bluuebunny/crossref_metadata_2025 huggingface dataset:
Organisational Narratives of Applied Knowledge in Technology-Based Organisations
Authors: Piteira Margarida C. , Gomes Jorge F. S.
Published: October 2016

This paper presents the conclusions of four case studies in technology-based (TB) organisations. These companies have a strong international presence and also represent success-stories of Portuguese innovation, covering the 1980s through to the 2000s. Using a qualitative approach, the authors pinpoint the critical success factors that made these companies a reference in terms of innovation. These cases were chosen as they all recount the successful application of sustainable innovation in social processes to organisations. The research question was: What are the key factors that drive innovation processes in successful Portuguese technology-based organisations? Results show that the lessons learned from narratives of innovation play an instrumental role in the comprehension of social interaction complexities. Furthermore, the study identifies several management practices that highlight the significance of the players involved in innovation. The findings show that a passion for knowledge and its productive applications are key differentiating factors.
Evidence in Management Research
Authors: Bang Vasant V. , Phadtare Milind T.
Published: October 2016

Scholars point out a fundamental difference between research in disciplines of management and natural sciences. Using stakeholder framework, in this paper, the authors first define domain of management research from practitioners' perspective. Then, they highlight contextual nature of management and argue that practitioners and researchers differ in terms of extent of generalisation they are interested in. The authors present a framework which links management research to practice and identify conceptual issue related to reliability and validity. Statistical techniques generally try to decipher a pattern. But innovation by definition amounts to breaking free from the pattern. A formula which led to success of one organisation at one point of time can be intentionally disrupted by managers in competing organisations. This is possible because human beings are endowed with three unique characteristics of cognition, judgment and intention. This explains limitations of management research in predicting future on the basis of valid explanations of today. That is why even if managers try to search for a common reality in a replicable fashion, managerial practice may not necessarily benefit.
Investigation of the Role of Mobile Personalisation at Large Sports Events
Authors: Sun Xu , May Andrew , Wang Qingfeng
Published: October 2016

This article describes a field study investigating the impact on user experience of personalisation of content provided on a mobile device. The target population was Chinese spectators and the application was large sports events. A field-based experiment showed that provision of personalised content significantly enhanced the user experience for the spectator. Design implications are discussed, with general support for countermeasures designed to overcome recognised limitations of adaptive systems. The study also highlights the need for culturally sensitive methods for requirements capture, design, and data collection during experimentation.
An Efficient Image Retrieval Based on Fusion of Fast Features and Query Image Classification
Authors: Singh Vibhav Prakash , Srivastava Subodh , Srivastava Rajeev
Published: October 2016

Content Based Image Retrieval (CBIR) is an emerging research area in computer vision, in which, we yield similar images as per the query content. For the implementation of CBIR system, feature extraction plays a vital role, where colour feature is quite remarkable. But, due to unevenly colored or achromatic surfaces, the role of texture is also important. In this paper, an efficient and fast CBIR system is proposed, which is based on a fusion of computationally light weighted colour and texture features; chromaticity moment, colour percentile, and local binary pattern (LBP). Using these features with multiclass classifier, the authors propose a supervised query image classification and retrieval model, which filters all irrelevant class images. Basically, this model categorizes and recovers the class of a query image based on its visual content, and this successful classification of image significantly enhances the performance and searching time of retrieval system. Descriptive experimental analysis on benchmark databases confirms the effectiveness of proposed retrieval framework.
Intervention Promoting Medication Adherence: A Randomized, Phase I, Small-N Study
Authors: Schwartz Jaclyn K. , Smith Roger O.
Published: October 2016

OBJECTIVE. Many people with chronic health conditions fail to take their medications as prescribed, resulting in declines in health and function. The purpose of this study was to perform a Phase I feasibility study to understand whether an integrated occupational therapy intervention could help people with chronic health conditions improve their adherence to medications.

METHOD. Using a small-N design, we report single-subject analyses of the medication adherence of 11 participants before and after either an occupational therapy intervention or a standard care intervention. We used a multiple baseline approach with intersubject replication and blinding.

RESULTS. The occupational therapy intervention was found to decrease performance variability and to increase medication adherence rates in some people with chronic conditions.

CONCLUSION. These findings suggest that an occupational therapy intervention can improve medication adherence in people with chronic health conditions. The intervention tested in this study is feasible and would benefit from further research.
The Prepared Mind
Authors: Garber Susan L.
Published: October 2016

Every day, in clinics and hospitals around the world, occupational therapists care for patients with serious problems requiring viable solutions. Each patient is unique, and his or her problem does not necessarily correspond to existing practice models. Practitioners must adapt standard approaches to provide effective outcomes, yet problems exist for which few or no beneficial approaches have been identified. Such clinical issues require solutions to be generated de novo from the practitioner’s body of knowledge and past experience. Yet, no single new intervention can be used without prior validation of its efficacy. Only a therapist with a prepared mind can accept such challenges, recognize what is known and not yet known, design studies to acquire that needed knowledge, and translate it into successful clinical treatment strategies. The occupational therapist with a prepared mind is one willing to seize unexpected opportunities and construct new paradigms of practice. Innovation through scientific inquiry requires a prepared mind.
Utopianism in today’s health care
Authors: De Dijn Herman
Published: October 2016

Utopias are much more prone to realization than people would have thought possible, according to Berdiaeff. In the twentieth century, we have witnessed realized totalitarian utopias (such as the ‘really existing socialism’ in East Germany). In the twenty-first century, late modern, capitalist society seems well under way towards the construction of another kind of realized utopianism. Recent developments in today’s health care system (changes in the very meaning of health and care, in medicine and nursing, and even in the ethics of care) all point in the same direction: the growing hold of the utopian mind (the expression is Kolnai’s) on crucial aspects of human life and society. Must we not agree with Berdiaeff that insight in the new ‘realized’ utopianism should induce us to dream ‘of a non-utopian society less “perfect”, but more free’?
Utopianism and its discontents
Authors: Kloeg Julien
Published: October 2016

Utopianism is often rejected out of hand for one of two reasons: either it is thought to be politically dangerous, or it is thought to be a mere fantasy. It is nevertheless an important theme in contemporary political philosophy. This article reviews part of the political-philosophical career of ‘utopia’ as a concept by considering the different traditions that have been influential in shaping the way utopia and utopianism are perceived today. A brief reading of Thomas More’s Utopia is followed by a consideration of the utopian socialist tradition and Karl Marx’s criticism of it. Their understanding of utopia continued into the twentieth century. Utopianism’s bad reputation is partly due to its association with the attempt to realize communism in the Soviet Union, but other factors include the Eastonian empirical turn in political theory and the onset of postmodern incredulity. It made a perhaps surprising comeback in the work of John Rawls, whose work was recently criticized by Amartya Sen for being overly ‘utopian’ – a criticism that is highly analogous to Marx’s onslaught against the utopian socialists. With the help of counterarguments devised by Pablo Gilabert, the article considers three ways in which utopianism can be useful to contemporary political thought.
An overview of the use of Facebook in National Weather Services
Authors: Palacio Virginia , Principe Olatz , Martija Maialen , Gaztelumendi Santiago
Published: October 2016

Abstract. National Meteorological Services (NMSs) use different "classical" tools in order to diffuse meteorological information, including television, radio, newspaper, phone, e-mail and websites. In recent years, new communication technologies and, in particular, the rapid expansion of Facebook allows users to efficiently exchange information and to easily share it with a large part of the population. Facebook is one of the most used social networks and it represents a perfect virtual platform to share information and to promote active and immediate interaction amongst users. This is why many NMSs develop new communication strategies and incorporate this tool for different purposes. Some NMSs not only provide forecast, real-time observed data and other routine information, but they also upload videos (for example, with the weatherperson explaining the forecast or short reports) and amazing pictures taken by followers. In addition, they also give educational and didactic information (above all about climatic issues) and organize photographic competitions. In this paper, firstly, we investigate when Facebook was introduced in different NMSs worldwide as an additional tool for the diffusion of meteorological information. Then, we propose a classification of these NMSs based on the success of their Facebook page, i.e. on the number of followers. Finally, we select some representative cases of NMSs and we analyze how Facebook is used to improve their services.
Microbial dynamics in a High Arctic glacier forefield: a combined field,
laboratory, and modelling approach
Authors: Bradley James A. , Arndt Sandra , Šabacká Marie , Benning Liane G. , Barker Gary L. , Blacker Joshua J. , Yallop Marian L. , Wright Katherine E. , Bellas Christopher M. , Telling Jonathan , Tranter Martyn , Anesio Alexandre M.
Published: October 2016

Abstract. Modelling the development of soils in glacier forefields is necessary in order to assess how microbial and geochemical processes interact and shape soil development in response to glacier retreat. Furthermore, such models can help us predict microbial growth and the fate of Arctic soils in an increasingly ice-free future. Here, for the first time, we combined field sampling with laboratory analyses and numerical modelling to investigate microbial community dynamics in oligotrophic proglacial soils in Svalbard. We measured low bacterial growth rates and growth efficiencies (relative to estimates from Alpine glacier forefields) and high sensitivity of bacterial growth rates to soil temperature (relative to temperate soils). We used these laboratory measurements to inform parameter values in a new numerical model and significantly refined predictions of microbial and biogeochemical dynamics of soil development over a period of roughly 120 years. The model predicted the observed accumulation of autotrophic and heterotrophic biomass. Genomic data indicated that initial microbial communities were dominated by bacteria derived from the glacial environment, whereas older soils hosted a mixed community of autotrophic and heterotrophic bacteria. This finding was simulated by the numerical model, which showed that active microbial communities play key roles in fixing and recycling carbon and nutrients. We also demonstrated the role of allochthonous carbon and microbial necromass in sustaining a pool of organic material, despite high heterotrophic activity in older soils. This combined field, laboratory, and modelling approach demonstrates the value of integrated model–data studies to understand and quantify the functioning of the microbial community in an emerging High Arctic soil ecosystem.
Statues Also Die
Authors: Fraiture Pierre-Philippe
Published: October 2016

“African thinking,” “African thought,” and “African philosophy.” These phrases are often used indiscriminately to refer to intellectual activities in and/or about Africa. This large field, which sits at the crossroads between analytic philosophy, continental thought, political philosophy and even linguistics is apparently limitless in its ability to submit the object “Africa” to a multiplicity of disciplinary approaches. This absence of limits has far-reaching historical origins. Indeed it needs to be understood as a legacy of the period leading to African independence and to the context in which African philosophy emerged not so much as a discipline as a point of departure to think colonial strictures and the constraints of colonial modes of thinking. That the first (self-appointed) exponents of African philosophy were Westerners speaks volumes. Placide Tempels but also some of his predecessors such as Paul Radin (Primitive Man as Philosopher, 1927) and Vernon Brelsford (Primitive Philosophy, 1935) were the first scholars to envisage this extension of philosophy into the realm of the African “primitive.” The material explored in this article – Statues Also Die (Marker, Resnais, and Cloquet), Bantu Philosophy (Tempels), The Cultural Unity of Negro Africa (Cheikh Anta Diop), and It For Others (Duncan Campbell) - resonates with this initial gesture but also with the ambition on part of African philosophers such as VY Mudimbe to challenge the limits of a discipline shaped by late colonialism and then subsequently recaptured by ethnophilosophers. Statues Also Die is thus used here as a text to appraise the limitations of African philosophy at an early stage.  The term “stage,” however, is purely arbitrary and the work of African philosophers has since the 1950s often been absorbed by an effort to retrieve African philosophizing practices before, or away from, the colonial matrix. This activity has gained momentum and has been characterized by an ambition to excavate and identify figures and traditions that had hitherto remained unacknowledged: from Ptah-hotep in ancient Egypt (Obenga 1973, 1990) and North-African Church fathers such as Saint Augustine, Tertullian and Arnobius of Sicca (Mudimbe and Nkashama 1977), to “falsafa”-practising Islamic thinkers (Diagne 2008; Jeppie and Diagne 2008), from the Ethiopian tradition of Zera Yacob and Walda Heywat (Sumner 1976), to Anton-Wilhelm Arno, the Germany-trained but Ghana-born Enlightenment philosopher (Hountondji [1983] 1996).
On the Concepts of Disorder, Retraditionalization, and Crisis in African Studies
Authors: Kavwahirehi Kasereka
Published: October 2016

Over the last two decades, concepts of “disorder as political instrument in Africa,” “politics of belly,” and “re-traditionalization” (Chabal, Daloz, 199) have been used and reused in African studies by European and African scholars to describe the African social and political condition of the last decades. However, despite their canonization, one can question their efficiency and relevance to the analysis and understanding of what is really happening in postcolonial Africa. One might even wonder if these analytical concepts are not reawakening the imaginary of the colonial anthropology which pathologized the “Dark Continent” in order to enclose it in its difference and represent it as the absolute alterity as Hegel did in his philosophical ethnography.
The changes in biochemical parameters due to wine consumption depending on gender
Authors: Gažarová Martina , Chlebová Zuzana , Predná Lenka , Chlebo Peter , Habánová Marta
Published: October 2016

The aim of this study was to investigate the effect of red wine consumption on the lipid profile and glucose in the group of male (13 men aged 34 - 64 years) and the group of female (11 women aged 28 - 57 years). Research consisted of moderate red wine consumption for 6 weeks. The dose of alcohol ranged from 200 to 300 mL per day of red wine Lemberger (Winery Masaryk, Slovakia). The blood samples were obtained after overnight fasting and were collected at baseline and after three days, three weeks and six weeks of wine consumption. Differences between male and female subjects were reflected in the results of different biochemical parameters in the dynamics of wine consumption. We found out that while in females the total cholesterol level did not change significantly and had a predominantly downward trend, for male subjects we observed at the beginning the slight increase of the levels, which, however, after 6 weeks of consumption significantly decreased from an initial value of 5.75 ±1.32 mmol.L-1 to 5.35 ±1.25 mmol.L-1 (p <0.05). The blood concentration of triglycerides in the dynamics of the experiment did not change significantly in either one gender, although small differences were observed, because while the female subjects had triglyceride development over consumption upward trend in male subjects it was vice versa. LDL-cholesterol changed significantly only in the group of female. Level of this lipid parameter decreased significantly during the six weeks of consumption of Lemberger from an initial value 3.37 ±0.68 mmol.L-1 to the lowest 2.99 ±0.61 mmol.L-1, which was recorded in the third week of consumption (p <0.0001), but statistically significant differences versus baseline we monitored after three days and six weeks of consumption (p <0.01). In the group of male, we did not observe such significant changes, but it should be noted, that the men had changes in LDL-cholesterol downward direction and all the values were in the range of benchmarks. In the group of female, HDL-cholesterol increased to 2.05 ±0.6 mmol.L-1 after six weeks of consumption from baseline of 1.7 ±0.69 mmol.L-1, and the difference was statistically significant (p <0.05), in the group of male, its level changed first significantly after three days of consumption of steep increase (1.46 ±0.61 mmol.L-1, p <0.05), and for the next six weeks, it was the significantly increase (1.59 ±0.5 mmol.L-1, p <0.01). The glucose concentration did not change significantly in the dynamics of wine consumption among men and women, and all the values were between the limits of the standard.
Polyphenol content and antioxidant capacity of fruit and vegetable beverages processed by different technology methods
Authors: Mlček Jiří­ , Jurí­ková Tünde , Škrovánková Soňa , Paličková Marcela , Orsavová Jana , Mišurcová Ladislava , Hlaváčová Irena , Sochor Jiří­ , Sumczynski Daniela
Published: October 2016

The purpose of the natural drinks production is the preservation of biologically active compounds in maximal amount in prepared drinks. The issue is the loss of these substances due to conventional conservation methods, such as pasteurization. Pascalization, a conservation method using high pressure, performs a new trend in conservation. According to available research, it causes only a minimal loss of bioactive compounds. Influence of conservation technology of fruit and vegetable beverages on the content of bioactive substances - polyphenols, flavonoids and on their antioxidative activity has been investigated. Their content has been compared in fresh juice samples, in samples conserved by pasteurization and after the appliance of high pressure treatment - pascalization (HPP). HPP has a positive effect on total antioxidative capacity of juices - broccoli with apple (increase of the amount from 189.12 mg.100 mL-1 to 217.12 mg.100 mL-1) and beetroot and on total polyphenol content within all samples of beverages except from carrot juice. Decrease of the amounts of flavonoids has been observed within all beverages. For drinks after pasteurization treatment there is evident the decrease of total polyphenols content and total antioxidant activity, besides carrot juice, where the antioxidant capacity value had increased from 37.24 to 43.14 mg.100 mL-1. The flavonoid content of fruit and vegetable juices after heat treatment had increased only in the juice prepared from broccoli with apple (from 40.71 mg.100 mL-1 to 45.14 mg.100 mL-1), the content in other juices had decreased. However, the decrease of the flavonoid content is lower after heat treatment in comparison to HPP, except the samples of cabbage juice with apple. With the exception of flavonoids, HPP has been proved as a gentle conservation technology enabling preserving higher amounts of bioactive substances with antioxidative properties if compared with the heat treatment. For the samples treated by HPP there was observed statistically significant difference in comparison with fresh juice in all factors mentioned above (p <0.05).
DIVERSIDADE DE COLEOPTERA (ARTHROPODA: INSECTA) E ATRIBUTOS EDÁFICOS EM SISTEMAS DE USO DO SOLO NO PLANALTO CATARINENSE
Authors: Pompeo Pâmela Niederauer , Iuñes Oliveira Filho Luís Carlos , Klauberg Filho Osmar , Mafra Álvaro Luiz , Riviera Duarte Maluche Baretta Carolina , Baretta Dilmar
Published: October 2016

Os coleópteros (Coleoptera) se distribuem em diferentes áreas e profundidades do solo e são importantes executores de serviços ambientais. Seu estudo representa um excelente foco para elucidar os efeitos da perturbação antrópica sobre a biodiversidade e funções dos ecossistemas. O objetivo desse estudo foi avaliar a diversidade de famílias de coleópteros em sistemas de uso do solo (SUS), bem como a relação destes com os atributos edáficos. Os sistemas estudados envolvem: floresta nativa (FN), reflorestamento de eucalipto (RE), pastagem (PA), integração lavoura-pecuária (ILP) e lavoura com plantio direto (PD). As amostras foram coletadas em grade de amostragem de 3 × 3 pontos, distanciados entre si em 30 m, nos períodos de inverno e verão, em três municípios do Planalto Sul Catarinense, considerados réplicas verdadeiras. Os invertebrados edáficos foram coletados pelos métodos Tropical Soil Biology and Fertility (TSBF) e Pitfall traps (armadilhas de queda). Nos mesmos pontos coletaram-se amostras para determinação dos atributos físicos e químicos do solo. Utilizou-se análise estatística multivariada para a composição da comunidade, sendo, as variáveis ambientais consideradas como explicativas. Foram estudados 1.437 indivíduos, sendo a Família Staphylinidae a mais representativa. Os sistemas RE e PD apresentaram maior diversidade de acordo com o índice de Shannon (H). As análises de componentes principais demonstraram distinção na distribuição dos invertebrados entre os diferentes SUS. As propriedades do solo contribuíram para explicar essa variação, dando destaque aos atributos matéria orgânica e porosidade que favoreceram a maior abundância de Coleoptera em FN e a ocorrência de Staphylinidae, potencial bioindicador das condições do ambiente.
Beyond the Debate on Promises and Risks in Digital Health: Analysing the Psychological Function of Wearable Devices
Authors: Rio Carral Maria del , Roux Pauline , Bruchez Christine , Santiago-Delefosse Marie
Published: October 2016

In the past years, the recording and collection of physical and physiological data from the body through wearable devices has become an increasingly common health-related practice in contemporary Western societies. The rapid development of digital self-tracking technologies has given rise to the production of different scientific discourses. The analysis of 200 published articles has led to the definition of a continuum between “technophile-promises” and “technocritical-risks” representations. However, these representations include different views of corporeality and sociality. Beyond this debate, we propose an alternative theoretical framework that links corporeality and sociality. It interrogates the psychological function that wearable devices may take (or not) for subjects to which these “tools” are addressed. We argue that such psychological function must be embraced by taking into consideration of activity done by the users of these technologies, which engages meaning: It is not the device, but the user him/herself who is confronted to the interpretation of biometric data linked to his/her own body functions on the basis of concrete lived experience. Moreover, we discuss that the activity of users can only be analysed in the sociocultural context to which the associated practices relate (health, sports, play, medicalisation). The conclusion highlights the need to further study the appropriation process of new personal experimentation instruments as to better understand the potential collaborations, risks or resistances that users may develop.
The Evaluation of Asymmetry in Price Transmission and Market Power in Iran Sugar Production Industry
Authors: Omrani Mohammad , Tash Mohammad Nabi Shahiki , Akbari Ahmad
Published: October 2016

Asymmetric price transmission in production institutes can be a reason for the existence of market power. In this regard, by the help of an integrative sample, this study simultaneously analyzes the price transmission between production markets and retails markets of sugar in the presence of the parameter of market power. For this purpose, the seasonal data of the required variables during the years 1995-2013 was used. In order to meet the study objectives, the behavior of the retails price of sugar was evaluated in the framework of two regimes of different changes which were compatible with nature of presenting agricultural products that are widely supplied in the harvest seasons. Also, the inverse elasticity of product supply was used as the parameter of market power. Considering the more probable regime (second regime), it was realized that the marketing elements at the wholesale level intend to price transmission increase more intensively than price decrease to the retail trades level. In this regime, asymmetric price transmission and existence of market power were approved. In the first regime, market power was much more and considering the fact that it has the 30% probability of happening, it has more compatibility with the seasons when supply is abundant. In these seasons, sugar production and refining units increase the market power and create a monopsony market in buying the inputs.
An Analysis of the Mother and Child Education Program’s Effects on the Relationship between Mothers and Their Five- or Six-Year-Old Children
Authors: Ulutas Aysegul , Kanak Mehmet
Published: October 2016

This study aims to analyze the effect of the Mother and Child Education Program on the relationship between mothers and their five- or six-year-old children. The study used an experimental design of pretest-posttest-monitoring test with a control group. The participants consisted of 50 preschool children aged five or six along with their mothers. Twenty-five were in the experimental group and 25 were in the control group. Members of the experimental group participated in the Mother and Child Education Program once a week for ten weeks. The study data were collected using the Child-Parent Relationship Scale developed by Pianta in 1992 to evaluate the parent-child relationship and adapted to Turkish language by Akgün and Yeşilyaprak (2010). The NCSS 2007 (Number Cruncher Statistical System-Kaysville, Utah, USA) was used for statistical analyses. The Independent Samples t-test, Mann-Whitney U test, Paired Samples t-test and Wilcoxon signed-rank tests were used to compare quantitative data. Significance was evaluated at the levels of p<0.01 and p<0.05. The findings of this study showed a difference between the mother-child relationship scores of the experimental and control groups in favor of the experimental group (p<0.05), and that the effects of the education program continued long-term.
Implementing person-centered care in a general medical clinic: cultural barriers and driving forces
Authors: Carlstrom Eric
Published: October 2016

Public healthcare organisations in Sweden have been described as strongly hierarchical and coherent organisations [1]. To bring about control, generalized care models have been developed to handle hospital clinics and primary care sites [2]. This paper examines the preparedness to change in hospital settings. The purpose of the present study was to reveal barriers to the introduction of person-centred care (PCC). Organisational culture and resistance to change on hospital ward and clinical level and was based on the 2 concepts of “organisational culture” and “resistance to change”. These 2 concepts were measured by questionnaires based on theories of organisational culture and resistance to change.
In-hospital delays for stroke care: losing sight of patient-centered care
Authors: Ellis Charles
Published: October 2016

The emergence of patient-centered care has offered a challenge for health professionals in some settings to fully engage patients in all stages of the care process. For example, stroke is a condition that requires urgent and comprehensive care. This comprehensive care may be provided to patients who are experiencing compromised cognitive and communication skills. In addition, “in-hospital delays” in care can occur during the process of evaluation and treatment. In-hospital delays in receipt of acute stroke care and the challenges of post-stroke cognitive and communication functioning can result in some patients having negative perceptions of the care process. This brief communication is an exploration of focus group data that suggest achieving the key elements of patient-centered care is challenging in acute care settings that provide care for complex conditions such as stroke.
Through a Glass, Darkly: The Challenge of Integration of the Science and the Art of Medicine.
Authors: Wyer Peter , Silva Suzana Alves
Published: October 2016

We have entered a new phase in the dialogue between proponents of evidence-based medicine and humanistic medicine. Over 30 years of parallel development of patient-centered and evidence-based care make possible concrete approaches to the integration of the fruits of these developments. Such integration is of increasing importance to the viability of today’s highly structured and regulated healthcare environment. Attempts at integrated model building on the part of proponents of both EBM and humanistic care have suffered from common deficiencies. These include the failure to distinguish between decision-making and practice models, failure to illuminate processes traversing categories of knowledge and information, failure to embrace the principles of relationship-centered care and failure adequately to address the epistemological issues inherent to the integration of the experiential and scientific domains of clinical practice. A published model-building attempt is used to illustrate what a correction of such limitations might look like.  Efforts to develop person-centered care as an integrated and patient-centered vision of healthcare are encouraged.
Commentary on Discussion Paper by Miles, A and Mezzich J.E. (2011). Person-centred medicine as an emergent model of clinical practice: The devil is in the details
Authors: Charles Cathy , Gafni Amiram
Published: October 2016

Miles and Mezzich have written a comprehensive review of the origins, development and current status of two influential international movements aimed at shaping the practice of medicine - evidence-based medicine (EBM) and patient-centred care. As the authors point out, these two movements have been largely independent of each other with little crossover of ideas as each pursues its own goals of trying to broaden its influence. Miles and Mezzich propose to take the strengths of both movements and to create a new integrated model of person-centred care (PCC) which is evidence-informed (rather than evidence-based) and incorporates a role for patient values in clinical decision-making. While laudable and logical to try to move forward with this approach which integrates two seemingly contradictory principles underlying each movement (clinical practice based on the findings of clinical research evidence and clinical practice that is responsive to patients’ values, preferences and beliefs), this task is not easy and, as the authors themselves note, the model that results from this process is still in elementary form. By proposing this new integrated model, the authors hope to stimulate further debate on the meaning of a person centred-care approach to medical practice.
Evidence-based medicine offers an optimal starting point for person-centered medicine
Authors: Post Piet , Guyatt Gordon
Published: October 2016

In their discussion paper, Miles and Mezzich argue that evidence-based medicine (EBM) and patient-centered care have developed in parallel, but rarely have entered into exchange and dialogue. These authors emphasize the need for a rational form of integration to take part between EBM and patient-centered care. We agree wholeheartedly with the desirability of both dialogue and integration. The dialogue will be much less likely to be productive, however, when authors ignore or altogether misconstrue the evolution of evidence-based medicine and the recent work of EBM leaders. Statements claiming “a foundational irreconcilability between the fundamental principles of EBM and those of patient-centered care” are not likely to promote enthusiastic dialogue with the EBM community. In this commentary, we demonstrate that EBM has introduced and aggressively advocated for the integration of patient’s values and preferences in the process of clinical decision-making. Furthermore, EBM has highlighted the need for research into optimal ways of integrating patient values and preferences and, most recently, introduced and studied innovative ways of facilitating shared decision-making.
Operationalizing person-centered medicine
Authors: Marcum James , Griggs Jackson , Barron Lauren
Published: October 2016

To recapture medicine’s “soul” for the “care” of patients, Miles and Mezzich propose a version of person-centered medicine in which they “coalesce” both evidence-based medicine and patient-centered care. To that end, they identify 5 key principles from which they formulate a 4-part working definition of person-centered medicine. In this paper, we first analyze philosophically -ontologically, epistemologically and ethically - both their principles and definition and we then present a clinical case to operationalize their notion of person-centered medicine. We conclude with a brief comment on its feasibility for modern clinical practice.
Exploring the macro level barriers that affect Iranian GPs’ diagnosis and management of depression disorders
Authors: Shirazi Mandana , Gandomkar Roghayeh , Ponzer Sari , Silen Charlotte
Published: October 2016

Background: The fact that general practitioners (GPs) find it difficult to detect and treat depression is a worldwide concern. This is also the case in Iran, where this study was conducted. Educational interventions have been used to support GPs in their work when treating patients with depression disorders.Objective: To explore GPs' views regarding macro level barriers of the management of depression in primary care settings.Methods: In this qualitative study, semi-structured interviews exploring GPs’ views, beliefs and experiences regarding the diagnosis and treatment of depression were done. A purposeful sampling to obtain a broad range of views was carried out among GPs that had previously participated in an educational intervention study. Eleven GPs were interviewed and their views were probed in depth to get rich descriptions to ensure trustworthiness of the data. The data were analyzed by using qualitative content  analysis.Results: GPs’ beliefs regarding macro level barriers emerged as 2 significant themes Organizational and Society-Related factors. The Organizational factors included barriers related to the local health network system and organizational support and the Society-Related factors included economic, cultural and social factors. The individual GP´s opinions about management strategies seemed not to be related to their perceptions of macro level barriers.Conclusion: The results of this study imply that a number of macro level obstacles were of great importance when managing patients with depression disorders. In order to improve the effectiveness of CME events they should be tailored for the actual context and the infrastructural issues that is, organizational and societal factors should be addressed.
What patients know: evidence-based medicine and its discontents in the U.S.
Authors: Tanenbaum Sandra
Published: October 2016

Almost 20 years ago, the New England Journal of Medicine published this author’s article entitled, “What Physicians Know” [1]. In it, I raised epistemological challenges to evidence-based medicine (EBM), noting the limitations of probabilistic knowledge for patient care. Since that time, EBM has put down strong roots in medicine and health policy but research policy, at least in the U.S., has begun to acknowledge the shortcomings of EBM’s hierarchy of knowing and now inches toward a more pluralistic view of medical knowledge. In 2010, the Affordable Care Act (ACA) created the Patient-Centered Outcomes Research Institute (PCORI), a public-private entity charged with defining, facilitating and funding patient-centered comparative effectiveness research (CER). Not only does PCORI expressly recognize the limits of RCTs and the strengths of other statistical study designs, but it legitimizes individual patient and practitioner knowledge as a component of medical decision-making. PCORI's Methodology Committee presented its draft report to the Board on May 10, 2012, and a month earlier, the Institute had announced the funding of 50 pilot research projects.  Upon review, both the report and the proposed projects can be said to more often, but not always, challenge the tenets of traditional EBM and value what patients know.
Experiences of general practitioners, practice nurses, psychologists and patients with stepped collaborative care for depression: a focus group study in a large primary healthcare organization
Authors: Gidding Luc , Spigt Mark , Brouwer Emmaline , De Snoo Jessica , Mijnheer Katinka , Dinart Geert-Jan
Published: October 2016

Rationale, aims and objectives: Depression is a major and complex problem in primary care. Stepped Collaborative Care (SCC) models for depression have been developed to support primary care in diagnostic and therapeutic procedures. This study aimed to compare barriers and facilitators experienced by general practitioners (GPs), practice nurses for psychosocial care, primary care psychologists and patients working with SCC for depression and to discuss possible solutions for barriers in daily practice.Method: Conventional content analysis of focus group data. Nine mono-disciplinary focus groups including 16 general practitioners (GPs), 4 practice nurses, 6 psychologists and 23 patients.Results: All 4 participant groups appeared to perceive a need for more skills, support and time for GPs to adequately assess symptoms and initiate psychosocial management accordingly. Psychologists often ignore a GP’s diagnosis. The GPs’ diagnostic uncertainty and their unfamiliarity with psychological therapies can result in inappropriate treatments, incorrect referrals and long waiting lists. To improve stepped collaborative care programs for psychosocial symptoms, improving initial symptom assessment by the GP, seems the most important aspect. All participants agreed that diagnostic tools/questionnaires should be used in primary care, but such activities should not be complicated and should not add to the GPs’ workload. Patients need more information to share decisions with their care providers.Conclusion: There is a need for a diagnostic-therapeutic tool to support GPs in regulating the influx of patients in SCC models and enhancing the effect of SCC in daily practice in order to improve the person-centeredness and efficiency of primary healthcare.
"Practitioner Wellness, Person Centered Healthcare, Reflective Practice, and the Mission of Mindfulness Training" Commentary on Garneau K, Hutchinson T, Zhan Q, & Dobkin PL Cultivating Person-Centered Medicine in Future Physicians European Journal of P
Authors: Wyer Peter , Quinlan Patricia , Da Silva Susana Alves
Published: October 2016

A primary purpose of healthcare is the enhancement of health, wellbeing and in understanding and responding to the illness experience in individual patientsA primary purpose of healthcare is the enhancement of health, wellbeing and in understanding and responding to the illness experience in individual patients.
Intensive multidisciplinary care programme for frail patients
Authors: Urreta I , Aranegi P , Artetxe J , Zubeldia X , Huerta I , Emparanza J.I.
Published: October 2016

Rationale and Objectives: Patients with chronic diseases re-admitted for acute events are associated with a high use of hospital resources and represent a challenge for healthcare systems. In such cases, follow-up interventions at discharge can be effective. The widespread adoption of follow-up procedures not involving telemonitoring may greatly decrease re-admissions rates without the costs associated with telemedicine. To assess the impact of a structured follow-up programme on patient-perceived healthcare quality, treatment adherence, re-admissions and Emergency Department attendances.Methods: This was a before and after study of 242 patients at risk of re-admission for chronic obstructive pulmonary disease (COPD) or heart failure (HF), recruited between 1st July 2009 and 30th June 2010 at Donostia Tertiary University Hospital (Gipuzkoa, Spain). The follow-up ended on 30th December 2010. The intervention involved identifying independent re-admitted patients, providing personalised information and a direct number to call in the event of clinical worsening, assigning specialists and liaison nurses, structured follow-up by telephone and appointments and contact with general practitioners. Patient perceived quality of care estimated was analyzed using a focus group technique. To assess the number of re-admissions and the Emergency Department attendances we estimated the relative risk reduction as a percentage and corresponding 95% confidence intervals.Results: In terms of perceived quality of care, the most valued elements were related to having an assigned doctor/nurse and easy access in the event of worsening. Overall, 97.9% of patients reported full adherence to treatment (95% CI: 95.4-98.83).Hospital bed days and Emergency Department attendances decreased by 60.7% (95% CI: 58.7-62.7) and 77% (95% CI: 73.2-80.3), respectively.Conclusions: The intensive multidisciplinary care programme can reduce Emergency Department attendances and improve perceived quality of care in patients with HF and COPD.
When a white coat fear is really a white coat fear: implications of sexual abuse by a physician for interactions with healthcare professionals
Authors: Dunleavy Kim , Kubo Slowik A , Daitch C , Elconin L , Horowitz M , Kestenberg W , Sobol J , Wicks N , Withheld N
Published: October 2016

Background and Purpose: Sexual exploitation of patients by medical practitioners has devastating effects on victims, including difficulty seeking and tolerating healthcare. This case report describes the long-term effect of a rape by a physician on interactions with healthcare providers. The implications for healthcare encounters are presented from the patient’s perspective as well as from those of multiple healthcare providers.Methods: The case report used a qualitative descriptive approach with healthcare providers from multiple specialties contributing semi-structured ethnographic interviews and a first person case history and commentary provided by the patient. A modified Delphi approach was employed to determine consensus on the key mechanisms for improving patient tolerance of medical management.Outcomes: Key elements which helped the patient tolerate medical care included allowing family or an assistant in the room, observing the patient for signs of discomfort, adjusting techniques, avoiding touch, not wearing a white coat and carefully selecting specialists for referral. Interdisciplinary communication played a significant role in limiting major fear responses during breast cancer surgery. Patient-centered approaches such as receptive communication, respect for the patient’s feelings, detailed explanations and giving the patient control were considered vital across multiple professional disciplines.Discussion: All healthcare providers modified their approaches to provide a person-centered approach to care. In the presence of a history of abuse, communication becomes complex and challenging. Psychotherapeutic support is essential and developing a referral base of patient-centered practitioners is likely to enhance the patient’s experiences. Presence or absence of patient-centered management could facilitate or setback interactions with other healthcare providers for patients with a history of physician abuse.
Depression screening in low vision rehabilitation services in Australia: exploring barriers and solutions to implementation using a theoretical framework
Authors: Rees Gwyneth , Holloway Edith E
Published: October 2016

Rationale: Depression is commonly co-morbid with vision impairment yet often remains undetected and therefore untreated. This study aimed to use a theoretical framework of behaviour change to identify issues surrounding the implementation of depression screening in a low vision rehabilitation service in Australia. Evidence-based strategies to address barriers are highlighted.Method: Twenty-two low vision rehabilitation staff, who had undergone training in using a depression screening tool, took part in semi-structured interviews covering 11 theoretical domains of behaviour change. Interviews were audio-taped and transcribed. Two researchers independently coded the transcripts from each interview and assigned a score to determine whether the transcript showed evidence of poor, partial, or good implementation within each domain.Results: Major barriers to depression screening included lack of time, face-to-face contact with clients and private workspace. Limited referral options and concerns about the efficacy of referrals to primary care services were highlighted. Negative emotions anticipated during depression screening (e.g., feeling awkward, uncomfortable or nervous) and concerns that depression screening would have a detrimental impact on the client and client relationship were also barriers to depression screening in practice.Conclusions: Enhancing knowledge and skill around depression screening is not sufficient to create change. Practical-based training needs to be combined with the development of strong referral pathways to ensure implementation success.
Kate Thompson, Therapeutic Journal Writing; An Introduction for Professionals. London: Jessica Kingsley Publishers, 2011. ISBN 978-1-84310-690-6
Authors: Lindsay Margot
Published: October 2016

No abstract
Brian Draper, Understanding Alzheimer’s Disease and other Dementias, London: 2013, Jessica Kingsley Publishers. ISBN 978-84905-374-7.
Authors: Lindsay Margot
Published: October 2016

No abstract