Re-skilling vocational education and training practitioners in Indonesia

Globalisation, together with the escalating levels of internationalisation of education, is placing emerging and unfamiliar pressures on the Indonesia vocational education and training system. Increasingly, Indonesia, like many other ASEAN nations, is being challenged by the growth of employee mobility and currently, their educational institutions struggle to provide the human resource development frameworks to build a modern skilled and efficient workforce. Recognising this need to meet these urgent demands for a modern skilled and trained workforce, the Indonesian government has focused on the introduction of advanced technical and vocational education through a 'Revitalisation Program for Vocational Higher Education Institutions'. This program is designed to improve the relevance, engagement and understanding between vocational and higher education institutions with business and industry, but it often calls on international educational support. In this paper, we examine the implications of importing 'external knowhow' into the Indonesian vocational education and training sector, placing particular focus on culturally appropriate training models, the growing reliance on 'external' models of engagement, and the implications for appropriate and sustainable vocational training models. Central to this re-skilling of the vocational education and training sector, are programs that: address the human resource capability development of the educator workforce; build viable and sustainable links to industry in order to provide seamless workforce needs; explore and examine models for successful industry development; and nurture mutually beneficial 'strategic partnerships' both locally and internationally

The potential therapeutic effects of creatine supplementation on body composition and muscle function in cancer

Low muscle mass in individuals with cancer has a profound impact on quality of life and independence and is associated with greater treatment toxicity and poorer prognosis. Exercise interventions are regularly being investigated as a means to ameliorate treatment-related adverse effects, and nutritional/supplementation strategies to augment adaptations to exercise are highly valuable. Creatine (Cr) is a naturally-occurring substance in the human body that plays a critical role in energy provision during muscle contraction. Given the beneficial effects of Cr supplementation on lean body mass, strength, and physical function in a variety of clinical populations, there is therapeutic potential in individuals with cancer at heightened risk for muscle loss. Here, we provide an overview of Cr physiology, summarize the evidence on the use of Cr supplementation in various aging/clinical populations, explore mechanisms of action, and provide perspectives on the potential therapeutic role of Cr in the exercise oncology setting

Using Evidence-Based Criteria for Block Grant Funding of Collaborative Time for Educator Professional Development

This report was prepared by the Maine Education Policy Research Institute (MEPRI) at the request of the Maine State Legislature to provide recommendations for the development of a block grant program of supplemental funding to school districts to support evidence-based professional development for educators and/ or leaders or instructional coaching support in schools and classrooms. The report provides guidance to inform decisions on pending legislation, LD 1394, “An Act to Implement the Recommendations of the Commission to Strengthen the Adequacy and Equity of Certain Cost Components of the School Funding Formula”. The report builds on an earlier MEPRI report which reviewed the most rigorous empirical research literature on educator professional development, and uses the evidence-based findings to recommend criteria for a block grant funding program. Specifically, this report: 1) identifies evidence-based characteristics of effective professional development and criteria for evaluating block grants applications, 2) suggests possible funding priorities for awarding grants based on school district attributes, and 3) suggests evaluation measures that grant recipients could report annually as a requirement of continued funding. In addition, the report provides findings from data collected through a focus group with 12 curriculum coordinators/ school districts from the Penobscot region around professional development supports needed to implement proficiency-based education. Finally, the authors discuss some broader considerations for policy and suggest that more work is needed to develop a coherent infrastructure for educator professional development in Maine and support for the use of evidence-based practices and effective implementation at the local level

Atheoretical Versus Theory-Based Approaches in Promoting Safer ADHD-Medication Prescribing for Adults

Gaps between treatment guidelines and medical decisions persist despite interventions with physicians, which are mostly atheoretical. The purpose of this retrospective cross-sectional study was to compare atheoretical and theory-based logistic regression models of a binary outcome: potentially unsafe prescribing of attention-deficit hyperactivity disorder (ADHD) medications to adults. Social cognitive theory and self-determination theory provided the framework for the study. Predictors were framed as social cognitive theoretical constructs: knowledge (e.g., physician specialty) and environmental influence (e.g., interventions). Atheoretical hypotheses were based on legislation mandating meaningful use of electronic health records and computerized decision support (CDS). Theory-based hypotheses were derived from literature on cognition in medicine and on the controlled motivation construct in self-determination theory. Research questions addressed associations of CDS and meaningful use with the outcome and fit of competing models. The sample included office-based physician visits made by patients aged \u3e 17 years with ADHD (n = 810) or potentially unsafe medical conditions (n = 9,101), recorded in a U.S. database in 2014–2016. Findings for the atheoretical model were reduced odds of the outcome with CDS, and nonsignificant improvement in model fit using theory. Supporting the self-determination theory-based hypothesis, odds were increased with meaningful use. This study adds to research suggesting autonomy as a core issue in medicine. Positive social change may result from psychology-based strategies to empower physicians through participation in developing clinically relevant information systems

Robust Aeroelastic Control of Very Flexible Wings using Intrinsic Models

This paper explores the robust control of large exible wings when their dynamics are written in terms of intrinsic variables, that is, velocities and stress resultants. Assuming 2-D strip theory for the aerodynamics, the resulting nonlinear aeroelastic equations of motion are written in modal coordinates. It is seen that a system which experiences large displacements can nonetheless be accurately described by a system with only weak nonlinear couplings in this description of the wing dynamics. As result, a linear robust controller acting on a control surface is able to effectively provide gust load alleviation and flutter suppression even when the wing structure undergoes large deformations. This is numerically demonstrated on various representative test cases. © 2013 by Yinan Wang, Andrew Wynn and Rafael Palacios

Increasing the Value of Health Care: The Role of Nurses

Increasing health care value has become a central objective of payment policies, insurance design and purchasing, and patient and provider decision-making. The word “value” appeared in the title of seven sections of the Affordable Care Act (ACA), and earlier this year CMS set a goal of having 50 percent of reimbursement based on value. This brief reviews nurses’ contribution to value, highlighting evidence published by researchers in the Interdisciplinary Nursing Quality Research Initiative (INQRI), an 8-year program funded by the Robert Wood Johnson Foundation. It also looks at interventions designed to address outcomes targeted by ACA- or Medicare-related payment policies

Ketamine for the treatment of depression in patients receiving hospice care: a retrospective medical record review of thirty-one cases.

BACKGROUND: Depression is prevalent in patients receiving hospice care. Standard antidepressant medications do not work rapidly enough in this setting. Evidence suggests that ketamine rapidly treats treatment refractory depression in the general population. Ketamine׳s role for treating depression in the hospice population warrants further study. METHODS: A retrospective medical record review of 31 inpatients receiving hospice care who received ketamine for depression on a clinical basis was conducted. The primary outcome measure was the Clinical Global Impression Scale, which was used retrospectively to rate subjects׳ therapeutic improvement, global improvement, and side effects from ketamine over 21 days. Additionally, time to onset of therapeutic effect was analyzed. RESULTS: Using the Clinical Global Impression Scale, ketamine was found to be significantly therapeutically effective through the first week after ketamine dosing (p \u3c 0.05), with 93% of patients showing positive results for days 0-3 and 80% for days 4-7 following ketamine dosing. Patients experienced global improvement during all 4 studied time periods following ketamine dosing (p \u3c 0.05). Significantly more patients had either no side effects or side effects that did not significantly impair functioning at each of the 4 assessed time periods following ketamine dosing (p \u3c 0.05). Additionally, significantly more patients experienced their first therapeutic response during days 0-1 following ketamine dosing (p \u3c 0.001) than during any other time period. CONCLUSIONS: These data suggest that ketamine may be a safe, effective, and rapid treatment for clinical depression in patients receiving hospice care. Blinded, randomized, and controlled trials are required to substantiate these findings and support further clinical use of this medication in hospice settings

Delivering the Strengthening Families Program to Native American Families During COVID-19: Lessons & Next Steps

The COVID-19 pandemic (COVID) of 2020 has forced adaptation for all Americans. Programs that serve Native American children and families are particularly critical during this time due to the disproportionate risks and disparities faced by this population. The objective of this qualitative evaluation is to gather adult participant feedback on strengths and needed changes with a telehealth adaptation of the Strengthening Families Program. This evaluation builds on previous knowledge of SFP group leadership which suggests that supportive helping relationships paired with dynamic flexibility are facilitators of effective family engagement. Participant feedback suggests that caregiver’s felt comfort, care, and genuine concern. In addition all participants noticed a difference in their families’ communication and relationships. Although tragic and challenging, the COVID-19 pandemic, forced a spotlight on barriers (limited internet access, social services, and food resources) that were needed to sustain participation and increase resilience among Native American residents in this mid-western state.  The individualized planning and checking in on every level which started out as a “how do we replicated this service” became about building resilience strategies for Native American families in this critical time in history