Holocene Tufa-Coated Serpulid Mounds From the Dominican Republic: Depositional and Diagenetic History, With Comparison to Modern Serpulid Aggregates From Baffin Bay, Texas

Ronald D. Lewis and Bruce C. Panuska (eds.) Proceedings of the 11th Symposium on the Geology of the Bahamas and Other Carbonate Regions: San Salvador, Gerace Research Cente

Seed Dispersal And Recruitment Limitation Across Spatial Scales In Temperate Forest Fragments

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/116983/1/ecy2004852507.pd

A Comparative Review of Canadian Health Professional Education Accreditation Systems

Canadian governments and various stakeholder groups are advocating greater interprofessional collaboration amongst health care providers as a fundamental strategy for enhancing coordination and quality of care in the health care system. Interprofessional education for collaborative patient-centred practice (IECPCP) is an educational process by which students/learners (or workers) from different health professions learn together to improve collaboration. The educational system is believed to be a main determinant of interprofessional collaborative practice, yet academic institutions are largely influenced by accreditation, certification and licensure bodies. Accreditation processes have been linked to the continuous improvement of curricula in the health professions, and have also been identified as potential avenues for encouraging educational change and innovation. The purpose of this paper is to summarize the characteristics of the national accreditation systems of select Canadian health professional education programs at both the pre- and post-licensure educational levels and to show how these systems support and/or foster IECPCP. A review of the educational accreditation systems of medicine, nursing, pharmacy, social work, occupational therapy and physiotherapy was undertaken through key informant interviews and an analysis of accreditation process documentation. The results of this comparative review suggest that accreditation systems are more prevalent across the health professions at a pre-licensure level. Accreditation at the post- licensure level, particularly at the continuing professional education level, appears to be less well established across the majority of health professions. Overall, the findings of the review also suggest that current accreditation systems do not appear to promote nor foster interprofessional education for collaborative patient-centred practice in a systematic manner through either accreditation processes or standards. Through a critical adult learning perspective we argue that in order for traditional uni-professional structures within the health professional education system to be challenged, the accreditation system needs to place greater value on interprofessional education for collaborative patient-centred practice.Les gouvernements du Canada ainsi que divers groupes d’intervenants appellent à une plus grande collaboration interprofessionnelle entre les fournisseurs de services de santé comme stratégie fondamentale pour rehausser la coordination et la qualité des soins dans le système des soins de santé. L’éducation interprofessionnelle pour la pratique collaborative centrée sur le patient (IECPCP) constitue un processus éducatif qui permet aux étudiants/apprenants (ou travailleurs) de diverses professions de la santé d’apprendre ensemble à mieux collaborer. Le système éducatif est perçu comme le principal déterminant de la pratique collaborative interprofessionnelle; cependant, les institutions éducatives sont fortement infl uencées par les organismes qui octroient les accréditations, certifi cations et autorisations d’exercer. Les processus d’accréditation ont été reliés à l’amélioration continue des programmes d’études dans les professions de santé et ils ont été également identifi és comme avenues potentielles pour encourager le changement et l’innovation en milieu éducatif. L’objectif de cet article est de résumer les caractéristiques des systèmes nationaux d’accréditation de certains programmes de formation des professionnels de la santé au Canada à tous les niveaux (pré- et post-autorisation d’exercer) et de montrer comment ces systèmes soutiennent ou encouragent l’IECPCP. Nous avons passé en revue les systèmes d’accréditation en médecine, soins infirmiers, pharmacie, travail social, ergothérapie et physiothérapie par le biais d’entrevues avec des personnes-clés et par l’analyse de la documentation sur les processus d’accréditation. Les résultats de cette étude comparative suggèrent que les systèmes d’accréditation dans les services de santé sont plus courants avant l’octroi de l’autorisation d’exercer. L’accréditation post-autorisation d’exercer, en particulier dans le domaine de la formation professionnelle continue, semble être moins bien établie dans la majorité des professions de la santé. Globalement, les résultats de l’étude suggèrent aussi que les systèmes actuels d’accréditation ne semblent pas promouvoir ou encourager la formation interprofessionnelle pour la pratique collaborative centrée sur le patient de façon systématique par les processus ou normes d’accréditation. Dans la perspective critique de l’apprentissage des adultes, nous avançons que, pour remettre en question les structures uniprofessionnelles traditionnelles du système éducatif des professions de la santé, le système d’accréditation doit accorder une plus grande place à l’éducation interprofessionnelle sur la pratique collaborative centrée sur le patient.&nbsp

The NASA Electric Propulsion Program

Nearly all space missions require on-board propulsion systems and these systems typically have a major impact on spacecraft mass and cost. Electric propulsion systems offer major performance advantages over conventional chemical systems for many mission functions and the NASA Office of Space Access and Technology (OSAT) supports an extensive effort to develop the technology for high-performance, on-board electric propulsion system options to enhance and enable near- and far-term US space missions. This program includes research and development efforts on electrothermal, electrostatic, and electromagnetic propulsion system technologies to cover a wide range of potential applications. To maximize expectations of technology transfer, the program emphasizes strong interaction with the user community through a variety of cooperative and contracted approaches. This paper provides an overview of the OSAT electric propulsion program with an emphasis on recent progress and future directions

Phosphorus Efficiency Of Bornean Rain Forest Productivity: Evidence Against The Unimodal Efficiency Hypothesis

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/117012/1/ecy20058661548.pd

Effects of Small Rodent and Large Mammal Exclusion on Seedling Recruitment in Costa Rica 1

We examined whether the experimental exclusion of large mammalian and small rodent seed predators had differing effects on seedling recruitment under natural seed rain conditions. In both primary and late-successional secondary forested areas, exclosure experiments using natural seed densities were designed to assess seedling recruitment. To assess the differences in seedling recruitment, we monitored three exclosure treatments (1.2 m radius/1.5 m height) in two forest types (primary vs. late-successional secondary forest): (1) fenced exclosures that excluded large mammals; (2) fenced exclosures that excluded both large and small mammals; and (3) open controls. Within each exclosure treatment, we marked and identified all seedlings at the beginning of the experiment (February 2001), followed the marked seedlings' fate for a year, and then marked and identified all new seedlings after a year. Two preliminary findings were generated from these data: for some tree species, small rodents and large mammals have differential effects on seedling recruitment, and the effect of excluding mammals did not differ with habitat type (primary vs. late-successional secondary forest). These preliminary results highlight the need to examine further how the effects of small rodent and large mammal exclusion may affect species-specific seed predation and seedling recruitment in a variety of habitat/land use types ( e.g. , primary forest, late-successional forest, and early-successional forest).Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74037/1/j.1744-7429.2006.00117.x.pd

Cylindrical Mega-Voids in Quaternary Aeolianites, Little Exuma Island, The Bahamas: Georadar Response

In addition to karst features, tropical carbonates contain a wide range of smaller cylindrical voids (“pipes”) attributed to bioturbation, tree molds, or dissolution, among others. During geophysical investigation of the Little Exuma Island, The Bahamas, several sites with enigmatic voids were investigated using a high-frequency ground-penetrating radar (GPR) imaging. The aim of the paper is to assess the feasibility of GPR to detect voids within lithified Holocene calcarenites of the Hannah Bay Membe

Implementation outcomes of evidence-based quality improvement for depression in VA community based outpatient clinics

<p>Abstract</p> <p>Background</p> <p>Collaborative-care management is an evidence-based practice for improving depression outcomes in primary care. The Department of Veterans Affairs (VA) has mandated the implementation of collaborative-care management in its satellite clinics, known as Community Based Outpatient Clinics (CBOCs). However, the organizational characteristics of CBOCs present added challenges to implementation. The objective of this study was to evaluate the effectiveness of evidence-based quality improvement (EBQI) as a strategy to facilitate the adoption of collaborative-care management in CBOCs.</p> <p>Methods</p> <p>This nonrandomized, small-scale, multisite evaluation of EBQI was conducted at three VA Medical Centers and 11 of their affiliated CBOCs. The Plan phase of the EBQI process involved the localized tailoring of the collaborative-care management program to each CBOC. Researchers ensured that the adaptations were evidence based. Clinical and administrative staff were responsible for adapting the collaborative-care management program for local needs, priorities, preferences and resources. Plan-Do-Study-Act cycles were used to refine the program over time. The evaluation was based on the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) Framework and used data from multiple sources: administrative records, web-based decision-support systems, surveys, and key-informant interviews.</p> <p>Results</p> <p><it>Adoption: </it>69.0% (58/84) of primary care providers referred patients to the program. <it>Reach: </it>9.0% (298/3,296) of primary care patients diagnosed with depression who were not already receiving specialty care were enrolled in the program. <it>Fidelity: </it>During baseline care manager encounters, education/activation was provided to 100% (298/298) of patients, barriers were assessed and addressed for 100% (298/298) of patients, and depression severity was monitored for 100% (298/298) of patients. Less than half (42.5%, 681/1603) of follow-up encounters during the acute stage were completed within the timeframe specified. During the acute phase of treatment for all trials, the Patient Health Questionnaire (PHQ9) symptom-monitoring tool was used at 100% (681/681) of completed follow-up encounters, and self-management goals were discussed during 15.3% (104/681) of completed follow-up encounters. During the acute phase of treatment for pharmacotherapy and combination trials, medication adherence was assessed at 99.1% (575/580) of completed follow-up encounters, and side effects were assessed at 92.4% (536/580) of completed follow-up encounters. During the acute phase of treatment for psychotherapy and combination trials, counseling session adherence was assessed at 83.3% (239/287) of completed follow-up encounters. <it>Effectiveness: </it>18.8% (56/298) of enrolled patients remitted (symptom free) and another 22.1% (66/298) responded to treatment (50% reduction in symptom severity). <it>Maintenance: </it>91.9% (10/11) of the CBOCs chose to sustain the program after research funds were withdrawn.</p> <p>Conclusions</p> <p>Provider adoption was good, although reach into the target population was relatively low. Fidelity and maintenance were excellent, and clinical outcomes were comparable to those in randomized controlled trials. Despite the organizational barriers, these findings suggest that EBQI is an effective facilitation strategy for CBOCs.</p> <p>Trial registration</p> <p>Clinical trial # <a href="http://www.clinicaltrials.gov/ct2/show/NCT00317018">NCT00317018</a>.</p

NL360+: A Multisource Feedback & Peer-Coaching Pilot Program: Final Evaluation Report

In November 2018, the Office of Professional & Educational Development (OPED), Faculty of Medicine, Memorial University received an unrestricted educational grant from the College of Physicians and Surgeons of Newfoundland and Labrador (CPSNL) to design, develop, pilot, and evaluate a Quality Improvement (QI) program for Newfoundland and Labrador (NL) physicians - NL360+: A Multisource Feedback & Peer-Coaching Pilot Program. The purpose of this program was to provide physicians in the province with a voluntary opportunity to participate in, and evaluate, a pilot multisource feedback and peer-coaching experience. The initial timeline for completion of pilot program delivery and evaluation was December 2020. However, the COVID-19 public health emergency caused significant delays in the matching of participants and peer-coaches and subsequently, the coaching sessions. The process continued to move forward and a preliminary evaluation report was submitted to the CPSNL in December 2020. The NL360+ pilot program closed in June 2021