bluuebunny/crossref_metadata_2025_split huggingface dataset:
Three requirements for justifying an educational neuroscience
Authors: Hruby George G 
Published: March 2012

Background. Over the past quarter century, efforts to bridge between research in the neurosciences and research, theory, and practice in education have grown from a mere hope to noteworthy scholarly sophistication. Many dedicated educational researchers have developed the secondary expertise in the necessary neurosciences and related fields to generate both empirical research and theoretical syntheses of noteworthy promise. Nonetheless, thoughtful and critical scholars in education have expressed concern about both the intellectual coherence and ethical dangers of this new area. It is still an open question whether educational neuroscience is for some time yet to remain only a formative study area for adventurous scholars or is already a fully fledged field of educational scholarship.Aims. In this paper, I suggest that to be a worthy field of educational research, educational neuroscience will need to address three issues: intellectual coherence, mutually informing and respected scholarly expertise, and an ethical commitment to the moral implications and obligations shared within educational research generally. I shall set forth some examples of lapses in this regard, focusing primarily on work on reading development, as that is my area of expertise, and make recommendations for due diligence.Arguments. First, intellectual coherence requires both precision in definition of technical terms (so that diverse scholars and professionals may communicate findings and insights consistently across fields), and precision in the logical warrants by which educational implications are drawn from empirical data from the neurosciences. Both needs are facilitated by careful attention to categorical boundary and avoidance of category error. Second, educational neuroscientists require focused and broad expertise in both the neurosciences and educational scholarship on teaching and learning in classrooms (and/or ancillary fields). If history is our guide, neuroscience implications for practice will prove unlikely in practice without expertise on practice. Additionally, respect for the expertise of others in this hybrid and necessarily collaborative enterprise is required. Third, educational neuroscience must take seriously the heightened moral and ethical concerns and commitments of educational professionals generally and educational researchers particularly. This means keeping a vigilant eye towards preserving the integrity of empirical and theoretical findings against rhetorical misuse by educational marketers, policy makers, and polemicists targeting the general public.Conclusions. I conclude that educational neuroscience is more than a hybrid patchwork of individual interests constituting a study area, and is perhaps ready to stand as a legitimate field of educational inquiry. It will not be accepted as such, however, nor should it be, unless the need to demonstrate a capacity for consistent intellectual coherence, scholarly expertise, and ethical commitment is met.
Validation of GPU based TomoTherapy dose calculation engine
Authors: Chen Quan , Lu Weiguo , Chen Yu , Chen Mingli , Henderson Douglas , Sterpin Edmond 
Published: March 2012

Purpose: The graphic processing unit (GPU) based TomoTherapy convolution/superposition(C/S) dose engine (GPU dose engine) achieves a dramatic performance improvement over the traditional CPU‐cluster based TomoTherapy dose engine (CPU dose engine). Besides the architecture difference between the GPU and CPU, there are several algorithm changes from the CPU dose engine to the GPU dose engine. These changes made the GPU dose slightly different from the CPU‐cluster dose. In order for the commercial release of the GPU dose engine, its accuracy has to be validated.Methods: Thirty eight TomoTherapy phantom plans and 19 patient plans were calculated with both dose engines to evaluate the equivalency between the two dose engines. Gamma indices (Γ) were used for the equivalency evaluation. The GPU dose was further verified with the absolute point dose measurement with ion chamber and film measurements for phantom plans. Monte Carlo calculation was used as a reference for both dose engines in the accuracy evaluation in heterogeneous phantom and actual patients.Results: The GPU dose engine showed excellent agreement with the current CPU dose engine. The majority of cases had over 99.99% of voxels with Γ(1%, 1 mm) < 1. The worst case observed in the phantom had 0.22% voxels violating the criterion. In patient cases, the worst percentage of voxels violating the criterion was 0.57%. For absolute point dose verification, all cases agreed with measurement to within ±3% with average error magnitude within 1%. All cases passed the acceptance criterion that more than 95% of the pixels have Γ(3%, 3 mm) < 1 in film measurement, and the average passing pixel percentage is 98.5%–99%. The GPU dose engine also showed similar degree of accuracy in heterogeneous media as the current TomoTherapy dose engine.Conclusions: It is verified and validated that the ultrafast TomoTherapy GPU dose engine can safely replace the existing TomoTherapy cluster based dose engine without degradation in dose accuracy.
Governance of preventive Health Intervention and On time Verification of its Efficiency: the GIOVE Study
Authors: Mennini Francesco Saverio , Baio Gianluca , Montagano Giuseppe , Cauzillo Gabriella , Locuratolo Francesco , Becce Gerardo , Gitto Lara , Marcellusi Andrea , Zweifel Peter , Capone Alessandro , Favato Giampiero 
Published: March 2012

ObjectivesThe GIOVE Study was aimed to the achievement of allocative efficiency of the budget allocated to the prevention of human papillomavirus (HPV)-induced diseases. An ex-ante determination of the most efficient allocation of resources between screening and multicohort quadrivalent immunisation programmes was followed by the ex-post assessment of the allocative efficiency actually achieved after a 12-month period.DesignA bound optimisation model was developed to determine the ex-ante allocative efficiency of resources. The alternatives compared were the screening programme alone and the quadrivalent immunisation with access to screening. A sensitivity analysis was carried out to assess the uncertainty associated with the main inputs of the model. Subsequently, a cohort of girls with a complete recorded vaccination history were enrolled in an observational retrospective study for 18 months to ensure full compliance with the recommended schedule of vaccination (0, 2, 6 months) within a 12-month time horizon.SettingBasilicata region, in the south of Italy.Participants12 848 girls aged 12, 15, 18 or 25 years.InterventionImmunisation with quadrivalent anti-HPV vaccine.Outcome measuresThe vaccination coverage rate was considered to be the indicator of the best achievable benefit, given the budgetary constraints.ResultsAssuming a vaccine price of €100 per dose, a vaccination coverage rate of 59.6% was required for the most effective allocation of resources. The optimal rate of coverage was initially in favour of the multicohort strategy of vaccination against HPV (72.8%±2%). When the price paid for the quadrivalent vaccine dropped to €85 per dose, the most efficient coverage rate (69.5%) shifted closer to the immunisation rate actually achieved during the 12-month observation period.ConclusionsThe bound optimisation model demonstrated to be a useful approach to the ex-ante allocation and the ex-post assessment of the resources allocated to the implementation of a multicohort quadrivalent anti-HPV vaccination programme.
Development and evaluation of a 3-day patient safety curriculum to advance knowledge, self-efficacy and system thinking among medical students
Authors: Aboumatar Hanan J , Thompson David , Wu Albert , Dawson Patty , Colbert Jorie , Marsteller Jill , Kent Paula , Lubomski Lisa H , Paine Lori , Pronovost Peter 
Published: March 2012

PurposeTo develop a patient safety curriculum and evaluate its impact on medical students' safety knowledge, self-efficacy and system thinking.MethodsThis study reports on curriculum development and evaluation of a 3-day, clinically oriented patient safety intersession that was implemented at the Johns Hopkins School of Medicine in January 2011. Using simulation, skills demonstrations, small group exercises and case studies, this intersession focuses on improving students' teamwork and communication skills and system-based thinking while teaching on the causes of preventable harm and evidence-based strategies for harm prevention. One hundred and twenty students participated in this intersession as part of their required second year curriculum. A pre–post assessment of students' safety knowledge, self-efficacy in safety skills and system-based thinking was conducted. Student satisfaction data were also collected.ResultsStudents' safety knowledge scores significantly improved (mean +19% points; 95% CI 17.0 to 21.6; p<0.01). Composite system thinking scores increased from a mean pre-intersession score of 60.1 to a post-intersession score of 67.6 (p<0.01). Students had statistically significant increases in self-efficacy for all taught communication and safety skills. Participant satisfaction with the intersession was high.ConclusionsThe patient safety intersession resulted in increased knowledge, system-based thinking, and self-efficacy scores among students. Similar intersessions can be implemented at medical, nursing, pharmacy and other allied health schools separately or jointly as part of required school curricula. Further study of the long-term impact of such education on knowledge, skills, attitudes and behaviours of students is warranted.
A new model for breaking bad news to people with learning disabilities
Authors: Tuffrey-Wijne Irene 
Published: March 2012

BackgroundCurrent models for breaking bad news are inadequate in meeting the needs of people with learning disabilities (LD). People with LD are often not told of a life-limiting diagnosis. The task of breaking bad news is often left to carers who are poorly prepared and supported to cope with this. Healthcare professionals don't know how to communicate adequately with people with LD.A new model for breaking bad newsThe model was developed following a focus group/interview study involving 109 participants, including people with LD, family carers, LD professionals and healthcare professionals (see related abstract for oral presentation). The findings were combined with the literature. A preliminary model was developed; 60 stakeholders gave feedback on this, including a wide range of family carers, professionals and academics. The preliminary model was modified following this feedback. The poster will present the model in a visual format. The model has four components.Building a Foundation of Knowledge is central to the model. Gradually and over time, the person with learning disabilities builds his/her understanding of the way his/her situation is changing because of the bad news. The people around him/her help with this, by giving small, singular chunks of information that make sense to the person. This does not have to done by talking much of the information will be understood through experience. The other three components must be considered throughout.Capacity and understanding, taking account of the Mental Capacity ActThe people involved, including family, partners, friends, paid carers and professionalsThe support needed by everyone involved, including information, emotional, social, practical and spiritual support The model now needs to be tested in practice.
Hospital mortuaries: the blind spot of end of life care
Authors: Wilson Eleanor , Arthur Antony , Seymour Jane 
Published: March 2012

BackgroundThere is a marked absence of research about the role of hospital mortuaries in palliative care, despite ‘care after death’ being step six in the End of Life Care Strategy (2008). Mortuaries are seen as ‘backstage’ areas and consequently receive little recognition or resource. This paper reports qualitative data from an independent evaluation of the King's Fund programme to enhance Environments for Care at End of Life. As part of the programme teams of hospital staff renovated physical environments in which end of life care was delivered.AimTo understand the role of hospital mortuaries within end of life care.MethodsThis paper presents qualitative data from a subset of three case studies where renovation and refurbishment of mortuary viewing facilities at three UK hospitals took place. At phase one, prior to building work, participants from each hospital took part in a focus group (n=3). At phase two after the renovations had been completed, the same participants took park in individual interviews (n=15).FindingsThree themes were extracted from the data. Mortuaries were ‘hidden from view’, both in terms of their physical location and in the function that they provided. Mortuaries were ‘resource poor’ with a history of underinvestment resulting in staff having to compensate and apologise for the environment in which they worked. There was evidence of ‘untapped potential’ with relatively simple changes to the environment resulting in improved hospital flow and an area in which the deceased could be cared for rather than processed.ConclusionsMortuaries play a key role in end of life care which is often unrecognised. The authors have constructed an understanding of mortuaries as the ‘blind spot’ within the provision of end of life care.
Caring for the carers? An observational study of the role of the district nurse in palliative care
Authors: Walshe Catherine , Payne Sheila , Luker Karen 
Published: March 2012

BackgroundCurrent policies emphasise the importance of informal/family carers in supporting people at the end of their lives. Guidance suggests that carers' needs should be assessed, acknowledged and addressed. If carers' needs are not met this can precipitate changes in their health status and unplanned care setting transitions. There are few studies that investigate how carer assessment and support is enacted in practice.AimTo investigate the role of the district nurse in palliative care provision, with a particular focus on observational exploration of their role and practice in providing care to patients and their carers.MethodsA longitudinal qualitative ethnographic design, comprising observation of district nurse/palliative care patient/carer encounters over time, and post observation interviews with patients, carers and district nurses (DNs). Patients were sampled from 12 DN team caseloads across three primary care organisations. Observations and interviews were audio-recorded and transcribed. Iterative data analysis comprised familiarisation, coding and categorisation using techniques of constant comparison to generate typologies of concepts. The study received all necessary ethics and governance approvals.Results17 DN/patient/carer encounters were observed (n=11 patients, 8 nurses) with 23 postobservation interviews (11 DN, 12 patient/carer). DNs talked about developing a relationship with carers to facilitate future care. Carers discussed the DN role as being with patients rather than themselves. This is borne out in practice, as the focus of all observed encounters where the carer was present (n=11) was the patient. Overt carer assessment or support by DNs was negligible. Carers were participants in the DN/patient encounter, primarily facilitating the provision of information about patient care and problems.ConclusionsCarer needs appeared tangential to DNs practice, although DNs appreciated their role and acknowledged their needs outside the observed encounters. DNs need to understand how to better incorporate carer assessment and support into their everyday practice.
Perspective of healthcare professionals on ‘do not resuscitate’ decision-making in Singapore
Authors: Kwee Ann , Yang Grace , Krishna Lalit 
Published: March 2012

BackgroundIt has been established that families play a significant role in decision making in Asian societies, particularly those imbued with family centric ideals and Confucian ethics. Yet the implication of familial determination and its anticipated effect upon end of life decision-making, particularly ‘do not resuscitate’ (DNR) orders remain unstudied in this region.AimsTo determine the views of oncology and palliative care doctors and nurses on who should be involved in DNR discussions and the implications and perceptions of such orders.Methods146 doctors and nurses in oncology and palliative care working within a tertiary specialist cancer centre in Singapore participated in a questionnaire survey.ResultsMajority thought that patients (78.8%) and their next-of-kin (78.1%) should be involved in DNR discussions, but only 24.7% thought as many family members as possible should be involved. On a 5-point Likert scale, 15.1% thought doctors should always ultimately decide on the DNR order, while 22.6% felt that the patient/family should always take on the responsibility. Between patients and their families, 21.2% felt that patients should always be more involved as opposed to just 4.8% who opted for the family always being more involved. 35.6% felt that a DNR should be discussed as early as possible and 10.2% felt it should be discussed when prognosis was a week or less.ConclusionsFrom the viewpoint of oncology and palliative care healthcare professionals; this paper suggests that local healthcare professionals do subscribe to the patient autonomy albeit with limitations. This for the most part does tally with other studies conducted in Asian contexts that suggest to a greater family involvement than patients in decision-making. This reflects the complexity of decision-making at the end of life and the importance of considering the innumerable psychosocial, cultural, financial and physical factors involved.
How do people with cancer and palliative care needs understand and contribute to the management of communication surrounding their care?
Authors: Jarrett Nikki , Porter Katerina , Addington-Hall Julia , Corner Jessica , Davis Carol , Duke Sue , Lathlean Judith 
Published: March 2012

BackgroundThe authors have very limited knowledge regarding how people with cancer and palliative care needs understand and contribute to the often complex networks and pathways of communication between the different people, teams and locations involved in their care.AimExplore how people with cancer and palliative care needs understand and contribute to the communication surrounding their care.MethodDuring indepth interviews (n=24; mean length 65 min), patients were asked to discuss the communication that surrounds their care. Framework analysis of the transcribed interviews considered patients' understanding of the communication surrounding them, and any contributions they make to facilitating or managing that communication.ResultsPatients (15 female, 9 male; age range: 48–85) had a wide range of primary tumours (mean time since diagnosis: 9.5 months; range: 0.5–61 months). All were described as receiving or needing specialist or generalist palliative care at the time of recruitment (through General Practice (n=5); Hospital Specialist Palliative Care Team (n=8); Specialist Palliative Care Unit (n=11)). Analysis reveals variation in the extent of patients' understanding of, and contribution to, the management of the communication surrounding their care, including ‘active involvement’, ‘understanding’, ‘storing information’, ‘opportunism’ and ‘delegation’. Some patients are less involved, with approaches including ‘cooperation’ and ‘reluctance to communicate’. Some patients who attempt ‘active involvement’ encounter ‘barriers’ to achieving this.ConclusionIt is concluded that patients demonstrate a variety of ways of dealing with, understanding, and contributing to the communication surrounding their care. Example cases illustrate the range of approaches some individuals appear to use, compared with those that appear available to other patients. These are explored in terms of factors such as patient disposition, ‘insider knowledge’, uncertainty in less-common cancer, ‘behind the scenes’ communication, and the complexity of some care packages. These findings present implications for facilitating supported self-management while recognising/minimising patient burden.
Factors considered in end-of-life decision-making of healthcare professionals
Authors: Foo Wei Ting , Zheng Yiliang , Yang Grace Meijuan , Kwee Ann K , Krishna Lalit Kumar Radha 
Published: March 2012

BackgroundThe factors considered in decision making at the end of life is largely unknown.AimTo explore the importance of factors influencing end-of-life decision-making of healthcare professionals (HCP).MethodsThis short survey reviewed the significance of regularly reported factors and scenarios involving the patient, family and HCPs themselves in discerning end of life decision making and was carried out among physicians and nurses from the Oncology and Palliative Medicine department at the Singapore General Hospital and the National Cancer Centre between 1 and 31 March 2011. A response rate of 78.6% was acquired from the 187 questionnaires distributed. The ages of participants ranged from 19 to 68 years (mean 32.1, median 29) and their experience in oncology or palliative care ranged from 0 to 40 years (mean 5.87 years, median 4).ResultsFirst, respondents rated patient's wishes (96.6%), their clinical symptoms (93.9%) and the patient's beliefs (91.1%) as the pivotal factors determining their decision making process. Least important were the HCP's own beliefs (54.79%). Second, 94.6% of HCPs reported that they would respect the wishes of a competent patient over the family's wishes should there be a conflict of goals, but 59.9% would switch to the family's wishes when the patient loses capacity even if it ran against the patient's previously stated wishes. Third, of the 57.1% of respondents who had read the hospital's end of life care policy, most felt it useful in guiding their decisions and rarely required for them to be overruled.ConclusionEnd-of-life care decision making in Singapore appears to be largely patient-centred with patients' wishes and objective factors such as clinical symptoms taking precedence over HCP-related factors. However, familial determination remains influential especially when the patient is incapacitated. A better understanding of the factors can help inform future decision-making framework or guidelines.