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

Toccata E Corale

Physical copy includes duplicate pages 20-31Toccata e Carafe is an eight minute work scored for full orchestra. The title represents the two main parts of the work. The opening toccata section is named after the keyboard works of the Renaissance and Baroque, which are characterized by fast moving, virtuosic, imitative, and varied material. The transitional middle section is an expressive adagio focusing on lush string writing with the melody in the violins. The final section begins with a chorale first presented in the brass, accompanied by fast moving scalar lines in the strings and woodwinds. The piece concludes with a brief recapitulation of the toccata and adagio sections before a "Grand Pause", and a final presentation of chorale in C within the coda. The form of the work is influenced by the third movement of Witold Lutoslawski's Concerto for Orchestra entitled "Passacaglia, Toccata e Corale." Lutoslawski skillfully combines three different musical textures into one cohesive movement through the use of melodic and structural motivic connections. This piece attempts to achieve the same cohesive whole through similar techniques. The work develops from the material presented in the first 28 measures. The opening melody contains half step motions used throughout the work, both melodically and structurally. The top note in the opening harmony and melody in the violins, flutes, and piccolo starts on C:!$, which is an important melodic pitch in the toccata. The C# also serves a structural purpose later in the work as the tonal center for the complete presentation of the chorale, starting in measure 154. The C# is used as a structural chromatic upper neighbor to C, which is the ultimate arrival pitch and harmony in the coda, starting in measure 212. The melodic contour in the adagio section, in turn, is developed from the opening melody's alternating, arpeggiated, and scalar motions, but the harmony used in the adagio anticipates the chorale's harmonic sound world. In this way each section contributes musically to every following section, creating a cohesiveness that binds the different musical textures present in the work

Case Study of School Practices, Policies, and Culture That Foster Small, Faith-Based School Teacher Retention

Teachers are the very foundation of a successful educational program. High rates of teacher attrition threaten the core mission of small, private, non-Catholic, faith-based secondary schools—to transform students spiritually, intellectually, and personally. It is vital that the faculty at these schools is comprised of quality teachers who return year-to-year to deepen relationships with students and continue the momentum of student transformation. The problem addressed in this single, instrumental case study is the high rate of teacher attrition that exists within small, private, non-Catholic, faith-based schools. The purpose of this study was to examine practices and policies that support teacher retention within small, private, non-Catholic faith-based secondary schools. The study was guided by the research question: What work conditions at small faith-based secondary schools support strong teacher retention? The research study was conducted at a small, non-Catholic, faith-based, private high school in rural Texas. Data was collected through on-site teacher interviews and observations and an off-site document review. The results revealed that school culture, administrative support, teacher voice, and student discipline played major roles in the teachers’ decisions to return year-to-year. Additionally, the results indicated that teacher workload and compensation did not significantly impact teachers’ plans to return. These results offer a foundation of understanding the work conditions that influence teacher retention in small, private, non-Catholic, faith-based secondary schools and set the stage for further research

Countdown to 2010: Can we assess Ireland’s insect species diversity and loss?

peer-reviewedThe insects are the most diverse organisms on this planet and play an essential role in ecosystem functioning, yet we know very little about them. In light of the Convention on Biological Diversity, this paper summarises the known insect species numbers for Ireland and questions whether this is a true refl ection of our insect diversity. The total number of known species for Ireland is 11,422. Using species accumulation curves and a comparison with the British fauna, this study shows that the Irish list is incomplete and that the actual species number is much higher. However, even with a reasonable knowledge of the species in Ireland, insects are such speciose, small, and inconspicuous animals that it is diffi cult to assess species loss. It is impossible to know at one point in time the number of insect species in Ireland and, although it is useful to summarise the known number of species, it is essential that biodiversity indicators, such as the Red List Index, are developed

Progress toward the Synthesis of the Basiliolides and Transtaganolides: An Intramolecular Pyrone Diels−Alder Entry into a Novel Class of Natural Products

Efforts directed toward the synthesis of a basiliolide/transtaganolide model system are disclosed. A highly endo-selective intramolecular pyrone Diels−Alder (IMPDA) cycloaddition rapidly constructs the tricyclic core of the basiliolides and transtaganolides

Feeding Guilds Among Artificial-Reef Fishes in the Northern Gulf of Mexico

To examine the diets of 25 demersal artificial-reef-associated fish species, 540 fishes were collected with spears and hand-nets off Panama City, Florida, in the summer of 1993. Fishes were preserved whole in the field. Stomach contents were later analyzed by frequency of occurrence, numerical abundance, and percent volume. These measures were combined into an Index of Relative Importance (IRI). The data set was then analyzed with cluster and detrended correspondence (DCA) analyses. Forage items of the reef fishes were dominated by fishes, xanthid crabs, unidentified items, squids, polychaetes, and penaeid shrimps. The DCA and cluster analysis revealed that these 25 artificial reef fishes could be organized into seven feeding guilds: lower structure pickers, ambush predators, lower structure crustacean predators, upper structure pickers, upper structure predators, water column pickers, and reef-associated open-water feeders. All of the demersal gamefish in this study were in the same feeding guild (i.e., reef-associated openwater feeders). Species in this feeding guild were associated with artificial reefs diurnally and foraged away from reefs nocturnally. Our data indicate that many important artificial-reef-associated fishes in the northern Gulf of Mexico obtain most of their energy foraging away from the artificial reef structure