Expert Profiles Research Articles

The Expert Nurse Profile and Diagnostic Content Validity of Sedentary Lifestyle: The Spanish Validation

To identify the diagnostic content validity of Sedentary Lifestyle and to identify the expert nurse profile in validating this nursing diagnosis in the Spanish cultural context. Fehring's Diagnostic Content Validity (DCV), the factorial validity of the defining characteristics, the analysis of convergent validity, and the expert profile were assessed. The DCV index for experts was .70. The factorial validity showed two different factors: the expression of laziness and the performance of activities of daily living. On the expert profile related factors analysis, two factors, experience and education, were identified. The DCV for Sedentary Lifestyle was high among the expert nurses. A nurse was considered to be an expert who was able to accurately answer the four labels identified as nursing diagnoses, had read at least one nursing process article in the past year, and was able to list three nursing process reference books. Clarifying the manifestations of sedentary lifestyle will assist clinical nurses in determining this diagnosis, and the expert profiles will assist in the selection of participants for content validity studies.

Handbook for health care ethics committees

Preface Acknowledgments I. Curriculum for Ethics Committees 1. Ethical Foundations of Clinical Practice The Role of Ethics in Clinical Medicine Ethics Committees in the Health Care Setting Fundamental Ethical Principles Principlism and Alternative Approaches The Role of Culture, Race, and Ethnicity in Health Care Conflicting Obligations and Ethical Dilemmas 2. Decision Making and Decisional Capacity in Adults Health Care Decisions and Decision Making Decision-Making Capacity Assessment and Determination of Capacity Deciding for Patients without Capacity 3. Informed Consent and Refusal Evolution of the Doctrine of Informed Consent Elements of Informed Consent and Refusal The Nature of Informed Consent Exceptions to the Consent Requirement 4. Truth Telling Justifications Disclosure Disclosure of Adverse Outcomes and Medical Error Privacy and Confidentiality Genomic Testing and Control of Information 5. Special Decision-Making Concerns of Minors Decisional Capacity and Minors Consent for and by Minors Confidentiality and Disclosure Special Problems of Functionally Alone Adolescents 6. Ethical Issues in Reproduction The Ethics and Politics of Reproductive Choice Assisted Reproductive Technologies Surrogacy and Gestational Carriers Termination of Pregnancy Maternal-Fetal Issues Prenatal/Newborn Genetic Testing and Genomic Newborn Screening Special Decision-Making Concerns of the Elderly The Other Side of the Mountain Diminishing Autonomy and Decisional Capacity Promise that you won't ever put me in a nursing home Independence, Dependence, and Role Reversals Prior Wishes and Current Needs Intimacy and Security Transition from Hospital to Home or Nursing Home 8. Ethical Issues in the Care of Disabled Persons Disability and Its Place in Bioethics Defining Disability The Medical and Social Models of Disability The Disability Rights Critique of Prenatal Genetic Testing Special Challenges in the Care of Persons with Severe Cognitive Impairment Medical Decision Making and the Disabled 9. End-of-Life Issues Decision Making at the End of Life Defining Death Organ Donation Advance Health Care Planning Honoring Patients' End-of-Life Decisions Goals of Care at the End of Life Forgoing Life-Sustaining Treatment Protecting Patients from Treatment Rejection of Recommended Treatment and Requests to Do Everything Medical Futility 10. Palliation From Caring to Curing and Back Again The Experience of and Response to Pain The Moral Imperative to Relieve Pain Assisted and Permitted Dying Pediatric Palliative Care Palliative Care and Hospice Palliative Care 11. Justice, Health, and Access to Health Care Access to Health Care in the United States Justice and Health Disparities Health Care as a Requirement of Justice Health Care and Health Theories of Justice Rationing Health Care Reform 12. Organizational Ethics From Bioethics to Health Care Organizational Ethics Moral Responsibilities of Health Care Organizations Organizational Ethics and Compliance Ethics and the Allocation of Resources Ethics Committees and Organizational Issues Developing an Organizational Ethics Service II. The Creation, Nature, and Functioning of Ethics Committees 13. Profile of Ethics Committees Origins Committee Functions Membership Expertise in Ethics Leadership Securing a Foothold Clinical Ethics Consultation Overview of Ethics Consultation Three Models of Clinical Ethics Consultation Services Building an Ethics Consultation Service Credentialing and Privileging Clinical Ethics Consultants Analytic Approaches to Clinical Ethics Consultation Selecting the Best Clinical Ethics Consultation Service Model for Your Institution Access to Clinical Ethics Consultation Policies 15. Ethics Education Brown Bag Lunches Journal Clubs Case Conferences Ethics Grand Rounds Ethics Modules in Residency Training and Medical School Programs Ethics Symposia White Papers, Memoranda, Guidelines, and Protocols Additional Education Opportunities 16. Sample Clinical Cases Adolescent Decision Making Advance Directives Autonomy in Tension with Best Interest Confidentiality Decisional Capacity Disclosure and Truth Telling End-of-Life Care Forgoing Life-Sustaining Treatment Goals of Care Informed Consent and Refusal Medical Futility Parental Decision Making Surrogate Decision Making 17. Sample Policies and Procedures III. Organizational Codes of Ethics Regional Medical Center Code of Conduct Metropolitan Medical Center Code of Ethics University Health Network Code of Ethics IV. Key Legal Cases Informed Consent Privacy Confidentiality Health Care Decision Making Medical Decision Making for Minors Reproductive Rights State Action to Protect Public Health State Action to Control What Practitioners Must or Must Not Discuss with Their Patients Health Care Reimbursement V. An Ethics Committee Meeting Index

What kind of knowledge sharing network for a consultant profile?

Management consultants appear to be particular knowledge workers that are characterised by an expert and self-sufficient profile. The aim of this research is to understand whether their professional characteristics still allow them to share knowledge and lead them to use a formal network (through a knowledge management system, kms) or an informal one (person-to-person). To study their kms using and sharing behaviour, a qualitative case study methodology was adopted, based on observation and multi-hierarchical ranking, multi-site, partly-structured interviews among consultants within the same consulting firm. The results firstly show that use and knowledge-sharing behaviours are differently influenced by practical and social characteristics; moreover, the social professional context of these self-sufficient experts encourages most of them to share knowledge within a more informal network.

Automatic expert identification using a text categorization technique in knowledge management systems

Since tacit knowledge such as know-how and experiences is hard to be managed effectively using information technology, it is recently proposed that providing an appropriate expert identification mechanism in KMS to pinpoint experts in the organizations with searched expertise is more effective and efficient to utilize this type of knowledge. In this paper, we propose a framework to automate expert identification using a text categorization technique called Vector Space Model to minimize maintenance cost of expert profiles as well as problems related to incorrectness and obsolescence resulted from subjective manual profile processing. Also, we define the structure of expertise consisting of activeness, relevance, and usefulness factors to enable deriving the overall expertise level of experts by analyzing knowledge artifacts registered to the knowledge base. The developed prototype system, “Knowledge Portal for Researchers in Science and Technology”, is introduced to show the applicability of the proposed framework.

E-Mental health in Pakistan: a pilot study of training and supervision in child psychiatry using the internet

The ‘brain drain’, resulting from the recruitment by the UK of highly qualified mental health professionals from middle- and low-income countries, has been described as a serious problem effecting the service provision, training and research capacity of these countries (Doku & Mallett, 2003; Thara et al, 2004). Although this issue is important, the benefits of such migration are seldom highlighted. Professionals who migrate often invest in families and businesses in their home country and are a source of valuable foreign income. Many professionals undergo specialised training and gain experience not available in their home countries and then return to provide an enhanced level of service (Tareen, 2000). Such movement may also serve a catalytic purpose. An example of a sector that has gained enormously from the so-called brain drain is information technology in India, which is built largely around expatriates in the USA and their networks back home. The high profile of Indian information technology experts has encouraged a whole new generation to pursue excellence in this field.

Computer-Aided Diagnoses of Chronic Head Pain: Explanation, Study Data, Implications, and Challenges

The differential diagnosis of diseases and disorders having head pain as a symptom is often a difficult challenge for health care professionals. The complexity of this problem, the need for computer aided diagnosis, and the assumptions upon which one diagnostic software program was developed are discussed. A database driven user-oriented Internet website was offered at no charge to headache sufferers, and this vehicle provided the data source for research. The software program compares consistent user surveys to 253 expert profiles compiled from searches of the best available material in the medical/dental literature. A database of 1288 consistent user surveys was studied and analyzed for this paper. Findings discussed are: 1. the large amount of users (63%) who do not match any expert profile to a reasonable degree of medical certainty; 2. the significance of the relatively large amount of headache sufferers (17%) whose diagnosis or diagnoses are solely within the realm of dentistry; and 3. the importance of differentiating between discriminating and substantiating diagnostic criteria. Many users do not fit existing algorithms for chronic head pain. Data generated by this computer-aided diagnostic software program challenge some current paradigms and concepts of diagnosis. The data generated question “correct to a reasonable degree of medical certainty,” challenge “a preponderance of the evidence” as scientific diagnostic standards, and also question whether rendering a working diagnosis is possible on each and every patient.

The ideal profile of the PA expert at the EU level

AbstractIf public affairs management is what public affairs managers do, then there is no stable definition of the ideal profile of such a manager. There is, however, a need for this in practice. If an interest group decides to strengthen its public affairs function and to open a vacancy, what then should be the text of the profile? The question also has much academic relevance, as it invites a selection of the most important characteristics required for effectively handling and influencing a specific playing field. Below is presented the ideal profile of the public affairs expert at the level of the European Union. As the ideal is always above the reality, we suggest in addition specific training of skills and development of talents in order to bridge the gap. Copyright © 2002 Henry Stewart Publications.

Usefulness of a psychometric questionnaire in exploring parental attitudes in children's dental care

In this methodological study we investigated the usefulness and reliability of a questionnaire designed to capture 4 aspects of parental dental attitudes: dental knowledge, child oral health behavior, perceived importance of dental related aims, and parental responsibility. The study was undertaken in a group of 140 parents of schoolchildren aged 8-12 years from four comprehensive schools in Sweden. Test-retest reliability, quantified by the intraclass correlation coefficient (ICC) or by Cohen's kappa, varied from acceptable to excellent for different aspects of the questionnaire. The knowledge and responsibility-taking sections were also answered by a group of dental experts who showed a high level of internal agreement. Expert profiles, to which the parental assessments could be compared, were created. Exploration of the 4 aspects showed that this group of parents commonly had a multifocal view on the etiology and prevention of caries. Correlations between their knowledge assessments and the assessments made by the expert group varied from moderately negative to strongly positive. The parents revealed a high degree of dental-related motivation and responsibility, particularly according to oral health behaviors. In conclusion, the results indicate that this 4-part psychometric questionnaire might be a suitable instrument in investigations of priority and responsibility-taking as new aspects of parental dental attitudes, along with dental knowledge and child oral health behaviors.

The Austrian foresight programme: organisation and expert profile

Austria's first systematic Foresight programme, run between 1996 and 1998, is examined as an example of a Foresight approach in a small country. Practice of foresight is rather diverse among small countries, but approaches tend to be more selective in scope, tailored to more specific goals, and putting greater emphasis on demand aspects than in bigger countries. "Delphi Austria", built on a series of preparatory studies, expert panels, and two parallel Delphi exercises, reflects these characteristics including a number of methodologically innovative elements such as the combination of a Technology Foresight with a Society and Culture Foresight. The objectives and approach of this novel element in Technology Foresight is described and exemplary results are presented. Another innovative element which had been developed in the latest German Delphi study, a so-called mega-trends-section in Technology Foresight, is presented and used to examine the general attitudinal profile of the expert base. A summary and a view on the diffusion and implementation of the outcomes of "Delphi Austria" conclude the article.

Attachment and play in child care centres: Reliability and validity of the attachment Q-sort for mothers and professional caregivers in Italy

The purpose of this article was to adapt and validate the Attachment Q-Sort (AQS; Vaughn & Waters, 1990) in the Italian context of child rearing at home and in centre care, and to analyse the associations of attachment to the mother and to the professional caregiver with play behaviour of the child. The article reports on three studies. The first study describes the procedure used to create the Italian version of the Attachment Q-Sort. Fifteen Italian experts provided the AQS descriptions of the prototypical “most secure child”; moreover, 18 Italian caregivers used the AQS to describe the hypothetical “ideal child” in the context of the child care centre. The profiles of the Italian experts were very similar to those of American experts. Italian experts and Italian caregivers also strongly agreed in their descriptions, respectively, of the “most secure” and the “ideal” child. The second study reports on the reliability of the AQS data. Eighty-six children (43% male; 59%first-borns) and their mothers and caregivers participated in the research. Children’s ages ranged from 14 to 36 months ( M = 26.6; SD = 6.78). All children spent at least 30 hours per week in the child care centres. Test-retest reliability and inter-observer agreement appeared to be satisfactory. Agreement between mother/caregiver- and observer-reported security scores was less convincing. In the third study, the associations between the network of attachment and level of play were examined. Fifty children (58% male; 60% first-borns) participated. Children’s ages ranged from 14 to 36 months ( M = 25.8; SD = 6.56). Play behaviour was observed at the child care centre during free play sessions of 30 minutes and social and cognitive play categories were coded. Secure attachment led to higher cognitive levels of play. Attachment to the caregiver was generally more influential than attachment to the mother.

Developing a personality profile of the bomb-disposal expert: the role of sensation seeking and field dependence–independence

The high-risk, prosocial professional should score highly on sensation seeking, particularly on the thrill-and-adventure-seeking subscale (TAS). However, the TAS subscale will not permit differential prediction of who will prefer which high-risk job. The cognitive style of field dependence–independence (FDI) could have predictive faculty. We compared a group of bomb-disposal experts to one comprising anti-terror operatives, examining both personality (sensation seeking and the Eysenckian Big Three) and cognitive style. Our prediction was that while both groups would score high on TAS, they would differ on FDI. For comparison, we provide relevant data taken from recently published norms [Glicksohn, J., & Abulafia, J. (1998). Embedding sensation seeking within the big three. Personality and Individual Differences, 24, 1–15]. The personality profile of the high-risk, prosocial, professional was found to conform to that of the nonimpulsive sensation seeker who is emotionally stable. As hypothesized, bomb-disposal experts were found to be markedly more field independent than were anti-terror operatives.

Interpreting VASS Dimensions and Profiles for Physics Students.

Student views about knowing and learning physics have been probed with the Views About Sciences Survey (VASS) along six conceptual dimensions, and classified into four distinct profiles: expert, high transitional, low transitional, and folk. As an aid to interpreting VASS results, this article provides a qualitative analysis of student responses to items within each of the six dimensions and a quantitative analysis of their relation to students' profiles. Students with an expert profile are chiefly scientific realists and critical learners. Students with a folk profile are primarily naive realists and passive learners. Students with transitional profiles hold mixtures of these views. Student profiles correlate significantly with physics achievement. Indeed, they may be major determinants of what students learn in physics courses.

On the Use of Neural Network Techniques to Analyze Sleep EEG Data

This is the third communication on the use of neural network techniques to classify sleep stages. In our first communication we presented the algorithms and the selection of the feature space and its reduction by using evolutionary and genetic procedures. In our second communication we trained the evolutionary optimized networks on the basis of multiple subject data in context with some smoothing algorithms in analogy of Rechtschaffen and Kales (RK). In this third communication we could demonstrate that the robustness concerning individual specific features of automatically generated sleep profiles could be reasonably improved by an additional modification of the procedure used by SASCIA (Sleep Analysis System to Challenge Innovative Artificial Networks). The outputs of nine different networks that were created by the data of 9 different subjects were used simultaneously for classification. The medians of the values obtained in each output measure were selected for the allocation to a sleep stage. The fitness criteria of 16 automatically generated sleep profiles showed reasonable concordance with the expert profile. Even though in single cases the concordance between conventional RK classifications and automatically generated profiles were a few percentages lower, the average correct classification of the 12 classified subjects improved substantially, thus proving that the classifier is more robust against individuum-specific variability. Despite the fact that the expert generally employs three channels (EEG, EMG and EOG), at least to build up sleep profiles, the SASCIA system was able to produce profiles on the basis of only one EEG channel with 80% concordance and a correlation coefficient of 0.86. The feature selections were performed by genetic algorithms and the topologies of the networks were optimized by evolutionary algorithms. This algorithm will now be used for larger sample forward classification.

Record Formats for Integrated Databases: a review and comparison

An information retrieval system contains many different kinds of data, the significant ones being bibliographic and factual data. An integrated database system capable of holding both bibliographic and factual information, in a single database structure, is more convenient for search and retrieval by end-users. Several bibliographic formats have been developed and are used for bibliographic control purposes. Features of six major bibliographic formats, viz. USMARC, UKMARC, UNIMARC, CCF, MIBIS and ABNCD, are reviewed. Only two formats - CCF and ABNCD are capable of holding both bibliographic and factual information and supporting the design of integrated databases. A comparison suggests that, while CCF makes more detailed provision for bibliographic information, ABNCD makes better provision for factual information such as profiles of institutions, information systems, projects and human experts.

A Prototype View of Expert Teaching

We call for a reconceptualization of teaching expertise, one grounded in a psychological understanding of how (a) experts differ from nonexperts, and (b) people think about expertise as they encounter it in real-world settings. To this end, we propose that teaching expertise be viewed as a category that is structured by the similarity of expert teachers to one another rather than by a set of necessary and sufficient features. A convenient way of thinking about such categories is in terms of a central exemplar or prototype ( Rosch, 1978 ), and we believe that a prototype view can contribute in important ways to a dialogue on expert teaching. Most importantly, a prototype view provides a way of thinking about expertise that incorporates standards (such that not every experienced practitioner is an expert) but also allows for variability in the profiles of individual experts. In this article, we outline a rudimentary model of prototype-based categorization and identify possible features, drawn from psychological research, on which the family resemblance among expert teachers may be founded. We discuss several implications of the prototype view for understanding and fostering expertise among teachers.

Development of An Asia-Pacific Regional Network For Public Health

As public health by its very nature is multi-disciplinary, it may benefit individual programs to formulate a regional network, joining researchers and academics across programs. This approach may afford extended benefits, such as the establishment of regional health surveillance systems and collaborative funding initiatives. To explore this potential, member institutions comprising the Asia-Pacific Academic Consortium for Public Health provided data to form an aggregate profile of cross-institutional expertise and resources, which was presented to Health Specialists at the Asian Development Bank. The study provided a foundation for a planned regional network. A four-pronged approach was proffered detailing concurrent aspects of development: 1) network formation and expansion, 2) research coordination, 3) cross-institutional communication and instruction, and 4) promotion of self-sufficiency. The proposed plan affords the groundwork for an improved approach to public health research and practice that builds upon the established Consortium, and encourages new horizons. Regionalization is an increasing phenomenon world wide, and should be furthered as a concept for improved public health intervention and control.

Practice, Research and Education — What is the Link?

<h2>Summary</h2> This paper discusses the need for physiotherapists to be able to defend a strong and coherent professional profile of expertise within the current reforms of health care. The concept of paradigm as a theoretical framework which may help to express and evaluate the fundamental beliefs which underpin physiotherapy activities is explored. The need to consolidate and develop an exclusive physiotherapy theory which can both extend and determine the limits of practice is argued, and a need for more co-ordination of the diverse activities of the fields of practice, research and education of the profession is suggested. It is concluded that the critical stance of a reflective practitioner should be adopted by all members of the profession. Crucial elements of the unique mode of thinking and acting which is common in professional methods of indentifying and solving physiotherapy problems must be made explicit. It is necessary that the evolution of the exclusive theory, expertise, goals and aspirations of the practice of physiotherapy which occurs through contemporary practice is clearly understood by practitioners if they are to play an active part in promotion and development of the profession.

Development of a computerized database for the study of anaesthesia care.

To record, tabulate and report problems associated with anaesthesia, we have developed an information collection system and computer software to follow all patients attended by an anaesthetist at a teaching hospital in Canada. For the last 15 mo, data for 17,000 patients have been collected and the system is ongoing. Data collection is from three sources: carbonless copies of the handwritten Operating Room (OR) and Post Anaesthetic Care Unit (PACU) records, other hospital databases, and postoperative visits. Adverse events (observations which differ from specific physiological variables, or require an intervention and do not normally occur during the routine conduct of anaesthesia), are defined directly on each OR and PACU record. These events are recorded when they occur by the attending anaesthetist or the PACU nurse. All data are verified by a research nurse and an anaesthetist. Computer software, developed from DBase IV, is used to track 95 individual items on preoperative status and anaesthetic technique and another possible 1,450 selections for drugs, physicians, airways, surgical procedures and events for each patient. Data are analyzed with SAS software and reports generated to link the casemix and process with outcome. Comparison of data entered into the computer programme to a retrospective chart review revealed discrepancies of less than 0.5%. Collection, verification and computer entry takes five minutes per patient and the on-going cost is estimated at $4 per patient record. Analysis of the information collected in this database has been useful for research of adverse outcome following anaesthesia, resident expertise profiles, and the administrative management of an anaesthesia department.

Hochdruckextraktion von Majoran. 1. Mitt. Sensorische Charakterisierung von Majoranoleoresin mittels Profilanalyse

A flavour profile analysis has been developed for the evaluation of carbon dioxide extracts of marjoram. On the basis of the commercial quality of various proveniences of marjoram a first flavour profile was established. Components which decisively influence the flavour were examined for the determination of relevance factors. The taste profile is the basis for the calculation of the quality coefficient as measure of the sensory quality. The expert profile as a theoretical model is based on optimum intensities of individual taste components. Differences from the expert profile are considered by corrected intensities and lead to a decrease of the quality coefficient. The method used for the development of a high pressure extraction technology is quite suitable for the characterization of marjoram extracts as well as for the evaluation of commercial marjoram samples.

R&amp;D ‘programmes‐competencies’ matrix: analyzing R&amp;D expertise within the firm

AbstractThe author suggests that the systematic identification of a firm's technologies opens up the possibility of evaluating, protecting, optimizing, enriching and exploiting these technologies to the full. A firm's technologies fall into two parts: those embodied and exploited in current operations and those evolving from the collective competencies of its R&amp;D staff. The author's aim is to evaluate and describe the firm's R&amp;D competencies.The identification of R&amp;D competencies proceeds in three steps: tracing the background of the current and past programmes, constructing a programmes/competencies matrix, and deriving an expertise profile. The construction of the matrix is the key activity and requires much care in its execution, if competencies are to be properly defined and truly existing, and if it is to be exhaustive. The author sketches a procedure for constructing a matrix and discusses problems of implementation and draws attention to some of its limitations.The author claims that such an inventory of expertise could improve the efficiency of the use of the R&amp;D resource, identify a laboratory's strengths and weaknesses, direct R&amp;D into hitherto neglected channels, assist individuals to identify and evaluate their own expertise, justify obtaining funding for building expertise in shortage areas. The method should be considered as a starting point to formulate appropriate strategies to gain access to technology.