systematic Planning ◽  
Definition Of

The article provides a theoretical basis for a model of potential for entrepreneurship competencies. Recently more stress has been put on a support of entrepreneurship during the school age in the context of the effort to educate “new wave of entrepreneurs” through supporting entrepreneurship competencies of young people. Entrepreneurship education is nowadays understood as an indispensable part of many government actions of EU countries. However, there exist no precise definition of current practice in entrepreneurship education and there can be found a wide range of different methodologies which differ between individual countries as well as within them, where they differ in relation to individual educational facilities. So-called entrepreneurship competencies have become a key term and they can be defined as knowledge, skills and attitudes which influence willingness and ability to carry out business activities and creating new value, and which can be measured directly or indirectly and improved through education. Currently, there exists a range of concepts of entrepreneurship competencies focusing predominantly on adult (already self-employed) population and they fall within one of the two main trends in understanding these competencies—as innate personal characteristics and as skills which can be acquired through education and experience. Based on the current knowledge we defined our own modified theoretical model of potential for entrepreneurship competencies. The model includes three main dimensions with a range of sub-factors—attitudinal competencies (e.g. self-esteem, ability to tolerate ambiguity instead of control), behavioural competencies (e.g. persistence, initiative, creativity, risk capacity) and management skills (e.g. systematic planning, communication skills, ability to solve problems). The focus is mainly on the question of potential for entrepreneurship competencies, which are developmentally adequate for pupils of a lower-secondary level, and which create space for the development of entrepreneurship competencies as such later in life.

Typologization of security regulation

2020 ◽  
pp. 20-27
Author(s):  
Denis Tikhomirov
Keyword(s):  
Social Relations ◽  
Scientific Literature ◽  
Legal Regulation ◽  
Procedural Understanding ◽  
Limited Ability ◽  
Methodological Basis ◽  
Wide Range ◽  
The Subject ◽  
Definition Of ◽  
Legal Understanding

The purpose of the article is to typologize terminological definitions of security, to find out the general, to identify the originality of their interpretations depending on the subject of legal regulation. The methodological basis of the study is the methods that made it possible to obtain valid conclusions, in particular, the method of comparison, through which it became possible to correlate different interpretations of the term "security"; method of hermeneutics, which allowed to elaborate texts of normative legal acts of Ukraine, method of typologization, which made it possible to create typologization groups of variants of understanding of the term "security". Scientific novelty. The article analyzes the understanding of the term "security" in various regulatory acts in force in Ukraine. Typological groups were understood to understand the term "security". Conclusions. The analysis of the legal material makes it possible to confirm that the issues of security are within the scope of both legislative regulation and various specialized by-laws. However, today there is no single conception on how to interpret security terminology. This is due both to the wide range of social relations that are the subject of legal regulation and to the relativity of the notion of security itself and the lack of coherence of views on its definition in legal acts and in the scientific literature. The multiplicity of definitions is explained by combinations of material and procedural understanding, static - dynamic, and conditioned by the peculiarities of a particular branch of legal regulation, limited ability to use methods of one or another branch, the inter-branch nature of some variations of security, etc. Separation, common and different in the definition of "security" can be used to further standardize, in fact, the regulatory legal understanding of security to more effectively implement the legal regulation of the security direction.

Music after the Fall

2017 ◽  
Author(s):  
Tim Rutherford-Johnson
Keyword(s):  
New Media ◽  
Contemporary Music ◽  
The United States ◽  
Art Music ◽  
Sound Art ◽  
Musical Composition ◽  
Western Art ◽  
Wide Range ◽  
Definition Of ◽  
The Cold War

By the start of the 21st century many of the foundations of postwar culture had disappeared: Europe had been rebuilt and, as the EU, had become one of the world’s largest economies; the United States’ claim to global dominance was threatened; and the postwar social democratic consensus was being replaced by market-led neoliberalism. Most importantly of all, the Cold War was over, and the World Wide Web had been born. Music After The Fall considers contemporary musical composition against this changed backdrop, placing it in the context of globalization, digitization, and new media. Drawing on theories from the other arts, in particular art and architecture, it expands the definition of Western art music to include forms of composition, experimental music, sound art, and crossover work from across the spectrum, inside and beyond the concert hall. Each chapter considers a wide range of composers, performers, works, and institutions are considered critically to build up a broad and rich picture of the new music ecosystem, from North American string quartets to Lebanese improvisers, from South American electroacoustic studios to pianos in the Australian outback. A new approach to the study of contemporary music is developed that relies less on taxonomies of style and technique, and more on the comparison of different responses to common themes, among them permission, fluidity, excess, and loss.

scholarly journals Size-adjusted aortic valve area: refining the definition of severe aortic stenosis

2020 ◽  
Author(s):  
Branka Vulesevic ◽  
Naozumi Kubota ◽  
Ian G Burwash ◽  
Claire Cimadevilla ◽  
Sarah Tubiana ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Predictive Accuracy ◽  
Severe Aortic Stenosis ◽  
Aortic Valve Area ◽  
Obese Patients ◽  
Derivation Cohort ◽  
Wide Range ◽  
Definition Of ◽  
Diagnostic And Prognostic Value ◽  
Valve Area

Abstract Aims Severe aortic valve stenosis (AS) is defined by an aortic valve area (AVA) <1 cm2 or an AVA indexed to body surface area (BSA) <0.6 cm/m2, despite little evidence supporting the latter approach and important intrinsic limitations of BSA indexation. We hypothesized that AVA indexed to height (H) might be more applicable to a wide range of populations and body morphologies and might provide a better predictive accuracy. Methods and results In 1298 patients with degenerative AS and preserved ejection fraction from three different countries and continents (derivation cohort), we aimed to establish an AVA/H threshold that would be equivalent to 1.0 cm2 for defining severe AS. In a distinct prospective validation cohort of 395 patients, we compared the predictive accuracy of AVA/BSA and AVA/H. Correlations between AVA and AVA/BSA or AVA/H were excellent (all R2 > 0.79) but greater with AVA/H. Regressions lines were markedly different in obese and non-obese patients with AVA/BSA (P < 0.0001) but almost identical with AVA/H (P = 0.16). AVA/BSA values that corresponded to an AVA of 1.0 cm2 were markedly different in obese and non-obese patients (0.48 and 0.59 cm2/m2) but not with AVA/H (0.61 cm2/m for both). Agreement for the diagnosis of severe AS (AVA < 1 cm2) was significantly higher with AVA/H than with AVA/BSA (P < 0.05). Similar results were observed across the three countries. An AVA/H cut-off value of 0.6 cm2/m [HR = 8.2(5.6–12.1)] provided the best predictive value for the occurrence of AS-related events [absolute AVA of 1 cm2: HR = 7.3(5.0–10.7); AVA/BSA of 0.6 cm2/m2 HR = 6.7(4.4–10.0)]. Conclusion In a large multinational/multiracial cohort, AVA/H was better correlated with AVA than AVA/BSA and a cut-off value of 0.6 cm2/m provided a better diagnostic and prognostic value than 0.6 cm2/m2. Our results suggest that severe AS should be defined as an AVA < 1 cm2 or an AVA/H < 0.6 cm2/m rather than a BSA-indexed value of 0.6 cm2/m2.

Cubical Agda: A dependently typed programming language with univalence and higher inductive types

2021 ◽  
Vol 31 ◽  
Author(s):  
ANDREA VEZZOSI ◽  
ANDERS MÖRTBERG ◽  
ANDREAS ABEL
Keyword(s):  
Programming Language ◽  
Type Theory ◽  
Type Checking ◽  
Dependent Type Theory ◽  
Wide Range ◽  
General Schema ◽  
Direct Definition ◽  
Inductive Types ◽  
Definition Of ◽  
Cubical Type Theory

Abstract Proof assistants based on dependent type theory provide expressive languages for both programming and proving within the same system. However, all of the major implementations lack powerful extensionality principles for reasoning about equality, such as function and propositional extensionality. These principles are typically added axiomatically which disrupts the constructive properties of these systems. Cubical type theory provides a solution by giving computational meaning to Homotopy Type Theory and Univalent Foundations, in particular to the univalence axiom and higher inductive types (HITs). This paper describes an extension of the dependently typed functional programming language Agda with cubical primitives, making it into a full-blown proof assistant with native support for univalence and a general schema of HITs. These new primitives allow the direct definition of function and propositional extensionality as well as quotient types, all with computational content. Additionally, thanks also to copatterns, bisimilarity is equivalent to equality for coinductive types. The adoption of cubical type theory extends Agda with support for a wide range of extensionality principles, without sacrificing type checking and constructivity.

scholarly journals Definitions and Prevalence of Multimorbidity in Large Database Studies: A Scoping Review

2021 ◽  
Vol 18 (4) ◽  
pp. 1673
Author(s):  
Ying Pin Chua ◽  
Ying Xie ◽  
Poay Sian Sabrina Lee ◽  
Eng Sing Lee
Keyword(s):  
Scoping Review ◽  
Chronic Conditions ◽  
Meta Analysis ◽  
Epidemiological Studies ◽  
Cross Sectional ◽  
Coding Systems ◽  
Wide Range ◽  
Scoping Reviews ◽  
Retrospective Cohort Studies ◽  
Definition Of

Background: Multimorbidity presents a key challenge to healthcare systems globally. However, heterogeneity in the definition of multimorbidity and design of epidemiological studies results in difficulty in comparing multimorbidity studies. This scoping review aimed to describe multimorbidity prevalence in studies using large datasets and report the differences in multimorbidity definition and study design. Methods: We conducted a systematic search of MEDLINE, EMBASE, and CINAHL databases to identify large epidemiological studies on multimorbidity. We used the Preferred Reporting Items for Systematic Reviews and Meta-analysis Extension for Scoping Reviews (PRISMA-ScR) protocol for reporting the results. Results: Twenty articles were identified. We found two key definitions of multimorbidity: at least two (MM2+) or at least three (MM3+) chronic conditions. The prevalence of multimorbidity MM2+ ranged from 15.3% to 93.1%, and 11.8% to 89.7% in MM3+. The number of chronic conditions used by the articles ranged from 15 to 147, which were organized into 21 body system categories. There were seventeen cross-sectional studies and three retrospective cohort studies, and four diagnosis coding systems were used. Conclusions: We found a wide range in reported prevalence, definition, and conduct of multimorbidity studies. Obtaining consensus in these areas will facilitate better understanding of the magnitude and epidemiology of multimorbidity.

The Registered Dietitian in Primary Care: The Hamilton Experience

2007 ◽  
Vol 68 (2) ◽  
pp. 81-85 ◽  
Author(s):  
Wendy Gamblen ◽  
Sherri Schamehorn ◽  
Anne Marie Crustolo ◽  
Tracy Hussey ◽  
Nick Kates ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Interdisciplinary Collaboration ◽  
Community Services ◽  
Care Providers ◽  
Clinical Role ◽  
Nutrition Services ◽  
Wide Range ◽  
Canadian Health ◽  
Shared Care Model

The Hamilton Health Service Organization Nutrition Program integrates nine registered dietitians (RDs) into the offices of 80 family physicians (FPs) at 50 sites in Hamilton, Ontario. The program is based on a shared care model, in which FPs and RDs work collaboratively to provide nutrition services aimed at prevention, treatment, and management of nutrition-related problems. In addition to their clinical role, dietitians in the program are involved in health promotion, disease prevention and early intervention strategies, interdisciplinary collaboration, building links with community services, and research. The RDs’ specialized knowledge, skills, and experience allow them to provide a wide range of services that complement and augment those of the FP. This model is consistent with Canadian health care reform recommendations and offers significant benefits for both health care providers and consumers.

Interaction, engagement, and perceived interactivity in single-handed interaction

2016 ◽  
Vol 26 (5) ◽  
pp. 1134-1157 ◽  
Author(s):  
Donghee Shin ◽  
Myunggoon Choi ◽  
Jang Hyun Kim ◽  
Jae-gil Lee
Keyword(s):  
Behavioral Intention ◽  
Interaction Techniques ◽  
Content Type ◽  
Thumb Movement ◽  
Wide Range ◽  
Mobile Industry ◽  
Perceived Interactivity ◽  
The Subject ◽  
Definition Of ◽  
Practical Implications

Purpose The purpose of this paper is to examine the effects of interaction techniques (e.g. swiping and tapping) and the range of thumb movement on interactivity, engagement, attitude, and behavioral intention in single-handed interaction with smartphones. Design/methodology/approach A 2×2 between-participant experiment (technological features: swiping and tapping×range of thumb movement: wide and narrow) was conducted to study the effects of interaction techniques and thumb movement ranges. Findings The results showed that the range of thumb movement had significant effects on perceived interactivity, engagement, attitude, and behavioral intention, whereas no effects were observed for interaction techniques. A narrow range of thumb movement had more influence on the interactivity outcomes in comparison to a wide range of thumb movement. Practical implications While the subject of actual and perceived interactivity has been discussed, the issue has not been applied to smartphone. Based on the research results, the mobile industry may come up with a design strategy that balances feature- and perception-based interactivity. Originality/value This study adopted the perspective of the hybrid definition of interactivity, which includes both actual and perceived interactivity. Interactivity effect outcomes mediated by perceived interactivity.

scholarly journals Cycle and flow trusses in directed networks

2016 ◽  
Vol 3 (11) ◽  
pp. 160270 ◽  
Author(s):  
Taro Takaguchi ◽  
Yuichi Yoshida
Keyword(s):  
Truss Structures ◽  
Directed Network ◽  
Unified Framework ◽  
Directed Networks ◽  
Research Fields ◽  
Wide Range ◽  
Definition Of ◽  
Information Finding ◽  
Empirical Networks ◽  
Module Structures

When we represent real-world systems as networks, the directions of links often convey valuable information. Finding module structures that respect link directions is one of the most important tasks for analysing directed networks. Although many notions of a directed module have been proposed, no consensus has been reached. This lack of consensus results partly because there might exist distinct types of modules in a single directed network, whereas most previous studies focused on an independent criterion for modules. To address this issue, we propose a generic notion of the so-called truss structures in directed networks. Our definition of truss is able to extract two distinct types of trusses, named the cycle truss and the flow truss, from a unified framework. By applying the method for finding trusses to empirical networks obtained from a wide range of research fields, we find that most real networks contain both cycle and flow trusses. In addition, the abundance of (and the overlap between) the two types of trusses may be useful to characterize module structures in a wide variety of empirical networks. Our findings shed light on the importance of simultaneously considering different types of modules in directed networks.

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