Practice Paradigm Research Articles

Community empowerment: A concept analysis.

To report an analysis of the concept of community empowerment. Concept analysis. Literature published in the CINAHL, PubMed, Scopus and Medline electronic databases from 2016 to 2022 were systematically searched from 30 July to 1 October 2022. The amended guideline from Walker and Avant's approach (2011) to concept analysis was performed in nine stages: choosing a concept, determining the purpose of analysis, identifying definitions of the concept, defining attributes, identifying a model case, identifying antecedents, identifying consequences, defining empirical referents and applying the concept to nursing practice. Community empowerment is a fundamental idea in health promotion that may assist communities in defining priorities, making choices, developing strategies and executing them to improve health and minimize inequalities in health. Community empowerment is an effective tool that advanced practice nurses (APNs) may employ to eliminate health inequities and promote community health. This concept analysis is one step towards broadening nurses' understanding of one of the ideas of health promotion. Additionally, the concept of community empowerment represents an opportunity for additional research in nursing that is applicable to communities. Community empowerment has served as a guiding paradigm for both theory and practice in health promotion. Also, it is recognized that social, economic and environmental elements have a direct effect on health status. However, community empowerment research in advanced nursing practices is limited. This paper will guide future nursing research on community empowerment that goes beyond involvement and engagement, for this is an effective strategy APNs can use to address health disparities and improve community health.

Toward Energy Neutrality: Novel Wastewater Treatment Incorporating Acidophilic Ammonia Oxidation.

Chemically enhanced primary treatment (CEPT) followed by partial nitritation and anammox (PN/A) and anaerobic digestion (AD) is a promising roadmap to achieve energy-neutral wastewater treatment. However, the acidification of wastewater caused by ferric hydrolysis in CEPT and how to achieve stable suppression of nitrite-oxidizing bacteria (NOB) in PN/A challenge this paradigm in practice. This study proposes a novel wastewater treatment scheme to overcome these challenges. Results showed that, by dosing FeCl3 at 50 mg Fe/L, the CEPT process removed 61.8% of COD and 90.1% of phosphate and reduced the alkalinity as well. Feeding by low alkalinity wastewater, stable nitrite accumulation was achieved in an aerobic reactor operated at pH 4.35 aided by a novel acid-tolerant ammonium-oxidizing bacteria (AOB), namely, Candidatus Nitrosoglobus. After polishing in a following anoxic reactor (anammox), a satisfactory effluent, containing COD at 41.9 ± 11.2 mg/L, total nitrogen at 5.1 ± 1.8 mg N/L, and phosphate at 0.3 ± 0.2 mg P/L, was achieved. Moreover, the stable performances of this integration were well maintained at an operating temperature of 12 °C, and 10 investigated micropollutants were removed from the wastewater. An energy balance assessment indicated that the integrated system could achieve energy self-sufficiency in domestic wastewater treatment.

What Does It Take for Organizations to Adopt Massive Open Online Courses (MOOCs)? A Fuzzy DANP Analysis

The growing utilization of advanced technologies such as massive open online courses (MOOCs) within organizations represents change, and embracing such change begins with individual and organizational end-users who often resist newly introduced systems. Recent studies have primarily focused on identifying critical factors in educational and corporate MOOCs adoption, while the consolidation of these factors has been overlooked. With our fuzzy DEMATEL-based analytical network process (DANP) analysis, this research fills this critical gap by prioritizing the identified factors and specifying their causality to understand how these critical factors can influence the successful implementation of MOOCs training systems in the workplace. Through consensus from a panel of human resource development (HRD) experts, 20 success factors at individual, content, and organizational levels were screened. Results indicate that the individual factors are the most influential, while the content factors are influenced most by other factors under study. Results also indicate that organizational sub-factors of technical support ranked first, training on how to work with MOOCs system second, and the presence of content experts ranked third. Therefore, our study unravels the significance of ranking multi-level determinants for educators and managers who plan to embark on MOOCs to attain a competitive advantage for both the globalized economy and societal trends. We propose a paradigm for future research and practice.

Indigenous social work with older persons: An international perspective

As social work gains strength as a global profession, indigenous social work has emerged within the growing calls to decolonize the profession and offers an alternative worldview. This article uses a systematic literature review to engage with the application of this indigenous social work paradigm in practice with older persons from an international perspective. Using the knowledge mobilization perspective, it examines the current state of knowledge on indigenous social work and draws implications for practice with older persons. It concludes by advocating for a political stance to practice rooted in indigenous ways of knowing, being and doing.

Conceptual modeling as language design

AbstractConceptual modeling is a broad practice encompassing knowledge organization, domain modeling, and knowledge representation. It is best understood not as a scientific process of discovery, but as a constructive process of language design. This constructive process involves both explicating differences of meaning implicit in some discursive tradition and revising those differences to improve that tradition. Understood this way, conceptual modeling can serve as the basis for a paradigm of information research and practice that does not reproduce fundamental asymmetries between researchers and the people they study, or between practitioners and the people they serve. Progress within this paradigm will involve combining methods from what have up to now been different traditions or modes of conceptual modeling. It will require paying closer attention to the historical and structural dimensions of discursive traditions and reimagining the function of critique.

Prolonged Partial REBOA: A Practice Paradigm for Managing Hemorrhage from Abdominal Gunshot Wounds

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a valuable tool for management of life-threateningtruncal hemorrhage. However, prolonged use of REBOA is limited by the ischemia that it causes distalto the occlusion. Partial REBOA (pREBOA) is a developing technique to inflate the balloon partially to allow for avariable degree of distal blood flow and mitigate some of the complications of prolonged occlusion of the aortawhile also ameliorating ongoing blood loss. We describe a case of a patient who presented with a gunshot woundto the right upper quadrant of the abdomen with significant liver, kidney, and colon injuries. The patient was successfully treated with pREBOA for 20 hours without ischemic sequalae. This is the longest reported use of prolonged pREBOA and suggests that this technique may offer a means for hemorrhage control in the pre-/intra- and postoperative settings.

Effectiveness of a rapid access musculoskeletal service in rural primary care.

Facing a crippling scarcity of community physiotherapists, a family doctor clinic in rural Canada collaborated with a highly skilled and experienced physiotherapist to provide rapid access to musculoskeletal (MSK) assessment for patients presenting to the doctor or practice nurses. The physiotherapist saw six patients for 30 minutes each in a weekly session. He did an expert assessment and frequently found a home programme of exercises was the appropriate treatment with onward referral and/or investigation for more complex cases. Rapid access was provided in a convenient location. The alternative was a 12-15 month wait for physiotherapy at least 1 hour's drive away. Outcomes were good. The results of two audits will be presented. Practice use of lab tests and X-rays was reduced. MSK knowledge and skills of doctor and nurses was improved. We hypothesised that rapid access to a physiotherapist would lead to improved outcomes compared with the above-noted long wait times. We limited contact to two or, at most, three sessions - ideally just one - to safeguard our goal of rapid access. What we did not expect, and were very surprised to see, was the number of patients - approximately 75% of the total - who had good to excellent outcomes following one or two visits. We postulate that hard-pressed physiotherapy services need a new practice paradigm, using this community-based model. We recommend establishment of further pilot projects with very careful selection of practitioners and detailed evaluation of outcomes.

Poverty-Aware Programs in Social Service Departments in Israel: A Rapid Evidence Review of Outcomes for Service Users and Social Work Practice.

Critical perspectives and practices are fundamental to social work, yet there are only scarce examples of direct critical practice in public social services, and even fewer empirical evaluations of their outcomes for service users and social workers. This article presents a rapid evidence review of 25 evaluation studies of five programs that operate in the social services departments in Israel according to the principles of the Poverty-Aware Paradigm (PAP). The PAP is a critical paradigm for direct social work practice with people living in poverty that was implemented in the welfare services by the Ministry of Welfare, targeting over 14,000 service users. The evaluation studies we reviewed encompass an overall quantitative sample of 4612 service users and 1363 professionals, and a qualitative sample of 420 service users and 424 professionals. The findings present: (1) the program's outcomes for service users in terms of relationship with social workers, financial circumstances, family relations, and children's safety; and (2) the program's impact on social workers' attitudes and practices. Finally, we discuss the lessons learned regarding social workers' role in combatting poverty, the construction of success in interventions with people in poverty, and the article's limitations.

Thoracoscopic Resection of Pulmonary Lesions in Israel: The Mentorship Approach.

Most congenital pulmonary airway malformations (CPAMs) are detected antenatally. The majority of newborns are asymptomatic. Patients are prone to subsequent respiratory complications and to a lesser extent malignant transformation remains concerning. In Israel, until 2013, pediatric surgeries were performed by thoracotomy. To minimize its morbidity, we introduced thoracoscopy using a mentorship approach. We present our experience with thoracoscopic resections coordinated by the mentorship of a pediatric worldwide leader in his field and compare our results with resections performed by thoracotomy. A retrospective review of records of children operated between 2013 and 2020 was conducted. Data were compared using t-test for quantitative variables. Fifty patients were operated by thoracoscopy with a median age of 4 years, a thoracoscopic lobectomy performed in 68%. There was no conversion with a median length of stay (LOS) of 3½ days. Thirty patients were operated by thoracotomy by a thoracic surgeon with a median age of 3.5 years. A lobectomy was performed in 87% with a median LOS of 7 days. Thoracoscopic lobectomy is a technically demanding procedure with a long learning curve, strongly related to the low volume of cases. The role of a mentorship program in acquiring those surgical skills is crucial through standardization of the technique applied and supervised by the mentor. Early thoracoscopy for congenital pulmonary lesions at an early age can be achieved with a low conversion rate and minimal complications creating a change in the paradigm of practice when considering surgery for CPAM in Israel.

The Acute Care Surgery Initiative

Acute Care Surgery describes a new surgical practice paradigm and a surgical training curriculum. This article will highlight the history and driving forces behind this initiative, describe the training curriculum and its requirements, and discuss the practice and setting of a surgeon trained in this area of expertise. While there are no new technical surgeries represented in the model, it is a unique way to utilize surgical expertise that is focused on emergent and acute problems. The purpose of this article is to make the reader aware of this model of surgical care, and to consider the advantages to incorporating this into their own environment. It is unclear if this practice paradigm, which is remarkably attractive to graduates of US general surgery training programs, will become more international in scope.

Training and Practice Settings of Physicians Dual-Certified in Emergency and Sports Medicine.

Survey study of training and practice paradigms and job satisfaction of dual-boarded emergency medicine (EM) and sports medicine (SM) physicians. The REDCap survey was sent to 193 American Board of EM members who hold a Certificate of Added Qualification in SM. A total of 124 EM/SM physicians responded (67.5% male). More than 70% completed three-year residencies while only 28.5% had an EM/SM residency faculty. One-quarter delayed fellowship after residency 6.45 years on average. Regarding their first job after fellowship, 27.6% practiced only EM, 54.5% practiced both EM and SM, and 12.2% practiced only SM. Regarding their current job, 29.1% practice only EM. 47.3% practice both EM and SM, and 20.9% practice only SM. Only 13.9% and 9.9% indicated they are unhappy with their first job and current job, respectively. There is significant variability in practice settings for EM/SM physicians with the overwhelming majority being happy with their career choices.

Three dimensional (3D) printing in Orthopaedics: Scope of application and future perspectives

Three dimensional (3D) printing also known as additive manufacturing has the potential to change the paradigm of Orthopaedic practice. Modern times have witnessed exponential growth in 3D-printing technology as well as its uses. A wide spectrum of printers are now available, ranging from the desktop printer to high end manufacturing units. The ability to use a plethora of materials and create almost limitless geometric shapes with varying surface topography makes this method of production highly appealing. Certain inherent advantages include easy customizability, small production runs, less wastage of material, smaller footprint. Challenges such as lack of data, absence of established government regulations and cost considerations remain, but one can expect these to be overcome as the economy of scale plays out and the medical fraternity becomes more accommodating of the new technology. Keywords: Three dimensional printing, Recent Advances, Arthroplasty, Spine, Tumor Implants

Transformation of scientific paradigms in social practice

The article dedicated to the 100th anniversary of the birth of Academician of the Russian Academy of Sciences Vladimir Nikolaevich Kudryavtsev provides a brief analysis of his creative experience in Criminal Law, criminology and legal conflictology, reveals the theoretical and practical significance of the author’s works, which in many ways have become the theoretical basis for new areas of research in jurisprudence; the transformation of scientific ideas developed by the scientist into social practice is shown, in particular into criminal legislation, law enforcement and criminological measures to prevent crime, resolve conflicts by legal means.

Practice patterns regarding combination treatments and laser and energy based devices: A survey of American Society for Laser Medicine and Surgery Members

The use of laser and energy-based devices (LEBD) has grown exponentially in recent years, and variations in common practices exist. Our study sought to evaluate the current practice paradigms of leaders in the field of LEBD with regard to antimicrobial prophylaxis, adjuvant topical treatments, use of laser procedures in pregnancy, and combination of procedures. Anonymous surveys were distributed to leading dermatologists in American Society for Laser Medicine & Surgery (ASLMS) via email. Surveys were distributed to 65 ASLMS members;37 submitted responses. Routine antiviral prophylaxis is used by 76% for fractional ablative procedures of the face, but only 27% for fractional non-ablative procedures. Routine antifungal prophylaxis was used by a minority (16%) for ablative procedures, whereas antibacterial prophylaxis was used by 68%, with varying antibiotics. Wide variations exist in skin preparation and topicals used post-laser treatment. Most respondents feel comfortable combining same-day LEBD and botulinum toxin injections, specifically vascular or Q-switched/picosecond lasers. Most respondents avoid performing LEBD during pregnancy. Expert consensus in a rapidly growing field sheds light on common, reliable practices. However, even at the expert level, variations exist. Further high-quality research is needed to standardize and update guidelines.

ESPO AND SOCIAL RESEARCH, POLICY, AND PRACTICE SECTION SYMPOSIUM: WHAT AROUND THE PERSON MATTERS: REIMAGINING ENVIRONMENTAL JUSTICE AND AGING

Abstract From Lawton’s seminal Ecological Theory of Aging (ETA) to the recent development of Wahl’s COntext Dynamics of Aging (CODA), conceptual and empirical work has repeatedly shown that the living environments fundamentally influence health and wellbeing in later life. The CODA framework posits five correlated contexts that can predict developmental outcomes in aging: physical, social, service, socioeconomic, and technological contexts. The ongoing COVID-19 pandemic further manifested the lack of environmental justice for marginalized and minoritized older adults, calling for reflection on the paradigm for ecological aging research, practice, and actionable policymaking. This SRPP/ESPO symposium featured emerging and established scholars’ work that shed light on reimagining environmental justice for older adults with diverse abilities, backgrounds, and resources. Panelists will share stories of their professional development journeys, highlighting empirical evidence with under-researched, systematically excluded populations and examining new directions in aging and environment research. Topics include accessible and affordable housing, built environment, neighborhood contexts, conceptualizing the community, and the experiences of those most likely to bear the burden of precarious housing in later life. This symposium will hold the space for emerging scholars to learn and discuss short- and long-term practice and policy priorities for promoting environmental justice for older adults and provide tools to conceptualize their research informed through ecological and equity-centered perspectives.

Operative group therapy: an alternative paradigm for the clinical practice with subjects, groups, and mental health institutions?

Resumen: El paradigma biomédico predominante ha llevado a la crisis de las psicopatologías actuales (al no incluir la subjetividad), a la crisis de las clasificaciones y sistemas diagnósticos (DSM) y a la crisis de los propios servicios de salud mental (SSM). Se propone la Clínica Grupal Operativa (CGO) como alternativa, pues el modelo biomédico sobremedicaliza el sufrimiento de la población. La CGO se basa en el paradigma biopsicosocial, incluye la subjetividad e intersubjetividad en la psicopatología, propone una psicopatología vincular y grupal, y plantea estrategias psicoterapéuticas de mayor complejidad (pareja, grupo, familia y multifamiliar). La CGO, que tiene como núcleo central la teoría psicoanalítica, es un nuevo modelo grupal para la comprensión de los procesos de salud-enfermedad mental, fundamental, a nuestro entender, en la formación de los profesionales para el buen desarrollo de las tareas de asistencia, docencia e investigación en los SSM.

Advancing integrated care through cotraining of residents and psychology postdoctoral fellows.

While integrated behavioral health (IBH) is growing as a primary care practice paradigm, there are gaps in developing the workforce needed. In particular, there are few examples of cotraining curricula in IBH for family medicine residents with postdoctoral psychology fellows. Furthermore, even fewer programs incorporate a colearning primary care practice environment featuring a targeted approach to care for patients with chronic illness using panel management and integrated care. In this article, the authors describe a cotraining experience in an urban federally qualified health center supported by a 5-year Health Resources and Services Administration Title VII grant, within a social justice mission-driven academic department to prepare both family medicine (FM) residents and primary care psychology (PCP) postdoctoral fellows for IBH practice. The article will discuss the specific components of the shared/parallel curriculum, integration of social justice and population health principles and practices, and a structured approach for resident/fellow partnership. The authors share the clinical and educational impacts of this integrated cotraining curriculum model as described by the FM residents and PCP fellows. The article describes workforce results measuring the diversity of the trainees and their postprogram jobs serving vulnerable populations. The interdisciplinary cotraining between FM residents and PCP fellows presents an innovative approach to developing workforce capacity for integrated practice in medically underserved settings. This article describes the creation and implementation of a cotraining curriculum and provides recommendations for other programs and residencies preparing their residents and future PCP psychologists to practice and teach skills in integrated care. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Investigating the Method of Da’wah and the Role of Political-Economy of Jemaah Tarbiyah in Urban Malang Society

Since the emergence of the overwhelming electoral vote for Partai Keadilan Sejahtera (Prosperous Justice Party) in the 2019 legislative election in Malang City, we discovered the impact of political-economy of Jemaah Tarbiyah on the urban society is a significant boost in electability for PKS. The subject selected is an Islamic philanthropic organisation, Ash-Shahwah Foundation (YASA) in Malang City as the sympathisers of Jemaah Tarbiyah. The supportive factors for regulating the political economy of Jemaah Tarbiyah include the method, role, and participation of YASA in Malang City. Through the method of da’wah, the figure of Jemaah Tarbiyah, Abu Haidar, stated that shalat is the key to success in life, and this has been successfully gaining hundreds of members. The role of YASA is to educate the urban society that obligatory alms become a lifestyle for their charitable politics. YASA becomes an intermediary to the connection of elite-mass or mustahiq-cadres’ relationships for gaining trust and getting massive electoral votes. The urban society participation, particularly the benefactors, can be seen from their enthusiasm in donating their wealth and demonstrating solidarity among individuals to strengthen informal religious learning courses in mosques. Findings show that the political economy of Jemaah Tarbiyah initiated the great success of gaining substantial electoral votes through philanthropic practices used as indirect support and funding for election campaigns. Notably, there is a political tendency for YASA to change its paradigm of philanthropic practice, for which the initial goal was to raise humanitarian aid and charitable funds and to shift funds toward financing a campaign.

Developing a virtual global dermatology curriculum: Qualitative analysis based on a pilot study in Ethiopia

Developing a virtual global dermatology curriculum: Qualitative analysis based on a pilot study in Ethiopia

Enlightenment of Understanding on Music Education from the Perspective of Philosophical Hermeneutics

China's music education system has always followed the western aesthetic pedagogy and the traditional music education system, and its philosophical basis is mainly the traditional subject object dichotomy epistemology. With the continuous development of human society, especially in the context of the great development of China's economy and culture in the 21st century, problems such as the lack of culture, the prevalence of rational logic technology, and the disconnection between music and life have become prominent in China's music education. Starting with the core understanding view of philosophical hermeneutics, this paper studies music education around the three key concepts of situation, vision and dialogue, with the intention of revealing the diversified, open and inclusive development trend of music education in China in the future with a new thinking concept, and providing several practical paradigms of music education.