Realistic Aim Research Articles

Need for Information about Medical Rehabilitation of Persons with German Pension Insurance: a Written Survey

In order to acquire target group-specific information on rehabilitation for members of the German pension insurance, they were asked about their ideas about medical rehabilitation and desired information regarding subjects and kind of information transfer. The core of the project was a written survey of members of the German pension insurance. N=600 insured people were invited to participate in the study. The questionnaire was developed in a qualitative pre-study. N=196 questionnaires were evaluated. Recovery of working ability was mentioned by most persons as the aim of medical rehabilitation. The most common idea regarding indication for rehabilitation was a specific operation. Physiotherapy was most often considered as therapy during medical rehabilitation. Information about formal steps, realistic aims and rehabilitation clinics were important. A conversation with their physician, written information material and a website were the preferred information pathways. Two-thirds of participants thought that information about medical rehabilitation was important even though they had no rehabilitation indication at the time of survey. The identified target-related information needs can be considered in a need-oriented development of information material. These can contribute to an informed decision for members of the German pension insurance for or against medical rehabilitation or an application for rehabilitation. Moreover, patient-oriented information can contribute to more successful rehabilitation participation, higher satisfaction with and a better rating of medical rehabilitation.

Intestinal parasites and vector-borne pathogens in stray and free-roaming cats living in continental and insular Greece.

This survey investigated the distribution of various intestinal parasites and vector-borne pathogens in stray and free-roaming cats living in four regions of Greece. A total number of one hundred and fifty cats living in three Islands (Crete, Mykonos and Skopelos) and in Athens municipality was established as a realistic aim to be accomplished in the study areas. All cats were examined with different microscopic, serological and molecular assays aiming at evaluating the occurrence of intestinal parasites, and exposure to or presence of vector-borne infections. A total of 135 cats (90%) was positive for one or more parasites and/or pathogens transmitted by ectoparasites. Forty-four (29.3%) cats were positive for one single infection, while 91 (60.7%) for more than one pathogen. A high number of (n. 53) multiple infections caused by feline intestinal and vector-borne agents including at least one zoonotic pathogen was detected. Among them, the most frequently recorded helminths were roundworms (Toxocara cati, 24%) and Dipylidium caninum (2%), while a high number of examined animals (58.8%) had seroreaction for Bartonella spp., followed by Rickettsia spp. (43.2%) and Leishmania infantum (6.1%). DNA-based assays revealed the zoonotic arthropod-borne organisms Bartonella henselae, Bartonella clarridgeiae, Rickettsia spp., and L. infantum. These results show that free-ranging cats living in areas of Greece under examination may be exposed to a plethora of internal parasites and vector-borne pathogens, some of them potentially able to infect humans. Therefore, epidemiological vigilance and appropriate control measures are crucial for the prevention and control of these infections and to minimize the risk of infection for people.

Hide and seek? Israeli–Turkish relations and the Baghdad pact

ABSTRACTThe aim of this article is to address the impact of the Baghdad Pact and the Anglo-American defense system and its collapse on the Turkish–Israeli relationship from 1954 to 1958, a discussion that is absent from scholarly studies. The article will highlight the different approaches and views of the two parties and their impact on the cold war alliances and the Arab–Israeli conflict. Examining this from the perspectives of both Ankara and Jerusalem will contribute to a comprehensive study of the bilateral relations during the 1950s. Some of the main questions to be addressed are: to what extent, if at all, did the Baghdad Pact change bilateral relations between Turkey and Israel? What were Israel's main concerns? Were its suspicions of Turkey's changing policy founded? How much was Turkey influenced by Iraq's membership of the Pact and its hostile attitude toward Israel? Was Turkey's attempt to maintain reasonable relations with both Israel and Iraq a realistic aim? All these will be assessed against regional upheavals and the cold war politics with current implications.

The opportunities and obstacles nurses have in carrying out their work–A case study in an operating department in Sweden

BackgroundTo improve working conditions and counteract nursing shortages, more knowledge is needed about the opportunities nurses have to carry out their work and what guide nurses’ work. The aim of this study was to use the ARIA guide to identify the opportunities and obstacles in nurse managers, registered specialist nurses and non-registered assistant nurses work in an operating department. MethodsA descriptive case study design was performed in an operating department, comprising structured individual and group interviews according to work content analyses with nurse managers, registered specialist nurses and assistant nurses. Interviews were analysed in terms of predetermined aspects regarding working conditions and criteria for performance obstacles. Extracts from documents stating goals and registered data supplemented the interviews. ResultsThe findings show that the daily surgery schedule, not the goal documents, guided daily work. An over-optimistic surgery schedule with unplanned changes and cancellations, over which the nurses had very little influence, as well as the time required to locate necessary equipment that was spread throughout the ward, resulted in nurses rushing through medical records and other preparations rather than preparing calmly for surgery. Although the registered specialist nurses and assistant nurses considered quality of care to be highly important, no standardised evaluations on quality of care were performed. ConclusionThe study reveals the importance of a functioning physical work environment including storage, technical equipment supplies, and the positioning of technical equipment in operating rooms, in order for registered specialist and assistant nurses to perform their tasks well. Due to goal incongruence and performance obstacles, the nurses were often unable to reach their daily goals. Involving registered specialist nurses in the process of planning of the surgery schedule could facilitate their work to better match the prerequisites in the physical work environment and among available staff. In order for the Operating Department Goal Document to guide work, goals must be transformed into understandable, realistic, applicable and evaluable aims, and incorporated into daily work.

Housing First and Social Integration: A Realistic Aim?

Housing First is now dominating discussions about how best to respond to homelessness among people with high and complex needs throughout the EU and in several countries within the OECD. Whilst recognised internationally as an effective model in addressing homelessness, little attention has been given as to whether Housing First also assists previously homeless people become more socially integrated into their communities. This paper reviews the available research evidence (utilising a Rapid Evidence Assessment methodology) on the extent to which Housing First services are effective in promoting social integration. Existing evidence suggests Housing First is delivering varying results in respect of social integration, despite some evidence suggesting normalising effects of settled housing on ontological security. The paper argues that a lack of clarity around the mechanisms by which Housing First is designed to deliver ‘social integration’, coupled with poor measurement, helps explain the inconsistent and sometimes limited results for Housing First services in this area. It concludes that there is a need to look critically at the extent to which Housing First can deliver social integration, moving the debate beyond the successes in housing sustainment and identifying what is needed to enhance people’s lives in the longer-term.

PUPILS’ AND STUDENTS’ VIEWS ABOUT THE PBEC EFFECTIVENESS IN OMAN

The aim of this study was to investigate the PBEC (Post Basic Education Curriculum) the views of key participants (pupils and students) about the PBEC effectiveness and the extent to which the PBEC aims, skills and content prepare young people for the world of work or higher education. In addition, we consider the question, what are the important aims, skills and content for these participants’ future? And how can these be made effective to prepare students for their future? This study used specially designed questionnaires to collect data. The total sample was 550 pupils and students. The results showed that the participants tended to strongly support the PBEC aims, skills and subjects in principle. However, they seemed less satisfied with them in practice. Further, Participants were quite sceptical about the importance and need for some PBEC subjects; specifically, music and research methodology in preparing them for the world of work and HE. This research evaluates how the PBEC is viewed by pupils and provides the Ministry of Education with information about the PBEC efficacy in achieving its aims. This will give policymakers feedback to develop the PBEC to be more effective. A number of recommendations: the need to review and develop the content of PBEC to meet pupils’ expectations and be more flexible so teachers can use it to deliver pupils the required skills. Also, reviewing the documents of PBEC and putting in place clearer and more realistic aims of learning compatible with its anticipated expectations. Finally, there is a need to make an improvement of a teachers training program for pre-service and in-service to developing teachers’ skills on how to improve, the pupils’ way of thinking, their way of working, their tools for working and how they can apply these in the world. Article visualizations:

Anne Brontë’s Realist ‘Bluebeard’

Despite scholarly attention to the role of fairy tales in the novels of Charlotte and Emily Brontë, no one has discussed the possibility that ‘realist’ sister Anne deployed fairy tales as well. But the core plot of The Tenant of Wildfell Hall strikingly resembles ‘Bluebeard’. The heroine of The Tenant of Wildfell Hall shares the essential predicament of Bluebeard’s wife: marriage to a man whose past threatens her in the present. This essay argues that Anne Brontë’s adult fiction, too, reflects the Brontës’ childhood engagement with fairy-tale and fantasy literature — but in a subtle way that works in concert with her unflinchingly realist aims.

Nutrient inputs into the Gulf of Finland: Trends and water protection targets

Abstract The catchment area of the Gulf of Finland (GOF) is nearly 14 times larger than the sea area and is home to 12 million people. The GOF is thus heavily polluted by nutrients, and eutrophication is one of the major environmental concerns. The aim of this study was to estimate trends in the nutrient input and to evaluate whether current water protection targets (national, EU, HELCOM) will be achieved. We used both national and international (HELCOM) databases to evaluate nutrient inputs from the surrounding three countries (Estonia, Finland and Russia). The average nitrogen (N) input into the GOF was 112,000 t y− 1 for the period 2009–2013, with rivers responsible for 79%, direct point sources accounting for 10% and deposition for 11% of the input. Phosphorus (P) input was 4270 t y− 1, of which rivers were responsible for 88% and point sources for 12%. The largest proportions (61% for N and 73% for P) of the inputs came from Russia, despite the specific areal inputs (input divided by land area) being smaller than in Estonia and Finland. The changes in nutrient inputs into the GOF are largely due to the changes in Russian inputs, and in particular changes in the nutrient fluxes of the River Neva. The latest available flow-normalised data showed that N export decreased slightly from 1994 to 2010, while flow-normalised P export had clearly decreased by 2010. The P input ending up in the GOF as a whole has decreased significantly over the past 10 years as a result of the re-construction of wastewater treatment infrastructure in St Petersburg and following control of a P leak at the Phosphorit factory in 2012. This measure also explains the steep decrease in riverine P export during recent years. Further reduction of inputs to meet the ambitious nutrient reduction goals of HELCOM and of WFD seems to be a challenge for Finland and Estonia in particular. Russia appears to have already reached approximately 90% of the BSAP's reduction target, with fulfilment of the remainder of the P target appearing a fairly realistic aim as well.

Single-Channel Recording of Ligand-Gated Ion Channels.

Single-channel recordings reveal the microscopic properties of individual ligand-gated ion channels. Such recordings contain much more information than measurements of ensemble behavior and can yield structural and functional information about the receptors that participate in fast synaptic transmission in the brain. With a little care, a standard patch-clamp electrophysiology setup can be adapted for single-channel recording in a matter of hours. Thenceforth, it is a realistic aim to record single-molecule activity with microsecond resolution from arbitrary cell types, including cell lines and neurons.

Egyptian writers and dialect: choices and goals towards the constyruction of a national literature (1858-1965)

Modern Egyptian fiction arises in a moment of general transformation of the society. Arguably, it contributes to the construction of a national consciousness and experiments innovative forms and modes of expression. In the first half of the 20th century the writers of the Modern School make innovative linguistic choices to represent truth, a purpose inspiring also the Social Realism of the 50s. A remarkable role is given to the realistic characterization of dialogue and narrative discourse through the adoption of the Egyptian vernacular as a literary language. Narrators who have entered the literary canon and others face diglossia and finalize their realistic aims by reproducing in their works the composite and unstable reality of orality. The present paper addresses the linguistic choices of some modern Egyptian writers, trying to explain their purposes and methods in relation to the observation of reality, to its representation, and to the ideologies current in their time.

Is intellectual character growth a realistic educational aim?

Responsibilist approaches to virtue epistemology examine the epistemic significance of intellectual virtues like curiosity, attentiveness, intellectual humility, open-mindedness, intellectual courage, and intellectual tenacity. On one way of thinking about these traits, they are the deep personal qualities or character traits of a good thinker or learner. Given the intimate connection between intellectual virtues and good thinking and learning, responsibilist virtue epistemology appears ripe for application to educational theory and practice. At a minimum, growth in intellectual virtues seems like a worthy educational aim. But is such an aim realistic? There are at least three objections to thinking that it is. In this paper, I defend the enterprise of educating for growth in intellectual virtues against each of these objections. I conclude that if pursued in the right way, intellectual character growth is a worthy and realistic educational aim—one that justifies rethinking some fundamental educational priorities and practices.

Understanding Audit in Obstetrics.

Aim of this audit is to analyse indication and proportion of babies delivered by elective caesarean section at less than 39(+0)weeks of gestation exposed to antenatal corticosteroids performed in a Premier Hospital, Hywel Dda Health University. The second aim was to learn how an audit can be done and used for improving clinical practice. Present study involved all patients who underwent elective caesarean delivery before 39weeks completed period of gestation in August and September 2014. Data collected from medical record tracking using ICD-9 codes and analysed by clinical audit department. Patients who underwent elective caesarean section after 39weeks completed period of gestation. The audit showed 66.6% of patients were given antenatal corticosteroids. The observation was discussed in consultant meetings, labour forum, and was send as e-mail to every one working in Department of Obstetrics and Gynaecology. The goal was 100%. Reaudit is to be performed in year time to know the effect of change in practice. All successful audits are structured programmes with realistic aims and objectives, leadership and attitude of senior management, nondirective, hands-on approach, support of staff, strategy groups and regular discussions, emphasis on team working and support, environment conducive to conducting audit.

El papel del trabajador social en una sociedad precarizada

The decline of the welfare state and the rapid recent changes in production processes have brought about a radical transformation of the labour market. In societies whose structure has been shaped around paid work, the increasing lack of employment has created acute polarization and inequality. This has led to the birth of a new majority class of precarious and vulnerable workers as well as a new layout of marginality in unfamiliar ghettos. The social worker, a direct witness of the most devastating consequences of these transformations, cannot find suitable intervention procedures for this new society of «growth without employment», where full employment will never again be a realistic aim.

A comparison of software-based approaches to identifying FOPDT and SOPDT model parameters from process step response data

System identification is the experimental approach to deriving process models, which can take many forms depending upon their intended use. In the work described in this paper, the ultimate aim is to use them in the design of controllers for regulating engineering processes. Modelling always involves approximations since all real systems are to some extent non-linear, time-varying, and distributed. Thus, it is highly improbable that any set of models will contain the ‘true’ system structure. A more realistic aim is therefore to identify a model that provides an acceptable approximation, in the context of the application in which it is used. In controller design, a first step is often to determine the model using step and frequency response data. This paper compares different modern software approaches that exploit step response data, where the aim is to determine either a first- or second-order-plus-dead-time (FOPDT or SOPDT) transfer function. They include an integral equation method, an algorithm available in the MATLAB Optimization Toolbox, and recently developed in-house software that uses a particle swarm optimisation (PSO) approach.

Improving the Legitimacy of Medicines Funding Decisions: A Critical Literature Review.

Many health care systems globally provide publicly subsidized access to prescribed medicines. Decisions about which medicines to fund affect a range of stakeholders, and it is not reasonable to expect that medicines funding decisions are supported by all stakeholder groups all the time. A more realistic aim may be for decisions to be understood and accepted as legitimate by stakeholders; however, several shortcomings of existing processes make it difficult to achieve this aim. To date, the main strategy to address these shortcomings has been to increase stakeholder involvement in decision making, either by eliciting stakeholder values or increasing stakeholder participation in decision making. Despite these efforts, there is growing evidence that decision makers are falling short when it comes to the perceived legitimacy of their resource allocation processes and decisions. As such, there is a pressing need for decision makers to think seriously and creatively about ways to increase the legitimacy of their processes and to make them more acceptable to a wider range of stakeholders. In this article we summarize and critique existing literature on the legitimacy of public resource allocation processes, and we make some practical suggestions for those who are concerned about this issue.

Clinical relevance of unloading in cartilage therapy of the knee--shoe insoles, knee braces or additional operative procedure?

Restoration of a neutral biomechanical environment and reduction of overload is an important factor contributing to the success of any cartilage repair procedure. Reduction of overload can by achieved by so called unloading procedures in order to reduce intraarticular pressure from the repair zone. Unloading can be achieved via loss of weight, wedged shoe insoles, knee braces or via operations such as osteotomies around the knee joint. The cartilage therapy and the concomitant unloading procedure should be adapted to the individual pathology and realistic aims of the patient. Wedged insoles and braces are the least invasive treatment methods. In comparison, however, beneficial effects of braces outline those of laterally wedged heels. Nevertheless long-term compliance with insoles and braces is poor. Concerning braces either because the positive effects of the braces are too small or because the adverse effects are too large. Unloading in the long run may only be achieved through operative procedures. When an osteotomy seems to be too invasive the arthroscopic release of the posterior oblique ligament might be an option. Patients with an intact contralateral chondral status, medium to slight malalignment who want to remain at high activity levels, remain good candidates for unloading osteotomies.

Identidades profesionales y el impacto de la guerra: Maestros, historias y memorias

Teachers’ individual lives and careers, identities and experiences are so various as to almost defy generalization. A valid and realistic aim of educational research is however to identify significant commonalities that enhance an understanding of the teacher’s role. Memory is a prime resource for investigating factors that change over time in the course of a career and oral history provides a means of accessing and interpreting such a rich vein of evidence. One common feature shared by teachers in Britain during the mid-twentieth century was the impact on schooling of total war.This paper draws on the memories of three teachers interviewed during a large-scale enquiry into British teachers whose careers spanned World War II. Analysis of this evidence is made with reference to recent writings on professional identity, and one aim of the paper is to promote continuing reflection on the way teachers’ identities develop under the constraints of changing historical circumstance. Testimony selected for discussion here concerns their early education and career choices, their initial teacher training and their continuing professional formation, punctured for each at different points by the single overwhelming historical event of war.The paper concludes with reference to recent literature on teacher identity, indicating how historical research and autobiographical perspectives across a whole career can contribute to contemporary understandings of how teachers perceive their work, and the formation of professional identities.

Von Interaktion zu Transaktion – Konsequenzen eines pragmatischen Mensch-Umwelt-Verständnisses für eine Geographie der Mitwelt

Abstract. Questions about how human-environment-relations can be conceptualized in a non-dualistic way have been intensively discussed throughout the last decades. The majority of the established realist and constructivist perspectives aim at explaining a given situation by analytically dissecting it. Unfortunately, such an interactionist perspective systematically reproduces the dualistic division between humans, environment and nature. In contrast, this paper offers a transactive perspective origin in classical pragmatism and discusses its meta-theoretical consequences for human-environment-research. A transactionist perspective interprets the world as a flow of unique and entangled events. Instead of ontologically separating humans and environment, it advocates to look at their relations as being part of a "connatural world". Such a point of view raises new ethical and political questions for geographical human-environment research, argues for a renaissance of ideographic methodologies and hints to a fruitful unity of geographical inquiry.

Extending the applicability of the Tkatchenko-Scheffler dispersion correction via iterative Hirshfeld partitioning.

Recently we have demonstrated that the applicability of the Tkatchenko-Scheffler (TS) method for calculating dispersion corrections to density-functional theory can be extended to ionic systems if the Hirshfeld method for estimating effective volumes and charges of atoms in molecules or solids (AIM's) is replaced by its iterative variant [T. Bučko, S. Lebègue, J. Hafner, and J. Ángyán, J. Chem. Theory Comput. 9, 4293 (2013)]. The standard Hirshfeld method uses neutral atoms as a reference, whereas in the iterative Hirshfeld (HI) scheme the fractionally charged atomic reference states are determined self-consistently. We show that the HI method predicts more realistic AIM charges and that the TS/HI approach leads to polarizabilities and C6 dispersion coefficients in ionic or partially ionic systems which are, as expected, larger for anions than for cations (in contrast to the conventional TS method). For crystalline materials, the new algorithm predicts polarizabilities per unit cell in better agreement with the values derived from the Clausius-Mosotti equation. The applicability of the TS/HI method has been tested for a wide variety of molecular and solid-state systems. It is demonstrated that for systems dominated by covalent interactions and/or dispersion forces the TS/HI method leads to the same results as the conventional TS approach. The difference between the TS/HI and TS approaches increases with increasing ionicity. A detailed comparison is presented for isoelectronic series of octet compounds, layered crystals, complex intermetallic compounds, and hydrides, and for crystals built of molecules or containing molecular anions. It is demonstrated that only the TS/HI method leads to accurate results for systems where both electrostatic and dispersion interactions are important, as illustrated for Li-intercalated graphite and for molecular adsorption on the surfaces in ionic solids and in the cavities of zeolites.

‘Curative’ treatments and palliative care

A survey was performed to assess whether authors who report about palliative treatments or palliative care share a common understanding of 'curative' treatments. Of 107 authors from publications about cancer who used both 'palliative' and 'curative' in the same abstract, 42 (39%) responded. The majority (n=24; 57%) understood 'curative' treatments as 'aimed at complete absence of disease for the rest of life', but 43% (n=18) did not share this view. For example, 19% (n=7) stated that the term describes cancer-directed therapy for prolongation of life or even regardless of the aspired goal. In the care for cancer patients, unambiguous terminology is essential for the participatory and interdisciplinary decision-making process. Clinicians, researchers and policy makers should be aware of the difference between curative and disease-modifying therapies. Otherwise, this may be a major source of misunderstandings as disease-modifying therapy may be indicated in the incurable stages of the disease as well. In these palliative situations, it is essential to identify the realistic aim(s) of the therapy: prolongation of life, alleviation of suffering or both.