Creating the Health Care Team of the Future: The Toronto Model for Interprofessional Education and Practice

[Excerpt] In 2000, the Institute of Medicine\u27s landmark report To Err Is Human launched the contemporary patient safety movement with its clarion call to the health care systems all over the globe to act to prevent the errors that kill over 100,000 patients a year and harm many thousands more in the United States alone. Ten years later, in 2010, the World Health Organization\u27s (WHO) Framework for Action on Interprofessional Education and Collaborative Practice was released, as was the Lancet Commission report Health Professionals for a New Century: Transforming Education to Strengthen Health Systems in an Interdependent World. In fact, over the past decade or more, studies have documented that, far from improving, in countries such as the United States and Canada, there has been little progress in preventing patient deaths and harm. Original calculations such as those done by the Institute of Medicine in 2000 are now considered to have been dramatic underestimations of the harm done to patients in health care institutions around the world. Although the complexity of today\u27s high-tech health care systems is often used as a rationalization for the maintenance of the status quo, all these groundbreaking reports argue that team-based, or interprofessional, care is a key strategy to move our current underperforming health care systems toward a more safe, efficient, integrated, and cost-effective model. Contemporary health care institutions do indeed have a bewildering number of players. Despite this, the responsibility for ensuring that patients receive the right care at the right time from the right providers relies on a few basic principles: Practitioners need to understand they are part of a diverse team. Practitioners must communicate effectively with the patient and family, as well as with other members of their team. Practitioners need to know what other team members do to limit duplication and prevent gaps in care. Practitioners need to know how to work together to optimize care so that the patient journey from inpatient care to home care, or from primary care to the specialist clinic is experienced as seamless. Since 2000, the eleven health professional programs at the University of Toronto and the forty-nine teaching hospitals associated with them have developed an Interprofessional Education and Care (IPE/C) program that begins in the first year of a health professional student\u27s entry into his or her program, continues through various educational activities throughout their studies, and straddles the education/practice divide. Over the past decade, the university and teaching hospital partners have been engaged in the co-development and support of the IPE curriculum for learners. They are also investing in the development of faculty and the ongoing training of staff to support and model collaborative practice and team-based care. What we have come to think of as the Toronto Model is integrated across all sites and professions and includes classroom, simulation, and practice education

Protein regulation: Tag wrestling with relatives of ubiquitin

AbstractUbiquitin modification is a well established way of regulating protein levels and activities. Modification by related ubiquitin-like proteins is turning out to have a diverse range of interesting cellular functions

Legal and political barriers and enablers to the deployment of marine renewable energy

Ocean energy is a promising source of clean renewable energy, with clear development targets set by the European Commission. However, the ocean energy sector faces non-technological challenges and opportunities that are frequently overlooked in deployment plans. The present study aimed to provide a critical evaluation of the ocean energy sector’s legal, institutional, and political frameworks with an identification and analysis of both barriers and enabling features for the deployment of ocean energy. In the first stage, a literature review on the current political and regulatory frameworks of a set of European countries was carried out, setting the basis for the main challenges and enabling factors faced by the sector. Secondly, a critical analysis of the main non-technological barriers and enablers was performed, which was supported by questionnaires sent to regulators, technology developers, and test-site managers. This questionnaire allowed us to collect and integrate the views, perceptions, and personal experiences of the main stakeholders of the ocean energy sector in the analysis. The most relevant insights were collected to guide future policy instruments, supports, and consenting measures in a more informed and effective manner and to help accelerate the development of the sector

Use of the child and adolescent functional assessment scale (CAFAS) as an outcome measure in clinical settings

This article discusses how the Child and Adolescent Functional Assessment Scale (CAFAS) can be used as an outcome measure in clinical settings. Outcome data from two clinical samples are provided: a small community mental health center located in Michigan and a large referred sample from the Fort Bragg Evaluation Project. Outcome indicators for assessing change over time included overall level of dysfunction, percentage of respondents with severe impairment, mean total score, mean scores for individual CAFAS subscales, and change in total score at the client level. Implications of the findings were discussed from several perspectives: improving services to individual clients, developing databases at the local level that can be used for the agency's continuing self-scrutiny, and pooling databases across sites that can be used to study broader issues within a managed care environment.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45765/1/11414_2005_Article_BF02287471.pd

Animal Tracks Wetlands Action Pack

Welcome to Animal Tracks®, a classroom education program of the National Wildlife Federation focusing on teacher training and environmental education resources. In Animal Tracks materials, the animals and their tracks lead educators and students on an exploration of conservation issues. Thank you for using this Action Pack, our newest resource. We hope you find the Action Packs useful and as a work-in-progress, we welcome any comments you might have for I improvements. As you turn the page you\u27ll see our questionnaire. Please take a minute to fill it out and put it in the mail. We\u27ll include you on our mailing list and you\u27ll get invitations to any Animal Tracks educator workshops that we hold in your area as well as the latest information on Animal Tracks programs and materials. Animal Tracks Workshops are a large part of the Animal Tracks program. The Action Pack series was originally developed as our teacher training module. The workshops are designed to help teachers easily fit environmental and conservation issues into their lesson plans across the curriculum. Animal Tracks workshops emphasize learning by doing and include an interactive discussion of how to successfully incorporate action projects into learning. Animal Tracks has educator materials and information available online at http://www.nwf.org/atracks including the Water and Habitat Action Packs, Current Events Hotline, information about NWF\u27s EarthTomorrow® program for Detroit area schools, Environmental Education Online Conference, Animal Tracks Workshop schedule, and Animal Tracks Online classroom activities. There are also Animal Tracks kids\u27 pages at http://www.nwf.org/nwf/kids/ with our Cool Tour o/the Environment, Ranger Rick® site, resources in Spanish, games, and more fun. The next pages of the Action Pack are a questionnaire and an explanation about how to effectively use the Animal Tracks Action Packs. Again, we hope you find this a valuable resource and be sure to check out all the Animal Tracks Action Pack titles

Recommended isolated-line profile for representing high-resolution spectroscopic transitions (IUPAC Technical Report)

The report of an IUPAC Task Group, formed in 2011 on "Intensities and line shapes in high-resolution spectra of water isotopologues from experiment and theory" (Project No. 2011-022-2-100), on line profiles of isolated high-resolution rotational-vibrational transitions perturbed by neutral gas-phase molecules is presented. The well-documented inadequacies of the Voigt profile (VP), used almost universally by databases and radiative-transfer codes, to represent pressure effects and Doppler broadening in isolated vibrational-rotational and pure rotational transitions of the water molecule have resulted in the development of a variety of alternative line-profile models. These models capture more of the physics of the influence of pressure on line shapes but, in general, at the price of greater complexity. The Task Group recommends that the partially Correlated quadratic-Speed-Dependent Hard-Collision profile should be adopted as the appropriate model for high-resolution spectroscopy. For simplicity this should be called the Hartmann--Tran profile (HTP). The HTP is sophisticated enough to capture the various collisional contributions to the isolated line shape, can be computed in a straightforward and rapid manner, and reduces to simpler profiles, including the Voigt profile, under certain simplifying assumptions.Comment: Accepted for publication in Pure and Applied Chemistr

Single-Color Centers Implanted in Diamond Nanostructures

The development of material-processing techniques that can be used to generate optical diamond nanostructures containing a single-color center is an important problem in quantum science and technology. In this work, we present the combination of ion implantation and top-down diamond nanofabrication in two scenarios: diamond nanopillars and diamond nanowires. The first device consists of a 'shallow' implant (similar to 20 nm) to generate nitrogen-vacancy (NV) color centers near the top surface of the diamond crystal prior to device fabrication. Individual NV centers are then mechanically isolated by etching a regular array of nanopillars in the diamond surface. Photon anti-bunching measurements indicate that a high yield (> 10%) of the devices contain a single NV center. The second device demonstrates 'deep' (similar to $1 \mu m$) implantation of individual NV centers into diamond nanowires as a post-processing step. The high single-photon flux of the nanowire geometry, combined with the low background fluorescence of the ultrapure diamond, allowed us to observe sustained photon anti-bunching even at high pump powers.Engineering and Applied SciencesPhysic

Psychometric characteristics of a multidimensional measure to assess impairment: The Child and Adolescent Functional Assessment Scale

The Child and Adolescent Functional Assessment Scale (CAFAS) is a multidimensional measure of degree of impairment in functioning. Interrater reliability data are presented for lay raters, graduate students, and frontline staff. Reliability was high for the total score and behaviorally-oriented scales. Construct, concurrent, and discriminant validity were assessed with the sample of children and adolescents evaluated at the Fort Bragg Demonstration Evaluation Project. Youth and their caregivers were evaluated via interview and selfcompleted instruments at four time points. Significant correlations were found between the CAFAS and other related constructs. Concurrent validity was demonstrated by logistic regression analyses examining the relationship between CAFAS ratings and problematic behaviors endorsed on measures completed by parents, teachers, or the youth. Youth with higher CAFAS total scores were much more likely to have poor social relationships, difficulties in school, and problems with the law. Discriminant validity was assessed with a repeated measures analysis of variance with intensity of care at intake and time as factors. Youth who were inpatients or in residential treatment centers at intake had higher CAFAS scores than those who were outpatients. These findings provide strong evidence for the reliability and validity of the CAFAS.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44651/1/10826_2005_Article_BF02233865.pd