Правове регулювання повторного шлюбу у римському та ранньовізантійському праві

В статті досліджується традиційна проблема інституту повторного шлюбу в контексті його еволюції на засадах античних та християнських цінностей.В статье исследуется традиционная проблема института повторного брака в контексте его эволюции на принципах античных и христианских ценностей.In the article the traditional problem of institute of the deuterogamy is probed in the context of its evolution on principles of ancient and christian values

Interval exercise versus continuous exercise in patients with moderate to severe chronic obstructive pulmonary disease – study protocol for a randomised controlled trial [ISRCTN11611768]

BACKGROUND: Physical exercise has become a cornerstone of management of chronic obstructive pulmonary disease (COPD) because it leads to clinically relevant improvements of exercise capacity and health-related quality of life (HRQL). Despite the scarcity of randomised trials directly comparing exercise protocols, current guidelines recommend high intensity continuous exercise for lower extremities as the probably most effective exercise modality. However, for patients admitted to inpatient respiratory rehabilitation programmes, it is often difficult to initiate such an exercise programme because they are severely limited by dyspnoea and leg fatigue and therefore unable to perform continuous exercise at higher intensities and for periods longer than 30 minutes. Interval exercise may be an attractive alternative for these COPD patients because it allows high intensity exercise with recovery periods. The aim of this study is to assess if interval exercise compared to high intensity continuous exercise is not of inferior effectiveness in terms of HRQL and exercise capacity improvements but associated with better exercise tolerance in patients with moderate to severe COPD at the beginning of a respiratory rehabilitation. METHODS/DESIGN: We will assign patients with moderately severe to severe COPD to either continuous exercise or interval exercise using a stratified randomisation. Patients will follow 12–15 exercise sessions during a comprehensive inpatient respiratory rehabilitation. Primary end point for effectiveness is HRQL as measured by the Chronic Respiratory Questionnaire (CRQ) two weeks after the end of rehabilitation and secondary endpoints include additional clinical outcomes such as functional exercise capacity, other HRQL measures, patients' experience of physical exercise as well as physiological measures of the effects of physical exercise such as cardiopulmonary exercise testing. Including expected drop-outs, we will need 52 patients per group to show differences corresponding to the minimal clinically important difference of the CRQ. Outcome assessors and investigators involved in data analysis will be blinded to group assignment until analyses have been carried out. DISCUSSION: Clinicians and the scientific community need evidence on the benefits and tolerance of exercise protocols available in clinical practice. The proposed trial will provide important and needed data on interval and continuous exercise for decision making in clinical practice

Werkregels voor innovatiemanagers : Vernieuwing in het hoger beroepsonderwijs in een versnelling

Stagnation in educational innovations is an important cause for the lack of results. The stagnation is the result of two core problems in educational innovation: (1) A basic linear reasoning that does not meet the difficulty to predict course of educational innovation. (2) The innovation ignores the substantive debate with teachers, as a result of which teachers are not inclined to implement the new behavior. In this research, the basic linear reasoning is exchanged for the dynamic multi-actor perspective. This new perspective demands different behavior from the leader of educational innovation, the innovation manager. The aim of this study is to design work rules that an innovation manager can use to realize continuity in educational innovation, from the dynamic multi-actor perspective. In a design-oriented study, a set of 18 work rules for innovation managers was developed with three different research methods. The work rules are projected onto a spiral-shaped ordering framework, with which an orientation base has been created for innovation managers, a source from which they can draw upon the understanding and intervene in educational innovation. The orientation base comprises four rounds representing the transfer of development energy between actor groups in different stages of educational innovation. Release of development energy keeps educational innovation going, failing leads to stagnation. First tests in practice show that the use of the orientation base by innovation managers contributes to the continuity of educational innovation

Development of a Master's Level Competency Profile for Sports Physiotherapists.

Purpose: Sports Physiotherapy for All is a Leonardo da Vinci funded project that aims to enhance professional mobility and recognition of sports physiotherapists in Europe, and to promote safe sports and activity participation. The first step of the project involved the development of European competencies and standards for sports physiotherapists. The protocol for developing the competency profile for sports physiotherapists is outlined and examples of the resulting competencies are provided. Protocol: The design of a competency profile first required analysis of the sports physiotherapy profession. Different professional roles were differentiated and the required behaviours were defined as competencies. A model has been developed in the context of specialised professional physiotherapy master's qualifications in the Netherlands. This defines specific interconnecting roles within the profession and provided the structure for the competency profile. International documentation relating to sports physiotherapy practice and education was collected and qualitatively analysed for similarities and differences in descriptions of knowledge, skills and attitudes. Themes were developed and cross-checked by an expert panel of sports physiotherapists. A cut-and-paste technique was used to locate each individual theme within the interconnecting professional roles. The expert panel grouped these themes into competencies: behaviours that require the interconnection of knowledge, skills and attitudes, used effectively in a specific professional context1. Output: The professional model incorporates four interconnecting roles: case manager, advisor, professional leader and innovator. Eleven competencies are located within the different roles and the areas of overlap. The model illustrates the interaction of all sports physiotherapy competencies to form the profession. For example, a sports physiotherapist cannot be competent in evidence-based rehabilitation without developing the interconnected life-long learning competency. Discussion The sports physiotherapy competencies were adopted at the International Federation of Sports Physiotherapy General Meeting, November 2004. Standards have been developed to define criteria for minimum threshold levels of achievement of each competency. Support strategies will be developed to facilitate sports physiotherapists in their development and demonstration of their competencies, promoting their professional recognition throughout Europe.sch_phy1 Ministry for Education, Culture and Science [Minister Van Onderwijs, Cultuur en Wetenschappen] (2002) Competenties: van complicaties tot compromis. Uitgave van de Onderwijsraad, Den Haag, Netherlandsunpub1973unpu

Development of a Master's Level Competency Profile for Sports Physiotherapists.

Purpose: Sports Physiotherapy for All is a Leonardo da Vinci funded project that aims to enhance professional mobility and recognition of sports physiotherapists in Europe, and to promote safe sports and activity participation. The first step of the project involved the development of European competencies and standards for sports physiotherapists. The protocol for developing the competency profile for sports physiotherapists is outlined and examples of the resulting competencies are provided. Protocol: The design of a competency profile first required analysis of the sports physiotherapy profession. Different professional roles were differentiated and the required behaviours were defined as competencies. A model has been developed in the context of specialised professional physiotherapy master's qualifications in the Netherlands. This defines specific interconnecting roles within the profession and provided the structure for the competency profile. International documentation relating to sports physiotherapy practice and education was collected and qualitatively analysed for similarities and differences in descriptions of knowledge, skills and attitudes. Themes were developed and cross-checked by an expert panel of sports physiotherapists. A cut-and-paste technique was used to locate each individual theme within the interconnecting professional roles. The expert panel grouped these themes into competencies: behaviours that require the interconnection of knowledge, skills and attitudes, used effectively in a specific professional context1. Output: The professional model incorporates four interconnecting roles: case manager, advisor, professional leader and innovator. Eleven competencies are located within the different roles and the areas of overlap. The model illustrates the interaction of all sports physiotherapy competencies to form the profession. For example, a sports physiotherapist cannot be competent in evidence-based rehabilitation without developing the interconnected life-long learning competency. Discussion The sports physiotherapy competencies were adopted at the International Federation of Sports Physiotherapy General Meeting, November 2004. Standards have been developed to define criteria for minimum threshold levels of achievement of each competency. Support strategies will be developed to facilitate sports physiotherapists in their development and demonstration of their competencies, promoting their professional recognition throughout Europe.sch_phy1 Ministry for Education, Culture and Science [Minister Van Onderwijs, Cultuur en Wetenschappen] (2002) Competenties: van complicaties tot compromis. Uitgave van de Onderwijsraad, Den Haag, Netherlandsunpub1973unpu

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