Seven-step Approach Research Articles

A seven-step approach to master the practical skills in microbiology among 2nd year medical undergraduates: A randomized control trial

Context: Undergraduate students are taught, basic procedures of microbiology such as Gram's-staining, Ziehl–Neelsen staining, and focusing of the stained slide using light microscope. It is found that students mostly fail to perform right staining procedures and report a given slide. Aims: This study aims to evaluate the effectiveness of modified Peyton's seven step method to learn basic procedures of microbiology, in comparison to 'see one, do one' method, by a randomized control trial following McGaghie's Mastery learning model. Subjects and Methods: The study group of 45 students was taught by adopting Peyton's seven step method, the control group of 41 students was taught through “see one, do one” method. The performance of the students was objectively measured where in it was evaluated by the faculty. Statistical Analysis Used: Performance was analyzed using Student's unpaired t-test, to determine if there was a true difference between the two groups. Performance at the interpretation station was analyzed using Chi-square test with Yates correction (χ2YC). Results: The study group performed significantly better in Gram's-staining (P = 0.018) and Ziehl–Neelsen staining (P = 0.012) procedures but not in focusing (P = 0.961) and interpretation (P = 0.850 with χ2YC = 0.0356) skills, in comparison to control group. Conclusions: This study proves that a Peyton's seven step method to be effective, in teaching practical skills to students when compared to traditional “see one, do one” method. The modification has components of dyad practice, peer observation, peer feedback, and observational practice.

Translating PEARLS: Lessons Learned from Providers and Participants

The Program to Encourage Active, Rewarding Lives (PEARLS) began 15 years ago when the director of our local area agency on aging (AAA) approached the University of Washington Health Promotion Research Center (HPRC). She was looking for a way to serve older adults with depression, including those served by the agency’s home and community-based services (HCBS) program. Depression in this population is high, when we analyzed data from 16,032 elders receiving HCBS in Washington State in 2005, two-thirds met criteria for clinical depression (1). This partnership between the university and local aging service providers created PEARLS, a brief, home-based program to teach people tools to effectively tackle the things in their lives that overwhelm them, and to in turn, improve their depressive symptoms. These tools include a seven-step approach to problem-solving and action planning to increase physical, social, and pleasant activities. PEARLS is a structured intervention delivered in 6 to 8 one-hour visits over the course of a 4- to 5-month period. Sessions are tapered from weekly to monthly to give participants an opportunity to practice and learn the skills. More information about the program can be found at www.pearlsprogram.org. The Program to Encourage Active, Rewarding Lives (PEARLS) reduced depression and improved quality of life in two randomized controlled trials (2, 3). Since then, UW HPRC continues to work with the local AAA and other sites to help translate the evidence-based program into everyday practice. The implementation challenges are striking given that PEARLS includes several ingredients for program success: it was designed with an adopting organization as a key partner, the model trains existing staff to deliver PEARLS so new staff do not need to be hired, and the program is successfully funded in some locations through several diverse funding streams. We have learned a lot from organizations and staff that deliver PEARLS through our monthly technical assistance calls and other dissemination research and activities. We have also learned a lot from program participants through PEARLS sessions, focus groups and interviews. A selection of key learnings is provided below, organized by Glasgow’s RE-AIM framework to help improve the success of evidence-based program delivery in “real-world” settings (4–6). This framework consists of five elements – reach, effectiveness, adoption, implementation, and maintenance – that present the overall public health impact of a program or policy. It is important for programs to perform well across each of these five elements in order to maximize overall impact (7).

Values, choices, responsibilities: thinking beyond the scholarly place of ethics for the GIScience and technology profession and GIScience

To help ethical issues gain traction in geographic information technology education, this article proposes that the education of GIScience and technology professionals go beyond abstract scholarly ethics to applied approaches based on practical wisdom. The main point for educators made in this paper is that applied ethics' focus on values, choices, and responsibilities helps students and professionals understand the significance of knowledge and science, their potential contributions, and possible roles – values, choices, and responsibilities. An interpretation of Aristotle's practical wisdom as moral skills and moral wills provides the foundation for developing pedagogical strategies including Davis' seven-step approach.

The Development of Innovative Online Problem-Based Learning: A Leadership Course for Leaders in European Public Health

The shift to a knowledge information society has given rise to a need for lifelong learning programmes. Such programmes are especially relevant for public health professionals, whose dynamic field of practice is subject to changes due to rapidly developing technologies, evolving expectations of the labour market and new health treats. Lifelong learning programmes for public health should address topics like planning, organisation, leadership, teamwork and research methods, and schools of public health should introduce innovative educational approaches that enable professionals to learn from the experiences of others. This paper describes the rationale for the development of a European online problem-based course on leadership for public health professionals in Europe, the first pilot evaluation and its impact on the final shape of the course. Problem-based learning (PBL) is an excellent approach for a course focused on lifelong learning, because it stimulates constructive, collaborative, and self-directed learning from authentic problems that are relevant to professional practice, and thereby facilitates the transfer of knowledge. Blended learning, which combines face-to-face and online learning, provides new opportunities for working professionals, enabling participation in international student teams and attendance of lectures by international experts without the need to travel. This makes blended problem-based learning a highly effective and efficient learning strategy for continuing professional development. The paper presents a structure for an online pilot leadership course underpinned by a review of the literature and developed and implemented by an international collaboration of four European universities. The curriculum consisted of eight sessions. Each session was developed and offered by a different university center. Two first sessions were delivered face-to-face and the other sessions were online. The seven-step approach of Maastricht University was suitable for a blended mode of PBL. Twelve public health professionals for NHS took part in the course and final evaluation. They found it difficult to use online communication tools for learning and professional activities. Based on the results of the pilot the leadership course was adapted. The training at the beginning was extended with information on behaviour during online sessions. Online practice sessions were integrated before the course. The problems were reformulated and build around a common theme. Educational institutions who would like to embark on a similar project, should consider complexities related to coordination, development and implementation of such a complex educational practice.

Synthesis of Dual Thermosensitive and pH-Sensitive Hollow Nanospheres Based on Poly(acrylic acid-b-2-hydroxyethyl methacrylate) via an Atom Transfer Reversible Addition–Fragmentation Radical Process

A seven-step approach was developed to synthesize poly(acrylic acid-b-2-hydroxyethyl methacrylate) [P(AA-b-HEMA)]-based temperature- and pH-sensitive hollow nanospheres. Silica nanoparticles were used as primary cores that could be etched with an aqueous hydrofluoric acid (HF) solution. A surface-attached atom transfer radical polymerization initiator was converted to a reversible addition–fragmentation chain transfer (RAFT) agent, and AA and HEMA were polymerized via “grafting from” RAFT polymerization. The PAA block was cross-linked partially via an esterification reaction with -COOH groups with 1,4-butanediol, and hollow nanospheres were obtained by etching silica cores with an aqueous HF solution. These hollow nanospheres exhibited dual pH-sensitive and thermosensitive properties as measured by the hydrodynamic diameter at different values of pH (3–12) and temperature (25–55 °C) at different concentrations (1 and 5 mg/mL). Results showed that this behavior could be changed at different concentrations; therefore, at low contents, the particles show one lower critical solution temperature (LCST), while at higher contents, two LCSTs are observed.

ChemInform Abstract: Synthesis of a Series of Promising Isobenzofuranones for the Treatment of Acute Mucositis Caused by Chemo‐ and Radiotherapy.

A small series of 3,5-dihydroxy-7-methoxy-3,6-dimethyl­isobenzofuran-1(3H)-one analogues of the immunosuppressant, mycophenolate mofelite (MMF), has been identified during a screening campaign as possible mediators to prevent mucositis. Herein, we present a general seven-step approach for the preparation of small molecule mycophenolate mofelite analogues, which are readily available for further biological evaluation in our mucositis model.

Synthesis of a Series of Promising Isobenzofuranones for the Treatment of Acute Mucositis Caused by Chemo- and Radiotherapy

A small series of 3,5-dihydroxy-7-methoxy-3,6-dimethyl­isobenzofuran-1(3H)-one analogues of the immunosuppressant, mycophenolate mofelite (MMF), has been identified during a screening campaign as possible mediators to prevent mucositis. Herein, we present a general seven-step approach for the preparation of small molecule mycophenolate mofelite analogues, which are readily available for further biological evaluation in our mucositis model.

Using Personal Selling Techniques in Embedded Librarianship

This article examines the role of personal selling techniques in promoting embedded library services in a college of business. Using experiences from creating a successful embedded library presence at Northern Illinois University's College of Business, the author gives examples of how librarians can apply selling strategies to strengthen patron relationships and increase demand for services. The techniques used follow a traditional seven-step approach to selling and include techniques such as prospecting, cold calls, referrals, cross-selling, and up-selling.

How much CO2 emissions do we reduce by saving electricity? A focus on methods

In this paper we evaluate two approaches for estimating CO2 emission reduction from electricity savings: one based on average CO2 intensities of electricity generation and another that relies on marginal CO2 intensities. It is found that the average CO2 intensity approach has a significant shortcoming when it comes to scenario-based approaches for CO2 emission reduction. This shortcoming lies in the chicken–egg problem created, where larger future electricity savings are actually big enough to change the CO2 intensity in such a way that it cannot be used anymore to estimate the CO2 emission reduction. We show that in these cases the marginal approach is preferred. To correctly apply this approach, it is important to determine the CO2 intensity of the future power mix which will not be built in order to avoid under or overestimation of the CO2 savings calculated. We propose a seven-step approach which can be used in scenario-based potential studies as guidance for estimating the CO2 emission reductions from not only electricity savings but also renewable electricity and mitigation options that consume electricity such as electric cars and heat pumps. Using our approach would avoid a disconnection of the CO2 reduction potential with the underlying reference scenario.

Using Evidence-Based Practice to Reduce Catheter-Associated Urinary Tract Infections

In November 2009, AJN launched a 12-part series, Evidence-Based Practice, Step by Step, authored by nursing leaders from the Arizona State University College of Nursing and Health Innovation's Center for the Advancement of Evidence-Based Practice. Through hypothetical scenarios, based on the authors' collective clinical experience, the series illustrated the seven steps of evidence-based practice (EBP), defined as "a problem-solving approach to the delivery of health care that integrates the best evidence from studies and patient care data with clinician expertise and patient preferences and values." This article reports on an EBP project in which the seven-step approach to EBP described in the AJN series was used to reduce the incidence of catheter-associated urinary tract infection among adult patients in a long-term acute care hospital by reducing the duration of catheterization.

Systematic Review of Attitudes Toward Donation After Cardiac Death Among Healthcare Providers and the General Public*

Organ donation after cardiac death (DCD) is one promising possibility of combating the organ shortage, but it raises ethical issues that differ from those raised in donation after brain death (DBD). Also, DCD may be perceived differently than DBD by medical staff and the public. The aim of this article is to systematically review empirical studies on attitudes of medical personnel and the public toward DCD and to discuss the findings from an ethical perspective. Our study was conducted in accordance with a seven-step approach for systematic reviews of empirical studies in bioethics. The authors chose PubMed, EMBASE, CINAHL, PSYCINFO, and PSYNDEX, thus attempting to cover biomedical, sociological and ethical articles on the subject. A search algorithm using controlled vocabulary of the respective databases (where applicable) was created, and criteria for the relevance assessment of the articles were established. Article quality was assessed using the Critical Appraisal Skills Programme tool. The authors took an integrative approach to the data, combining it for further analysis. Qualitative data were synthesized by means of thematic analysis, and a spectrum of relevant themes was identified. Then the authors extracted the quantitative data that corresponded with the identified themes. Quantitative data on common subjects were juxtaposed and presented later. Identified themes were the levels of support for DBD vs. DCD, attitudes toward postmortem measures without previous consent, lack of knowledge about DCD, concerns about the Dead Donor Rule, the potential for conflict of interest, making donation happen, and the call for standardized DCD protocols. All of these issues are of ethical relevance and merit further discussion. We conclude that deep-rooted concerns about DCD exist among medical personnel and the general public. These need to be taken seriously in order to maintain or foster trust in the transplantation system.

Professional Judgment Matters: Assessing the Merits of Enhanced Communication and Collaboration

Chartered Accountants (CAs) practice in a wide variety of fields including public accounting, industry, government, education, research, consulting, regulation and standard setting. In each of these areas, CAs are recognized for their expertise and for their ability to exercise sound “professional judgment” in a multitude of different contexts. According to the academic research, the value of professional judgment is a function of both its importance and its quality, and each depends on the other. Together, these two attributes provide the foundation for this research initiative, which assesses whether there is a need for enhanced communication and collaboration by CAs on professional judgment matters. In other words, can an Internet-based professional judgment resource centre help to improve the quality of professional judgment? This is in the public interest, as well as the interests of policy developers and the business community. Clearly, it is also in the best interests of the profession. This research initiative takes a seven-step approach, as follows: Step 1 – Review the definitions of professional judgment (see Chapter 1); Step 2 – Review the current research literature (see Chapter 2); Step 3 – Create a communications blog (see Chapter 3); Step 4 – Open a dialogue with CAs (see Chapter 4); Step 5 – Undertake an Internet-based survey (see Chapter 5); Step 6 – Review recent developments and other matters (see Chapter 6); Step 7 – Suggest practical ways to move forward (see Chapter 7).In summary, the seven-step approach to this initiative had a single purpose. The goal was to answer the research question: “With regard to professional judgment matters, is there a need for enhanced communication and collaboration by Chartered Accountants?” Based on the results of the academic and professional literature review, the interest shown in the communications blog, and the collective views expressed by CAs in face-to-face meetings and by an online survey, the answer is clear. It’s time to collaborate! Accordingly, this research report sets out practical ways to move forward. It offers a number of suggestions regarding the nature and extent of the content that would be appropriate for an Internet-based resource centre. In addition, it suggests who would be appropriate to host this centre, both initially and ongoing.

Voluntary Medical Male Circumcision: A Qualitative Study Exploring the Challenges of Costing Demand Creation in Eastern and Southern Africa

BackgroundThis paper proposes an approach to estimating the costs of demand creation for voluntary medical male circumcision (VMMC) scale-up in 13 countries of eastern and southern Africa. It addresses two key questions: (1) what are the elements of a standardized package for demand creation? And (2) what challenges exist and must be taken into account in estimating the costs of demand creation?Methods and FindingsWe conducted a key informant study on VMMC demand creation using purposive sampling to recruit seven people who provide technical assistance to government programs and manage budgets for VMMC demand creation. Key informants provided their views on the important elements of VMMC demand creation and the most effective funding allocations across different types of communication approaches (e.g., mass media, small media, outreach/mobilization). The key finding was the wide range of views, suggesting that a standard package of core demand creation elements would not be universally applicable. This underscored the importance of tailoring demand creation strategies and estimates to specific country contexts before estimating costs. The key informant interviews, supplemented by the researchers' field experience, identified these issues to be addressed in future costing exercises: variations in the cost of VMMC demand creation activities by country and program, decisions about the quality and comprehensiveness of programming, and lack of data on critical elements needed to “trigger the decision” among eligible men.ConclusionsBased on this study's findings, we propose a seven-step methodological approach to estimate the cost of VMMC scale-up in a priority country, based on our key assumptions. However, further work is needed to better understand core components of a demand creation package and how to cost them. Notwithstanding the methodological challenges, estimating the cost of demand creation remains an essential element in deriving estimates of the total costs for VMMC scale-up in eastern and southern Africa.

How to use a systems diagram to analyse and structure complex problems for policy issue papers

Many policy problems are complex in the sense that natural, technological, social and human elements interact. Problem exploration and structuring are essential as a basis for deliberate and focused approaches towards problem resolution. The results of problem exploration efforts can be laid down in the form of a policy issue paper. We have developed a systemic, stepwise approach, which has been elaborated and taught for over a decade to hundreds of students. This seven-step approach centers on the construction of a system diagram as a means to provide structure to the conceptualisation of a complex problem situation. The approach is based on a conscious combination of existing relatively straightforward analytical methods including objectives hierarchy, means-ends analysis, causal diagramming, stakeholder analysis, and contextual scenarios. The obtained insights are then summed up in a policy issue paper, which is the basis for further planning and research.

The lived experiences of newly qualified children's nurses

This paper reports a study that explored the lived experiences of newly qualified registered children's nurses (RCN) in their transition from postgraduate student nurse to staff nurse. What are the experiences of newly qualified RCNs in their transition from postgraduate student nurse to staff nurse? A qualitative phenomenological approach was chosen for the study and six newly qualified RCNs were interviewed. Data analysis was based on the work of Coliazzi (1978) who devised a seven-step approach to assist the analysis within phenomenological inquiry. Findings indicate that support is the most important aspect of the transition experience for these nurses. Mentorship and preceptorship programmes facilitate support during the transition period and previous experience prescribes the amount of support required by the newly qualified RCN. In highlighting the experiences of newly qualified RCNs in their transition from postgraduate student nurse to staff nurse, this study raises awareness among children's nurses, children's nurse educators and children's nursing managers about this unique group of nurses.

Detection of collusion in government procurement auctions

Research on bidder collusion in procurement auctions is reasonably successful in unveiling the mechanisms of collusion among the bidders. But it is relatively weak in forwarding effective practical methods of collusion detection before the winner is declared, because they presuppose the knowledge of collusion in specific auctions. Past studies, however, point out the need for working with bid price-to-reserve price ratios rather than bid prices or winning bid prices, to be free from the problem of heteroscedasticity. They also draw an important inference that the set of collusive data are significantly different from the set of competitive data. On the basis of these basic facts, the current paper outlines a seven-step approach to collusion detection. The approach makes rudimentary statistical analysis of bid price-to-reserve price ratios for all the bidders. The analysis comprises tests of equality of means, medians and variance and tests of skewness, autocorrelation and normality of the ratios. It divides the ratios into two significantly different clusters. The cluster with the higher mean and variance values of the ratios corresponds to collusive bidding with the other cluster corresponding to competitive bidding. The paper proposes the construction of a process control chart to detect occurrence of collusion in an auction immediately after the price bids are opened. The approach is illustrated by applying it to data from procurement auctions for construction projects in a State Department of the Republic of India.

A Metaethnography of Traumatic Childbirth and its Aftermath: Amplifying Causal Looping

Integrating results from multiple analytic approaches used in a research program by the same researcher is a type of metasynthesis that has not often been reported in the literature. In this article the findings of one type of qualitative synthesis approach, a metaethnography, of six qualitative studies on birth trauma and its resulting posttraumatic stress disorder from my program of research are presented. This metaethnography provides a wide-angle lens to view and interpret the far-reaching, stinging tentacles of this often invisible phenomenon that new mothers experience. I used Noblit and Hare's seven-step approach for synthesizing the findings of qualitative studies. The original trigger of traumatic childbirth resulted in six amplifying feedback loops, four of which were reinforcing (positive direction), and two which were balancing (negative direction). Leverage points that identify where pressure in the amplifying causal loop can break the feedback loop where necessary are discussed.

The Logical Framework Approach-Millennium

The Logical Framework Approach (LFA) has proved to be a valuable tool for project approval, design, and evaluation. However, a few pitfalls make it hard to use within today's project management framework and to integrate with other project management tools. This article proposes an updated version of the LFA to improve its compatibility with today's corporate culture, project management framework, and tools. We propose to call the updated tool the Logical Framework Approach-Millennium (LFA-M). The LFA-M is a seven-step approach leading to the development of the Logframe-Millennium (LF-M), a five-column and four-line matrix describing major project commitments and providing an overall understanding of the project. It was successfully implemented at the Canadian Space Agency and the Canadian Nuclear Safety Commission. The LFA-M fits well within today's project management framework and corporate culture and leads easily to other project management tools.

Synthesis of 13C-Perlabeled Cellulose with more than 99% Isotopic Enrichment by a Cationic Ring-Opening Polymerization Approach

(13)C-Perlabeled cellulose was obtained in a seven-step approach from (13)C(6)-labeled d-glucose with a cationic ring-opening polymerization as the key step. Isopropylidene protection, benzylation of the remaining free 3-O-position and subsequent deprotection afforded 3-O-benzyl-(13)C(6)-glucose (2). Regioselective bis-pivaloylation followed by subsequent ortho-esterification provided the precursor for the cationic ring-opening polymerization, 3-O-benzyl-(13)C(6)-glucopyranose 1,2,4-orthopivalate (4). The actual polymerization step gave a stereo- and regioregular (13)C-perlabeled (1-->4)-beta-glucopyranan derivative, which was deprotected into fully labeled (13)C-cellulose, as the cellulose II allomorph with a DP of 40, in an overall 28% yield. All reaction steps were optimized beforehand with nonlabeled compounds toward high yields and high reproducibility and the final compound was comprehensively analytically characterized.

The phenomenon of resilience as described by adults who have experienced mental illness

This paper is a report of a study to explore the phenomenon of resilience in the lives of adult patients of mental health services who have experienced mental illness. Mental illness is a major health concern worldwide, and the majority experiencing it will continue to battle with relapses throughout their lives. However, in many instances people go on to overcome their illness to lead productive and socially engaged lives. Contemporary mental health nursing practice primarily focuses on symptom reduction, and working with resilience has not generally been a consideration. A descriptive phenomenological study was carried out in 2006. One participant was recruited through advertisements in community newspapers and newsletters and the others using the snowballing method. Information was gathered through in-depth individual interviews which were tape-recorded and subsequently transcribed. Colaizzi's original seven-step approach was used for data analysis, with the inclusion of two additional steps. The following themes were identified: Universality, Acceptance, Naming and knowing, Faith, Hope, Being the fool and Striking a balance, Having meaning and meaningful relationships, and 'Just doing it'. The conceptualization identified as encapsulating the themes was 'Viewing life from the ridge with eyes wide open', which involved knowing the risks and dangers ahead and making a decision for life amid ever-present hardships. Knowledge about resilience should be included in the theoretical and practical education of nursing students and experienced nurses. Early intervention, based on resilience factors identified through screening processes, is needed for people with mental illness.