Guidelines for the management of the foot health problems associated with rheumatoid arthritis

Background. Rheumatoid arthritis (RA) as a chronic systemic disease, commonly affects the feet, impacting negatively on patients' quality of life. Specialist podiatrists have a prime role to play in the assessment and management of foot and ankle problems within this patient group. However, it has been identified that in many areas there is no specialist podiatry service, with many patients being managed by non‐specialist podiatrists. Therefore, the North West Clinical Effectiveness Group for the Foot in Rheumatic Diseases (NWCEG) identified the need to develop ‘practitioner facing’ guidelines for the management of specific foot health problems associated with RA. Methods. Members of a guideline development group from the NWCEG each reviewed the evidence for specific aspects of the assessment and management of foot problems. Where evidence was lacking, ‘expert opinion’ was obtained from the members of the NWCEG and added as a consensus on current and best practice. An iterative approach was employed, with the results being reviewed and revised by all members of the group and external reviewers before the final guideline document was produced. Results. The management of specific foot problems (callus, nail pathology, ulceration) and the use of specific interventions (foot orthoses, footwear, patient education, steroid injection therapy) are detailed and standards in relation to each are provided. A diagrammatic screening pathway is presented, with the aim of guiding nonspecialist podiatrists through the complexity of assessing and managing those patients with problems requiring input from a specialist podiatrist and other members of the rheumatology multidisciplinary team. Conclusion. This pragmatic approach ensured that the guidelines were relevant and applicable to current practice as ‘best practice’, based on the available evidence from the literature and consensus expert opinion. These guidelines provide both specialist and non‐specialist podiatrists with the essential and ‘gold standard’ aspects of managing people with RA‐related foot problems

Spiritual Care of Couples Practicing Natural Family Planning

There are few studies that have investigated the spiritual problems of couples practicing natural family planning (NFP). The purpose of this paper is to analyze the spiritual problems and interventions of couples who were taught NFP by means of a professional online Web-based support system. Responses from this online system and its forums were categorized according to spiritual responses, spiritual problems, and spiritual interventions to the practice of NFP. Themes addressed included spiritual care in regards to decisions about the transmission of new life, difficulties in dealing with chastity and abstinence, bioethical problems related to pregnancy and illness, end of the reproductive life decisions, ethical treatment of women\u27s health problems, sacrifice, and personal and relational struggles. Online community support, help in building confidence in NFP methods, and bioethicist referral are key interventions. The complexity of these spiritual responses, problems, and appropriate interventions require the expertise of health professionals in cooperation with bioethicists. We concluded that NFP can be viewed as both a spiritual practice and a means of spiritual growth

Promoting inquiry skills in Curriculum for Excellence in Science: conceptualising inquiry to improve practice

This paper describes a Scottish initiative (arising out of a EU funded development project) involving university researchers, a local authority curriculum development officer and a group of teachers interested in developing more inquiry based approaches in science education. The project is not one in which the researchers bring prescriptions from research. Rather, it is seen as a joint effort aimed at solving practitioners' conceptual and practice issues. The overall question for the teachers was, How do I (we) make our practice more inquiry based? The question for the researchers was, How do we help you (the interested science teachers) to make your practice more inquiry based? This has two sub-questions: How do we help you to conceptualise the issues? How do we help you to solve the practice problems? As it turned out, the particular group of teachers we worked with did not ask for help with practice issues, so we have not made much progress in answering the second question. Therefore, this paper will focus on the first. We seem to have been successful in helping the teachers to acquire some useful conceptual tools for thinking about and changing their practice in ways that they valued for themselves. Perhaps the answer to the second question is that researchers can help teachers to solve their practice problems by helping them to conceptualise the issues

THE PROBLEMS FACED BY PRACTICE TEACHERS OF ENGLISHDEPARTMENT IN WRITING LESSON PLAN

Lesson plan is guidance and teaching outline of the teacher, used to teach in teaching learning process. It is the reminder for the teachers about what they have to prepare, what they will bring, and what they will do in the classroom. The present study is intended to know the problems faced by practice teachers of English Department in writing lesson plan, describe the reasons underlined practice teacher having problems, and the suggestions that can be given by supervisor teachers. In this study, the researcher used descriptive qualitative research design. The research subjects were six practice teachers of English Department of University of Muhamadiyah Malang who have finished conducting practice teaching at SMPN 3 Malang. The instruments used to collect the data were interview and document. The interview was used for both practice teachers and supervisor teachers to obtain the data on the problems faced by practice teachers of English Department in writing lesson plan and to find the suggestions that can be given by supervisor teachers to cope practice teachers’ problems. And document were used is practice teachers’ lesson plan. The data of the study were analyzed qualitatively. The result of the study shows that practice teachers faced problems in writing lesson plan. The problems concerned with objective, indicator, material, method, teaching activities, and media/source. It caused by less of knowledge in develop lesson plan and how to create the variation of teaching preparation. The other problems that often faced were in connecting the objectives and the teaching learning activities because it was hard to arrange various teaching learning activities to reach the objectives. To cope the problems, supervisor teachers gave the suggestions they were; consult the lesson plan to the supervisor regularly; share the problems with the teams of practice teachers or ask to the supervisor directly. It is concluded that practice teachers having problems caused by less of knowledge in how to develop lesson plan and how to create the variation of teaching preparation though they have guided by experienced supervisor teachers and understand the standard objective of the school. They also solve the problems by themselves not by consult it to the supervisor teachers directly

Building Communities of Practice

{Excerpt} According to Etienne Wenger, communities of practice are groups of people who share a passion for something they do and who interact regularly to learn how to do it better. Communities of practice define themselves along three dimensions: what they are about, how they function, and what capabilities they produce. Each community of practice has a unique domain, community, and practice (and the support it requires). But, inconnecting and collecting, communities of practice share the following common characteristics: • They are peer-to-peer collaborative networks. • They are driven by the willing participation of their members. • They are focused on learning and building capacity. • They are engaged in sharing knowledge, developing expertise, and solving problems

Beyond Representation: Philosophy And Poetic Imagination

The essays in this volume explore the ways in which traditional philosophical problems about self-knowledge, self-identity, and value have migrated into literature since the Romantic and Idealist periods. How do so-called literary works take up these problems in a new way? What conception of the subject is involved in this literary practice? How are the lines of demarcation between philosophy and literature problematized. The contributors examine these issues with reference both to Romantic and Idealist writers and to some of their subsequent literary and philosophical inheritors and revisers. Their essays offer a philosophical understanding of the roots and nature of contemporary literary and philosophical practice, and elaborate powerful and influential, but rarely decisively articulated, conceptions of the human subject and of valu

Distribution-Aware Sampling and Weighted Model Counting for SAT

Given a CNF formula and a weight for each assignment of values to variables, two natural problems are weighted model counting and distribution-aware sampling of satisfying assignments. Both problems have a wide variety of important applications. Due to the inherent complexity of the exact versions of the problems, interest has focused on solving them approximately. Prior work in this area scaled only to small problems in practice, or failed to provide strong theoretical guarantees, or employed a computationally-expensive maximum a posteriori probability (MAP) oracle that assumes prior knowledge of a factored representation of the weight distribution. We present a novel approach that works with a black-box oracle for weights of assignments and requires only an {\NP}-oracle (in practice, a SAT-solver) to solve both the counting and sampling problems. Our approach works under mild assumptions on the distribution of weights of satisfying assignments, provides strong theoretical guarantees, and scales to problems involving several thousand variables. We also show that the assumptions can be significantly relaxed while improving computational efficiency if a factored representation of the weights is known.Comment: This is a full version of AAAI 2014 pape