WorldWideScience

Sample records for benefits observational practice

  1. Movement Matters: Observing the Benefits of Movement Practice

    Science.gov (United States)

    Fuchs, Melani Alexander

    2015-01-01

    Montessori's first premise is that movement and cognition are closely entwined, and movement can enhance thinking and learning (Lillard, 2005). Children must move, and practice moving, to develop strength, balance, and the stability needed to fully participate in the rigors of daily life. It is imperative for young children's motor…

  2. Retrieval Practice Benefits Deductive Inference

    Science.gov (United States)

    Eglington, Luke G.; Kang, Sean H. K.

    2018-01-01

    Retrieval practice has been shown to benefit learning. However, the benefit has sometimes been attenuated with more complex materials that require integrating multiple units of information. Critically, Tran et al. "Psychonomic Bulletin & Review, 22," 135-140 (2015) found that retrieval practice improves sentence memory but not the…

  3. Observing Classroom Practice

    Science.gov (United States)

    Danielson, Charlotte

    2012-01-01

    Classroom observation is a crucial aspect of any system of teacher evaluation. No matter how skilled a teacher is in other aspects of teaching--such as careful planning, working well with colleagues, and communicating with parents--if classroom practice is deficient, that individual cannot be considered a good teacher. Classroom observations can…

  4. Benefits of ecological engineering practices

    NARCIS (Netherlands)

    Van den Boomen, R.; Chaudhuri, N.; Heeb, J.; Jenssen, P.; Kalin, M.; Schönborn, A.; Brüll, A.; Van Bohemen, H.; Costanza, R.; Mitsch, W.J.

    2011-01-01

    With the intention to further promote the field of ecological engineering and the solutions it provides, a workshop on “Benefits of Ecological Engineering Practices” was held 3 Dec 2009. It was conducted by the International Ecological Engineering Society in Paris at the conference “Ecological

  5. Adapted PBL Practical Exercises: Benefits for Apprentices

    Science.gov (United States)

    Monks, Alan

    2010-01-01

    Use was made of adapted problem-based learning (PBL) practical exercises to address the disengagement of apprentices with the existing assembly-style electronic laboratory programme. Apprentices perceived the traditional routines as having little real-world relevance. This detracted from the value and benefit to them of the practical component of…

  6. Observed benefits from product configuration systems

    DEFF Research Database (Denmark)

    Hvam, Lars; Haug, Anders; Mortensen, Niels Henrik

    2013-01-01

    This article presents a study of the benefits obtained from applying product configuration systems based on a case study in four industry companies. The impacts are described according to main objectives in literature for imple-menting product configuration systems: lead time in the specification...... affected by the use of product configu-ration systems e.g. increased sales, decrease in the number of SKU's, improved ability to introduce new products, and cost reductions.......This article presents a study of the benefits obtained from applying product configuration systems based on a case study in four industry companies. The impacts are described according to main objectives in literature for imple-menting product configuration systems: lead time in the specification...... processes, on-time delivery of the specifica-tions, and resource consumption for making specifications, quality of specifications, optimization of products and services, and other observations. The purpose of the study is partly to identify specific impacts observed from implementing product configuration...

  7. Microservices and containers : benefits and best practices

    OpenAIRE

    Koskinen, Miina

    2016-01-01

    Microservices architecture and containers are fairly new technologies used in software development in cloud environments. They have become more popular and widely used the recent years. Microservices architecture is replacing the old fashioned way of developing a software system as a monolithic architecture. Microservices architecture is claimed to solve many issues that comes with a large scale monolithic systems. The goal of the thesis was to evaluate the benefits and best practices o...

  8. Obtaining the Greatest Scientific Benefit from Observational Platforms by Consideration of the Relative Benefit of Observations

    Science.gov (United States)

    Chelberg, David; Drews, Frank; Fleeman, David; Welch, Lonnie; Marquart, Jane; Pfarr, Barbara

    2003-01-01

    One of the current trends in spacecraft software design is to increase the autonomy of onboard flight and science software. This is especially true when real-time observations may affect the observation schedule of a mission. For many science missions, such as those conducted by the Swift Burst Alert Telescope, the ability of the spacecraft to autonomously respond in real-time to unpredicted science events is crucial for mission success. We apply utility theory within resource management middleware to optimize the real-time performance of application software and achieve maximum system level benefit. We then explore how this methodology can be extended to manage both software and observational resources onboard a spacecraft to achieve the best possible observations.

  9. Clinical and Demographic Profile of Patients Receiving Fingolimod in Clinical Practice in Germany and the Benefit-Risk Profile of Fingolimod After 1 Year of Treatment: Initial Results From the Observational, Noninterventional Study PANGAEA.

    Science.gov (United States)

    Ziemssen, Tjalf; Lang, Michael; Tackenberg, Björn; Schmidt, Stephan; Albrecht, Holger; Klotz, Luisa; Haas, Judith; Lassek, Christoph; Medin, Jennie; Cornelissen, Christian

    2018-01-01

    The population with multiple sclerosis receiving treatment in clinical practice differs from that in randomized controlled trials (RCTs). An assessment of the real-world benefit-risk profile of therapies is needed. This analysis used data from the large, noninterventional, observational German study Post-Authorization Non-interventional German sAfety study of GilEnyA (PANGAEA) to assess prospectively baseline characteristics and outcomes after 12 months (± 90 days) of fingolimod treatment. Patients were divided into 2 cohorts: fingolimod starter [first received fingolimod in PANGAEA (n = 3315)] and previous study [received fingolimod before enrollment in PANGAEA in RCTs (n = 875), some of whom also had baseline data at entry into RCTs (n = 505)]. At PANGAEA baseline, patients in the fingolimod starter versus the previous study cohort had a higher annualized relapse rate [ARR (95% confidence interval): 1.79 (1.75-1.83) vs 1.32 (1.25-1.40)] and Expanded Disability Status Scale score [3.11 (3.04-3.17) vs 2.55 (2.44-2.66)]. A greater proportion in the fingolimod starter versus previous study cohort had diabetes (2.0% vs 0.7%). After 12 months of fingolimod, ARRs were lower than in the 12 months before PANGAEA enrollment in the fingolimod starter [0.386 (0.360-0.414)] and previous study [0.276 (0.238-0.320)] cohorts. Expanded Disability Status Scale scores were stable versus baseline. Adverse events were experienced by similar proportions in both cohorts during fingolimod treatment. Relevant differences exist in disease activity and comorbidities between patients receiving fingolimod in clinical practice versus RCTs. Irrespective of baseline differences indicating a higher proportion at an advanced stage of multiple sclerosis in the real world versus RCTs, fingolimod remains effective, with a manageable safety profile.

  10. Estimating the Economic Benefits of Regional Ocean Observing Systems

    National Research Council Canada - National Science Library

    Kite-Powell, Hauke L; Colgan, Charles S; Wellman, Katharine F; Pelsoci, Thomas; Wieand, Kenneth; Pendleton, Linwood; Kaiser, Mark J; Pulsipher, Allan G; Luger, Michael

    2005-01-01

    We develop a methodology to estimate the potential economic benefits from new investments in regional coastal ocean observing systems in US waters, and apply this methodology to generate preliminary...

  11. Estimating the Economic Benefits of Regional Ocean Observing Systems

    National Research Council Canada - National Science Library

    Kite-Powell, Hauke L; Colgan, Charles S; Wellman, Katharine F; Pelsoci, Thomas; Wieand, Kenneth; Pendleton, Linwood; Kaiser, Mark J; Pulsipher, Allan G; Luger, Michael

    2005-01-01

    ... prediction, offshore energy, power generation, and commercial fishing. Our findings suggest that annual benefits to users from the deployment of ocean observing systems are likely to run in the multiple...

  12. EMPLOYEES’ BENEFITS, BETWEEN THEORY AND PRACTICE

    Directory of Open Access Journals (Sweden)

    Alexandru Sălceanu

    2013-06-01

    Full Text Available The concept of “employee benefits” promotes economic security, offering a financial protection to a company’s employees and their families, thus contributing to increasing the living standards. This concept is put into practice through a partnership of government, economic entities and employees. In order to implement this concept, the state elaborates regulatory documents that legalize relations between the entity and employees and the economic entities receive services from employees and pay them by expending resources. A properly achievement of this partnership enables the achievement of at least two important objectives such as: the security of employees' incomes and the increasing of living standards.

  13. Biotechnology risks and benefits: Science instructor perspectives and practices

    Science.gov (United States)

    Gardner, Grant Ean

    Developing scientifically literate students who understand the socially contextualized nature of science and technology is a national focus of science education reform. Understanding teachers' views on this topic is of equal importance. This document focuses on the topic of risks and benefits posed by science and technology as an important topic for which the socially contextualized nature of science and technology readily emerges. Following introduction of a theoretical model and a review of the literature, two research studies are described that examined teachers' perceptions of the risks posed by biotechnology and the role of risk topics in an undergraduate science course. The first research study examines four groups of science educators; pre-service science teachers, in-service science teachers, science graduate teaching assistants, and science professors (n = 91). The participants completed a survey and card sort task to determine their perceptions of the risks of biotechnology. The results show that teacher perceptions were shaped by the risk severity, regulation processes, public acceptance, fear, reciprocal benefits, and whether the applications would impact humans or the environment. Factors determining risk perception included personal worldviews, trust in communicating institutions, and personal experiences with biotechnology. The different types of science teachers were compared and contrasted in light of these factors and the implications of instructor perceptions on science pedagogy are discussed. The second research manuscript describes a case study in which six biology graduate teaching assistants (GTAs) were observed teaching as lesson on the potential risks and benefits of biotechnology. The data sources included classroom observations and semi-structured interviews. Qualitative analysis reveals that GTAs framed the instruction of risk in one of three ways: analytical, focus on perspectives and biases, and promotion of individual reflection

  14. "Keeping SCORE": Reflective Practice through Classroom Observations

    Science.gov (United States)

    Farrell, Thomas S. C.

    2011-01-01

    Reflective practice means that teachers must subject their own teaching beliefs and practices to critical examination. One way of facilitating reflective practice in ESL teachers is to encourage them to engage in classroom observations as part of their professional development. This paper reports on a case study of a short series of classroom…

  15. Linking the Observation of Essential Variables to Societal Benefits

    Science.gov (United States)

    Sylak-Glassman, E.

    2017-12-01

    Different scientific communities have established sets of commonly agreed upon essential variables to help coordinate data collection in a variety of Earth observation areas. As an example, the World Meteorological Organization Global Climate Observing System has identified 50 Essential Climate Variables (ECVs), such as sea-surface temperature and carbon dioxide, which are required to monitoring the climate and detect and attribute climate change. In addition to supporting climate science, measuring these ECVs deliver many types of societal benefits, ranging from disaster mitigation to agricultural productivity to human health. While communicating the value in maintaining and improving observational records for these variables has been a challenge, quantifying how the measurement of these ECVs results in the delivery of many different societal benefits may help support their continued measurement. The 2016 National Earth Observation Assessment (EOA 2016) quantified the impact of individual Earth observation systems, sensors, networks, and surveys (or Earth observation systems, for short) on the achievement of 217 Federal objectives in 13 societal benefit areas (SBAs). This study will demonstrate the use of the EOA 2016 dataset to show the different Federal objectives and SBAs that are impacted by the Earth observation systems used to measure ECVs. Describing how the measurements from these Earth observation systems are used not only to maintain the climate record but also to meet additional Federal objectives may help articulate the continued measurement of the ECVs. This study will act as a pilot for the use of the EOA 2016 dataset to map between the measurements required to observe additional sets of variables, such as the Essential Ocean Variables and Essential Biodiversity Variables, and the ability to achieve a variety of societal benefits.

  16. Analysis of Critical Earth Observation Priorities for Societal Benefit

    Science.gov (United States)

    Zell, E. R.; Huff, A. K.; Carpenter, A. T.; Friedl, L.

    2011-12-01

    To ensure that appropriate near real-time (NRT) and historical Earth observation data are available to benefit society and meet end-user needs, the Group on Earth Observations (GEO) sponsored a multi-disciplinary study to identify a set of critical and common Earth observations associated with 9 Societal Benefit Areas (SBAs): Agriculture, Biodiversity, Climate, Disasters, Ecosystems, Energy, Health, Water, and Weather. GEO is an intergovernmental organization working to improve the availability, access, and use of Earth observations to benefit society through a Global Earth Observation System of Systems (GEOSS). The study, overseen by the GEO User Interface Committee, focused on the "demand" side of Earth observation needs: which users need what types of data, and when? The methodology for the study was a meta-analysis of over 1,700 publicly available documents addressing Earth observation user priorities, under the guidance of expert advisors from around the world. The result was a ranking of 146 Earth observation parameters that are critical and common to multiple SBAs, based on an ensemble of 4 statistically robust methods. Within the results, key details emerged on NRT observations needed to serve a broad community of users. The NRT observation priorities include meteorological parameters, vegetation indices, land cover and soil property observations, water body and snow cover properties, and atmospheric composition. The results of the study and examples of NRT applications will be presented. The applications are as diverse as the list of priority parameters. For example, NRT meteorological and soil moisture information can support monitoring and forecasting for more than 25 infectious diseases, including epidemic diseases, such as malaria, and diseases of major concern in the U.S., such as Lyme disease. Quickly evolving events that impact forests, such as fires and insect outbreaks, can be monitored and forecasted with a combination of vegetation indices, fuel

  17. Can earthquake source inversion benefit from rotational ground motion observations?

    Science.gov (United States)

    Igel, H.; Donner, S.; Reinwald, M.; Bernauer, M.; Wassermann, J. M.; Fichtner, A.

    2015-12-01

    With the prospects of instruments to observe rotational ground motions in a wide frequency and amplitude range in the near future we engage in the question how this type of ground motion observation can be used to solve seismic inverse problems. Here, we focus on the question, whether point or finite source inversions can benefit from additional observations of rotational motions. In an attempt to be fair we compare observations from a surface seismic network with N 3-component translational sensors (classic seismometers) with those obtained with N/2 6-component sensors (with additional colocated 3-component rotational motions). Thus we keep the overall number of traces constant. Synthetic seismograms are calculated for known point- or finite-source properties. The corresponding inverse problem is posed in a probabilistic way using the Shannon information content as a measure how the observations constrain the seismic source properties. The results show that with the 6-C subnetworks the source properties are not only equally well recovered (even that would be benefitial because of the substantially reduced logistics installing N/2 sensors) but statistically significant some source properties are almost always better resolved. We assume that this can be attributed to the fact the (in particular vertical) gradient information is contained in the additional rotational motion components. We compare these effects for strike-slip and normal-faulting type sources. Thus the answer to the question raised is a definite "yes". The challenge now is to demonstrate these effects on real data.

  18. Practical Observations of the Transit of Venus

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 9; Issue 5. Practical Observations of the Transit of Venus. B S Shyalaja. Classroom Volume 9 Issue 5 May 2004 pp 79-83. Fulltext. Click here to view fulltext PDF. Permanent link: https://www.ias.ac.in/article/fulltext/reso/009/05/0079-0083 ...

  19. Rebates and spreads: pharmacy benefit management practices and corporate citizenship.

    Science.gov (United States)

    Rentmeester, Christy A; Garis, Robert I

    2008-10-01

    How ought we determine whether businesses in the health care sector profit fairly? One class of companies in the health care sector, pharmacy benefit managers (PBMs), deserves special consideration. We describe two specific revenue-generating practices--rebates and spread pricing--that account significantly for PBMs' profits but have been neglected in the bioethics and health policy literature as important sources of fiscal waste in our current health care system. We offer analyses of two common cases, consider employers' and employees' vulnerabilities, explore normative assumptions about how markets function, and raise questions about transparency in contract agreements between PBMs and employers. We consider ethical dimensions of PBMs' corporate citizenship in the health care sector and suggest how employers can negotiate more effectively with PBMs.

  20. Implementing portfolio in postgraduate general practice training. Benefits and recommendations.

    Science.gov (United States)

    Alotaibi, Fawaz S

    2012-10-01

    This paper presents a review to explore the literature focusing on portfolio in postgraduate general practice (GP) training, and to examine the impact of implementation of portfolio on learning process, as well as proposing recommendations for its implementation in postgraduate GP training. An electronic search was carried out on several databases for studies addressing portfolio in postgraduate GP training. Six articles were included to address specifically the effectiveness of portfolio in postgraduate GP training. Five of them described successful experiences of portfolio-based learning implementation. Only one article addressed portfolio-based assessment in postgraduate GP training. The existing evidence provides various benefits of professional portfolio-based learning. It does appear to have advantages of stimulating reflective learning, promoting proactive learning, and bridging the hospital experiences of the learners to GP. Moreover, the challenges to implementation of portfolio-based learning are often based on orientation and training of stakeholders.

  1. Value of Earth Observations: Key principles and techniques of socioeconomic benefits analysis (Invited)

    Science.gov (United States)

    Friedl, L.; Macauley, M.; Bernknopf, R.

    2013-12-01

    Internationally, multiple organizations are placing greater emphasis on the societal benefits that governments, businesses, and NGOs can derive from applications of Earth-observing satellite observations, research, and models. A growing set of qualitative, anecdotal examples on the uses of Earth observations across a range of sectors can be complemented by the quantitative substantiation of the socioeconomic benefits. In turn, the expanding breadth of environmental data available and the awareness of their beneficial applications to inform decisions can support new products and services by companies, agencies, and civil society. There are, however, significant efforts needed to bridge the Earth sciences and social and economic sciences fields to build capacity, develop case studies, and refine analytic techniques in quantifying socioeconomic benefits from the use of Earth observations. Some government programs, such as the NASA Earth Science Division's Applied Sciences Program have initiated activities in recent years to quantify the socioeconomic benefits from applications of Earth observations research, and to develop multidisciplinary models for organizations' decision-making activities. A community of practice has conducted workshops, developed impact analysis reports, published a book, developed a primer, and pursued other activities to advance analytic methodologies and build capacity. This paper will present an overview of measuring socioeconomic impacts of Earth observations and how the measures can be translated into a value of Earth observation information. It will address key terms, techniques, principles and applications of socioeconomic impact analyses. It will also discuss activities to pursue a research agenda on analytic techniques, develop a body of knowledge, and promote broader skills and capabilities.

  2. Family practice residents' maternity leave experiences and benefits.

    Science.gov (United States)

    Gjerdingen, D K; Chaloner, K M; Vanderscoff, J A

    1995-09-01

    A growing number of residents are having babies during residency training. While many businesses are working to improve maternity conditions and benefits for their employees, residency programs are often not prepared to accommodate pregnant residents. This study was conducted to examine the maternity leave experiences of women who delivered infants during their family practice residency training. Program directors from each of the 394 family practice residency programs listed in the 1993 Directory of Family Practice Residency Programs were asked to distribute surveys to female residents who gave birth during their residency training and had returned to work by the time of the study. Of 199 known eligible residents, 171 (86%) completed surveys; these women represented 127 programs located in 36 states and Puerto Rico. Only 56.8% of women were aware of their program having a written maternity leave policy. The average length of maternity leave was 8 weeks; 76% had leaves of 10 weeks or less. For many, the maternity leave was derived from more than one source, including vacation, sick time, or a mother-child elective. Nearly all (88.3%) the women breast-fed, and the mean duration of breast-feeding was more than 19 weeks. In general, participants believed that having a baby during residency was somewhat difficult. Problems frequently encountered by women after their return to work included sleep deprivation and tiredness, difficulty arranging for child care, guilt about child care, and breast-feeding. Factors that detracted most from the childbirth experience were too little sleep, problems arranging for child care, and lack of support from the partner, residency faculty, and other residents. Having a baby during residency is somewhat difficult for the average female resident. Factors that may ease this difficulty include getting adequate sleep and receiving support from one's partner, faculty, and other residents.

  3. Patient-Related Benefits for Adults with Cochlear Implantation: A Multicultural Longitudinal Observational Study

    Science.gov (United States)

    Lenarz, Thomas; Muller, Lida; Czerniejewska-Wolska, Hanna; Vallés Varela, Hector; Orús Dotú, César; Durko, Marcin; Huarte Irujo, Alicia; Piszczatowski, Bartosz; Zadrożniak, Marek; Irwin, Colin; Graham, Petra L.; Wyss, Josie

    2017-01-01

    Objectives To assess subjectively perceived, real-world benefits longitudinally for unilateral cochlear implant (CI) recipients in a multinational population treated routinely. To identify possible predictors of self-reported benefits. Design This was a prospective, multicenter, repeated-measures study. Self-assessment of performance at preimplantation and postimplantation at 1, 2, and 3 years using standardized, validated, local language versions of the Speech, Spatial, and Qualities of Hearing Scale (SSQ), and the Health Utilities Index Mark 3 (HUI3) was performed. Outcomes were analyzed using a longitudinal mixed-effects model incorporating country effect. Patient demographics were explored for associations with change over time. Subjects Two hundred ninety-one routinely treated, unilateral CI recipients, aged 137–81 years, from 9 clinics across 4 countries. Results Highly significant improvements were observed for all outcome measures (p < 0.0001). Postimplantation, mean outcome scores remained stable beyond 1 year, with notable individual variability. A significant association for one or more outcomes with preimplantation contralateral hearing aid use, telephone use, age at implantation, implantation side, preimplantation comorbidities, dizziness, and tinnitus was observed (p < 0.004). Conclusions Longitudinal benefits of CI treatment can be measured using clinically standardized self-assessment tools to provide a holistic view of patient-related benefits in routine clinical practice for aggregated data from multinational populations. Self-reported outcomes can provide medical-based evidence regarding CI treatment to support decision-making by health service providers. PMID:28719901

  4. Participant Observation: Teaching Students the Benefits of Using a Framework

    Science.gov (United States)

    Daas, Karen L.; McBride, M. Chad

    2014-01-01

    Participant observation is a topic covered in most Introduction to Communication Research classes and specialized courses on qualitative inquiry. However, as humans are natural observers in everyday life, students may not appreciate the importance of systematic and thoughtful observation and note taking. The purpose of the one-to-two class period…

  5. Coordinated Regional Benefit Studies of Coastal Ocean Observing Systems

    National Research Council Canada - National Science Library

    Kite-Powell, Hauke L; Colgan, Charles S; Luger, Michael; Wieand, Ken; Pulsipher, Allan; Pendleton, Linwood; Wellman, Katherine; Pelsoci, Tom

    2003-01-01

    .... The authors will first produce regional "inventories" of ocean observation user sectors, including information about the physical and economic scale of their activities, how products from improved...

  6. Mental Practice : some observations and speculations

    OpenAIRE

    Lippman, L.P.

    1992-01-01

    The use of words such as mental practice, imagery, and rehearsal have great meaning in the psychological, motor learning and sport psycology literature. There exists logic and precedence to simplifyterminology and research that utilizes the paradigm where any kind of mental rehearsal is takin place. In fact, there is some justification that such a mechanism is and always have been an integral part of the learning process. A rubric incorporating mental practice into the mainstream of learning ...

  7. Practice management: observations, issues, and empirical evidence.

    Science.gov (United States)

    Wong, H M; Braithwaite, J

    2001-02-01

    The primary objective of this study is to provide objective, empirical, evidence-based practice management information. This is a hitherto under-researched area of considerable interest for both the practitioner and educator. A questionnaire eliciting a mix of structured and free text responses was administered to a random sample of 480 practitioners who are members of the American Academy of Periodontology. Potential respondents not in private practice were excluded and the next listed person substituted. The results provide demographic and descriptive information about some of the main issues and problems facing practice managers, central to which are information technology (IT), financial, people management, and marketing. Human resource and marketing management appear to represent the biggest challenges. Periodontists running practices would prefer more information, development, and support in dealing with IT, finance, marketing, and people management. The empirical evidence reported here suggests that although tailored educational programs on key management issues at both undergraduate and postgraduate levels have become ubiquitous, nevertheless some respondents seek further training opportunities. Evidence-based practice management information will be invaluable to the clinician considering strategic and marketing planning, and also for those responsible for the design and conduct of predoctoral and postdoctoral programs.

  8. Information Sharing: Practices That Can Benefit Critical Infrastructure Protection

    National Research Council Canada - National Science Library

    2001-01-01

    .... Information sharing and coordination are key elements in developing comprehensive and practical approaches to defending against computer-based, or cyber, attacks, which could threaten the national welfare...

  9. OBSERVATION OF ALPORT SYNDROME IN OBSTETRIC PRACTICE

    Directory of Open Access Journals (Sweden)

    Ольга Сергеевна Тышкевич

    2016-06-01

    Full Text Available The relevance of Alport syndrome as a manifestation of differentiated forms of connective tissue dysplasia is caused by the difficulty of diagnosis, the severity of clinical manifestations and high risk of complications as the underlying disease, since pregnancy and childbirth. Supervision of the pregnant woman with the differentiated form of a displaziya of connecting tissue – Alport's syndrome is presented in original article. Interference of two states – pregnancy and Alport's syndrome is shown. Conclusion. The practicing doctor of any specialty needs to possess full information on a clinical picture and the principles of diagnostics of the DCT forms, on features of influence on the process of a gestation. As importance underestimation the changes of connecting fabric conducts to untimely verification of the diagnosis, inferiority of in due time effective preventive actions, an incorrect choice of tactics of maintaining patients.

  10. The Perception of Tertiary Institutions Prospective Teachers on the Benefits of Teaching Practice

    Directory of Open Access Journals (Sweden)

    Hassan Olusola

    2017-03-01

    Full Text Available This study assessed the perception of two tertiary institutions prospective teachers’ on the Benefits of Teaching Practice in Ogun State. Survey research design was adopted for the study. A sample of four hundred students was randomly selected for the study. Prospective Teachers Perception on Teaching practice Benefits Questionnaire (PTPTPBQ with the reliability coefficient of 0.80 was administered on the respondents. Data collected was analyzed using Mean Score, Charts, Percentages and t-test of significance. The study reveals that prospective teachers have low perception on the benefits of teaching practice also, finance and housing were the two major challenges faced by prospective teachers.. It is evident from the findings that there is need for concerted effort by school to orientate prospective teachers on the benefits of teaching practice. Also the major challenges faced by prospective teachers should also be addressed to allow them have good grasp from the benefits of teaching practice.

  11. Innovation, Cooperation, and the Perceived Benefits and Costs of Sustainable Agriculture Practices

    Directory of Open Access Journals (Sweden)

    Mark Lubell

    2011-12-01

    Full Text Available A central goal of most sustainable agriculture programs is to encourage growers to adopt practices that jointly provide economic, environmental, and social benefits. Using surveys of outreach professionals and wine grape growers, we quantify the perceived costs and benefits of sustainable viticulture practices recommended by sustainability outreach and certification programs. We argue that the mix of environmental benefits, economic benefits, and economic costs determine whether or not a particular practice involves decisions about innovation or cooperation. Decision making is also affected by the overall level of knowledge regarding different practices, and we show that knowledge gaps are an increasing function of cost and a decreasing function of benefits. How different practices are related to innovation and cooperation has important implications for the design of sustainability outreach programs. Cooperation, innovation, and knowledge gaps are issues that are likely to be relevant for the resilience and sustainability of many different types of social-ecological systems.

  12. Patient-Centered Medical Home Undergraduate Internship, Benefits to a Practice Manager: Case Study.

    Science.gov (United States)

    Sasnett, Bonita; Harris, Susie T; White, Shelly

    Health services management interns become practice facilitators for primary care clinics interested in pursuing patient-centered recognition for their practice. This experience establishes a collaborative relationship between the university and clinic practices where students apply their academic training to a system of documentation to improve the quality of patient care delivery. The case study presents the process undertaken, benefits, challenges, lessons learned, and recommendations for intern, practice mangers, and educators. The practice manager benefits as interns become Patient-Centered Medical Home facilitators and assist practice managers in the recognition process.

  13. Observing Literacy Practices in Neighbor Institutions

    DEFF Research Database (Denmark)

    Reusch, Charlotte

    ’procedures on language and literacy. Based on this material, we developed an observation scheme and a guide for preschool teachers to follow, inspired by an action learning concept.During fall 2015, a pilot project is carried out. Preschool teachers from one institution visit a neighbor institution one by one during...... work hours, in order to observe and register how language and literacy events look like there. Afterwards, they share their registrations at a team meeting, and discuss and decide which procedures to test in their own institution. Thus, they form a professional learning network. In the pilot project......The Danish National Centre for Reading and a municipality in southern Denmark cooperate to develop a program to improve preschool children’s early literacy skills. The project aims to support preschool teachers’ ability to create a rich literacy environment for children age 3‒6. Recent research...

  14. A Practical Scheme to Quantify Safety Benefits of Disaster Robots

    International Nuclear Information System (INIS)

    Choi, Young; Jeong, Kyungmin; Kim, Inn Seock

    2016-01-01

    The nuclear robotics team of KAERI is also endeavoring to construct disaster robots, and first of all, interested in how much safety benefits the disaster robots will bring about. The nuclear robotics team of Korea Atomic Energy Research Institute (KAERI) has long been involved in robot development for a variety of applications such as emergency refueling manipulation at a pressurized heavy water reactor and decommissioning of nuclear power plants. In light of great advances these days in remote response technology and the need to upgrade the coping capabilities of the nuclear power plants against beyond-design-basis external events, a primary focus is placed on developing disaster robots that can be deployed to the field where a disastrous or potentially disastrous event is happening. Where a decision has to be made to select a robotic mitigating measure out of several alternatives, the approach also may be applied in evaluating the safety benefit for each alternative so that the result can be used in the selection process together with other decision factors. As part of the fundamental research in the robotics development program of KAERI, a new approach to quantify the safety benefits associated with the mitigation actions to be implemented by disaster robots in the case of an extreme nuclear accident has been developed. This approach is based on a PRA model, and seismic-induced station blackout condition was used as the target scenario. Where a decision has to be made to select a robotic mitigating measure out of several alternatives, the approach also may be applied in evaluating the safety benefit for each alternative so that the result can be used in the selection process along with other decision factors (e.g., development costs, technical feasibility). Although only the action of starting and aligning the SBO diesel generator was used as a mitigating measure that might be performed by the disaster robots in this study, they could also be used for many

  15. A Practical Scheme to Quantify Safety Benefits of Disaster Robots

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Young; Jeong, Kyungmin [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of); Kim, Inn Seock [ISSA Technology, Germantown (United States)

    2016-10-15

    The nuclear robotics team of KAERI is also endeavoring to construct disaster robots, and first of all, interested in how much safety benefits the disaster robots will bring about. The nuclear robotics team of Korea Atomic Energy Research Institute (KAERI) has long been involved in robot development for a variety of applications such as emergency refueling manipulation at a pressurized heavy water reactor and decommissioning of nuclear power plants. In light of great advances these days in remote response technology and the need to upgrade the coping capabilities of the nuclear power plants against beyond-design-basis external events, a primary focus is placed on developing disaster robots that can be deployed to the field where a disastrous or potentially disastrous event is happening. Where a decision has to be made to select a robotic mitigating measure out of several alternatives, the approach also may be applied in evaluating the safety benefit for each alternative so that the result can be used in the selection process together with other decision factors. As part of the fundamental research in the robotics development program of KAERI, a new approach to quantify the safety benefits associated with the mitigation actions to be implemented by disaster robots in the case of an extreme nuclear accident has been developed. This approach is based on a PRA model, and seismic-induced station blackout condition was used as the target scenario. Where a decision has to be made to select a robotic mitigating measure out of several alternatives, the approach also may be applied in evaluating the safety benefit for each alternative so that the result can be used in the selection process along with other decision factors (e.g., development costs, technical feasibility). Although only the action of starting and aligning the SBO diesel generator was used as a mitigating measure that might be performed by the disaster robots in this study, they could also be used for many

  16. Does advanced practice in radiography benefit the healthcare system? A literature review.

    Science.gov (United States)

    Thom, S E

    2018-02-01

    With ever-increasing demands on the National Health Service (NHS), members of staff are blurring their professional boundaries in the attempt to benefit the healthcare system. This review aims to establish whether advancing practice within radiography does benefit the healthcare system by examining published literature. Key words were input into databases such as: CINAHL, Science Direct and PubMed. Various filters were applied to narrow down the articles. Key themes were identified within the literature: cost, job satisfaction, patient benefits, restrictions and workload. Having advanced practitioners undertake some of the radiologists' workload was potentially cost effective whilst continuing/increasing the standard of quality. Patients benefitted from the quality of their examinations, the high accuracy of their reports and the speed those reports were attained. Evidence within the literature emphasises that advanced practice does benefit the healthcare system by means of: cost reduction, job satisfaction, patient benefits and workload. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  17. Mapping the Delivery of Societal Benefit through the International Arctic Observations Assessment Framework

    Science.gov (United States)

    Lev, S. M.; Gallo, J.

    2017-12-01

    The international Arctic scientific community has identified the need for a sustained and integrated portfolio of pan-Arctic Earth-observing systems. In 2017, an international effort was undertaken to develop the first ever Value Tree framework for identifying common research and operational objectives that rely on Earth observation data derived from Earth-observing systems, sensors, surveys, networks, models, and databases to deliver societal benefits in the Arctic. A Value Tree Analysis is a common tool used to support decision making processes and is useful for defining concepts, identifying objectives, and creating a hierarchical framework of objectives. A multi-level societal benefit area value tree establishes the connection from societal benefits to the set of observation inputs that contribute to delivering those benefits. A Value Tree that relies on expert domain knowledge from Arctic and non-Arctic nations, international researchers, Indigenous knowledge holders, and other experts to develop a framework to serve as a logical and interdependent decision support tool will be presented. Value tree examples that map the contribution of Earth observations in the Arctic to achieving societal benefits will be presented in the context of the 2017 International Arctic Observations Assessment Framework. These case studies will highlight specific observing products and capability groups where investment is needed to contribute to the development of a sustained portfolio of Arctic observing systems.

  18. How to estimate the health benefits of additional research and changing clinical practice

    OpenAIRE

    Claxton, Karl; Griffin, Susan; Koffijberg, Hendrik; McKenna, Claire

    2015-01-01

    A simple extension of standard meta-analysis can provide quantitative estimates of the potential health benefits of further research and of implementing the findings of existing research, which can help inform research prioritisation and efforts to change clinical practice

  19. How to estimate the health benefits of additional research and changing clinical practice

    OpenAIRE

    Claxton, Karl; Griffin, Susan; Koffijberg, Hendrik; McKenna, Claire

    2015-01-01

    A simple extension of standard metaanalysis can provide quantitative estimates of the potential health benefits of further research and of implementing the findings of existing research, which can help inform research prioritisation and efforts to change clinical practice

  20. Individualized cardiovascular disease prevention in clinical practice : Estimation of benefit and cost

    NARCIS (Netherlands)

    Slob, MC

    2017-01-01

    For treatment decisions in clinical practice, group-level treatment effects need to be translated into benefit for an individual patient. In both the primary and secondary cardiovascular prevention setting (Chapter 2), patients differ widely in the risk for cardiovascular events, and the benefit

  1. Impacts of generic competition and benefit management practices on spending for prescription drugs: evidence from Medicare's Part D benefit.

    Science.gov (United States)

    Sheingold, Steven; Nguyen, Nguyen Xuan

    2014-01-01

    This study estimates the effects of generic competition, increased cost-sharing, and benefit practices on utilization and spending for prescription drugs. We examined changes in Medicare price and utilization from 2007 to 2009 of all drugs in 28 therapeutic classes. The classes accounted for 80% of Medicare Part D spending in 2009 and included the 6 protected classes and 6 classes with practically no generic competition. All variables were constructed to measure each drug relative to its class at a specific plan sponsor. We estimated that the shift toward generic utilization had cut in half the rate of increase in the price of a prescription during 2007-2009. Specifically, the results showed that (1) rapid generic penetration had significantly held down costs per prescription, (2) copayment and other benefit practices shifted utilization to generics and favored brands, and (3) price increases were generally greater in less competitive classes of drugs. In many ways, Part D was implemented at a fortuitous time; since 2006, there have been relatively few new blockbuster drugs introduced, and many existing high-volume drugs used by beneficiaries were in therapeutic classes with multiple brands and generic alternatives. Under these conditions, our paper showed that plan sponsors have been able to contain costs by encouraging use of generics or drugs offering greater value within therapeutic classes. It is less clear what will happen to future Part D costs if a number of new and effective drugs for beneficiaries enter the market with no real competitors.

  2. Benefits and challenges of practicing taekwondo to adolescents in Addis Ababa City, Ethiopia

    Directory of Open Access Journals (Sweden)

    Michael Emru Tadesse

    2016-03-01

    Full Text Available This study aimed at examining the benefits and challenges of practicing Taekwondo (TKD to adolescents in Addis Ababa. In so doing, the study investigated the nature of TKD training, benefits of practicing TKD, and challenges/problems related with practicing TKD. A descriptive concurrent mixed methods research design was used. Accordingly, the quantitative part of the study had 108 TKD adolescent participants while the qualitative part had 12 participants (eight TKD adolescents and four TKD coaches, from four TKD clubs in Addis Ababa. Both one-stage cluster sampling technique and purposive sampling technique were employed to select participants for the quantitative and qualitative parts of the study, respectively. Questionnaires and in-depth interviews were used to collect data from participants. Results of the study indicated: (1 the TKD training provided by the four TKD clubs was more of a modern/sport form of TKD; (2 TKD adolescents and coaches perceived that the benefits of TKD for adolescents are multifaceted, i.e., social benefits, physical benefits, mental benefits, self-defense, addiction avoidance, and other benefits; and (3 though majority (63.6% of the respondents claimed that they did not face any problem as a result of practicing TKD, the following were identified as major problems that could threaten the wellbeing of TKD adolescents: family-related problems, community-related problems, and competition-related problems. In general, results show that the training of TKD can have a multifaceted positive contribution to adolescents’ wellbeing.

  3. The knowledge, attitude, priority of usage, and benefits associated with management accounting practices

    DEFF Research Database (Denmark)

    Nielsen, Steen; Melander, Preben; Jakobsen, Morten

    2009-01-01

    There have been several studies of the diffusion of new management accounting practices. This study adds a new dimension: in order to indicate the number of practices associated with the respondents, their interrelationships, the respondents, were asked to answer questions in a questionnaire...... covering four variables: level of knowledge, level of attitude, priority of usage, and level of benefit for 15 new accounting practices. The survey includes a sample of 119 large and medium-sized privately owned manufacturing and non-manufacturing companies, comprising 15 new or recently developed...... management accounting practices. Our results reveal that companies in general experience a high level of benefit from the practices. However, significance differences between low priority of usage and high number of practices associated with the company are very likely to contribute to a more modest level...

  4. Characterizing Mathematics Classroom Practice: Impact of Observation and Coding Choices

    Science.gov (United States)

    Ing, Marsha; Webb, Noreen M.

    2012-01-01

    Large-scale observational measures of classroom practice increasingly focus on opportunities for student participation as an indicator of instructional quality. Each observational measure necessitates making design and coding choices on how to best measure student participation. This study investigated variations of coding approaches that may be…

  5. Observations of teachers in Ilorin, Nigeria on their practices of ...

    African Journals Online (AJOL)

    Objective: To document the observations of elementary school teachers (ESTs) in Ilorin, Nigeria on their practice of some types of corporal punishment (CP) that could result in eye injuries among their pupils. Materials and Methods: A short battery of questions that explored ESTs' observations on attitudes to, and knowledge ...

  6. Problem solving teaching practices: Observer and teacher's view

    OpenAIRE

    Felmer , Patricio; Perdomo-Díaz , Josefa; Giaconi , Valentina; Espinoza , Carmen ,

    2015-01-01

    International audience; In this article, we report on an exploratory study on teaching practices related to problem solving of a group of 29 novel secondary mathematics teachers. For this purpose, two independent instruments were designed, the first one is based on lesson observations, and the second one is a questionnaire answered by teachers about their teaching practices while working on non-routine problem solving with their students. For each instrument, we perform a statistical analysis...

  7. Assessing the costs and benefits of improved land management practices in three watershed areas in Ethiopia

    Directory of Open Access Journals (Sweden)

    Abonesh Tesfaye

    2016-03-01

    Full Text Available Unsustainable land use management and the resulting soil erosion are among the most pervasive problems in rural Ethiopia, where most of the country’s people live, jeopardizing food security. Despite various efforts to introduce soil conservation measures and assess their costs and benefits, it is unclear how efficient these measures are from an economic point of view in securing food production. This paper examines the costs and benefits of three soil conservation measures applied in the country in three different rural districts facing different degrees of soil erosion problems using survey data collected from 750 farm households. A production function is estimated to quantify the costs and benefits of more sustainable land use management practices. We show that the soil conservation measures significantly increase productivity and hence food security. Comparing the costs and benefits, the results indicate that implementing soil conservation measures would benefit farm communities in the case study areas through increased grain productivity and food security.

  8. A practical approach to communicating benefit-risk decisions of medicines to stakeholders

    Directory of Open Access Journals (Sweden)

    James eLeong

    2015-06-01

    Full Text Available AbstractPurposeThe importance of a framework for a systematic structured assessment of the benefits and risks has been established, but in addition, it is necessary that the benefit-risk decisions and the processes to derive those decisions are documented and communicated to various stakeholders for accountability. Hence there is now a need to find appropriate tools to enhance communication in a manner that would uphold transparency, consistency and standards. MethodsA retrospective, non-comparative study was conducted to determine the applicability and practicality of a summary template in documenting benefit-risk assessment and communicating benefit-risk balance and conclusions for reviewers to other stakeholders. The benefit-risk (BR Summary Template and its User Manual was evaluated by 12 reviewers within a regulatory agency in Singapore, the Health Sciences Authority (HSA. ResultsThe BR Summary Template was found to be adequate in documenting benefits, risks, relevant summaries and conclusions, while the User Manual was useful in guiding the reviewer in completing the template. The BR Summary Template was also considered a useful tool for communicating benefit-risk decisions to a variety of stakeholders.ConclusionsThe use of a template may be of value for the communicating benefit-risk assessment of medicines to stakeholders.

  9. A practical approach to communicating benefit-risk decisions of medicines to stakeholders.

    Science.gov (United States)

    Leong, James; Walker, Stuart; Salek, Sam

    2015-01-01

    The importance of a framework for a systematic structured assessment of the benefits and risks has been established, but in addition, it is necessary that the benefit-risk decisions and the processes to derive those decisions are documented and communicated to various stakeholders for accountability. Hence there is now a need to find appropriate tools to enhance communication between regulators and other stakeholders, in a manner that would uphold transparency, consistency and standards. A retrospective, non-comparative study was conducted to determine the applicability and practicality of a summary template in documenting benefit-risk assessment and communicating benefit-risk balance and conclusions for reviewers to other stakeholders. The benefit-risk (BR) Summary Template and its User Manual was evaluated by 12 reviewers within a regulatory agency in Singapore, the Health Sciences Authority (HSA). The BR Summary Template was found to be adequate in documenting benefits, risks, relevant summaries and conclusions, while the User Manual was useful in guiding the reviewer in completing the template. The BR Summary Template was also considered a useful tool for communicating benefit-risk decisions to a variety of stakeholders. The use of a template may be of value for the communicating benefit-risk assessment of medicines to stakeholders.

  10. The knowledge, attitude, priority of usage, and benefits associated with management accounting practices

    DEFF Research Database (Denmark)

    Nielsen, Steen; Melander, Preben; Jakobsen, Morten

    2009-01-01

    There have been several studies of the diffusion of new management accounting practices. This study adds a new dimension: in order to indicate the number of practices associated with the respondents, their interrelationships, the respondents, were asked to answer questions in a questionnaire...... management accounting practices. Our results reveal that companies in general experience a high level of benefit from the practices. However, significance differences between low priority of usage and high number of practices associated with the company are very likely to contribute to a more modest level...... and those companies seldom use a theoretical concept but are inspired to design home-made models. This also confirms that accounting practices are used for inspiration of design. The findings can provide a further basis for the discussion and development of a theory for new management accounting models....

  11. Eco-innovative Practices for Sustainable Consumption and Production: What are the Possible Benefits for Companies?

    Directory of Open Access Journals (Sweden)

    Maria Rosa De Giacomo

    2014-07-01

    Full Text Available The paper aims to present some eco-innovative practices regarding Sustainable Consumption and Production (SCP. The study also focuses on potential benefits for the actors who implement these practices, mainly with reference to companies. After a literature review on the actual importance of SCP and on the effects of eco-innovation tools and policies on companies, authors present the developed eco-innovation practices in three focus areas related to sustainable consumption and production. The aim of the study is to contribute to literature studies on SCP with the development of eco-innovative practices resulting by the integration of existing tools, by pointing out and valorizing their potentials and synergies. These practices have been pointing out in the framework of the international European project. Three focus areas are involved by the practices: sustainability of products and services, sustainability of production processes and sustainable management of industrial areas. Authors developed four eco innovative practices resulting from the integration of 15 existing tools. These practices offer many opportunities to many actors, mainly companies and public authorities, in order to achieve environmental and competitive benefits and implement eco-innovation principles with a cooperative and shared approach.

  12. Observed Food Safety Practices in the Summer Food Service Program

    Science.gov (United States)

    Patten, Emily Vaterlaus; Alcorn, Michelle; Watkins, Tracee; Cole, Kerri; Paez, Paola

    2017-01-01

    Purpose/Objectives: The purpose of this exploratory, observational study was three-fold: 1) Determine current food safety practices at Summer Food Service Program (SFSP) sites; 2) Identify types of food served at the sites and collect associated temperatures; and 3) Establish recommendations for food safety training in the SFSP.…

  13. Job satisfaction of practice assistants in general practice in Germany: an observational study.

    Science.gov (United States)

    Goetz, Katja; Campbell, Stephen; Broge, Bjoern; Brodowski, Marc; Steinhaeuser, Jost; Wensing, Michel; Szecsenyi, Joachim

    2013-08-01

    Job satisfaction of practice staff is important for optimal health care delivery and for minimizing the turnover of non-medical professions. To document the job satisfaction of practice assistants in German general practice and to explore associations between job satisfaction, staff characteristics and culture in general practice organizations. The study was based on data from the European Practice Assessment accreditation scheme for general practices and used an observational design. The study population consisted of 1158 practice assistants from 345 general practices across Germany. Job satisfaction was measured with the 10-item Warr-Cook-Wall questionnaire. Organizational culture was evaluated with four items. A linear regression analysis was performed in which each of the job satisfaction items was handled as dependent variable. Out of 1716 staff member questionnaires handed out to practice assistants, 1158 questionnaires were completed (response rate: 67.5%). Practice assistants were most satisfied with their colleagues and least satisfied with their income. Higher job satisfaction was associated with issues of organizational culture, particularly a good working atmosphere, opportunities to suggest and influence areas for improvement and clear responsibilities within the practice team. Prioritizing initiatives to maintain high levels of, or to improve the job satisfaction of practice assistants, is important for recruitment and retention. It will also help to improve working conditions for both practice assistants and GPs and create an environment to provide better quality care.

  14. The Road to Hell Is Paved with Good Intentions: Why Harm-Benefit Analysis and Its Emphasis on Practical Benefit Jeopardizes the Credibility of Research.

    Science.gov (United States)

    Grimm, Herwig; Eggel, Matthias; Deplazes-Zemp, Anna; Biller-Andorno, Nikola

    2017-09-11

    It is our concern that European Union Directive 2010/63/EU with its current project evaluation of animal research in the form of a harm-benefit analysis may lead to an erosion of the credibility of research. The HBA assesses whether the inflicted harm on animals is outweighed by potential prospective benefits. Recent literature on prospective benefit analysis prioritizes "societal benefits" that have a foreseeable, positive impact on humans, animals, or the environment over benefit in the form of knowledge. In this study, we will argue that whether practical benefits are realized is (a) impossible to predict and (b) exceeds the scope and responsibility of researchers. Furthermore, we believe that the emphasis on practical benefits has the drawback of driving researchers into speculation on the societal benefit of their research and, therefore, into promising too much, thereby leading to a loss of trust and credibility. Thus, the concepts of benefit and benefit assessment in the HBA require a re-evaluation in a spirit that embraces the value of knowledge in our society. The generation of scientific knowledge has been utilised to great benefit for humans, animals, and the environment. The HBA, as it currently stands, tends to turn this idea upside down and implies that research is of value only if the resulting findings bring about immediate societal benefit.

  15. A practical technique for benefit-cost analysis of computer-aided design and drafting systems

    International Nuclear Information System (INIS)

    Shah, R.R.; Yan, G.

    1979-03-01

    Analysis of benefits and costs associated with the operation of Computer-Aided Design and Drafting Systems (CADDS) are needed to derive economic justification for acquiring new systems, as well as to evaluate the performance of existing installations. In practice, however, such analyses are difficult to perform since most technical and economic advantages of CADDS are ΣirreduciblesΣ, i.e. cannot be readily translated into monetary terms. In this paper, a practical technique for economic analysis of CADDS in a drawing office environment is presented. A Σworst caseΣ approach is taken since increase in productivity of existing manpower is the only benefit considered, while all foreseen costs are taken into account. Methods of estimating benefits and costs are described. The procedure for performing the analysis is illustrated by a case study based on the drawing office activities at Atomic Energy of Canada Limited. (auth)

  16. Peer-editing Practice in the Writing Classroom: Benefits and Drawbacks

    Directory of Open Access Journals (Sweden)

    Ann Rosnida Md. Deni

    2011-01-01

    Full Text Available Small scale studies have shown that peer-editing is beneficial to students as it increases their awareness of the complex process of writing, it improves their knowledge of and skills in writing and helps them become more autonomous in learning. Teachers too may benefit from peer-editing as this practice discloses invaluable information on students’ writing weaknesses and strengths: and teachers’ teaching effectiveness. This is a small scale study conducted on fifteen first-year degree students majoring in Tourism to view the usefulness of peer-editing practice in enhancing their writing skills. Retrospective notes were taken to record students’ receptiveness and reaction towards peer editing practice: students writing samples and peer- editing questionnaires were analyzed to view students’ revisions and comments; and an open— ended questionnaire was distributed to identify students perceptions of peer—editing practice in the writing classroom. Analysis of data gathered revealed that peer-editing practice benefitted both the teacher and most of her students as it exposed important information that could improve her teaching of writing and her students’ writing practices. Data analysis also. however, discloses that peer-editing practice may have adverse effects on students’ motivation and improvement in writing if they are not deployed properly.

  17. Perceived Benefits and Drawbacks of Disclosure Practices: An Analysis of PLWHAs' Strategies for Disclosing HIV Status.

    Science.gov (United States)

    Catona, Danielle; Greene, Kathryn; Magsamen-Conrad, Kate

    2015-01-01

    People living with HIV/AIDS must make decisions about how, where, when, what, and to whom to disclose their HIV status. This study explores their perceptions of benefits and drawbacks of various HIV disclosure strategies. The authors interviewed 53 people living with HIV/AIDS from a large AIDS service organization in a northeastern U.S. state and used a combination of deductive and inductive coding to analyze disclosure strategies and advantages and disadvantages of disclosure strategies. Deductive codes consisted of eight strategies subsumed under three broad categories: mode (face-to-face, non-face-to-face, and third-party disclosure), context (setting, bringing a companion, and planning a time), and content (practicing and incremental disclosure). Inductive coding identified benefits and drawbacks for enacting each specific disclosure strategy. The discussion focuses on theoretical explanations for the reasons for and against disclosure strategy enactment and the utility of these findings for practical interventions concerning HIV disclosure practices and decision making.

  18. Existing and Emerging Best Practices for Ocean Observation

    Science.gov (United States)

    Pearlman, J.; Buttigieg, P. L.; Simpson, P.; Arko, R. A.; Garello, R.; Pissierssens, P.

    2016-12-01

    Best practices emerge from experience, usually at the local level - in universities, private and public research institutions and other organizations. Large programs such as the European FixO3 for fixed mooring observations or IOOS in the USA for data management may document best practices and urge propagation of techniques. Sometimes communities come together under projects such as the Ocean Data Interoperability Project (ODIP), AtlantOS or international organizations such as the UNESCO IODE or GOOS to create a forum for discussing, recommending and documenting observation and data practices. On the whole the process is fragmented and results are difficult to sustain. From this perspective, several projects and organizations such as ODIP, IODE and AtlantOS are working in collaboration with Ocean Networks Canada, IOOS and selected European projects to address means of improved access to documented best practices and a way to provide the observing community with a compendium that can be sustained for use in training new oceanographers and data scientists and also providing references for experts that are working across disciplines. Where practical, a solution should reach across science communities and networks to support multi-disciplinary applications The initial challenge is to create a base for efficient discovery of documented best practices and getting sufficient documentation in the first place. Working across disciplines, this becomes both a question of appropriate vocabularies and some means for a scientist to understand the background, provenance (including any certification) and value of a best practice. New approaches to semantics and Linked Data, and increasing use of persistent identifiers such as Open Researcher and Contributor IDs (ORCIDs) and International Geo Sample Numbers (IGSNs), will facilitate distributed search across repositories. The approach must be scalable and easy for users to engage so provision of best practice documentation has a low

  19. Brownfields to green fields: Realising wider benefits from practical contaminant phytomanagement strategies.

    Science.gov (United States)

    Cundy, A B; Bardos, R P; Puschenreiter, M; Mench, M; Bert, V; Friesl-Hanl, W; Müller, I; Li, X N; Weyens, N; Witters, N; Vangronsveld, J

    2016-12-15

    Gentle remediation options (GROs) are risk management strategies or technologies involving plant (phyto-), fungi (myco-), and/or bacteria-based methods that result in a net gain (or at least no gross reduction) in soil function as well as effective risk management. GRO strategies can be customised along contaminant linkages, and can generate a range of wider economic, environmental and societal benefits in contaminated land management (and in brownfields management more widely). The application of GROs as practical on-site remedial solutions is still limited however, particularly in Europe and at trace element (typically metal and metalloid) contaminated sites. This paper discusses challenges to the practical adoption of GROs in contaminated land management, and outlines the decision support tools and best practice guidance developed in the European Commission FP7-funded GREENLAND project aimed at overcoming these challenges. The GREENLAND guidance promotes a refocus from phytoremediation to wider GROs- or phyto-management based approaches which place realisation of wider benefits at the core of site design, and where gentle remediation technologies can be applied as part of integrated, mixed, site risk management solutions or as part of "holding strategies" for vacant sites. The combination of GROs with renewables, both in terms of biomass generation but also with green technologies such as wind and solar power, can provide a range of economic and other benefits and can potentially support the return of low-level contaminated sites to productive usage, while combining GROs with urban design and landscape architecture, and integrating GRO strategies with sustainable urban drainage systems and community gardens/parkland (particularly for health and leisure benefits), has large potential for triggering GRO application and in realising wider benefits in urban and suburban systems. Quantifying these wider benefits and value (above standard economic returns) will be

  20. Family presence during resuscitation (FPDR): Perceived benefits, barriers and enablers to implementation and practice.

    Science.gov (United States)

    Porter, Joanne E; Cooper, Simon J; Sellick, Ken

    2014-04-01

    There are a number of perceived benefits and barriers to family presence during resuscitation (FPDR) in the emergency department, and debate continues among health professionals regarding the practice of family presence. This review of the literature aims to develop an understanding of the perceived benefits, barriers and enablers to implementing and practicing FPDR in the emergency department. The perceived benefits include; helping with the grieving process; everything possible was done, facilitates closure and healing and provides guidance and family understanding and allows relatives to recognise efforts. The perceived barriers included; increased stress and anxiety, distracted by relatives, fear of litigation, traumatic experience and family interference. There were four sub themes that emerged from the literature around the enablers of FPDR, these included; the need for a designated support person, the importance of training and education for staff and the development of a formal policy within the emergency department to inform practice. In order to ensure that practice of FPDR becomes consistent, emergency personnel need to understand the need for advanced FPDR training and education, the importance of a designated support person role and the evidence of FPDR policy as enablers to implementation. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Observing representational practices in art and anthropology - a transdisciplinary approach

    Directory of Open Access Journals (Sweden)

    R Preiser

    2010-04-01

    Full Text Available It has been suggested that anthropology operates in “liminal spaces” which can be defined as “spaces between disciplines”. This study will explore the space where the fields of art and anthropology meet in order to discover the epistemological and representational challenges that arise from this encounter. The common ground on which art and anthropology engage can be defined in terms of their observational and knowledge producing practices. Both art and anthropology rely on observational skills and varying forms of visual literacy to collect and represent data. Anthropologists represent their data mostly in written form by means of ethnographic accounts, and artists represent their findings by means of imaginative artistic mediums such as painting, sculpture, filmmaking and music. Departing from a paradigm that acknowledges the importance of transdisciplinary enquiry, the paper proposes a position suggesting that by combining observational and knowledge producing practices, both anthropology and art can overcome the limits that are inherent in their representational practices. The paper will explore how insights from complexity theory offer the necessary conceptual tools with which anthropology and art can work together in offering solutions to problems of presentation that emerge when dealing with complex issues.

  2. Citizen expectations of 'academic entrepreneurship' in health research: public science, practical benefit.

    Science.gov (United States)

    Miller, Fiona A; Painter-Main, Michael; Axler, Renata; Lehoux, Pascale; Giacomini, Mita; Slater, Barbara

    2015-12-01

    Responsiveness to citizens as users of technological innovation helps motivate translational research and commercial engagement among academics. Yet, retaining citizen trust and support for research encourages caution in pursuit of commercial science. We explore citizen expectations of the specifically academic nature of commercial science [i.e. academic entrepreneurship (AE)] and the influence of conflict of interest concerns, hopes about practical benefits and general beliefs. We conducted a cross-sectional national opinion survey of 1002 Canadians online in 2010. Approval of AE was moderate (mean 3.2/5, SD 0.84), but varied by entrepreneurial activity. Concern about conflict of interests (COI) was moderate (mean 2.9/5, SD 0.86) and varied by type of concern. An ordinary least-squares regression showed that expectations of practical benefits informed support for AE, specifically that academic-industry collaboration can better address real-world problems; conflict of interest concerns were insignificant. These findings suggest that citizens support AE for its potential to produce practical benefits, but enthusiasm varies and is reduced for activities that may prioritize private over public interests. Further, support exists despite concern about COI, perhaps due to trust in the academic research context. For user engagement in research priority setting, these findings suggest the need to attend to the commercial nature of translational science. For research policy, they suggest the need for governance arrangements for responsible innovation, which can sustain public trust in academic research, and realize the practical benefits that inform public support for AE. © 2014 John Wiley & Sons Ltd.

  3. High workload and job stress are associated with lower practice performance in general practice: an observational study in 239 general practices in the Netherlands

    Directory of Open Access Journals (Sweden)

    Grol Richard

    2009-07-01

    Full Text Available Abstract Background The impact of high physician workload and job stress on quality and outcomes of healthcare delivery is not clear. Our study explored whether high workload and job stress were associated with lower performance in general practices in the Netherlands. Methods Secondary analysis of data from 239 general practices, collected in practice visits between 2003 to 2006 in the Netherlands using a comprehensive set of measures of practice management. Data were collected by a practice visitor, a trained non-physician observer using patients questionnaires, doctors and staff. For this study we selected five measures of practice performance as outcomes and six measures of GP workload and job stress as predictors. A total of 79 indicators were used out of the 303 available indicators. Random coefficient regression models were applied to examine associations. Results and discussion Workload and job stress are associated with practice performance. Workload: Working more hours as a GP was associated with more positive patient experiences of accessibility and availability (b = 0.16. After list size adjustment, practices with more GP-time per patient scored higher on GP care (b = 0.45. When GPs provided more than 20 hours per week per 1000 patients, patients scored over 80% on the Europep questionnaire for quality of GP care. Job stress: High GP job stress was associated with lower accessibility and availability (b = 0.21 and insufficient practice management (b = 0.25. Higher GP commitment and more satisfaction with the job was associated with more prevention and disease management (b = 0.35. Conclusion Providing more time in the practice, and more time per patient and experiencing less job stress are all associated with perceptions by patients of better care and better practice performance. Workload and job stress should be assessed by using list size adjusted data in order to realise better quality of care. Organisational development using

  4. High workload and job stress are associated with lower practice performance in general practice: an observational study in 239 general practices in the Netherlands.

    Science.gov (United States)

    van den Hombergh, Pieter; Künzi, Beat; Elwyn, Glyn; van Doremalen, Jan; Akkermans, Reinier; Grol, Richard; Wensing, Michel

    2009-07-15

    The impact of high physician workload and job stress on quality and outcomes of healthcare delivery is not clear. Our study explored whether high workload and job stress were associated with lower performance in general practices in the Netherlands. Secondary analysis of data from 239 general practices, collected in practice visits between 2003 to 2006 in the Netherlands using a comprehensive set of measures of practice management. Data were collected by a practice visitor, a trained non-physician observer using patients questionnaires, doctors and staff. For this study we selected five measures of practice performance as outcomes and six measures of GP workload and job stress as predictors. A total of 79 indicators were used out of the 303 available indicators. Random coefficient regression models were applied to examine associations. Workload and job stress are associated with practice performance.Workload: Working more hours as a GP was associated with more positive patient experiences of accessibility and availability (b = 0.16). After list size adjustment, practices with more GP-time per patient scored higher on GP care (b = 0.45). When GPs provided more than 20 hours per week per 1000 patients, patients scored over 80% on the Europep questionnaire for quality of GP care.Job stress: High GP job stress was associated with lower accessibility and availability (b = 0.21) and insufficient practice management (b = 0.25). Higher GP commitment and more satisfaction with the job was associated with more prevention and disease management (b = 0.35). Providing more time in the practice, and more time per patient and experiencing less job stress are all associated with perceptions by patients of better care and better practice performance. Workload and job stress should be assessed by using list size adjusted data in order to realise better quality of care. Organisational development using this kind of data feedback could benefit both patients and GP.

  5. Observation of peers in learning to write: Practice and research

    Directory of Open Access Journals (Sweden)

    Rijlaarsdam, Gert

    2008-01-01

    Full Text Available Elke Van Steendam, Anne Toorenaar,Journal of Writing Research 1(1, 53-83In this paper we discuss the role of observation in learning to write. We argue that the acquisition of skill in such a complex domain as writing relies on observation, the classical imitatio. An important phase in learning to write, at all ages, is learning to write by observing and evaluating relevant processes: writing processes, reading processes or communication processes between writers and readers.First, we present two practical cases: writing lessons in which observation and inquiry are amongst other key elements and where students participate in a community of learners. Then, we review research that may inspire and substantiate proposals for implementing observation as a learning activity in writing education. Two types of studies are discussed: studies in which learners acquire strategies by observing and evaluating writing and reading processes of peers, as a prewriting instructional activity, and studies in which learners are stimulated to 'pre-test' and then revise their first draft, as a post writing instructional activity. The paper closes with some recommendations for further research.

  6. Truth telling in medical practice: students' opinions versus their observations of attending physicians' clinical practice.

    Science.gov (United States)

    Tang, Woung-Ru; Fang, Ji-Tseng; Fang, Chun-Kai; Fujimori, Maiko

    2013-07-01

    Truth telling or transmitting bad news is a problem that all doctors must frequently face. The purpose of this cross-sectional study was to investigate if medical students' opinions of truth telling differed from their observations of attending physicians' actual clinical practice. The subjects were 275 medical clerks/interns at a medical center in northern Taiwan. Data were collected on medical students' opinions of truth telling, their observations of physicians' clinical practice, students' level of satisfaction with truth telling practiced by attending physicians, and cancer patients' distress level when they were told the truth. Students' truth-telling awareness was significantly higher than the clinical truth-telling practice of attending physicians (pmedical students' opinions on truth telling and attending physicians' actual clinical practice. More research is needed to objectively assess physicians' truth telling in clinical practice and to study the factors affecting the method of truth telling used by attending physicians in clinical practice. Copyright © 2012 John Wiley & Sons, Ltd.

  7. The Potential Benefits of Earth Observations for the Water-Energy-Food Nexus and Beyond

    Science.gov (United States)

    Lawford, R. G.

    2016-12-01

    Earth Observations have been shown to have the potential to play an important role in the management of the Water-Energy-Food (W-E-F) Nexus. To date, their primary application has come through support to decisions related to the better use of water in the production of food and in the extraction of energy. However, to be fully effective, the uses of Earth observations should be coordinated across the sectors and appropriately applied at multiple levels of the governance process. This observation argues for a new approach to governance and management of the W-E-F Nexus that implements collaborative planning based on broader usage of Earth observations. The Future Earth W-E-F Nexus Cluster project has documented a number of ways in which Earth observations can support decision-making that benefits the management of these sectors and has identified gaps in the data and information systems needed for this purpose. This presentation will summarize those findings and discuss how the role of Earth observations could be strengthened and expanded to the Sustainable Development Goals and Integrated Water Resources Management.

  8. Observations on the use of cost-benefit analysis in the control of radioactive waste disposal

    International Nuclear Information System (INIS)

    Shepherd, J.G.; Hetherington, J.A.

    1975-10-01

    The disposal of radioactive waste to the environment can lead to the irradiation of large numbers of people, and although the individual doses may be very small compared with the ICRP dose limits the total population dose may not be insignificant. In these circumstances the control procedure is likely to be determined by the requirement that doses be kept 'as low as is readily achievable'(see ICRP-9, para. 52). This recommendation has been interpreted in ICRP-22, where the use of cost-benefit analysis is suggested as a means of application in practice. This paper discusses some of the implications of these recommendations in relation to the control of radioactive waste disposal, under the following headings: the use of collective dose; the costing of collective dose; the assessment and use of detrimental costs; and the payment of detrimental costs. (author)

  9. Benefits from retrieval practice are greater for students with lower working memory capacity.

    Science.gov (United States)

    Agarwal, Pooja K; Finley, Jason R; Rose, Nathan S; Roediger, Henry L

    2017-07-01

    We examined the effects of retrieval practice for students who varied in working memory capacity as a function of the lag between study of material and its initial test, whether or not feedback was given after the test, and the retention interval of the final test. We sought to determine whether a blend of these conditions exists that maximises benefits from retrieval practice for lower and higher working memory capacity students. College students learned general knowledge facts and then restudied the facts or were tested on them (with or without feedback) at lags of 0-9 intervening items. Final cued recall performance was better for tested items than for restudied items after both 10 minutes and 2 days, particularly for longer study-test lags. Furthermore, on the 2-day delayed test the benefits from retrieval practice with feedback were significantly greater for students with lower working memory capacity than for students with higher working memory capacity (r = -.42). Retrieval practice may be an especially effective learning strategy for lower ability students.

  10. The m-Health revolution: Exploring perceived benefits of WhatsApp use in clinical practice.

    Science.gov (United States)

    Ganasegeran, Kurubaran; Renganathan, Pukunan; Rashid, Abdul; Al-Dubai, Sami Abdo Radman

    2017-01-01

    The dawn of m-Health facilitates new horizons of professional communication through WhatsApp, allowing health professionals to interact fast and efficiently for effective patient management. This preliminary study aimed to investigate perceived benefits, if any, of WhatsApp use across general medical and emergency teams during clinical practice in Malaysia. A cross-sectional study was conducted in a universal sample of 307 health professionals comprising of nurses, medical assistants, medical residents, medical officers and physicians across medical and casualty departments in a Malaysian public hospital. The self-administered questionnaire consisted of items on socio-demographics, WhatsApp usage characteristics and the type of communication events during clinical practice. The majority of respondents (68.4%) perceived WhatsApp as beneficial during clinical practice. In multivariate analysis, perceived benefits was significantly higher amongst the clinical management group (aOR=2.6, 95% CI 1.5-4.6, p=0.001), those using WhatsApp for >12months (aOR=1.7, 95% CI 1.0-3.0, p=0.047), those receiving response ≤15min to a new communication (aOR=1.9, 95% CI 1.1-3.2, p=0.017), and frequent information giving events (aOR=2.4, 95% CI 1.2-4.8, p=0.016). Perceived benefits of WhatsApp use in clinical practice was significantly associated with usage characteristics and type of communication events. This study lays the foundation for quality improvement innovations in patient management delivered through m-Health technology. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Relating Teacher PCK and Teacher Practice Using Classroom Observation

    Science.gov (United States)

    Barendsen, Erik; Henze, Ineke

    2017-09-01

    Science teachers' pedagogical content knowledge (PCK) has been researched in many studies, yet little empirical evidence has been found to determine how this knowledge actually informs teachers' actions in the classroom. To complement previous quantitative studies, there is a need for more qualitative studies to investigate the relationship between teacher knowledge (as formulated by the teacher) and classroom practice, especially in the context of an educational innovation. In this study we explored a possible way to investigate this relationship in an in-depth and systematic fashion. To this end, we conducted a case study with a chemistry teacher in the context of the implementation of a context-based science curriculum in The Netherlands. The teacher's PCK was captured using the Content Representation form by Loughran, Mulhall, and Berry. We used an observation table to monitor classroom interactions in such a way that the observations could be related to specific elements of teachers' PCK. Thus, we were able to give a detailed characterization of the correspondences and differences between the teacher's personal PCK and classroom practice. Such an elaborate description turned out to be a useful basis for discussing mechanisms explaining the relationship between teachers' knowledge and teachers' actions.

  12. The Psychological Benefits from Reconceptualizing Music-Making as Mindfulness Practice.

    Science.gov (United States)

    Steinfeld, Matthew; Brewer, Judson

    2015-06-01

    While the music psychology and education literatures have devoted considerable attention to how musical instrumentalists practice their instruments, less formal scholarly attention has been given in consideration of what it means to maintain a musical "practice" over time and across context. In this paper, the practice of mindfulness meditation is used as heuristic, arguing for a view of mindfulness meditation as a formalized de-specialization of the infinite number of other activities with which people can achieve mindfulness. Sitting meditation, requiring of one to observe the contents of their mind unmediated, can serve as a useful model for the musician in understanding the phenomenology of the music-making process and the "flow" states that can result from an embodied musical practice. Finally, reconceptualizing music-making as a mindfulness practice is considered with psychological and pedagogical implications relevant for developing musicians.

  13. Economic benefits of less restrictive regulation of advanced practice nurses in North Carolina.

    Science.gov (United States)

    Conover, Chris; Richards, Robert

    2015-01-01

    With looming provider shortages and increased demand for health care, many states are looking for low-cost ways to alleviate the shortages. The purpose of this study was to assess the economic impact of less restrictive regulations for advanced practice registered nurses (APRNs) in North Carolina. We use economic impact analysis to demonstrate the economic impacts of making state scope-of-practice regulations on APRNs less restrictive in North Carolina. Outcomes include economic output, value-added, payroll compensation, employment, and tax revenue for North Carolina and for various subregions. If North Carolina adopted the same approach to APRN regulation as the least restrictive states, its economy will benefit from substantial increases in economic output and employment. The state will also see increases in tax revenue. In addition to substantially shrinking the size of projected physician shortages, allowing full scope-of-practice for APRNs will bring significant economic benefits to the state of North Carolina. Our analysis should be helpful to policy makers considering ways to deal with provider shortages. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Clinician-Reported Outcome Assessments of Treatment Benefit: Report of the ISPOR Clinical Outcome Assessment Emerging Good Practices Task Force.

    Science.gov (United States)

    Powers, John H; Patrick, Donald L; Walton, Marc K; Marquis, Patrick; Cano, Stefan; Hobart, Jeremy; Isaac, Maria; Vamvakas, Spiros; Slagle, Ashley; Molsen, Elizabeth; Burke, Laurie B

    2017-01-01

    A clinician-reported outcome (ClinRO) assessment is a type of clinical outcome assessment (COA). ClinRO assessments, like all COAs (patient-reported, observer-reported, or performance outcome assessments), are used to 1) measure patients' health status and 2) define end points that can be interpreted as treatment benefits of medical interventions on how patients feel, function, or survive in clinical trials. Like other COAs, ClinRO assessments can be influenced by human choices, judgment, or motivation. A ClinRO assessment is conducted and reported by a trained health care professional and requires specialized professional training to evaluate the patient's health status. This is the second of two reports by the ISPOR Clinical Outcomes Assessment-Emerging Good Practices for Outcomes Research Task Force. The first report provided an overview of COAs including definitions important for an understanding of COA measurement practices. This report focuses specifically on issues related to ClinRO assessments. In this report, we define three types of ClinRO assessments (readings, ratings, and clinician global assessments) and describe emerging good measurement practices in their development and evaluation. The good measurement practices include 1) defining the context of use; 2) identifying the concept of interest measured; 3) defining the intended treatment benefit on how patients feel, function, or survive reflected by the ClinRO assessment and evaluating the relationship between that intended treatment benefit and the concept of interest; 4) documenting content validity; 5) evaluating other measurement properties once content validity is established (including intra- and inter-rater reliability); 6) defining study objectives and end point(s) objectives, and defining study end points and placing study end points within the hierarchy of end points; 7) establishing interpretability in trial results; and 8) evaluating operational considerations for the implementation of

  15. Scientific Teaching: Defining a Taxonomy of Observable Practices

    Science.gov (United States)

    Couch, Brian A.; Brown, Tanya L.; Schelpat, Tyler J.; Graham, Mark J.; Knight, Jennifer K.

    2015-01-01

    Over the past several decades, numerous reports have been published advocating for changes to undergraduate science education. These national calls inspired the formation of the National Academies Summer Institutes on Undergraduate Education in Biology (SI), a group of regional workshops to help faculty members learn and implement interactive teaching methods. The SI curriculum promotes a pedagogical framework called Scientific Teaching (ST), which aims to bring the vitality of modern research into the classroom by engaging students in the scientific discovery process and using student data to inform the ongoing development of teaching methods. With the spread of ST, the need emerges to systematically define its components in order to establish a common description for education researchers and practitioners. We describe the development of a taxonomy detailing ST’s core elements and provide data from classroom observations and faculty surveys in support of its applicability within undergraduate science courses. The final taxonomy consists of 15 pedagogical goals and 37 supporting practices, specifying observable behaviors, artifacts, and features associated with ST. This taxonomy will support future educational efforts by providing a framework for researchers studying the processes and outcomes of ST-based course transformations as well as a concise guide for faculty members developing classes. PMID:25713097

  16. Benefits and Limitations of Real Options Analysis for the Practice of River Flood Risk Management

    Science.gov (United States)

    Kind, Jarl M.; Baayen, Jorn H.; Botzen, W. J. Wouter

    2018-04-01

    Decisions on long-lived flood risk management (FRM) investments are complex because the future is uncertain. Flexibility and robustness can be used to deal with future uncertainty. Real options analysis (ROA) provides a welfare-economics framework to design and evaluate robust and flexible FRM strategies under risk or uncertainty. Although its potential benefits are large, ROA is hardly used in todays' FRM practice. In this paper, we investigate benefits and limitations of a ROA, by applying it to a realistic FRM case study for an entire river branch. We illustrate how ROA identifies optimal short-term investments and values future options. We develop robust dike investment strategies and value the flexibility offered by additional room for the river measures. We benchmark the results of ROA against those of a standard cost-benefit analysis and show ROA's potential policy implications. The ROA for a realistic case requires a high level of geographical detail, a large ensemble of scenarios, and the inclusion of stakeholders' preferences. We found several limitations of applying the ROA. It is complex. In particular, relevant sources of uncertainty need to be recognized, quantified, integrated, and discretized in scenarios, requiring subjective choices and expert judgment. Decision trees have to be generated and stakeholders' preferences have to be translated into decision rules. On basis of this study, we give general recommendations to use high discharge scenarios for the design of measures with high fixed costs and few alternatives. Lower scenarios may be used when alternatives offer future flexibility.

  17. Deregulation of allopathic prescription and medical practice in India: Benefits and pitfalls

    Directory of Open Access Journals (Sweden)

    Raman Kumar

    2016-01-01

    Full Text Available In the background of debates on Universal Health Coverage, skill transfer from the medical practice license holders to other health-care providers such as nurse practitioner has become a global norm. In India, where the world's largest numbers of medical graduates are produced, this discussion is expanding to extremes and serious suggestions are coming forward for the development of legal framework for allowing dentists, homeopaths, pharmacists, and half duration trained doctors; permission to issue allopathic prescription. Allopathic medical prescription. It is noteworthy that this discussion only pertains to the pharmaceutical products retailed through “allopathic medical prescriptions.” A prescription is not only advice for patient's recovery but it also is a legitimate order for the sale of controlled drugs and pharmaceutical product; thereby functions as a regulatory tool for consumption of pharmaceutical products at retail level. Who is ultimately going to benefit from this prescription deregulation? This editorial explores benefits and pitfalls of prescription and medical practice deregulation.

  18. Observations on Citation Practices in Mathematics Education Research. Research Commentary

    Science.gov (United States)

    Leatham, Keith R.

    2015-01-01

    The author argues that the field of mathematics education as a whole can and should improve its citation practices. He discusses 4 forms of citation practice and considers how they vary with respect to transparency of voice. He also discusses several ways that citation practices may misrepresent cited authors' ideas. He concludes with suggestions…

  19. Scientific teaching: defining a taxonomy of observable practices.

    Science.gov (United States)

    Couch, Brian A; Brown, Tanya L; Schelpat, Tyler J; Graham, Mark J; Knight, Jennifer K

    2015-03-02

    Over the past several decades, numerous reports have been published advocating for changes to undergraduate science education. These national calls inspired the formation of the National Academies Summer Institutes on Undergraduate Education in Biology (SI), a group of regional workshops to help faculty members learn and implement interactive teaching methods. The SI curriculum promotes a pedagogical framework called Scientific Teaching (ST), which aims to bring the vitality of modern research into the classroom by engaging students in the scientific discovery process and using student data to inform the ongoing development of teaching methods. With the spread of ST, the need emerges to systematically define its components in order to establish a common description for education researchers and practitioners. We describe the development of a taxonomy detailing ST's core elements and provide data from classroom observations and faculty surveys in support of its applicability within undergraduate science courses. The final taxonomy consists of 15 pedagogical goals and 37 supporting practices, specifying observable behaviors, artifacts, and features associated with ST. This taxonomy will support future educational efforts by providing a framework for researchers studying the processes and outcomes of ST-based course transformations as well as a concise guide for faculty members developing classes. © 2015 B. A. Couch et al. CBE—Life Sciences Education © 2015 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

  20. Observational study of food safety practices in retail deli departments.

    Science.gov (United States)

    Lubran, M B; Pouillot, R; Bohm, S; Calvey, E M; Meng, J; Dennis, S

    2010-10-01

    In order to improve the safety of refrigerated ready-to-eat food products prepared at retail deli departments, a better understanding of current practices in these establishments is needed. Food employees in deli departments at six chain and three independent retail establishments in Maryland and Virginia were observed, using notational analysis, as they prepared deli products for sale. The frequency of contact with objects and deli products before sale, hand washing and glove changing during preparation, and equipment, utensil, and surface cleaning and sanitizing was determined. Compliance with the U.S. Food and Drug Administration's 2005 model Food Code recommendations, which must be adopted by the individual state and local jurisdictions that are responsible for directly regulating retail establishments, was also assessed. Observations indicated there were a large number of actions for which hand washing was recommended at independent and chain stores (273 recommended of 1,098 total actions and 439 recommended of 3,073 total actions, respectively). Moreover, 67% (295 of 439) of the actions for which hand washing was recommended at the chain stores and 86% (235 of 273) of those at the independent stores resulted from employees touching non-food contact surfaces prior to handling ready-to-eat food. Compliance with hand washing recommendations was generally low and varied depending on store type with independent stores exhibiting lower compliance than chain stores (5 instances of compliance for 273 recommended actions and 73 instances of compliance for 439 recommended actions, respectively). Potential risk mitigation measures that may reduce the frequency of hand washing actions needed during ready-to-eat food preparation in retail deli departments are discussed. More research is needed to determine the impact of such measures on food safety.

  1. Practice development: providing benefits for both managers and older patients with delerium and dementia.

    Science.gov (United States)

    Bezzant, Kim

    2008-03-01

    This article describes the ways in which practice development can aid Nurse Managers to enhance both efficiency and effectiveness, focussing particularly on the care of older people with delerium and dementia. Practitioners caring for this group of patients in acute general hospitals need specialist skills, particularly skills in working with the unusual ('challenging') behaviours that these patients often exhibit. These skills are rarely present at the point of registration but practice development techniques can facilitate the acquisition of appropriate skills with resultant benefits for both patients and organization. The study contains an outline of the ways in which a practice development approach can be delivered and appraised: the theories are outlined, strategies for delivery of the techniques are described and methods of evaluation are suggested. These theories and techniques are being applied in a project in Portsmouth called 'Rise to the Challenge', which has the specific aim of improving the care of people with delerium and dementia in an acute hospital setting. This project is currently running and will be evaluated in the summer of 2008.

  2. Benefits and risks of adopting the global code of practice for recreational fisheries

    Science.gov (United States)

    Arlinghaus, Robert; Beard, T. Douglas; Cooke, Steven J.; Cowx, Ian G.

    2012-01-01

    Recreational fishing constitutes the dominant or sole use of many fish stocks, particularly in freshwater ecosystems in Western industrialized countries. However, despite their social and economic importance, recreational fisheries are generally guided by local or regional norms and standards, with few comprehensive policy and development frameworks existing across jurisdictions. We argue that adoption of a recently developed Global Code of Practice (CoP) for Recreational Fisheries can provide benefits for moving recreational fisheries toward sustainability on a global scale. The CoP is a voluntary document, specifically framed toward recreational fisheries practices and issues, thereby complementing and extending the United Nation's Code of Conduct for Responsible Fisheries by the Food and Agricultural Organization. The CoP for Recreational Fisheries describes the minimum standards of environmentally friendly, ethically appropriate, and—depending on local situations—socially acceptable recreational fishing and its management. Although many, if not all, of the provisions presented in the CoP are already addressed through national fisheries legislation and state-based fisheries management regulations in North America, adopting a common framework for best practices in recreational fisheries across multiple jurisdictions would further promote their long-term viability in the face of interjurisdictional angler movements and some expanding threats to the activity related to shifting sociopolitical norms.

  3. Realizing NASA's Goal of Societal Benefits From Earth Observations in Mesoamerica Through the SERVIR Project

    Science.gov (United States)

    Hardin, D. M.; Irwin, D.; Sever, T.; Graves, S.

    2006-12-01

    One of the goals of NASA's Applied Sciences Program is to manifest societal benefits from the vast store of Earth Observations through partnerships with public, private and academic organizations. The SERVIR project represents an early success toward this goal. By combining Earth Observations from NASA missions, results from environmental models and decision support tools from its partners the SERVIR project has produced an integrated systems solution that is yielding societal benefits for the region of Mesoamerica. The architecture of the SERVIR system consists of an operational facility in Panama with regional nodes in Costa Rica, Nicaragua, Honduras, Guatemala, El Salvador and Belize plus a Rapid Prototyping Center (RPC), located in Huntsville, Alabama. The RPC, funded by NASA's Applied Sciences Division, and developed by the Information Technology and Systems Center at the University of Alabama in Huntsville, and NASA Marshall Space Flight Center, produces scientifically strong decision support products and applications. When mature, the products and applications migrate to the operational center in Panama. There, they are available to environmental ministers and decision makers in Mesoamerica. In June 2004, the SERVIR project was contacted by the environmental ministry of El Salvador, which urgently requested remote sensing imagery of the location, direction, and extent of a HAB event off the coast of El Salvador and Guatemala. Using MODIS data the SERVIR team developed a value added product that predicts the location, direction, and extent of HABs. The products are produced twice daily and are used by the El Salvadoran and Guatemalan governments to alert their tourism and fishing industries of potential red tide events. This has enabled these countries to save millions of dollars for their industries as well as improve the health of harvested fish. In the area of short term weather forecasting the SERVIR team, in collaboration with the NASA Short

  4. Maternal symptoms of depression are related to observations of controlling feeding practices in mothers of young children.

    Science.gov (United States)

    Haycraft, Emma; Farrow, Claire; Blissett, Jackie

    2013-02-01

    Maternal depression can impair parenting practices and has been linked with less sensitive feeding interactions with children, but existing research is based on self-reports of feeding practices. This study examined relationships between maternal self-reported symptoms of depression with observations of mothers' child feeding practices during a mealtime. Fifty-eight mothers of 3- and 4-year-old children were video recorded eating a standardized lunch. The recording was then coded for instances of maternal controlling feeding practices and maternal vocalizations using the Family Mealtime Coding System. Mothers also provided information on current symptoms of depression and anxiety. Mothers who reported greater symptoms of depression were observed to use more verbal and physical pressure for their child to eat and to offer more incentives or conditions in exchange for their child eating. Mothers also used more vocalizations with their child about food during the observed mealtime when they had greater symptoms of depression. There was no link between symptoms of depression and observations of maternal use of restriction. Symptoms of depression are linked with observations of mothers implementing a more controlling, less sensitive feeding style with their child. Health professionals working with families in which mothers have symptoms of depression may benefit from receiving training about the possible impact of maternal depression on child-feeding practices, and mothers with symptoms of depression may benefit from guidance regarding its potential impact on their child-feeding interactions. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  5. Developing an Arctic Observing Network: Looking Beyond Scientific Research as a Driver to Broader Societal Benefits as Drivers

    Science.gov (United States)

    Jeffries, M. O.

    2017-12-01

    This presentation will address the first ever application of the Societal Benefit Areas approach to continuing efforts to develop an integrated pan-Arctic Observing Network. The scientific research community has been calling for an Arctic Observing Network since the early years of this century, at least. There is no question of the importance of research-driven observations at a time when rapid changes occurring throughout the Arctic environmental system are affecting people and communities in the Arctic and in regions far from the Arctic. Observations are need for continued environmental monitoring and change detection; improving understanding of how the system and its components function, and how they are connected to lower latitude regions; advancing numerical modeling capabilities for forecasting and projection; and developing value-added products and services for people and communities, and for decision- and policymaking. Scientific research is, without question, a benefit to society, but the benefits of Earth observations extend beyond scientific research. Societal Benefit Areas (SBAs) were first described by the international Group on Earth Observations (GEO) and have since been used by USGEO as the basis for its National Earth Observation Assessments. The most recent application of SBAs to Earth observing realized a framework of SBAs, SBA Sub-areas, and Key Objectives required for the completion of a full Earth observing assessment for the Arctic. This framework, described in a report released in June 2017, and a brief history of international efforts to develop an integrated pan-Arctic Observing Network, are the subjects of this presentation.

  6. PROMOTING NATURA 2000 NETWORK BENEFITS FOR LOCAL COMMUNITIES BY PRACTICING ECOTOURISM AND AGROTOURISM

    Directory of Open Access Journals (Sweden)

    Mirela STANCIU

    2014-04-01

    Full Text Available This paper presents the benefits of the local communities across Natura 2000 sites. Human activities in these areas should take into account the economic, social, cultural, and environmental protection. It examines the most common problems encountered in forests, pastures and hayfields in the area of Natura 2000 sites. There are some examples of good practice exemplified by the activities of farmers living on the radius of Natura 2000 sites in different European countries. Natura 2000 sites are suitable for development of eco-tourism and agro-tourism based on tradition and organic products, which may lead to a brand. Tourism and specifically eco-friendly tourism industries (ecotourism, agrotourism, etc. are encouraging development areas at regional and national Natura 2000 sites as a sustainable opportunity for people and nature.

  7. Energy information systems (EIS): Technology costs, benefit, and best practice uses

    Energy Technology Data Exchange (ETDEWEB)

    Granderson, Jessica; Lin, Guanjing; Piette, Mary Ann

    2013-11-26

    Energy information systems are the web-based software, data acquisition hardware, and communication systems used to store, analyze, and display building energy data. They often include analysis methods such as baselining, benchmarking, load profiling, and energy anomaly detection. This report documents a large-scale assessment of energy information system (EIS) uses, costs, and energy benefits, based on a series of focused case study investigations that are synthesized into generalizable findings. The overall objective is to provide organizational decision makers with the information they need to make informed choices as to whether or not to invest in an EIS--a promising technology that can enable up to 20 percent site energy savings, quick payback, and persistent low-energy performance when implemented as part of best-practice energy management programs.

  8. Benefits, pitfalls and risks of phytotherapy in clinical practice in otorhinolaryngology.

    Science.gov (United States)

    Laccourreye, O; Werner, A; Laccourreye, L; Bonfils, P

    2017-04-01

    To elucidate the benefits, pitfalls and risks of phytotherapy in the clinical practice of otorhinolaryngology. The PubMed and Cochrane databases were searched using the following keywords: phytotherapy, phytomedicine, herbs, otology, rhinology, laryngology, otitis, rhinitis, laryngitis and otorhinolaryngology. Seventy-two articles (18 prospective randomized studies, 4 Cochrane analyses, 4 meta-analysis and 15 reviews of the literature) devoted to clinical studies were analyzed. Articles devoted to in vitro or animal studies, biochemical analyses or case reports (including fewer than 10 patients) and articles dealing with honey, aromatherapy or minerals were excluded. Per os ginkgo biloba has no indications in tinnitus, presbycusis or anosmia following viral rhinitis. Traditional Asian medicine has no proven benefit in sudden deafness or laryngeal papillomatosis. Per os mistletoe extracts associated to conventional treatment for head and neck squamous cell carcinoma does not increase 5-year survival. Extracts of various herbs, notably echinacea, eucalyptus, petasites hybridus, pelargonium sidoides, rosemary, spirulina and thyme, show superiority over placebo for rhinosinusitis and allergic rhinitis, as does gingko biloba for selected vertigo. There have been encouraging preliminary results for intratumoral injection of mistletoe in head and neck carcinoma and acupoint herbal patching for allergic rhinitis. Herb intake should be screened for in case of certain unexplained symptoms such as epistaxis, headache or dizziness, or signs suggesting allergy. Phytotherapy should be interrupted ahead of surgery and/or chemotherapy. Scientific proof of the benefit of phytotherapy in otorhinolaryngology remains to be established but, given its widespread use and the reported data, knowledge of this form of treatment needs to be developed. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  9. Lightweight Data Systems in the Cloud: Costs, Benefits and Best Practices

    Science.gov (United States)

    Fatland, R.; Arendt, A. A.; Howe, B.; Hess, N. J.; Futrelle, J.

    2015-12-01

    We present here a simple analysis of both the cost and the benefit of using the cloud in environmental science circa 2016. We present this set of ideas to enable the potential 'cloud adopter' research scientist to explore and understand the tradeoffs in moving some aspect of their compute work to the cloud. We present examples, design patterns and best practices as an evolving body of knowledge that help optimize benefit to the research team. Thematically this generally means not starting from a blank page but rather learning how to find 90% of the solution to a problem pre-built. We will touch on four topics of interest. (1) Existing cloud data resources (NASA, WHOI BCO DMO, etc) and how they can be discovered, used and improved. (2) How to explore, compare and evaluate cost and compute power from many cloud options, particularly in relation to data scale (size/complexity). (3) What are simple / fast 'Lightweight Data System' procedures that take from 20 minutes to one day to implement and that have a clear immediate payoff in environmental data-driven research. Examples include publishing a SQL Share URL at (EarthCube's) CINERGI as a registered data resource and creating executable papers on a cloud-hosted Jupyter instance, particularly iPython notebooks. (4) Translating the computational terminology landscape ('cloud', 'HPC cluster', 'hadoop', 'spark', 'machine learning') into examples from the community of practice to help the geoscientist build or expand their mental map. In the course of this discussion -- which is about resource discovery, adoption and mastery -- we provide direction to online resources in support of these themes.

  10. A practical approach to risk-benefit estimation in pediatric drug research.

    Science.gov (United States)

    Koren, Gideon

    2015-02-01

    One of the most difficult challenges in pediatric drug research is in exposing children to risk, often without a balanced chance of benefits. While the concept of risk is similar in adult research, the adult patient can decide for himself/herself on an acceptable level of risk, whereas children have to accept the decisions of their guardians. This paper attempts to put the complexities of estimating risk in pediatric drug research into their practical perspective, and to familiarize the reader with the way such processes are conducted in different parts of the world. Although there are regional differences, all authorities typically quantify risks of pediatric research in general, and drug research in particular, in three levels: those experienced in day-to-day life; risks slightly above this 'baseline' risk; and risks substantially above 'baseline risk'. Proportionally, the diligence of the ethics process depends on these levels, as well as on the potential benefits (or lack of) to the child involved in the research. Importantly, risk is context dependent, and a particular intervention may be effective or safe in one setting but not in another, based on local experience, staffing levels, and similar variabilities.

  11. Estimating the harms and benefits of prostate cancer screening as used in common practice versus recommended good practice: A microsimulation screening analysis

    NARCIS (Netherlands)

    S. Carlsson (Sigrid); T.M. de Carvalho Delgado Marques (Tiago); M.J. Roobol-Bouts (Monique); J. Hugosson (Jonas); A. Auvinen (Anssi); M. Kwiatkowski (Maciej); A. Villers (Arnoud); M. Zappa (Marco); V. Nelen (Vera); A. Páez (Alvaro); J.A. Eastham (James); H. Lilja (Hans); H.J. de Koning (Harry); A.J. Vickers (Andrew); E.A.M. Heijnsdijk (Eveline)

    2016-01-01

    textabstractBACKGROUND: Prostate-specific antigen (PSA) screening and concomitant treatment can be implemented in several ways. The authors investigated how the net benefit of PSA screening varies between common practice versus “good practice.”. METHODS: Microsimulation screening analysis (MISCAN)

  12. Compensation and benefit sharing: Why resettlement policies and practices must be reformed

    Institute of Scientific and Technical Information of China (English)

    Michael M. Cernea

    2008-01-01

    Many public and private sector projects, such as hydropower dams or mines, trigger forced population displacement but fail to resettle people sustainably and instead cause their impoverishment. Social science research has found that one root cause of such failures and of impoverishment is asset dispossession and the insufficient financing of resettlement. Most governments, however, state that (1) compensation alone is sufficient for restoring the income and livelihood of those displaced, and (2) resources to supplement compensation with additional financing are not available. The author critiques and rejects these positions. He offers a theoretical analysis of the limits and flaws of compensation payments for expropriated assets, and argues that resources are available for supplementing compensation with financial investments for resettlers' development. The sources for supplementary financing are the economic rent (windfall profits) generated by natural resource projects such as hydropower or mining and the regular stream of benefits generated by all projects that require resettlement. Further, the author argues that financial investments in resettlers' welfare are indispensable and that benefit sharing is feasible. Therefore, both should become basic principles of resettlement legislation and practice. In addition to theoretical analysis, the author documents with empirical evidence that some countries (China, Brazil, Canada, Columbia and Japan) already make investments additional to compensation for post-displacement reconstruction. The author sums up his argument in these key points:(1) Compensation alone cannot prevent the impoverishment of resettlers and cannot in itself restore and improve their livelihoods;(2) Additional financing is needed for direct investments in resettlement with development;(3) Compensation levels must be increased;(4) Financing resources are available in most cases for investing in resettlers' development, but allocation of

  13. Compensation and benefit sharing: Why resettlement policies and practices must be reformed

    Directory of Open Access Journals (Sweden)

    Michael M. Cernea

    2008-03-01

    Full Text Available Many public and private sector projects, such as hydropower dams or mines, trigger forced population displacement but fail to resettle people sustainably and instead cause their impoverishment. Social science research has found that one root cause of such failures and of impoverishment is asset dispossession and the insufficient financing of resettlement. Most governments, however, state that (1 compensation alone is sufficient for restoring the income and livelihood of those displaced, and (2 resources to supplement compensation with additional financing are not available. The author critiques and rejects these positions. He offers a theoretical analysis of the limits and flaws of compensation payments for expropriated assets, and argues that resources are available for supplementing compensation with financial investments for resettlers’ development. The sources for supplementary financing are the economic rent (windfall profits generated by natural resource projects such as hydropower or mining and the regular stream of benefits generated by all projects that require resettlement. Further, the author argues that financial investments in resettlers’ welfare are indispensable and that benefit sharing is feasible. Therefore, both should become basic principles of resettlement legislation and practice. In addition to theoretical analysis, the author documents with empirical evidence that some countries (China, Brazil, Canada, Columbia and Japan already make investments additional to compensation for post-displacement reconstruction. The author sums up his argument in these key points: (1Compensation alone cannot prevent the impoverishment of resettlers and cannot in itself restore and improve their livelihoods; (2Additional financing is needed for direct investments in resettlement with development; (3Compensation levels must be increased; (4Financing resources are available in most cases for investing in resettlers’ development, but

  14. Practical performance evaluation of the Wave Glider in geophysical observations

    Science.gov (United States)

    Sugioka, Hiroko; Hamano, Yozo

    2016-04-01

    The Wave Glider (WG), manufactured by Liquid Robotics Inc. of California, USA, is the first wave and solar powered autonomous sea surface vehicle. It has led the way to make ocean data collection and communications easier and safer, lower risk and cost, and real-time. By analyzing data from a long-term deployment of the WG in the sea to investigate the feasibility, an assessment of operating characteristics informs the potential utility of the WG to identify the parameters for a seafloor experiment designed the WG as a station-keeping gateway. We apply the WG in the following two observation systems that we have been developing. First, after the 2011 Tohoku earthquake tsunami, we have developed a real-time offshore tsunami monitoring system using a new type of seafloor tsunami sensor called Vector TsunaMeter (VTM) able to directly estimate the tsunami propagation vector based on the electromagnetic induction theory to provide early and reliable information at the coastal area. The WG equipped with both an acoustic modem and a satellite communication modem is used in the system as a relay platform for data transfer and communications between the sea bottom observatory and the land station. We had some experiments beginning with newly developing of the VTM in November 2012 to complete as a real-time monitoring system using the WG in March 2014. During the last experiment, we succeeded in detecting the micro-tsunami associated with the 2014 Iquique, Chile earthquake with Mw 8.2 on April 1 to confirm the practical utility of the WG. Second, since the Nishinoshima volcano of the Bonin Islands erupted in November 2013, we have been developing an isolated volcanic activity monitoring system using the unmanned WG vehicle. In this system the WG plays roles not only in a relay station with a satellite communication modem but also in a multi-purpose observatory platform with microphone for detecting acoustic waves in the air due to eruptions, with hydrophones for detecting

  15. Looking beyond borders: integrating best practices in benefit-risk analysis into the field of food and nutrition.

    Science.gov (United States)

    Tijhuis, M J; Pohjola, M V; Gunnlaugsdóttir, H; Kalogeras, N; Leino, O; Luteijn, J M; Magnússon, S H; Odekerken-Schröder, G; Poto, M; Tuomisto, J T; Ueland, O; White, B C; Holm, F; Verhagen, H

    2012-01-01

    An integrated benefit-risk analysis aims to give guidance in decision situations where benefits do not clearly prevail over risks, and explicit weighing of benefits and risks is thus indicated. The BEPRARIBEAN project aims to advance benefit-risk analysis in the area of food and nutrition by learning from other fields. This paper constitutes the final stage of the project, in which commonalities and differences in benefit-risk analysis are identified between the Food and Nutrition field and other fields, namely Medicines, Food Microbiology, Environmental Health, Economics and Marketing-Finance, and Consumer Perception. From this, ways forward are characterized for benefit-risk analysis in Food and Nutrition. Integrated benefit-risk analysis in Food and Nutrition may advance in the following ways: Increased engagement and communication between assessors, managers, and stakeholders; more pragmatic problem-oriented framing of assessment; accepting some risk; pre- and post-market analysis; explicit communication of the assessment purpose, input and output; more human (dose-response) data and more efficient use of human data; segmenting populations based on physiology; explicit consideration of value judgments in assessment; integration of multiple benefits and risks from multiple domains; explicit recognition of the impact of consumer beliefs, opinions, views, perceptions, and attitudes on behaviour; and segmenting populations based on behaviour; the opportunities proposed here do not provide ultimate solutions; rather, they define a collection of issues to be taken account of in developing methods, tools, practices and policies, as well as refining the regulatory context, for benefit-risk analysis in Food and Nutrition and other fields. Thus, these opportunities will now need to be explored further and incorporated into benefit-risk practice and policy. If accepted, incorporation of these opportunities will also involve a paradigm shift in Food and Nutrition benefit

  16. Optimization Of Methodological Support Of Application Tax Benefits In Regions: Practice Of Perm Region

    Directory of Open Access Journals (Sweden)

    Alexandr Ivanovich Tatarkin

    2015-03-01

    Full Text Available In the article, the problem of the methodological process support of regional tax benefits is reviewed. The method of tax benefits assessment, accepted in Perm Region, was chosen as an analysis object because the relatively long period of application of benefits has allowed to build enough statistics base. In the article, the reliability of budget, economic, investment, and social effectiveness assessments of application benefits, based on the Method, is investigated. The suggestions of its perfection are formulated

  17. An Observational Study of Intermediate Band Students' Self-Regulated Practice Behaviors

    Science.gov (United States)

    Miksza, Peter; Prichard, Stephanie; Sorbo, Diana

    2012-01-01

    The purpose of this study was to investigate intermediate musicians' self-regulated practice behaviors. Thirty sixth- through eighth-grade students were observed practicing band repertoire individually for 20 min. Practice sessions were coded according to practice frame frequency and duration, length of musical passage selected, most prominent…

  18. Job satisfaction of practice assistants in general practice in Germany: an observational study

    NARCIS (Netherlands)

    Goetz, K.; Campbell, S.; Broge, B.; Brodowski, M.; Steinhaeuser, J.; Wensing, M.; Szecsenyi, J.

    2013-01-01

    BACKGROUND: Job satisfaction of practice staff is important for optimal health care delivery and for minimizing the turnover of non-medical professions. OBJECTIVE: To document the job satisfaction of practice assistants in German general practice and to explore associations between job satisfaction,

  19. The Eldicus prospective, observational study of triage decision making in European intensive care units. Part II: Intensive care benefit for the elderly

    DEFF Research Database (Denmark)

    Sprung, Charles L; Artigas, Antonio; Kesecioglu, Jozef

    2012-01-01

    on mortality and intensive care unit benefit, specifically for elderly patients. DESIGN:: Prospective, observational study of triage decisions from September 2003 until March 2005. SETTING:: Eleven intensive care units in seven European countries. PATIENTS:: All patients >18 yrs with an explicit request......RATIONALE:: Life and death triage decisions are made daily by intensive care unit physicians. Admission to an intensive care unit is denied when intensive care unit resources are constrained, especially for the elderly. OBJECTIVE:: To determine the effect of intensive care unit triage decisions...... care unit rejections than younger patients and have a higher mortality when admitted, the mortality benefit appears greater for the elderly. Physicians should consider changing their intensive care unit triage practices for the elderly....

  20. Classroom Observation Practice in Career Schools: A Multiple Case Study

    Science.gov (United States)

    Withers, Marya G.

    2017-01-01

    Post-secondary career school educational leaders are charged with formulating sufficient, ongoing, and effective faculty development programming to ensure the delivery of quality education in their unique trade-expert led institutions. Classroom observations, which include substantive feedback exchanges from trained personnel are well documented…

  1. Peer Observation of Teaching: A Practical Tool in Higher Education

    Science.gov (United States)

    Fletcher, Jeffrey A.

    2018-01-01

    There are limited viewpoints in the literature about peer observation of teaching in higher education and how it can be an effective tool to improve the quality of instruction in the classroom (Bell, 2001; Bell, 2005; Bell & Mladenovic, 2008; Brancato, 2003; Chism, 2007; Huston & Weaver, 2008; Shortland, 2004; Shortland, 2010; Smith,…

  2. Observational Learning on Industry Work Practices toward Job Readiness

    Science.gov (United States)

    Rojuli, Subkhan; Rahayu, Agus; Disman

    2017-01-01

    This research aims to find out the influence of observational learning on job readiness based on some indicators and variables. This is a quantitative research in which Structural Equation Modeling (SEM) was used. The research method is survey. The participants of this research are the Grade XII students of Accountancy Department of State…

  3. Healthcare benefits linked with Below Poverty Line registration in India: Observations from Maharashtra Anaemia Study (MAS).

    Science.gov (United States)

    Ahankari, Anand; Fogarty, Andrew; Tata, Laila; Myles, Puja

    2017-01-01

    A 2015 Lancet paper by Patel et al. on healthcare access in India comprehensively discussed national health programmes where some benefits are linked with the country's Below Poverty Line (BPL) registration scheme. BPL registration aims to support poor families by providing free/subsidised healthcare. Technical issues in obtaining BPL registration by poor families have been previously reported in the Indian literature; however there are no data on family assets of BPL registrants. Here, we provide evidence of family-level assets among BPL registration holders (and non-BPL households) using original research data from the Maharashtra Anaemia Study (MAS). Social and health data from 287 pregnant women and 891 adolescent girls (representing 1178 family households) across 34 villages in Maharashtra state, India, were analysed. Several assets were shown to be similarly distributed between BPL and non-BPL households; a large proportion of families who would probably be eligible were not registered, whereas BPL-registered families often had significant assets that should not make them eligible. This is likely to be the first published evidence where asset distribution such as agricultural land, housing structures and livestock are compared between BPL and non-BPL households in a rural population. These findings may help planning BPL administration to allocate health benefits equitably, which is an integral part of national health programmes.

  4. 'Holistic Engineers' Observed through the Practice Looking-Glass

    DEFF Research Database (Denmark)

    Buch, Anders

    2013-01-01

    Many observers, policy makers, educationalists and industry representatives have called for reforms of engineering education that stress more ‘holistic’ and less disciplinary approaches to engineering problem solving (Buch 2012). And some reform initiatives within engineering education in Denmark...... and collaborative work space it turned out to be a forum for reactive and coordinative problem solving....... have indeed perused these ambitions. Problem based learning (PBL) has been implemented in engineering education at Aalborg University (Graff & Kolmos 2003) and a progressive ‘Design and Innovation’ engineering programme have been launched at the Technical University of Denmark (Jørgensen & Valderrama...

  5. Multijurisdictional practice and the health lawyer: will your practice benefit from the new ABA model rules of professional conduct?

    Science.gov (United States)

    Pomerance, Philip L

    2004-01-01

    At the end of the twentieth century, bar scholars and regulators were reexamining two traditionally improper aspects of legal practice. The first was the multidisciplinary practice of law, which would permit lawyers to offer accounting and other professional services to their clients, and allow lawyers to share fees with non-lawyers. The second was the multijurisdictional practice of law, which would permit a lawyer licensed in one jurisdiction to practice law in other jurisdiction in which he was not admitted to the bar. Enron and other corporate scandals deflated the movement towards multidisciplinary practice, but the movement to allow multijurisdictional practice bore some limited, yet important, results. This Article argues that the American Bar Association's new Model Rules 5.5 and 8.5, which broaden the ability of healthcare lawyers to practice outside of the states in which they are admitted, are a suitable accommodation to today's mode of practice, while still preserving the states' ability to regulate lawyers and protect clients.

  6. Practical implementation of Channelized Hotelling Observers: Effect of ROI size.

    Science.gov (United States)

    Ferrero, Andrea; Favazza, Christopher P; Yu, Lifeng; Leng, Shuai; McCollough, Cynthia H

    2017-03-01

    Fundamental to the development and application of channelized Hotelling observer (CHO) models is the selection of the region of interest (ROI) to evaluate. For assessment of medical imaging systems, reducing the ROI size can be advantageous. Smaller ROIs enable a greater concentration of interrogable objects in a single phantom image, thereby providing more information from a set of images and reducing the overall image acquisition burden. Additionally, smaller ROIs may promote better assessment of clinical patient images as different patient anatomies present different ROI constraints. To this end, we investigated the minimum ROI size that does not compromise the performance of the CHO model. In this study, we evaluated both simulated images and phantom CT images to identify the minimum ROI size that resulted in an accurate figure of merit (FOM) of the CHO's performance. More specifically, the minimum ROI size was evaluated as a function of the following: number of channels, spatial frequency and number of rotations of the Gabor filters, size and contrast of the object, and magnitude of the image noise. Results demonstrate that a minimum ROI size exists below which the CHO's performance is grossly inaccurate. The minimum ROI size is shown to increase with number of channels and be dictated by truncation of lower frequency filters. We developed a model to estimate the minimum ROI size as a parameterized function of the number of orientations and spatial frequencies of the Gabor filters, providing a guide for investigators to appropriately select parameters for model observer studies.

  7. Benefit and outcome of using temozolomide-based chemoradiotherapy followed by temozolomide alone for glioblastoma in clinical practice.

    Science.gov (United States)

    Salma, Svetlana; Djan, Igor; Bjelan, Mladen; Vulekovic, Petar; Novakovic, Mico; Vidovic, Vladimir; Lucic, Milos

    2017-01-01

    Temozolomide (TEM), an oral alkylating agent, has shown promising activity in the last 10 years in the treatment of glioblastoma multiforme (GBM). Our goal was to show the benefit of concomitant therapy involving 3D conformal radiotherapy and temozolomide in clinical practice. This was a retrospective/prospective study and included a total of 113 patients with GBM diagnosis. Forty- seven patients received postoperative radiotherapy and 66 received concomitant temozolomide plus 3D conformal radiotherapy. The mean overall survival of patients who received postoperative radiotherapy alone was 9.93±6.475 months, compared to statistically longer overall survival in the group of patients who received radiotherapy plus temozolomide (13.89±8.049 months) (p=0.006). The latter group was divided into two subgroups, one consisting of patients who received 6 complete cycles of temozolomide, and a second with patients who received incomplete treatment. Statistically significant longer overall survival was registered in the first subgroup compared to the second (p=0.006). The concomitant usage of temozolomide and radiotherapy was beneficial, and statistically significant difference among groups and subgroups was observed regarding overall survival.

  8. Corporate benefits of CSR activities

    OpenAIRE

    Maja Żychlewicz

    2014-01-01

    The main aim of the paper is to present the benefits that a company may derive from socially responsible activities. The paper lists various definitions of CSR that indicate the expected benefits stemming from its use. Both in theory and in practice, there is observed the need for strategic connection between the CSR concept and its real-life benefits.

  9. Corporate benefits of CSR activities

    Directory of Open Access Journals (Sweden)

    Maja Żychlewicz

    2014-11-01

    Full Text Available The main aim of the paper is to present the benefits that a company may derive from socially responsible activities. The paper lists various definitions of CSR that indicate the expected benefits stemming from its use. Both in theory and in practice, there is observed the need for strategic connection between the CSR concept and its real-life benefits.

  10. Optimizing and Enhancing the Integrated Atlantic Ocean Observing System to enhance the societal, scientific and economic benefit

    Science.gov (United States)

    Reitz, Anja; Karstensen, Johannes; Visbeck, Martin; AtlantOS Consortium, the

    2017-04-01

    Atlantic Ocean observation is currently undertaken through loosely-coordinated, in-situ observing networks, satellite observations and data management arrangements of heterogeneous international, national and regional design to support science and a wide range of information products. Thus there is tremendous opportunity to develop the systems towards a fully integrated Atlantic Ocean Observing System consistent with the recently developed 'Framework of Ocean Observing'. The vision of AtlantOS is to improve and innovate Atlantic Ocean observing by establishing an international, more sustainable, more efficient, more integrated, and fit-for-purpose system. Hence, the EU Horizon 2020 project AtlantOS with its 62 partners from 18 countries (European and international) and several members will have a long-lasting and sustainable contribution to the societal, economic and scientific benefit by supporting the full cycle of the integrated ocean observation value chain from requirements via data gathering and observation, product generation, information, prediction, dissemination and stakeholder dialogue towards information and product provision. The benefits will be delivered by improving the value for money, extent, completeness, quality and ease of access to Atlantic Ocean data required by industries, product supplying agencies, scientist and citizens. The overarching target of the AtlantOS initiative is to deliver an advanced framework for the development of an integrated Atlantic Ocean Observing System that goes beyond the state-of -the-art, and leaves a legacy of sustainability after the life of the project. The legacy will derive from the following aims: i) to improve international collaboration in the design, implementation and benefit sharing of ocean observing, ii) to promote engagement and innovation in all aspects of ocean observing, iii) to facilitate free and open access to ocean data and information, iv) to enable and disseminate methods of achieving quality

  11. The Benefits of Simply Observing: Mindful Attention Modulates the Link between Motivation and Behavior

    NARCIS (Netherlands)

    Papies, E.K.; Pronk, T.M.; Keesman, M.; Barsalou, L.W.

    2015-01-01

    Mindful attention, a central component of mindfulness meditation, can be conceived as becoming aware of one’s thoughts and experiences, and being able to observe them as transient mental events. Here, we present a series of studies demonstrating the effects of applying this meta-cognitive

  12. The benefits of simply observing : Mindful attention modulates the link between motivation and behavior

    NARCIS (Netherlands)

    Papies, E.K.; Pronk, T.M.; Keesman, M.; Barsalou, L.

    2015-01-01

    Mindful attention, a central component of mindfulness meditation, can be conceived as becoming aware of one's thoughts and experiences and being able to observe them as transient mental events. Here, we present a series of studies demonstrating the effects of applying this metacognitive perspective

  13. Citizen Scientist Contributions to Observations Benefiting the Earth through the GLOBE Program

    Science.gov (United States)

    Chambers, L. H.; Riebeek Kohl, H.; Murphy, A.; Butler, D. M.

    2017-12-01

    Citizen science has proliferated recently due to widespread use of the internet and mobile devices, but it has a long history (i.e., the Christmas Bird Count). Since the mid-1990s, the GLOBE Program has engaged participants at a global scale. Though initially focused on teachers and students in formal education settings, it quickly attracted interest from the public as well. In 2016, GLOBE formally launched an initiative to widely engage citizen scientists in its 117 countries through release of a mobile app called GLOBE Observer (GO). GO seeks to increase the number and distribution of participants by providing a simple, engaging - and fun - interface to collect and report data. Observations featured in the app are a carefully selected subset of 50+ GLOBE measurement protocols. They must leverage app features, require little to no equipment besides the mobile device, and have scientists or other stakeholders ready to use the data. The app is designed to minimize barriers to participation, but for those who want to do or know more GLOBE also offers on-line training to turn observers into community members with recognized certification in a protocol area. First released was a cloud observation protocol, supporting validation of a variety of Earth imaging sensors. Second was a mosquito habitat mapping protocol, poised to greatly increase the amount and distribution of local data to validate disease forecast models based on remotely sensed conditions, with additional focus on eliminating disease-carrying mosquito breeding sites. Next in development is a land cover protocol to obtain ground truth imagery for the Landsat science team. The app is also being leveraged for quick development of a short-term eclipse mini-app, to be used on August 21st only during the North American eclipse. This app is designed to make it easy for large numbers of people observing the eclipse, throughout North America, to take and record high time resolution observations of cloud cover and

  14. Land surface skin temperature climatology: benefitting from the strengths of satellite observations

    International Nuclear Information System (INIS)

    Jin Menglin; Dickinson, Robert E

    2010-01-01

    Surface skin temperature observations (T skin ), as obtained by satellite remote sensing, provide useful climatological information of high spatial resolution and global coverage that enhances the traditional ground observations of surface air temperature (T air ) and so, reveal new information about land surface characteristics. This letter analyzes nine years of moderate-resolution imaging spectroradiometer (MODIS) skin temperature observations to present monthly skin temperature diurnal, seasonal, and inter-annual variations at a 0.05 deg. latitude/longitude grid over the global land surface and combines these measurements with other MODIS-based variables in an effort to understand the physical mechanisms responsible for T skin variations. In particular, skin temperature variations are found to be closely related to vegetation cover, clouds, and water vapor, but to differ from 2 m surface T air in terms of both physical meaning and magnitude. Therefore, the two temperatures (T skin and T air ) are complementary in their contribution of valuable information to the study of climate change.

  15. Connecting Medical Records: An Evaluation of Benefits and Challenges for Primary Care Practices

    Directory of Open Access Journals (Sweden)

    Deborah Ruth Compeau

    2017-06-01

    Full Text Available Background: Implementation of systems to support health information sharing has lagged other areas of healthcare IT, yet offers a strong possibility for benefit.  Clinical acceptance is a key limiting factor in health IT adoption. Objectives:  To assess the benefits and challenges experienced by clinicians using a custom-developed health information exchange system, and to show how perceptions of benefits and challenges influence perceptions of productivity and care-related outcomes. Methods: We used a mixed methods design with two phases. First, we conducted interviews with stakeholders who were familiar with the health information exchange system to inform the development of a measure of benefits and challenges of the use of this system. Second, using this measure we conducted a survey of current and former users of the health information exchange system using a modified Dillman method. Results: 105 current and former users completed the survey. The results showed information quality, ease of completing tasks and clinical process improvement as key benefits that reduced workload and improved patient care.  Challenges related to system reliability, quality of reports and service quality increased workload and decreased impact on care, though the effect of the challenges was smaller than that of the benefits. Conclusions:  Even very limited health information exchange capabilities can improve outcomes for primary care users.  Improving perceptions of benefits may be even more important the removing challenges to use, though it is likely that a threshold of quality must be achieved for this to be true.

  16. Estimating the harms and benefits of prostate cancer screening as used in common practice versus recommended good practice: A microsimulation screening analysis.

    Science.gov (United States)

    Carlsson, Sigrid V; de Carvalho, Tiago M; Roobol, Monique J; Hugosson, Jonas; Auvinen, Anssi; Kwiatkowski, Maciej; Villers, Arnauld; Zappa, Marco; Nelen, Vera; Páez, Alvaro; Eastham, James A; Lilja, Hans; de Koning, Harry J; Vickers, Andrew J; Heijnsdijk, Eveline A M

    2016-11-15

    Prostate-specific antigen (PSA) screening and concomitant treatment can be implemented in several ways. The authors investigated how the net benefit of PSA screening varies between common practice versus "good practice." Microsimulation screening analysis (MISCAN) was used to evaluate the effect on quality-adjusted life-years (QALYs) if 4 recommendations were followed: limited screening in older men, selective biopsy in men with elevated PSA, active surveillance for low-risk tumors, and treatment preferentially delivered at high-volume centers. Outcomes were compared with a base model in which annual screening started at ages 55 to 69 years and were simulated using data from the European Randomized Study of Screening for Prostate Cancer. In terms of QALYs gained compared with no screening, for 1000 screened men who were followed over their lifetime, recommended good practice led to 73 life-years (LYs) and 74 QALYs gained compared with 73 LYs and 56 QALYs for the base model. In contrast, common practice led to 78 LYs gained but only 19 QALYs gained, for a greater than 75% relative reduction in QALYs gained from unadjusted LYs gained. The poor outcomes for common practice were influenced predominantly by the use of aggressive treatment for men with low-risk disease, and PSA testing in older men also strongly reduced potential QALY gains. Commonly used PSA screening and treatment practices are associated with little net benefit. Following a few straightforward clinical recommendations, particularly greater use of active surveillance for low-risk disease and reducing screening in older men, would lead to an almost 4-fold increase in the net benefit of prostate cancer screening. Cancer 2016;122:3386-3393. © 2016 American Cancer Society. © 2016 American Cancer Society.

  17. The Benefits and Challenges of Multiple Health Behavior Change in Research and in Practice

    Science.gov (United States)

    Prochaska, Judith J.; Nigg, Claudio R.; Spring, Bonnie; Velicer, Wayne F.; Prochaska, James O.

    2009-01-01

    Objective The major chronic diseases are caused by multiple risks, yet the science of multiple health behavior change (MHBC) is at an early stage, and factors that facilitate or impede scientists’ involvement in MHBC research are unknown. Benefits and challenges of MHBC interventions were investigated to strengthen researchers’ commitment and prepare them for challenges. Method An online anonymous survey was emailed to listservs of the Society of Behavioral Medicine between May 2006 and 2007. Respondents (N = 69) were 83% female; 94% held a doctoral degree; 64% were psychologists, 24% were in public health; 83% targeted MHBC in their work. Results A sample majority rated 23 of the 24 benefits, but only 1 of 31 challenge items, as very-to-extremely important. Those engaged in MHBC rated the total benefits significantly higher than respondents focused on single behaviors, F(1,69) = 4.21, pbehaviors do not fully appreciate the benefits that impress MHBC researchers; it is not that substantial barriers are holding them back. Benefits of MHBC interventions need emphasizing more broadly to advance this research area. PMID:19948184

  18. The benefit of using additional hydrological information from earth observations and reanalysis data on water allocation decisions in irrigation districts

    Science.gov (United States)

    Kaune, Alexander; López, Patricia; Werner, Micha; de Fraiture, Charlotte

    2017-04-01

    Hydrological information on water availability and demand is vital for sound water allocation decisions in irrigation districts, particularly in times of water scarcity. However, sub-optimal water allocation decisions are often taken with incomplete hydrological information, which may lead to agricultural production loss. In this study we evaluate the benefit of additional hydrological information from earth observations and reanalysis data in supporting decisions in irrigation districts. Current water allocation decisions were emulated through heuristic operational rules for water scarce and water abundant conditions in the selected irrigation districts. The Dynamic Water Balance Model based on the Budyko framework was forced with precipitation datasets from interpolated ground measurements, remote sensing and reanalysis data, to determine the water availability for irrigation. Irrigation demands were estimated based on estimates of potential evapotranspiration and coefficient for crops grown, adjusted with the interpolated precipitation data. Decisions made using both current and additional hydrological information were evaluated through the rate at which sub-optimal decisions were made. The decisions made using an amended set of decision rules that benefit from additional information on demand in the districts were also evaluated. Results show that sub-optimal decisions can be reduced in the planning phase through improved estimates of water availability. Where there are reliable observations of water availability through gauging stations, the benefit of the improved precipitation data is found in the improved estimates of demand, equally leading to a reduction of sub-optimal decisions.

  19. The Significance of Reporting Employee Benefits in Accordance with IFRS in the Czech Business Practice

    Directory of Open Access Journals (Sweden)

    Hana Vimrová

    2016-12-01

    Full Text Available The aim of the research the results of which are presented in this paper, based on an empirical survey of forty financial statements using IFRS by non-financial companies active in the Czech business environment, is to map the process and scope of reporting of employee benefits by Czech companies applying IFRS in the preparation of their consolidated and individual financial statements and to find out the differences in the extent, detail and relevancy of reporting employee benefits in accordance with IFRS among companies whose securities are publicly traded and other companies as well as to measure the differences in the scope, detail and relevancy of reporting employee benefits in accordance with IFRS among companies which are considered the best employers in the Czech Republic and other companies, including the interpretation of results.

  20. Sustained benefits of a community dietetics intervention designed to improve oral nutritional supplement prescribing practices.

    LENUS (Irish Health Repository)

    Kennelly, S

    2011-10-01

    Healthcare professionals working in the community do not always prescribe oral nutritional supplements (ONS) according to best practice guidelines for the management of malnutrition. The present study aimed to determine the impact of a community dietetics intervention on ONS prescribing practices and expenditure 1 year later.

  1. How an Integrative STEM Curriculum Can Benefit Students in Engineering Design Practices

    Science.gov (United States)

    Fan, Szu-Chun; Yu, Kuang-Chao

    2017-01-01

    STEM-oriented engineering design practice has become recognized increasingly by technology education professionals in Taiwan. This study sought to examine the effectiveness of the application of an integrative STEM approach within engineering design practices in high school technology education in Taiwan. A quasi-experimental study was conducted…

  2. Mesenchymal Stem Cell Benefits Observed in Bone Marrow Failure and Acquired Aplastic Anemia

    Science.gov (United States)

    Gonzaga, Vivian Fonseca; Lisboa, Gustavo Sabino; Frare, Eduardo Osório

    2017-01-01

    Acquired aplastic anemia (AA) is a type of bone marrow failure (BMF) syndrome characterized by partial or total bone marrow (BM) destruction resulting in peripheral blood (PB) pancytopenia, which is the reduction in the number of red blood cells (RBC) and white blood cells (WBC), as well as platelets (PLT). The first-line treatment option of AA is given by hematopoietic stem cell (HSCs) transplant and/or immunosuppressive (IS) drug administration. Some patients did not respond to the treatment and remain pancytopenic following IS drugs. The studies are in progress to test the efficacy of adoptive cellular therapies as mesenchymal stem cells (MSCs), which confer low immunogenicity and are reliable allogeneic transplants in refractory severe aplastic anemia (SAA) cases. Moreover, bone marrow stromal cells (BMSC) constitute an essential component of the hematopoietic niche, responsible for stimulating and enhancing the proliferation of HSCs by secreting regulatory molecules and cytokines, providing stimulus to natural BM microenvironment for hematopoiesis. This review summarizes scientific evidences of the hematopoiesis improvements after MSC transplant, observed in acquired AA/BMF animal models as well as in patients with acquired AA. Additionally, we discuss the direct and indirect contribution of MSCs to the pathogenesis of acquired AA. PMID:29333168

  3. Health benefits observed after probiotic Lactobacillus fermentum CCM 7421 application in dogs.

    Science.gov (United States)

    Strompfová, Viola; Kubašová, Ivana; Lauková, Andrea

    2017-08-01

    The importance of the intestinal microbiota has attracted much interest in recent years particularly with respect to ways in which the microbiota can be manipulated in order to improve health. Improving gut health through the use of probiotic microorganisms has become an area of research activity in both human and animal nutrition. However, the amount of research using companion animals is insufficient. The present review evaluates and compares the effects achieved after application of canine-derived probiotic strain Lactobacillus fermentum CCM 7421 to healthy dogs as well as to dogs suffering from gastrointestinal disorders. The experiments involved varying duration of application (4 days-14 days), dosage (10 7 -10 9  CFU), form of application (fresh culture or lyophilized from) or combination with natural substances. Results from nine independent studies show the ability of probiotic strains to establish themselves in the canine gastrointestinal tract, alter the composition of intestinal microbiota and metabolites (organic acids), and modulate the physiology (serum biochemical parameters) and immunity parameters in dogs. Almost all observed effects were irrespective of dose or duration of probiotic administration.

  4. Mechanisms within the Parietal Cortex Correlate with the Benefits of Random Practice in Motor Adaptation

    Directory of Open Access Journals (Sweden)

    Benjamin Thürer

    2017-08-01

    Full Text Available The motor learning literature shows an increased retest or transfer performance after practicing under unstable (random conditions. This random practice effect (also known as contextual interference effect is frequently investigated on the behavioral level and discussed in the context of mechanisms of the dorsolateral prefrontal cortex and increased cognitive efforts during movement planning. However, there is a lack of studies examining the random practice effect in motor adaptation tasks and, in general, the underlying neural processes of the random practice effect are not fully understood. We tested 24 right-handed human subjects performing a reaching task using a robotic manipulandum. Subjects learned to adapt either to a blocked or a random schedule of different force field perturbations while subjects’ electroencephalography (EEG was recorded. The behavioral results showed a distinct random practice effect in terms of a more stabilized retest performance of the random compared to the blocked practicing group. Further analyses showed that this effect correlates with changes in the alpha band power in electrodes over parietal areas. We conclude that the random practice effect in this study is facilitated by mechanisms within the parietal cortex during movement execution which might reflect online feedback mechanisms.

  5. Service-Learning in Supply Chain Management: Benefits, Challenges and Best Practices

    Science.gov (United States)

    Schoenherr, Tobias

    2015-01-01

    Service-learning (SL) is a pedagogical approach in which students are assigned a course-related project in a not-for-profit organization, and are tasked to apply course content to execute the project. While the benefits are multifarious, only recently have supply chain management (SCM) courses adapted this innovative teaching methodology. The…

  6. Health insurance in practice: international variations in financing, benefits, and problems

    National Research Council Canada - National Science Library

    Glaser, William G

    1991-01-01

    In "Health Insurance in practice", the author pinpoints the strengths and weaknesses of health insurance programs in developing countries and uses a lessons-from-abroad approach to offer suggestions...

  7. Agomelatine in the treatment of depressive disorders in clinical practice: multicenter observational CHRONOS study

    Directory of Open Access Journals (Sweden)

    Ivanov SV

    2014-04-01

    Full Text Available Stanislav V Ivanov, Marina A Samushiya Department of “Borderline” Mental Pathology and Psychosomatic Disorders, Mental Health Research Center of the Russian Academy of Medical Science, Moscow, Russian Federation Background: CHRONOS was a large naturalistic study designed to evaluate the effectiveness and safety of agomelatine in the management of patients with major depression in routine clinical practice. Methods: Patients (n=6,276 with a moderate or severe major depressive episode without psychotic symptoms were treated initially as outpatients (80.2% or in psychiatric facilities (19.8% in 54 regions of the Russian Federation. Patients received a flexible-dosing regimen of agomelatine 25 mg or 50 mg once daily for 8 weeks, with frequent study visits (weeks 1, 2, 3, 4, 6, and 8. Results: Patients (mean age 44 years, 72.6% female showed progressive improvement on the 17-item Hamilton Rating Scale for Depression (HAMD-17 total score from 22±6.9 at baseline to 4.7±4.7 at week 8 (P<0.0001. The proportion of responders (HAMD-17 decrease of ≥50% was 90.1% and the proportion of remitters (HAMD-17 <7 was 79.1% at week 8. All individual HAMD-17 item scores improved rapidly, and the change relative to baseline was significant (P<0.0001 at week 1 and at each subsequent visit in all cases. There were corresponding rapid improvements in Clinical Global Impression Severity and Improvement scores. In the subgroup of patients with more severe illness (HAMD-17 ≥21 at baseline; n=3,478, the proportions of responders and remitters were 92.4% and 72.8%, respectively, at week 8. Conclusion: Agomelatine was effective and well tolerated in a large sample of depressed patients in an observational treatment setting, and showed a rapid onset of benefit across all HAMD-17 items. Keywords: agomelatine, antidepressant, Hamilton Rating Scale for Depression, major depressive disorder, observational study

  8. ACUTE PSYCHOLOGICAL BENEFITS OF EXERCISE PERFORMED AT SELF-SELECTED WORKLOADS: IMPLICATIONS FOR THEORY AND PRACTICE

    OpenAIRE

    Attila Szabo

    2003-01-01

    Given that most studies to date examined the connection between exercise and affect without considering the participants’ preferred exercise workload, in this research the affective-benefits of jogging or running at a participant-selected pace were investigated in a pilot field and a laboratory experiment. Ninety-six male and female students (19.5 yrs) took part in the pilot field experiment whereas 32 women (20.3 yrs) completed the laboratory experiment. In both experiments, the participants...

  9. Reported and observed controlling feeding practices predict child eating behavior after 12 months.

    Science.gov (United States)

    Bergmeier, Heidi J; Skouteris, Helen; Haycraft, Emma; Haines, Jess; Hooley, Merrilyn

    2015-06-01

    Controlling feeding practices are linked to children's self-regulatory eating practices and weight status. Maternal reports of controlling feeding practices are not always significantly related to independently rated mealtime observations. However, prior studies only assessed 1 mealtime observation, which may not be representative of typical mealtime settings or routines. The first aim was to examine associations between reported and observed maternal pressure to eat and restriction feeding practices at baseline (T1) and after ∼ 12 mo (T2). The second aim was to evaluate relations between maternal and child factors [e.g., concern about child weight, child temperament, child body mass index (BMI)-for-age z scores (BMIz)] at T1 and reported and observed maternal pressure to eat and restriction feeding practices (T1 and T2). The third aim was to assess prospective associations between maternal feeding practices (T1) and child eating behaviors (T2) and child BMIz (T2). A sample of 79 mother-child dyads in Victoria, Australia, participated in 2 lunchtime home observations (T1 and T2). BMI measures were collected during the visits. Child temperament, child eating behaviors, maternal parenting styles, and maternal feeding practices were evaluated at T1 and T2 via questionnaires. Associations were assessed with Pearson's correlation coefficients, paired t tests, and hierarchical regressions. Reported restriction (T1) was inversely associated with observed restriction at T1 (r = -0.24, P controlling strategies. © 2015 American Society for Nutrition.

  10. Negotiating NORM cleanup and land use limits: Practical use of dose assessment and cost benefit analysis

    International Nuclear Information System (INIS)

    Blanchard, A.D.H.

    1997-01-01

    Oil companies are presently faced with complex and costly environmental decisions, especially concerning NORM cleanup and disposal. Strict cleanup limits and disposal restrictions are established, in theory, to protect public health and environment. While public health is directly measured in terms of dose (mrem/yr), most NORM regulations adopt soil concentration limits to ensure future public health is maintained. These derived soil limits create the potential for unnecessary burden to operators without additional health benefit to society. Operators may use a dose assessment to show direct compliance with dose limits, negotiating less restrictive cleanup levels and land use limits. This paper discusses why a dose assessment is useful to Oilfield operators, NORM exposure scenarios and pathways, assessment advantages, variables and recommendations and one recent dose assessment application. Finally, a cost benefit analysis tool for regulatory negotiations will be presented allowing comparison of Oilfield NORM health benefit costs to that of other industries. One use for this tool--resulting in the savings of approximately $100,000--will be discussed

  11. Acute psychological benefits of exercise performed at self-selected workloads: implications for theory and practice.

    Science.gov (United States)

    Szabo, Attila

    2003-09-01

    Given that most studies to date examined the connection between exercise and affect without considering the participants' preferred exercise workload, in this research the affective-benefits of jogging or running at a participant-selected pace were investigated in a pilot field and a laboratory experiment. Ninety-six male and female students (19.5 yrs) took part in the pilot field experiment whereas 32 women (20.3 yrs) completed the laboratory experiment. In both experiments, the participants ran/jogged for 20 minutes at a self-selected pace. They completed an abbreviated version of a 'right now form' of the Profile of Mood States (POMS - Grove and Prapavessis, 1992) inventory before and after exercise. In both experiments all dependent measures changed significantly from pre- to post-exercise, except 'fatigue' and 'vigor' that did not change in the laboratory. Total mood disturbance (TMD) decreased significantly in both experiments (68% and 89%). No significant correlations were found between exercise intensity (expressed as percent (%) of maximal heart rate reserve) and the magnitude of changes seen in the dependent measures. It is concluded that exercising at a self-selected workload yields positive changes in affect that are unrelated to exercise intensity. These results suggest that the physiological theories linking exercise with positive changes in affect, in which exercise intensity is instrumental, could not account for the acute affective benefits of exercise. It is proposed that a 'cognitive appraisal hypothesis' may be more appropriate in explaining the acute affective benefits of exercise.

  12. Treatment of urinary incontinence in women in general practice: observational study.

    OpenAIRE

    Seim, A.; Sivertsen, B.; Eriksen, B. C.; Hunskaar, S.

    1996-01-01

    OBJECTIVE--To examine what is attainable when treating urinary incontinence in women in general practice. DESIGN--Observational study with 12 months' follow up. Interview and clinical examination before, during, and after treatment of women seeking help for urinary incontinence in general practice. SETTING--General practice in the rural district of Rissa, Norway. SUBJECTS--105 women aged 20 or more with urinary incontinence. INTERVENTIONS--Treatment with pelvic floor exercises, electrostimula...

  13. The Practices of Existential Psychotherapists: Development and Application of an Observational Grid

    Science.gov (United States)

    Correia, Edgar A.; Sartóris, Vítor; Fernandes, Tiago; Cooper, Mick; Berdondini, Lucia; Sousa, Daniel; Pires, Branca Sá; da Fonseca, João

    2018-01-01

    Within the major therapeutic paradigms, observational instruments have been developed to assess orientation-specific interventions or processes. However, to date, no such instrument exists to assess existential practices. Recent research indicates the key practices of existential therapists, and forms an empirical basis on which to develop an…

  14. Flexible Working Practices: How Employees Can Reap the Benefits for Engagement and Performance

    NARCIS (Netherlands)

    C. Wessels (Christina)

    2017-01-01

    markdownabstractTechnological developments such as the advent of laptops, mobile devices, and related new communication channels (e.g., social and business networks, instant messaging programs) enabled the uptake of flexible working practices in knowledge work organizations. Whether flexible working

  15. Designing Chemistry Practice Exams for Enhanced Benefits: An Instrument for Comparing Performance and Mental Effort Measures

    Science.gov (United States)

    Knaus, Karen J.; Murphy, Kristen L.; Holme, Thomas A.

    2009-01-01

    The design and use of a chemistry practice exam instrument that includes a measure for student mental effort is described in this paper. Use of such an instrument can beneficial to chemistry students and chemistry educators as well as chemical education researchers from both a content and cognitive science perspective. The method for calculating…

  16. ACUTE PSYCHOLOGICAL BENEFITS OF EXERCISE PERFORMED AT SELF-SELECTED WORKLOADS: IMPLICATIONS FOR THEORY AND PRACTICE

    Directory of Open Access Journals (Sweden)

    Attila Szabo

    2003-09-01

    Full Text Available Given that most studies to date examined the connection between exercise and affect without considering the participants' preferred exercise workload, in this research the affective-benefits of jogging or running at a participant-selected pace were investigated in a pilot field and a laboratory experiment. Ninety-six male and female students (19.5 yrs took part in the pilot field experiment whereas 32 women (20.3 yrs completed the laboratory experiment. In both experiments, the participants ran/jogged for 20 minutes at a self-selected pace. They completed an abbreviated version of a 'right now form' of the Profile of Mood States (POMS - Grove and Prapavessis, 1992 inventory before and after exercise. In both experiments all dependent measures changed significantly from pre- to post-exercise, except 'fatigue' and 'vigor' that did not change in the laboratory. Total mood disturbance (TMD decreased significantly in both experiments (68% and 89%. No significant correlations were found between exercise intensity (expressed as percent (% of maximal heart rate reserve and the magnitude of changes seen in the dependent measures. It is concluded that exercising at a self-selected workload yields positive changes in affect that are unrelated to exercise intensity. These results suggest that the physiological theories linking exercise with positive changes in affect, in which exercise intensity is instrumental, could not account for the acute affective benefits of exercise. It is proposed that a 'cognitive appraisal hypothesis' may be more appropriate in explaining the acute affective benefits of exercise

  17. Analyzing the blood-brain barrier: the benefits of medical imaging in research and clinical practice.

    Science.gov (United States)

    Chassidim, Yoash; Vazana, Udi; Prager, Ofer; Veksler, Ronel; Bar-Klein, Guy; Schoknecht, Karl; Fassler, Michael; Lublinsky, Svetlana; Shelef, Ilan

    2015-02-01

    A dysfunctional BBB is a common feature in a variety of brain disorders, a fact stressing the need for diagnostic tools designed to assess brain vessels' permeability in space and time. Biological research has benefited over the years various means to analyze BBB integrity. The use of biomarkers for improper BBB functionality is abundant. Systemic administration of BBB impermeable tracers can both visualize brain regions characterized by BBB impairment, as well as lead to its quantification. Additionally, locating molecular, physiological content in regions from which it is restricted under normal BBB functionality undoubtedly indicates brain pathology-related BBB disruption. However, in-depth research into the BBB's phenotype demands higher analytical complexity than functional vs. pathological BBB; criteria which biomarker based BBB permeability analyses do not meet. The involvement of accurate and engineering sciences in recent brain research, has led to improvements in the field, in the form of more accurate, sensitive imaging-based methods. Improvements in the spatiotemporal resolution of many imaging modalities and in image processing techniques, make up for the inadequacies of biomarker based analyses. In pre-clinical research, imaging approaches involving invasive procedures, enable microscopic evaluation of BBB integrity, and benefit high levels of sensitivity and accuracy. However, invasive techniques may alter normal physiological function, thus generating a modality-based impact on vessel's permeability, which needs to be corrected for. Non-invasive approaches do not affect proper functionality of the inspected system, but lack in spatiotemporal resolution. Nevertheless, the benefit of medical imaging, even in pre-clinical phases, outweighs its disadvantages. The innovations in pre-clinical imaging and the development of novel processing techniques, have led to their implementation in clinical use as well. Specialized analyses of vessels' permeability

  18. Veterinary syndromic surveillance in practice: costs and benefits for governmental organizations

    Directory of Open Access Journals (Sweden)

    Fernanda C. Dórea

    2015-12-01

    Full Text Available Background: We describe a veterinary syndromic surveillance system developed in Sweden based on laboratory test requests. Materials and methods: The system is a desktop application built using free software. Results: Development took 1 year. During the first year of operation, utility was demonstrated by the detection of statistically significant increases in the number of laboratory submissions. The number of false alarms was considered satisfactory in order to achieve the desired sensitivity. Discussion: Besides the demonstrated benefit for disease surveillance, the system contributed to improving data quality and communication between the diagnostic departments and the epidemiology department.

  19. OPTIMAL practice conditions enhance the benefits of gradually increasing error opportunities on retention of a stepping sequence task.

    Science.gov (United States)

    Levac, Danielle; Driscoll, Kate; Galvez, Jessica; Mercado, Kathleen; O'Neil, Lindsey

    2017-12-01

    Physical therapists should implement practice conditions that promote motor skill learning after neurological injury. Errorful and errorless practice conditions are effective for different populations and tasks. Errorful learning provides opportunities for learners to make task-relevant choices. Enhancing learner autonomy through choice opportunities is a key component of the Optimizing Performance through Intrinsic Motivation and Attention for Learning (OPTIMAL) theory of motor learning. The objective of this study was to evaluate the interaction between error opportunity frequency and OPTIMAL (autonomy-supportive) practice conditions during stepping sequence acquisition in a virtual environment. Forty healthy young adults were randomized to autonomy-supportive or autonomy-controlling practice conditions, which differed in instructional language, focus of attention (external vs internal) and positive versus negative nature of verbal and visual feedback. All participants practiced 40 trials of 4, six-step stepping sequences in a random order. Each of the 4 sequences offered different amounts of choice opportunities about the next step via visual cue presentation (4 choices; 1 choice; gradually increasing [1-2-3-4] choices, and gradually decreasing [4-3-2-1] choices). Motivation and engagement were measured by the Intrinsic Motivation Inventory (IMI) and the User Engagement Scale (UES). Participants returned 1-3 days later for retention tests, where learning was measured by time to complete each sequence. No choice cues were offered on retention. Participants in the autonomy-supportive group outperformed the autonomy-controlling group at retention on all sequences (mean difference 2.88s, p errorful (4 choice) sequence (p error opportunities over time, suggest that participants relied on implicit learning strategies for this full body task and that feedback about successes minimized errors and reduced their potential information-processing benefits. Subsequent

  20. Knowledge, Attitude And Practice Of Pregnant Women About Benefits And Doses Of Folic Acid Consumption During Pregnancy

    Directory of Open Access Journals (Sweden)

    Safdarian L

    2004-09-01

    Full Text Available Background: The aim of this study was to assess the knowledge, attitude and practice of pregnant women about benefits and doses of folic acid consumption during pregnancy. Materials and Methods: A simple randomized study has been done with 300 pregnant women in (Mahdied, Shohada, Shariati hospital. Women were asked about their information and about consumption of folic acid in order to prevent nural tube defect and reasons for not taking it. Results: There were 300 women, 150 (50% had been recommended before to consume folic acid but only 46 (31% of them used it during pregnancy. There were 37 (12% who aware about taking it. Conclusion: Although 50% of women had been recommended to consume of folic acid, less than 50% of the women who were surveyed have been taking it. Strategies are required to increase folate intake among pregnant women and inform of the benefits of folate supplementation by the health eduction.

  1. Direct observation of the nutrition care practices of Australian general practitioners

    Directory of Open Access Journals (Sweden)

    Ball LE

    2014-06-01

    Full Text Available INTRODUCTION: Nutrition care refers to nutrition-related advice or counselling provided by health professionals in an attempt to improve the nutrition behaviour of patients. AIM: The aim of this study was to describe the practices of a sample of Australian general practitioners (GPs when providing nutrition care to adult patients. METHODS: Eighteen GPs (13 male, 5 female were observed by fourth-year medical students during their general practice rotation. Each GP was observed for five consultations that included nutrition care, totalling 90 observed consultations. In each consultation, students completed a 31-item nutrition care checklist of nutrition care practices that could feasibly occur in a standard consultation. Each practice was marked with either a ‘yes’ (completed, ‘no’ (did not complete or ‘completed by practice nurse prior to or after the consultation’. RESULTS: Twenty-eight nutrition care practices were observed at least once. The most frequently observed practices were measuring and discussing blood pressure (76.7%; n=69, followed by general questions about current diet (74.4%; n=67. Approximately half of the consultations included a statement of a nutrition-related problem (52.2%; n=47, and the provision of nutrition advice that focused on a nutrient (45.6%; n=41 or food group (52.2%; n=47. Consultations with male GPs, as well as GPs with more than 25 years of experience, were associated with an increased number of nutrition care practices per consultation. DISCUSSION: The GPs performed nutrition care practices in varying frequencies. Further research is required to identify the most effective GP nutrition care practices to improve the nutrition behaviour of patients.

  2. Raising Backyard Poultry in Rural Bangladesh: Financial and Nutritional Benefits, but Persistent Risky Practices

    DEFF Research Database (Denmark)

    Shanta, I. S.; Hasnat, Md A.; Zeidner, N.

    2016-01-01

    Poultry is commonly raised by households in rural Bangladesh. In 2007, the Government of Bangladesh began a mass media campaign to disseminate 10 recommended precautions to prevent transmission of H5N1 from poultry to humans. This longitudinal study explored the contribution of backyard poultry...... interviewed the raisers to collect data on poultry-raising practices. They followed the raisers for 2–12 months to collect data on household income and nutrition from poultry. Income from backyard poultry flocks accounted for 2.8% of monthly household income. Return on annual investment (ROI) per flock...... handling poultry. Only 3% reported poultry illness and deaths to local authorities. These reported practices did not improve during the study period. Raising backyard poultry in rural Bangladesh provides important income and nutrition with an excellent ROI. Government recommendations to reduce the risk...

  3. Raising Backyard Poultry in Rural Bangladesh: Financial and Nutritional Benefits, but Persistent Risky Practices.

    Science.gov (United States)

    Shanta, I S; Hasnat, Md A; Zeidner, N; Gurley, E S; Azziz-Baumgartner, E; Sharker, M A Y; Hossain, K; Khan, S U; Haider, N; Bhuyan, A A; Hossain, Md A; Luby, S P

    2017-10-01

    Poultry is commonly raised by households in rural Bangladesh. In 2007, the Government of Bangladesh began a mass media campaign to disseminate 10 recommended precautions to prevent transmission of H5N1 from poultry to humans. This longitudinal study explored the contribution of backyard poultry on household economy and nutrition and compared poultry-raising practices to government recommendations. From 2009 to 2012, we enrolled a nationally representative sample of 2489 primary backyard poultry raisers from 115 rural villages selected by probability proportional to population size. Researchers interviewed the raisers to collect data on poultry-raising practices. They followed the raisers for 2-12 months to collect data on household income and nutrition from poultry. Income from backyard poultry flocks accounted for 2.8% of monthly household income. Return on annual investment (ROI) per flock was 480%. Yearly, median family consumption of eggs was one-fifth of the total produced eggs and three poultry from their own flock. Respondents' reported practices conflicted with government recommendations. Sixty per cent of raisers had never heard of avian influenza or 'bird flu'. Among the respondents, 85% handled sick poultry or poultry that died due to illness, and 49% slaughtered or defeathered sick poultry. In 37% of households, children touched poultry. Fifty-eight per cent never washed their hands with soap after handling poultry, while poultry. Only 3% reported poultry illness and deaths to local authorities. These reported practices did not improve during the study period. Raising backyard poultry in rural Bangladesh provides important income and nutrition with an excellent ROI. Government recommendations to reduce the risk of avian influenza transmission did not impact the behaviour of poultry producers. Further research should prioritize developing interventions that simultaneously reduce the risk of avian influenza transmission and increase productivity of

  4. Measurable benefits on brain activity from the practice of educational leisure

    OpenAIRE

    Requena, Carmen; López, Verónica

    2014-01-01

    Even if behavioral studies relate leisure practices to the preservation of memory in old persons, there is unsubstantial evidence of the import of leisure on brain activity. Aim: This study was to compare the brain activity of elderly retired people who engage in different types of leisure activities. Methods: Quasi-experimental study over a sample of 60 elderly, retired subjects distributed into three groups according to the leisure activities they practised: educational leisure (G1), ...

  5. Measurable benefits on brain activity from the practice of educational leisure.

    Science.gov (United States)

    Requena, Carmen; López, Verónica

    2014-01-01

    Even if behavioral studies relate leisure practices to the preservation of memory in old persons, there is unsubstantial evidence of the import of leisure on brain activity. This study was to compare the brain activity of elderly retired people who engage in different types of leisure activities. Quasi-experimental study over a sample of 60 elderly, retired subjects distributed into three groups according to the leisure activities they practised: educational leisure (G1), memory games (G2), and card games (G3). Applied measures include the conceptual distinction between free time and leisure, the test of the organization of free time measuring 24 clock divisions, and EEG register during 12 word list memorizing. The results show that the type of leisure activity is associated with significant quantitative differences regarding the use of free time. G1 devotes more time to leisure activities than G2 (p = 0.007) and G3 (p = 0.034). G1 rests more actively than the other two groups (p = 0.001). The electrical localization of brain activity indicated a reverse tendency of activation according to the bands and groups. Engaging in educational leisure activities is a useful practice to protect healthy brain compensation strategies. Future longitudinal research may verify the causal relation between practicing educational leisure activities and functional brain aging.

  6. Measurable benefits on brain activity from the practice of educational leisure

    Directory of Open Access Journals (Sweden)

    Carmen eRequena

    2014-03-01

    Full Text Available Even if behavioural studies relate leisure practices to the preservation of memory in old persons, there is unsubstantial evidence of the import of leisure on brain activity. Aim of this study was to compare the brain activity of elderly retired people who engage in different types of leisure activities. Methods: quasi-experimental study over a sample of 60 elderly, retired subjects distributed into three groups according to the leisure activities they practised: educational leisure (G1, memory games (G2 and card games (G3. Applied measures include the conceptual distinction between free time and leisure, the Test of Organization of Free Time (TOFT measuring 24 clock divisions, and EEG register during 12 word list memorizing. The results show that the type of leisure activity is associated with significant quantitative differences regarding the use of free time. G1 devotes more time to leisure activities than G2 (p = 0.007 and G3 (p = 0.034. G1 rests more actively than the other two groups (p=0.001. The electrical localization of brain activity indicated a reverse tendency of activation according to the bands and groups. Discussion. Engaging in educational leisure activities is a useful practice to protect healthy brain compensation strategies. Future longitudinal research may verify the causal relation between practicing educational leisure activities and functional brain aging.

  7. Astronomy in the training of teachers and the role of practical rationality in sky observation

    Science.gov (United States)

    Bretones, P. S.; Compiani, M.

    2006-08-01

    This work analyses a program in the training of teachers that departs from the courses based on the technical rationality. An Astronomy course was offered to Science and Geography teachers of the four last years of high school education, comprising 46 hours, and organized in 2002 by the Instituto Superior de Ciências Aplicadas in Limeira, Brazil. Following the course a study group was established and held five meetings. The data was obtained through assessments, interviews, and accounts by the teachers and records from the classes and meetings. The actions and conceptual changes and the role of the Practical Rationality were then investigated. It was verified that for sky observation, the model of Practical Rationality within the reflective teacher theoretical framework and tutorial actions leads to knowledge acquisition, conceptual changes and extracurricular activities. Examples are: suggestions, personal actions of the teachers without their students, accounts of extracurricular activities and development of astronomical contents in class, actions in the pedagogical practices and reflections of the teachers with the teacher/ researcher towards the assessment of such changes are shown. It is important to stress that sky observation has specific features that lead to an equally specific school practice, in which the contents and procedures based on observations and their representation point towards a more practical rationality. Even in a training course for teachers based on technical rationality, the introduction of sky observation deepens the practical rationality and the development of principles that guide the acquisition and the teaching of knowledge about sky observation.

  8. How changes to the Medicare Benefits Schedule could improve the practice of cardiology and save taxpayer money.

    Science.gov (United States)

    Harper, Richard W; Nasis, Arthur; Sundararajan, Vijaya

    2015-09-21

    Rising health care costs above inflation are placing serious strains on the sustainability of the Australian Medicare system in its current structure. The Medicare Benefits Schedule (MBS), which lists rebates payable to patients for private medical services provided on a fee-for-service basis, is the cornerstone of the Australian health care system. Introduced in the 1980s, the MBS has changed little despite major advances in the evidence base for the practice of cardiology. We outline how we believe sensible changes to the MBS listings for four cardiac services--invasive coronary angiography, computed tomography coronary angiography, stress testing and percutaneous coronary intervention--would improve the clinical practice of cardiology and save substantial amounts of taxpayer money.

  9. A prospective observational study assessing home parenteral nutrition in patients with gastrointestinal cancer: benefits for quality of life.

    Science.gov (United States)

    Senesse, Pierre; Tadmouri, Abir; Culine, Stéphane; Dufour, Patrick R; Seys, Patrick; Radji, Abderraouf; Rotarski, Maciej; Balian, Axel; Chambrier, Cecile

    2015-02-01

    Patients with gastrointestinal cancer are at high risk for deterioration of nutrition. Home parenteral nutrition (HPN) could improve nutritional status and quality of life (QoL). The purpose of this study was 1) to evaluate the impact of HPN on QoL, 2) to assess changes in nutritional status, and 3) to assess proxy perception of patient well-being. We conducted a prospective, observational, and a multicenter study. Inclusion criteria were adult patients with gastrointestinal cancer, for whom HPN was indicated and prescribed for at least 14 days. The physician, the patient, and a family member completed questionnaires at inclusion and 28 days later. The QoL was assessed by the patients using the Functional Assessment of Cancer Therapy-General questionnaire, at inclusion and 28 days later. The study included 370 patients with gastrointestinal cancer. The HPN was indicated for cancer-related undernutrition in 89% of the patients and was used as a complement to oral intake in 84%. After 28 days of parenteral intake, global QoL was significantly increased (48.9 at inclusion vs. 50.3, P=0.007). The patients' weight improved significantly by 2.7% (Pnutrition risk screening also decreased significantly (3.2±1.1 vs. 2.8±1.3, P=0.003). HPN could provide benefit for malnourished patients with gastrointestinal cancer. However, randomized controlled studies are required to confirm this benefit and the safety profile. Copyright © 2015. Published by Elsevier Inc.

  10. Evaluating an Art-Based Intervention to Improve Practicing Nurses' Observation, Description, and Problem Identification Skills.

    Science.gov (United States)

    Nease, Beth M; Haney, Tina S

    Astute observation, description, and problem identification skills provide the underpinning for nursing assessment, surveillance, and prevention of failure to rescue events. Art-based education has been effective in nursing schools for improving observation, description, and problem identification. The authors describe a randomized controlled pilot study testing the effectiveness of an art-based educational intervention aimed at improving these skills in practicing nurses.

  11. Irrigation water quality and the benefits of implementing good agricultural practices during tomato (Lycopersicum esculentum) production.

    Science.gov (United States)

    Estrada-Acosta, M; Jiménez, M; Chaidez, C; León-Félix, J; Castro-Del Campo, N

    2014-07-01

    The implementation of good agricultural practices (GAP) from irrigation water to the tomato packaging process enhances the safety of fresh produce and its value throughout the food chain. The aim of the present study was to show that fresh produce farms that apply and enforce GAP could reduce the presence of Salmonella in finished produce. Samples were collected biweekly from six packing houses from the central region of Sinaloa, México, for the isolation of Salmonella spp by the ISO 6579:2002 method, and the isolated strains were serotyped and genotyped by the Kauffmman-White scheme and pulsed field gel electrophoresis (PFGE), respectively. Salmonella strains were detected in 13 (36.1 %) irrigation water samples, while only two tomato samples were positive (5.5 %). Eight different serotypes were identified in irrigation water, and Salmonella Oranienburg (34 %) was the most prevalent; however, only Salmonella Agona and Salmonella Weltevreden were present on tomatoes. Salmonella Oranienburg was the most widely dispersed and variable serotype, with 10 different PFGE profiles. Salmonella Weltevreden was isolated from both types of samples, albeit with distinct genetic profiles, implying that the sources of contamination differ. These results confirm the utility of implementing good agricultural practices to reduce Salmonella contamination in irrigation water and the packaging process.

  12. Uncovering the benefits of participatory research: implications of a realist review for health research and practice.

    Science.gov (United States)

    Jagosh, Justin; Macaulay, Ann C; Pluye, Pierre; Salsberg, Jon; Bush, Paula L; Henderson, Jim; Sirett, Erin; Wong, Geoff; Cargo, Margaret; Herbert, Carol P; Seifer, Sarena D; Green, Lawrence W; Greenhalgh, Trisha

    2012-06-01

    Participatory research (PR) is the co-construction of research through partnerships between researchers and people affected by and/or responsible for action on the issues under study. Evaluating the benefits of PR is challenging for a number of reasons: the research topics, methods, and study designs are heterogeneous; the extent of collaborative involvement may vary over the duration of a project and from one project to the next; and partnership activities may generate a complex array of both short- and long-term outcomes. Our review team consisted of a collaboration among researchers and decision makers in public health, research funding, ethics review, and community-engaged scholarship. We identified, selected, and appraised a large-variety sample of primary studies describing PR partnerships, and in each stage, two team members independently reviewed and coded the literature. We used key realist review concepts (middle-range theory, demi-regularity, and context-mechanism-outcome configurations [CMO]) to analyze and synthesize the data, using the PR partnership as the main unit of analysis. From 7,167 abstracts and 591 full-text papers, we distilled for synthesis a final sample of twenty-three PR partnerships described in 276 publications. The link between process and outcome in these partnerships was best explained using the middle-range theory of partnership synergy, which demonstrates how PR can (1) ensure culturally and logistically appropriate research, (2) enhance recruitment capacity, (3) generate professional capacity and competence in stakeholder groups, (4) result in productive conflicts followed by useful negotiation, (5) increase the quality of outputs and outcomes over time, (6) increase the sustainability of project goals beyond funded time frames and during gaps in external funding, and (7) create system changes and new unanticipated projects and activities. Negative examples illustrated why these outcomes were not a guaranteed product of PR

  13. [Practical and theoretical aspects of cost-benefit relations in viscerosynthesis].

    Science.gov (United States)

    Fuchs, K H; Heimbucher, J; Geiger, D; Thiede, A

    1997-01-01

    The necessity of limiting health care costs requires adequate service recording and quality control even in visceral surgery. In this field, the safety of the anastomoses is of greatest importance. Anastomoses at risk are esophageal connections to jejunum or colon and deep rectal anastomoses. At these locations expensive suture devices, such as stapling instruments, can be used in a cost saving aspect, if they help to increase anastomotic safety, time saving and expansion of surgical indication. Manual sutures thus represent the cheapest anastomotic technique as continuous sutures would cost between DM 10.- to 20.- and single stitch sutures between DM 60.- and 100.-. A surgical school should prevalently aim at training manual anastomoses, while special anastomotic techniques should only complete the skill for selected indications. The overall staff expenditure for extended operations amounts around DM 600.- per hour respectively DM 10.- per minute. Time for surgery might be shortened by auxiliary tools as much as to perform an additional operation. However, a circular stapler anastomosis that costs between DM 650.- to 850.- is twice as expensive as manual sutures notwithstanding the double time needed. In the past years, the necessity for a rational use of different anastomotic techniques has shown to be mandatory since, increasingly, financial aspects of health economy require cost benefit calculations in visceral surgery.

  14. Is physical activity, practiced as recommended for health benefit, a risk factor for osteoarthritis?

    Science.gov (United States)

    Lefèvre-Colau, Marie-Martine; Nguyen, Christelle; Haddad, Rebecca; Delamarche, Paul; Paris, Guillaume; Palazzo, Clémence; Poiraudeau, Serge; Rannou, François; Roren, Alexandra

    2016-06-01

    In this critical narrative review, we examine the role of physical activity (PA), recreational and elite sports in the development of knee/hip osteoarthritis (OA), taking into account the role of injury in this relationship. The process of article selection was unsystematic. Articles were selected on the basis of the authors' expertise, self-knowledge, and reflective practice. In the general adult population, self-reported diagnosis of knee/hip OA was not associated with low, moderate or high levels of PA. For studies using radiographic knee/hip OA as a primary outcome, the incidence of asymptomatic radiographic OA was higher for subjects with the highest quartile of usual PA than the least active subjects. The risk of incident radiographic knee/hip OA features was increased for subjects with a history of regular sports participation (for osteophyte formation but not joint space narrowing). This risk depended on the type of sport (team and power sports but not endurance and running), and certain conditions (high level of practice) were closely related to the risk of injury. The prevalence of radiographic OA was significantly higher, especially the presence of osteophytes, in former elite athletes than controls. The risk of OA was higher with participation in mixed sports, especially soccer or power sports, than endurance sport. However, the prevalence of clinical OA between former elite athletes and controls was similar, with less hip/knee disability in former athletes. Moderate daily recreational or sport activities, whatever the type of sport, are not a consistent risk factor for clinical or radiographic knee/hip OA. Risk of injury in different sports may be the key factor to understanding the risk of OA related to sport. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  15. Bedside practice of blood transfusion in a large teaching hospital in Uganda: An observational study

    Directory of Open Access Journals (Sweden)

    de Graaf J

    2009-01-01

    Full Text Available Background: Adverse transfusion reactions can cause morbidity and death to patients who receive a blood transfusion. Blood transfusion practice in Mulago Hospital, Kampala, Uganda is analyzed to see if and when these practices play a role in the morbidity and mortality of patients. Materials and Methods: An observational study on three wards of Mulago Hospital. Physicians, paramedics, nurses, medical students and nurse students were observed using two questionnaires. For comparison, a limited observational study was performed in the University Medical Centre Groningen (UMCG in Groningen, The Netherlands. Results: In Mulago Hospital guidelines for blood transfusion practice were not easily available. Medical staff members work on individual professional levels. Students perform poorly due to inconsistency in their supervision. Documentation of blood transfusion in patient files is scarce. There is no immediate bedside observation, so transfusion reactions and obstructions in the blood transfusion flow are not observed. Conclusion: The poor blood transfusion practice is likely to play a role in the morbidity and mortality of patients who receive a blood transfusion. There is a need for a blood transfusion policy and current practical guidelines.

  16. Combining Water Quality and Cost-Benefit Analysis to Examine the Implications of Agricultural Best Management Practices

    Science.gov (United States)

    Rao, N. S.; Easton, Z. M.; Lee, D. R.; Steenhuis, T. S.

    2007-12-01

    Nutrient runoff from agricultural fields threatens water quality and can impair habitats in many watersheds. Agencies consider these potential risks as they determine acceptable levels of nutrient loading. For example, in the New York City (NYC) watershed, the Environmental Protection Agency's Total Maximum Daily Load (TMDL) for phosphorus (P) has been set at 15μg P L-1 to protect against eutrophication and bacterial outbreaks. In the NYC watersheds agricultural Best Management Practices (BMPs) are the primary means to control nonpoint source P loading. BMPs include riparian buffers, filter strips, manure storage facilities, crop rotation, stripcropping, tree planting and nutrient management plans (NMPs). Water quality research on BMPs to date has included studies on site-specificity of different BMPs, short and long term BMP efficacy, and placement of BMPs with respect to critical source areas. A necessary complement to studies addressing water quality aspects of different BMPs are studies examining the cost-benefit aspects of BMPs. In general, there are installment, maintenance and opportunity costs associated with each BMP, and there are benefits, including cost share agreements between farmers and farm agencies, and increased efficiency of farm production and maintenance. Combining water quality studies and related cost-benefit analyses would help planners and watershed managers determine how best improve water quality. Our research examines the costs-benefit structure associated with BMP scenarios on a one-farm headwater watershed in the Catskill Mountains of NY. The different scenarios include "with and without" BMPs, combinations of BMPs, and different BMP placements across agricultural fields. The costs associated with each BMP scenarios are determined using information from farm agencies and watershed planning agencies. With these data we perform a cost-benefit analysis for the different BMP scenarios and couple the water quality modeling using the

  17. Teacher Research Experiences: Impacting and Benefiting Teacher Professional Development and School-wide Practices (Invited)

    Science.gov (United States)

    Manning, C. B.

    2013-12-01

    Providing authentic research opportunities is a potent form of professional development that significantly impacts teaching practices. The University of Rhode Island's ARMADA Project (2003-2010) was funded by the National Science Foundation to create opportunities for teachers to work with marine science researchers and implement best-practices in their classrooms. In early 2009, I participated in a 6-week research experience that has changed how I teach and how I learn. On board the R/V Knorr, I worked as a sedimentologist with an international crew who used geophysics, geochemistry, microbiology and geology to understand the controls on and distribution of subseafloor microbial life in the equatorial Pacific. This experience has affected my educational practices in two ways: (1) motivating me to fill gaps in my own understanding of natural chemical processes, and (2) prioritizing authentic research opportunities for all students at my school. My participation in the ARMADA project underscored the importance of an interdisciplinary approach to research. The team of scientists exposed me to a variety of topics. Biochemistry and the role of redox reactions in biological systems were relatively new to me. Scientists encouraged me to dig deeper into the chemical systems that we were researching. Through self-study and coursework focusing on biogeochemical cycles, deriving energy through chemical processes, and atmospheric chemistry, I have learned much of the chemistry that I am now expected to teach in my courses. I continue to seek out opportunities to learn more and am currently volunteering at geochemistry laboratories at the USGS. My ARMADA research experience depended on teamwork. I learned that while the dynamics of research teams can be simplified if the teams are carefully designed, it is important that students need to learn to work with a variety of people in different situations. Therefore, in my courses, students work in different teams to design and

  18. The ICF-CY and Goal Attainment Scaling: benefits of their combined use for pediatric practice.

    Science.gov (United States)

    McDougall, Janette; Wright, Virginia

    2009-01-01

    There is much heterogeneity and disconnect in the approaches used by service providers to conduct needs assessments, set goals and evaluate outcomes for clients receiving pediatric rehabilitation services. The purpose of this article is to describe how the International Classification of Functioning, Disability and Health-Child and Youth (ICF-CY) can be used in combination with Goal Attainment Scaling (GAS), an individualised measure of change, to connect the various phases of the therapeutic process to provide consistent clinical care that is family-centred, collaborative, well directed and accountable. A brief description of both the ICF-CY and GAS as they pertain to pediatric rehabilitation is provided as background. An explanation is given of how the ICF-CY offers a framework through which clients, families and service providers can together identify the areas of clients' needs. In addition, the article discusses how the use of GAS facilitates translation of clients' identified needs into distinct, measurable goals set collaboratively by clients, their families and service providers. Examples of integrated GAS goals set for the various components of the ICF-CY are provided. The utility of GAS as a measure of clinical outcomes for individual clients is also discussed. Used in combination, the ICF-CY and GAS can serve to coordinate, simplify and standardise assessment and outcome evaluation practices for individual clients receiving pediatric rehabilitation services.

  19. The application and practical benefits of “C theory” in project management

    Directory of Open Access Journals (Sweden)

    Kao I-Chan

    2017-01-01

    Full Text Available This study regarded adult in-service students who are familiar with project management courses as the subjects and collected data through questionnaires for confirmatory factor analysis and reliability analysis. The aim is to construct a “C Theory” questionnaire scale that encompasses the essence of Chinese management philosophy like decision-making of Taoism, leadership of Legalism, tactics of School of Military Strategists, creativity of Mohism, and coordination of Confucianism. Furthermore, management performance scales were constructed for learning and growth, internal operation, customer satisfaction, and financial control, while the questionnaires and statistical analyses were expected to probe into the impact of “C Theory” on project management performance. This study found that the application and practice of “C Theory” have a high and positive correlation with project management and a significant influence on the improvement of performance. It is therefore suggested that management methods in “C Theory” be appropriately used in project management in order to enhance the efficiency of project management and facilitate the achievement of project management targets.

  20. Requisites, benefits, and challenges of sustainable HIV/AIDS system-building: where theory meets practice.

    Science.gov (United States)

    Indyk, Debbie; Rier, David A

    2006-01-01

    This paper is the third and final of a series that has previously presented the rationale (Rier and Indyk, this volume) and major program elements (Indyk and Rier, this volume) of an approach to link community and tertiary sociomedical providers, clients/patients, sites, and systems into an integrated response to HIV/AIDS. The primary goal has been to improve sociomedical HIV/AIDS services for a hard-to-reach inner city population. The current paper first summarizes the main advantages (e.g., greater efficiency; more realistic, effective programs with greater credibility among the community; stimulation of knowledge production and dissemination amongst players rarely formally engaged in such activities; creation of a platform useful for other applications) of this work. It then examines some of the main organizational challenges in conducting the work (involving issues such as personnel, coordination, funding, turf conflicts, sustainability). From this discussion emerge organizational requisites to conducting this work (e.g., development of key boundary-spanning figures; attention to the specific interests of potential linkage partners; translation efforts to demonstrate the value of participation; a continuous quality improvement approach featuring wide distribution of feedback in user-friendly form; flexibility, tact and patience), so that others can adapt and apply the linkage approach to manage HIV/AIDS or other problems. Finally, we explain how theory and practice have driven one another in this work.

  1. Benefits and harms of general health checks- lifelong learning in general practice: how to read and use scientific literature

    DEFF Research Database (Denmark)

    Arreskov, Anne Beiter; Graungaard, Anette Hauskov; Nielsen, Kirsten Lykke

    the paper using the method of critical appraisal. Session content The didactic method used in the workshop is mostly small group activities with eight participants and two tutors in each group. The participants will receive two scientific papers: the BMJ-version of the Cochrane review about general health......Abstract title: Benefits and harms of general health checks - lifelong learning in general practice: how to read and use scientific literature Objectives After this workshop the participants will know the basics of how to read a systematic literature review and interpret a meta-analysis and be able......, assesses, and implements methods of diagnosis and treatment on the basis of the best available current research, clinical expertise, and combines this with the needs and preferences of the patient, is termed evidence-based medicine. By learning and practising the principles of evidence-based medicine, GPs...

  2. Benefits, challenges, and best practices for involving audiences in the development of interactive coastal risk communication tools: Professional communicators' experiences

    Science.gov (United States)

    Stephens, S. H.; DeLorme, D.

    2017-12-01

    To make scientific information useful and usable to audiences, communicators must understand audience needs, expectations, and future applications. This presentation synthesizes benefits, challenges, and best practices resulting from a qualitative social science interview study of nine professionals on their experiences developing interactive visualization tools for communicating about coastal environmental risks. Online interactive risk visualization tools, such as flooding maps, are used to provide scientific information about the impacts of coastal hazards. These tools have a wide range of audiences and purposes, including time-sensitive emergency communication, infrastructure and natural resource planning, and simply starting a community conversation about risks. Thus, the science, purposes, and audiences of these tools require a multifaceted communication strategy. In order to make these tools useable and accepted by their audiences, many professional development teams solicit target end-user input or incorporate formal user-centered design into the development process. This presentation will share results of seven interviews with developers of U.S. interactive coastal risk communication tools, ranging from state-level to international in scope. Specific techniques and procedures for audience input that were used in these projects will be discussed, including ad-hoc conversations with users, iterative usability testing with project stakeholder groups, and other participatory mechanisms. The presentation will then focus on benefits, challenges, and recommendations for best practice that the interviewees disclosed about including audiences in their development projects. Presentation attendees will gain an understanding of different procedures and techniques that professionals employ to involve end-users in risk tool development projects, as well as important considerations and recommendations for effectively involving audiences in science communication design.

  3. A concealed observational study of infection control and safe injection practices in Jordanian governmental hospitals.

    Science.gov (United States)

    Al-Rawajfah, Omar M; Tubaishat, Ahmad

    2017-10-01

    The recognized international organizations on infection prevention recommend using an observational method as the gold standard procedure for assessing health care professional's compliance with standard infection control practices. However, observational studies are rarely used in Jordanian infection control studies. This study aimed to evaluate injection practices among nurses working in Jordanian governmental hospitals. A cross-sectional concealed observational design is used for this study. A convenience sampling technique was used to recruit a sample of nurses working in governmental hospitals in Jordan. Participants were unaware of the time and observer during the observation episode. A total of 384 nurses from 9 different hospitals participated in the study. A total of 835 injections events were observed, of which 73.9% were performed without handwashing, 64.5% without gloving, and 27.5% were followed by needle recapping. Handwashing rate was the lowest (18.9%) when injections were performed by beginner nurses. Subcutaneous injections were associated with the lowest rate (26.7%) of postinjection handwashing compared with other routes. This study demonstrates the need for focused and effective infection control educational programs in Jordanian hospitals. Future studies should consider exploring the whole infection control practices related to waste disposal and the roles of the infection control nurse in this process in Jordanian hospitals. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  4. Generalizing from Observations of Mathematics Teachers' Instructional Practice Using the Instructional Quality Assessment

    Science.gov (United States)

    Wilhelm, Anne Garrison; Kim, Sungyeun

    2015-01-01

    One crucial question for researchers who study teachers' classroom practice is how to maximize information about what is happening in classrooms while minimizing costs. This report extends prior studies of the reliability of the Instructional Quality Assessment (IQA), a widely used classroom observation toolkit, and offers insight into the often…

  5. REFLECTIVE PRACTICE THROUGH JOURNAL WRITING AND PEER OBSERVATION: A Case Study

    Directory of Open Access Journals (Sweden)

    B. Samrajya LAKSHMI

    2014-10-01

    Full Text Available Journal writing and Peer Observation in an educational context have become popular techniques, with several different types of applications. They have now been used quite widely in both language teaching and in teacher training. However, despite its reported advantages in both teaching and research, there are not many Peer Observation and Diary studies available based on the writing of experienced language teachers. The Teacher participants maintain Journal writing and Peer Observation as a means of reflective practice. They consider these practices as a mirror, which reflects the teacher’s own image as a practioner. The post-reflection discussion reveals that the teacher participants believe in reflective practice as an effective means of self-evaluation and of developing sensitivity to students’ learning. This paper examines Peer Observation and journal writing of two teachers working on the same language programme in terms of a variety of topic headings, and suggests that reflective practice can be a useful tool for both classroom research and teachers’ professional development.

  6. Self-Regulation of Practice Behavior Among Elite Youth Soccer Players : An Exploratory Observation Study

    NARCIS (Netherlands)

    Toering, Tynke; Elferink-Gemser, Marije; Jordet, Geir; Jorna, Casper; Pepping, Gert-Jan; Visscher, Chris

    2011-01-01

    This study aimed to measure behavioral correlates of self-regulation in elite youth soccer players. Behaviors regarded as indicative of self-regulated learning were identified by interviewing six expert youth soccer coaches. These behaviors were observed during practice of eight elite youth soccer

  7. Radiographers' and radiology practitioners' opinion, experience and practice of benefit-risk communication and consent in paediatric imaging

    International Nuclear Information System (INIS)

    Portelli, J.L.; McNulty, J.P.; Bezzina, P.; Rainford, L.

    2016-01-01

    Objectives: To investigate radiographers' and radiology practitioners' opinion, experience and practice of radiation benefit-risk communication and consent for paediatric imaging examinations. Methods: A cross-sectional survey was conducted amongst radiographers and radiology practitioners working at a primary paediatric referral centre in Malta, so as to acquire information about their interactions with paediatric patients and/or their parents, particularly their opinion and practice of communicating benefit-risk information and seeking consent for imaging examinations. Results: The return of 112 questionnaires provided a response rate of 66.7%. Findings revealed varied practice relating to the provision of benefit-risk information, whereby details concerning examination benefits and potential risks are not always conveyed. For 89% of participants, parental consent was sought for paediatric imaging examinations in their current practice. Only 36.7% of participants indicated that they were highly confident in their ability to communicate benefit-risk information. The study findings also revealed that parents can truly be worried about the associated radiation exposure, with some even refusing an imaging examination as a result of such concerns. Conclusions: The practice of communicating benefit-risk information to paediatric patients and/or their parents is varied. A possible gap in benefit-risk communication education and/or training was identified, which may impact radiographers' and radiology practitioners' confidence in conveying such information. Education/training activities for radiographers and radiology practitioners are therefore necessary to foster improved benefit-risk dialogues and help provide reassurance to parents/guardians about the benefits of appropriately indicated paediatric imaging examinations. - Highlights: • The practice of communicating radiation benefit-risk information to parents of paediatric patients is varied.

  8. Observations of infection prevention and control practices in primary health care, Kenya.

    Science.gov (United States)

    Bedoya, Guadalupe; Dolinger, Amy; Rogo, Khama; Mwaura, Njeri; Wafula, Francis; Coarasa, Jorge; Goicoechea, Ana; Das, Jishnu

    2017-07-01

    To assess compliance with infection prevention and control practices in primary health care in Kenya. We used an observational, patient-tracking tool to assess compliance with infection prevention and control practices by 1680 health-care workers during outpatient interactions with 14 328 patients at 935 health-care facilities in 2015. Compliance was assessed in five domains: hand hygiene; protective glove use; injections and blood sampling; disinfection of reusable equipment; and waste segregation. We calculated compliance by dividing the number of correct actions performed by the number of indications and evaluated associations between compliance and the health-care worker's and facility's characteristics. Across 106 464 observed indications for an infection prevention and control practice, the mean compliance was 0.318 (95% confidence interval, CI: 0.315 to 0.321). The compliance ranged from 0.023 (95% CI: 0.021 to 0.024) for hand hygiene to 0.871 (95% CI: 0.866 to 0.876) for injection and blood sampling safety. Compliance was weakly associated with the facility's characteristics (e.g. public or private, or level of specialization) and the health-care worker's knowledge of, and training in, infection prevention and control practices. The observational tool was effective for assessing compliance with infection prevention and control practices across multiple domains in primary health care in a low-income country. Compliance varied widely across infection prevention and control domains. The weak associations observed between compliance and the characteristics of health-care workers and facilities, such as knowledge and the availability of supplies, suggest that a broader focus on behavioural change is required.

  9. The impact and societal benefits of using earth observation for ground water policies in the agricultural sector

    Science.gov (United States)

    Pearlman, Francoise; Bernknopf, Richard; Pearlman, Jay; Rigby, Michael

    2017-04-01

    Assessment of the impact and societal benefit of Earth Observation (EO) is a multidisciplinary task that involves the social, economic and environmental knowledge to formulate indicators and methods. The value of information (VOI) of EO is based on case studies that document the value in use of the information in a specific decision. A case study is an empirical inquiry investigating a phenomenon. It emphasizes detailed contextual analysis of a limited number of events or conditions and their relationships. Quantitative estimates of the benefits and costs of the geospatial information derived from EO data document and demonstrate its economic value. A case study was completed to examine some of the technical perspectives of adapting and coupling satellite imagery and in situ water quality measurements to forecast changes in groundwater quality in the agricultural sector in Iowa. The analysis was conducted to identify the ability of EO to assist in improving agricultural land management and regulation of balancing production and groundwater contamination. The Iowa case study described the application of Landsat data in a land adaptation strategy to maintain agricultural production and groundwater water quality. Results demonstrated that Landsat information facilitates spatiotemporal analysis of the impact of nitrates (fertilizer application) on groundwater resources and that crop production could be retained while groundwater quality is maintained. To transition to the operational use of the geospatial information, the Landsat data should be applied in a use case where Interaction of various stakeholders within a decision process are addressed. The objective is to design implementation experiments of a system from the user's and contributor's perspective, and to communicate system behavior in their terms. A use case requires communication of system requirements, how the system operates and may be used, the roles that all participants play and what value the user

  10. Transfusion practice and complications after laparotomy - an observational analysis of a randomized clinical trial

    DEFF Research Database (Denmark)

    Nielsen, Kamilla; Meyhoff, C S; Johansson, P I

    2012-01-01

    Background  Transfusion of allogeneic red blood cells (RBC) may be associated with side effects. This study aimed to assess whether an association could be detected between transfusion practice and the occurrence of complications after laparotomy. Study design and methods  This study is an observ......Background  Transfusion of allogeneic red blood cells (RBC) may be associated with side effects. This study aimed to assess whether an association could be detected between transfusion practice and the occurrence of complications after laparotomy. Study design and methods  This study...... is an observational analysis of data from a randomized trial in 1400 patients who underwent laparotomy. A subgroup of 224 transfused patients with an intraoperative blood loss ≥200 ml were included in the analysis. Logistic regression analysis was used to investigate risk factors for postoperative complications...

  11. Observing the interactive qualities of L2 instructional practices in ESL and FSL classrooms

    Directory of Open Access Journals (Sweden)

    Michael Zuniga

    2016-03-01

    Full Text Available Discourse features that promote the generation of interactionally modified input and output, such as negotiation for meaning, have been shown to significantly enhance second language acquisition. Research has also identified several characteristics of instructional practices that render them more or less propitious to the generation of these discourse features. While various classroom observation studies have successfully measured the communicative orientation of classroom environments, most of the indicators of interactivity analyzed in those studies were obtained through micro-level discourse analyses and not through macro-level analyses of task-related factors shown to directly influence the interactivity of instructional practices. Such a macro-level scale has potential practical implications for teachers and administrators seeking an efficient tool for assessing and improving the interactivity afforded by a given curriculum. The objective of the present study was therefore to develop macro-level scale to determine the extent to which teachers of French and English as a second language use interaction-friendly instructional practices. Using an observation scheme designed to code data on factors shown to influence interactivity, 63 hours of FSL and ESL classes from secondary schools in the Montreal area were observed and analyzed. Results indicate clear differences between the two groups. While both ESL and FSL classes were less teacher-centered than those observed in previous studies, they were still rated as not-very-interactive. Target language differences showed that the FSL classes were more teacher-centered and characterized by fewer interaction-friendly tasks and activities than the ESL classes. Task characteristics, reasons for ESL and FSL differences and recommendations for improvement are discussed.

  12. Self-practice and self-reflection in cognitive behaviour therapy training: what factors influence trainees' engagement and experience of benefit?

    Science.gov (United States)

    Bennett-Levy, James; Lee, Nicole K

    2014-01-01

    Previous studies of self-practice/self-reflection (SP/SR) CBT training have found that trainees report significant benefits from practising CBT techniques on themselves (self-practice) and reflecting on their experience (self-reflection) as a formal part of their CBT training. However, not all trainees experience the same level of benefit from SP/SR and not all types of training course produce benefits to the same extent. This paper examines the question: What factors influence trainees' reported benefit from SP/SR? The aim was to develop a model to maximize the value of SP/SR training. The authors used a grounded theory analysis of four SP/SR training courses, varying along several dimensions, to derive a model that could account for the data. A model was derived comprising of seven elements: Two outcomes - "Experience of Benefit" and "Engagement with the Process" - that mutually influence one another; and five other influencing factors - "Course Structure and Requirements", "Expectation of Benefit", "Feeling of Safety with the Process", "Group Process", and "Available Personal Resources" - that mediate the impact on Engagement with the Process and Experience of Benefit from SP/SR. A model that provides guidance about the best ways to set up and develop SP/SR programs has been developed. This model may now be subject to empirical testing by trainers and researchers. Implications and recommendations for the design and development of future SP/SR programs are discussed.

  13. Health benefits of different sport disciplines for adults: systematic review of observational and intervention studies with meta-analysis.

    Science.gov (United States)

    Oja, Pekka; Titze, Sylvia; Kokko, Sami; Kujala, Urho M; Heinonen, Ari; Kelly, Paul; Koski, Pasi; Foster, Charlie

    2015-04-01

    The aim was to assess the quality and strength of evidence for the health benefits of specific sport disciplines. Electronic search yielded 2194 records and the selection resulted in 69 eligible studies (47 cross-sectional, 9 cohort, 13 intervention studies). 105 comparisons between participation and non-participation groups in 26 different sport disciplines were reported. Moderately strong evidence showed that both running and football improve aerobic fitness and cardiovascular function at rest, and football reduces adiposity. Conditional evidence showed that running benefits metabolic fitness, adiposity and postural balance, and football improves metabolic fitness, muscular performance, postural balance, and cardiac function. Evidence for health benefits of other sport disciplines was either inconclusive or tenuous. The evidence base for the health benefits of specific sports disciplines is generally compromised by weak study design and quality. Future research should address the health effects of different sport disciplines using rigorous research designs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  14. Nursing practice in the prevention of pressure ulcers: an observational study of German Hospitals.

    Science.gov (United States)

    Hoviattalab, Khadijeh; Hashemizadeh, Haydeh; D'Cruz, Gibson; Halfens, Ruud J G; Dassen, Theo

    2015-06-01

    The study aimed to establish the range and extent of preventive interventions undertaken by nurses for patients who are at high risk of developing or currently have a pressure ulcer. Since 2000, the German National Expert Standard for the prevention of pressure ulcers has provided evidence-based recommendations, but limited studies have been published on its adherence in hospitals. There are also limited observational studies that investigated whether patients who are at risk of or have pressure ulcers are provided with appropriate preventative measures. A nonparticipant observational descriptive design was used. A sample of 32 adult patients who were at high risk of developing or currently had a pressure ulcer were observed during all shifts in medical and surgical wards in two general hospitals in Germany. A range of preventive interventions that were in line with the German National Expert Standard was observed. The most frequent preventive measures were 'cleaning the patients' skin' and 'minimizing exposure to moisture' that were undertaken in more than 90% of all patients. The least frequent measures were 'patient and relative education', 'assessment and recording of nutritional status'. This study demonstrates that the pressure ulcers preventive interventions as set out in the German National Expert Standard were not fully implemented. The study highlights the need for further studies on the barriers that impede the undertaking of the interventions that may prevent the development or deterioration of pressure ulcers and the delivery of evidence-based preventative care. This study provides an insight into the extent of pressure ulcers preventive practices used by nurses. The results may serve as a basis for developing an effective strategy to improve nursing practice in this area and the promotion of evidence-based practice. However, our results refer to two general hospitals and for a broader population, further studies with larger data samples are needed.

  15. [Benefits and usability of a pharmaceutical record in medical practice. A survey of hospital doctors and pharmacists (MATRIX study)].

    Science.gov (United States)

    Schuers, M; Timsit, M; Gillibert, A; Fred, A; Griffon, N; Bénichou, J; Darmoni, S J; Staccini, P

    2016-09-01

    To evaluate the impact of the pharmaceutical patient record use in emergency, geriatric and anaesthesia and intensive care departments, an experimentation was launched in 2013 in 55 hospitals. The purpose of the study was to assess the opinions of physicians and pharmacists about the benefits and usability of the patient pharmaceutical record. An e-mailed self-administered questionnaire was sent to all the pharmacists, anaesthesiologists, geriatricians and emergency physicians of the 55 hospitals involved in the patient pharmaceutical record experimentation. The questionnaire assessed the usability of the patient pharmaceutical record using the "System Usability Scale", as well as its use, its benefits and limitations perceived in clinical practice, and overall user satisfaction. Questionnaires were collected from November 2014 to January 2015. Ninety-six questionnaires were collected, from 47 hospitals, representing 86% of the hospitals involved in the experimentation. The patient pharmaceutical record was effectively operational in 36 hospitals. Data from 73 questionnaires filled by physicians and pharmacists with potential experience with the patient pharmaceutical record were used for evaluation. Forty-two respondents were pharmacists (57%) and 31 were physicians (43%), including 13 geriatricians, 11 emergency physicians and 7 anaesthesiologists. Patient pharmaceutical record overall usability score was 62.5 out of 100. It did not vary with the profession or seniority of the respondent. It was positively correlated with the frequency of use. More than half of respondents reported that they never or uncommonly used the patient pharmaceutical record. The length of access to data period was considered as insufficient. Main obstacles to more utilization of the patient pharmaceutical record were the lack of information about the dosage of dispensed drugs, the low number of patients in possession of their health card and the low number of patients with an activated

  16. Concordance of chart and billing data with direct observation in dental practice.

    Science.gov (United States)

    Demko, Catherine A; Victoroff, Kristin Zakariasen; Wotman, Stephen

    2008-10-01

    The commonly used methods of chart review, billing data summaries and practitioner self-reporting have not been examined for their ability to validly and reliably represent time use and service delivery in routine dental practice. A more thorough investigation of these data sources would provide insight into the appropriateness of each approach for measuring various clinical behaviors. The aim of this study was to assess the validity of commonly used methods such as dental chart review, billing data, or practitioner self-report compared with a 'gold standard' of information derived from direct observation of routine dental visits. A team of trained dental hygienists directly observed 3751 patient visits in 120 dental practices and recorded the behaviors and procedures performed by dentists and hygienists during patient contact time. Following each visit, charts and billing records were reviewed for the performed and billed procedures. Dental providers characterized their frequency of preventive service delivery through self-administered surveys. We standardized the observation and abstraction methods to obtain optimal measures from each of the multiple data sources. Multi-rater kappa coefficients were computed to monitor standardization, while sensitivity, specificity, and kappa coefficients were calculated to compare the various data sources with direct observation. Chart audits were more sensitive than billing data for all observed procedures and demonstrated higher agreement with directly observed data. Chart and billing records were not sensitive for several prevention-related tasks (oral cancer screening and oral hygiene instruction). Provider self-reports of preventive behaviors were always over-estimated compared with direct observation. Inter-method reliability kappa coefficients for 13 procedures ranged from 0.197 to 0.952. These concordance findings suggest that strengths and weaknesses of data collection sources should be considered when investigating

  17. Factors associated with weaning practices in term infants: a prospective observational study in Ireland.

    LENUS (Irish Health Repository)

    Tarrant, R C

    2010-11-01

    The WHO (2001) recommends exclusive breast-feeding and delaying the introduction of solid foods to an infant\\'s diet until 6 months postpartum. However, in many countries, this recommendation is followed by few mothers, and earlier weaning onto solids is a commonly reported global practice. Therefore, this prospective, observational study aimed to assess compliance with the WHO recommendation and examine weaning practices, including the timing of weaning of infants, and to investigate the factors that predict weaning at ≤ 12 weeks. From an initial sample of 539 pregnant women recruited from the Coombe Women and Infants University Hospital, Dublin, 401 eligible mothers were followed up at 6 weeks and 6 months postpartum. Quantitative data were obtained on mothers\\' weaning practices using semi-structured questionnaires and a short dietary history of the infant\\'s usual diet at 6 months. Only one mother (0.2%) complied with the WHO recommendation to exclusively breastfeed up to 6 months. Ninety-one (22.6%) infants were prematurely weaned onto solids at ≤ 12 weeks with predictive factors after adjustment, including mothers\\' antenatal reporting that infants should be weaned onto solids at ≤ 12 weeks, formula feeding at 12 weeks and mothers\\' reporting of the maternal grandmother as the principal source of advice on infant feeding. Mothers who weaned their infants at ≤ 12 weeks were more likely to engage in other sub-optimal weaning practices, including the addition of non-recommended condiments to their infants\\' foods. Provision of professional advice and exploring antenatal maternal misperceptions are potential areas for targeted interventions to improve compliance with the recommended weaning practices.

  18. Implementation of pressure ulcer prevention best practice recommendations in acute care: an observational study.

    Science.gov (United States)

    Barker, Anna Lucia; Kamar, Jeannette; Tyndall, Tamara Jane; White, Lyn; Hutchinson, Anastasia; Klopfer, Nicole; Weller, Carolina

    2013-06-01

    Pressure ulcers are a common but preventable problem in hospitals. Implementation of best practice guideline recommendations can prevent ulcers from occurring. This 9-year cohort study reports prevalence data from point prevalence surveys during the observation period, and three practice metrics to assess implementation of best practice guideline recommendations: (i) nurse compliance with use of a validated pressure ulcer risk assessment and intervention checklist; (ii) accuracy of risk assessment scoring in usual-care nurses and experienced injury prevention nurses; and (iii) use of pressure ulcer prevention strategies. The prevalence of hospital-acquired pressure ulcers decreased following implementation of an evidence-based prevention programme from 12·6% (2 years preprogramme implementation) to 2·6% (6 years postprogramme implementation) (P pressure ulcer prevention documentation according to best practice guidelines was high (>84%). A sample of 270 patients formed the sample for the study of risk assessment scoring accuracy and use of prevention strategies. It was found usual-care nurses under-estimated patients' risk of pressure ulcer development and under-utilised prevention strategies compared with experienced injury prevention nurses. Despite a significant reduction in prevalence of hospital-acquired pressure ulcers and high documentation compliance, use of prevention strategies could further be improved to achieve better patient outcomes. Barriers to the use of prevention strategies by nurses in the acute hospital setting require further examination. This study provides important insights into the knowledge translation of pressure ulcer prevention best practice guideline recommendations at The Northern Hospital. © 2012 The Authors. International Wound Journal © 2012 John Wiley & Sons Ltd and Medicalhelplines.com Inc.

  19. Online information about risks and benefits of screening mammography in 10 European countries: An observational Web sites analysis.

    Science.gov (United States)

    Spagnoli, Laura; Navaro, Monica; Ferrara, Pietro; Del Prete, Viola; Attena, Francesco

    2018-06-01

    Most publications about breast cancer do not provide accurate and comprehensive information, giving few or no data about risk/benefit ratios. We conducted a comparative study among 10 European countries about health information on breast cancer screening, assessing the first 10 Web sites addressing the general public that appeared following an Internet search.With the help of medical residents involved in the EuroNet MRPH Association, we analyzed the first 30 results of an Internet search in 10 European countries to determine the first 10 sites that offered screening mammography. We searched for the following information: source of information, general information on mammography and breast cancer screening, potential harms and risks (false positives, false positives after biopsy, false negatives, interval cancer, overdiagnosis, lead-time bias, and radiation exposure), and potential benefits (reduced mortality and increased survival).The United Kingdom provided the most information: 39 of all 70 possible identified risks (56%) were reported on its sites. Five nations presented over 35% of the possible information (United Kingdom, Spain, France, Ireland, and Italy); the others were under 30% (Portugal, Poland, Slovenia, Netherlands, and Croatia). Regarding the benefits, sites offering the most complete information were those in France (95%) and Poland (90%).Our results suggest that, despite consensus in the scientific community about providing better information to citizens, further efforts are needed to improve information about breast cancer screening. That conclusion also applies to countries showing better results. We believe that there should be greater coordination in this regard throughout Europe.

  20. The Romance and the Reality between Pre-Service Teachers' Beliefs about the Potential Benefits of a Short-Term Study Abroad Programme and Their Practices

    Science.gov (United States)

    Tam, Angela Choi Fung

    2016-01-01

    This qualitative study aimed to explore Hong Kong pre-service teachers' beliefs about the potential benefits of a short-term study abroad programme and their practices. Pre- and post-programme semi-structured interviews and reflective journals were employed to collect data. The findings suggest that the transformation of beliefs into practices…

  1. A justice-theoretic approach to the distribution of transportation benefits: Implications for transportation planning practice in the United States

    NARCIS (Netherlands)

    Martens, C.J.C.M.; Golub, A.; Robinson, G.

    2012-01-01

    Transportation improvements inevitably lead to an uneven distribution of user benefits, in space and by network type (private and public transport). This paper makes a moral argument for what would be a fair distribution of these benefits. The argument follows Walzer’s ‘‘Spheres of Justice’’

  2. Acquisition and improvement of human motor skills: Learning through observation and practice

    Science.gov (United States)

    Iba, Wayne

    1991-01-01

    Skilled movement is an integral part of the human existence. A better understanding of motor skills and their development is a prerequisite to the construction of truly flexible intelligent agents. We present MAEANDER, a computational model of human motor behavior, that uniformly addresses both the acquisition of skills through observation and the improvement of skills through practice. MAEANDER consists of a sensory-effector interface, a memory of movements, and a set of performance and learning mechanisms that let it recognize and generate motor skills. The system initially acquires such skills by observing movements performed by another agent and constructing a concept hierarchy. Given a stored motor skill in memory, MAEANDER will cause an effector to behave appropriately. All learning involves changing the hierarchical memory of skill concepts to more closely correspond to either observed experience or to desired behaviors. We evaluated MAEANDER empirically with respect to how well it acquires and improves both artificial movement types and handwritten script letters from the alphabet. We also evaluate MAEANDER as a psychological model by comparing its behavior to robust phenomena in humans and by considering the richness of the predictions it makes.

  3. Pediatric anesthesia after the anaesthesia practice in children observational trial study: who should do it?

    Science.gov (United States)

    Habre, Walid

    2018-02-12

    This review highlights the requirements for harmonization of training, certification and continuous professional development and discusses the implications for anesthesia management of children in Europe. A large prospective cohort study, Anaesthesia PRactice In Children Observational Trial (APRICOT), revealed a high incidence of perioperative severe critical events and a large variability of anesthesia practice across 33 European countries. Relevantly, quality improvement programs have been implemented in North America, which precisely define the requirements to manage anesthesia care for children. These programs, with the introduction of an incident-reporting system at local and national levels, could contribute to the improvement of anesthesia care for children in Europe. The main factors that likely contributed to the APRICOT study results are discussed with the goal of defining clear requirement guidelines for anesthetizing children. Emphasis is placed on the importance of an incident-reporting system that can be used for both competency-based curriculum for postgraduate training as well as for continuous professional development. Variability in training as well as in available resources, equipment and facilities limit the generalization of some of the APRICOT results. Finally, the impact on case outcome of the total number of pediatric cases attended by the anesthesiologist should be taken into consideration along with the level of expertise of the anesthesiologist for complex pediatric anesthesia cases.

  4. Psychological variables potentially implicated in opioid-related mortality as observed in clinical practice.

    Science.gov (United States)

    Passik, Steven D; Lowery, Amy

    2011-06-01

    Opioid-related deaths in the United States have become a public health problem, with accidental and unintended overdoses being especially troubling. Screening for psychological risk factors is an important first step in safeguarding against nonadherence practices and identifying patients who may be vulnerable to the risks associated with opioid therapy. Validated screening instruments can aid in this attempt as a complementary tool to clinicians' assessments. A structured screening is imperative as part of an assessment, as clinician judgment is not the most reliable method of identifying nonadherence. As a complement to formal screening, we present for discussion and possible future study certain psychological variables observed during years of clinical practice that may be linked to medication nonadherence and accidental overdose. These variables include catastrophizing, fear, impulsivity, attention deficit disorders, existential distress, and certain personality disorders. In our experience, chronic pain patients with dual diagnoses may become "chemical copers" as a way of coping with their negative emotion. For these patients, times of stress could lead to accidental overdose. Behavioral, cognitive-behavioral (acceptance and commitment, dialectical behavior), existential (meaning-centered, dignity), and psychotropic therapies have been effective in treating these high-risk comorbidities, while managing expectations of pain relief appears key to preventing accidental overdose. Wiley Periodicals, Inc.

  5. Economic benefits of high value medicinal plants to Pakistani communities: an analysis of current practice and potential.

    Science.gov (United States)

    Sher, Hassan; Aldosari, Ali; Ali, Ahmad; de Boer, Hugo J

    2014-10-10

    Poverty is pervasive in the Swat Valley, Pakistan. Most of the people survive by farming small landholdings. Many earn additional income by collecting and selling plant material for use in herbal medicine. This material is collected from wild populations but the people involved have little appreciation of the potential value of the plant material they collect and the long term impact their collecting has on local plant populations. In 2012, existing practices in collecting and trading high value minor crops from Swat District, Pakistan, were analyzed. The focus of the study was on the collection pattern of medicinal plants as an economic activity within Swat District and the likely destinations of these products in national or international markets. Local collectors/farmers and dealers were surveyed about their collection efforts, quantities collected, prices received, and resulting incomes. Herbal markets in major cities of Pakistan were surveyed for current market trends, domestic sources of supply, imports and exports of herbal material, price patterns, and market product-quality requirements. It was observed that wild collection is almost the only source of medicinal plant raw material in the country, with virtually no cultivation. Gathering is mostly done by women and children of nomadic Middle Hill tribes who earn supplementary income through this activity, with the plants then brought into the market by collectors who are usually local farmers. The individuals involved in gathering and collecting are largely untrained regarding the pre-harvest and post-harvest treatment of collected material. Most of the collected material is sold to local middlemen. After that, the trade pattern is complex and heterogeneous, involving many players. Pakistan exports of high value plants generate over US$10.5 million annually in 2012, with a substantial percentage of the supply coming from Swat District, but its market share has been declining. Reasons for the decline were

  6. Impact of observing hand hygiene in practice and research: a methodological reconsideration.

    Science.gov (United States)

    Gould, D J; Creedon, S; Jeanes, A; Drey, N S; Chudleigh, J; Moralejo, D

    2017-02-01

    The purpose of hand hygiene is to break the chain of healthcare-associated infection. In many countries hand hygiene is regularly audited as part of quality assurance based on recommendations from the World Health Organization. Direct observation is the recommended audit method but is associated with disadvantages, including potential for being observed to alter usual behaviour. The Hawthorne effect in relation to hand hygiene is analogous with productivity improvement by increasing the frequency with which hand hygiene is undertaken. Unobtrusive and/or frequent observation to accustom staff to the presence of observers is considered an acceptable way of reducing the Hawthorne effect, but few publications have discussed how to implement these techniques or examine their effectiveness. There is evidence that awareness of being watched can disrupt the usual behaviour of individuals in complex and unpredictable ways other than simple productivity effect. In the presence of auditors, health workers might defer or avoid activities that require hand hygiene, but these issues are not addressed in guidelines for practice or research studies. This oversight has implications for the validity of hand hygiene audit findings. Measuring hand hygiene product use overcomes avoidance tactics. It is cheaper and generates data continuously to assess the compliance of all clinicians without disrupting patient care. Disadvantages are the risk of overestimating uptake through spillage, wastage, or use by visitors and non-clinical staff entering patient care areas. Electronic devices may overcome the Hawthorne and avoidance effects but are costly and are not widely used outside research studies. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  7. Strategy-focused writing instruction: just observing and reflecting on a model benefits 6th grade students

    NARCIS (Netherlands)

    Fidalgo, R.; Torrance, M.; Rijlaarsdam, G.; van den Bergh, H.; Álvarez, M.L.

    2015-01-01

    Three groups of typically-developing 6th grade students (total N = 62) each completed strategy-focused writing training. Using a combined lagged-group and cross-panel design we assessed the effectiveness of a sequence of four different instructional components: observation and group reflection on a

  8. [German translation of Suicidal Patient Observation Chart (SPOC) - an instrument for practice].

    Science.gov (United States)

    Löhr, Michael; Schulz, Michael; Hemkendreis, Bruno; Björkdahl, Anna; Nienaber, André

    2013-12-01

    Nursing of suicidal in-patients is a complex and responsible task. A direct and immediate intensive caring and therapeutic supervision, also known as special observation is still recommended in guidelines (DGPPN, 2012) and maybe one of the most used interventions in the caring of suicidal patients in inpatient settings. It involves many kinds to develop the relationship between the observer and the patient. The original SPOC was developed in Sweden with the aim to increase the quality of a systematically documentation during the supervision of suicidal patients. It is an instrument to ensure systematic documentation of observational behavior or noticeable mood during acute suicidal crisis, for example feelings like "worried, anxious" or other possible influencing factors like "sudden mood variation". By this means the SPOC can ensure the process of systematic documentation of special observation and increase its quality, i. e. who documented what at what time. Furthermore SPOC can facilitate a better communication of the observation process to the multidisciplinary team and to the patient as well. The SPOC includes the 28 items and covers 24 separate observation periods. The aim of this paper is to constitute the translation process from the English to the German SPOC version. The translation process followed a five step model. In the first step the English version was translated from two German native speakers. In the second step, the first two translation results where discussed by the Expert group (authors) and a new version was developed. In the third step the first german version was translated back (two English native Speakers) into English. The fourth step was taken, to review the results by the expert groups (authors) and set up the so called "pre version". The last step includes the proof of content validity by 52 nurses. The proof was able to identify a few misunderstandings and helped to enhance the tool in its final version. With the translation, the

  9. Design of a practical model-observer-based image quality assessment method for CT imaging systems

    Science.gov (United States)

    Tseng, Hsin-Wu; Fan, Jiahua; Cao, Guangzhi; Kupinski, Matthew A.; Sainath, Paavana

    2014-03-01

    The channelized Hotelling observer (CHO) is a powerful method for quantitative image quality evaluations of CT systems and their image reconstruction algorithms. It has recently been used to validate the dose reduction capability of iterative image-reconstruction algorithms implemented on CT imaging systems. The use of the CHO for routine and frequent system evaluations is desirable both for quality assurance evaluations as well as further system optimizations. The use of channels substantially reduces the amount of data required to achieve accurate estimates of observer performance. However, the number of scans required is still large even with the use of channels. This work explores different data reduction schemes and designs a new approach that requires only a few CT scans of a phantom. For this work, the leave-one-out likelihood (LOOL) method developed by Hoffbeck and Landgrebe is studied as an efficient method of estimating the covariance matrices needed to compute CHO performance. Three different kinds of approaches are included in the study: a conventional CHO estimation technique with a large sample size, a conventional technique with fewer samples, and the new LOOL-based approach with fewer samples. The mean value and standard deviation of area under ROC curve (AUC) is estimated by shuffle method. Both simulation and real data results indicate that an 80% data reduction can be achieved without loss of accuracy. This data reduction makes the proposed approach a practical tool for routine CT system assessment.

  10. The Effect of Social perception of environmental problems and goods on the practice of cost-benefit analysis

    Energy Technology Data Exchange (ETDEWEB)

    Bunuel, M.; Delgado, M. L.

    2002-07-01

    When revealed, willingness to pay (WTP) is considerably lesser than willingness to accept (WTA), as economists explain. Sociological studies in Spain reveal that citizens assign a high value to the environment (high WTA), but are not ready to pay to preserve it (low WTP)because they think that it is industrial sector and the government's responsibility. This is a new factor, not studied before, that may result in underestimating environmental goods when WTP is used. The gap between WTP and WTA makes cost-benefits analysis difficult, creating the risk of environmental political judgments being replaced by pseudo scientific noise instead of by objective economic analysis.hence, it is sometimes convenient to use alternative methods to cost-benefit analysis: cost-effectiveness analysis trade-off analysis, economic-impact valuation, and risk-benefit analysis. (Author)

  11. Research-Practice Partnerships: Building Engagement to Benefit Children and Youth. Social Policy Report Brief. Volume 30, Issue 4

    Science.gov (United States)

    Bridgman, Anne

    2017-01-01

    Gaps exist between research and practice, with some researchers expressing frustration that practitioners do not use or misuse research findings, and some practitioners saying research is not relevant to their work or not easily accessible or understood. In research-practice partnerships, which have proliferated recently, researchers and…

  12. The Pedagogical Benefits of Enacting Positive Psychology Practices through a Student-Faculty Partnership Approach to Academic Development

    Science.gov (United States)

    Cook-Sather, Alison; Schlosser, Joel Alden; Sweeney, Abigail; Peterson, Laurel M.; Cassidy, Kimberly Wright; Colón García, Ana

    2018-01-01

    Academic development that supports the enactment of positive psychology practices through student-faculty pedagogical partnership can increase faculty confidence and capacity in their first year in a new institution. When student partners practice affirmation and encouragement of strengths-based growth, processes of faculty acclimation and…

  13. The Classroom Observation Protocol for Undergraduate STEM (COPUS): A New Instrument to Characterize University STEM Classroom Practices

    OpenAIRE

    Smith, Michelle K.; Jones, Francis H. M.; Gilbert, Sarah L.; Wieman, Carl E.

    2013-01-01

    Instructors and the teaching practices they employ play a critical role in improving student learning in college science, technology, engineering, and mathematics (STEM) courses. Consequently, there is increasing interest in collecting information on the range and frequency of teaching practices at department-wide and institution-wide scales. To help facilitate this process, we present a new classroom observation protocol known as the Classroom Observation Protocol for Undergraduate STEM or C...

  14. Experience as a doctor in the developing world: does it benefit the clinical and organisational performance in general practice?

    Directory of Open Access Journals (Sweden)

    de Wit Niek J

    2009-12-01

    Full Text Available Abstract Background Many physicians have medical experience in developing countries early in their career, but its association with their medical performance later is not known. To explore possible associations we compared primary care physicians (GPs with and without professional experience in a developing country in performance both clinical and organisational. Methods A retrospective survey using two databases to analyse clinical and organisational performance respectively. Analysis was done at the GP level and practice level. 517 GPs received a questionnaire regarding relevant working experience in a developing country. Indicators for clinical performance were: prescription, referral, external diagnostic procedures and minor procedures. We used the district health insurance data base covering 570.000 patients. Explorative secondary analysis of practice visits of 1004 GPs in 566 practices in the Netherlands from 1999 till 2001. We used a validated practice visit method (VIP; 385 indicators in 51 dimensions of practice management to compare having experience in a developing country or not. Results Almost 8% of the GPs had experience in a developing country of at least two years. These GPs referred 9,5% less than their colleagues and did more surgical procedures. However, in the multivariate analysis 'experience in a developing country' was not significantly associated with clinical performance or with other GP- and practice characteristics. 16% of the practices a GP or GPs with at least two years experience in a developing country. They worked more often in group and rural practices with less patients per fte GP and more often part-time. These practices are more hygienic, collaborate more with the hospital and score better on organisation of the practice. These practices score less on service and availability, spend less time on patients in the consultation and the quality of recording in the EMD is lower. Conclusions We found interesting

  15. Observational study to analyze patterns of treatment of breakthrough dyspnea in cancer patients in clinical practice.

    Science.gov (United States)

    Cabezón-Gutiérrez, Luis; Delgado-Mingorance, Ignacio; Nabal-Vicuña, María; Jiménez-López, Antonio Javier; Cabezón-Álvarez, Ana; Soler-López, Begoña

    2018-06-12

    Although breakthrough dyspnea is very frequent in cancer patients, there are no precise recommendations for treating it. The main objective of this study was to analyze what treatments are used in clinical practice for the management of breakthrough dyspnea in cancer patients in Spain and the secondary objectives were to describe the characteristics of cancer patients with breakthrough dyspnea and the attributes of the disorder. Cancer patients over 18 years of age, with breakthrough dyspnea and a Karnofsky performance score of ≥30, who were treated at departments of oncology in institutes across Spain were included in this cross-sectional observational study. The characteristics of breakthrough dyspnea, history of treatment, anthropometric variables, Mahler dyspnea index, Borg scale, Edmonton Symptoms Assessment Scale, and patient satisfaction with current breakthrough dyspnea treatment were assessed. The mean age of the 149 included patients was 66 years (95% confidence interval: 64.3 to 67.9), and 53 were females (35.6%). The mean breakthrough dyspnea intensity was 5.85 (95% confidence interval 5.48 to 6.22, Borg scale). A total of 55.1% of the first-choice treatments consisted of opioids, followed by oxygen (17.3%). A total of 119 patients (79.9%) received monotherapy for breakthrough dyspnea. Patients presenting with basal dyspnea received oxygen in a greater proportion of cases (21.1% vs 7.4%; p = 0.07). Patients with predictable dyspnea received a greater proportion of opioids (70.9% vs 44.4%; p = 0.01). Opioids constitute first-line therapy for breakthrough dyspnea in routine clinical practice, though the scientific evidence supporting their use is scarce. Further information derived from controlled clinical trials is needed regarding the comparative efficacy of the different treatments in order to justify their use.

  16. Supporting communities of practice: A reflection on the benefits and challenges facing communities of practice for research and engagement in nursing

    Directory of Open Access Journals (Sweden)

    Maretha De Waal

    2016-09-01

    Full Text Available Because of its potential self-sustainability, communities of practice may serve as useful practice-based knowledge sharing platforms for collaborative research and training, and thereby enhance development of human resources in the health sector. However, communities of practice are complex structures and need support from their host organisations and commitment from their members.  This article examines the diverse ways in which communities of nurse educators and practitioners who were part of a funded program in Tshwane District, South Africa evolved over a period of seven years. Adopting an ethnographic approach of reflexivity and learning, we compared and analysed the ways in which the communities of practice became sustainable over time. Our recommendations for institutional support of communities of practice in the health sector are based on the lessons we learned during the program that contributed to the configuration and reconfiguration of some of our communities of practice and the disengagement of others. We believe that our findings may have implications for replicability and sustainability of other communities of practice. Keywords: collaborative learning, collective knowledge, self-sustainability

  17. Perceptions of the benefits and challenges of the role of advanced practice nurses in nurse-led out-of-hours care in Hong Kong: a questionnaire study.

    Science.gov (United States)

    Christiansen, Angela; Vernon, Veronica; Jinks, Annette

    2013-04-01

    The aim of the study was to identify the factors that nurses perceive may facilitate or hinder the development of advanced practice nurse roles in Hong Kong. Advanced practice nurses are increasingly prominent in nurse-led out-of-hours care in Hong Kong in response to changes to junior doctors' hours of work. Three five-day workshops for Hong Kong-based advanced practice nurses were offered in partnership with UK clinicians. The aim of the workshops was to share UK experiences of implementation of the 'Hospital at Night' model of care delivery. The questionnaire study undertaken was not part of the workshop programme. However, the workshops gave the authors a unique opportunity to access relatively large numbers of Hong Kong-based advanced practice nurses. The workshops were attended by experienced nurses who had been or were about to be appointed as advanced practice nurses. All nurses who attended one of the three workshops (n=120) agreed to participate in the study. Responses to two open questions posed in the questionnaire were the subject of a content analysis. A prominent finding of the study was that respondents viewed the benefits of introducing advanced practice nurse roles in Hong Kong as outweighing any challenges. One of the main features of the perceived benefits relates to improving the quality and safety of patient care. The greatest challenges associated with the role related to acceptance of the role by other healthcare professionals, and difficulties associated with the general public's traditional attitudes to healthcare provision in Hong Kong. Education of the public concerning the implementation of such roles is of crucial importance. Findings from this study enhance understanding of the factors that hinder or facilitate advanced practice roles in out-of-hours care in Hong Kong. © 2012 Blackwell Publishing Ltd.

  18. Number needed to benefit from information (NNBI): proposal from a mixed methods research study with practicing family physicians.

    Science.gov (United States)

    Pluye, Pierre; Grad, Roland M; Johnson-Lafleur, Janique; Granikov, Vera; Shulha, Michael; Marlow, Bernard; Ricarte, Ivan Luiz Marques

    2013-01-01

    We wanted to describe family physicians' use of information from an electronic knowledge resource for answering clinical questions, and their perception of subsequent patient health outcomes; and to estimate the number needed to benefit from information (NNBI), defined as the number of patients for whom clinical information was retrieved for 1 to benefit. We undertook a mixed methods research study, combining quantitative longitudinal and qualitative research studies. Participants were 41 family physicians from primary care clinics across Canada. Physicians were given access to 1 electronic knowledge resource on handheld computer in 2008-2009. For the outcome assessment, participants rated their searches using a validated method. Rated searches were examined during interviews guided by log reports that included ratings. Cases were defined as clearly described searches where clinical information was used for a specific patient. For each case, interviewees described information-related patient health outcomes. For the mixed methods data analysis, quantitative and qualitative data were merged into clinical vignettes (each vignette describing a case). We then estimated the NNBI. In 715 of 1,193 searches for information conducted during an average of 86 days, the search objective was directly linked to a patient. Of those searches, 188 were considered to be cases. In 53 cases, participants associated the use of information with at least 1 patient health benefit. This finding suggested an NNBI of 14 (715/53). The NNBI may be used in further experimental research to compare electronic knowledge resources. A low NNBI can encourage clinicians to search for information more frequently. If all searches had benefits, the NNBI would be 1. In addition to patient benefits, learning and knowledge reinforcement outcomes are frequently reported.

  19. Employee motivation and benefits

    OpenAIRE

    Březíková, Tereza

    2009-01-01

    The topic of my bachelor's thesis is the employee motivation and benefits. The thesis is divided in two parts, a theoretical one and a practical one. The theoretical part deals with the theory of motivation and individual employee benefits. The practical part describes employee benefits in ČSOB, where I did my research by questionnaires that were filled in by employees from different departments of ČSOB. These employees answered questions about their work motivation and benefits. The resultts...

  20. Effectiveness of Vildagliptin in Clinical Practice: Pooled Analysis of Three Korean Observational Studies (the VICTORY Study

    Directory of Open Access Journals (Sweden)

    Sunghwan Suh

    2017-01-01

    Full Text Available The present observational study aimed to evaluate the clinical effectiveness of vildagliptin with metformin in Korean patients with type 2 diabetes mellitus (T2DM. Data were pooled from the vildagliptin postmarketing survey (PMS, the vildagliptin/metformin fixed drug combination (DC PMS, and a retrospective observational study of vildagliptin/metformin (fixed DC or free DC. The effectiveness endpoint was the proportion of patients who achieved a glycemic target (HbA1c of ≤7.0% at 24 weeks. In total, 4303 patients were included in the analysis; of these, 2087 patients were eligible. The mean patient age was 56.99 ± 11.25 years. Overall, 58.94% patients achieved an HbA1c target of ≤7.0% at 24 weeks. The glycemic target achievement rate was significantly greater in patients with baseline HbA1c < 7.5% versus ≥7.5% (84.64% versus 43.97%, receiving care at the hospital versus clinic (67.95% versus 52.33%, and receiving vildagliptin/metformin fixed DC versus free DC (70.69% versus 55.42%. Multivariate logistic regression analysis indicated that disease duration (P<0.0001, baseline HbA1c (P<0.0001, and DC type (P=0.0103 had significant effects on drug effectiveness. Vildagliptin plus metformin appeared as an effective treatment option for patients with T2DM in clinical practice settings in Korea.

  1. Intimate partner violence and breastfeeding practices: a systematic review of observational studies

    Directory of Open Access Journals (Sweden)

    Raquel de Souza Mezzavilla

    2018-05-01

    Full Text Available Objective: To review the association between intimate partner violence and breastfeeding practices in the literature. Data sources: The search was carried out in five databases, including MEDLINE, LILACS, SCOPUS, PsycoINFO, and Science Direct. The search strategy was carried out in February 2017. The authors included original studies with observational design, which investigated forms of intimate partner violence (including emotional, physical, and/or sexual and breastfeeding practices. The quality of the studies was assessed based on the bias susceptibility through criteria specifically developed for this review. Summary of data: The study included 12 original articles (10 cross-sectional, one case-control, and one cohort study carried out in different countries. The forms of intimate partner violence observed were emotional, physical, and/or sexual. Breastfeeding was investigated by different tools and only assessed children between 2 days and 6 months of life. Of the 12 studies included in this review, eight found a lower breastfeeding intention, breastfeeding initiation, and exclusive breastfeeding during the first six months of the child's life, and a higher likelihood of early termination of exclusive breastfeeding among women living at home where violence was present. The quality varied between the studies and six were classified as having low bias susceptibility based on the assessed items. Conclusions: Intimate partner violence is associated with inadequate breastfeeding practices of children aged 2 days to 6 months of life. Resumo: Objetivo: Revisar na literatura a associação da violência entre parceiros íntimos e as práticas de aleitamento materno. Fontes dos dados: Foram utilizadas para as buscas cinco bases de dados, incluindo o MEDLINE, LILACS, SCOPUS, PsycoINFO e Science Direct. A estratégia de busca foi realizada em fevereiro de 2017. Foram incluídos estudos originais com desenho observacional, os quais investigaram formas

  2. Intimate partner violence and breastfeeding practices: a systematic review of observational studies

    Directory of Open Access Journals (Sweden)

    Raquel de Souza Mezzavilla

    2018-05-01

    Full Text Available Objective: To review the association between intimate partner violence and breastfeeding practices in the literature. Data sources: The search was carried out in five databases, including MEDLINE, LILACS, SCOPUS, PsycoINFO, and Science Direct. The search strategy was carried out in February 2017. The authors included original studies with observational design, which investigated forms of intimate partner violence (including emotional, physical, and/or sexual and breastfeeding practices. The quality of the studies was assessed based on the bias susceptibility through criteria specifically developed for this review. Summary of data: The study included 12 original articles (10 cross‐sectional, one case‐control, and one cohort study carried out in different countries. The forms of intimate partner violence observed were emotional, physical, and/or sexual. Breastfeeding was investigated by different tools and only assessed children between 2 days and 6 months of life. Of the 12 studies included in this review, eight found a lower breastfeeding intention, breastfeeding initiation, and exclusive breastfeeding during the first six months of the child's life, and a higher likelihood of early termination of exclusive breastfeeding among women living at home where violence was present. The quality varied between the studies and six were classified as having low bias susceptibility based on the assessed items. Conclusions: Intimate partner violence is associated with inadequate breastfeeding practices of children aged 2 days to 6 months of life. Resumo: Objetivo: Revisar na literatura a associação da violência entre parceiros íntimos e as práticas de aleitamento materno. Fontes dos dados: Foram utilizadas para as buscas cinco bases de dados, incluindo o MEDLINE, LILACS, SCOPUS, PsycoINFO e Science Direct. A estratégia de busca foi realizada em fevereiro de 2017. Foram incluídos estudos originais com desenho observacional, os quais investigaram

  3. CRRTnet: a prospective, multi-national, observational study of continuous renal replacement therapy practices.

    Science.gov (United States)

    Heung, Michael; Bagshaw, Sean M; House, Andrew A; Juncos, Luis A; Piazza, Robin; Goldstein, Stuart L

    2017-07-06

    Continuous renal replacement therapy (CRRT) is the recommended modality of dialysis for critically ill patients with hemodynamic instability. Yet there remains significant variability in how CRRT is prescribed and delivered, and limited evidence-basis to guide practice. This is a prospective, multi-center observational study of patients undergoing CRRT. Initial enrollment phase will occur at 4 academic medical centers in North America over 5 years, with a target enrollment of 2000 patients. All adult patients (18-89 years of age) receiving CRRT will be eligible for inclusion; patients who undergo CRRT for less than 24 h will be excluded from analysis. Data collection will include patient characteristics at baseline and at time of CRRT initiation; details of CRRT prescription and delivery, including machine-generated treatment data; and patient outcomes. The goal of this study is to establish a large comprehensive registry of critically ill adults receiving CRRT. Specific aims include describing variations in CRRT prescription and delivery across quality domains; validating quality measures for CRRT care by correlating processes and outcomes; and establishing a large registry for use in quality improvement and benchmarking efforts. For initial analyses, some particular areas of interest are anticoagulation protocols; approach to fluid overload; CRRT-related workload; and patient safety. Registered on ClinicalTrials.gov 1/10/2014: NCT02034448.

  4. The Curtin Coaches: Benefits of an outreach tutoring program for first year pre-service teachers. A Practice Report

    Directory of Open Access Journals (Sweden)

    Saul Karnovsky

    2015-03-01

    Full Text Available The Curtin Coaches program represents a dynamic outreach opportunity for pre-service teachers enrolled in their first year of study at Curtin University to engage with school-aged students as classroom tutors. Research has shown that cross-age tutoring experiences in schools can benefit both the students receiving support and those who tutor, particularly in settings where individuals are engaging in community support work. According to program feedback, participants were able to develop a range of profession-related skills such as relationship building and gain new knowledge such as understanding how students learn. These competencies are salient as they align with the newly implemented standards for graduate teachers. Understanding the benefits such outreach programs bring pre-service teachers is vital as the future of HEPPP funded programs such as the Curtin Coaches is uncertain but the importance of Work Integrated Learning is increasing.

  5. Helping Pre-Service Mathematics Teachers Connect Theory and Practice: Using Reading, Writing, and Observation Protocols to Structure Field Experiences

    Science.gov (United States)

    Cross, Stephanie Behm; Bayazit, Nermin Tosmur

    2014-01-01

    The authors designed the project described her in order to address their students' expressed frustrations at the perceived disconnect between theory and practice. The project combined course readings, journaling, collaboratively created observation protocols, and classroom observation into a semester-long iterative assignment. The students' work…

  6. Increased Severe Trauma Patient Volume is Associated With Survival Benefit and Reduced Total Health Care Costs: A Retrospective Observational Study Using a Japanese Nationwide Administrative Database.

    Science.gov (United States)

    Endo, Akira; Shiraishi, Atsushi; Fushimi, Kiyohide; Murata, Kiyoshi; Otomo, Yasuhiro

    2017-06-07

    The aim of this study was to evaluate the associations of severe trauma patient volume with survival benefit and health care costs. The effect of trauma patient volume on survival benefit is inconclusive, and reports on its effects on health care costs are scarce. We conducted a retrospective observational study, including trauma patients who were transferred to government-approved tertiary emergency hospitals, or hospitals with an intensive care unit that provided an equivalent quality of care, using a Japanese nationwide administrative database. We categorized hospitals according to their annual severe trauma patient volumes [1 to 50 (reference), 51 to 100, 101 to 150, 151 to 200, and ≥201]. We evaluated the associations of volume categories with in-hospital survival and total cost per admission using a mixed-effects model adjusting for patient severity and hospital characteristics. A total of 116,329 patients from 559 hospitals were analyzed. Significantly increased in-hospital survival rates were observed in the second, third, fourth, and highest volume categories compared with the reference category [94.2% in the highest volume category vs 88.8% in the reference category, adjusted odds ratio (95% confidence interval, 95% CI) = 1.75 (1.49-2.07)]. Furthermore, significantly lower costs (in US dollars) were observed in the second and fourth categories [mean (standard deviation) for fourth vs reference = $17,800 ($17,378) vs $20,540 ($32,412), adjusted difference (95% CI) = -$2559 (-$3896 to -$1221)]. Hospitals with high volumes of severe trauma patients were significantly associated with a survival benefit and lower total cost per admission.

  7. Investigating preventive-medicine consultations in first-opinion small-animal practice in the United Kingdom using direct observation.

    Science.gov (United States)

    Robinson, N J; Brennan, M L; Cobb, M; Dean, R S

    2016-02-01

    Preventive-medicine consultations account for a large proportion of the veterinary caseload and previous research has suggested these consultations are fundamentally different from those in which the animal is presented for a specific health problem. There has been recent controversy around some aspects of preventive medicine for cats and dogs, and the full health benefits of the preventive-medicine consultation remain unclear. The aim of this study was to compare characteristics of the consultation and the problems discussed during the consultation between preventive-medicine consultations and other types of consultations. Data were gathered during direct observation of small-animal consultations in seven first-opinion practices in the United Kingdom. Data collected included type of clinical examination performed, patient signalment, and details of all problems discussed (including whether the problem was presenting or non-presenting, new or pre-existing, who had raised the problem, body system affected and whether an action was taken). A two-level multivariable logistic-regression model was developed, with canine and feline patients at Level 1 nested within consulting veterinary surgeons at Level 2, and a binary outcome variable of preventive-medicine consultation versus specific health-problem consultation. A total of 1807 patients were presented, of which 690 (38.2%) presented for a preventive-medicine consultation. Dogs were the most frequently presented species (n=1168; 64.6%) followed by cats (n=510; 28.2%), rabbits (n=86; 4.8%) and patients of other species (n=43; 2.4%). The five variables remaining in the multi-level model were whether multiple patients were presented, patient age, clinical examination type, weighing and number of problems discussed. Species, breed, sex, neutering status and practice did not remain in the final model. Many non-presenting problems, including both preventive-medicine problems and specific-health problems, were discussed and

  8. Pokémon Go: Ubiquitous Computing Delivering Better Health or Co-Incidental Health Benefits from Technology Use? A Participatory Observational Study.

    Science.gov (United States)

    Yee, Kwang Chien; Wong, Ming Chao; Turner, Paul

    2017-01-01

    Stimulating sustained behavioural change through information and technology has been an aim of much health informatics research. Traditional approaches use technology to mediate communications between health professionals and patients. More recent lifestyle technologies engage the patient directly with information and advice - but what of the phenomena that is Pokémon Go - does it point to another way of achieving health benefits through fun? This paper aims to explore some of the conceptual questions for health informatics stimulated by the phenomenal popularity of Pokémon Go. The paper is grounded analysis of data generated through a preliminary participatory observational study in Australia.

  9. Current clinical nutrition practices in critically ill patients in Latin America: a multinational observational study.

    Science.gov (United States)

    Vallejo, Karin Papapietro; Martínez, Carolina Méndez; Matos Adames, Alfredo A; Fuchs-Tarlovsky, Vanessa; Nogales, Guillermo Carlos Contreras; Paz, Roger Enrique Riofrio; Perman, Mario Ignacio; Correia, Maria Isabel Toulson Davisson; Waitzberg, Dan Linetzky

    2017-08-25

    Malnutrition in critically ill adults in the intensive care unit (ICU) is associated with a significantly elevated risk of mortality. Adequate nutrition therapy is crucial to optimise outcomes. Currently, there is a paucity of such data in Latin America. Our aims were to characterise current clinical nutrition practices in the ICU setting in Latin America and evaluate whether current practices meet caloric and protein requirements in critically ill patients receiving nutrition therapy. We conducted a cross-sectional, retrospective, observational study in eight Latin American countries (Argentina, Brazil, Chile, Colombia, Ecuador, Mexico, Panama, and Peru). Eligible patients were critically ill adults hospitalised in the ICU and receiving enteral nutrition (EN) and/or parenteral nutrition (PN) on the Screening Day and the previous day (day -1). Caloric and protein balance on day -1, nutritional status, and prescribed nutrition therapy were recorded. Multivariable logistic regression analysis was performed to identify independent predictors of reaching daily caloric and protein targets. The analysis included 1053 patients from 116 hospitals. Evaluation of nutritional status showed that 74.1% of patients had suspected/moderate or severe malnutrition according to the Subjective Global Assessment. Prescribed nutrition therapy included EN alone (79.9%), PN alone (9.4%), and EN + PN (10.7%). Caloric intake met >90% of the daily target in 59.7% of patients on day -1; a caloric deficit was present in 40.3%, with a mean (±SD) daily caloric deficit of -688.8 ± 455.2 kcal. Multivariable logistic regression analysis showed that combined administration of EN + PN was associated with a statistically significant increase in the probability of meeting >90% of daily caloric and protein targets compared with EN alone (odds ratio, 1.56; 95% confidence interval, 1.02-2.39; p = 0.038). In the ICU setting in Latin America, malnutrition was highly prevalent and caloric

  10. The balance sheet of benefits and harms of breast cancer population-based screening in Europe: outcome research, practice and future challenges.

    Science.gov (United States)

    Broeders, Mireille; Paci, Eugenio

    2015-11-01

    Breast cancer screening programs are still object of harsh debate. In 2012, the Independent UK Panel reviewed the benefits and harms of mammography screening based on randomized trials and the EUROSCREEN Working Group reviewed European observational outcome studies. The conclusion was that screening programs should continue, while acknowledging that harms, such as the occurrence of false-positive results and overdiagnosis, can have a negative impact on a woman's life. Information on the balance sheet of the benefits and harms of breast cancer screening should help women and their physicians to make an informed choice. The future challenge for breast screening programs is to assess the feasibility, acceptability, effectiveness and impact of risk-based screening in order to maximize benefit-to-harm ratios.

  11. Relationships between Safe Pesticide Practice and Perceived Benefits and Subjective Norm, and the Moderation Role of Information Acquisition: Evidence from 971 Farmers in China.

    Science.gov (United States)

    Wang, Jianhua; Deng, Yuanyuan; Ma, Yuting

    2017-08-25

    Improper use of pesticides among farmers has caused food safety issues which are serious threats to public health in China. A central question concerns how to motivate farmers to self-regulate their pesticide usage. The paper aims to identify the influence of an internal driving factor, i.e., perceived benefits, and an external driving factor, i.e., subjective norm, on farmers' safe pesticide behaviors, and whether the two factors are moderated by the exposure to information on government policies and the market, based on a sample of 971 farmers selected from 5 Chinese provinces. The results revealed that farmers' safe pesticide usage was predominately driven by perceived benefits whereas external pressure or subjective norm did not play much of a role. Interaction effects were found between the exposure to market information and perceived benefits, and also between subjective norm and exposure to government policy. Extensions agencies are recommended to effectively convey to farmers the benefits to follow safe pesticide practices. Meanwhile, surveillance and monitoring systems should be established so that the prices of their agricultural products are reflected by the quality of the products.

  12. KNOWLEDGE ABOUT THE BENEFITS OF BREASTFEEDING AND DISADVANTAGES OF THE PACIFIER RELATED TO THE MOTHER'S PRACTICE WITH PRETERM INFANTS.

    Science.gov (United States)

    Dadalto, Elâine Cristina Vargas; Rosa, Edinete Maria

    2017-01-01

    To evaluate the knowledge and expectations of mothers of preterm newborn infants admitted in a neonatal intensive care unit about breastfeeding and pacifier use, and to analyze their experience in dealing with the sucking urge in the first months of life. Mothers were interviewed during hospitalization of the newborn in the neonatal intensive care unit and when the infant was six months old. All mothers with availability to participate in the study were included. Exclusion criteria comprised infants with syndromes and neurological disorders and mothers with cognitive impairment, depression, and drug users. Data were analyzed with the SPSS software, with descriptive statistics and chi-square test. Sixty-two mothers were interviewed in the beginning and 52 at a six-month follow-up. Mothers' expectations concerning breastfeeding were positive when they listed the benefits to the mother (90.3%) and infant (100%). However, they had difficulties maintaining exclusive breastfeeding and used the baby bottle (75.0%), which most mothers (69.4%) had already acquired before the infant was born. The fact of having a pacifier in the infant's layette (43.6%) did not influence its use (p=0.820). This also occurred among mothers who said they would not offer the pacifier due to disadvantages to the mother (80.7%) and infant (96.8%). The previous expectation that the pacifier could bring benefits for mother and infant did not affect its use (p=0.375 and p=0.158). Mothers demonstrated prior knowledge about breastfeeding benefits and disadvantages of the pacifiers. However, they changed their view when dealing with the infant and introduced bottles and pacifiers.

  13. Senior Benefits

    Science.gov (United States)

    Information Medicaid Public Health Centers Temporary "Cash" Assistance Senior Benefits Program GovDelivery Skip Navigation Links Health and Social Services > Public Assistance > Senior Benefits Page Content Senior Benefits Senior Benefits Logo Senior Benefits Fact Sheet - June, 2016 Reduction Information

  14. Milestone-compatible neurology resident assessments: A role for observable practice activities.

    Science.gov (United States)

    Jones, Lyell K; Dimberg, Elliot L; Boes, Christopher J; Eggers, Scott D Z; Dodick, David W; Cutsforth-Gregory, Jeremy K; Leep Hunderfund, Andrea N; Capobianco, David J

    2015-06-02

    Beginning in 2014, US neurology residency programs were required to report each trainee's educational progression within 29 neurology Milestone competency domains. Trainee assessment systems will need to be adapted to inform these requirements. The primary aims of this study were to validate neurology resident assessment content using observable practice activities (OPAs) and to develop assessment formats easily translated to the Neurology Milestones. A modified Delphi technique was used to establish consensus perceptions of importance of 73 neurology OPAs among neurology educators and trainees at 3 neurology residency programs. A content validity score (CVS) was derived for each neurology OPA, with scores ≥4.0 determined in advance to indicate sufficient content validity. The mean CVS for all OPAs was 4.4 (range 3.5-5.0). Fifty-seven (78%) OPAs had a CVS ≥4.0, leaving 16 (22%) below the pre-established threshold for content validity. Trainees assigned a higher importance to individual OPAs (mean CVS 4.6) compared to faculty (mean 4.4, p = 0.016), but the effect size was small (η(2) = 0.10). There was no demonstrated effect of length of education experience on perceived importance of neurology OPAs (p = 0.23). Two sample resident assessment formats were developed, one using neurology OPAs alone and another using a combination of neurology OPAs and the Neurology Milestones. This study provides neurology training programs with content validity evidence for items to include in resident assessments, and sample assessment formats that directly translate to the Neurology Milestones. Length of education experience has little effect on perceptions of neurology OPA importance. © 2015 American Academy of Neurology.

  15. Shared decision making observed in clinical practice: visual displays of communication sequence and patterns.

    Science.gov (United States)

    Elwyn, G; Edwards, A; Wensing, M; Hibbs, R; Wilkinson, C; Grol, R

    2001-05-01

    The aim of the study was to examine the communication strategies of general practitioners attempting to involve patients in treatment or management decisions. This empirical data was then compared with theoretical 'competences' derived for 'shared decision making'. The subjects were four general practitioners, who taped conducted consultations with the specific intent of involving patients in the decision-making process. The consultations were transcribed, coded into skill categorizations and presented as visual display using a specifically devised sequential banding The empirical data from these purposively selected consultation from clinicians who are experienced in shared decision making did not match suggested theoretical frameworks. The views of patients about treatment possibilities and their preferred role in decision making were not explored. The interactions were initiated by a problem-defining phase, statements of 'equipoise' consistently appeared and the portrayal of option information was often intermingled with opportunities to allow patients to question and reflect. A decision-making stage occurred consistently after approximately 80% of the total consultation duration and arrangements were consistently made for follow-up and review. Eight of the 10 consultations took more than 11 min - these specific consultations were characterized by significant proportions of time provided for information exchange and patient interaction. The results demonstrate that some theoretical competences are not distinguishable in practice and other stages, not previously described, such as the 'portrayal of equipoise', are observed. The suggested ideal of a shared decision-making interaction will either require more time than currently allocated, or alternative strategies to enable information exchange outside the consultation.

  16. Pharmacotherapy of elderly patients in everyday anthroposophic medical practice: a prospective, multicenter observational study

    Directory of Open Access Journals (Sweden)

    Bockelbrink Angelina

    2010-07-01

    Full Text Available Abstract Background Pharmacotherapy in the older adult is a complex field involving several different medical professionals. The evidence base for pharmacotherapy in elderly patients in primary care relies on only a few clinical trials, thus documentation must be improved, particularly in the field of complementary and alternative medicine (CAM like phytotherapy, homoeopathy, and anthroposophic medicine. This study describes diagnoses and therapies observed in elderly patients treated with anthroposophic medicine in usual care. Methods Twenty-nine primary care physicians in Germany participated in this prospective, multicenter observational study on prescribing patterns. Prescriptions and diagnoses were reported for each consecutive patient. Data were included if patients were at least 60 years of age. Multiple logistic regression analysis was used to determine factors associated with anthroposophic prescriptions. Results In 2005, a total of 12 314 prescriptions for 3076 patients (68.1% female were included. The most frequent diagnoses were hypertension (11.1%, breast cancer (3.5%, and heart failure (3.0%. In total, 30.5% of the prescriptions were classified as CAM remedies alone, 54.4% as conventional pharmaceuticals alone, and 15.1% as a combination of both. CAM remedies accounted for 41.7% of all medications prescribed (35.5% anthroposophic. The adjusted odds ratio (AOR for receiving an anthroposophic remedy was significantly higher for the first consultation (AOR = 1.65; CI: 1.52-1.79, treatment by an internist (AOR = 1.49; CI: 1.40-1.58, female patients (AOR = 1.35; CI: 1.27-1.43, cancer (AOR = 4.54; CI: 4.12-4.99, arthropathies (AOR = 1.36; CI: 1.19-1.55, or dorsopathies (AOR = 1.34; CI: 1.16-1.55 and it decreased with patient age (AOR = 0.97; CI: 0.97-0.98. The likelihood of being prescribed an anthroposophic remedy was especially low for patients with hypertensive diseases (AOR = 0.36; CI: 0.32-0.39, diabetes mellitus (AOR = 0.17; CI: 0

  17. MR imaging in patients with knee injury: an observational study in general practice

    NARCIS (Netherlands)

    S.S. Boks (Simone)

    2007-01-01

    textabstractKnee trauma is often seen in general practice. The availability of magnetic resonance (MR) imaging has improved the diagnostic possibilities after knee trauma. Nevertheless, little is known about the findings on MR imaging after knee trauma in general practice. Especially, there is

  18. Bedside practice of blood transfusion in a large teaching hospital in Uganda : an observational study

    NARCIS (Netherlands)

    de Graaf, J D; Kajja, I; Bimenya, G S; Postma, Maarten; Smit Sibinga, C.Th.

    BACKGROUND: Adverse transfusion reactions can cause morbidity and death to patients who receive a blood transfusion. Blood transfusion practice in Mulago Hospital, Kampala, Uganda is analyzed to see if and when these practices play a role in the morbidity and mortality of patients. MATERIALS AND

  19. The Application of Observational Practice and Educational Networking in Simulation-Based and Distributed Medical Education Contexts.

    Science.gov (United States)

    Welsher, Arthur; Rojas, David; Khan, Zain; VanderBeek, Laura; Kapralos, Bill; Grierson, Lawrence E M

    2018-02-01

    Research has revealed that individuals can improve technical skill performance by viewing demonstrations modeled by either expert or novice performers. These findings support the development of video-based observational practice communities that augment simulation-based skill education and connect geographically distributed learners. This study explores the experimental replicability of the observational learning effect when demonstrations are sampled from a community of distributed learners and serves as a context for understanding learner experiences within this type of training protocol. Participants from 3 distributed medical campuses engaged in a simulation-based learning study of the elliptical excision in which they completed a video-recorded performance before being assigned to 1 of 3 groups for a 2-week observational practice intervention. One group observed expert demonstrations, another observed novice demonstrations, and the third observed a combination of both. Participants returned for posttesting immediately and 1 month after the intervention. Participants also engaged in interviews regarding their perceptions of the usability and relevance of video-based observational practice to clinical education. Checklist (P simulation-based skill learning in a group of geographically distributed trainees. These findings support the use of Internet-mediated observational learning communities in distributed and simulation-based medical education contexts.

  20. Transcranial magnetic stimulation (TMS) for major depression: a multisite, naturalistic, observational study of quality of life outcome measures in clinical practice.

    Science.gov (United States)

    Janicak, Philip G; Dunner, David L; Aaronson, Scott T; Carpenter, Linda L; Boyadjis, Terrence A; Brock, David G; Cook, Ian A; Lanocha, Karl; Solvason, Hugh B; Bonneh-Barkay, Dafna; Demitrack, Mark A

    2013-12-01

    Transcranial magnetic stimulation (TMS) is an effective and safe therapy for major depressive disorder (MDD). This study assessed quality of life (QOL) and functional status outcomes for depressed patients after an acute course of TMS. Forty-two, U.S.-based, clinical TMS practice sites treated 307 outpatients with a primary diagnosis of MDD and persistent symptoms despite prior adequate antidepressant pharmacotherapy. Treatment parameters were based on individual clinical considerations and followed the labeled procedures for use of the approved TMS device. Patient self-reported QOL outcomes included change in the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and the EuroQol 5-Dimensions (EQ-5D) ratings from baseline to end of the acute treatment phase. Statistically significant improvement in functional status on a broad range of mental health and physical health domains was observed on the SF-36 following acute TMS treatment. Similarly, statistically significant improvement in patient-reported QOL was observed on all domains of the EQ-5D and on the General Health Perception and Health Index scores. Improvement on these measures was observed across the entire range of baseline depression symptom severity. These data confirm that TMS is effective in the acute treatment of MDD in routine clinical practice settings. This symptom benefit is accompanied by statistically and clinically meaningful improvements in patient-reported QOL and functional status outcomes.

  1. Observations of teachers in Ilorin, Nigeria on their practices of corporal punishment that are potentially injurious to their pupils' eyes.

    Science.gov (United States)

    Mahmoud, Abdulraheem Olarongbe; Ayanniyi, Abdulkabir Ayansiji; Salman, Medinat Folorunso

    2011-01-01

    To document the observations of elementary school teachers (ESTs) in Ilorin, Nigeria on their practice of some types of corporal punishment (CP) that could result in eye injuries among their pupils. A short battery of questions that explored ESTs' observations on attitudes to, and knowledge of some commonly used CP practices was self-administered on 172 consenting teachers from six sampled schools. The potentials for their pupils to sustain eye injuries while receiving such CP practices were inferred from the usage of items with sharp and protruding ends to administer CP, and the application of CP onto pupils' body parts that are in close proximity to the eye such as the head and face. Only 50 of the 172 ESTs favored the practice of CP of pupils by their teachers. Analyses of several potentially moderating variables on this response such as ESTs' ages, years of EST teaching experience, school, and class or grade that EST teaches did not prove significant. Over three-quarters of ESTs (80.2%) had ever observed that pupils were being disciplined by ESTs with a cane. About a fifth of them had also observed that ESTs applied CP to the head (19.8%) and the face (16.3%) of pupils. Findings suggest that ESTs' commonly employed CP practices have significant injurious potential to their pupils' eyes. It is recommended that CP be abolished in elementary schools, and instead alternative nonabusive methods of disciplining erring pupils by teachers be introduced.

  2. Transfer Paths of Research Results to the Practice: Observations From the Receiving End

    Science.gov (United States)

    Findikakis, A. N.

    2005-12-01

    A non-scientific poll of fellow practicing professionals suggests that there is a range of opinions regarding the effectiveness of different ways of becoming acquainted with and using the results of academic research in their practice. Journal articles remain the dominant path for transferring research results to the profession, even though accessing them is becoming more difficult with time. Driven primarily by cost considerations personal and corporate subscriptions seem to be on the decline. Libraries are one of the first victims of cost cutting measures in the industry. Even though the availability of journal articles in electronic form facilitates their availability, their prices are prohibitive. This is especially true during when a professional is searching for a solution to a problem and may have to review several papers on the subject. One colleague suggested that the professional organizations and other publishers of research articles could learn from the experience of the music industry, by lowering the cost of downloading individual papers to something like a dollar per article, recovering thus their production costs through the increase in the volume of purchased articles. The posting on the internet of special reports and dissertations by research institutions is viewed as very useful by those working in practice. The distribution through the internet of reports by federal organizations conducting or sponsoring research, such as the U.S. Geological Survey and the U.S. Environmental Protection Agency is greatly appreciated by the practicing professionals. The use of leading researchers as consultants provides a direct path for bringing research results to the practice, but it is limited to a small number of cases where bringing in a consultant can be justified. Short courses are viewed as an effective way of familiarizing professionals with the latest research findings on specific subjects. The notes distributed in such courses are considered

  3. Structured education to improve primary-care management of headache: how long do the benefits last? A follow-up observational study.

    Science.gov (United States)

    Braschinsky, M; Haldre, S; Kals, M; Arge, M; Saar, B; Niibek, M; Katsarava, Z; Steiner, T J

    2018-03-01

    Our earlier study showed that structured education of general practitioners (GPs) improved their practice in headache management. Here the duration of this effect was assessed. In a follow-up observational study in southern Estonia, subjects were the same six GPs as previously, managing patients presenting with headache as the main complaint. Data reflecting their practice were collected prospectively during a 1-year period commencing 2 years after the educational intervention. The primary outcome measure was referral rate (RR) to neurological services. Comparisons were made with baseline and post-intervention data from the earlier study. In 366 patients consulting during the follow-up period, the RR was 19.9%, lower than at baseline (39.5%; P betterment. A few measures suggest the beginnings of a decline towards baseline levels. This policy-informing evidence for continuing medical education indicates that the educational programme needs repeating every 2-3 years. © 2017 EAN.

  4. High workload and job stress are associated with lower practice performance in general practice: an observational study in 239 general practices in the Netherlands.

    NARCIS (Netherlands)

    Hombergh, P. van den; Kunzi, B.; Elwyn, G.; Doremalen, J.H.M. van; Akkermans, R.P.; Grol, R.P.T.M.; Wensing, M.J.P.

    2009-01-01

    BACKGROUND: The impact of high physician workload and job stress on quality and outcomes of healthcare delivery is not clear. Our study explored whether high workload and job stress were associated with lower performance in general practices in the Netherlands. METHODS: Secondary analysis of data

  5. Behavioral Observation and Microbiological Analysis of Older Adult Consumers' Cross-Contamination Practices in a Model Domestic Kitchen.

    Science.gov (United States)

    Evans, Ellen W; Redmond, Elizabeth C

    2018-04-01

    The incidence of foodborne illness is higher in older adults because of their increased susceptibility; therefore, food safety practices are important. However, inadequate knowledge and negative attitudes toward food safety have been reported, which may increase use of unsafe food handling practices. Data on the actual food safety behaviors of older adults are lacking. In this study, food safety practices of older adults were observed and linked to microbiological analysis of kitchen surfaces to identify suspected routes of contamination. Older adults (≥60 years, n = 100) prepared a set meal in a model domestic kitchen sanitized according to a validated protocol to ensure minimal and consistent microbiological loads. Food safety behaviors were observed using ceiling-mounted cameras and recorded using a predetermined behavioral checklist. Surface microbiological contamination also was determined after food preparation. Overall, older adults frequently implemented unsafe food handling practices; 90% failed to implement adequate hand decontamination immediately after handling raw chicken. For older adults who used a larger number of adequate hand decontamination attempts, microbiological contamination levels in the kitchen following the food preparation session were significantly lower ( P food handling practices as suspected routes of microbiological cross-contamination in a model domestic kitchen. Findings indicate the potential impact on domestic food safety of unsafe food handling practices used by older adult consumers. This innovative approach revealed that a large proportion of older adults implement behaviors resulting in microbiological cross-contamination that may increase the risk of foodborne illness in the home.

  6. Computer-assisted surgery simulations and directed practice of total knee arthroplasty: educational benefits to the trainee.

    Science.gov (United States)

    Myden, C A; Anglin, C; Kopp, G D; Hutchison, C R

    2012-01-01

    Orthopaedic residents typically learn to perform total knee arthroplasty (TKA) through an apprenticeship-type model, which is a necessarily slow process. Surgical skills courses, using artificial bones, have been shown to improve technical and cognitive skills significantly within a couple of days. The addition of computer-assisted surgery (CAS) simulations challenges the participants to consider the same task in a different context, promoting cognitive flexibility. We designed a hands-on educational intervention for junior residents with a conventional tibiofemoral TKA station, two different tibiofemoral CAS stations, and a CAS and conventional patellar resection station, including both qualitative and quantitative analyses. Qualitatively, structured interviews before and after the course were analyzed for recurring themes. Quantitatively, subjects were evaluated on their technical skills before and after the course, and on a multiple-choice knowledge test and error detection test after the course, in comparison to senior residents who performed only the testing. Four themes emerged: confidence, awareness, deepening knowledge and changed perspectives. The residents' attitudes to CAS changed from negative before the course to neutral or positive afterwards. The junior resident group completed 23% of tasks in the pre-course skills test and 75% of tasks on the post-test (peducational interventions, promoting cognitive flexibility, would benefit trainees, attending surgeons, the healthcare system and patients.

  7. Analysis of Employee Benefits

    OpenAIRE

    Burešová, Lenka

    2013-01-01

    The target of this bachelor thesis is to analyze employee benefits from the perspective of employees and to employers suggest possible ideas to improve their provision. The work is divided into two parts: theoretical and practical. The theoretical part describes the overal remuneration of employees, payroll system and employee benefits. Benefits are included in the remuneration system, broken and some of them are defined. The practical part presents a survey among employees in the Czech Repub...

  8. The benefits of motivational interviewing and coaching for improving the practice of comprehensive family assessments in child welfare.

    Science.gov (United States)

    Snyder, Elizabeth H; Lawrence, C Nicole; Weatherholt, Tara N; Nagy, Paul

    2012-01-01

    The engagement of families in child welfare services is critical for successful outcomes related to safety, permanency, and child and family well-being. Motivational interviewing (MI), an effective approach to working with individuals struggling with alcohol and drug addiction, has great appeal for use with families involved with the child welfare system. Consequently, many social service agencies are beginning to integrate MI into their training curriculum. However, research has shown that training in MI alone is not enough; ongoing coaching is crucial in order to transfer learned MI skills into practice.The current study employs qualitative interview data from case-workers in order to examine the implementation of MI and long-term coaching within the child welfare system. Findings showed that MI can be implemented successfully within the child welfare system, and that caseworkers believed MI, supported by ongoing coaching, to be a valuable tool in engaging families in the assessment process.

  9. Survey highlights the need to expand offerings of introductory pharmacy practice experiences in psychiatry and neurology: Benefits and example experiences.

    Science.gov (United States)

    Bostwick, Jolene R; Leung, Gillian P; Smith, Tawny L; Ahmed, Uzma; Bainbridge, Jacquelyn L; Peyronnet, Jean-Xavier

    2018-01-01

    Introductory pharmacy practice experiences (IPPEs) are 1 requirement schools and colleges of pharmacy must fulfill to meet accreditation standards. The purpose of this manuscript is to report existing IPPEs in psychiatry and neurology across the United States. Two separate electronic surveys were administered to individual College of Psychiatric and Neurologic Pharmacists members with board certification in psychiatric pharmacy with an academic affiliation and academic institutions in the 2014-15 academic year to assess the neuropsychiatric curriculum in pharmacy programs. Results focusing on IPPEs were summarized using descriptive statistics. Academic institutional data reveal only 37.3% offered IPPEs in psychiatry, and 6.7% offered neurology. The number of available IPPEs is low even if a program offered an available rotation. The majority of College of Psychiatric and Neurologic Pharmacists member respondents (69.9%) did not offer IPPEs in psychiatry in the 2014-15 academic year, and none offered an IPPE in neurology. More than half of individual respondents feel their institution should increase IPPEs in psychiatry and neurology in order to enhance their curriculum. To expand IPPE availability, pharmacy programs should increase early exposure of pharmacy students to patients with psychiatric and neurologic conditions. Longitudinal experiences may allow students to engage in hands-on experiences, which may impact future career aspirations and reduce stigma. Current example IPPEs at the authors' institutions are included to stimulate discussion and action among readers on how IPPEs in these practice areas may be developed. Implementation of IPPEs in psychiatry and neurology is needed for students to gain experience working with these patients.

  10. Maintaining physical exercise as a matter of synchronising practices: Experiences and observations from training in Mixed Martial Arts.

    Science.gov (United States)

    Blue, Stanley

    2017-07-01

    This paper is concerned with the establishment, maintenance, and decline of physical exercise practices. Drawing on experiences and observations taken from a carnal ethnography and rhythmanalysis of the practices involved in training in Mixed Martial Arts (MMA), I argue that maintaining this physical exercise practice is not straightforwardly an outcome of individual commitment, access to facilities, or the availability of free time. It rather depends on the synchronisation of practices: those of MMA, those that support MMA, and those that more broadly make up everyday life. This research suggests that increasing rates of physical activity might be better fostered through facilitating the integration of combinations of healthy activities into everyday life. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Investigating Postsecondary Self-Regulated Learning Instructional Practices: The Development of the Self-Regulated Learning Observation Protocol

    Science.gov (United States)

    Hoops, Leah D.; Yu, Shirley L.; Wang, Qianqian; Hollyer, Virginia L.

    2016-01-01

    Promoting students' self-regulated learning (SRL) is one way to improve postsecondary student success. However, few studies have investigated the instructional practices of postsecondary instructors that may support students' SRL. This study sought to fill this gap. An undergraduate mathematics course was observed to determine instruction utilized…

  12. Pesticide application practices, pest knowledge, and cost-benefits of plantain production in the Bribri-Cabécar Indigenous Territories, Costa Rica.

    Science.gov (United States)

    Polidoro, Beth A; Dahlquist, Ruth M; Castillo, Luisa E; Morra, Matthew J; Somarriba, Eduardo; Bosque-Pérez, Nilsa A

    2008-09-01

    The use of pesticides in the cultivation of cash crops such as banana and plantain is increasing, in Costa Rica and worldwide. Agrochemical use and occupational and environmental exposures in export banana production have been documented in some parts of Central America. However, the extent of agrochemical use, agricultural pest knowledge, and economic components in plantain production are largely unknown in Costa Rica, especially in remote, high-poverty areas such as the Bribri-Cabécar Indigenous Territories. Our objective was to integrate a rapid rural appraisal of indigenous farmer pesticide application practices and pest knowledge with a cost-benefit analysis of plantain production in the Bribri-Cabécar Indigenous Territories, for the development of better agricultural management practices and improved regulatory infrastructure. Interviews conducted with 75 households in 5 indigenous communities showed that over 60% of participants grew plantain with agrochemicals. Of these plantain farmers, over 97% used the insecticide chlorpyrifos, and 84% applied nematicides, 64% herbicides, and 22% fungicides, with only 31% of participants reporting the use of some type of protective clothing during application. The banana weevil (Cosmopolites sordidus Germar) was ranked as the most important agricultural pest by 85% of participants, yet only 28% could associate the adult and larval form. A cost-benefit analysis conducted with a separate group of 26 plantain farmers identified several national markets and one export market for plantain production in the Indigenous Territories. Yearly income averaged US$6200/ha and yearly expenses averaged US$1872/ha, with an average cost-benefit ratio of 3.67 for plantain farmers. Farmers applied an average of 9.7 kg a.i./ha/yr of pesticide products and 375 kg/ha/yr of fertilizer, but those who sold their fruit to the national markets applied more nematicides, herbicides, and fertilizers than those who sold primarily to export markets

  13. Pesticide application practices, pest knowledge, and cost-benefits of plantain production in the Bribri-Cabecar Indigenous Territories, Costa Rica

    International Nuclear Information System (INIS)

    Polidoro, Beth A.; Dahlquist, Ruth M.; Castillo, Luisa E.; Morra, Matthew J.; Somarriba, Eduardo; Bosque-Perez, Nilsa A.

    2008-01-01

    The use of pesticides in the cultivation of cash crops such as banana and plantain is increasing, in Costa Rica and worldwide. Agrochemical use and occupational and environmental exposures in export banana production have been documented in some parts of Central America. However, the extent of agrochemical use, agricultural pest knowledge, and economic components in plantain production are largely unknown in Costa Rica, especially in remote, high-poverty areas such as the Bribri-Cabecar Indigenous Territories. Our objective was to integrate a rapid rural appraisal of indigenous farmer pesticide application practices and pest knowledge with a cost-benefit analysis of plantain production in the Bribri-Cabecar Indigenous Territories, for the development of better agricultural management practices and improved regulatory infrastructure. Interviews conducted with 75 households in 5 indigenous communities showed that over 60% of participants grew plantain with agrochemicals. Of these plantain farmers, over 97% used the insecticide chlorpyrifos, and 84% applied nematicides, 64% herbicides, and 22% fungicides, with only 31% of participants reporting the use of some type of protective clothing during application. The banana weevil (Cosmopolites sordidus Germar) was ranked as the most important agricultural pest by 85% of participants, yet only 28% could associate the adult and larval form. A cost-benefit analysis conducted with a separate group of 26 plantain farmers identified several national markets and one export market for plantain production in the Indigenous Territories. Yearly income averaged US$6200/ha and yearly expenses averaged US$1872/ha, with an average cost-benefit ratio of 3.67 for plantain farmers. Farmers applied an average of 9.7 kg a.i./ha/yr of pesticide products and 375 kg/ha/yr of fertilizer, but those who sold their fruit to the national markets applied more nematicides, herbicides, and fertilizers than those who sold primarily to export markets

  14. Is practice rate rather than exercise intensity more important in health benefits of moderately obese postmenopausal women?

    Science.gov (United States)

    Garnier, S; Joffroy, S; Gaubert, I; Sanguignol, F; Auneau, G; Guiraud, T; Mauriège, P

    2015-06-01

    The aim of this study was to evaluate the impact of brisk walking on physical fitness, body composition and fasting lipid-lipoprotein profile of women 50-65 years-old, once adherence or exercise intensity is considered. A sample of 159 healthy, sedentary, obese postmenopausal women (body mass index [BMI]=29-35 kg/m2) was subjected to 3 sessions/week of 45 min-walking, at 60% of heart rate reserve (HRR), during 16 weeks. Body composition, physical fitness and fasting lipid-lipoprotein profile were assessed before and after the intervention. Among the three tertiles of adherence to exercise sessions (87%) women displaying the greatest one were characterized by the highest reduction in body weight (-1.9±2.7 kg) (mean±SD), fat mass (-2.0±2.3 kg) and waist girth (-4.4±3.4 cm) and the best improvement in physical fitness (7.3±3.5 mL O2/kg/min), (P63% HRR) did not show between-group differences in body composition or physical fitness. Also, the fasting lipid-lipoprotein profile was improved by a reduction of cholesterol, LDL cholesterol, and triglyceride levels and by an increase in HDL cholesterol, irrespective of the participants' adherence (0.05Health benefits appear at 78 minutes of brisk walk per week and increase with adherence to training, in moderately obese and initially sedentary, postmenopausal women. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  15. [Breastfeeding (part one): Frequency, benefits and drawbacks, optimal duration and factors influencing its initiation and prolongation. Clinical guidelines for practice].

    Science.gov (United States)

    Chantry, A A; Monier, I; Marcellin, L

    2015-12-01

    The objectives were to on assess the frequency and the duration of breastfeeding in France. On the other hand, the objectives were to identify its benefits and drawbacks, and to study the factors influencing its initiation and its extension. Bibliographic research in Medline, Google Scholar and in the Cochrane Library. Breastfeeding concerns in France about 70% of children at birth (EL2). Its median duration is about 15 weeks and 3 weeks ½ for exclusive breastfeeding. At three months, only one third of children breastfed at birth are still being breastfed (EL2). Whether this is due to the composition of breast milk or the behavior of mothers with their children or their socio-cultural level, or even by all these components at once, breastfeeding is associated with better cognitive development children (EL2). This effect is even more reinforced that mothers breastfeed exclusively and prolonged (EL2). As part of the prevention of many diseases (ear infections, gastrointestinal infections, atopic diseases, obesity and cardiovascular diseases…), exclusive and prolonged breastfeeding (grade B) between 4 to 6 months is recommended (professional consensus). Breastfeeding is not a means of preventing postpartum depression (professional consensus). To reduce the incidence of breast cancer, prolonged breastfeeding is recommended (grade B). In order to increase the rate of initiation of breastfeeding as well as its duration, it is recommended that health professionals work closely with mothers in their project (grade A), the breastfeeding promotion messages include message to husbands (grade B), and to promote breastfeeding on demand without fixed interval between feedings (grade B). However, there is not enough data to recommend the use of a specific position during breastfeeding, or the use of one or two breast or to early start breastfeeding or not (professional consensus). Exclusive and extended breastfeeding is recommended (grade B) between 4 to 6 months (professional

  16. Evidence-based obstetrics in four hospitals in China: An observational study to explore clinical practice, women's preferences and provider's views

    Directory of Open Access Journals (Sweden)

    Liang Ji

    2001-05-01

    Full Text Available Abstract Background Evidence-based obstetric care is widely promoted in developing countries, but the success of implementation is not known. Using selected childbirth care procedures in four hospitals in Shanghai, we compared practice against evidence-based information, and explored user and provider views about each procedure. Methods Observational study. Using the Cochrane Library, we identified six procedures that should be avoided as routine and two that should be encouraged. Procedure rate determined by exit interviews with women, verified using hospital notes. Views of women and providers explored with in depth interviews. The study sites were three hospitals in Shanghai and one in neighbouring province of Jiangsu. 150 women at each centre for procedure rate, and 48 in-depth interviews with women and providers. Results Vaginal births were 50% (303/599 of the total. Of the six practices where evidence suggests they should be avoided as routine, three were performed with rates above 70%: pubic shaving (3 hospitals, rectal examination (3 hospitals, and episiotomy (3 hospitals. Most women delivered lying down, pain relief was rarely given, and only in the urban district hospital did women routinely have a companion. Most women wanted support or companionship during labour and to be given pain relief; but current practice is insufficient to meet women's needs. Conclusion Obstetric practice is not following best available evidence in the hospitals studied. There is a need to adjust hospital policy to support the use of interventions proven to be of benefit to women during childbirth, and develop approaches that ensure clinical practice changes.

  17. Quality of weight-loss counseling by Dutch practice nurses in primary care: an observational study

    NARCIS (Netherlands)

    Dillen, S.M. van; Noordman, J.; Dulmen, S. van; Hiddink, G.J.

    2015-01-01

    BACKGROUND/OBJECTIVE: To assess the quality of weight-loss counseling provided by Dutch primary care practice nurses (PNs) to overweight and obese patients including both PNs' compliance with the Five A's Model for behavioral counseling in primary care, and the use of different communication styles.

  18. An Observational Study of Score Study Practices among Undergraduate Instrumental Music Education Majors

    Science.gov (United States)

    Silvey, Brian A.; Montemayor, Mark; Baumgartner, Christopher M.

    2017-01-01

    The purpose of this study was to investigate undergraduate instrumental music education majors' score study practices as they related to the effectiveness of their simulated conducting. Participants (N = 30) were video recorded in two sessions in which they completed a 20-min score study session and a simulated conducting performance. In the first…

  19. Translation of clinical prediction rules for febrile children to primary care practice : an observational cohort study

    NARCIS (Netherlands)

    van Ierland, Yvette; Elshout, Gijs; Berger, Marjolein Y.; Vergouwe, Yvonne; de Wilde, Marcel; van der Lei, Johan; Mol, Henritte A.; Oostenbrink, Rianne

    Background Clinical prediction rules (CPRs) to identify children with serious infections lack validation in low-prevalence populations, which hampers their implementation in primary care practice. Aim To evaluate the diagnostic value of published CPRs for febrile children in primary care. Design and

  20. Enhancing Technical Skill Learning through Interleaved Mixed-Model Observational Practice

    Science.gov (United States)

    Welsher, Arthur; Grierson, Lawrence E. M.

    2017-01-01

    A broad foundation of behavioural (Hayes et al. in "Exp Brain Res" 204(2): 199-206, 2010) and neurophysiological (Kohler et al. in "Science" 297(5582): 846-848, 2002) evidence has revealed that the acquisition of psychomotor skills, including those germane to clinical practice (Domuracki et al. in "Med Educ" 49(2):…

  1. Teacher Evaluations: A Correlation of Observed Teaching Practice and Student Achievement

    Science.gov (United States)

    Wright, Pamela D.

    2017-01-01

    This quantitative study employed a correlational research design to examine the extent to which overall teacher evaluation scores and instructional practice domain scores relate to student achievement scores in mathematics and English language arts among 3rd grade students. This research tested the theory of instruction by Jerome Bruner as it…

  2. Trends in suicidal behaviour in Dutch general practice 1983–2013: a retrospective observational study.

    NARCIS (Netherlands)

    Beurs, D.P. de; Hooiveld, M.; Kerkhof, A.J.F.M.; Korevaar, J.C.; Donker, G.A.

    2016-01-01

    Objectives To analyse trends in suicidal behaviour as reported by the Dutch sentinel general practices from 1983 to 2013. Second, to examine the relationship between suicidal behaviour and several patient characteristics. Finally, to compare the relationship between suicidal

  3. Prospective, observational study comparing automated and visual point-of-care urinalysis in general practice.

    Science.gov (United States)

    van Delft, Sanne; Goedhart, Annelijn; Spigt, Mark; van Pinxteren, Bart; de Wit, Niek; Hopstaken, Rogier

    2016-08-08

    Point-of-care testing (POCT) urinalysis might reduce errors in (subjective) reading, registration and communication of test results, and might also improve diagnostic outcome and optimise patient management. Evidence is lacking. In the present study, we have studied the analytical performance of automated urinalysis and visual urinalysis compared with a reference standard in routine general practice. The study was performed in six general practitioner (GP) group practices in the Netherlands. Automated urinalysis was compared with visual urinalysis in these practices. Reference testing was performed in a primary care laboratory (Saltro, Utrecht, The Netherlands). Analytical performance of automated and visual urinalysis compared with the reference laboratory method was the primary outcome measure, analysed by calculating sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) and Cohen's κ coefficient for agreement. Secondary outcome measure was the user-friendliness of the POCT analyser. Automated urinalysis by experienced and routinely trained practice assistants in general practice performs as good as visual urinalysis for nitrite, leucocytes and erythrocytes. Agreement for nitrite is high for automated and visual urinalysis. κ's are 0.824 and 0.803 (ranked as very good and good, respectively). Agreement with the central laboratory reference standard for automated and visual urinalysis for leucocytes is rather poor (0.256 for POCT and 0.197 for visual, respectively, ranked as fair and poor). κ's for erythrocytes are higher: 0.517 (automated) and 0.416 (visual), both ranked as moderate. The Urisys 1100 analyser was easy to use and considered to be not prone to flaws. Automated urinalysis performed as good as traditional visual urinalysis on reading of nitrite, leucocytes and erythrocytes in routine general practice. Implementation of automated urinalysis in general practice is justified as automation is expected to reduce

  4. The practical and economic benefits of ionising radiation for the postharvest treatment of fruit and vegetables: an evaluation

    International Nuclear Information System (INIS)

    Morris, S.C.

    1987-01-01

    It can be concluded validly from the literature examined that all irradiated fruit and vegetables are safe for human consumption and suffer no major reduction in nutritional quality for doses of 2 kGy and below. However, the majority of crops are adversely affected at treatment doses with appearance and quality being reduced significantly. This is because the sensitivity of the crop to irradiation is greater than the sensitivity of the pathogen to physiological process which irradiation is attempting to control. Of the nine commodities in Australia that have potential for treatment with irradiation, only the banana, citrus, mushroom, onion and potato industries have production areas with sufficient concentration of growers. However, irradiation as a treatment for these five crops does not appear to be economically viable, as there is either insufficient demand or insufficient advantages in using irradiation when compared to existing industry practice. It is apparent that no single fruit or vegetable crop in Australia has either the volume of product or potential demand to justify full scale commercialisation. Thus the only possible route for commercialisation of fruit and vegetable irradiation is by using the facilities of a multi-purpose irradiation plant. Whether such a system would ever be commercially viable for fruits and vegetables has yet to be demonstrated; to date only low volume specialty items or research scale quantities have been processed in multi-purpose plants at highly subsidised rates

  5. The “Artistic Image” Concept Applied to a Fugue at the Early Stage of Piano Practice: An Observational Study

    Directory of Open Access Journals (Sweden)

    Luís Cláudio Barros

    2017-10-01

    Full Text Available This article presents the results of an investigation on the concept of “artistic image of a musical composition” proposed by Heinrich Neuhaus (1888-1964 at the initial stage of learning a fugue by J.S. Bach. The data was gathered during the first practice session of six undergraduate piano majors learning a fugue, all from two public universities in southern Brazil. The concepts proposed by Neuhaus served as a parameter for an observational study of the students’ behavior and the technical-musical activities undertaken during their practice. The aim was to verify if the concept of artistic image had been used during practice and, if so, how it was established. We also examined the study strategies that helped comprehend the musical content, guiding the learning process and organization of practice. The results should assist in increasing our knowledge of the processes involving piano practice and the strategies linked to the concept of artistic image, stressing empirical observation as an important tool to validate theoretical concepts.

  6. Sustained Classroom Observation: What Does It Reveal about Changing Teaching Practices?

    Science.gov (United States)

    Lawson, Tony

    2011-01-01

    In the context of the tension between classroom observation as a form of empowerment and as an instrument of control, the partnership between three 16-19 colleges and a university School of Education in delivering a programme of sustained observation over eight years is explicated. Drawing on the literature about continuing professional…

  7. Peer Observation, Feedback and Reflection for Development of Practice in Synchronous Online Teaching

    Science.gov (United States)

    Jones, Mark H.; Gallen, Anne-Marie

    2016-01-01

    Peer observation of teaching is an established developmental tool in face-to-face settings. While there have been studies into peer observation as applied to asynchronous online teaching, less is known about its application to teaching online using synchronous communication systems. We describe a small-scale study of an online peer observation…

  8. Learning crisis resource management: Practicing versus an observational role in simulation training - a randomized controlled trial.

    Science.gov (United States)

    Lai, Anita; Haligua, Alexis; Dylan Bould, M; Everett, Tobias; Gale, Mark; Pigford, Ashlee-Ann; Boet, Sylvain

    2016-08-01

    Simulation training has been shown to be an effective way to teach crisis resource management (CRM) skills. Deliberate practice theory states that learners need to actively practice so that learning is effective. However, many residency programs have limited opportunities for learners to be "active" participants in simulation exercises. This study compares the effectiveness of learning CRM skills when being an active participant versus being an observer participant in simulation followed by a debriefing. Participants were randomized to two groups: active or observer. Active participants managed a simulated crisis scenario (pre-test) while paired observer participants viewed the scenario via video transmission. Then, a trained instructor debriefed participants on CRM principles. On the same day, each participant individually managed another simulated crisis scenario (post-test) and completed a post-test questionnaire. Two independent, blinded raters evaluated all videos using the Ottawa Global Rating Scale (GRS). Thirty-nine residents were included in the analysis. Normally distributed data were analyzed using paired and unpaired t-tests. Inter-rater reliability was 0.64. Active participants significantly improved from pre-test to post-test (P=0.015). There was no significant difference between the post-test performance of active participants compared to observer participants (P=0.12). We found that learning CRM principles was not superior when learners were active participants compared to being observers followed by debriefing. These findings challenge the deliberate practice theory claiming that learning requires active practice. Assigning residents as observers in simulation training and involving them in debriefing is still beneficial. Copyright © 2016 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

  9. The benefits of co-location in primary care practices: the perspectives of general practitioners and patients in 34 countries.

    Science.gov (United States)

    Bonciani, M; Schäfer, W; Barsanti, S; Heinemann, S; Groenewegen, P P

    2018-02-21

    There is no clear evidence as to whether the co-location of primary care professionals in the same facility positively influences their way of working and the quality of healthcare as perceived by patients. The aim of this study was to identify the relationships between general practitioner (GP) co-location with other GPs and/or other professionals and the GP outcomes and patients' experiences. We wanted to test whether GP co-location is related to a broader range of services provided, the use of clinical governance tools and inter-professional collaboration, and whether the patients of co-located GPs perceive a better quality of care in terms of accessibility, comprehensiveness and continuity of care with their GPs. The source of data was the QUALICOPC study (Quality and Costs of Primary Care in Europe), which involved surveys of GPs and their patients in 34 countries, mostly in Europe. In order to study the relationships between GP co-location and both GPs' outcomes and patients' experience, multilevel linear regression analysis was carried out. The GP questionnaire was filled in by 7183 GPs and the patient experience questionnaire by 61,931 patients. Being co-located with at least one other professional is the most common situation of the GPs involved in the study. Compared with single-handed GP practices, GP co-location are positively associated with the GP outcomes. Considering the patients' perspective, comprehensiveness of care has the strongest negative relationship of GP co-location of all the dimensions of patient experiences analysed. The paper highlights that GP mono- and multi-disciplinary co-location is related to positive outcomes at a GP level, such as a broader provision of technical procedures, increased collaboration among different providers and wider coordination with secondary care. However, GP co-location, particularly in a multidisciplinary setting, is related to less positive patient experiences, especially in countries with health systems

  10. Using the Real-time Instructor Observing Tool (RIOT) for Reflection on Teaching Practice

    Science.gov (United States)

    Paul, Cassandra; West, Emily

    2018-03-01

    As physics educators, we are constantly looking for ways to improve our practice. There are many different kinds of professional development opportunities that have been shown to help us with this endeavor. We can seek assistance from professionals, like mentor teachers or centers for faculty development, we can attend workshops to learn new curricula or pedagogical skills, and we can engage in learning communities to develop shared visions and become more reflective educators. However, when these activities end, what can we do on our own to continue to improve? How can we track our improvement? And perhaps even most importantly, what can we do when these resources aren't available to us? While publications like The Physics Teacher offer excellent pedagogical practices we can try out in the classroom, how do we get feedback on what we decide to implement?

  11. Reducing Loss of Life and Property from Disasters: A Societal Benefit Area of the Strategic Plan for U.S. Integrated Earth Observation System (IEOS)

    Science.gov (United States)

    Helz, Rosalind L.; Gaynor, John E.

    2007-01-01

    Natural and technological disasters, such as hurricanes and other extreme weather events, earthquakes, volcanic eruptions, landslides and debris flows, wildland and urban-interface fires, floods, oil spills, and space-weather storms, impose a significant burden on society. Throughout the United States, disasters inflict many injuries and deaths, and cost the nation $20 billion each year (SDR, 2003). Disasters in other countries can affect U.S. assets and interests overseas (e.g. the eruption of Mt. Pinatubo in the Philippines, which effectively destroyed Clark Air Force Base). Also, because they have a disproportionate impact on developing countries, disasters are major barriers to sustainable development. Improving our ability to assess, predict, monitor, and respond to hazardous events is a key factor in reducing the occurrence and severity of disasters, and relies heavily on the use of information from well-designed and integrated Earth observation systems. To fully realize the benefits gained from the observation systems, the information derived must be disseminated through effective warning systems and networks, with products tailored to the needs of the end users and the general public.

  12. ARCADO - Adding random case analysis to direct observation in workplace-based formative assessment of general practice registrars.

    Science.gov (United States)

    Ingham, Gerard; Fry, Jennifer; Morgan, Simon; Ward, Bernadette

    2015-12-10

    Workplace-based formative assessments using consultation observation are currently conducted during the Australian general practice training program. Assessment reliability is improved by using multiple assessment methods. The aim of this study was to explore experiences of general practice medical educator assessors and registrars (trainees) when adding random case analysis to direct observation (ARCADO) during formative workplace-based assessments. A sample of general practice medical educators and matched registrars were recruited. Following the ARCADO workplace assessment, semi-structured qualitative interviews were conducted. The data was analysed thematically. Ten registrars and eight medical educators participated. Four major themes emerged - formative versus summative assessment; strengths (acceptability, flexibility, time efficiency, complementarity and authenticity); weaknesses (reduced observation and integrity risks); and contextual factors (variation in assessment content, assessment timing, registrar-medical educator relationship, medical educator's approach and registrar ability). ARCADO is a well-accepted workplace-based formative assessment perceived by registrars and assessors to be valid and flexible. The use of ARCADO enabled complementary insights that would not have been achieved with direct observation alone. Whilst there are some contextual factors to be considered in its implementation, ARCADO appears to have utility as formative assessment and, subject to further evaluation, high-stakes assessment.

  13. Recording the Personal: The Benefits in Maintaining Research Diaries for Documenting the Emotional and Practical Challenges of Fieldwork in Unfamiliar Settings

    Directory of Open Access Journals (Sweden)

    Brendan Ciaran Browne PhD

    2013-02-01

    Full Text Available Through an analysis of personal research diaries maintained during a prolonged period spent working in Palestine, this article analyses the importance of maintaining research diaries when on fieldwork. The evidence produced stems from a content analysis of fieldwork diaries kept while researching commemorative events in the West Bank, Palestine, during a period of global uncertainty and at a time of much change in the region. In espousing the benefits of the fieldwork diary it is shown that diaries assume a more important role than acting as a mere logging device; they have the capacity to allow for personal reflection and to help with the development of strategic responses to the inevitable challenges one would expect to face when working far from the relative comfort of home. The research diary as a cathartic tool for researchers to record fears and shortcomings in their work is discussed and personal insights into some of the challenges this researcher faced when engaged in ethnographic work in Ramallah, Palestine are provided. In summarising the benefits of maintaining research diaries, the author, lamenting the lack of transparency in the literature to date on the practicalities of fieldwork, calls for more open and honest reflection on the challenges associated with conducting fieldwork, particularly that which takes place in volatile or unstable regions.

  14. "Doctor, Why Didn't You Adopt My Baby?" Observant Participation, Care, and the Simultaneous Practice of Medicine and Anthropology.

    Science.gov (United States)

    Sufrin, Carolyn

    2015-12-01

    Medical anthropology has long appreciated the clinical encounter as a rich source of data and a key site for critical inquiry. It is no surprise, then, that a number of physician-anthropologists have used their clinical insights to make important contributions to the field. How does this duality challenge and enhance the moral practice and ethics of care inherent both to ethnography and to medicine? How do bureaucratic and professional obligations of HIPAA and the IRB intersect with aspirations of anthropology to understand human experience and of medicine to heal with compassion? In this paper, I describe my simultaneous fieldwork and clinical practice at an urban women's jail in the United States. In this setting, being a physician facilitates privileged access to people and spaces within, garners easy trust, and enables an insider perspective more akin to observant participation than participant observation. Through experiences of delivering the infants of incarcerated pregnant women and of being with the mothers as they navigate drug addiction, child custody battles, and re-incarceration, the roles of doctor and anthropologist become mutually constitutive and transformative. Moreover, the dual practice reveals congruities and cracks in each discipline's ethics of care. Being an anthropologist among informants who may have been patients reworks expectations of care and necessitates ethical practice informed by the dual roles.

  15. Photodynamic therapy with verteporfin: observations on the introduction of a new treatment into clinical practice.

    Science.gov (United States)

    Schein, Oliver D; Bressler, Neil M; Price, Patrick

    2005-01-01

    To assess adherence to Food and Drug Administration-approved indications and Centers for Medicare & Medicaid Services policy through June 2001 regarding the use of photodynamic therapy in Medicare beneficiaries. Systematic review of pretreatment fluorescein angiograms of 1245 consecutive Medicare patients who received photodynamic therapy from physicians in 3 contiguous Medicare coverage areas (fee-for-service arrangement) and in 136 consecutive patients in a Medicare health maintenance organization. In the 3 Medicare fee-for-service regions, payment denial due to nonconforming fluorescein angiograms ranged from 17% to 29% by region in 1245 beneficiaries. In the health maintenance organization setting, 60 (44%) of 136 submitted angiograms were nonconforming, including 8 in which the photographic quality was too poor to grade the lesion size, composition, or both. A substantial proportion of the actual or intended clinical application of photodynamic therapy with verteporfin was directed to patients who did not meet concurrent published clinical criteria associated with treatment benefit or national coverage policy. Although this policy has evolved, it still depends on fluorescein angiographic interpretation, suggesting that there is an opportunity to improve the cost-effectiveness of delivery of photodynamic therapy with verteporfin to Medicare beneficiaries.

  16. Non-Hodgkin's lymphoma in the practice of the family doctor (clinical observation.

    Directory of Open Access Journals (Sweden)

    I. V. Vasylevska

    2018-05-01

    Full Text Available There is presented a clinical observation on the problem of establishing an oncological diagnosis by a family doctor, the route to a doctor-oncologist for specific treatment with subsequent work in the brigade team and medical support during the course of chemotherapy for the prevention and timely elimination of side effects and complications.

  17. Non-Hodgkin's lymphoma in the practice of the family doctor (clinical observation).

    OpenAIRE

    I. V. Vasylevska

    2018-01-01

    There is presented a clinical observation on the problem of establishing an oncological diagnosis by a family doctor, the route to a doctor-oncologist for specific treatment with subsequent work in the brigade team and medical support during the course of chemotherapy for the prevention and timely elimination of side effects and complications.

  18. Inferring the drivers of discarding practices from observer data to identify appropriate fishery‐specific solutions

    DEFF Research Database (Denmark)

    Catchpole, Tom; Rochet, Marie‐Joëlle; Madsen, Niels

    2012-01-01

    with associated quota that are above the MLS or minimum length landed. The model is applied to data from the full English observer programme and to French, Danish, Greek, and Spanish case study métiers. The proportionate contribution of the different categories is determined, the differences between métiers...

  19. How registered nurses, licensed practical nurses and resident aides spend time in nursing homes: An observational study.

    Science.gov (United States)

    McCloskey, Rose; Donovan, Cindy; Stewart, Connie; Donovan, Alicia

    2015-09-01

    Calls for improved conditions in nursing homes have pointed to the importance of optimizing the levels and skills of care providers. Understanding the work of care providers will help to determine if staff are being used to their full potential and if opportunities exist for improved efficiencies. To explore the activities of care providers in different nursing homes and to identify if variations exist within and across homes and shifts. A multi-centre cross-sectional observational work flow study was conducted in seven different nursing homes sites in one Canadian province. Data were collected by a research assistant who conducted 368 h of observation. The research assistant collected data by following an identical route in each site and recording observations on staff activities. Findings indicate staff activities vary across roles, sites and shifts. Licensed practical nurses (nursing assistants) have the greatest variation in their role while registered nurses have the least amount of variability. In some sites both registered nurses and licensed practical nurses perform activities that may be safely delegated to others. Care providers spend as much as 53.7% of their time engaged in non-value added activities. There may be opportunities for registered nurses and licensed practical nurses to delegate some of their activities to non-regulated workers. The time care providers spend in non-value activities suggest there may be opportunities to improve efficiencies within the nursing home setting. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Metacognition and L2 listening. Observation of university-level teaching practices

    Directory of Open Access Journals (Sweden)

    Jaqueline Hernandez Wilson

    2016-01-01

    Full Text Available Theoretical and empirical research offers support for explicit instruction on metacognition and cognitive strategies as an effective way to improve L2 listening skills. This study is aimed at identifying whether both metacognition and cognitive strategies are worked on in a university-level French class on a daily basis. A second-year French-class teacher and his students (n=26 were observed during five listening-based sessions over a semester. Quantitative data was collected with regard to six dimensions of explicit metacognitive instruction of listening skills, using a teacher self-evaluation questionnaire, a student questionnaire and a structured observation. The results reveal implicit cognitive work during the pre-, while- and post-listening teaching stages. Nonetheless, strategy assessment, and the explicit teaching of metacognitive strategies for planning, monitoring, controlling and problem identifying, both remain controversial.

  1. Developing best practices teaching procedures for skinfold assessment: observational examination using the Think Aloud method.

    Science.gov (United States)

    Holmstrup, Michael E; Verba, Steven D; Lynn, Jeffrey S

    2015-12-01

    Skinfold assessment is valid and economical; however, it has a steep learning curve, and many programs only include one exposure to the technique. Increasing the number of exposures to skinfold assessment within an undergraduate curriculum would likely increase skill proficiency. The present study combined observational and Think Aloud methodologies to quantify procedural and cognitive characteristics of skinfold assessment. It was hypothesized that 1) increased curricular exposure to skinfold assessment would improve proficiency and 2) the combination of an observational and Think Aloud analysis would provide quantifiable areas of emphasis for instructing skinfold assessment. Seventy-five undergraduates with varied curricular exposure performed a seven-site skinfold assessment on a test subject while expressing their thoughts aloud. A trained practitioner recorded procedural observations, with transcripts generated from audio recordings to capture cognitive information. Skinfold measurements were compared with a criterion value, and bias scores were generated. Participants whose total bias fell within ±3.5% of the criterion value were proficient, with the remainder nonproficient. An independent-samples t-test was used to compare procedural and cognitive observations across experience and proficiency groups. Additional curricular exposure improved performance of skinfold assessment in areas such as the measurement of specific sites (e.g., chest, abdomen, and thigh) and procedural (e.g., landmark identification) and cognitive skills (e.g., complete site explanation). Furthermore, the Think Aloud method is a valuable tool for determining curricular strengths and weaknesses with skinfold assessment and as a pedagogical tool for individual instruction and feedback in the classroom. Copyright © 2015 The American Physiological Society.

  2. A Practical, Robust Methodology for Acquiring New Observation Data Using Computationally Expensive Groundwater Models

    Science.gov (United States)

    Siade, Adam J.; Hall, Joel; Karelse, Robert N.

    2017-11-01

    Regional groundwater flow models play an important role in decision making regarding water resources; however, the uncertainty embedded in model parameters and model assumptions can significantly hinder the reliability of model predictions. One way to reduce this uncertainty is to collect new observation data from the field. However, determining where and when to obtain such data is not straightforward. There exist a number of data-worth and experimental design strategies developed for this purpose. However, these studies often ignore issues related to real-world groundwater models such as computational expense, existing observation data, high-parameter dimension, etc. In this study, we propose a methodology, based on existing methods and software, to efficiently conduct such analyses for large-scale, complex regional groundwater flow systems for which there is a wealth of available observation data. The method utilizes the well-established d-optimality criterion, and the minimax criterion for robust sampling strategies. The so-called Null-Space Monte Carlo method is used to reduce the computational burden associated with uncertainty quantification. And, a heuristic methodology, based on the concept of the greedy algorithm, is proposed for developing robust designs with subsets of the posterior parameter samples. The proposed methodology is tested on a synthetic regional groundwater model, and subsequently applied to an existing, complex, regional groundwater system in the Perth region of Western Australia. The results indicate that robust designs can be obtained efficiently, within reasonable computational resources, for making regional decisions regarding groundwater level sampling.

  3. Effectiveness and Persistence with Liraglutide Among Patients with Type 2 Diabetes in Routine Clinical Practice--EVIDENCE: A Prospective, 2-Year Follow-Up, Observational, Post-Marketing Study.

    Science.gov (United States)

    Gautier, Jean-Francois; Martinez, Luc; Penfornis, Alfred; Eschwège, Eveline; Charpentier, Guillaume; Huret, Benoît; Madani, Suliya; Gourdy, Pierre

    2015-09-01

    The aim of this study was to investigate whether the efficacy of liraglutide observed in randomized controlled trials translates into therapeutic benefits in the French population during routine clinical practice. This observational, prospective, multicenter study included 3152 adults with type 2 diabetes who had recently started or were about to start liraglutide treatment. During 2 years of follow-up, an evaluation of the reasons for prescribing liraglutide, maintenance dose of liraglutide, changes in combined antidiabetic treatments, level of glycemic control, change in body weight and body mass index (BMI), patient satisfaction with diabetes treatment and safety of liraglutide were investigated. The primary study endpoint was the proportion of patients still receiving liraglutide and presenting with HbA1c effectiveness of liraglutide in real-world clinical practice is similar to that observed in randomized controlled trials. Novo Nordisk A/S. ClinicalTrials.gov identifier, NCT01226966.

  4. Hand-hygiene practices and observed barriers in pediatric long-term care facilities in the New York metropolitan area.

    Science.gov (United States)

    Løyland, Borghild; Wilmont, Sibyl; Cohen, Bevin; Larson, Elaine

    2016-02-01

    To describe hand-hygiene practices in pediatric long-term care (pLTC) facilities and to identify observed barriers to, and potential solutions for, improved infection prevention. Observational study using (i) the World Health Organization's '5 Moments for Hand Hygiene' validated observation tool to record indications for hand hygiene and adherence; and (ii) individual logs of subjective impressions of behavioral and/or systemic barriers witnessed during direct observation. Staff in three pLTC facilities (284 beds total) were observed by two trained nurses 1 day a week for 3 weeks in February and March 2015. Direct providers of health, therapeutic and rehabilitative care, and other staff responsible for social and academic activities for children with complex, chronic medical conditions. Hand-hygiene indications, adherence and barriers. Hand hygiene was performed for 40% of the 847 indications observed and recorded. Adherence increased at one site and decreased in the other two sites during the study period. Adherence appeared to be influenced by individuals' knowledge, attitudes, beliefs and work setting. Poor hand-hygiene adherence was observed overall. Specific barriers were identified, which suggest a contextual approach to the interpretation of results indicated in this uniquely challenging setting. We offer some practical suggestions for overcoming those barriers or mitigating their effect. Ultimately, an adaptation of the '5 Moments for Hand Hygiene' may be necessary to improve infection prevention in pLTC. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  5. Correspondence between mothers' self-reported and observed child-rearing practices.

    Science.gov (United States)

    Kochanska, G; Kuczynski, L; Radke-Yarrow, M

    1989-02-01

    The correspondence between self-reported child-rearing attitudes and practices and actual child management was examined among 68 mothers of young children. Data on mothers' verbal and physical control techniques along with children's responses (cooperation vs. resistance) were obtained during 90 min of spontaneous interaction in a naturalistic setting. Self-report data (the Block Q-Sort) were obtained 1-2 weeks later. The Block Q-Sort factors were combined to represent authoritarian and authoritative patterns of attitudes. The authoritarian pattern was positively associated with the use of direct commands, physical enforcements, reprimands, and prohibitive interventions, and negatively associated with the use of suggestions. The authoritative pattern was positively related to the use of suggestions and positive incentives, and negatively related to the use of physical enforcements, prohibitive interventions, and direct commands. Mothers' enjoyment of the parental role and their negative affect toward the child, as expressed in the Block Q-Sort, were more a result of the child's cooperation/resistance during the interaction than predictors of maternal control strategies.

  6. Supplementary Tooth: To Extract or Observe? Evidence Based Practice with the Literature Review

    Directory of Open Access Journals (Sweden)

    Nikhil G Patel

    2015-01-01

    Full Text Available Background : Supernumerary teeth are the teeth present in addition to the normal set of teeth. They may be single, multiple, unilateral or bilateral, erupted or unerupted present in one or both jaws and may or may not be associated with other disease or syndrome. Multidisciplinary approach is necessary to meet the treatment challenges of supernumerary teeth. Supernumerary teeth can be managed either by removal/ endodontic/ orthodontic therapy or by maintaining them in the arch and frequent observation. Removal of supernumerary teeth is recommended where there is compromised esthetic and functional status. This article reviews case series of supernumerary teeth with no associated disease or syndromes.

  7. Association of anxiety and depression with hypertension control: a US multidisciplinary group practice observational study.

    Science.gov (United States)

    Ho, Aaron K; Thorpe, Carolyn T; Pandhi, Nancy; Palta, Mari; Smith, Maureen A; Johnson, Heather M

    2015-11-01

    The presence of a mental health disorder with hypertension is associated with higher cardiovascular disease mortality than hypertension alone. Although earlier detection of hypertension has been demonstrated in patients with anxiety and depression, the relationship of mental health disorders to hypertension control is unknown. Our objective was to evaluate rates and predictors of incident hypertension control among patients with anxiety and/or depression compared with patients without either mental health diagnosis. A 4-year retrospective analysis included 4362 patients, at least 18 years old, who received primary care in a large academic group practice from 2008 to 2011. Patients met The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure criteria and had a hypertension diagnosis. Kaplan-Meier analysis estimated the probability of achieving control for patients with and without anxiety and/or depression. Cox proportional hazard models were fit to identify predictors of time to control. Overall, 13% (n = 573) had a baseline diagnosis of anxiety and/or depression. Those with anxiety and/or depression demonstrated more primary care and specialty visits than those without either condition. After adjustment, patients with anxiety and/or depression had faster rates of hypertension control (hazard ratio [HR] 1.22; 1.07-1.39] than patients without either diagnosis. Other associations of faster hypertension control included female gender (HR 1.32; 1.20-1.44), absence of tobacco use (HR 1.17; 1.03-1.33), Medicaid use (HR 1.27; 1.09-1.49), and a higher Adjusted Clinical Group Risk Score (HR 1.13; 1.10-1.17), a measure of healthcare utilization. Greater healthcare utilization among patients with anxiety and/or depression may contribute to faster hypertension control.

  8. Facilitating the entry into force and implementation of the Amendment to the Convention on the Physical Protection of Nuclear Material: Observations, challenges and benefits

    International Nuclear Information System (INIS)

    Johnson, Peri Lynne; )

    2014-01-01

    Amendment to enter into force is clear and its benefits are recognised, further consideration needs to be given to identifying why it has not yet entered into force. More particularly, what are the reasons why nearly half of the current CPPNM states parties, including those with and without nuclear material and nuclear facilities, have still not joined the Amendment? Also, what challenges do they face in joining and effectively implementing the instrument? This article will seek to provide answers and also to identify some benefits of the Amendment. Part A of this article places the Amendment into context by identifying the relevant legal instruments comprising the international legal framework for nuclear security. Part B highlights some of the Amendment's new and extended provisions. The IAEA Secretariat's internal Plan of Action on Facilitating Adherence to and Implementation of the Amendment (the 'Plan of Action') is highlighted in Part C, which also addresses relevant IAEA activities by identifying the broad range of services provided to IAEA member states. Part D identifies some observations and challenges associated with the entry into force and implementation of the Amendment, the main focus is on its provisions, which are likely to require changes to the national legislative framework. Finally, Part E of this article concludes with some identified potential benefits of joining the Amendment, in particular, those considered by the IAEA Advisory Group on Nuclear Security ('AdSec'). (author)

  9. European Practice Assessment of Cardiovascular risk management (EPA Cardio: protocol of an international observational study in primary care

    Directory of Open Access Journals (Sweden)

    van Lieshout Jan

    2009-01-01

    Full Text Available Abstract Background Despite important improvements in available prevention and treatment, cardiovascular diseases (CVD remain an important cause of morbidity and mortality. Not all high-risk patients and patients with CVD have healthy lifestyles and receive the best possible healthcare. Internationally comparative data are needed to compare cardiovascular risk management in different countries, and to examine the impact of improvement programs and others factors. Objectives This study aims to provide internationally comparative data on cardiovascular risk management provided in primary care and on health-related lifestyles of patients in Europe. The study will also explore the views of doctors and patients on innovative preventive services for CVDs. Design and methods An observational cross-sectional study is planned. In 10 European countries, stratified samples of 36 practices per country will be recruited. In each practice, three samples of 15 patients each will be sampled: patients with coronary heart disease, patients at high risk for CVD, and healthy adult patients. The quality of cardiovascular risk management has been specified in terms of 44 performance indicators that resulted from an international Delphi-procedure with general practitioners. Most indicators are based on medical records, and some on a structured interview with a contact person of the practice. Lifestyle (smoking, physical exercise, diet will be measured with previously validated questionnaires that are completed by patients. Additional measures include practice characteristics and exposure to programs to improve cardiovascular care.

  10. SOSPES: SPIRIVA® observational study measuring SGRQ score in routine medical practice in Central and Eastern Europe

    Directory of Open Access Journals (Sweden)

    Fležar M

    2013-10-01

    Full Text Available Matjaž Fležar,1 Karina Jahnz-Rózyk,2 Gloria Enache,3 Tatiana Martynenko,4 Peter Kristufek,5 Sanda Škrinjaric-Cincar,6 Pavla Kadlecová,7 Goran Martinovic81University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia; 2Military Institute of Medicine, Department of Immunology and Allergology, Warsaw, Poland; 3Saint John Clinical Emergency Hospital, Bucharest, Romania; 4Municipal Medical Institution City Hospital, Barnaul, Russian Federation; 5SACCME, Slovak Medical University, Bratislava, Slovakia; 6Clinical Hospital Center, Osijek, Croatia; 7ADDS Sro, Jana Uhra, Brno, Czech Republic; 8Boehringer Ingelheim RCV GmbH and Co KG, Ingelheim, Vienna, AustriaPurpose: The long-acting inhaled anticholinergic agent, tiotropium, is recommended as first-line maintenance therapy for moderate to very severe Chronic Obstructive Pulmonary Disease (COPD to improve symptoms, exercise tolerance, health status, and to reduce exacerbations. Few studies have evaluated the therapeutic efficacy of tiotropium in patients in routine clinical conditions. The current study was designed to investigate the therapeutic efficacy of tiotropium delivered via the HandiHaler® device on the health status of patients with COPD with Global initiative for chronic Obstructive Lung Disease (GOLD disease classification 2–4 in six central and eastern European countries in a real-life clinical setting.Methods: The study was an open-label, prospective, uncontrolled, and single-arm surveillance study with three clinic visits during a 6-month observation period (baseline, and months 3 and 6. Health status was measured using the disease-specific St George's Respiratory Questionnaire (SGRQ. The primary efficacy endpoint was the mean change from baseline in SGRQ total score at the end of the 6-month observational period.Results: Patients treated with tiotropium 18 µg once daily showed statistically significant and clinically meaningful reduction (improvement of 21

  11. Virtual study groups and online Observed Structured Clinical Examinations practices - enabling trainees to enable themselves.

    Science.gov (United States)

    Davidson, Dennisa; Evans, Lois

    2018-03-01

    To explore online study groups as augmentation tools in preparing for the Royal Australian and New Zealand College of Psychiatrists Observed Structured Clinical Examinations (OSCE) for fellowship. An online survey of New Zealand trainees was carried out to assess exam preparedness and openness to virtual study groups and results analysed. Relevant material around virtual study groups for fellowship examinations was reviewed and used to inform a pilot virtual study group. Four New Zealand trainees took part in the pilot project, looking at using a virtual platform to augment OSCE preparation. Of the 50 respondents 36% felt adequately prepared for the OSCE. Sixty-four per cent were interested in using a virtual platform to augment their study. Virtual study groups were noted to be especially important for rural trainees, none of whom felt able to form study groups for themselves. The pilot virtual study group was trialled successfully. All four trainees reported the experience as subjectively beneficial to their examination preparation. Virtual platforms hold promise as an augmentation strategy for exam preparation, especially for rural trainees who are more geographically isolated and less likely to have peers preparing for the same examinations.

  12. Global Learning and Observation to Benefit the Environment (GLOBE) Mission EARTH (GME) program delivers climate change science content, pedagogy, and data resources to K12 educators, future teachers, and professional development providers.

    Science.gov (United States)

    Ostrom, T.

    2017-12-01

    This presentation will include a series of visuals that discuss how hands-on learning activities and field investigations from the the Global Learning and Observation to Benefit the Environment (GLOBE) Mission EARTH (GME) program deliver climate change science content, pedagogy, and data resources to K12 educators, future teachers, and professional development providers. The GME program poster presentation will also show how teachers strengthen student preparation for Science, Technology, Engineering, Art and Mathematics (STEAM)-related careers while promoting diversity in the future STEM workforce. In addition to engaging students in scientific inquiry, the GME program poster will show how career exploration and preparation experiences is accomplished through direct connection to scientists and real science practices. The poster will show which hands-on learning activities that are being implemented in more than 30,000 schools worldwide, with over a million students, teachers, and scientists collecting environmental measurements using the GLOBE scientific protocols. This poster will also include how Next Generation Science Standards connect to GME learning progressions by grade strands. The poster will present the first year of results from the implementation of the GME program. Data is currently being agrigated by the east, midwest and westen regional operations.

  13. Patient information materials in general practices and promotion of health literacy: an observational study of their effectiveness.

    Science.gov (United States)

    Protheroe, Joanne; Estacio, Emee Vida; Saidy-Khan, Sirandou

    2015-03-01

    Government policy in the UK emphasises providing patients with good health information to encourage participation in their health care. Patient information leaflets (PILs) form part of this policy and have been shown to affect patient health outcomes; however, many are poorly written. To describe the PILs in general practice surgeries in Stoke-on-Trent in terms of readability and variety of content. An observational study of randomly selected GP practices (n = 17) across Stoke-on-Trent. PILs were assessed for readability (Flesch Reading Ease and Flesch-Kincaid Grade Level) and compared with national skills level data and with the recommended level for medical information. The PILs were also categorised for content using the Rudd (2007) health material classification framework. A total of 345 PILs were collected and assessed. Only 24.3% meet recommended reading-level criteria. Compared with national skills levels, over 75% of the PILs collected were too complex for at least 15% of the English population. Of the PILs, 47.8% were classified as 'systems navigation' (information regarding services); 22.9% were disease prevention (screening and immunisations); 14.2% personal and public safety; and less than 10% were for managing illness or health promotion. Current PILs in general practices do not all promote health literacy. Information only accessible to a proportion of higher skilled patients may increase inequalities in health. Less than 10% of PILs promote managing illness or healthy lifestyles. Processes must be put in place to improve the readability and variety of content of PILs in GP practices. © British Journal of General Practice 2015.

  14. An International Coordinated Effort to Further the Documentation & Development of Quality Assurance, Quality Control, and Best Practices for Oceanographic Observations

    Science.gov (United States)

    Bushnell, M.; Waldmann, C.; Hermes, J.; Tamburri, M.

    2017-12-01

    Many oceanographic observation groups create and maintain QA, QC, and best practices (BP) to ensure efficient and accurate data collection and quantify quality. Several entities - IOOS® QARTOD, AtlantOS, ACT, WMO/IOC JCOMM OCG - have joined forces to document existing practices, identify gaps, and support development of emerging techniques. While each group has a slightly different focus, many underlying QA/QC/BP needs can be quite common. QARTOD focuses upon real-time data QC, and has produced manuals that address QC tests for eleven ocean variables. AtlantOS is a research and innovation project working towards the integration of ocean-observing activities across all disciplines in the Atlantic Basin. ACT brings together research institutions, resource managers, and private companies to foster the development and adoption of effective and reliable sensors for coastal, freshwater, and ocean environments. JCOMM promotes broad international coordination of oceanographic and marine meteorological observations and data management and services. Leveraging existing efforts of these organizations is an efficient way to consolidate available information, develop new practices, and evaluate the use of ISO standards to judge the quality of measurements. ISO standards may offer accepted support for a framework for an ocean data quality management system, similar to the meteorological standards defined by WMO (https://www.wmo.int/pages/prog/arep/gaw/qassurance.html). We will first cooperatively develop a plan to create a QA/QC/BP manual. The resulting plan will describe the need for such a manual, the extent of the manual, the process used to engage the community in creating it, the maintenance of the resultant document, and how these things will be done. It will also investigate standards for metadata. The plan will subsequently be used to develop the QA/QC/BP manual, providing guidance which advances the standards adopted by IOOS, AtlantOS, JCOMM, and others.

  15. Pediatric supraglottic airway devices in clinical practice: A prospective observational study.

    Science.gov (United States)

    Kleine-Brueggeney, Maren; Gottfried, Anne; Nabecker, Sabine; Greif, Robert; Book, Malte; Theiler, Lorenz

    2017-09-02

    Supraglottic airway devices (SGA) are commonly used in pediatric anesthesia and serve as primary or back-up devices for difficult airway management. Most SGA are marketed without proper clinical evaluation. The purpose of this study was to evaluate the performance of the pediatric LMA Supreme™, Air-Q® and Ambu® Aura-i™. This prospective observational study was performed at Bern University Hospital, Switzerland. With ethics committee approval and a waiver for written informed consent 240 children undergoing elective surgery with an ASA class I-III and a weight of 5-30 kg were included. Three different pediatric supraglottic airway devices were assessed: The LMA Supreme™, Air-Q® and Ambu® Aura-i™. Primary outcome parameter was airway leak pressure. Secondary outcome parameters included first attempt and overall success rate, insertion time, fiberoptic view through the SGA, and adverse events. The primary hypothesis was that the mean airway leak pressure of each tested SGA was 20 cmH 2 O ± 10%. None of the SGA showed a mean airway leak pressure of 20 cmH 2 O ± 10%, but mean airway leak pressures differed significantly between devices [LMA Supreme™ 18.0 (3.4) cmH 2 O, Air-Q® 15.9 (3.2) cmH 2 O, Ambu® Aura-i™ 17.3 (3.7) cmH 2 O, p < 0.001]. First attempt success rates (LMA Supreme™ 100%, Air-Q® 90%, Ambu® Aura-i™ 91%, p = 0.02) and overall success rates (LMA Supreme™ 100%, Air-Q® 91%, Ambu® Aura-i™ 95%, p = 0.02) also differed significantly. Insertion times ranged from 20 (7) seconds (Air-Q®) to 24 (6) seconds (LMA Supreme™,

  16. Scrutinizing a Survey-Based Measure of Science and Mathematics Teacher Knowledge: Relationship to Observations of Teaching Practice

    Science.gov (United States)

    Talbot, Robert M.

    2017-12-01

    There is a clear need for valid and reliable instrumentation that measures teacher knowledge. However, the process of investigating and making a case for instrument validity is not a simple undertaking; rather, it is a complex endeavor. This paper presents the empirical case of one aspect of such an instrument validation effort. The particular instrument under scrutiny was developed in order to determine the effect of a teacher education program on novice science and mathematics teachers' strategic knowledge (SK). The relationship between novice science and mathematics teachers' SK as measured by a survey and their SK as inferred from observations of practice using a widely used observation protocol is the subject of this paper. Moderate correlations between parts of the observation-based construct and the SK construct were observed. However, the main finding of this work is that the context in which the measurement is made (in situ observations vs. ex situ survey) is an essential factor in establishing the validity of the measurement itself.

  17. How to Address a Global Problem with Earth Observations? Developing Best Practices to Monitor Forests Around the World

    Science.gov (United States)

    Flores Cordova, Africa I.; Cherrington, Emil A.; Vadrevu, Krishna; Thapa, Rajesh Bahadur; Odour, Phoebe; Mehmood, Hamid; Quyen, Nguyen Hanh; Saah, David; Yero, Kadidia; Mamane, Bako; hide

    2017-01-01

    Forests represent a key natural resource, for which degradation or disturbance is directly associated to economic implications, particularly in the context of the United Nations program REDD+ in supporting national policies to fight illegal deforestation. SERVIR, a joint NASA-USAID initiative that brings Earth observations (EO) for improved environmental decision making in developing countries, works with established institutions, called SERVIR hubs, in four regions around the world. SERVIR is partnering with global programs with great experience in providing best practices in forest monitoring systems, such as SilvaCarbon and the Global Forest Observation Initiative (GFOI), to develop a capacity building plan that prioritizes user needs. Representatives from the SERVIR global network met in February 2017 with experts in the field of Synthetic Aperture Radar (SAR) for forest applications to envisage this capacity building plan that aims to leverage the state-of-the-art knowledge on remote sensing to enhance forest monitoring for user agencies in SERVIR regions.

  18. Emotional climate, feeding practices, and feeding styles: an observational analysis of the dinner meal in Head Start families

    Directory of Open Access Journals (Sweden)

    Hall Sharon K

    2011-06-01

    Full Text Available Abstract Background A number of studies conducted with ethnically diverse, low-income samples have found that parents with indulgent feeding styles had children with a higher weight status. Indulgent parents are those who are responsive to their child's emotional states but have problems setting appropriate boundaries with their child. Because the processes through which styles impact child weight are poorly understood, the aim of this study was to observe differences in the emotional climate created by parents (including affect, tone of voice, and gestures and behavioral feeding practices among those reporting different feeding styles on the Caregiver's Feeding Styles Questionnaire. A secondary aim was to examine differences on child weight status across the feeding styles. Methods Participants were 177 Head Start families from Houston, Texas (45% African-American; 55% Hispanic. Using an observational approach, the relationship between the observed emotional climate of the meal, behavioral feeding practices, and self-reported parent feeding styles were examined. Mean age of the children was 4.4 years (SD = 0.7 equally distributed across gender. Families were observed on 3 separate dinner occasions. Heights and weight were measured on the parents and children. Results Parents with self-reported indulgent feeding styles made fewer demands on their children to eat during dinner and showed lower levels of negative affect and intrusiveness. Surprisingly, these parents also showed higher levels of emotional detachment with their children during dinner. Hispanic boys with indulgent parents had significantly higher BMI z scores compared to Hispanic boys in the other three feeding style groups. No other differences were found on child weight status. Conclusions Results suggest that the emotional climate created by indulgent parents during dinner and their lack of demands on their children to eat may play an important role in how young children become

  19. Emotional climate, feeding practices, and feeding styles: an observational analysis of the dinner meal in Head Start families.

    Science.gov (United States)

    Hughes, Sheryl O; Power, Thomas G; Papaioannou, Maria A; Cross, Matthew B; Nicklas, Theresa A; Hall, Sharon K; Shewchuk, Richard M

    2011-06-10

    A number of studies conducted with ethnically diverse, low-income samples have found that parents with indulgent feeding styles had children with a higher weight status. Indulgent parents are those who are responsive to their child's emotional states but have problems setting appropriate boundaries with their child. Because the processes through which styles impact child weight are poorly understood, the aim of this study was to observe differences in the emotional climate created by parents (including affect, tone of voice, and gestures) and behavioral feeding practices among those reporting different feeding styles on the Caregiver's Feeding Styles Questionnaire. A secondary aim was to examine differences on child weight status across the feeding styles. Participants were 177 Head Start families from Houston, Texas (45% African-American; 55% Hispanic). Using an observational approach, the relationship between the observed emotional climate of the meal, behavioral feeding practices, and self-reported parent feeding styles were examined. Mean age of the children was 4.4 years (SD = 0.7) equally distributed across gender. Families were observed on 3 separate dinner occasions. Heights and weight were measured on the parents and children. Parents with self-reported indulgent feeding styles made fewer demands on their children to eat during dinner and showed lower levels of negative affect and intrusiveness. Surprisingly, these parents also showed higher levels of emotional detachment with their children during dinner. Hispanic boys with indulgent parents had significantly higher BMI z scores compared to Hispanic boys in the other three feeding style groups. No other differences were found on child weight status. Results suggest that the emotional climate created by indulgent parents during dinner and their lack of demands on their children to eat may play an important role in how young children become overweight. Numerous observed emotional climate and behavioral

  20. Medicines administration for residents with dysphagia in care homes: A small scale observational study to improve practice.

    Science.gov (United States)

    Serrano Santos, Jose Manuel; Poland, Fiona; Wright, David; Longmore, Timothy

    2016-10-30

    In the UK, 69.5% of residents in care homes are exposed to one or more medication errors and 50% have some form of dysphagia. Hospital research identified that nurses frequently crush tablets to facilitate swallowing but this has not been explored in care homes. This project aimed to observe the administration of medicines to patients with dysphagia (PWD) and without in care homes. A convenient sample of general practitioners in North Yorkshire invited care homes with nursing, to participate in the study. A pharmacist specialised in dysphagia observed nurses during drug rounds and compared these practices with national guidelines. Deviations were classified as types of medication administration errors (MAEs). Overall, 738 administrations were observed from 166 patients of which 38 patients (22.9%) had dysphagia. MAE rates were 57.3% and 30.8% for PWD and those without respectively (pdysphagia and need to communicate its presence to the resident's GP. Further research should explore the design of an effective training for nurses. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. Reduced benefit from mnemonic strategies in early-stage Alzheimer's disease: a brief testing-the-limits paradigm for clinical practice.

    Science.gov (United States)

    Uttner, Ingo; Schurig, Niklas; von Arnim, Christine A F; Lange-Asschenfeldt, Christian; Tumani, Hayrettin; Riepe, Matthias W

    2010-10-01

    Discriminating incipient Alzheimer's disease (AD) from major depression (MD) and age related memory decline is a challenge in clinical practice. Since AD is characterized by an early loss of neuronal and functional plasticity, a dynamic test strategy, such as the testing-the-limits (TtL) approach, that measures learning capacity can be a helpful diagnostic tool. To evaluate this, a short recognition paradigm consisting of a pre-test (baseline) and two post-test conditions with an interposed encoding instruction was developed and administered to individuals with incipient AD (n = 19; Mini Mental Status Examination (MMSE) 26.5), patients with depressive disorders (n = 11; MMSE 30), and healthy controls (n = 11; MMSE 30). In addition, participants completed a set of traditional neuropsychological tests that focused on the subjects' cognitive baseline performance. Intergroup comparisons (Kruskal-Wallis, U test) revealed significantly higher post-test failure rates in AD patients. Pre-test performance of MD and AD patients did not differ. Intra-group comparisons (Friedman, Wilcoxon test) showed that all three subject samples benefit from intervention in post-test 1. In contrast to MD and healthy individuals, who revealed significantly lower failure rates in post-test 2 compared to the pre-test, AD patients did not improve. Out of the 15 traditional test scores obtained, only two discriminated simultaneously between AD and each of the other groups. Our data confirm the finding of an impaired cognitive plasticity already present in very early stages of AD and illustrate the efficiency of a dynamic test approach in identifying incipient dementia.

  2. Storage in alluvial deposits controls the timing of particle delivery from large watersheds, filtering upland erosional signals and delaying benefits from watershed best management practices

    Science.gov (United States)

    Pizzuto, J. E.; Skalak, K.; Karwan, D. L.

    2017-12-01

    Transport of suspended sediment and sediment-borne constituents (here termed fluvial particles) through large river systems can be significantly influenced by episodic storage in floodplains and other alluvial deposits. Geomorphologists quantify the importance of storage using sediment budgets, but these data alone are insufficient to determine how storage influences the routing of fluvial particles through river corridors across large spatial scales. For steady state systems, models that combine sediment budget data with "waiting time distributions" (to define how long deposited particles remain stored until being remobilized) and velocities during transport events can provide useful predictions. Limited field data suggest that waiting time distributions are well represented by power laws, extending from 104 years, while the probability of storage defined by sediment budgets varies from 0.1 km-1 for small drainage basins to 0.001 km-1 for the world's largest watersheds. Timescales of particle delivery from large watersheds are determined by storage rather than by transport processes, with most particles requiring 102 -104 years to reach the basin outlet. These predictions suggest that erosional "signals" induced by climate change, tectonics, or anthropogenic activity will be transformed by storage before delivery to the outlets of large watersheds. In particular, best management practices (BMPs) implemented in upland source areas, designed to reduce the loading of fluvial particles to estuarine receiving waters, will not achieve their intended benefits for centuries (or longer). For transient systems, waiting time distributions cannot be constant, but will vary as portions of transient sediment "pulses" enter and are later released from storage. The delivery of sediment pulses under transient conditions can be predicted by adopting the hypothesis that the probability of erosion of stored particles will decrease with increasing "age" (where age is defined as the

  3. Practice Patterns for Chronic Respiratory Diseases in the Asia-Pacific Region: A Cross-Sectional Observational Study.

    Science.gov (United States)

    Wang, De Yun; Cho, Sang-Heon; Lin, Horng-Chyuan; Ghoshal, Aloke Gopal; Bin Abdul Muttalif, Abdul Razak; Thanaviratananich, Sanguansak; Tunceli, Kaan; Urdaneta, Eduardo; Zhang, Dongmu; Faruqi, Rab

    2018-06-06

    Allergic rhinitis (AR), asthma, chronic obstructive pulmonary disease (COPD), and rhinosinusitis are common and little studied in the Asia-Pacific region. We sought to investigate real-world practice patterns for these respiratory diseases in India, Korea, Malaysia, Singapore, Taiwan, and Thailand. This cross-sectional observational study enrolled adults (age ≥18 years) presenting to general practitioners (GP) or specialists for physician-diagnosed AR, asthma, COPD, or rhinosinusitis. Physicians and patients completed study-specific surveys at one visit, recording patient characteristics, health-related quality of life (QoL), work impairment, and healthcare resource use. Findings by country and physician category (GP or specialist) were summarized. Of the 13,902 patients screened, 7,243 (52%) presented with AR (18%), asthma (18%), COPD (7%), or rhinosinusitis (9%); 5,250 of the 7,243 (72%) patients were eligible for this study. Most eligible patients (70-100%) in India, Korea, Malaysia, and Singapore attended GP, while most (83-85%) in Taiwan and Thailand attended specialists. From 42% (rhinosinusitis) to 67% (AR) of new diagnoses were made by GP. On average, patients with COPD reported the worst health-related QoL, particularly to GP. Median losses of work productivity for each condition and activity impairment, except for asthma, were numerically greater for patients presenting to GP vs. specialists. GP prescribed more antibiotics for AR and asthma, and fewer intranasal corticosteroids for AR, than specialists (p < 0.001 for all comparisons). Our findings, albeit mostly descriptive and influenced by between-country differences, suggest that practice patterns differ between physician types, and the disease burden may be substantial for patients presenting in general practice. © 2018 S. Karger AG, Basel.

  4. Teaching points-do they occur and what do they contain? An observation study concerning the general practice rotation.

    Science.gov (United States)

    Duncan, Gertrude Florence; Roth, Lisa Marie; Donner-Banzhoff, Nobert; Boesner, Stefan

    2016-04-18

    A general practice rotation is mandatory in most undergraduate medical education programs. However, little is known about the student-teacher interaction which takes place in this setting. In this study we analyzed occurrence and content of teaching points. From April to December 2012, 410 individual patient consultations were observed in twelve teaching practices associated with the Philipps University Marburg, Germany. Material was collected using structured field-note forms and videotaping. Data analysis was descriptive in form. A teaching point is defined here as a general rule or specific, case-related information divulged by the teaching practitioner. According to the analysis of 410 consultations, teaching points were made in 66.3% of consultations. During these consultations, 74.3% general- and 46.3% case related teaching points occurred; multiple categorizations were possible. Of seven possible topics, therapy was most common, followed, in frequency of occurrence, by patient history, diagnostic procedure, physical examination, disease pathology, differential diagnosis, risk factors and case presentation. The majority of consultations conducted within student presence contained teaching points, most frequently concerning therapy. General teaching points were more common than specific teaching points. Whilst it is encouraging that most consultations included teaching points, faculty development aimed at raising awareness for teaching and learning techniques is important.

  5. Blood transfusion in patients having caesarean section: a prospective multicentre observational study of practice in three Pakistan hospitals.

    Science.gov (United States)

    Ismail, S; Siddiqui, S; Shafiq, F; Ishaq, M; Khan, S

    2014-08-01

    Increasing awareness of the risks of blood transfusion has prompted examination of red cell transfusion practice in obstetrics. A six-month prospective observational study was performed to examine blood transfusion practices in patients undergoing caesarean delivery at three hospitals in Pakistan. In the three hospitals (two private, one public) 3438 caesarean deliveries were performed in the study period. Data were collected on patient demographics, indications for transfusion, ordering physicians, consent, associations with obstetric factors, estimated allowable blood loss, calculated blood loss, pre- and post-transfusion haemoglobin and discharge haemoglobin. A total number of 397 (11.5%) patients who underwent caesarean section received a blood transfusion. The highest transfusion rate of 16% was recorded in the public tertiary care hospital compared to 5% in the two private hospitals. Emergency caesarean delivery and multiparity were associated with blood transfusion (Ptransfusion in 98% of cases. In 343 (86%) patients, blood transfusion was given even when the haemoglobin was >7g/dL. The method for documenting the indication or consent for transfusion was not found in any of the three hospitals. Blood transfusion was prescribed more readily in the public hospital. Identification of a transfusion trigger and the development of institutional guidelines to reduce unnecessary transfusion are required. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Community benefits from wind power: a study of UK practice and comparison with leading European countries. Report to the Renewables Advisory Board and the DTI

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-07-01

    The size and nature of local community benefits from wind power projects in the UK is investigated. These are compared with the benefits in Denmark, Germany, Spain and Ireland where wind power has enjoyed significantly higher rates of development and benefits come within the framework of all wind power projects. Ten wind power projects in the UK are examined and the remaining projects are surveyed. Support mechanisms, public acceptance, planning systems, community involvement (jobs, local income, ownership) in the UK and the other four countries are analysed. Typical community benefits from wind power in the different countries are listed, and recommendations are given.

  7. The Impact of Social Media on Dissemination and Implementation of Clinical Practice Guidelines: A Longitudinal Observational Study.

    Science.gov (United States)

    Narayanaswami, Pushpa; Gronseth, Gary; Dubinsky, Richard; Penfold-Murray, Rebecca; Cox, Julie; Bever, Christopher; Martins, Yolanda; Rheaume, Carol; Shouse, Denise; Getchius, Thomas S D

    2015-08-13

    Evidence-based clinical practice guidelines (CPGs) are statements that provide recommendations to optimize patient care for a specific clinical problem or question. Merely reading a guideline rarely leads to implementation of recommendations. The American Academy of Neurology (AAN) has a formal process of guideline development and dissemination. The last few years have seen a burgeoning of social media such as Facebook, Twitter, and LinkedIn, and newer methods of dissemination such as podcasts and webinars. The role of these media in guideline dissemination has not been studied. Systematic evaluation of dissemination methods and comparison of the effectiveness of newer methods with traditional methods is not available. It is also not known whether specific dissemination methods may be more effectively targeted to specific audiences. Our aim was to (1) develop an innovative dissemination strategy by adding social media-based dissemination methods to traditional methods for the AAN clinical practice guidelines "Complementary and alternative medicine in multiple sclerosis" ("CAM in MS") and (2) evaluate whether the addition of social media outreach improves awareness of the CPG and knowledge of CPG recommendations, and affects implementation of those recommendations. Outcomes were measured by four surveys in each of the two target populations: patients and physicians/clinicians ("physicians"). The primary outcome was the difference in participants' intent to discuss use of complementary and alternative medicine (CAM) with their physicians or patients, respectively, after novel dissemination, as compared with that after traditional dissemination. Secondary outcomes were changes in awareness of the CPG, knowledge of CPG content, and behavior regarding CAM use in multiple sclerosis (MS). Response rates were 25.08% (622/2480) for physicians and 43.5% (348/800) for patients. Awareness of the CPG increased after traditional dissemination (absolute difference, 95% confidence

  8. Patient-Reported Outcome and Observer-Reported Outcome Assessment in Rare Disease Clinical Trials: An ISPOR COA Emerging Good Practices Task Force Report.

    Science.gov (United States)

    Benjamin, Katy; Vernon, Margaret K; Patrick, Donald L; Perfetto, Eleanor; Nestler-Parr, Sandra; Burke, Laurie

    Rare diseases (RDs) affect a small number of people within a population. About 5000 to 8000 distinct RDs have been identified, with an estimated 6% to 8% of people worldwide suffering from an RD. Approximately 75% of RDs affect children. Frequently, these conditions are heterogeneous; many are progressive. Regulatory incentives have increased orphan drug designations and approvals. To develop emerging good practices for RD outcomes research addressing the challenges inherent in identifying, selecting, developing, adapting, and implementing patient-reported outcome (PRO) and observer-reported outcome (ObsRO) assessments for use in RD clinical trials. This report outlines the challenges and potential solutions in determining clinical outcomes for RD trials. It follows the US Food and Drug Administration Roadmap to Patient-Focused Outcome Measurement in Clinical Trials. The Roadmap consists of three columns: 1) Understanding the Disease or Condition, 2) Conceptualizing Treatment Benefit, and 3) Selecting/Developing the Outcome Measure. Challenges in column 1 include factors such as incomplete natural history data and heterogeneity of disease presentation and patient experience. Solutions include using several information sources, for example, clinical experts and patient advocacy groups, to construct the condition's natural history and understand treatment patterns. Challenges in column 2 include understanding and measuring treatment benefit from the patient's perspective, especially given challenges in defining the context of use such as variations in age or disease severity/progression. Solutions include focusing on common symptoms across patient subgroups, identifying short-term outcomes, and using multiple types of COA instruments to measure the same constructs. Challenges in column 3 center around the small patient population and heterogeneity of the condition or study sample. Few disease-specific instruments for RDs exist. Strategies include adapting existing

  9. AWARENESS OF THE BENEFITS OF BREASTFEEDING AMONG ...

    African Journals Online (AJOL)

    FOBUR

    The aim of this study therefore was to determine awareness of breastfeeding benefits ... benefits of breastfeeding are important factors for breastfeeding practices. Awareness .... practicing Exclusive Breastfeeding in the first six months of ...

  10. Early pushing urge in labour and midwifery practice: a prospective observational study at an Italian maternity hospital.

    Science.gov (United States)

    Borrelli, Sara E; Locatelli, Anna; Nespoli, Antonella

    2013-08-01

    to investigate the early pushing urge (EPU) incidence in one maternity unit and explore how it is managed by midwives. The relation to some obstetric outcomes was also observed but not analysed in depth. prospective observational study. Italian maternity hospital. 60 women (44 nullips and 16 multips) experiencing EPU during labour. the total EPU incidence percentage was 7.6%. The single midwives' incidences range had a very wide margin, noting an inverse proportion between the number of diagnoses of EPU and midwife's waiting time between urge to push and vaginal examination. Two care policies were adopted in relation to the phenomenon: the stop pushing technique (n=52/60) and the 'let the woman do what she feels' technique (n=8/60). In case of stop pushing techniques, midwives proposed several combined techniques (change of maternal position, blowing breath, vocalisation, use of the bath). The EPU diagnosis at less than 8cm of cervical dilatation was associated with more medical interventions. Maternal and neonatal outcomes were within the range of normal physiology. An association between the dilatation at EPU diagnosis and obstetric outcomes was observed, in particular the modality of childbirth and perineal outcomes. this paper contributes new knowledge to the body of literature around the EPU phenomenon during labour and midwifery practices adopted in response to it. Overall, it could be argued that EPU is a physiologic variation in labour if maternal and fetal conditions are good. Midwives might suggest techniques to woman to help her to stay with the pain, such as change of position, blowing breath, vocalisation and use of the bath. However, the impact of policies, guidelines and culture on midwifery practices of the specific setting are a limitation of the study because it is not representative of other similar maternity units. Thus, a larger scale work should be considered, including different units and settings. The optimal response to the phenomenon

  11. Benefits at risk

    DEFF Research Database (Denmark)

    Lassen, Jesper; Sandøe, Peter

    2007-01-01

    Herbicide resistant GM plants have been promoted as a tool in the development of more environment-friendly agriculture. The environmental benefits here, however, depend not only on farmer's acceptance of GM crops as such, but also on their willingness to use herbicides in accordance with altered ...... spraying plans. In this paper, we will argue that factors driving the spraying practices of Danish farmers may hamper efforts to secure the environmental benefits of the new crops....

  12. Benefit of the addition of hormone therapy to neoadjuvant anthracycline-based chemotherapy for breast cancer: comparison of predicted and observed pCR.

    Science.gov (United States)

    Generali, Daniele; Corona, Silvia Paola; Pusztai, Lajos; Rouzier, Roman; Allevi, Giovanni; Aguggini, Sergio; Milani, Manuela; Strina, Carla; Frati, Albane

    2018-03-01

    Neoadjuvant hormonal therapy is generally considered a valid option for hormone receptor positive breast cancer (BC) patients who are unfit for chemotherapy or surgery. Whilst numerous studies analyzed efficacy of neoadjuvant chemotherapy (CT) or endocrine therapy (HT) alone in hormone receptor positive patients, there is a lack of research looking at the usefulness of a preoperative combinatorial approach of CT and HT in this patient subgroup. Using a predictive model previously described in the literature, developed to analyze the probability of benefit from preoperative chemotherapy, we were able to compare pathological complete response (pCR) rates expected with the use of CT alone with the pCR rates reported in a population of 192 patients treated with the combination of tamoxifen plus anthracycline-based CT at Cremona Hospital between 2003 and 2006. Even with a relatively small patient population, this approach provided insightful information for the selection of hormone receptor positive BC patients most likely to benefit from the use of preoperative HT and CT in combination. Whilst no statistically significant benefit was obtained with the addition of tamoxifen to neoadjuvant chemotherapy in the entire population, or in any of the molecular stratification subgroups, the analysis of the calibration curve showed that a combinatorial approach may improve pCR in patients with luminal B tumors. More specific trials should be designed to confirm our initial results. To the best of our knowledge, this is the first report investigating the efficacy of the combination of CT and HT in the neoadjuvant treatment of hormone receptor positive BC.

  13. Healthcare benefits linked with Below Poverty Line registration in India: Observations from Maharashtra Anaemia Study (MAS [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Anand Ahankari

    2017-01-01

    Full Text Available A 2015 Lancet paper by Patel et al. on healthcare access in India comprehensively discussed national health programmes where some benefits are linked with the country’s Below Poverty Line (BPL registration scheme. BPL registration aims to support poor families by providing free/subsidised healthcare. Technical issues in obtaining BPL registration by poor families have been previously reported in the Indian literature; however there are no data on family assets of BPL registrants. Here, we provide evidence of family-level assets among BPL registration holders (and non-BPL households using original research data from the Maharashtra Anaemia Study (MAS.   Social and health data from 287 pregnant women and 891 adolescent girls (representing 1178 family households across 34 villages in Maharashtra state, India, were analysed. Several assets were shown to be similarly distributed between BPL and non-BPL households; a large proportion of families who would probably be eligible were not registered, whereas BPL-registered families often had significant assets that should not make them eligible. This is likely to be the first published evidence where asset distribution such as agricultural land, housing structures and livestock are compared between BPL and non-BPL households in a rural population. These findings may help planning BPL administration to allocate health benefits equitably, which is an integral part of national health programmes.

  14. How to address a global problem with Earth Observations? Developing best practices to monitor forests around the world

    Science.gov (United States)

    Flores Cordova, A. I.; Cherrington, E. A.; Vadrevu, K.; Thapa, R. B.; Oduor, P.; Mehmood, H.; Quyen, N. H.; Saah, D. S.; Yero, K.; Mamane, B.; Bartel, P.; Limaye, A. S.; French, R.; Irwin, D.; Wilson, S.; Gottielb, S.; Notman, E.

    2017-12-01

    Forests represent a key natural resource, for which degradation or disturbance is directly associated to economic implications, particularly in the context of the United Nations program REDD+ in supporting national policies to fight illegal deforestation. SERVIR, a joint NASA-USAID initiative that brings Earth observations (EO) for improved environmental decision making in developing countries, works with established institutions, called SERVIR hubs, in four regions around the world. SERVIR is partnering with global programs with great experience in providing best practices in forest monitoring systems, such as SilvaCarbon and the Global Forest Observation Initiative (GFOI), to develop a capacity building plan that prioritizes user needs. Representatives from the SERVIR global network met in February 2017 with experts in the field of Synthetic Aperture Radar (SAR) for forest applications to envisage this capacity building plan that aims to leverage the state-of-the-art knowledge on remote sensing to enhance forest monitoring for user agencies in SERVIR regions. SERVIR Hubs in West Africa, Eastern and Southern Africa, Hindu Kush-Himalaya and Lower Mekong, have long-lasting relations with local, national and regional initiatives, and there is a strong understanding of needs, concerns and best practices when addressing forest monitoring and capacity building. SERVIR Hubs also have a wealth of experience in building capacity on the use of EO to monitor forests, mostly using optical imagery. Most of the forest cover maps generated with SERVIR support have been used as the official national forest cover dataset for international reporting commitments. However, as new EO datasets become available, and in view of the inherent limitations of optical imagery, there is a strong need to use all freely available EO datasets, including SAR, to improve Monitoring & Measurement, Reporting and Verification (MRV) systems and provide more frequent and accurate information. SERVIR

  15. The Brief Classroom Interaction Observation-Revised: An Observation System to Inform and Increase Teacher Use of Universal Classroom Management Practices

    Science.gov (United States)

    Reinke, Wendy M.; Stormont, Melissa; Herman, Keith C.; Wachsmuth, Sean; Newcomer, Lori

    2015-01-01

    Schools are increasingly using multi-tiered prevention models to address the academic and behavior needs of students. The foundation of these models is the implementation of universal, or Tier 1, practices designed to support the academic and behavioral needs of the vast majority of students. To support teachers in the use of effective Tier 1…

  16. Utilizing NASA Earth Observations to Monitor Land Management Practices and the Development of Marshlands to Rice Fields in Rwanda

    Science.gov (United States)

    Dusabimana, M. R.; Blach, D.; Mwiza, F.; Muzungu, E.; Swaminathan, R.; Tate, Z.

    2014-12-01

    Rwanda, a small country with the highest population density in Sub-Saharan Africa, is one of the world's poorest countries. Although agriculture is the backbone of Rwandan economy, agricultural productivity is extremely low. Over 90 % of the population is engaged in subsistence farming and only 52 % of the total land surface area is arable. Of this land, approximately 165,000 hectares are marshlands, of which only 57 % has been cultivated. Rwandan government has invested in the advancement of agriculture with activities such as irrigation, marshland reclamation, and crop regionalization. In 2001, Ministry of Agriculture and Animal Resources (MINAGRI) released the Rural Sector Support Program (RSSP), which aimed at converting marshlands into rice fields at various development sites across the country. The focus of this project was to monitor rice fields in Rwanda utilizing NASA Earth observations such as Landsat 5 Thematic Mapper and Landsat 8 Operational Land Imager. Modified Normalized Difference Water Index (MNDWI) was used to depict the progress of marshland to rice field conversion as it highlights the presence of irrigated rice fields from the surrounding area. Additionally, Decision Support System for Agrotechnology Transfer (DSSAT) was used to estimate rice yield at RSSP sites. Various simulations were run to find perfect conditions for cultivating the highest yield for a given farm. Furthermore, soil erosion susceptibility masks were created by combining factors derived from ASTER, MERRA, and ground truth data using Revised Universal Soil Loss Equation (RUSLE). The end results, maps, and tutorials were delivered to the partners and policy makers in Rwanda to help make informed decisions. It can be clearly seen that Earth observations can be successfully used to monitor agricultural and land management practices as a cost effective method that will enable farmers to improve crop yield production and food security.

  17. Multiple Benefits.

    Science.gov (United States)

    Kreider, Beth

    1997-01-01

    Discusses the benefits of dome architecture for a community's middle- and high-school multi-purpose facility. The dome construction is revealed as being cost effective in construction and in maintenance and energy costs. (GR)

  18. Weight, blood pressure, and dietary benefits after 12 months of a Web-based Nutrition Education Program (DASH for health): longitudinal observational study.

    Science.gov (United States)

    Moore, Thomas J; Alsabeeh, Nour; Apovian, Caroline M; Murphy, Megan C; Coffman, Gerald A; Cullum-Dugan, Diana; Jenkins, Mark; Cabral, Howard

    2008-12-12

    The dietary habits of Americans are creating serious health concerns, including obesity, hypertension, diabetes, cardiovascular disease, and even some types of cancer. While considerable attention has been focused on calorie reduction and weight loss, approaches are needed that will not only help the population reduce calorie intake but also consume the type of healthy, well-balanced diet that would prevent this array of medical complications. To design an Internet-based nutrition education program and to explore its effect on weight, blood pressure, and eating habits after 12 months of participation. We designed the DASH for Health program to provide weekly articles about healthy nutrition via the Internet. Dietary advice was based on the DASH diet (Dietary Approaches to Stop Hypertension). The program was offered as a free benefit to the employees of EMC Corporation, and 2834 employees and spouses enrolled. Enrollees voluntarily entered information about themselves on the website (food intake), and we used these self-entered data to determine if the program had any effect. Analyses were based upon the change in weight, blood pressure, and food intake between the baseline period (before the DASH program began) and the 12th month. To be included in an outcome, a subject had to have provided both a baseline and 12th-month entry. After 12 months, 735 of 2834 original enrollees (26%) were still actively using the program. For subjects who were overweight/obese (body mass index > 25; n = 151), weight change at 12 months was -4.2 lbs (95% CI: -2.2, -6.2; P Internet, with no person-to-person contact with health professionals, is associated with significant weight loss, blood pressure lowering, and dietary improvements after 12 months. Effective programs like DASH for Health, delivered via the Internet, can provide benefit to large numbers of subjects at low cost and may help address the nutritional public health crisis.

  19. Observation and analysis of a classroom teaching and learning practice based on augmented reality and serious games on mobile platforms

    Directory of Open Access Journals (Sweden)

    Sylvie Barma

    2015-06-01

    Full Text Available This qualitative research is part of a learning effort to better understand how serious games are exploited in a science education context. The research team examined this issue by focusing on augmented reality as a technological innovation imbedded on a tablet. Given the current state of knowledge related to serious games and augmented reality, and given the fact that its use in the context of teaching/learning is not extended, this paper focuses on an initial exploration of how a new teaching practice involving a serious game based on an interactive augmented reality solution would impact on students in a physics class. A Design Based Research methodology was applied in a real‑world context within a college‑level physics class. Two conceptual tests containing ten questions on spatial notions regarding electromagnetic fields were administered to two control groups and two groups using the proposed serious game. The latter groups were administrated a game evaluation questionnaire as well. Thematic interpretation of students written responses to the evaluation questionnaire as well as the lessons and observations we derived from the in-class experimentation are provided and discussed in the paper.

  20. A prospective, observational, open-label, multicentre study to investigate the daily treatment practice of ranibizumab in patients with neovascular age-related macular degeneration

    NARCIS (Netherlands)

    Asten, F. van; Evers-Birkenkamp, K.U.; Lith-Verhoeven, J.J. van; Jong-Hesse, Y. de; Hoppenreijs, V.P.T.; Hommersom, R.F.; Scholten, A.M.; Hoyng, C.B.; Klaver, J.H.

    2015-01-01

    PURPOSE: The HELIOS (Health Economics with Lucentis in Observational Settings) study was designed on request of the Dutch Health Authority for an observational study to assess the effectiveness and safety of ranibizumab for neovascular age-related macular degeneration (wet AMD) in daily practice.

  1. A prospective, observational, open-label, multicentre study to investigate the daily treatment practice of ranibizumab in patients with neovascular age-related macular degeneration

    NARCIS (Netherlands)

    van Asten, Freekje; Evers-Birkenkamp, Kim U.; van Lith-Verhoeven, Janneke J. C.; de Jong-Hesse, Yvonne; Hoppenreijs, Vincent P. T.; Hommersom, Richard F.; Scholten, Agnes M.; Hoyng, Carel B.; Klaver, Johannes H. J.; Klaver, J. H. J.; Hoyng, C. B.; Raijmakers, A. J.; van Lith-Verhoeven, J. J. C.; Rulo, A. H. F.; Verbraak, F. D.; Schlingemann, R. O.; Hommersom, C. F.; de Jong-Hesse, Y.; Bosch-Driessen, E. H.; Smeets, M. H.; Gonçalves, A.; Klomp, H. J.; Hoppenreijs, V. P. T.; Dito, J. J.

    2015-01-01

    The HELIOS (Health Economics with Lucentis in Observational Settings) study was designed on request of the Dutch Health Authority for an observational study to assess the effectiveness and safety of ranibizumab for neovascular age-related macular degeneration (wet AMD) in daily practice. The HELIOS

  2. The Classroom Observation Protocol for Undergraduate STEM (COPUS): A New Instrument to Characterize University STEM Classroom Practices

    Science.gov (United States)

    Smith, Michelle K.; Jones, Francis H. M.; Gilbert, Sarah L.; Wieman, Carl E.

    2013-01-01

    Instructors and the teaching practices they employ play a critical role in improving student learning in college science, technology, engineering, and mathematics (STEM) courses. Consequently, there is increasing interest in collecting information on the range and frequency of teaching practices at department-wide and institution-wide scales. To…

  3. Profile of South African Secondary-School Teachers' Teaching Quality: Evaluation of Teaching Practices Using an Observation Instrument

    Science.gov (United States)

    de Jager, Thelma; Coetzee, Mattheus Jacobus; Maulana, Ridwan; Helms-Lorenz, Michelle; van de Grift, Wim

    2017-01-01

    The need for quality teaching is reflected in the poor performance of students in international tests. Teachers' practices and contextual factors could contribute to substandard quality of teaching in South Africa. Several studies indicate that successful learning is largely dependent on the teachers' practices in class. The focus of the present…

  4. Observed Handwashing with Soap Practices among Cholera Patients and Accompanying Household Members in a Hospital Setting (CHoBI7 Trial)

    OpenAIRE

    Zohura, Fatema; Bhuyian, Sazzadul Islam; Monira, Shirajum; Begum, Farzana; Biswas, Shwapon K.; Parvin, Tahmina; Sack, David; Sack, R. Bradley; Leontsini, Elli; Saif-Ur-Rahman, K. M.; Rashid, Mahamud-ur; Sharmin, Rumana; Zhang, Xiaotong; Alam, Munirul; George, Christine Marie

    2016-01-01

    Household members of cholera patients are at a 100 times higher risk of cholera than the general population. Despite this risk, there are only a handful of studies that have investigated the handwashing practices among hospitalized diarrhea patients and their accompanying household members. To investigate handwashing practices in a hospital setting among this high-risk population, 444 hours of structured observation was conducted in a hospital in Dhaka, Bangladesh, among 148 cholera patients ...

  5. Sensitivity of the Action Observation Network to Physical and Observational Learning

    NARCIS (Netherlands)

    Cross, E.S.; Kraemer, D.J.M.; Hamilton, A.F.D.C.; Kelley, W.M.; Grafton, S.T.

    2009-01-01

    Human motor skills can be acquired by observation without the benefit of immediate physical practice. The current study tested if physical rehearsal and observational learning share common neural substrates within an action observation network (AON) including premotor and inferior parietal regions,

  6. Benefits | NREL

    Science.gov (United States)

    flexible work environment that enables and encourages a good work/life balance A growing, changing exceptional work. A woman riding her bike past the NREL entrance sign. Hundreds of NREL employees opt out of their cars, cycling to work, to take part in Bike To Work Day each year. Benefits Package NREL's

  7. Fringe Benefits.

    Science.gov (United States)

    Podgursky, Michael

    2003-01-01

    Uses statistics from the National Center for Education Statistics and the Bureau of Labor Statistics to examine teacher salaries and benefits. Discusses compensation of teachers compared with nonteachers. Asserts that statistics from the American Federation of Teachers and the National Education Association underestimate teacher compensation…

  8. Characteristics and limitations of GPS L1 observations from submerged antennas - Theoretical investigation in snow, ice, and freshwater and practical observations within a freshwater layer

    Science.gov (United States)

    Steiner, Ladina; Meindl, Michael; Geiger, Alain

    2018-05-01

    Observations from a submerged GNSS antenna underneath a snowpack need to be analyzed to investigate its potential for snowpack characterization. The magnitude of the main interaction processes involved in the GPS L1 signal propagation through different layers of snow, ice, or freshwater is examined theoretically in the present paper. For this purpose, the GPS signal penetration depth, attenuation, reflection, refraction as well as the excess path length are theoretically investigated. Liquid water exerts the largest influence on GPS signal propagation through a snowpack. An experiment is thus set up with a submerged geodetic GPS antenna to investigate the influence of liquid water on the GPS observations. The experimental results correspond well with theory and show that the GPS signal penetrates the liquid water up to three centimeters. The error in the height component due to the signal propagation delay in water can be corrected with a newly derived model. The water level above the submerged antenna could also be estimated.

  9. A practical approach for calculating reliable cost estimates from observational data: application to cost analyses in maternal and child health.

    Science.gov (United States)

    Salemi, Jason L; Comins, Meg M; Chandler, Kristen; Mogos, Mulubrhan F; Salihu, Hamisu M

    2013-08-01

    Comparative effectiveness research (CER) and cost-effectiveness analysis are valuable tools for informing health policy and clinical care decisions. Despite the increased availability of rich observational databases with economic measures, few researchers have the skills needed to conduct valid and reliable cost analyses for CER. The objectives of this paper are to (i) describe a practical approach for calculating cost estimates from hospital charges in discharge data using publicly available hospital cost reports, and (ii) assess the impact of using different methods for cost estimation in maternal and child health (MCH) studies by conducting economic analyses on gestational diabetes (GDM) and pre-pregnancy overweight/obesity. In Florida, we have constructed a clinically enhanced, longitudinal, encounter-level MCH database covering over 2.3 million infants (and their mothers) born alive from 1998 to 2009. Using this as a template, we describe a detailed methodology to use publicly available data to calculate hospital-wide and department-specific cost-to-charge ratios (CCRs), link them to the master database, and convert reported hospital charges to refined cost estimates. We then conduct an economic analysis as a case study on women by GDM and pre-pregnancy body mass index (BMI) status to compare the impact of using different methods on cost estimation. Over 60 % of inpatient charges for birth hospitalizations came from the nursery/labor/delivery units, which have very different cost-to-charge markups (CCR = 0.70) than the commonly substituted hospital average (CCR = 0.29). Using estimated mean, per-person maternal hospitalization costs for women with GDM as an example, unadjusted charges ($US14,696) grossly overestimated actual cost, compared with hospital-wide ($US3,498) and department-level ($US4,986) CCR adjustments. However, the refined cost estimation method, although more accurate, did not alter our conclusions that infant/maternal hospitalization costs

  10. Observed Benefits to On-site Medical Services during an Annual 5-day Electronic Dance Music Event with Harm Reduction Services.

    Science.gov (United States)

    Munn, Matthew Brendan; Lund, Adam; Golby, Riley; Turris, Sheila A

    2016-04-01

    With increasing attendance and media attention, large-scale electronic dance music events (EDMEs) are a subset of mass gatherings that have a unique risk profile for attendees and promoters. Shambhala Music Festival (Canada) is a multi-day event in a rural setting with a recognized history of providing harm reduction (HR) services alongside medical care. Study/Objective This manuscript describes the medical response at a multi-day electronic music festival where on-site HR interventions and dedicated medical care are delivered as parallel public health measures. This study was a descriptive case report. Medical encounters and event-related data were documented prospectively using an established event registry database. In 2014, Shambhala Music Festival had 67,120 cumulative attendees over a 7-day period, with a peak daily attendance of 15,380 people. There were 1,393 patient encounters and the patient presentation rate (PPR) was 20.8 per one thousand. The majority of these (90.9%) were for non-urgent complaints. The ambulance transfer rate (ATR) was 0.194 per one thousand and 0.93% of patient encounters were transferred by ambulance. No patients required intubation and there were no fatalities. Harm reduction services included mobile outreach teams, distribution of educational materials, pill checking facilities, a dedicated women's space, and a "Sanctuary" area that provided non-medical peer support for overwhelmed guests. More than 10,000 encounters were recorded by mobile and booth-based preventive and educational services, and 2,786 pills were checked on-site with a seven percent discard rate. Dedicated medical and HR services represent two complementary public health strategies to minimize risk at a multi-day electronic music festival. The specific extent to which HR strategies reduce the need for medical care is not well understood. Incorporation of HR practices when planning on-site medical care has the potential to inform patient management, reduce

  11. Accelerating time to benefit

    DEFF Research Database (Denmark)

    Svejvig, Per; Geraldi, Joana; Grex, Sara

    Despite the ubiquitous pressure for speed, our approaches to accelerate projects remain constrained to the old-fashioned understanding of the project as a vehicle to deliver products and services, not value. This article explores an attempt to accelerate time to benefit. We describe and deconstruct...... of the time. Although all cases valued speed and speed to benefit, and implemented most practices proposed by the methodology, only three of the five projects were more successful in decreasing time to speed. Based on a multi-case study comparison between these five different projects and their respective...

  12. Who benefits?

    DEFF Research Database (Denmark)

    Hjorth, Frederik Georg

    2016-01-01

    Cross-border welfare rights for citizens of European Union member states are intensely contested, yet there is limited research into voter opposition to such rights, sometimes denoted ‘welfare chauvinism’. We highlight an overlooked aspect in scholarly work: the role of stereotypes about benefici...... recipient identity. These effects are strongest among respondents high in ethnic prejudice and economic conservatism. The findings imply that stereotypes about who benefits from cross-border welfare rights condition public support for those rights....

  13. The best of both worlds: Building on the COPUS and RTOP observation protocols to easily and reliably measure various levels of reformed instructional practice.

    Science.gov (United States)

    Lund, Travis J; Pilarz, Matthew; Velasco, Jonathan B; Chakraverty, Devasmita; Rosploch, Kaitlyn; Undersander, Molly; Stains, Marilyne

    2015-01-01

    Researchers, university administrators, and faculty members are increasingly interested in measuring and describing instructional practices provided in science, technology, engineering, and mathematics (STEM) courses at the college level. Specifically, there is keen interest in comparing instructional practices between courses, monitoring changes over time, and mapping observed practices to research-based teaching. While increasingly common observation protocols (Reformed Teaching Observation Protocol [RTOP] and Classroom Observation Protocol in Undergraduate STEM [COPUS]) at the postsecondary level help achieve some of these goals, they also suffer from weaknesses that limit their applicability. In this study, we leverage the strengths of these protocols to provide an easy method that enables the reliable and valid characterization of instructional practices. This method was developed empirically via a cluster analysis using observations of 269 individual class periods, corresponding to 73 different faculty members, 28 different research-intensive institutions, and various STEM disciplines. Ten clusters, called COPUS profiles, emerged from this analysis; they represent the most common types of instructional practices enacted in the classrooms observed for this study. RTOP scores were used to validate the alignment of the 10 COPUS profiles with reformed teaching. Herein, we present a detailed description of the cluster analysis method, the COPUS profiles, and the distribution of the COPUS profiles across various STEM courses at research-intensive universities. © 2015 T. J. Lund et al. CBE—Life Sciences Education © 2015 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

  14. Benefits of China's efforts in gaseous pollutant control indicated by the bottom-up emissions and satellite observations 2000-2014

    Science.gov (United States)

    Xia, Yinmin; Zhao, Yu; Nielsen, Chris P.

    2016-07-01

    To evaluate the effectiveness of national air pollution control policies, the emissions of SO2, NOX, CO and CO2 in China are estimated using bottom-up methods for the most recent 15-year period (2000-2014). Vertical column densities (VCDs) from satellite observations are used to test the temporal and spatial patterns of emissions and to explore the ambient levels of gaseous pollutants across the country. The inter-annual trends in emissions and VCDs match well except for SO2. Such comparison is improved with an optimistic assumption in emission estimation that the emission standards for given industrial sources issued after 2010 have been fully enforced. Underestimation of emission abatement and enhanced atmospheric oxidization likely contribute to the discrepancy between SO2 emissions and VCDs. As suggested by VCDs and emissions estimated under the assumption of full implementation of emission standards, the control of SO2 in the 12th Five-Year Plan period (12th FYP, 2011-2015) is estimated to be more effective than that in the 11th FYP period (2006-2010), attributed to improved use of flue gas desulfurization in the power sector and implementation of new emission standards in key industrial sources. The opposite was true for CO, as energy efficiency improved more significantly from 2005 to 2010 due to closures of small industrial plants. Iron & steel production is estimated to have had particularly strong influence on temporal and spatial patterns of CO. In contrast to fast growth before 2011 driven by increased coal consumption and limited controls, NOX emissions decreased from 2011 to 2014 due to the penetration of selective catalytic/non-catalytic reduction systems in the power sector. This led to reduced NO2 VCDs, particularly in relatively highly polluted areas such as the eastern China and Pearl River Delta regions. In developed areas, transportation is playing an increasingly important role in air pollution, as suggested by the increased ratio of NO2 to SO

  15. Peer Mentoring Communities of Practice for Early and Mid-Career Faculty: Broad Benefits from a Research-Oriented Female Peer Mentoring Group

    Science.gov (United States)

    Rees, Amanda; Shaw, Kimberly

    2014-01-01

    In light of recent interest in the limitations of early and mid-career mentoring (Driscoll et al 2009; Trowers 2011), this case study of a women's scholarly activity and goal setting Community of Practice (CoP) indicates that such groups can offer extensive peer mentoring at one teaching-oriented state university in the United States. Using a…

  16. Practical Maintenance of Digital Systems: Guidance to Maximize the Benefits of Digital Technology for the Maintenance of Digital Systems and Plant Equipment

    Energy Technology Data Exchange (ETDEWEB)

    Hill, D; Scarola, K

    2004-10-30

    This report presents detailed guidance for the maintenance and testing of modern digital systems. The guidance provides practical means for plants to take advantage of the increased diagnostic and self-test capabilities of these systems. It helps plants avoid mistakes in design and installation that could lead to increased maintenance burden and decreased system reliability and availability.

  17. Practical Maintenance of Digital Systems. Guidance to Maximize the Benefits of Digital Technology for the Maintenance of Digital Systems and Plant Equipment

    International Nuclear Information System (INIS)

    Hill, D.; Scarola, K.

    2004-01-01

    This report presents detailed guidance for the maintenance and testing of modern digital systems. The guidance provides practical means for plants to take advantage of the increased diagnostic and self-test capabilities of these systems. It helps plants avoid mistakes in design and installation that could lead to increased maintenance burden and decreased system reliability and availability

  18. KNOWLEDGE ABOUT THE BENEFITS OF BREASTFEEDING AND DISADVANTAGES OF THE PACIFIER RELATED TO THE MOTHER’S PRACTICE WITH PRETERM INFANTS

    Science.gov (United States)

    Dadalto, Elâine Cristina Vargas; Rosa, Edinete Maria

    2017-01-01

    ABSTRACT Objective: To evaluate the knowledge and expectations of mothers of preterm newborn infants admitted in a neonatal intensive care unit about breastfeeding and pacifier use, and to analyze their experience in dealing with the sucking urge in the first months of life. Methods: Mothers were interviewed during hospitalization of the newborn in the neonatal intensive care unit and when the infant was six months old. All mothers with availability to participate in the study were included. Exclusion criteria comprised infants with syndromes and neurological disorders and mothers with cognitive impairment, depression, and drug users. Data were analyzed with the SPSS software, with descriptive statistics and chi-square test. Results: Sixty-two mothers were interviewed in the beginning and 52 at a six-month follow-up. Mothers’ expectations concerning breastfeeding were positive when they listed the benefits to the mother (90.3%) and infant (100%). However, they had difficulties maintaining exclusive breastfeeding and used the baby bottle (75.0%), which most mothers (69.4%) had already acquired before the infant was born. The fact of having a pacifier in the infant’s layette (43.6%) did not influence its use (p=0.820). This also occurred among mothers who said they would not offer the pacifier due to disadvantages to the mother (80.7%) and infant (96.8%). The previous expectation that the pacifier could bring benefits for mother and infant did not affect its use (p=0.375 and p=0.158). Conclusions: Mothers demonstrated prior knowledge about breastfeeding benefits and disadvantages of the pacifiers. However, they changed their view when dealing with the infant and introduced bottles and pacifiers. PMID:28977129

  19. Cinacalcet and achievement of the NKF/K-DOQI recommended target values for bone and mineral metabolism in real-world clinical practice--the ECHO observational study

    DEFF Research Database (Denmark)

    Urena, P.; Jacobson, S.H.; Zitt, E.

    2009-01-01

    sevelamer; use of calcium-based phosphate binders increased by 5.6%. There was no unexpected safety or tolerability concerns. CONCLUSION: This analysis of current European clinical practice shows that-consistent with findings from randomized controlled trials and retrospective observational studies...

  20. PORTAAL: A Classroom Observation Tool Assessing Evidence-Based Teaching Practices for Active Learning in Large Science, Technology, Engineering, and Mathematics Classes.

    Science.gov (United States)

    Eddy, Sarah L; Converse, Mercedes; Wenderoth, Mary Pat

    2015-01-01

    There is extensive evidence that active learning works better than a completely passive lecture. Despite this evidence, adoption of these evidence-based teaching practices remains low. In this paper, we offer one tool to help faculty members implement active learning. This tool identifies 21 readily implemented elements that have been shown to increase student outcomes related to achievement, logic development, or other relevant learning goals with college-age students. Thus, this tool both clarifies the research-supported elements of best practices for instructor implementation of active learning in the classroom setting and measures instructors' alignment with these practices. We describe how we reviewed the discipline-based education research literature to identify best practices in active learning for adult learners in the classroom and used these results to develop an observation tool (Practical Observation Rubric To Assess Active Learning, or PORTAAL) that documents the extent to which instructors incorporate these practices into their classrooms. We then use PORTAAL to explore the classroom practices of 25 introductory biology instructors who employ some form of active learning. Overall, PORTAAL documents how well aligned classrooms are with research-supported best practices for active learning and provides specific feedback and guidance to instructors to allow them to identify what they do well and what could be improved. © 2015 S. L. Eddy et al. CBE—Life Sciences Education © 2015 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

  1. Why health visiting? Examining the potential public health benefits from health visiting practice within a universal service: a narrative review of the literature.

    Science.gov (United States)

    Cowley, Sarah; Whittaker, Karen; Malone, Mary; Donetto, Sara; Grigulis, Astrida; Maben, Jill

    2015-01-01

    There is increasing international interest in universal, health promoting services for pregnancy and the first three years of life and the concept of proportionate universalism. Drawing on a narrative review of literature, this paper explores mechanisms by which such services might contribute to health improvement and reducing health inequalities. Through a narrative review of empirical literature, to identify: (1) What are the key components of health visiting practice? (2) How are they reflected in implementing the universal service/provision envisaged in the English Health Visitor Implementation Plan (HVIP)? The paper draws upon a scoping study and narrative review. We used three complementary approaches to search the widely dispersed literature: (1) broad, general search, (2) structured search, using topic-specific search terms, (3) seminal paper search. Our key inclusion criterion was information about health visiting practice. We included empirical papers from United Kingdom (UK) from 2004 to February 2012 and older seminal papers identified in search (3), identifying a total of 348 papers for inclusion. A thematic content analysis compared the older (up to 2003) with more recent research (2004 onwards). The analysis revealed health visiting practice as potentially characterized by a particular 'orientation to practice.' This embodied the values, skills and attitudes needed to deliver universal health visiting services through salutogenesis (health creation), person-centredness (human valuing) and viewing the person in situation (human ecology). Research about health visiting actions focuses on home visiting, needs assessment and parent-health visitor relationships. The detailed description of health visitors' skills, attitudes, values, and their application in practice, provides an explanation of how universal provision can potentially help to promote health and shift the social gradient of health inequalities. Identification of needs across an

  2. 'Before reaching the last mile'- Knowledge, attitude, practice and perceived barriers related to tuberculosis directly observed therapy among ASHA workers in Central India: A mixed method study.

    Science.gov (United States)

    Singh, Akash Ranjan; Pakhare, Abhijit; Kokane, Arun M; Shewade, Hemant Deepak; Chauhan, Ashish; Singh, Abhishek; Gangwar, Arti; Thakur, Prahlad Singh

    2017-12-01

    Community-based direct observed treatment (DOT) providers are an important bridge for the national tuberculosis programme in India to reach the unreached. The present study has explored the knowledge, attitude, practice and barriers perceived by the community-based DOT providers. Mixed-methods study design was used among 41 community-based DOT providers (Accredited Social Health Activist (ASHAs)) working in 67 villages from a primary health center in Raisen district of Madhya Pradesh, India. The cross-sectional quantitative component assessed the knowledge and practices and three focus-group discussions explored the attitude and perceived barriers related to DOT provision. 'Adequate knowledge' and 'satisfactory practice' related to DOT provision was seen in 14 (34%) and 13 (32%) ASHAs respectively. Only two (5%) received any amount of honorarium for completion of DOT in last 3years. The focus-group discussions revealed unfavourable attitude; inadequate training and supervision, non-payment of honorarium, issues related to assured services after referral and patient related factors as the barriers to satisfactory practice of DOT. Study revealed inadequate knowledge and unsatisfactory practice related to DOT provision among ASHAs. Innovations addressing the perceived barriers to improve practice of DOT provision by ASHAs are urgently required. Copyright © 2017 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

  3. Benefits of Multilingualism in Education

    Science.gov (United States)

    Okal, Benard Odoyo

    2014-01-01

    The article gives a brief analytical survey of multilingualism practices, its consequences, its benefits in education and discussions on the appropriate ways towards its achievement in education. Multilingualism refers to speaking more than one language competently. Generally there are both the official and unofficial multilingualism practices. A…

  4. Defined contribution health benefits.

    Science.gov (United States)

    Fronstin, P

    2001-03-01

    This Issue Brief discusses the emerging issue of "defined contribution" (DC) health benefits. The term "defined contribution" is used to describe a wide variety of approaches to the provision of health benefits, all of which have in common a shift in the responsibility for payment and selection of health care services from employers to employees. DC health benefits often are mentioned in the context of enabling employers to control their outlay for health benefits by avoiding increases in health care costs. DC health benefits may also shift responsibility for choosing a health plan and the associated risks of choosing a plan from employers to employees. There are three primary reasons why some employers currently are considering some sort of DC approach. First, they are once again looking for ways to keep their health care cost increases in line with overall inflation. Second, some employers are concerned that the public "backlash" against managed care will result in new legislation, regulations, and litigation that will further increase their health care costs if they do not distance themselves from health care decisions. Third, employers have modified not only most employee benefit plans, but labor market practices in general, by giving workers more choice, control, and flexibility. DC-type health benefits have existed as cafeteria plans since the 1980s. A cafeteria plan gives each employee the opportunity to determine the allocation of his or her total compensation (within employer-defined limits) among various employee benefits (primarily retirement or health). Most types of DC health benefits currently being discussed could be provided within the existing employment-based health insurance system, with or without the use of cafeteria plans. They could also allow employees to purchase health insurance directly from insurers, or they could drive new technologies and new forms of risk pooling through which health care services are provided and financed. DC health

  5. Who benefits most from therapist-assisted internet-delivered cognitive behaviour therapy in clinical practice? Predictors of symptom change and dropout.

    Science.gov (United States)

    Edmonds, M; Hadjistavropoulos, H D; Schneider, L H; Dear, B F; Titov, N

    2018-03-01

    Internet-delivered cognitive behavioral therapy (ICBT) is effective for treating anxiety and depression, but not for all patients. Predictors of dropout and outcomes from ICBT remain unclear and the literature could benefit from study of response to ICBT among larger community samples using advanced statistical techniques. In this study, we sought to identify predictors of dropout and symptom change in a large community sample (n = 1201) who received therapist-assisted transdiagnostic ICBT targeting anxiety and/or depression. Logistic regression was used to assess dropout, and showed that those who fully completed ICBT lessons (n = 880) were older and endorsed lower psychological distress at intake than those who only partially completed ICBT lessons (n = 321). During the course of therapy, patients responded to the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 at six time points. Autoregressive latent trajectory models were fitted to this data to assess the ability of demographic variables, program engagement, psychological and medical service usage, and psychological distress to explain individual variance in initial symptom levels and symptom change over time. Higher symptom scores at pre-treatment were predictive of greater symptom improvement. Symptom improvement was greater in those who were off work on disability and those without higher post-secondary education. Clinical implications are discussed. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  6. Practical surrogate marker of pulmonary dysanapsis by simple spirometry: an observational case-control study in primary care.

    Science.gov (United States)

    Shiota, Satomi; Ichikawa, Masako; Suzuki, Kazuhiro; Fukuchi, Yoshinosuke; Takahashi, Kazuhisa

    2015-03-26

    We see patients who present with spirometry airflow limitation despite their forced expiratory volume in one second (FEV1) as well as forced vital capacity (FVC) to be supernormal (FEV1/FVC spirometry conditions (results measured with spirometry) could be suitably used as a practical surrogate marker of pulmonary dysanapsis: the condition of disproportionate but physiologically normal growth between airways and lung parenchyma. We compared the conventional surrogate marker of dysanapsis, maximum mid-expiratory flow to FVC (MMF/FVC), in SUBJECTS (FEV1/FVC spirometry results with SUBJECTS) (n = 55), and in CONTROLS (age- and height- matched, normal spirometry results) (n = 25). Next we added imaging analysis to evaluate the relationship between the cross sectional airway luminal area (X-Ai) and the lung volume results among the three groups. The MMF/FVC was significantly lower in SUBJECTS and in EMPHYSEMA compared to CONTROLS. However, percent predicted peak expiratory flow (%PEFR) was significantly lower only in SUBJECTS and not in EMPHYSEMA compared to CONTROLS. The ratio of the X-Ai of the trachea and right apical bronchus to lung volume was significantly lower in SUBJECTS compared to CONTROLS. The simple spirometry conditions in SUBJECTS are highly suggestive of practical surrogate marker of pulmonary dysanapsis. Awareness of this concept would help to attenuate the risk of overdiagnosis of obstructive pulmonary disease.

  7. Observed practices and perceived advantages of different hand cleansing agents in rural Bangladesh: ash, soil, and soap.

    Science.gov (United States)

    Nizame, Fosiul A; Nasreen, Sharifa; Halder, Amal K; Arman, Shaila; Winch, Peter J; Unicomb, Leanne; Luby, Stephen P

    2015-06-01

    Bangladeshi communities have historically used ash and soil as handwashing agents. A structured observation study and qualitative interviews on the use of ash/soil and soap as handwashing agents were conducted in rural Bangladesh to help develop a handwashing promotion intervention. The observations were conducted among 1,000 randomly selected households from 36 districts. Fieldworkers observed people using ash/soil to wash their hand(s) on 13% of occasions after defecation and on 10% after cleaning a child's anus. This compares with 19% of people who used soap after defecation and 27% after cleaning a child who defecated. Using ash/soil or soap was rarely (soap. © The American Society of Tropical Medicine and Hygiene.

  8. Improving visual observation skills through the arts to aid radiographic interpretation in veterinary practice: A pilot study.

    Science.gov (United States)

    Beck, Cathy; Gaunt, Heather; Chiavaroli, Neville

    2017-09-01

    Radiographic interpretation is a perceptual and cognitive skill. Recently core veterinary radiology textbooks have focused on the cognitive (i.e., the clinical aspects of radiographic interpretation) rather than the features of visual observation that improve identification of abnormalities. As a result, the skill of visual observation is underemphasized and thus often underdeveloped by trainees. The study of the arts in medical education has been used to train and improve visual observation and empathy. The use of the arts to improve visual observation skills in Veterinary Science has not been previously described. Objectives of this pilot study were to adapt the existing Visual Arts in Health Education Program for medical and dental students at the University of Melbourne, Australia to third year Doctor of Veterinary Medicine students and evaluate their perceptions regarding the program's effects on visual observation skills and confidence with respect to radiographic interpretation. This adaptation took the form of a single seminar given to third year Doctor of Veterinary Medicine students. Following the seminar, students reported an improved approach to radiographic interpretation and felt they had gained skills which would assist them throughout their career. In the year following the seminar, written reports of the students who attended the seminar were compared with reports from a matched cohort of students who did not attend the seminar. This demonstrated increased identification of abnormalities and greater description of the abnormalities identified. Findings indicated that explicit training in visual observation may be a valuable adjunct to the radiology training of Doctor of Veterinary Medicine students. © 2017 American College of Veterinary Radiology.

  9. Motivation of employees and employee benefits

    OpenAIRE

    Haninger, David

    2011-01-01

    This bachelor's thesis examines the subject of employee motivation and employee benefits. The basic terms and theories needed to comprehend the subject are explained in the theoretical part of the work. The theoretical part of the work also focuses on employee benefits, mainly the goal of employee benefits and listing of currently available employee benefits. In the practical part of the work is an analysis and comparison of employee benefits used in two companies that are representing privat...

  10. Introducing 3-Dimensional Printing of a Human Anatomic Pathology Specimen: Potential Benefits for Undergraduate and Postgraduate Education and Anatomic Pathology Practice.

    Science.gov (United States)

    Mahmoud, Amr; Bennett, Michael

    2015-08-01

    Three-dimensional (3D) printing, a rapidly advancing technology, is widely applied in fields such as mechanical engineering and architecture. Three-dimensional printing has been introduced recently into medical practice in areas such as reconstructive surgery, as well as in clinical research. Three-dimensionally printed models of anatomic and autopsy pathology specimens can be used for demonstrating pathology entities to undergraduate medical, dental, and biomedical students, as well as for postgraduate training in examination of gross specimens for anatomic pathology residents and pathology assistants, aiding clinicopathological correlation at multidisciplinary team meetings, and guiding reconstructive surgical procedures. To apply 3D printing in anatomic pathology for teaching, training, and clinical correlation purposes. Multicolored 3D printing of human anatomic pathology specimens was achieved using a ZCorp 510 3D printer (3D Systems, Rock Hill, South Carolina) following creation of a 3D model using Autodesk 123D Catch software (Autodesk, Inc, San Francisco, California). Three-dimensionally printed models of anatomic pathology specimens created included pancreatoduodenectomy (Whipple operation) and radical nephrectomy specimens. The models accurately depicted the topographic anatomy of selected specimens and illustrated the anatomic relation of excised lesions to adjacent normal tissues. Three-dimensional printing of human anatomic pathology specimens is achievable. Advances in 3D printing technology may further improve the quality of 3D printable anatomic pathology specimens.

  11. Acute Blood Loss During Burn and Soft Tissue Excisions: An Observational Study of Blood Product Resuscitation Practices and Focused Review

    Science.gov (United States)

    2015-06-24

    prospective observational study. Number, component type , volume, and age of the blood products transfused were recorded during burn excision/grafting or soft...tissue debridement . Component bags (packed red blood cells, fresh frozen plasma, platelets, and cryoprecipitate) were collected, and the remaining...collection of information if it does not display a currently valid OMB control number. 1. REPORT DATE 24 JUN 2015 2. REPORT TYPE N/A 3. DATES

  12. Emotional climate, feeding practices, and feeding styles: an observational analysis of the dinner meal in Head Start families

    OpenAIRE

    Hall Sharon K; Nicklas Theresa A; Cross Matthew B; Papaioannou Maria A; Power Thomas G; Hughes Sheryl O; Shewchuk Richard M

    2011-01-01

    Abstract Background A number of studies conducted with ethnically diverse, low-income samples have found that parents with indulgent feeding styles had children with a higher weight status. Indulgent parents are those who are responsive to their child's emotional states but have problems setting appropriate boundaries with their child. Because the processes through which styles impact child weight are poorly understood, the aim of this study was to observe differences in the emotional climate...

  13. Local health practices and the knowledge of medicinal plants in a Brazilian semi-arid region: environmental benefits to human health.

    Science.gov (United States)

    Zank, Sofia; Peroni, Nivaldo; de Araújo, Elcida Lima; Hanazaki, Natalia

    2015-02-23

    The concept of eco-cultural health considers the dynamic interaction between humans and ecosystems, emphasizing the implications of the health of the ecosystem for the health and well-being of human populations. Ethnobotanical studies focusing on folk medicine and medicinal plants can contribute to the field of eco-cultural health if they incorporate the perspective and local knowledge of communities. We investigated the local health practices in three rural communities living within the vicinity of a protected area of sustainable use in a semi-arid region of Brazil. We analyzed the opinions of local health experts on the elements that influence human health and on how the environment contributes to this influence. We also analyzed and compared the local knowledge of medicinal plants, as knowledge of this type is an important factor when considering the interaction between environmental and human health. We performed structured interviews and free-listings with 66 local health experts. We used content analysis to systematize the elements of the influences on human health. We compared the richness of the plants cited among communities and analyzed the differences among the three communities regarding the ways in which the plants were obtained and the environments in which plants were collected. The local experts identified several influences of the environment on human health. These influences can be associated with ecosystem services, such as climatic conditions, water and air quality, recreation and medicinal and food resources. We identified 192 medicinal plant species, most of which were gathered from wild ecosystems. The most important environments for the three communities were the plateau mountain and backyards. The informants had a broad and integrated view of health, perceiving the importance of conserving the environment within the National Forest of Araripe for the health and well-being of the local populations.

  14. Findings from non-participant observational data concerning health promoting nursing practice in the acute hospital setting focusing on generalist nurses.

    Science.gov (United States)

    Casey, Dympna

    2007-03-01

    This paper reports on the non-participant observational findings from a study, which examined hospital-based nurses' health promoting nursing practice in an acute setting. Nurses are considered to have a key role in health promotion. However, the development of the role of the generalist hospital-based nurse in health promotion has been slow and is not well-understood. The conceptual framework used was based on the Ottawa Charter (WHO 1986). A single qualitative embedded case study, employing data source and methodological triangulation was used. A framework for identifying nurse's use of health promotion methods was developed and used to collect non-participant observations on a purposive sample of eight nurses working on an acute hospital ward. Following the observations a semi structured one-to-one interview was conducted with each observed nurse. One randomly selected patient that the observed nurse had cared for during the observations was also interviewed. Qualitative data analysis based on the work of Miles and Huberman was employed. Two categories were identified 'health promotion strategies and content' and 'patient participation'. The findings indicated that, overall, the strategies used by nurses to promote health were prescriptive and individualistic. The main strategy observed was information giving and the content was 'preparatory information'. Predominantly, nurses practised traditional health education. Overall, patient participation was limited to minor personal aspects of care as nurses focused on the routine and getting the tasks completed. There was no evidence of a ward culture which valued health promotion. Ward managers are key in creating a culture for health promotion. A review of the methods of organizing nursing care is warranted. Nursing programmes must highlight health promotion as integral to practice and emphasis the socio-political dimensions of health promotion.

  15. RED DRAGON FRUIT (Hylocereus costaricensis Britt. Et R. PEEL EXTRACT AS A NATURAL DYE ALTERNATIVE IN MICROSCOPIC OBSERVATION OF PLANT TISSUES: THE PRACTICAL GUIDE IN SENIOR HIGH SCHOOL

    Directory of Open Access Journals (Sweden)

    Heni Wagiyanti

    2017-11-01

    Full Text Available Prepared slide of plant tissue needs to be staining to facilitate observations under microscope. Laboratorium activities in schools usually use synthetic dyes which expensive and can be damaged the student. Therefore the exploration of alternative dyes need to be established, such as utilizing of red dragon fruit (Hylocereus castaricensis Britt. Et R.. This study aims to (1 find out the best concentration of dragon fruit peel extract for staining plant tissue prepared slide and (2 to develop the practical guide related to plant tissue observation. The qualitative research used different concentration of red dragon fruit peel extract, namely: 30%, 40%, 50%, 60%, 70%, 80%, 90%, and 100% with 3 repetitions. Data were obtained from observation photos of prepared slide. The result showed that the most contrast prepared slide was used red dragon fruit extract in 60% concentration. The result use to arrange practical guide in observation of plant tissues which is validated by material expert. The validation result showed “very good” criteria (86.01%.

  16. Effectiveness of dasabuvir/ombitasvir/paritaprevir/ritonavir for hepatitis C virus in clinical practice: A population-based observational study.

    Directory of Open Access Journals (Sweden)

    Maya Leventer-Roberts

    Full Text Available Direct acting antivirals for hepatitis C virus have shown dramatic results in clinical trials. However, their effectiveness has yet to be demonstrated within observational cohorts which lack exclusion criteria found in randomized control trials.To determine the effectiveness of dasabuvir/ombitasvir/paritaprevir/ritonavir in achieving sustained virological response.Retrospective observational cohort study of all Clalit Health Services members with hepatitis C virus genotype 1 who were dispensed dasabuvir/ombitasvir/paritaprevir/ritonavir from January 1, 2015 to-November 31, 2015.There were 564 participants during the study period. The average age was 61.9 years, 52.0% were male, and 61.5% were born Eastern/Central Europe or Central Asia. The prevalence of diabetes was 31.7% and 70.3% were overweight/obese. Cirrhosis was present in 41.0% of participants, of whom 52.8% had stage 4 fibrosis. Of the cohort, 416 (74.8% had follow-up viral load testing at 10 or more weeks after the end of treatment. We report a sustained virological response of 98.8% among those tested.Treatment with dasabuvir/ombitasvir/paritaprevir/ritonavir demonstrated a near universal effectiveness in achieving a sustained virological response among HCV patients in a large cohort.

  17. How fear of falling can increase fall-risk in older adults: applying psychological theory to practical observations.

    Science.gov (United States)

    Young, William R; Mark Williams, A

    2015-01-01

    It is widely reported that fear of falling (FOF) has a profound and largely detrimental effect on balance performance in older adults. However, the mechanisms by which FOF influence postural stability are poorly understood. In the current article, we use psychological theory to explain FOF-related changes to postural control. First, we review literature describing associations between FOF and the 'stiffening' strategies observed during control of posture, including observations of eye and head movements. Second, we present a framework illustrating the interactions between increased age, FOF, and altered attentional processes, which in turn influence balance performance and fall-risk. Psychological theory predicts that anxiety can cause attentional bias for threatening and task-irrelevant stimuli and compromise the efficiency of working memory resources. We argue that while the adoption of stiffening strategies is likely to be beneficial in avoiding a loss of balance during simple postural tasks, it will ultimately compromise performance in dynamic and highly demanding functional tasks. The adoption of stiffening strategies leads to inadequate acquisition of the sensory information necessary to plan and execute dynamic and interactive movements. We conclude with some suggestions for future research. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

  18. Awareness of knowledge and practice regarding physical activity: A population-based prospective, observational study among students in Nanjing, China.

    Directory of Open Access Journals (Sweden)

    Fei Xu

    Full Text Available Physical activity (PA promotion has proven effectiveness in preventing childhood obesity. Increasing children's health knowledge is the most frequently used approach in PA intervention programs targeting childhood obesity prevention. However, little is known about the specific association between the change in a child's knowledge awareness and their PA practice.A one-year follow-up study was conducted among primary and junior high school students in Nanjing, China. At baseline students' knowledge of healthy behavior, and their PA levels, were assessed. Students who were unaware of the association between PA and obesity were followed for one academic year. After nine-months their knowledge and PA levels were re-measured using the same validated questionnaire. Mixed effects regression models were used to estimate the relationship between awareness of knowledge about the link between PA and obesity and PA changes.Of the 1899 students who were unaware of the association between PA and obesity at baseline, 1859 (follow-up rate = 97.9% were successfully followed-up. After nine months 1318 (70.9% participants had become aware of PA-obesity association. Compared to their counterparts who remained unaware, students who became aware of the PA-obesity association were more likely to increase both the frequency (odds ratio (OR = 1.34, 95%CI = 1.09, 1.64 and duration (OR = 1.34, 95%CI = 1.09, 1.65 of PA, after adjusting for potentially confounding variables.Becoming aware of the known link between PA and obesity led to positive behavior modification regarding PA in this cohort of Chinese students. This is of particular importance that knowledge disimination and health education may be a useful approach for population-based physical activity promotion aiming at childhood obesity prevention in China.

  19. A prospective, observational, open-label, multicentre study to investigate the daily treatment practice of ranibizumab in patients with neovascular age-related macular degeneration.

    Science.gov (United States)

    van Asten, Freekje; Evers-Birkenkamp, Kim U; van Lith-Verhoeven, Janneke J C; de Jong-Hesse, Yvonne; Hoppenreijs, Vincent P T; Hommersom, Richard F; Scholten, Agnes M; Hoyng, Carel B; Klaver, Johannes H J

    2015-03-01

    The HELIOS (Health Economics with Lucentis in Observational Settings) study was designed on request of the Dutch Health Authority for an observational study to assess the effectiveness and safety of ranibizumab for neovascular age-related macular degeneration (wet AMD) in daily practice. The HELIOS study was a 2-year prospective, observational, open-label, multicentre study involving 14 sites. Patients with wet AMD were enrolled and observed for a period of 24 months. The data were collected at baseline and at the visits closest around the time-points 3, 6, 12, 18 and 24 months after inclusion. Treatment with ranibizumab resulted in prevention of vision loss. The mean ETDRS score increased from 45.1 letters at baseline to 48.5 letters at 24 months. This was achieved with a mean of 7.8 injections over 24 months. Stabilization of visual acuity was also reflected by the scores on the quality of life EQ-5D questionnaire, which did not significantly change over the study period. The more subjective EQ-VAS questionnaire showed an overall improvement. The VFQ-25 questionnaire was also mostly stable over time. After 24 months, 32.2% of the patients gained ≥1 letter and 17.1% gained >15 letters. Patients completing the loading phase were better responders, as demonstrated by increased long-term visual acuity. In addition, ranibizumab was well tolerated and had a safety profile commonly seen in routine clinical practice. This study demonstrates that also in daily practice ranibizumab was effective in preventing vision loss over a period of 24 months. No new safety findings were identified. © 2014 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  20. Modeling long period swell in Southern California: Practical boundary conditions from buoy observations and global wave model predictions

    Science.gov (United States)

    Crosby, S. C.; O'Reilly, W. C.; Guza, R. T.

    2016-02-01

    Accurate, unbiased, high-resolution (in space and time) nearshore wave predictions are needed to drive models of beach erosion, coastal flooding, and alongshore transport of sediment, biota and pollutants. On highly sheltered shorelines, wave predictions are sensitive to the directions of onshore propagating waves, and nearshore model prediction error is often dominated by uncertainty in offshore boundary conditions. Offshore islands and shoals, and coastline curvature, create complex sheltering patterns over the 250km span of southern California (SC) shoreline. Here, regional wave model skill in SC was compared for different offshore boundary conditions created using offshore buoy observations and global wave model hindcasts (National Oceanographic and Atmospheric Administration Wave Watch 3, WW3). Spectral ray-tracing methods were used to transform incident offshore swell (0.04-0.09Hz) energy at high directional resolution (1-deg). Model skill is assessed for predictions (wave height, direction, and alongshore radiation stress) at 16 nearshore buoy sites between 2000 and 2009. Model skill using buoy-derived boundary conditions is higher than with WW3-derived boundary conditions. Buoy-driven nearshore model results are similar with various assumptions about the true offshore directional distribution (maximum entropy, Bayesian direct, and 2nd derivative smoothness). Two methods combining offshore buoy observations with WW3 predictions in the offshore boundary condition did not improve nearshore skill above buoy-only methods. A case example at Oceanside harbor shows strong sensitivity of alongshore sediment transport predictions to different offshore boundary conditions. Despite this uncertainty in alongshore transport magnitude, alongshore gradients in transport (e.g. the location of model accretion and erosion zones) are determined by the local bathymetry, and are similar for all predictions.

  1. Non-physical practice improves task performance in an unstable, perturbed environment: Motor imagery and observational balance training

    Directory of Open Access Journals (Sweden)

    Wolfgang eTaube

    2014-12-01

    Full Text Available For consciously performed motor tasks executed in a defined and constant way, both motor imagery (MI and action observation (AO have been shown to promote motor learning. It is not known whether these forms of non-physical training also improve motor actions when these actions have to be variably applied in an unstable and unpredictable environment. The present study therefore investigated the influence of MI balance training (MI_BT and a balance training combining AO and MI (AO+MI_BT on postural control of undisturbed and disturbed upright stance on unstable ground. As spinal reflex excitability after classical (i.e., physical balance training (BT is generally decreased, we tested whether non-physical BT also has an impact on spinal reflex circuits. Thirty-six participants were randomly allocated into an MI_BT group, in which participants imagined postural exercises, an AO+MI_BT group, in which participants observed videos of other people performing balance exercises and imagined being the person in the video, and a non-active control group (CON. Before and after 4 weeks of non-physical training, balance performance was assessed on a free-moving platform during stance without perturbation and during perturbed stance. Soleus H-reflexes were recorded during stable and unstable stance. The post measurement revealed significantly decreased postural sway during undisturbed and disturbed stance after both MI_BT and AO+MI_BT. Spinal reflex excitability remained unchanged. This is the first study showing that non-physical training (MI_BT and AO+MI_BT not only promotes motor learning of ‘rigid’ postural tasks but also improves performance of highly variable and unpredictable balance actions. These findings may be relevant to improve postural control and thus reduce the risk of falls in temporarily immobilized patients.

  2. A Retrospective Observational Study of Anesthetic Induction Dosing Practices in Female Elderly Surgical Patients: Are We Overdosing Older Patients?

    Science.gov (United States)

    Akhtar, Shamsuddin; Heng, Joseph; Dai, Feng; Schonberger, Robert B; Burg, Mathew M

    2016-10-01

    Despite guidelines suggesting a 25-50 % reduction in induction doses of intravenous anesthetic agents in the elderly (≥65 years), we hypothesized that practitioners were not sufficiently correcting drug administration for age, contributing to an increased incidence of hypotension in older patients undergoing general anesthesia. We conducted a retrospective, observational study in a tertiary-care academic hospital. The study included 768 female patients undergoing gynecologic surgeries who received propofol-based induction of general anesthesia. Weight-adjusted anesthetic induction dosing, age-associated differences in dosing by ASA-PS (American Society of Anesthesiology-Physical Status), and hemodynamic outcomes between younger (18-64 years, n = 537) and older (≥65 years, n = 231) female patients were analyzed. Older patients received lower doses of propofol and midazolam than younger patients (propofol: 2.037 ± 0.783 vs 2.322 ± 0.834 mg/kg, p < 0.001; midazolam: 0.013 ± 0.014 vs 0.023 ± 0.042 mg/kg, p < 0.001). However, practitioners still consistently exceeded the FDA recommended dose (1-1.5 mg/kg) of propofol for elderly patients. There was no significant difference in the doses of fentanyl administered between the two age groups (1.343 ± 0.744 vs 1.363 ± 0.763 μg/kg, p = 0.744), and doses of fentanyl in older patients exceeded the recommended dose (0.5-1.0 μg/kg). Corresponding to observed overdosing of induction agents, older patients experienced larger decreases in post-induction blood pressure and were more likely to receive vasopressor therapy. Anesthetic induction doses of fentanyl and propofol were not sufficiently corrected in older patients in accordance with recommendations. Significantly greater frequency of post-induction hypotension occurred amongst older patients. Quality improvement efforts may lead to improved outcomes in this vulnerable population.

  3. Cost-benefit assessment of using electronic health records data for clinical research versus current practices: Contribution of the Electronic Health Records for Clinical Research (EHR4CR) European Project.

    Science.gov (United States)

    Beresniak, Ariel; Schmidt, Andreas; Proeve, Johann; Bolanos, Elena; Patel, Neelam; Ammour, Nadir; Sundgren, Mats; Ericson, Mats; Karakoyun, Töresin; Coorevits, Pascal; Kalra, Dipak; De Moor, Georges; Dupont, Danielle

    2016-01-01

    The widespread adoption of electronic health records (EHR) provides a new opportunity to improve the efficiency of clinical research. The European EHR4CR (Electronic Health Records for Clinical Research) 4-year project has developed an innovative technological platform to enable the re-use of EHR data for clinical research. The objective of this cost-benefit assessment (CBA) is to assess the value of EHR4CR solutions compared to current practices, from the perspective of sponsors of clinical trials. A CBA model was developed using an advanced modeling approach. The costs of performing three clinical research scenarios (S) applied to a hypothetical Phase II or III oncology clinical trial workflow (reference case) were estimated under current and EHR4CR conditions, namely protocol feasibility assessment (S1), patient identification for recruitment (S2), and clinical study execution (S3). The potential benefits were calculated considering that the estimated reduction in actual person-time and costs for performing EHR4CR S1, S2, and S3 would accelerate time to market (TTM). Probabilistic sensitivity analyses using Monte Carlo simulations were conducted to manage uncertainty. Should the estimated efficiency gains achieved with the EHR4CR platform translate into faster TTM, the expected benefits for the global pharmaceutical oncology sector were estimated at €161.5m (S1), €45.7m (S2), €204.5m (S1+S2), €1906m (S3), and up to €2121.8m (S1+S2+S3) when the scenarios were used sequentially. The results suggest that optimizing clinical trial design and execution with the EHR4CR platform would generate substantial added value for pharmaceutical industry, as main sponsors of clinical trials in Europe, and beyond. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Employees' motivation and emloyees' benefits

    OpenAIRE

    Nedzelská, Eva

    2014-01-01

    The subject of this bachelor thesis is analysing methods how to stimulate and motivate employees. The theoretical part of the thesis deals with the concept of motivation, concepts close to motivation and selected existing theories of motivation. It also deals with employee benefits, function, division and benefits which are frequently offered to employees. The practical part of the thesis, mainly based on written and online questionnaires, concentrates on motivation of employees at Nedcon Boh...

  5. Assessment of malnutrition and enteral feeding practices in the critically ill: A single-centre observational study

    Directory of Open Access Journals (Sweden)

    Prashant Paul Verghese

    2018-01-01

    Full Text Available Background and Aims: Early identification of malnutrition among hospitalised patients is essential to institute appropriate patient-specific nutritional strategies. This study was conducted to evaluate the nutritional status of medical patients at admission to the adult intensive care unit (ICU and to identify factors which prevent attainment of daily feeding goals in them. Methods: This was a 1 year prospective, observational study on 200 medical adult ICU patients. The study was carried out based on daily documentation. The primary outcome was the nutritional status of medical Patients at admission to the adult ICU. The tests for statistical analysis used were independent t test, Chi-square test, Fisher's exact test and multivariate logistic regression analysis. Results: Out of the 200 patients in our study, 45%, 48.5% and 9% of patients had mild, moderate and severe malnutrition, respectively, corresponding to subjective global assessment (SGA rating A,B and C, respectively. The most common reasons for non-attainment of daily feeding goals were delayed feed procurement (17.57%, and feeds being held for procedures (16.36%. The overall mean length of ICU stay was 8.63 ± 7.26 days, and the ICU mortality rate was 47.5% (95/200. Patients with SGA rating B and C at admission had higher risk of mortality in the ICU, with an adjusted odds ratio of 3.54 (95% confidence interval [CI]- 1.71–7.33, P = 0.001 and 11.11 (95% CI-2.26–54.66, P = 0.003, respectively. Conclusion: Malnutrition is commonly present at admission among medical ICU patients, and is associated with higher ICU mortality.

  6. [The practice of special observation in adults in the German-speaking part of Switzerland - a descriptive cross-sectional study].

    Science.gov (United States)

    Lienhardt, Andrea; Rabenschlag, Franziska; Panfil, Eva-Maria

    2018-06-08

    The practice of special observation in adults in the German-speaking part of Switzerland - a descriptive cross-sectional study Abstract. Psychiatric Special Observation (PSO) is an intervention often used by nurses to prevent service users of harming themselves or to protect others. The intervention ranges between control and therapy and is resource intensive. Despite the widespread use of PSO, there is still no data on the practice of the intervention in Switzerland. What is the current practice of PSO in adults in psychiatric hospitals in the German-speaking part of Switzerland? Descriptive cross-sectional study. Nurses from inpatient psychiatric services in the German-speaking part of Switzerland completed a questionnaire based on a concept analysis of PSO. 538 questionnaires were analysed. PSO was more often conducted intermittent than as constant observation. In more than one out of four cases, suicidality reasoned as a cause for prescription. Nurses generally used standardized instruments to assess the risk of harming oneself or others. The duration of PSO lasted eight hours or more in three out of four cases. In every fifth case, there was no validation of the need of the intervention taking place during one shift. Nurses have a neutral attitude towards the intervention and are experiencing no or weak negative feelings during performance of PSO. The results suggest that there is an inconsistent performance of PSO in Switzerland as well as in other countries. The validation of the need of the intervention is insufficient. To facilitate PSO as a justified performance, the preparation of an interprofessional guideline is recommended.

  7. How Well Are Pulses Measured? Practice-Based Evidence from an Observational Study of Acutely Ill Medical Patients During Hospital Admission

    DEFF Research Database (Denmark)

    Opio, Martin Otyek; Kellett, John

    2017-01-01

    BACKGROUND: Although taking a radial pulse is considered to be an essential clinical skill, there have been few reports on how well it is measured in clinical practice, and how its accuracy and precision are influenced by rate, rhythm, and blood pressure. METHODS: This study is a retrospective...... quality audit carried out as part of a larger ongoing prospective observational trial. The radial pulse rates recorded by 2 research nurses were compared with the electrocardiogram (ECG) heart rates measured on acutely ill medical patients during their admission to a resource-poor hospital in sub...

  8. Evaluation of a chronic disease management system for the treatment and management of diabetes in primary health care practices in Ontario: an observational study.

    Science.gov (United States)

    O'Reilly, D J; Bowen, J M; Sebaldt, R J; Petrie, A; Hopkins, R B; Assasi, N; MacDougald, C; Nunes, E; Goeree, R

    2014-01-01

    Computerized chronic disease management systems (CDMSs), when aligned with clinical practice guidelines, have the potential to effectively impact diabetes care. The objective was to measure the difference between optimal diabetes care and actual diabetes care before and after the introduction of a computerized CDMS. This 1-year, prospective, observational, pre/post study evaluated the use of a CDMS with a diabetes patient registry and tracker in family practices using patient enrolment models. Aggregate practice-level data from all rostered diabetes patients were analyzed. The primary outcome measure was the change in proportion of patients with up-to-date "ABC" monitoring frequency (i.e., hemoglobin A1c, blood pressure, and cholesterol). Changes in the frequency of other practice care and treatment elements (e.g., retinopathy screening) were also determined. Usability and satisfaction with the CDMS were measured. Nine sites, 38 health care providers, and 2,320 diabetes patients were included. The proportion of patients with up-to-date ABC (12%), hemoglobin A1c (45%), and cholesterol (38%) monitoring did not change over the duration of the study. The proportion of patients with up-to-date blood pressure monitoring improved, from 16% to 20%. Data on foot examinations, retinopathy screening, use of angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers, and documentation of self-management goals were not available or not up to date at baseline for 98% of patients. By the end of the study, attitudes of health care providers were more negative on the Training, Usefulness, Daily Practice, and Support from the Service Provider domains of the CDMS, but more positive on the Learning, Using, Practice Planning, CDMS, and Satisfaction domains. Few practitioners used the CDMS, so it was difficult to draw conclusions about its efficacy. Simply giving health care providers a potentially useful technology will not ensure its use. This real-world evaluation of a

  9. Practicing Tai Chi had lower energy metabolism than walking but similar health benefits in terms of aerobic fitness, resting energy expenditure, body composition and self-perceived physical health.

    Science.gov (United States)

    Hui, Stanley Sai-Chuen; Xie, Yao Jie; Woo, Jean; Kwok, Timothy Chi-Yui

    2016-08-01

    To examine the effects of Tai Chi and walking training on aerobic fitness, resting energy expenditure (REE), body composition, and quality of life; as well as analyzing the energy metabolism during exercises, to determine which one had better advantage in improving health status. Three hundred seventy-four middle-aged Chinese subjects who were recruited from nine geographic areas in Sha Tin were randomized into Tai Chi, walking, or control groups at area level. The 12-week (45min per day, 5days per week) Tai Chi or brisk walking training were conducted in respective intervention groups. Measures were performed at baseline and end of trial. Another 30 subjects were recruited to compare the energy metabolism between practicing Tai Chi and walking. The between-group difference of VO2max was 3.3ml/min/kg for Tai Chi vs. control and 3.7ml/min/kg for walking vs. control (both Pwalking. Regarding to energy metabolism test, the self-paced walking produced approximately 46% higher metabolic costs than Tai Chi. Practicing Tai Chi consumes a smaller amount of energy metabolism but similar health benefits as self-paced brisk walking. Copyright © 2016. Published by Elsevier Ltd.

  10. Non-interventional (observational study of application of the tamsulosin (Proflosin® in patients with benign prostatic hyperplasia in routine clinical practice

    Directory of Open Access Journals (Sweden)

    L. G. Spivak

    2014-01-01

    Full Text Available The problem of therapy of benign prostatic hyperplasia has not lost its relevance today due to the high prevalence rate of this pathologyamong the male population. The article provides the results of non-interventional (observational study of application of the tamsulosin(Proflosin® drug or combined therapy with tamsulosin (Proflosin® + Serenoa repens (Prostamol® Uno of patients with benign prostatic hyperplasia in routine clinical practice. 1,000 practicing urology experts from 100 cities and towns of Russia took part in the study as well as 23 492 patients with the established diagnosis of benign prostatic hyperplasia, which were prescribed with tamsulosin (Proflosin® monotherapy or combined therapy with tamsulosin (Proflosin® + Serenoa repens (Prostamol® Uno in conditions of outpatient clinical practice. As a result of the study, improvement of the life standard and subjective symptoms were stated with patients with the absence of significant side effects directly associated with intake of the drug studies.

  11. Non-interventional (observational study of application of the tamsulosin (Proflosin® in patients with benign prostatic hyperplasia in routine clinical practice

    Directory of Open Access Journals (Sweden)

    L. G. Spivak

    2015-02-01

    Full Text Available The problem of therapy of benign prostatic hyperplasia has not lost its relevance today due to the high prevalence rate of this pathologyamong the male population. The article provides the results of non-interventional (observational study of application of the tamsulosin(Proflosin® drug or combined therapy with tamsulosin (Proflosin® + Serenoa repens (Prostamol® Uno of patients with benign prostatic hyperplasia in routine clinical practice. 1,000 practicing urology experts from 100 cities and towns of Russia took part in the study as well as 23 492 patients with the established diagnosis of benign prostatic hyperplasia, which were prescribed with tamsulosin (Proflosin® monotherapy or combined therapy with tamsulosin (Proflosin® + Serenoa repens (Prostamol® Uno in conditions of outpatient clinical practice. As a result of the study, improvement of the life standard and subjective symptoms were stated with patients with the absence of significant side effects directly associated with intake of the drug studies.

  12. Analysis of employee benefits in company

    OpenAIRE

    Burda, Tomáš

    2011-01-01

    The main subject of Bachelor's Thesis called "Analysis of employee benefits in company" is to analyze system of employee benefits used in company Saint-Gobain Construction Products a.s. The theoretical part focuses on the meaning of employee benefits, their categorization, terms of tax legislation a trends. In the practical section of the work, the current state of employee benefits in the firm is discussed and reviewed. A survey was conducted to investigate the satisfaction of employees towa...

  13. Use of cumulative mortality data in patients with acute myocardial infarction for early detection of variation in clinical practice: observational study.

    Science.gov (United States)

    Lawrance, R A; Dorsch, M F; Sapsford, R J; Mackintosh, A F; Greenwood, D C; Jackson, B M; Morrell, C; Robinson, M B; Hall, A S

    2001-08-11

    Use of cumulative mortality adjusted for case mix in patients with acute myocardial infarction for early detection of variation in clinical practice. Observational study. 20 hospitals across the former Yorkshire region. All 2153 consecutive patients with confirmed acute myocardial infarction identified during three months. Variable life-adjusted displays showing cumulative differences between observed and expected mortality of patients; expected mortality calculated from risk model based on admission characteristics of age, heart rate, and systolic blood pressure. The performance of two individual hospitals over three months was examined as an example. One, the smallest district hospital in the region, had a series of 30 consecutive patients but had five more deaths than predicted. The variable life-adjusted display showed minimal variation from that predicted for the first 15 patients followed by a run of unexpectedly high mortality. The second example was the main tertiary referral centre for the region, which admitted 188 consecutive patients. The display showed a period of apparently poor performance followed by substantial improvement, where the plot rose steadily from a cumulative net lives saved of -4 to 7. These variations in patient outcome are unlikely to have been revealed during conventional audit practice. Variable life-adjusted display has been integrated into surgical care as a graphical display of risk-adjusted survival for individual surgeons or centres. In combination with a simple risk model, it may have a role in monitoring performance and outcome in patients with acute myocardial infarction.

  14. Development and validation of an observation tool for the assessment of nursing pain management practices in intensive care unit in a standardized clinical simulation setting.

    Science.gov (United States)

    Gosselin, Emilie; Bourgault, Patricia; Lavoie, Stephan; Coleman, Robin-Marie; Méziat-Burdin, Anne

    2014-12-01

    Pain management in the intensive care unit is often inadequate. There is no tool available to assess nursing pain management practices. The aim of this study was to develop and validate a measuring tool to assess nursing pain management in the intensive care unit during standardized clinical simulation. A literature review was performed to identify relevant components demonstrating optimal pain management in adult intensive care units and to integrate them in an observation tool. This tool was submitted to an expert panel and pretested. It was then used to assess pain management practice during 26 discrete standardized clinical simulation sessions with intensive care nurses. The Nursing Observation Tool for Pain Management (NOTPaM) contains 28 statements grouped into 8 categories, which are grouped into 4 dimensions: subjective assessment, objective assessment, interventions, and reassessment. The tool's internal consistency was calculated at a Cronbach's alpha of 0.436 for the whole tool; the alpha varies from 0.328 to 0.518 for each dimension. To evaluate the inter-rater reliability, intra-class correlation coefficient was used, which was calculated at 0.751 (p nurses' pain management in a standardized clinical simulation. The NOTPaM is the first tool created for this purpose. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  15. Influences of observation method, season, soil depth, land use and management practice on soil dissolvable organic carbon concentrations: A meta-analysis.

    Science.gov (United States)

    Li, Siqi; Zheng, Xunhua; Liu, Chunyan; Yao, Zhisheng; Zhang, Wei; Han, Shenghui

    2018-08-01

    Quantifications of soil dissolvable organic carbon concentrations, together with other relevant variables, are needed to understand the carbon biogeochemistry of terrestrial ecosystems. Soil dissolvable organic carbon can generally be grouped into two incomparable categories. One is soil extractable organic carbon (EOC), which is measured by extracting with an aqueous extractant (distilled water or a salt solution). The other is soil dissolved organic carbon (DOC), which is measured by sampling soil water using tension-free lysimeters or tension samplers. The influences of observation methods, natural factors and management practices on the measured concentrations, which ranged from 2.5-3970 (mean: 69) mg kg -1 of EOC and 0.4-200 (mean: 12) mg L -1 of DOC, were investigated through a meta-analysis. The observation methods (e.g., extractant, extractant-to-soil ratio and pre-treatment) had significant effects on EOC concentrations. The most significant divergence (approximately 109%) occurred especially at the extractant of potassium sulfate (K 2 SO 4 ) solutions compared to distilled water. As EOC concentrations were significantly different (approximately 47%) between non-cultivated and cultivated soils, they were more suitable than DOC concentrations for assessing the influence of land use on soil dissolvable organic carbon levels. While season did not significantly affect EOC concentrations, DOC concentrations showed significant differences (approximately 50%) in summer and autumn compared to spring. For management practices, applications of crop residues and nitrogen fertilizers showed positive effects (approximately 23% to 91%) on soil EOC concentrations, while tillage displayed negative effects (approximately -17%), compared to no straw, no nitrogen fertilizer and no tillage. Compared to no nitrogen, applications of synthetic nitrogen also appeared to significantly enhance DOC concentrations (approximately 32%). However, further studies are needed in the future

  16. Sustainable Offices: Small Practices for Big Benefits

    Science.gov (United States)

    2012-05-01

    comply with a collection of information if it does not display a currently valid OMB control number. 1. REPORT DATE MAY 2012 2. REPORT TYPE 3. DATES...16 Reducing Fuel Consumption • Participate in meetings via telephone • Telecommute or alternate work schedules • Carpool • Bike or walk around

  17. QUANTIFYING BENEFITS FOR COST-BENEFIT ANALYSIS

    OpenAIRE

    Attila GYORGY; Nicoleta VINTILA; Florian GAMAN

    2014-01-01

    Cost Benefit Analysis is one of the most widely used financial tools to select future investment projects in public and private sector. This method is based on comparing costs and benefits in terms of constant prices. While costs are easier to predict and monetize, the benefits should be identified not only in direct relation with the investment, but also widening the sphere of analysis to indirect benefits experienced by the community from the neighbourhood or the whole society. During finan...

  18. Exploring practical approaches to maximising data quality in electronic healthcare records in the primary care setting and associated benefits. Report of panel-led discussion held at SAPC in July 2014.

    Science.gov (United States)

    Dungey, Sheena; Glew, Simon; Heyes, Barbara; Macleod, John; Tate, A Rosemary

    2016-09-01

    Electronic healthcare records provide information about patient care over time which not only affords the opportunity to improve patient care directly through effective monitoring and identification of care requirements but also offers a unique platform for both clinical and service-model research essential to the longer-term development of the health service. The quality of the recorded data can, however, be variable and can compromise the validity of data use both for primary and secondary purposes. In order to explore the challenges and benefits of and approaches to recording high quality primary care electronic records, a Clinical Practice Research Datalink (CPRD) sponsored workshop was held at the Society of Academic Primary Care (SAPC) conference in 2014 with the aim of engaging GPs and other data users. The workshop was held as a structured discussion, led by an expert panel and focused around three questions: (1) What are the data quality priorities for clinicians and researchers? How do these priorities differ or overlap? (2) What challenges might GPs face in provision of good data quality both for treating their patients and for research? Do these aims conflict? (3) What tools (such as data metrics and visualisations or software components) could assist the GP in improving data quality and patient management and could this tie in with analytical processes occurring at the research stage? The discussion highlighted both overlap and differences in the perceived data quality priorities and challenges for different user groups. Five key areas of focus were agreed upon and recommendations determined for moving forward in improving quality. The importance of good high quality electronic healthcare records has been set forth along with the need for a practical user-considered and collaborative approach to its improvement.

  19. Reflection on observation: A qualitative study using practice development methods to explore the experience of being a hand hygiene auditor in Australia.

    Science.gov (United States)

    Jain, Susan; Edgar, Denise; Bothe, Janine; Newman, Helen; Wilson, Annmaree; Bint, Beth; Brown, Megan; Alexander, Suzanne; Harris, Joanna

    2015-12-01

    Within the Australian public health care system, an observation model is used to assess hand hygiene practice in health care workers, culminating in a publicly available healthcare service performance indicator. The intent of this study was for the results to inform the development of a strategy to support individual auditors and local sustainability of the hand hygiene auditing program. This qualitative study used a values clarification tool to gain an understanding of the experiences of hand hygiene auditors. The methodology involved qualitative interpretation of focus group discussions to identify the enablers and barriers to successful performance of the auditors' role. Twenty-five participants identified congruous themes of the need for peer and managerial support, improved communication and feedback, and consideration for succession planning. There was consistency in the participants' most frequently identified significant barriers in undertaking the role. Hand hygiene auditors take pride in their role and work toward the goal of reducing health care-associated infections by having a part to play in improving hand hygiene practices of all staff members. Important themes, barriers, and enablers were identified in this study. This research will be of interest nationally and globally, considering the dearth of published information on the experience of hand hygiene auditors. This study provides evidence of the need to support individual hand hygiene auditors. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

  20. Observations regarding the right of civil servants to pursue a career. About „instability” in civil service and law non-compliance practices

    Directory of Open Access Journals (Sweden)

    Camelia STOICA

    2013-06-01

    Full Text Available In the present study the regulation of the carrier of the civil servants is considered, especially the stability and continuity – essential elements at the European Union level. Unfortunately, in the Romanian legislation, as well as in the institutional case law, it remains a purely declarative issue. The study is based on a series of recent court decisions. We criticized the abusive use of the expeditious ordinances and the instruments of legislative regulation. This is considered as an abusive practice of the law maker and shows a legislative inability related to the regulation of the public office, especially by not observing the conditions in which a person could be relieved of his office. The conclusion of the study leads to the necessity for the law maker to revise the statute of the civil servant, especially by eliminating the fluctuation determined by the succession of the governing political forces.

  1. Benefits of Java

    Science.gov (United States)

    ... Wellness Preventing Illness Benefits of Coffee Print Email Benefits of Coffee Reviewed by Taylor Wolfram, MS, RDN, ... your daily cup (or three) provides some health benefits as well. Drinking moderate amounts of coffee (including ...

  2. Benefits of quitting tobacco

    Science.gov (United States)

    ... your risk of many serious health problems . THE BENEFITS OF QUITTING You may enjoy the following when ... about $2,000 a year on cigarettes. HEALTH BENEFITS Some health benefits begin almost immediately. Every week, ...

  3. An Open-Label, Multicenter Observational Study for Patients with Alzheimer’s Disease Treated with Memantine in the Clinical Practice

    Directory of Open Access Journals (Sweden)

    S.S. Stamouli

    2011-01-01

    Full Text Available Background/Aims: In this post-marketing observational study, the safety and effectiveness of memantine were evaluated in patients with Alzheimer’s disease (AD. Methods: In a 6-month, observational, open-label study at 202 specialist sites in Greece, the effectiveness of memantine was evaluated using the Mini-Mental State Examination (MMSE and the Instrumental Activities of Daily Living (IADL scale at baseline, and after 3 and 6 months. Discontinuation rates and adverse drug reactions (ADRs were also recorded to evaluate the safety profile of memantine. Results: 2,570 patients participated in the study. Three and 6 months after baseline, MMSE and IADL scores were significantly improved compared to baseline. At the end of the study, 67% of the patients had improved their MMSE score; 7.1% of the patients reported ≧1 ADRs, and treatment was discontinued due to ADR in 0.7%. Conclusion: Memantine was well tolerated and had a positive effect on the patient’s cognitive and functional ability in real-life clinical practice, in agreement with randomized, controlled trials.

  4. Electronics Environmental Benefits Calculator

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Electronics Environmental Benefits Calculator (EEBC) was developed to assist organizations in estimating the environmental benefits of greening their purchase,...

  5. Business Process Modeling: Perceived Benefits

    Science.gov (United States)

    Indulska, Marta; Green, Peter; Recker, Jan; Rosemann, Michael

    The process-centered design of organizations and information systems is globally seen as an appropriate response to the increased economic pressure on organizations. At the methodological core of process-centered management is process modeling. However, business process modeling in large initiatives can be a time-consuming and costly exercise, making it potentially difficult to convince executive management of its benefits. To date, and despite substantial interest and research in the area of process modeling, the understanding of the actual benefits of process modeling in academia and practice is limited. To address this gap, this paper explores the perception of benefits derived from process modeling initiatives, as reported through a global Delphi study. The study incorporates the views of three groups of stakeholders - academics, practitioners and vendors. Our findings lead to the first identification and ranking of 19 unique benefits associated with process modeling. The study in particular found that process modeling benefits vary significantly between practitioners and academics. We argue that the variations may point to a disconnect between research projects and practical demands.

  6. Data quality and practical challenges of thyroid volume assessment by ultrasound under field conditions - observer errors may affect prevalence estimates of goitre

    Directory of Open Access Journals (Sweden)

    Torheim Liv E

    2010-12-01

    Full Text Available Abstract Background The ultrasonographic estimation of thyroid size has been advocated as being more precise than palpation to diagnose goitre. However, ultrasound also requires technical proficiency. This study was conducted among Saharawi refugees, where goitre is highly prevalent. The objectives were to assess the overall data quality of ultrasound measurements of thyroid volume (Tvol, including the intra- and inter-observer agreement, under field conditions, and to describe some of the practical challenges encountered. Methods In 2007 a cross-sectional study of 419 children (6-14 years old and 405 women (15-45 years old was performed on a population of Saharawi refugees with prevalent goitre, who reside in the Algerian desert. Tvol was measured by two trained fieldworkers using portable ultrasound equipment (examiner 1 measured 406 individuals, and examiner 2, 418 individuals. Intra- and inter-observer agreement was estimated in 12 children selected from the study population but not part of the main study. In the main study, an observer error was found in one examiner whose ultrasound images were corrected by linear regression after printing and remeasuring a sample of 272 images. Results The intra-observer agreement in Tvol was higher in examiner 1, with an intraclass correlation coefficient (ICC of 0.97 (95% CI: 0.91, 0.99 compared to 0.86 (95% CI: 0.60, 0.96 in examiner 2. The ICC for inter-observer agreement in Tvol was 0.38 (95% CI: -0.20, 0.77. Linear regression coefficients indicated a significant scaling bias in the original measurements of the AP and ML diameter and a systematic underestimation of Tvol (a product of AP, ML, CC and a constant. The agreement between re-measured and original Tvol measured by ICC (95% CI was 0.76 (0.71, 0.81. The agreement between re-measured and corrected Tvol measured by ICC (95% CI was 0.97 (0.96, 0.97. Conclusions An important challenge when using ultrasound to assess thyroid volume under field

  7. Management of secondary hyperparathyroidism: practice patterns and outcomes of cinacalcet treatment with or without active vitamin D in Austria and Switzerland - the observational TRANSIT Study.

    Science.gov (United States)

    Pronai, Wolfgang; Rosenkranz, Alexander R; Bock, Andreas; Klauser-Braun, Renate; Jäger, Christine; Pendl, Gunther; Hemetsberger, Margit; Lhotta, Karl

    2017-05-01

    Secondary hyperparathyroidism is a complex disorder requiring an individualized multicomponent treatment approach. This study was conducted to identify treatment combinations used in clinical practice in Austria and Switzerland and the potential to control this disorder. A total of 333 adult hemodialysis and peritoneal dialysis patients were analyzed. All patients received conventional care prior to initiation of a cinacalcet-based regimen. During the study, treatment components, e.g. cinacalcet, active vitamin D analogues and phosphate binders, were adapted to individual patient requirements and treatment dynamics were documented. Overall, the mean intact parathyroid hormone (iPTH) increased from 64.2 pmol/l to 79.6 pmol/l under conventional therapy and decreased after cinacalcet initiation to 44.0 pmol/l after 12 months (mean decrease between baseline and 12 months -45%). Calcium remained within the normal range throughout the study and phosphorus ranged around the upper limit of normal. The Kidney Disease: Improving Global Outcomes (KDIGO) target achievement for iPTH increased from 44.5% of patients at baseline to 65.7% at 12 months, corrected calcium from 58.9% to 51.9% and phosphorus from 18.4% to 24.4%. On average, approximately 30% of patients adapted their regimen from one observation period to the next. The reasons for changing a given regimen were to attain or maintain any of the bone mineral markers within recommended targets and to avoid developments to extreme values. Some regional differences in practice patterns were identified. No new safety signals emerged. In conclusion, cinacalcet appears to be a necessary treatment component to achieve recommended targets. The detailed composition of the treatment mix should be adapted to patient requirements and reassessed on a regular basis.

  8. Impacts of Generic Competition and Benefit Management...

    Data.gov (United States)

    U.S. Department of Health & Human Services — According to findings reported in Impacts of Generic Competition and Benefit Management Practices on Spending for Prescription Drugs - Evidence from Medicares Part D...

  9. Video observation of hand hygiene practices during routine companion animal appointments and the effect of a poster intervention on hand hygiene compliance

    Science.gov (United States)

    2014-01-01

    Background Hand hygiene is considered one of the most important infection control measures in human healthcare settings, but there is little information available regarding hand hygiene frequency and technique used in veterinary clinics. The objectives of this study were to describe hand hygiene practices associated with routine appointments in companion animal clinics in Ontario, and the effectiveness of a poster campaign to improve hand hygiene compliance. Results Observation of hand hygiene practices was performed in 51 clinics for approximately 3 weeks each using 2 small wireless surveillance cameras: one in an exam room, and one in the most likely location for hand hygiene to be performed outside the exam room following an appointment. Data from 38 clinics were included in the final analysis, including 449 individuals, 1139 appointments before and after the poster intervention, and 10894 hand hygiene opportunities. Overall hand hygiene compliance was 14% (1473/10894), while before and after patient contact compliance was 3% (123/4377) and 26% (1145/4377), respectively. Soap and water was used for 87% (1182/1353) of observed hand hygiene attempts with a mean contact time of 4 s (median 2 s, range 1-49 s), while alcohol-based hand rub (ABHR) was used for 7% (98/1353) of attempts with a mean contact time of 8 s (median 7 s, range 1-30 s). The presence of the posters had no significant effect on compliance, although some staff reported that they felt the posters did increase their personal awareness of the need to perform hand hygiene, and the posters had some effect on product contact times. Conclusions Overall hand hygiene compliance in veterinary clinics in this study was low, and contact time with hand hygiene products was frequently below current recommendations. Use of ABHR was low despite its advantages over hand washing and availability in the majority of clinics. The poster campaign had a limited effect on its own, but could still be used as a

  10. Employee Benefits in a Selected Company

    OpenAIRE

    RODOVÁ, Veronika

    2015-01-01

    This thesis is focused on the analysis of employee benefits and proposes the possible changes in selected organization. The characteristics of thecompany are described in the introduction of practical part. Subsequently, the current situations of benefits in selected companies are provided through questionnaire surveys, where the employee satisfactions with benefits are verified. The obtained information from questionnaires solves the particular employee satisfaction with engagement level and...

  11. Backpack Programs and the Crisis Narrative of Child Hunger-A Critical Review of the Rationale, Targeting, and Potential Benefits and Harms of an Expanding but Untested Model of Practice.

    Science.gov (United States)

    Fram, Maryah S; Frongillo, Edward A

    2018-01-01

    In recent years, school-based food backpack programs (BPPs) have come into national prominence as a response to a perceived crisis of child hunger in America. Distributing bags of free food directly to schoolchildren for their own personal consumption each weekend, BPPs bring together private donors, faith communities, and public schools around an intuitively appealing project: children are hungry, and so we give them food. Perhaps because of their intuitive appeal, BPPs have expanded rapidly, without rigorous evaluation to determine their impacts on children, families, and schools. This Perspective aims to open up thinking about BPPs, first articulating the implicit conceptual model that undergirds BPPs, drawing on documentation offered by major program providers and on our own experience working with several schools implementing BPPs, to provide a window into what BPPs do and how and why they do it. We focus in particular on how the crisis narrative of child hunger has shaped the BPP model and on the related interplay between public sympathy and the neoliberal climate in which structural solutions to family poverty are eschewed. We then assess the BPP model in light of existing knowledge, concluding that BPPs fit poorly with the needs of the majority of children living in food-insecure households in the United States and consequently put children at risk of negative consequences associated with worry, shame, stigma, and disruptions to family functioning. Finally, we provide recommendations for practice and research, emphasizing the importance of 1) responding to children's actual needs throughout program implementation, 2) avoiding unnecessary risks by effective targeting of services to only those children who need them, and 3) rigorously evaluating program outcomes and unintended consequences to determine whether, even for the small number of US children who experience hunger, the benefits of the BPP model outweigh its psychosocial costs. © 2018 American

  12. The Distribution of Family Oriented Benefits.

    Science.gov (United States)

    EBRI Issue Brief, 1992

    1992-01-01

    This issue of a monthly newsletter is devoted to an overview of employee benefits that assist families, including child care, extended unpaid personal leave, and flexible work options. Findings are discussed from a recent study analyzing the distribution of two of those family benefits (child care assistance and flexible work practices) among…

  13. Characteristics and practices of Traditional Chinese Medicine retail shops in London, UK: A cross-sectional study using an observational approach.

    Science.gov (United States)

    Teng, Lida; Shaw, Debbie; Barnes, Joanne

    2015-09-15

    Traditional Chinese Medicine (TCM) is a popular form of ethnomedicine in the UK, and is accessed by Western, Chinese and other ethnic groups. The current regulatory regime does not effectively protect the public against poor-quality and unsafe TCMs. Understanding ethnopharmacological information on how TCM is promoted and practiced may help to inform initiatives aimed at ensuring the safe use of TCMs in the UK, and put laboratory-based ethnopharmacological investigations of TCMs in a broader context. This study aimed to examine the characteristics and practices of TCM retail outlets in London, UK, and to identify factors relevant to the safe use of TCM in the UK. TCM retail outlets ('shops') in London, UK, were identified using a systematic approach. A structured questionnaire including questions on shop business type was used to recruit participant shops. Shops consenting to participate were visited within six weeks of providing consent. A piloted semi-structured questionnaire on shop characteristics was used for data collection following observation. The British National Formulary 53 was used to classify medical conditions/uses for TCMs promoted in the shops. Data were stored and analysed using MS Access 2003, MS Excel 2003 and SPSS 13. In total, 54 TCM shops in London were identified, of which 94% offered TCM consultations with a TCM practitioner. Detailed characteristics were described within 35/50 shops that gave consent to observing their premises. Most shops labelled and displayed over 150 Chinese Materia Medica (CMMs; crude materials, particularly herbs) for dispensing after consultations with a TCM practitioner. Medical conditions/uses and Patent Chinese Medicines (PCMs) were commonly promoted. In total, 794 occurrences of 205 different medical conditions/uses (median=32, QL=19, QU=48) were identified. These conditions/uses most commonly related to the following therapeutic systems: central nervous system (160/794, 20.2%); musculoskeletal and joint disease

  14. Reaping benefits from intellectual capital.

    Science.gov (United States)

    Weston, Marla J; Estrada, Nicolette A; Carrington, Jane

    2007-01-01

    The wealth and value of organizations are increasingly based on intellectual capital. Although acquiring talented individuals and investing in employee learning adds value to the organization, reaping the benefits of intellectual capital involves translating the wisdom of employees into reusable and sustained actions. This requires a culture that creates employee commitment, encourages learning, fosters sharing, and involves employees in decision making. An infrastructure to recognize and embed promising and best practices through social networks, evidence-based practice, customization of innovations, and use of information technology results in increased productivity, stronger financial performance, better patient outcomes, and greater employee and customer satisfaction.

  15. Building Professional and Technical Skills in the Use of Earth Observations through the NASA DEVELOP National Program: Best Practices & Lessons Learned

    Science.gov (United States)

    Crepps, G.; Ross, K. W.; Childs-Gleason, L. M.; Allsbrook, K. N.; Rogers, L.; Ruiz, M. L.; Clayton, A.

    2017-12-01

    The NASA DEVELOP National Program offers 10-week research opportunities to participants to work on rapid feasibility projects utilizing NASA Earth observations in a variety of applications, including ecological forecasting, water resources, disasters, and health and air quality. DEVELOP offers a unique collaborative environment in which students, recent graduates, and transitioning career professionals are placed on interdisciplinary teams to conduct projects. DEVELOP offers a variety of opportunities and resources to build participants technical skills in remote sensing and GIS, as well as interpersonal and leadership skills. As a capacity building program, DEVELOP assesses participants' growth by using entrance and exit personal growth assessments, as well as gathering general program feedback through an exit survey. All of this information is fed back into the program for continual improvement. DEVELOP also offers a progression of opportunities through which participants can advance through the program, allowing participants to build a diverse set of technical and leadership skills. This presentation will explore best practices including the use of pre- and post-growth assessments, offering advanced leadership opportunities, and overall capacity building impacts on participants.

  16. [A retrospective, observational and multicentre study on patients with hyperactive bladder on treatment with mirabegron and oxybutinine under usual clinical practice conditions].

    Science.gov (United States)

    Sicras-Mainar, A; Navarro-Artieda, R; Ruiz-Torrejón, A; Saez, M; Coll-de Tuero, G; Sánchez, L

    To evaluate therapeutic persistence, healthcare resources, medical costs and adverse events of oxybutynin and mirabegron treatments in patients with overactive bladder in routine medical practice. An observational, retrospective, multicentre study was carried out using the records of patients attended to in 3 different geographic locations (Barcelona, Girona, Asturias). An analysis was made on the 2 study groups (oxybutynin and mirabegron). Follow-up time was one year. Persistence was defined as the time (months), without discontinuation of the initial treatment, or without change of treatment at least 60 days after the initial prescription. Primary endpoints: comorbidity, healthcare resources used, and adverse events. The data was analysed using the SPSSWIN Program, with a significance of Pbladder had similar persistence with the treatment, lower healthcare costs, but with higher oxybutynin vs. mirabegron adverse reaction rates. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Radiation: cost or benefit?

    International Nuclear Information System (INIS)

    Crouch, D.

    1988-01-01

    In a previous issue of SCRAM it was argued that the apparent increased incidence of child leukaemia around nuclear power stations could have been caused by radioactive discharges into the environment. The National Radiological Protection Board (NRPB) claim that the known levels of contamination could not be responsible for the observed cancer rates. NRPB estimates of radiation risk are, however, considered to be underestimates. The NRPB is criticised for its study of the Sellafield workforce which excluded ex-employees and which revealed, when a statistical mistake was put right, a significant excess of myeloma amongst the Windscale workforce. The radiation protection philosophy of the NRPB is based on a cost benefit analysis which balances the cost of protection against the benefits of power generation. Criticism is made of NRPB, not only for ignoring long-term risks and costs but also for suggesting that some levels of radiation exposure are acceptable. The Board is also accused of not being independent of the nuclear industry. (UK)

  18. Benefits realisation in maternity information systems.

    Science.gov (United States)

    Betts, H J; Gunn-Russell, R

    1997-01-01

    This paper describes the compilation of a monograph on benefits realisation of maternity information systems from maternity services around England and Wales. It was compiled to compliment a monograph produced in June 1995 on Nursing Information Systems. The paper summarises the structure of the monograph and outlines the concept of benefits realisation. The examples featured in the monograph are not "true" benefits realisation studies and many of the accounts are anecdotal in nature. However, the paper suggests that midwives do benefit from using a maternity information system particularly in the areas of auditing practice, effortless retrieval of statistics, less duplication of data entry, summaries of care and research purposes. Managers also benefit from some of these functions and those relating to estimating workload and allocation of resources. It is suggested that any benefits for staff and management should also benefit clients and improve the provision of the maternity services.

  19. Benefit Transfer Studies: Myths, Pragmatism, and Idealism

    Science.gov (United States)

    Boyle, Kevin J.; Bergstrom, John C.

    1992-03-01

    Benefit transfer has been an ongoing, practical analysis for years in legal proceedings and government policy analyses where timely benefit estimates are critically dependent on the use of existing data. Most benefit transfer studies to date have been conducted behind closed doors and have not been open to scholarly review, and no systematic research agenda has been established to determine whether benefit transfer estimates are valid for public policy analyses. In this paper we propose a systematic, conceptual foundation for conducting benefit transfer studies, and suggest a research agenda to identify conditions under which valid benefit transfer estimates can be derived. We conclude, however, that this research agenda must be accompanied by improved conduct and reporting of original valuation studies before benefit transfer can become a widely used tool in public policy analyses.

  20. Observing participating observation

    DEFF Research Database (Denmark)

    Keiding, Tina Bering

    2011-01-01

    Current methodology concerning participating observation in general leaves the act of observation unobserved. Approaching participating observation from systems theory offers fundamental new insights into the topic. Observation is always participation. There is no way to escape becoming...

  1. Observing participating observation

    DEFF Research Database (Denmark)

    Keiding, Tina Bering

    2010-01-01

    Current methodology concerning participating observation in general leaves the act of observation unobserved. Approaching participating observation from systems theory offers fundamental new insights into the topic. Observation is always participation. There is no way to escape becoming...

  2. General practice variation in spirometry testing among patients receiving first-time prescriptions for medication targeting obstructive lung disease in Denmark: a population-based observational study.

    Science.gov (United States)

    Koefoed, Mette M; Søndergaard, Jens; Christensen, René dePont; Jarbøl, Dorte E

    2013-08-07

    Spirometry testing is essential to confirm an obstructive lung disease, but studies have reported that a large proportion of patients diagnosed with COPD or asthma have no history of spirometry testing. Also, it has been shown that many patients are prescribed medication for obstructive lung disease without a relevant diagnosis or spirometry test registered. General practice characteristics have been reported to influence diagnosis and management of several chronic diseases. However, these findings are inconsistent, and it is uncertain whether practice characteristics influence spirometry testing among patients receiving medication for obstructive lung disease. The aim of this study was therefore to examine if practice characteristics are associated with spirometry testing among patients receiving first-time prescriptions for medication targeting obstructive lung disease. A national register-based cohort study was performed. All patients over 18 years receiving first-time prescriptions for medication targeting obstructive lung disease in 2008 were identified and detailed patient-specific data on sociodemographic status and spirometry tests were extracted. Information on practice characteristics like number of doctors, number of patients per doctor, training practice status, as well as age and gender of the general practitioners was linked to each medication user. Partnership practices had a higher odds ratio (OR) of performing spirometry compared with single-handed practices (OR 1.24, CI 1.09-1.40). We found a significant association between increasing general practitioner age and decreasing spirometry testing. This tendency was most pronounced among partnership practices, where doctors over 65 years had the lowest odds of spirometry testing (OR 0.25, CI 0.10-0.61). Training practice status was significantly associated with spirometry testing among single-handed practices (OR 1.40, CI 1.10-1.79). Some of the variation in spirometry testing among patients receiving

  3. AWARENESS OF THE BENEFITS OF BREASTFEEDING AMONG ...

    African Journals Online (AJOL)

    FOBUR

    Breastfeeding is a cultural practice conferring important health and development benefits to. 1,2 children, families, communities and the nation. It is the fundamental component of the child-survival strategy. The Baby Friendly Hospital Initiative. (BFHI) was designed to support, protect and promote breastfeeding practices.

  4. Benefits of Exercise

    Science.gov (United States)

    ... activity into your life. To get the most benefit, you should try to get the recommended amount ... likely even live longer. What are the health benefits of exercise? Regular exercise and physical activity may ...

  5. Medicare Hospice Benefits

    Science.gov (United States)

    CENTERS for MEDICARE & MEDICAID SERVICES Medicare Hospice Benefits This official government booklet includes information about Medicare hospice benefits: Who’s eligible for hospice care What services are included in hospice care How ...

  6. Does audit and feedback improve the adoption of recommended practices? Evidence from a longitudinal observational study of an emerging clinical network in Kenya

    Science.gov (United States)

    Gachau, Susan; Ayieko, Philip; Gathara, David; Mwaniki, Paul; Ogero, Morris; Akech, Samuel; Maina, Michuki; Agweyu, Ambrose; Oliwa, Jacquie; Julius, Thomas; Malla, Lucas; Wafula, James; Mbevi, George; Irimu, Grace; English, Mike

    2017-01-01

    Background Audit and feedback (A&F) is widely used in healthcare but there are few examples of how to deploy it at scale in low-income countries. Establishing the Clinical Information Network (CIN) in Kenya provided an opportunity to examine the effect of A&F delivered as part of a wider set of activities to promote paediatric guideline adherence. Methods We analysed data collected from medical records on discharge for children aged 2–59 months from 14 Kenyan hospitals in the CIN. Hospitals joined CIN in phases and for each we analysed their initial 25 months of participation that occurred between December 2013 and March 2016. A total of 34 indicators of adherence to recommendations were selected for evaluation each classified by form of feedback (passive, active and none) and type of task (simple or difficult documentation and those requiring cognitive work). Performance change was explored graphically and using generalised linear mixed models with attention given to the effects of time and use of a standardised paediatric admission record (PAR) form. Results Data from 60 214 admissions were eligible for analysis. Adherence to recommendations across hospitals significantly improved for 24/34 indicators. Improvements were not obviously related to nature of feedback, may be related to task type and were related to PAR use in the case of documentation indicators. There was, however, marked variability in adoption and adherence to recommended practices across sites and indicators. Hospital-specific factors, low baseline performance and specific contextual changes appeared to influence the magnitude of change in specific cases. Conclusion Our observational data suggest some change in multiple indicators of adherence to recommendations (aspects of quality of care) can be achieved in low-resource hospitals using A&F and simple job aides in the context of a wider network approach. PMID:29104769

  7. Clinical Practice in the Use of Adjuvant Chemotherapy for Patients with Colon Cancer in South Korea: a Multi-Center, Prospective, Observational Study.

    Science.gov (United States)

    Kim, Jung Han; Baek, Moo Jun; Ahn, Byung-Kwon; Kim, Dae Dong; Kim, Ik Yong; Kim, Jin Soo; Bae, Byung-Noe; Seo, Bong-Gun; Jung, Sang Hun; Hong, Kwan Hee; Kim, Hungdai; Park, Dong Guk; Lee, Ji Hye

    2016-01-01

    Adjuvant chemotherapy is a crucial part of treatment for patients with locally advanced colon cancer. This study was conducted to investigate the actual practice in the use of adjuvant chemotherapy for patients with high-risk stage II or stage III colon cancer in South Korea. This was a 24-month open-label, prospective, observational study conducted at 12 centers across South Korea. Patients with high-risk stage II and stage III colon cancer receiving adjuvant chemotherapy after curative surgery were included, and data were collected at baseline, third, and sixth month. A total of 246 patients were included in the analyses. Of five available regimens (FOLFOX, CAPOX, 5-FU/LV, capecitabine, and UFT/LV), FOLFOX was most commonly used (82.5%). Investigators indicated the "efficacy" as the major cause for selecting FOLFOX or CAPOX. For 5-FU/LV, capecitabine, or UFT/LV, the "safety" or "patient's characteristics (age, comorbidity, and stage)" was one of the most important selecting factors. Patients receiving 5-FU/LV, capecitabine, or UFT/LV had older age, worse PS and lower disease stage (stage II) than patients receiving FOLFOX or CAPOX. Hematologic toxicities were the most common cause of dose adjustment and treatment delay. In South Korea, FOLFOX was the most commonly used regimen for adjuvant chemotherapy and its efficacy was the main cause for selecting this regimen. Patients receiving 5-FU/LV, capecitabine, or UFT/LV had older age, worse PS and lower disease stage (stage II) than patients receiving FOLFOX or CAPOX.

  8. An Observational Study to Assess Brain MRI Change and Disease Progression in Multiple Sclerosis Clinical Practice-The MS-MRIUS Study.

    Science.gov (United States)

    Zivadinov, Robert; Khan, Nasreen; Medin, Jennie; Christoffersen, Pia; Price, Jennifer; Korn, Jonathan R; Bonzani, Ian; Dwyer, Michael G; Bergsland, Niels; Carl, Ellen; Silva, Diego; Weinstock-Guttman, Bianca

    2017-05-01

    To describe methodology, interim baseline, and longitudinal magnetic resonance imaging (MRI) acquisition parameter characteristics of the multiple sclerosis clinical outcome and MRI in the United States (MS-MRIUS). The MS-MRIUS is an ongoing longitudinal and retrospective study of MS patients on fingolimod. Clinical and brain MRI image scan data were collected from 600 patients across 33 MS centers in the United States. MRI brain outcomes included change in whole-brain volume, lateral ventricle volume, T2- and T1-lesion volumes, and new/enlarging T2 and gadolinium-enhancing lesions. Interim baseline and longitudinal MRI acquisition parameters results are presented for 252 patients. Mean age was 44 years and 81% were female. Forty percent of scans had 3-dimensional (3D) T1 sequence in the preindex period, increasing to 50% in the postindex period. Use of 2-dimensional (2D) T1 sequence decreased over time from 85% in the preindex period to 65% in the postindex. About 95% of the scans with FLAIR and 2D T1-WI were considered acceptable or good quality compared to 99-100% with 3D T1-WI. There were notable changes in MRI hardware, software, and coil (39.5% in preindex to index and 50% in index to postindex). MRI sequence parameters (orientation, thickness, or protocol) differed for 36%, 29%, and 20% of index/postindex scans for FLAIR, 2D T1-WI, and 3D T1-WI, respectively. The MS-MRIUS study linked the clinical and brain MRI outcomes into an integrated database to create a cohort of fingolimod patients in real-world practice. Variability was observed in MRI acquisition protocols overtime. © 2016 The Authors. Journal of Neuroimaging published by Wiley Periodicals, Inc. on behalf of American Society of Neuroimaging.

  9. Effectiveness and safety of exenatide in Korean patients with type 2 diabetes inadequately controlled with oral hypoglycemic agents: an observational study in a real clinical practice.

    Science.gov (United States)

    Hwang, You-Cheol; Kim, Ari; Jo, Euna; Yang, Yeoree; Cho, Jae-Hyoung; Lee, Byung-Wan

    2017-10-25

    Randomized clinical trials have shown the efficacy and safety of short-acting exenatide in patients with type 2 diabetes mellitus (T2DM). The aim of this observational study was to investigate the effectiveness and safety of exenatide twice a day in Korean patients with T2DM who are suboptimally controlled with oral hypoglycemic agents. This study was a post hoc analysis of multi-center (71 centers), prospective, observational, single-arm, post-marketing study of short-acting exenatide 5 to 10 μg twice a day from March 2008 to March 2014 and analyzed those who finished the follow-up over 20 weeks of medication. Changes of hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), and body weight values before and after exenatide treatment were analyzed. Adverse events and adverse drug reactions were estimated in patients who were treated with exenatide at least once and for whom follow-up for safety has been completed. After 20 weeks treatment with exenatide, mean HbA1c and body weight were significantly reduced from 8.4% to 7.7% and from 83.4 kg to 80.2 kg, respectively (both p levels showed an independent association with a greater reduction in glucose level. In addition, short duration of diabetes less than 5 years was an independent predictor for the improvement in glucose level. The majority of study subjects showed a reduction in both body weight and glucose level (63.3%) after exenatide treatment. In terms of safety profile, exenatide treatment was generally well-tolerated and the incidence of severe adverse event was rare (0.8%). The gastrointestinal side effects were most common and hypoglycemia was reported in 1.7% of subjects. In real clinical practice, 20 weeks treatment with short-acting exenatide was well tolerated and showed a significant body weight and glucose reduction in Korean patients with T2D who are suboptimally controlled with oral hypoglycemic agents. ClinicalTirals.gov , number NCT02090673 , registered 14 February 2008.

  10. Analysis of benefits

    OpenAIRE

    Kováříková, Kamila

    2012-01-01

    This master thesis deals with employee benefits in the current labour market, especially from the perspective of young employees. The first part is focused on the theory of motivation and employee benefits also with their tax impact on employee's income. Employee benefits in the current labour market, employee's satisfaction and employer's attitude to this issue are analyzed in the second part of this thesis.

  11. Mirror neuron system and observational learning: behavioral and neurophysiological evidence.

    Science.gov (United States)

    Lago-Rodriguez, Angel; Lopez-Alonso, Virginia; Fernández-del-Olmo, Miguel

    2013-07-01

    Three experiments were performed to study observational learning using behavioral, perceptual, and neurophysiological data. Experiment 1 investigated whether observing an execution model, during physical practice of a transitive task that only presented one execution strategy, led to performance improvements compared with physical practice alone. Experiment 2 investigated whether performing an observational learning protocol improves subjects' action perception. In experiment 3 we evaluated whether the type of practice performed determined the activation of the Mirror Neuron System during action observation. Results showed that, compared with physical practice, observing an execution model during a task that only showed one execution strategy does not provide behavioral benefits. However, an observational learning protocol allows subjects to predict more precisely the outcome of the learned task. Finally, intersperse observation of an execution model with physical practice results in changes of primary motor cortex activity during the observation of the motor pattern previously practiced, whereas modulations in the connectivity between primary and non primary motor areas (PMv-M1; PPC-M1) were not affected by the practice protocol performed by the observer. Copyright © 2013 Elsevier B.V. All rights reserved.

  12. Observance of Sterilization Protocol Guideline Procedures of Critical Instruments for Preventing Iatrogenic Transmission of Creutzfeldt-Jakob Disease in Dental Practice in France, 2017

    Directory of Open Access Journals (Sweden)

    Denis Bourgeois

    2018-04-01

    Full Text Available Effective sterilization of reusable instruments contaminated by Creutzfeldt–Jakob disease in dental care is a crucial issue for public health. The present cross-sectional study investigated how the recommended procedures for sterilization were implemented by French dental practices in real-world settings. A sample of dental practices was selected in the French Rhône-Alpes region. Data were collected by a self-questionnaire in 2016. Sterilization procedures (n = 33 were classified into 4 groups: (1 Pre-sterilization cleaning of reusable instruments; (2 Biological verification of sterilization cycles—Monitoring steam sterilization procedures; (3 Autoclave performance and practitioner knowledge of autoclave use; (4 Monitoring and documentation of sterilization procedures—Tracking and tracing the instrumentation. Answers were provided per procedure, along with the global implementation of procedures within a group (over 80% correctly performed. Then it was verified how adherence to procedure groups varied with the size of the dental practice and the proportion of dental assistants within the team. Among the 179 questionnaires available for the analyses, adherence to the recommended procedures of sterilization noticeably varied between practices, from 20.7% to 82.6%. The median percentages of procedures correctly implemented per practice were 58.1%, 50.9%, 69.2% and 58.2%, in Groups 1, 2, 3 and 4, respectively (corresponding percentages for performing over 80% of the procedures in the group: 23.4%, 6.6%, 46.6% and 38.6%. Dental practices ≥ 3 dental units performed significantly better (>80% procedures of Groups 2 and 4 (p = 0.01 and p = 0.002, respectively, while no other significant associations emerged. As a rule, practices complied poorly with the recommended procedures, despite partially improved results in bigger practices. Specific training regarding sterilization procedures and a better understanding of the reasons leading to their

  13. Peer Observation as a Means to Develop Teachers’ Professionalism

    Directory of Open Access Journals (Sweden)

    Tosriadi -

    2018-03-01

    Full Text Available The emergence of reflective practice in promoting teacher professional development has been discussed in many literatures. Research studies showed the benefits of conducting reflective practice to improve teachers’ classroom instruction. Peer observation as one of the reflective practice activities is viewed as an effective strategy in developing teachers’ pedagogy and professional competences. Peer observation refers to the act of teachers collaborate to identify the strength and the weakness of their teachings. By doing so, it is expected there will be improvement in learning outcomes. This study explored EFL teachers’ perceptions on peer observation as means to develop teachers’ professionalism. Two EFL teachers who worked as English teachers were purposively selected as the respondents of the study. The participating teachers got at least 1 year teaching experience to assure their involvement in peer observation. To meet the objectives of the study, the data were gained through classroom observation, and followed by in depth interview. Then, they were analyzed by using interactive model data analysis for qualitative study. The results of the study indicated teachers’ positive perceptions on peer observation as professional development tool. Peer observation brought some benefits for teachers. It helped teachers solve the problems they found in their teachings, instead it also could be used as learning opportunity by observing new teaching method/strategy from other colleagues. Key words: reflective practice; peer observation; classroom instruction; professional development tool

  14. Transit Benefit Program Data -

    Data.gov (United States)

    Department of Transportation — This data set contains information about any US government agency participating in the transit benefits program, funding agreements, individual participating Federal...

  15. Observational astrophysics

    CERN Document Server

    Léna, Pierre; Lebrun, François; Mignard, François; Pelat, Didier

    2012-01-01

    This is the updated, widely revised, restructured and expanded third edition of Léna et al.'s successful work Observational Astrophysics. It presents a synthesis on tools and methods of observational astrophysics of the early 21st century. Written specifically for astrophysicists and graduate students, this textbook focuses on fundamental and sometimes practical limitations on the ultimate performance that an astronomical system may reach, rather than presenting particular systems in detail. In little more than a decade there has been extraordinary progress in imaging and detection technologies, in the fields of adaptive optics, optical interferometry, in the sub-millimetre waveband, observation of neutrinos, discovery of exoplanets, to name but a few examples. The work deals with ground-based and space-based astronomy and their respective fields. And it also presents the ambitious concepts behind space missions aimed for the next decades. Avoiding particulars, it covers the whole of the electromagnetic spec...

  16. IT benefits management in local government

    DEFF Research Database (Denmark)

    Nielsen, Kenneth Møller Porto; Nielsen, Peter Axel; Persson, John Stouby

    2012-01-01

    Information technology (IT) is increasingly presented as a driving force for service and efficiency improvement in local governments. However, achieving these goals in creating value from IT investments is a significant challenge for local government organizations. Practitioners and researchers...... have proposed numerous approaches to IT benefits management, but our knowledge of current practices and capabilities in local government IT management is still limited. Thus, in this paper we resent an investigation of what characterizes IT benefits management in local government in order to understand...... and improve current practices. Through a comparative case study of two Danish municipalities, we have analyzed the different characteristics of benefits management. Based on this analysis we propose an initial framework for understanding IT benefits management in local government....

  17. Practical guidelines for the registration and monitoring of serious traffic injuries, Deliverable 7.1 of the H2020 project SafetyCube (Safety CaUsation, Benefits and Efficiency).

    NARCIS (Netherlands)

    Pérez, K. Weijermars, W.A.M. Amoros, E. Bauer, R. Bos, N. Dupont, E. Filtness, A. Houwing, S. Johannsen, H. Leskovsek, B. Machata, K. Martin, JL. Nuyttens, N. Olabarria, M. Pascal, L. & Van den Berghe, W.

    2017-01-01

    Safety CaUsation, Benefits and Efficiency (SafetyCube) is a European Commission supported Horizon 2020 project. The project’s main objective is the development of an innovative road safety Decision Support System (DSS) that will enable policy-makers and stakeholders to select and implement the most

  18. Talking about psychosocial problems: an observational study on changes in doctor–patient communication in general practice between 1977 and 2008.

    NARCIS (Netherlands)

    Butalid, L.; Bensing, J.M.; Verhaak, P.F.M.

    2014-01-01

    Objective: To examine whether GPs’ communication styles have changed since the introduction and implementation of clinical guidelines for psychosocial problems in Dutch general practice in the 1990s. Methods: From a database of 5184 consultations videotaped between 1977 and 2008, 512 consultations

  19. PORTAAL: A Classroom Observation Tool Assessing Evidence-Based Teaching Practices for Active Learning in Large Science, Technology, Engineering, and Mathematics Classes

    Science.gov (United States)

    Eddy, Sarah L.; Converse, Mercedes; Wenderoth, Mary Pat

    2015-01-01

    There is extensive evidence that active learning works better than a completely passive lecture. Despite this evidence, adoption of these evidence-based teaching practices remains low. In this paper, we offer one tool to help faculty members implement active learning. This tool identifies 21 readily implemented elements that have been shown to…

  20. Unemployment Benefit Exhaustion

    DEFF Research Database (Denmark)

    Filges, Trine; Pico Geerdsen, Lars; Knudsen, Anne-Sofie Due

    2015-01-01

    This systematic review studied the impact of exhaustion of unemployment benefits on the exit rate out of unemployment and into employment prior to benefit exhaustion or shortly thereafter. Method: We followed Campbell Collaboration guidelines to prepare this review, and ultimately located 12...

  1. Putting Paid to Benefits

    NARCIS (Netherlands)

    Stella Hoff; Gerda Jehoel-Gijsbers; J.M. Wildeboer Schut

    2003-01-01

    Original title: De uitkering van de baan. A good deal of time, money and effort is invested in the reintegration of benefit claimants. What is the result? How many recipients of disability, unemployment or social assistance benefit are in principle capable of working but are currently not

  2. Nanocosmetics: benefits and risks

    OpenAIRE

    Shokri, Javad

    2017-01-01

    Summary Various nanomaterials/nanoparticles (NPs) have been used for the development of cosmetic products - a field so-called nanocosmetic formulations. These advanced materials offer some benefits, while their utilization in the cosmetic formulations may be associated with some risks. The main aim of this editorial is to highlight the benefits and risks of the nanomaterials used in the cosmetic products.

  3. Who Benefits from Religion?

    Science.gov (United States)

    Mochon, Daniel; Norton, Michael I.; Ariely, Dan

    2011-01-01

    Many studies have documented the benefits of religious involvement. Indeed, highly religious people tend to be healthier, live longer, and have higher levels of subjective well-being. While religious involvement offers clear benefits to many, in this paper we explore whether it may also be detrimental to some. Specifically, we examine in detail…

  4. Wellbeing or welfare benefits

    DEFF Research Database (Denmark)

    Handlos, Line Neerup; Kristiansen, Maria; Nørredam, Marie Louise

    2016-01-01

    This debate article debunks the myth that migrants are driven primarily by the size of the welfare benefits in the host country, when they decide where to migrate to. We show that instead of welfare benefits, migrants are driven by a desire for safety, wellbeing, social networks and opportunities...

  5. Analysis of employee benefits in a certain company

    OpenAIRE

    Valderová, Lenka

    2009-01-01

    The aim of this bachelor's thesismis to present motivation, the employee benefits and possibilities of providing them by the employer. Next there will follow analysis of the provided employee benefits in a chosen company. The analysis should reveal if the company applies theoretical knowledge in providing the employee benefits into practical life to meet its employees satisfaction.

  6. Discounting future health benefits: the poverty of consistency arguments.

    Science.gov (United States)

    Nord, Erik

    2011-01-01

    In economic evaluation of health care, main stream practice is to discount benefits at the same rate as costs. But main papers in which this practice is advocated have missed a distinction between two quite different evaluation problems: (1) How much does the time of program occurrence matter for value and (2) how much do delays in health benefits from programs implemented at a given time matter? The papers have furthermore focused on logical and arithmetic arguments rather than on real value considerations. These 'consistency arguments' are at best trivial, at worst logically flawed. At the end of the day, there is a sensible argument for equal discounting of costs and benefits rooted in microeconomic theory of rational, utility maximising consumers' saving behaviour. But even this argument is problematic, first because the model is not clearly supported by empirical observations of individuals' time preferences for health, second because it relates only to evaluation in terms of overall individual utility. It does not provide grounds for claiming that decision makers with a wider societal perspective, which may include concerns for fair distribution, need to discount Copyright © 2010 John Wiley & Sons, Ltd. 2010 John Wiley & Sons, Ltd.

  7. Setting a national minimum standard for health benefits: how do state benefit mandates compare with benefits in large-group plans?

    Science.gov (United States)

    Frey, Allison; Mika, Stephanie; Nuzum, Rachel; Schoen, Cathy

    2009-06-01

    Many proposed health insurance reforms would establish a federal minimum benefit standard--a baseline set of benefits to ensure that people have adequate coverage and financial protection when they purchase insurance. Currently, benefit mandates are set at the state level; these vary greatly across states and generally target specific areas rather than set an overall standard for what qualifies as health insurance. This issue brief considers what a broad federal minimum standard might look like by comparing existing state benefit mandates with the services and providers covered under the Federal Employees Health Benefits Program (FEHBP) Blue Cross and Blue Shield standard benefit package, an example of minimum creditable coverage that reflects current standard practice among employer-sponsored health plans. With few exceptions, benefits in the FEHBP standard option either meet or exceed those that state mandates require-indicating that a broad-based national benefit standard would include most existing state benefit mandates.

  8. Cost-Benefit Analyses of Transportation Investments

    DEFF Research Database (Denmark)

    Næss, Petter

    2006-01-01

    This paper discusses the practice of cost-benefit analyses of transportation infrastructure investment projects from the meta-theoretical perspective of critical realism. Such analyses are based on a number of untenable ontological assumptions about social value, human nature and the natural......-to-pay investigations. Accepting the ontological and epistemological assumptions of cost-benefit analysis involves an implicit acceptance of the ethical and political values favoured by these assumptions. Cost-benefit analyses of transportation investment projects tend to neglect long-term environmental consequences...

  9. Quantifying the costs and benefits of energy

    International Nuclear Information System (INIS)

    Lindell, B.

    1975-06-01

    A number of principles which have been developed for cost-benefit assessments in the radiation field are applied to the more general cost-benefit assessment of energy production. Sources of energy may be assessed in relation to a reference practice. If this is done for one and the same electricity production, the main objective is to assess detriments in comparable terms. Detriment rates may be integrated in space and time and might also be expressed in equivalent monetary units. Although there are several practical limitations to any theoretical treatment of the problem, the basic principles may form a useful background to more realistic although more complicated approaches to the task. (author)

  10. PORTAAL: A Classroom Observation Tool Assessing Evidence-Based Teaching Practices for Active Learning in Large Science, Technology, Engineering, and Mathematics Classes

    OpenAIRE

    Eddy, Sarah L.; Converse, Mercedes; Wenderoth, Mary Pat

    2015-01-01

    There is extensive evidence that active learning works better than a completely passive lecture. Despite this evidence, adoption of these evidence-based teaching practices remains low. In this paper, we offer one tool to help faculty members implement active learning. This tool identifies 21 readily implemented elements that have been shown to increase student outcomes related to achievement, logic development, or other relevant learning goals with college-age students. Thus, this tool both c...

  11. Workplace Interventions to Prevent Disability from Both the Scientific and Practice Perspectives: A Comparison of Scientific Literature, Grey Literature and Stakeholder Observations.

    Science.gov (United States)

    Williams-Whitt, Kelly; Bültmann, Ute; Amick, Benjamin; Munir, Fehmidah; Tveito, Torill H; Anema, Johannes R

    2016-12-01

    Purpose The significant individual and societal burden of work disability could be reduced if supportive workplace strategies could be added to evidence-based clinical treatment and rehabilitation to improve return-to-work (RTW) and other disability outcomes. The goal of this article is to summarize existing research on workplace interventions to prevent disability, relate these to employer disability management practices, and recommend future research priorities. Methods The authors participated in a year-long collaboration that ultimately led to an invited 3-day conference, Improving Research of Employer Practices to Prevent Disability, held October 14-16, 2015, in Hopkinton, Massachusetts, USA. The collaboration included a topical review of the literature, group conference calls to identify key areas and challenges, drafting of initial documents, review of industry publications, and a conference presentation that included feedback from peer researchers and a question/answer session with an expert panel with direct employer experience. Results Evidence from randomized trials and other research designs has shown general support for job modification, RTW coordination, and organizational support, but evidence is still lacking for interventions at a more granular level. Grey literature reports focused mainly on job re-design and work organization. Panel feedback focused on organizational readiness and the beliefs and values of senior managers as critical factors in facilitating changes to disability management practices. While the scientific literature is focused on facilitating improved coping and reducing discomforts for individual workers, the employer-directed grey literature is focused on making group-level changes to policies and procedures. Conclusions Future research might better target employer practices by tying interventions to positive workplace influences and determinants, by developing more participatory interventions and research designs, and by

  12. Gendered nursing education and practice in Iran.

    Science.gov (United States)

    Fooladi, Marjaneh M

    2003-01-01

    Through qualitative ethnographic methods, the researcher gendered nursing education and practice among human nursing students and faculty. Interaction with nursing students and faculty occurred in a familiar turf using the native language in interviews and on field observations. Settings included classrooms, skills laboratory, faculty offices, clinical areas, and informants' homes. Formal and informal interviews, observations, and printed materials provided useful data to reach consistent common patterns. Thematic analysis and triangulation of data identified gender variations in care and compassion, spirituality, economic motives, and practice preference. Integrated experiences of pre-Islamic period were used to describe the current developments of gendered nursing education and practice in the Islamic Republic of Iran. Study of gendered nursing education and practice brings attention to the cultural significance of gender issues. This body of knowledge will benefit American nurses and educators by increasing their cultural understanding of gender.

  13. Analysis of the employee Benefits in Specific Organization

    OpenAIRE

    Procházková, Petra

    2011-01-01

    The main subject of my Bachelor's Thesis called "Analysis of employee Benefits in Specific Organization" is to analyze system of employee benefits used in company RWE Transgas, a. s. in 2010. Theoretical part will specify basic terms in general, which are important to cope with this issue. There will be especially importance, division, risks and trends in benefits. In practical part the analysis of employee benefits in specific joint-stock company is made. Part of this analysis is survey done...

  14. Contraceptives with novel benefits.

    Science.gov (United States)

    Su, Ying; Lian, Qing-Quan; Ge, Ren-Shan

    2012-01-01

    Progesterone receptor (PR) agonists (progestins) and antagonists are developed for female contraceptives. However, non-contraceptive applications of newer progestins and PR modulators are being given more attention. The newer PR agonists including drospirenone, nomegestrol, trimegestone, dienogest and nestorone are being evaluated as contraceptives with health benefits because of their unique pharmacological properties. The selective PR modulators (SPRM; PR antagonists with PR agonistic properties) are under development not only for emergency contraception but also for other health benefits such as the treatment of endometritis and leiomyoma. After searching the literature from PubMed, clinicaltrials.gov and patent database, this review focuses on the effects and mechanisms of these progestins, and SPRMs as contraceptives with other health benefits. PR agonists and antagonists that have novel properties may generate better contraceptive effects with other health benefits.

  15. Benefits of being biased!

    Indian Academy of Sciences (India)

    Administrator

    Journal of Genetics, Vol. 83, No. 2, August 2004. Keywords. codon bias; alcohol dehydrogenase; Darwinian ... RESEARCH COMMENTARY. Benefits of being biased! SUTIRTH DEY*. Evolutionary Biology Laboratory, Evolutionary & Organismal Biology Unit,. Jawaharlal Nehru Centre for Advanced Scientific Research,.

  16. Benefits of CHP Partnership

    Science.gov (United States)

    Learn about the benefits of being a EPA CHP Partner, which include expert advice and answers to questions, CHP news, marketing resources, publicity and recognition, and being associated with EPA through a demonstrated commitment to CHP.

  17. Low Cost Benefit Suggestions.

    Science.gov (United States)

    Doyel, Hoyt W.; McMillan, John D.

    1980-01-01

    Outlines eight low-cost employee benefits and summarizes their relative advantages. The eight include a stock ownership program, a sick leave pool, flexible working hours, production incentives, and group purchase plans. (IRT)

  18. An analytic observational study on complaints management in the general practice out of hours care setting: who complains, why, and what can we do about it?

    LENUS (Irish Health Repository)

    Barragry, Ruth A

    2016-01-01

    General Practice Co-Operatives provide most out of hours care in communities in Ireland. Limited data exists on patient complaints. This study reports on complaints at Kildare and West Wicklow Doctors on Call (\\'K Doc\\'), a GP Co-Operative in Ireland, examining the impact of a formal risk reduction strategy implemented (2010-2013). The aim of the study was to determine if it was possible to reduce the rate of written complaints per 1000 consultations through a formal approach encompassing evaluation of complaints, improved communication in relation to complaints, and more direct use of insights gained from complaints analysis in continuing professional development at the Co-Operative.

  19. Benefits for handicapped children

    CERN Multimedia

    2003-01-01

    The introduction of long-term care benefits within the CERN Health Insurance Scheme requires the coordination of the benefits foreseen for handicapped children. Measures were adopted by the Management following the recommendation made by the Standing Concertation Committee on 26 March 2003. A document clarifying these measures is available on the Web at the following address: http://humanresources.web.cern.ch/humanresources/external/soc/Social_affairs/social_affairs.asp Social Affairs Service 74201

  20. Health benefits of Kung Fu: a systematic review.

    Science.gov (United States)

    Tsang, Tracey Wai Man; Kohn, Michael; Chow, Chin Moi; Singh, Maria Fiatarone

    2008-10-01

    The Chinese martial arts (Kung Fu) have existed for centuries and are generally accepted as being beneficial for health without much empirical data. The aim of this systematic review was to assess the health effects of "hard" Kung Fu styles by performing electronic and manual searches of the literature. The aspects of health and the Kung Fu style examined varied between most studies; in some cases, the martial art group consisted of practitioners of other martial art styles also. Of 2103 references identified, only nine papers were eligible and reviewed. All were observational studies, observing a range of health aspects possibly related to Kung Fu training or performance. Our findings suggest that there is no evidence that Kung Fu practice is associated with the prevention or treatment of any health condition. However, as a moderate- to high-intensity form of aerobic exercise, it may confer benefits similar to those attributed to other aerobic training modalities. However, this hypothesis remains to be tested in clinical trials. Physiological benefits (e.g., aerobic capacity and bone density) may be associated with long-term Kung Fu practice. Future research in this area should adopt experimental designs, clearly identifying eligibility criteria, testing and training protocols, and include health-related outcomes and documentation of adverse events, to advance knowledge in this field.

  1. Associations of Mother's and Father's Parenting Practices with Children's Observed Social Reticence in a Competitive Situation: A Monozygotic Twin Difference Study

    Science.gov (United States)

    Guimond, Fanny-Alexandra; Brendgen, Mara; Forget-Dubois, Nadine; Dionne, Ginette; Vitaro, Frank; Tremblay, Richard E.; Boivin, Michel

    2012-01-01

    This study used the monozygotic (MZ) twin difference method to examine whether the unique environmental effects of maternal and paternal overprotection and hostility at the age of 30 months predict twins' observed social reticence in a competitive situation in kindergarten, while controlling for the effect of family-wide influences, including…

  2. Impact of omalizumab on treatment of severe allergic asthma in UK clinical practice: a UK multicentre observational study (the APEX II study).

    Science.gov (United States)

    Niven, Robert M; Saralaya, Dinesh; Chaudhuri, Rekha; Masoli, Matthew; Clifton, Ian; Mansur, Adel H; Hacking, Victoria; McLain-Smith, Susan; Menzies-Gow, Andrew

    2016-08-09

    To describe the impact of omalizumab on asthma management in patients treated as part of normal clinical practice in the UK National Health Service (NHS). A non-interventional, mixed methodology study, combining retrospective and prospective data collection for 12 months pre-omalizumab and post-omalizumab initiation, respectively. Data were collected in 22 UK NHS centres, including specialist centres and district general hospitals in the UK. 258 adult patients (aged ≥16 years; 65% women) with severe persistent allergic asthma treated with omalizumab were recruited, of whom 218 (84.5%) completed the study. The primary outcome measure was change in mean daily dose of oral corticosteroids (OCS) between the 12-month pre-omalizumab and post-omalizumab initiation periods. A priori secondary outcome measures included response to treatment, changes in OCS dosing, asthma exacerbations, lung function, employment/education, patient-reported outcomes and hospital resource utilisation. The response rate to omalizumab at 16 weeks was 82.4%. Comparing pre-omalizumab and post-omalizumab periods, the mean (95% CIs) daily dose of OCS decreased by 1.61 (-2.41 to -0.80) mg/patient/day (pomalizumab period. The mean number of A&E visits, inpatient hospitalisations, outpatient visits (excluding for omalizumab) and number of bed days/patient decreased significantly (pomalizumab period. These data support the beneficial effects of omalizumab on asthma-related outcomes, quality of life and resource utilisation in unselected patients treated in 'real-world' clinical practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  3. Exploring Pair Programming Benefits for MIS Majors

    Science.gov (United States)

    Dongo, Tendai; Reed, April H.; O'Hara, Margaret

    2016-01-01

    Pair programming is a collaborative programming practice that places participants in dyads, working in tandem at one computer to complete programming assignments. Pair programming studies with Computer Science (CS) and Software Engineering (SE) majors have identified benefits such as technical productivity, program/design quality, academic…

  4. Homework in Physical Education: Benefits and Implementation

    Science.gov (United States)

    Novak, Benjamin Edward; Lynott, Francis John, III.

    2015-01-01

    This article identifies homework as an underutilized strategy in physical education. It reviews the benefits associated with the use of homework in the physical education setting, and provides guidelines for the effective implementation of this strategy. The guidelines include practical application examples and define structured active homework…

  5. Benefits negotiation: three Swedish hospitals pursuit of potential electronic health record benefits.

    Science.gov (United States)

    Jeansson, John S

    2013-01-01

    At the very heart of Swedish healthcare digitalisation are large investments in electronic health records (EHRs). These integrated information systems (ISs) carry promises of great benefits and value for organisations. However, realising IS benefits and value has, in general, proven to be a challenging task, and as organisations strive to formalise their realisation efforts a misconception of rationality threatens to emerge. This misconception manifests itself when the formality of analysis threatens to underrate the impact of social processes in deciding which potential benefits to pursue. This paper suggests that these decisions are the result of a social process of negotiation. The purpose of this paper is to observe three benefits analysis projects of three Swedish hospitals to better understand the character and management of proposed benefits negotiations. Findings depict several different categories of benefits negotiations, as well as key factors to consider during the benefits negotiation process.

  6. Deserving social benefits?

    DEFF Research Database (Denmark)

    Esmark, Anders; Richardt Schoop, Sarah

    2017-01-01

    welfare reforms involving reductions of social benefits in Denmark in 2005 and 2013, the article analyses the frames used by politicians supporting and opposing reform, as well as the frames used by the media. The article shows, first, that political reforms reducing social benefits are followed...... by increased framing of recipients as undeserving. The article finds a strong correlation between the political objective of reducing benefits and the reliance on frames that position recipients as undeserving. Second, the article shows that media framing remains significantly different from political framing......The article contributes to the growing literature on framing of deservingness as an alternative to ‘blame avoidance’ strategies in the politics of welfare retrenchment. In particular, the article focuses on the interplay between political framing and media framing. Based on an analysis of two major...

  7. Value of Earth Observation for Risk Mitigation

    Science.gov (United States)

    Pearlman, F.; Shapiro, C. D.; Grasso, M.; Pearlman, J.; Adkins, J. E.; Pindilli, E.; Geppi, D.

    2017-12-01

    Societal benefits flowing from Earth observation are intuitively obvious as we use the information to assess natural hazards (such as storm tracks), water resources (such as flooding and droughts in coastal and riverine systems), ecosystem vitality and other dynamics that impact the health and economic well being of our population. The most powerful confirmation of these benefits would come from quantifying the impact and showing direct quantitative links in the value chain from data to decisions. However, our ability to identify and quantify those benefits is challenging. The impact of geospatial data on these types of decisions is not well characterized and assigning a true value to the observations on a broad scale across disciplines still remains to be done in a systematic way. This presentation provides the outcomes of a workshop held in October 2017 as a side event of the GEO Plenary that addressed research on economic methodologies for quantification of impacts. To achieve practical outputs during the meeting, the workshop focused on the use and value of Earth observations in risk mitigation including: ecosystem impacts, weather events, and other natural and manmade hazards. Case studies on approaches were discussed and will be part of this presentation. The presentation will also include the exchange of lessons learned and a discussion of gaps in the current understanding of the use and value of earth observation information for risk mitigation.

  8. Acknowledging and Accounting for Employee Benefits

    Directory of Open Access Journals (Sweden)

    Florentina MOISESCU

    2009-01-01

    Full Text Available Employee benefits are all forms of counter services granted by anentity in return to services given by the employees. This category includes onlythe benefits covered by the entity, not those from the state or the employee onthe payroll. The employer counting and presenting all the benefits of theemployees, including those provided on the basis of official programs or otherofficial contracts between the entity and the individual employees, groups ofemployees or their representatives, those established on the basis of legalprovisions or by contracts at the level of activity sector, through which theentities are required to contribute to national programs, as well as thoseresulting from unofficial practices give rise to an implicit obligation.Acknowledging and especially assessing these benefits are issues demandingspecial attention.

  9. Measuring the value of nonwage employee benefits: building a model of the relation between benefit satisfaction and value.

    Science.gov (United States)

    Weathington, Bart L; Jones, Allan P

    2006-11-01

    Researchers have commonly assumed benefits that employees view as more valuable have a greater influence on their attitudes and behaviors. Researchers have used 2 common methods to measure benefit value: attaching a monetary value to benefits and using self-reports of benefit importance. The present authors propose that the 2 approaches are conceptually distinct and have different implications. They use a social exchange perspective to justify this distinction and integrate both approaches and benefit satisfaction into a more comprehensive model of benefit perception. Results suggest that both measures have practical applications depending on the nature of the exchange relationship between the organization and employees. However, this relationship depends on the specific benefit and on employee satisfaction with that benefit. Some benefits lend themselves to a monetary estimate, whereas others lend themselves more to a nonmonetary valuation.

  10. BenefitClaimWebServiceBean/BenefitClaimWebService

    Data.gov (United States)

    Department of Veterans Affairs — A formal or informal request for a type of monetary or non-monetary benefit. This service provides benefit claims and benefit claim special issues data, allows the...

  11. Air and noise pollution lower than the legal minimum. What are the benefits?; Lucht en geluid beter dan het wettelijk minimum. Wat levert het op?

    Energy Technology Data Exchange (ETDEWEB)

    Donners, P.W.H.J.; Kok, A.; Op den Camp, C. [DGMR, Arnhem (Netherlands)

    2011-08-15

    Inclusion of health effects in large infrastructure projects and urban developments can result in benefits for health and a wider support. To find out if these benefits can be observed in practice, three standard situations were examined. [Dutch] Het meenemen van gezondheidseffecten bij grote infrastructurele projecten en stedenbouwkundige ontwikkelingen kan gezondheidswinst en groter draagvlak opleveren. Om na te gaan of de voordelen in de praktijk zijn terug te vinden, zijn drie standaardsituaties onderzocht.

  12. Valuing the Environmental Benefits of Urban WaterConservation

    Energy Technology Data Exchange (ETDEWEB)

    Coughlin, Katie M.; Bolduc, Chris A.; Chan, Peter T.; Dunham-Whitehead, C.; Van Buskirk, R.D.

    2007-05-01

    This report documents a project undertaken for theCalifornia Urban Water Conservation Council (the Council) to create a newmethod of accounting for the diverse environmental benefits of raw watersavings. The environmental benefits (EB) model was designed to providewater utilities with a practical tool that they can use to assign amonetary value to the benefits that may accrue from implementing any ofthe Council-recommended Best Management Practices. The model treats onlyenvironmental services associated directly with water, and is intended tocover miscellaneous impacts that are not currently accounted for in anyother cost-benefit analysis.

  13. The health benefits of wine.

    Science.gov (United States)

    German, J B; Walzem, R L

    2000-01-01

    Epidemiologic studies from numerous disparate populations reveal that individuals with the habit of daily moderate wine consumption enjoy significant reductions in all-cause and particularly cardiovascular mortality when compared with individuals who abstain or who drink alcohol to excess. Researchers are working to explain this observation in molecular and nutritional terms. Moderate ethanol intake from any type of beverage improves lipoprotein metabolism and lowers cardiovascular mortality risk. The question now is whether wine, particularly red wine with its abundant content of phenolic acids and polyphenols, confers additional health benefits. Discovering the nutritional properties of wine is a challenging task, which requires that the biological actions and bioavailability of the >200 individual phenolic compounds be documented and interpreted within the societal factors that stratify wine consumption and the myriad effects of alcohol alone. Further challenge arises because the health benefits of wine address the prevention of slowly developing diseases for which validated biomarkers are rare. Thus, although the benefits of the polyphenols from fruits and vegetables are increasingly accepted, consensus on wine is developing more slowly. Scientific research has demonstrated that the molecules present in grapes and in wine alter cellular metabolism and signaling, which is consistent mechanistically with reducing arterial disease. Future research must address specific mechanisms both of alcohol and of polyphenolic action and develop biomarkers of their role in disease prevention in individuals.

  14. Parent-reported and clinician-observed autism spectrum disorder (ASD) symptoms in children with attention deficit/hyperactivity disorder (ADHD): implications for practice under DSM-5.

    Science.gov (United States)

    Grzadzinski, Rebecca; Dick, Catherine; Lord, Catherine; Bishop, Somer

    2016-01-01

    Children with attention deficit/hyperactivity disorder (ADHD) often present with social difficulties, though the extent to which these clearly overlap with symptoms of autism spectrum disorder (ASD) is not well understood. We explored parent-reported and directly-observed ASD symptoms on the Autism Diagnostic Interview-Revised (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS) in children referred to ASD-specialty clinics who received diagnoses of either ADHD (n = 48) or ASD (n = 164). Of the ADHD sample, 21 % met ASD cut-offs on the ADOS and 30 % met ASD cut-offs on all domains of the ADI-R. Four social communication ADOS items (Quality of Social Overtures, Unusual Eye Contact, Facial Expressions Directed to Examiner, and Amount of Reciprocal Social Communication) adequately differentiated the groups while none of the items on the ADI-R met the criteria for adequate discrimination. Results of this work highlight the challenges that clinicians and researchers face when distinguishing ASD from other disorders in verbally fluent, school-age children.

  15. The benefit of sustainable industrial cooperation. Study on the economical and ecological benefits of industrial cooperatives

    International Nuclear Information System (INIS)

    Hansen, D.H.J.M.; Lavrijsen, T.; Vermeulen, W.J.V.

    2005-01-01

    From scientific literature and policy memoranda it appears that sustainable industrial cooperatives result into economical and ecological benefits. However, little empirical data on practical results is available. Therefore, recently, an analysis has been carried out determining the benefit of industrial cooperation. The economical and ecological offer businesses a cost-effective option to reduce the environmental burden. Still, real implementation of such cooperatives is only realized yet by forerunners in the field of environmental management [nl

  16. Long-Term Distribution Patterns of Chlorophyll-a Concentration in China’s Largest Freshwater Lake: MERIS Full-Resolution Observations with a Practical Approach

    Directory of Open Access Journals (Sweden)

    Lian Feng

    2014-12-01

    Full Text Available A new empirical Chl-a algorithm has been developed and validated for the largest freshwater lake of China (Poyang Lake using a normalized green-red difference index (NGRDI, where the uncertainty was estimated to be <45% for Chl-a ranging between 1.3 and 10.5 mg·m−3. The combined approach of using the NGRDI algorithm and atmospherically-corrected Medium Resolution Imaging Spectrometer (MERIS data showed an advantage over other popular approaches. The algorithm was then applied to 325 carefully-selected MERIS full-resolution (300-m scenes between 2003 and 2012, with pixels of extreme turbidity (NGRDI < 0.06, corresponding to >~25 mg·L−1 total suspended sediments or TSS masked. The long-term Chl-a distribution showed significant spatial gradient and temporal variability, with Chl-a ranging between 2.4 ± 0.2 mg·m−3 in April and 4.4 ± 1.0 mg·m−3 in July and no significant increasing or decreasing trend during the 10-year period. In waters where Chl-a was retrievable (i.e., where TSS is <25 mg·L−1, Chl-a concentration indicated a significant negative correlation with TSS concentration on a seasonal scale and a significant positive correlation with precipitation over the years. Potential eutrophic regions in the southern and eastern lake, thought to be results of limited water exchange with the main lake, were delineated based on the occurrence frequency of high Chl-a (>10 mg·m−3 in summer. The study not only provides, for the first time, synoptic baseline information on the lake’s Chl-a distributions and potential eutrophic regions, but also demonstrates a practical approach that might be extended to assess eutrophication conditions in other inland waters.

  17. Why the Effect of Tax Is Insufficient in Narrowing Income Gap in China? A Theoretical Analysis Framework and A Practical Observation

    Institute of Scientific and Technical Information of China (English)

    PAN Wen-xuan

    2014-01-01

    In recent years,the problem of income gap in China is rather severe.However,the effect of tax policy on narrowing income gap is not satisfactory,which reveals inadequate ability of the tax system in narrowing income gap.In accordance with the present situation of current tax system and tax collection administration,this paper constructs a theoretical framework consisting of the three integrated elements,namely,design of tax categories,tax system structure and tax administration,to make a theoretical analysis and practical study on the reasons of inadequate ability of the current tax system in narrowing income gap.The results of the study show that there exist some defects in the design of tax categories,such as consumption tax,personal income tax,property tax,and so on,which result in the weakening of the micro ability of tax in narrowing income gap.The dual imbalance in the structures of tax system and tax categories results in the weakening of the structural ability of taxes in narrowing income gap.The incompleteness in tax administration,especially the frail of the direct tax collection system,results in the weakening of the tax collection ability of taxes in narrowing income gap.Therefore,in order that tax policy can give full play to its role in narrowing income gap,efforts ought to be made to improve the micro ability,structural ability and collection ability of taxes in narrowing income gap through the improvement of the design of tax categories,the adjustment of the tax system structure and the enhancement of the tax collection administration.

  18. Cost of assessing a child for possible autism spectrum disorder? An observational study of current practice in child development centres in the UK.

    Science.gov (United States)

    Galliver, Mark; Gowling, Emma; Farr, William; Gain, Aaron; Male, Ian

    2017-01-01

    UK guidelines recommend that diagnosis of autism in children requires assessment by a multidisciplinary team. With growing numbers of referrals for assessment, diagnostic services have been under increasing pressure to meet the level of need. This study aimed to explore the number of hours of professional time required to complete such an assessment based on current practice in secondary care child development centres across the UK, and from this we calculate the cost of assessment. An online questionnaire, using SurveyMonkey.com, was sent to 20 child development centres asking them to retrospectively record team members involved at each stage of assessment and time taken, including report writing and administration for a typical assessment. Costs were estimated based on the hourly rate for each team member, including salary, on-costs and trust overheads. 12 questionnaires (60%) were returned. 10 centres adopted a two-stage approach to assessment with an initial 'screening' clinic determining whether the child needed to proceed to full multidisciplinary assessment. Median professional time involved was 13 hours (IQR 9.6-15.5 hours). This resulted in a median cost of £809 ($1213, based on conversion rate £1 equal to US$1.5 (November 2015)), (IQR £684-£925) ($1026-$1388)). This study confirms that multidisciplinary diagnostic assessment of a child with possible autism requires significant professional time, with staff costs of approximately £800 ($1200) per child. This does not include costs of intervention, parent psychological education, investigation and assessment and management of comorbidities. If growing waiting times for diagnostic assessment are to be avoided, funding for diagnostic services needs to reflect the human resources required and the resulting costs of that assessment.

  19. PENSION FUND BENEFITS SERVICE

    CERN Multimedia

    Benefits Service

    2002-01-01

    Please note that from now on, our offices (5-1-030) will be opened to members and beneficiaries on Tuesday, Wednesday and Thursday from 10 to 12 a.m. and from 3 to 5 p.m. We are otherwise available but by appointment only. Benefits Service (tel. 79194 / 72738)

  20. PENSION FUND BENEFITS SERVICE

    CERN Multimedia

    Benefits Service

    2002-01-01

    Please note that from now on, our offices will be opened to members and beneficiaries on Tuesday, Wednesday and Thursday from 10 to 12 a.m. and from 3 to 5 p.m. We are otherwise available but by appointment only. Benefits Service 5-1-030 tel. 79194 / 72738

  1. Bayesian benefits with JASP

    NARCIS (Netherlands)

    Marsman, M.; Wagenmakers, E.-J.

    2017-01-01

    We illustrate the Bayesian approach to data analysis using the newly developed statistical software program JASP. With JASP, researchers are able to take advantage of the benefits that the Bayesian framework has to offer in terms of parameter estimation and hypothesis testing. The Bayesian

  2. Studies Highlight Biodiesel's Benefits

    Science.gov (United States)

    , Colo., July 6, 1998 — Two new studies highlight the benefits of biodiesel in reducing overall air Energy's National Renewable Energy Laboratory (NREL) conducted both studies: An Overview of Biodiesel and Petroleum Diesel Life Cycles and Biodiesel Research Progress, 1992-1997. Biodiesel is a renewable diesel

  3. Your Medicare Benefits

    Science.gov (United States)

    ... schedule a lung cancer screening counseling and shared decision making visit with your doctor to discuss the benefits ... when they’re available in your MyMedicare.gov account. 58 Section 3: For more information Visit Medicare. gov for general information about Medicare ...

  4. Exploring Pair Programming Benefits for MIS Majors

    Directory of Open Access Journals (Sweden)

    April H. Reed

    2016-12-01

    Full Text Available Pair programming is a collaborative programming practice that places participants in dyads, working in tandem at one computer to complete programming assignments. Pair programming studies with Computer Science (CS and Software Engineering (SE majors have identified benefits such as technical productivity, program/design quality, academic performance, and increased satisfaction for their participants. In this paper, pair programming is studied with Management Information Systems (MIS majors, who (unlike CS and SE majors taking several programming courses typically take only one programming course and often struggle to develop advanced programming skills within that single course. The researchers conducted two pair programming experiments in an introductory software development course for MIS majors over three semesters to determine if pair programming could enhance learning for MIS students. The program results, researchers’ direct observations, and participants’ responses to a survey questionnaire were analyzed after each experiment. The results indicate that pair programming appears to be beneficial to MIS students’ technical productivity and program design quality, specifically the ability to create programs using high-level concepts. Additionally, results confirmed increased student satisfaction and reduced frustration, as the pairs worked collaboratively to produce a program while actively communicating and enjoying the process.

  5. Influence of learning styles on the practical performance after the four-step basic life support training approach - An observational cohort study.

    Directory of Open Access Journals (Sweden)

    Hanna Schröder

    Full Text Available Learning and training basic life support (BLS-especially external chest compressions (ECC within the BLS-algorithm-are essential resuscitation training for laypersons as well as for health care professionals. The objective of this study was to evaluate the influence of learning styles on the performance of BLS and to identify whether all types of learners are sufficiently addressed by Peyton's four-step approach for BLS training.A study group of first-year medical students (n = 334 without previous medical knowledge was categorized according to learning styles using the German Lernstilinventar questionnaire based on Kolb's Learning Styles Inventory. Students' BLS performances were assessed before and after a four-step BLS training approach lasting 4 hours. Standardized BLS training was provided by an educational staff consisting of European Resuscitation Council-certified advanced life support providers and instructors. Pre- and post-intervention BLS performance was evaluated using a single-rescuer-scenario and standardized questionnaires (6-point-Likert-scales: 1 = completely agree, 6 = completely disagree. The recorded points of measurement were the time to start, depth, and frequency of ECC.The study population was categorized according to learning styles: diverging (5%, n = 16, assimilating (36%, n = 121, converging (41%, n = 138, and accommodating (18%, n = 59. Independent of learning styles, both male and female participants showed significant improvement in cardiopulmonary resuscitation (CPR performance. Based on the Kolb learning styles, no significant differences between the four groups were observed in compression depth, frequency, time to start CPR, or the checklist-based assessment within the baseline assessment. A significant sex effect on the difference between pre- and post-interventional assessment points was observed for mean compression depth and mean compression frequency.The findings of this work show that the four

  6. Influence of learning styles on the practical performance after the four-step basic life support training approach - An observational cohort study.

    Science.gov (United States)

    Schröder, Hanna; Henke, Alexandra; Stieger, Lina; Beckers, Stefan; Biermann, Henning; Rossaint, Rolf; Sopka, Saša

    2017-01-01

    Learning and training basic life support (BLS)-especially external chest compressions (ECC) within the BLS-algorithm-are essential resuscitation training for laypersons as well as for health care professionals. The objective of this study was to evaluate the influence of learning styles on the performance of BLS and to identify whether all types of learners are sufficiently addressed by Peyton's four-step approach for BLS training. A study group of first-year medical students (n = 334) without previous medical knowledge was categorized according to learning styles using the German Lernstilinventar questionnaire based on Kolb's Learning Styles Inventory. Students' BLS performances were assessed before and after a four-step BLS training approach lasting 4 hours. Standardized BLS training was provided by an educational staff consisting of European Resuscitation Council-certified advanced life support providers and instructors. Pre- and post-intervention BLS performance was evaluated using a single-rescuer-scenario and standardized questionnaires (6-point-Likert-scales: 1 = completely agree, 6 = completely disagree). The recorded points of measurement were the time to start, depth, and frequency of ECC. The study population was categorized according to learning styles: diverging (5%, n = 16), assimilating (36%, n = 121), converging (41%, n = 138), and accommodating (18%, n = 59). Independent of learning styles, both male and female participants showed significant improvement in cardiopulmonary resuscitation (CPR) performance. Based on the Kolb learning styles, no significant differences between the four groups were observed in compression depth, frequency, time to start CPR, or the checklist-based assessment within the baseline assessment. A significant sex effect on the difference between pre- and post-interventional assessment points was observed for mean compression depth and mean compression frequency. The findings of this work show that the four-step-approach for

  7. Influence of learning styles on the practical performance after the four-step basic life support training approach – An observational cohort study

    Science.gov (United States)

    Henke, Alexandra; Stieger, Lina; Beckers, Stefan; Biermann, Henning; Rossaint, Rolf; Sopka, Saša

    2017-01-01

    Background Learning and training basic life support (BLS)—especially external chest compressions (ECC) within the BLS-algorithm—are essential resuscitation training for laypersons as well as for health care professionals. The objective of this study was to evaluate the influence of learning styles on the performance of BLS and to identify whether all types of learners are sufficiently addressed by Peyton’s four-step approach for BLS training. Methods A study group of first-year medical students (n = 334) without previous medical knowledge was categorized according to learning styles using the German Lernstilinventar questionnaire based on Kolb’s Learning Styles Inventory. Students’ BLS performances were assessed before and after a four-step BLS training approach lasting 4 hours. Standardized BLS training was provided by an educational staff consisting of European Resuscitation Council-certified advanced life support providers and instructors. Pre- and post-intervention BLS performance was evaluated using a single-rescuer-scenario and standardized questionnaires (6-point-Likert-scales: 1 = completely agree, 6 = completely disagree). The recorded points of measurement were the time to start, depth, and frequency of ECC. Results The study population was categorized according to learning styles: diverging (5%, n = 16), assimilating (36%, n = 121), converging (41%, n = 138), and accommodating (18%, n = 59). Independent of learning styles, both male and female participants showed significant improvement in cardiopulmonary resuscitation (CPR) performance. Based on the Kolb learning styles, no significant differences between the four groups were observed in compression depth, frequency, time to start CPR, or the checklist-based assessment within the baseline assessment. A significant sex effect on the difference between pre- and post-interventional assessment points was observed for mean compression depth and mean compression frequency. Conclusions The findings

  8. Projected benefits of actinide partitioning

    International Nuclear Information System (INIS)

    Braun, C.; Goldstein, M.

    1976-05-01

    Possible benefits that could accrue from actinide separation and transmutations are presented. The time frame for implementing these processes is discussed and the expected benefits are qualitatively described. These benefits are provisionally quantified in a sample computation

  9. Social Security and Medicare Benefits

    Data.gov (United States)

    Social Security Administration — Cash benefits and rehabilitation benefits paid in each year from the Old-Age and Survivors Insurance, and Disability Insurance Trust Funds, and benefits paid from...

  10. Observation On The Rates, Benefits And Complications Of ...

    African Journals Online (AJOL)

    Outcome measures were 2nd stage duration, birth weight, Apgar score, perineal tear, perineal pain, dyspareunia and incontinence in the pueperium. There were 1,404 vaginal deliveries and 34.5% of them had episiotomy. Episiotomy was more frequent in nulliparous (65.7%) than multiparous (17.4%) women.

  11. Estimating the Economic Benefits of Regional Ocean Observing Systems

    National Research Council Canada - National Science Library

    Kite-Powell, Hauke L; Colgan, Charles S; Wellman, Katharine F; Pelsoci, Thomas; Wieand, Kenneth; Pendleton, Linwood; Kaiser, Mark J; Pulsipher, Allan G; Luger, Michael

    2005-01-01

    ... range of industrial and recreational activities including recreational fishing and boating, beach recreation, maritime transportation, search and rescue operations, spill response, marine hazards...

  12. Practical Bias Correction in Aerial Surveys of Large Mammals: Validation of Hybrid Double-Observer with Sightability Method against Known Abundance of Feral Horse (Equus caballus) Populations.

    Science.gov (United States)

    Lubow, Bruce C; Ransom, Jason I

    2016-01-01

    Reliably estimating wildlife abundance is fundamental to effective management. Aerial surveys are one of the only spatially robust tools for estimating large mammal populations, but statistical sampling methods are required to address detection biases that affect accuracy and precision of the estimates. Although various methods for correcting aerial survey bias are employed on large mammal species around the world, these have rarely been rigorously validated. Several populations of feral horses (Equus caballus) in the western United States have been intensively studied, resulting in identification of all unique individuals. This provided a rare opportunity to test aerial survey bias correction on populations of known abundance. We hypothesized that a hybrid method combining simultaneous double-observer and sightability bias correction techniques would accurately estimate abundance. We validated this integrated technique on populations of known size and also on a pair of surveys before and after a known number was removed. Our analysis identified several covariates across the surveys that explained and corrected biases in the estimates. All six tests on known populations produced estimates with deviations from the known value ranging from -8.5% to +13.7% and corrected by our statistical models. Our results validate the hybrid method, highlight its potentially broad applicability, identify some limitations, and provide insight and guidance for improving survey designs.

  13. The impact of childhood acute rotavirus gastroenteritis on the parents’ quality of life: prospective observational study in European primary care medical practices

    Directory of Open Access Journals (Sweden)

    Domingo Javier

    2012-05-01

    Full Text Available Abstract Background Rotavirus (RV is the commonest cause of acute gastroenteritis in infants and young children worldwide. A Quality of Life study was conducted in primary care in three European countries as part of a larger epidemiological study (SPRIK to investigate the impact of paediatric rotavirus gastroenteritis (RVGE on affected children and their parents. Methods A self-administered questionnaire was linguistically validated in Spanish, Italian and Polish. The questionnaire was included in an observational multicentre prospective study of 302 children aged Results Questionnaire responses showed that acute RVGE in a child adversely affects the parents’ daily life as well as the child. Parents of children with RVGE experience worry, distress and impact on their daily activities. RVGE of greater clinical severity (assessed by the Vesikari scale was associated with higher parental worries due to symptoms and greater changes in the child’s behaviour, and a trend to higher impact on parents’ daily activities and higher parental distress, together with a higher score on the symptom severity scale of the questionnaire. Conclusions Parents of a child with acute RVGE presenting to primary care experience worry, distress and disruptions to daily life as a result of the child’s illness. Prevention of this disease through prophylactic vaccination will improve the daily lives of parents and children.

  14. Foundation observation of teaching project--a developmental model of peer observation of teaching.

    Science.gov (United States)

    Pattison, Andrew Timothy; Sherwood, Morgan; Lumsden, Colin James; Gale, Alison; Markides, Maria

    2012-01-01

    Peer observation of teaching is important in the development of educators. The foundation curriculum specifies teaching competencies that must be attained. We created a developmental model of peer observation of teaching to help our foundation doctors achieve these competencies and develop as educators. A process for peer observation was created based on key features of faculty development. The project consisted of a pre-observation meeting, the observation, a post-observation debrief, writing of reflective reports and group feedback sessions. The project was evaluated by completion of questionnaires and focus groups held with both foundation doctors and the students they taught to achieve triangulation. Twenty-one foundation doctors took part. All completed reflective reports on their teaching. Participants described the process as useful in their development as educators, citing specific examples of changes to their teaching practice. Medical students rated the sessions as better or much better quality as their usual teaching. The study highlights the benefits of the project to individual foundation doctors, undergraduate medical students and faculty. It acknowledges potential anxieties involved in having teaching observed. A structured programme of observation of teaching can deliver specific teaching competencies required by foundation doctors and provides additional benefits.

  15. Natural gas benefits

    International Nuclear Information System (INIS)

    1999-01-01

    The General Auditor in the Netherlands studied the natural gas policy in the Netherlands, as has been executed in the past decades, in the period 1997-1999. The purpose of the study is to inform the Dutch parliament on the planning and the backgrounds of the natural gas policy and on the policy risks with respect to the benefits for the Dutch State, taking into account the developments in the policy environment. The final conclusion is that the proposed liberalization of the national natural gas market will result in a considerable deprivation of income for the State in case the benefit policy is not adjusted. This report includes a reaction of the Dutch Minister of Economic Affairs and an afterword of the General Auditor. In the appendix an outline is given of the natural gas policy

  16. Risks and Benefits of Bisphosphonate Therapies

    DEFF Research Database (Denmark)

    Reyes, Carlen; Hitz, Mette; Prieto-Alhambra, Daniel

    2016-01-01

    -term adverse effects. Some of the adverse effects identified include an increased risk of atypical femur fractures, osteonecrosis of the jaw, gastrointestinal side effects, or atrial fibrillation. The harm/benefit thinking and the constant update regarding these medications are vital in the day-to-day decision-making...... in clinical practices. The aims of this review are to compile the basic characteristics of these drugs and outline the most important benefits and side effects and provide a clinical context as well as a research agenda to fill the gaps in our knowledge....

  17. Cost/benefit analyses of environmental impact

    International Nuclear Information System (INIS)

    Goldman, M.I.

    1974-01-01

    Various aspects of cost-benefit analyses are considered. Some topics discussed are: regulations of the National Environmental Policy Act (NEPA); statement of AEC policy and procedures for implementation of NEPA; Calvert Cliffs decision; AEC Regulatory Guide; application of risk-benefit analysis to nuclear power; application of the as low as practicable (ALAP) rule to radiation discharges; thermal discharge restrictions proposed by EPA under the 1972 Amendment to the Water Pollution Control Act; estimates of somatic and genetic insult per unit population exposure; occupational exposure; EPA Point Source Guidelines for Discharges from Steam Electric Power Plants; and costs of closed-cycle cooling using cooling towers. (U.S.)

  18. Harnessing natural ventilation benefits.

    Science.gov (United States)

    O'Leary, John

    2013-04-01

    Making sure that a healthcare establishment has a good supply of clean fresh air is an important factor in keeping patients, staff, and visitors, free from the negative effects of CO2 and other contaminants. John O'Leary of Trend Controls, a major international supplier of building energy management solutions (BEMS), examines the growing use of natural ventilation, and the health, energy-saving, and financial benefits, that it offers.

  19. Benefits of transmission interconnections

    International Nuclear Information System (INIS)

    Lyons, D.

    2006-01-01

    The benefits of new power transmission interconnections from Alberta were discussed with reference to the challenges and measures needed to move forward. Alberta's electricity system has had a long period of sustained growth in generation and demand and this trend is expected to continue. However, no new interconnections have been built since 1985 because the transmission network has not expanded in consequence with the growth in demand. As such, Alberta remains weakly interconnected with the rest of the western region. The benefits of stronger transmission interconnections include improved reliability, long-term generation capability, hydrothermal synergies, a more competitive market, system efficiencies and fuel diversity. It was noted that the more difficult challenges are not technical. Rather, the difficult challenges lie in finding an appropriate business model that recognizes different market structures. It was emphasized that additional interconnections are worthwhile and will require significant collaboration among market participants and governments. It was concluded that interties enable resource optimization between systems and their benefits far exceed their costs. tabs., figs

  20. Use of atomoxetine and suicidal ideation in children and adolescents: Results of an observational cohort study within general practice in England.

    Science.gov (United States)

    Davies, M; Coughtrie, A; Layton, D; Shakir, S A S

    2017-01-01

    To investigate the association between atomoxetine, a drug used in the treatment of Attention Deficit Hyperactivity Disorder (ADHD), and suicidal ideation, within a cohort of 2-18-year-old patients in England. The study was conducted using the observational cohort technique of Modified prescription event monitoring (M-PEM). Patients prescribed atomoxetine were identified from dispensed prescriptions issued by primary care physicians. A customised postal GP questionnaire was used to capture outcome data for suicidal ideation. A matched pair cohort analysis was performed within patients to compare the risk of suicidal ideation in the period after starting atomoxetine with the risk prior to starting atomoxetine; this was stratified by age and concomitant use of methylphenidate. Additional information on patient characteristics, and events of interest was also collected; individual cases of suicidal ideation were qualitatively assessed for drug relatedness. Of the final cohort (n=4509); 85.5% male (n=3857), median age 11 years (IQR: 9,14). Primary prescribing indication for atomoxetine was ADHD (n=4261, 94.6%). Almost a quarter of the cohort had been co-prescribed methylphenidate. Results of the matched pair cohort analysis indicated that the period after starting atomoxetine was not associated with an increase in the incidence of suicidal ideation compared to the period prior to starting treatment (RR: 0.71; CI: 0.48-1.07; P-value: 0.104). Individual case assessment of suicidal ideation suggested a causal association within a number of cases. This study found no evidence of an increased risk of suicidal ideation during treatment with atomoxetine, compared to the period prior to starting treatment. Amongst age specific subgroups, this risk may change. Nonetheless, individual case assessment suggested a causal relationship in some patients, hence physicians need to be aware of the possibility of developing this event, and furthermore consider how best to detect it in

  1. Site Practice

    DEFF Research Database (Denmark)

    Wahedi, Haseebullah

    2016-01-01

    different practices in the construction phase. The research is based on an ethnographic study of a case in Denmark. The empirical data were collected through direct observations and semi-structured interviews with site managers, contract managers, foremen and craftsmen. Findings revealed...... that the construction phase comprises several communities and practices, leading to various uses of the drawings. The results indicated that the craftsmen used drawings to position themselves in the correct location, and that the site managers and contract managers used them as management tools and legal documents...

  2. Benefits and costs of IFRS implementation in the opinion of Polish certified auditors

    Directory of Open Access Journals (Sweden)

    Anna Karmańska

    2017-12-01

    Full Text Available The article presents the results of a survey conducted among a carefully selected group of Polish certified auditors. The purpose of the study was to determine whether auditors, during the audit of financial state- ments, perceive certain costs and benefits resulting from the fact that the audited statements were pre- pared in accordance with IFRS. This survey was undertaken to demonstrate that the cost-benefit analysis of IFRS, after more than a decade of their use in Polish practice, could provide important observations for future legislative changes in this area. The study shows that, thanks to the implementation of IFRSs, auditors gain the benefit of lower audit workloads. At the same time, however, they identify six reasons why the audit process is prolonged, requiring special organization, prior special preparation and, as a result, higher auditing costs

  3. Benefits and assessment of annual budget requirements for pavement preservation.

    Science.gov (United States)

    2012-01-01

    This research identifies methods and best practices that can be used by the Indiana Department of Transportation (INDOT) in : performing various strategies for pavement preservation. It also identifies various methods of calculating the benefits of :...

  4. Urban agriculture: Rosario, Argentina reaps the benefits | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2010-10-06

    Oct 6, 2010 ... Urban agriculture: Rosario, Argentina reaps the benefits ... Urban agriculture has become a permanent part of the city's fabric, ... The Global Roundtable of Chief Economists highlights global trends and best practices to help ...

  5. Protecting your practice.

    Science.gov (United States)

    Kerr, Joseph

    2015-01-01

    Dentists have much invested in their practices. They need to protect their practices from fraud and noncompliance. The author provides practical suggestions for how to significantly reduce the risk of fraud and theft in the practice without disrupting day-to-day operations. By adhering to nonintrusive policy and procedure changes, dental practice owners can reduce inherent risks of fraud and theft, while increasing financial and human resource knowledge regarding their practice. Practice owners with the appropriate policies and procedures benefit from significantly lower risk of loss from fraud and theft. Furthermore, they have a better understanding of their practice's finances and human resources. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.

  6. Benefit-Sharing Arrangements between Oil Companies and Indigenous People in Russian Northern Regions

    Directory of Open Access Journals (Sweden)

    Svetlana Tulaeva

    2017-07-01

    Full Text Available This research provides an insight into various modes of benefit-sharing agreements between oil and gas companies and indigenous people in Russia’s northern regions, e.g., paternalism, corporate social responsibility, and partnership. The paper examines factors that influence benefit-sharing arrangements, such as regional specifics, dependency on international investors, corporate policies, and the level of local community organization. It analyses which instruments of benefit-sharing are most favourable, and why, for indigenous communities. The authors conducted research in three regions of Russia (Nenets Autonomous Okrug; Khanty-Mansi Autonomous Okrug, and Sakhalin by using qualitative methodology that involved semi-structured interviews, participant observation, and document analysis. Theoretically, the paper builds on the concept of benefit-sharing arrangements combined with the social equity framework. We assessed each case study in terms of procedural and distributive equity in benefit-sharing. The paper demonstrates that the procedural equity is the highest in the partnership mode of benefit-sharing on the island of Sakhalin where companies implement globally-accepted standards recognized by investment banks. The cases in Nenets Autonomous Okrug and Khanti Mansi Autonomous Okrug represent a reset of Soviet practices on a market basis, but whereas the distributional equity may be sufficient, the procedural equity is low as decisions are made by the company in concord with regional authorities.

  7. Realizing e-government benefits with minimal capabilities

    DEFF Research Database (Denmark)

    Pedersen, Keld

    2017-01-01

    but to fully automate processes the reliance on formal benefits realization practices is decreased. Research limitations/implications — The findings are based on single case. Originality/value — There is only little empirical research studying benefits realization in a public sector context. Furthermore...

  8. Sensitivity of the action observation network to physical and observational learning.

    Science.gov (United States)

    Cross, Emily S; Kraemer, David J M; Hamilton, Antonia F de C; Kelley, William M; Grafton, Scott T

    2009-02-01

    Human motor skills can be acquired by observation without the benefit of immediate physical practice. The current study tested if physical rehearsal and observational learning share common neural substrates within an action observation network (AON) including premotor and inferior parietal regions, that is, areas activated both for execution and observation of similar actions. Participants trained for 5 days on dance sequences set to music videos. Each day they physically rehearsed one set of dance sequences ("danced"), and passively watched a different set of sequences ("watched"). Functional magnetic resonance imaging was obtained prior to and immediately following the 5 days of training. After training, a subset of the AON showed a degree of common activity for observational and physical learning. Activity in these premotor and parietal regions was sustained during observation of sequences that were danced or watched, but declined for unfamiliar sequences relative to the pretraining scan session. These imaging data demonstrate the emergence of action resonance processes in the human brain based on observational learning without physical practice and identify commonalities in the neural substrates for physical and observational learning.

  9. Benefiting through partnering

    International Nuclear Information System (INIS)

    Carr, T.J.

    2000-01-01

    As a consequence of dramatic changes in the world market in nuclear services over the last decade, BNFL has embarked on a comprehensive strategic review of its business. Central to this review has been the need for the company to achieve cost reduction and improved efficiency in all aspects of its business. An area where substantial benefits can be gained is in improved efficiency in the discharge of the capital expenditure programme. This paper focuses on the opportunity of profiting through partnering in capital project delivery. (author)

  10. Cost-benefit

    International Nuclear Information System (INIS)

    1975-01-01

    A critical review of the cost benefit analysis is given for the LMFBR-type reactor development program given in an environmental impact statement of AEC. Several methodological shortcomings are signalled. As compared with a HTGR-type/LWR-type mix of reactors the LMFBR-type reactor will not be competitive until the U 3 O 8 prices reach a level of $ 50/lb which is not likely to happen before the year 2020. It is recommended to review the draft of the ZEC document and include timing as one of the issues. Deferal of the LMFBR-type reactor development program if necessary will not be intolerably costly

  11. Cost benefit ratio of industrial tracer applications

    International Nuclear Information System (INIS)

    Thyn, J.

    1990-01-01

    Simple relations are given, which could help to estimate the expected annual savings resulting from the application of radioisotope methods for the mixing time, segregation effect or residence time distribution determination. Criteria for estimation of benefit at optimum transition of the continuous production from one quality to another, criteria for estimate the benefits on basis of known holdup and for estimate of benefits resulting from knowledge of the distribution function of residence time and of the kinetics of chemical reaction are presented. Further are demonstrated two examples of evaluation of the economic effect of the results of a system analysis in chemical industry where beside the measurements of residence time distribution by help of radiotracers are used also results of other experimental methods and that practically without increasing production cost. (orig.) [de

  12. Combining the Benefits of Traditional Commerce and E-Commerce with M-Commerce benefits in the Retail Industry

    OpenAIRE

    Corbitso, Kenneth; Ash, Thomas; Pisone, Neil

    2011-01-01

    The convergence of traditional and electronic commerce practices is being driven by the need for businesses to keep up with the ever increasing competition of online retailing. This thesis aims to examine and analyze the possible benefits that may arise via the use and development of rapidly evolving mobile technology, through analyzing the benefits of each of the forms of commerce during outlined stages of retail process, in order to evaluate to what extend the benefits can be combined. The ...

  13. Benefits of adopting good radiation practices in reducing the whole body radiation dose to the nuclear medicine personnel during (18)F-fluorodeoxyglucose positron emission tomography/computed tomography imaging.

    Science.gov (United States)

    Verma, Shashwat; Kheruka, Subhash Chand; Maurya, Anil Kumar; Kumar, Narvesh; Gambhir, Sanjay; Kumari, Sarita

    2016-01-01

    Positron emission tomography has been established as an important imaging modality in the management of patients, especially in oncology. The higher gamma radiation energy of positron-emitting isotopes poses an additional radiation safety problem. Those working with this modality may likely to receive higher whole body doses than those working only in conventional nuclear medicine. The radiation exposure to the personnel occurs in dispensing the dose, administration of activity, patient positioning, and while removing the intravenous (i.v.) cannula. The estimation of radiation dose to Nuclear Medicine Physician (NMP) involved during administration of activity to the patient and technical staff assisting in these procedures in a positron emission tomography/computed tomography (PET/CT) facility was carried out. An i.v access was secured for the patient by putting the cannula and blood sugar was monitored. The activity was then dispensed and measured in the dose calibrator and administered to the patient by NMP. Personnel doses received by NMP and technical staff were measured using electronic pocket dosimeter. The radiation exposure levels at various working locations were assessed with the help of gamma survey meter. The radiation level at working distance while administering the radioactivity was found to be 106-170 μSv/h with a mean value of 126.5 ± 14.88 μSv/h which was reduced to 4.2-14.2 μSv/h with a mean value of 7.16 ± 2.29 μSv/h with introduction of L-bench for administration of radioactivity. This shows a mean exposure level reduction of 94.45 ± 1.03%. The radiation level at working distance, while removing the i.v. cannula postscanning was found to be 25-70 μSv/h with a mean value of 37.4 ± 13.16 μSv/h which was reduced to 1.0-5.0 μSv/h with a mean value of 2.77 ± 1.3 μSv/h with introduction of L-bench for removal of i.v cannula. This shows a mean exposure level reduction of 92.85 ± 1.78%. This study shows that good radiation practices are

  14. Nuclear energy: benefits versus risks

    International Nuclear Information System (INIS)

    Jordan, W.H.

    1975-01-01

    Of the benefits of nuclear power three are described briefly. 1. It offers virtually an inexhaustible supply of cheap electricity, so the real reason for its installation in the U.S. (80 nuclear power plants on order and 15 in operation) is to save money. (2) Nuclear power would offer a chance to clean up the atmosphere; it has been observed that the carbon dioxide concentration in the atmosphere is increasing at about 2 percent per decade, a change that may have implications for long-term effects on climate. (3) Power reactors will undoubtedly be the major producers of radioisotopes in the future; estimates of the benefits of these isotopes are of the order of $1000 million a year from such applications as fluid flow measurements, thickness gages, leak detection, well logging, deformation determinations, agricultural application, biological applications, and in medicine. Risks of operating nuclear power plants can be classified as: thermal pollution of the rivers and lakes; low level release of radioactivity into the air and ground waters caused by the normal operation of nuclear power and reprocessing plants; and the accidental release of large amounts of radioactivity. These risks are put in perspective by comparing them with common risks that man accepts daily--transportation, cigarette smoking, mountain climbing, etc.-- after which nuclear power seems not so risky after all

  15. Liquid fuel concept benefits

    International Nuclear Information System (INIS)

    Hron, M.

    1996-01-01

    There are principle drawbacks of any kind of solid nuclear fuel listed and analyzed in the first part of the paper. One of the primary results of the analyses performed shows that the solid fuel concept, which was to certain degree advantageous in the first periods of a nuclear reactor development and operation, has guided this branch of a utilization of atomic nucleus energy to a death end. On the background of this, the liquid fuel concept and its benefits are introduced and briefly described in the first part of the paper, too. As one of the first realistic attempts to utilize the advantages of liquid fuels, the reactor/blanket system with molten fluoride salts in the role of fuel and coolant simultaneously, as incorporated in the accelerator-driven transmutation technology (ADTT) being proposed and currently having been under development in the Los Alamos National Laboratory, will be studied both theoretically and experimentally. There is a preliminary design concept of an experimental assembly LA-O briefly introduced in the paper which is under preparation in the Czech Republic for such a project. Finally, there will be another very promising concept of a small low power ADTT system introduced which is characterized by a high level of safety and economical efficiency. In the conclusion, the overall survey of principal benefits which may be expected by introducing liquid nuclear fuel in nuclear power and research reactor systems is given and critically analyzed. 7 refs, 4 figs

  16. Observations on Current Practices in Preceptor Training

    Science.gov (United States)

    Volberding, Jennifer L.; Richardson, Lawrence

    2015-01-01

    Preceptor education is a major focus for all athletic training programs. Clinical education is a required and fundamental component of an athletic training student's education, so it is imperative the preceptors delivering and supervising clinical experiences have the highest level of training. The purpose of this exploratory qualitative…

  17. National evaluation of the benefits and risks of greater structuring and coding of the electronic health record: exploratory qualitative investigation.

    Science.gov (United States)

    Morrison, Zoe; Fernando, Bernard; Kalra, Dipak; Cresswell, Kathrin; Sheikh, Aziz

    2014-01-01

    We aimed to explore stakeholder views, attitudes, needs, and expectations regarding likely benefits and risks resulting from increased structuring and coding of clinical information within electronic health records (EHRs). Qualitative investigation in primary and secondary care and research settings throughout the UK. Data were derived from interviews, expert discussion groups, observations, and relevant documents. Participants (n=70) included patients, healthcare professionals, health service commissioners, policy makers, managers, administrators, systems developers, researchers, and academics. Four main themes arose from our data: variations in documentation practice; patient care benefits; secondary uses of information; and informing and involving patients. We observed a lack of guidelines, co-ordination, and dissemination of best practice relating to the design and use of information structures. While we identified immediate benefits for direct care and secondary analysis, many healthcare professionals did not see the relevance of structured and/or coded data to clinical practice. The potential for structured information to increase patient understanding of their diagnosis and treatment contrasted with concerns regarding the appropriateness of coded information for patients. The design and development of EHRs requires the capture of narrative information to reflect patient/clinician communication and computable data for administration and research purposes. Increased structuring and/or coding of EHRs therefore offers both benefits and risks. Documentation standards within clinical guidelines are likely to encourage comprehensive, accurate processing of data. As data structures may impact upon clinician/patient interactions, new models of documentation may be necessary if EHRs are to be read and authored by patients.

  18. Making benefit transfers work

    DEFF Research Database (Denmark)

    Bateman, I.J.; Brouwer, R.; Ferrini, S.

    We develop and test guidance principles for benefits transfers. These argue that when transferring across relatively similar sites, simple mean value transfers are to be preferred but that when sites are relatively dissimilar then value function transfers will yield lower errors. The paper also...... provides guidance on the appropriate specification of transferable value functions arguing that these should be developed from theoretical rather than ad-hoc statistical principles. These principles are tested via a common format valuation study of water quality improvements across five countries. Results...... support our various hypotheses providing a set of principles for future transfer studies. The application also considers new ways of incorporating distance decay, substitution and framing effects within transfers and presents a novel water quality ladder....

  19. PESTICIDES: BENEFITS AND HAZARDS

    Directory of Open Access Journals (Sweden)

    Ivan Maksymiv

    2015-05-01

    Full Text Available Pesticides are an integral part of modern life used to prevent growth of unwanted living  organisms. Despite the fact that scientific statements coming from many toxicological works provide indication on the low risk of the pesticides and their residues, the community especially last years is deeply concerned about massive application of pesticides in diverse fields. Therefore evaluation of hazard risks particularly in long term perspective is very important. In the fact there are at least two clearly different approaches for evaluation of pesticide using: the first one is defined as an objective or probabilistic risk assessment, while the second one is the potential economic and agriculture benefits. Therefore, in this review the author has considered scientifically based assessment of positive and negative effects of pesticide application and discusses possible approaches to find balance between them.

  20. University Benefits Survey. Part 1 (All Benefits Excluding Pensions).

    Science.gov (United States)

    University of Western Ontario, London.

    Results of a 1983 survey of benefits, excluding pensions, for 17 Ontario, Canada, universities are presented. Information is provided on the following areas: whether the university self-administers insurance plans, communication of benefits, proposed changes in benefits, provision of life and dismemberment insurance, maternity leave policy,…

  1. Assessing the healthcare resource use associated with inappropriate prescribing of inhaled corticosteroids for people with chronic obstructive pulmonary disease (COPD) in GOLD groups A or B: an observational study using the Clinical Practice Research Datalink (CPRD).

    Science.gov (United States)

    Chalmers, James D; Poole, Chris; Webster, Samantha; Tebboth, Abigail; Dickinson, Scott; Gayle, Alicia

    2018-04-11

    Recent recommendations from the Global Initiative for Chronic Obstructive Lung Disease (GOLD) position inhaled corticosteroids (ICS) for use in chronic obstructive pulmonary disease (COPD) patients experiencing exacerbations (≥ 2 or ≥ 1 requiring hospitalisation); i.e. GOLD groups C and D. However, it is known that ICS is frequently prescribed for patients with less severe COPD. Potential drivers of inappropriate ICS use may be historical clinical guidance or a belief among physicians that intervening early with ICS would improve outcomes and reduce resource use. The objective of this study was to compare healthcare resource use in the UK for COPD patients in GOLD groups A and B (0 or 1 exacerbation not resulting in hospitalisation) who have either been prescribed an ICS-containing regimen or a non-ICS-containing regimen. Linked data from the Clinical Practice Research Datalink (CPRD) and Hospital Episode Statistics (HES) database were used. For the study period (1 July 2005 to 30 June 2015) a total 4009 patients met the inclusion criteria; 1745 receiving ICS-containing therapy and 2264 receiving non-ICS therapy. Treatment groups were propensity score-matched to account for potential confounders in the decision to prescribe ICS, leaving 1739 patients in both treatment arms. Resource use was assessed in terms of frequency of healthcare practitioner (HCP) interactions and rescue therapy prescribing. Treatment acquisition costs were not assessed. Results showed no benefit associated with the addition of ICS, with numerically higher all-cause HCP interactions (72,802 versus 69,136; adjusted relative rate: 1.07 [p = 0.061]) and rescue therapy prescriptions (24,063 versus 21,163; adjusted relative rate: 1.05 [p = 0.212]) for the ICS-containing group compared to the non-ICS group. Rate ratios favoured the non-ICS group for eight of nine outcomes assessed. Outcomes were similar for subgroup analyses surrounding potential influential parameters, including

  2. Landfill Gas Energy Benefits Calculator

    Science.gov (United States)

    This page contains the LFG Energy Benefits Calculator to estimate direct, avoided, and total greenhouse gas reductions, as well as environmental and energy benefits, for a landfill gas energy project.

  3. Social cost-benefit analysis and nuclear futures

    International Nuclear Information System (INIS)

    Pearce, D.W.

    1979-01-01

    The usefulness of cost-benefit analysis in making nuclear power investment decisions is considered. The essence of social cost-benefit analysis is outlined and shown to be unavoidably value-laden. As a case study six issues relevant to the decision to build on oxide fuel reprocessing plant (THORP) are examined. The potential practical value of using cost-benefit analysis as an aid to decision-making is considered for each of these issues. It is concluded that cost-benefit approach is of limited value in the nuclear power case because of its inapplicability to such issues as the liberty of the individual and nuclear weapons proliferation. (author)

  4. The employee motivation and benefits

    OpenAIRE

    Fuhrmannová, Petra

    2013-01-01

    The aim of this bachelor's study is to describe and analyze the employee motivation and benefits in the payroll system and human recources field. Theoretical part attends to general terms as the employee motivation, the theory of the motivation,the types of the employee benefits, the influence of benefits to the employee's working performance. The practial part focuses on Elanor company, includes introduction of the company, it's history and the present, the offer of the employee benefits. Ne...

  5. Multinational observational study on clinical practices and therapeutic management of mineral and bone disorders in patients with chronic kidney disease stages 4, 5, and 5D: The OCEANOS study

    Directory of Open Access Journals (Sweden)

    Faissal A. M. Shaheen

    2016-01-01

    Full Text Available Our aim is to assess the current clinical practices in monitoring and treatment patterns of chronic kidney disease (CKD-mineral bone disorder and the degree to which these practices met the kidney disease improving global outcome (KDIGO guidelines. This was an international, multi-center, cross-sectional, observational study in adult patients diagnosed with CKD Stages 4, 5, and 5D. Patients were enrolled from Middle East, South Asia, Eurasia, and Africa; patients with estimated glomerular filtration rate ≥30 mL/min/1.73 m 2 or with any medical/surgical conditions precluding their participation were excluded. Frequency of measurements, levels of serum calcium (Ca, phosphorus and parathormone (parathyroid hormone [PTH], and presence vascular/valvular calcification were recorded. Of the 2250 patients enrolled, data on 2247 patients were evaluated. Overall, only a small percentage of patients met all three target KDIGO ranges of serum Ca, phosphorus, and PTH (13.7% [95% confidence interval: 12.0; 15.4], with a higher proportion among CKD Stage 5D patients (14.8% than CKD Stage 4 and 5 (5.6% patients. Majority (84.3% of the patients received treatment with phosphorous binders, of whom 85.5% received Ca-based phosphate binders. Overall, 57.0% of patients received Vitamin D treatment with a similar frequency among patients with CKD Stages 4, 5, and 5D. Over half (65.7% of the patients were screened for vascular/valvular calcification; of these, 58.8% had ≥1 calcification. Diabetes status, P, PTH, and low density lipoprotein-cholesterol had significant impact on the prescription pattern of phosphorous binders. The current practices for the management of bone and mineral metabolism in CKD patients in the study region fall far short of meeting the KDIGO target range.

  6. Cost benefit analysis vs. referenda

    OpenAIRE

    Martin J. Osborne; Matthew A. Turner

    2007-01-01

    We consider a planner who chooses between two possible public policies and ask whether a referendum or a cost benefit analysis leads to higher welfare. We find that a referendum leads to higher welfare than a cost benefit analyses in "common value" environments. Cost benefit analysis is better in "private value" environments.

  7. Benefit-based tree valuation

    Science.gov (United States)

    E.G. McPherson

    2007-01-01

    Benefit-based tree valuation provides alternative estimates of the fair and reasonable value of trees while illustrating the relative contribution of different benefit types. This study compared estimates of tree value obtained using cost- and benefit-based approaches. The cost-based approach used the Council of Landscape and Tree Appraisers trunk formula method, and...

  8. Observation of online communities

    DEFF Research Database (Denmark)

    Nørskov, Sladjana V.; Rask, Morten

    2011-01-01

    This paper addresses the application of observation to online settings with a special focus on observer roles. It draws on a study of online observation of a virtual community, i.e. an open source software (OSS) community. The paper examines general and specific advantages and disadvantages...... of the observer roles in online settings by relating these roles to the same roles assumed in offline settings. The study suggests that under the right circumstances online and offline observation may benefit from being combined as they complement each other well. Quality issues and factors important to elicit...... trustworthy observational data from online study settings, such as OSS communities, are discussed. A proposition is made concerning how threats to credibility and transferability in relation to online observation (i.e. lack of richness and detail, risk of misunderstandings) can be diminished, while...

  9. Liraglutide effect and action in diabetes-In (LEAD-In: A prospective observational study assessing safety and effectiveness of liraglutide in patients with type 2 diabetes mellitus treated under routine clinical practice conditions in India

    Directory of Open Access Journals (Sweden)

    Subhash Kumar Wangnoo

    2016-01-01

    Full Text Available Background: This 26-week, open-label observational study assessed the incidence and type of adverse events (AEs associated with liraglutide use according to the standard clinical practice settings and the local label in India. Materials and Methods: A total of 1416 adults with type 2 diabetes (T2D treated with liraglutide in 125 sites across India were included in the study. Participants were newly diagnosed or already receiving antidiabetic medications. Safety and efficacy data were collected at baseline and at approximately weeks 13 and 26. The primary outcome was incidence and type of AEs while using liraglutide, with events classified by Medical Dictionary for Regulatory Activities system organ class and preferred term. The secondary objective was to assess other clinical parameters related to effective T2D management. Results: Twenty AEs, predominately gastrointestinal, were reported in 1.3% of the study population in scheduled visits up to week 26. No serious AEs, including death, were reported. Hypoglycemic episodes were reported in 7.3% of participants at baseline and 0.7% at week 26. No major hypoglycemic events were reported up to week 26 (baseline: 0.4%. Glycated hemoglobin was reduced from baseline (8.8 ± 1.3% to week 26 by 1.6 ± 1.1% (P < 0.0001; significant improvements in fasting blood glucose, and 2-h postprandial blood glucose (post-breakfast, -lunch, and -dinner were also observed. Mean body weight decreased by 8.1 ± 6.5 kg from baseline (92.5 ± 14.6 kg; P< 0.0001. Conclusions: From the number of AEs reported, it is suggested that liraglutide was well tolerated in subjects with T2D treated under standard clinical practice conditions in India. Liraglutide was effective, and no new safety concerns were identified.

  10. Improving Corporate Governance Practices

    OpenAIRE

    M. Huse; J. Gabrielsson; A. Minichilli

    2009-01-01

    Peak performing organizations may benefit from active value creating boards. Suggestions to improve board behaviour and corporate governance practices are presented in this article. The suggestions result from findings in the “Valued Creating Board” research programme. However, active boards working in a shareholder activism framework may destroy rather than support value creation processes within firms. In peak performing organizations corporate governance practices should be designed and de...

  11. The benefit of daily photoprotection.

    Science.gov (United States)

    Seité, Sophie; Fourtanier, Anny M A

    2008-05-01

    It is now recognized that both ultraviolet (UV)-A and UVB wavelengths participate in the generation of photodamaged human skin during sun exposure. During usual daily activities, an appropriate protection against solar UV exposure should prevent clinical, cellular, and molecular changes potentially leading to photoaging. This study was designed to evaluate in human beings the protection afforded by a day cream containing a photostable combination of UVB and UVA filters and thus protect against the UV-induced skin alterations. In solar-simulated radiation exposed and unprotected skin sites we observed melanization. The epidermis revealed a significant increase in stratum corneum and stratum granulosum thickness. In the dermis, an enhanced expression of tenascin and a reduced expression of type I procollagen were evidenced just below the dermoepidermal junction. Although no change in elastic fibers in exposed buttock skin was seen, a slightly increased deposit of lysozyme and alpha-1 antitrypsin on elastin fibers was observed using immunofluorescence techniques. A day cream with photoprotection properties was shown to prevent all of the above-described alterations. This study was performed on a limited number of patients (n = 12) with specific characteristics (20-35 years old and skin type II and III). Two dermal alterations were evaluated by visual assessment and not by computer-assisted image analysis quantification. Our in vivo results demonstrate the benefits of daily photoprotection using a day cream containing appropriate broad-spectrum sunscreens, which prevent solar UV-induced skin damages.

  12. How isotopes benefit industry

    International Nuclear Information System (INIS)

    1967-01-01

    The life of bus engines and the time taken to make beer are not at first sight connected with atomic energy. Yet the first has been considerably lengthened and the second even more considerably shortened in different countries as a result of using nuclear techniques and materials. They are only two examples; there are many others which have improved efficiency in factories, oilfields, chemical plants and other industries. They indicate not only the results of ingenuity but the rewards possible from more widespread use of the new methods. At a symposium on radioisotope tracers in industry and geophysics organized by the Agency and held in Prague during November many reports showed not only what is possible but what is actually being accomplished in a number of industries as a matter of daily routine. The economic benefits were also demonstrated, and although the developments have been mainly in countries already highly industrialized, the potential for new industries in developing countries was clear. Research to improve performance of motorcar, aircraft and tractor engines has been directed at establishing the causes of friction, corrosion and wear. In brewing beer it has been possible to accelerate fermentation. Pollution both of water and air can be reduced and methods of waste disposal improved. Many economies have been effected in oil production. Better quality and lower costs have resulted from work in chemical plants and processes such as glass making, metal refining, plastics and many others. Dams and railways were also mentioned among the great variety of subjects suitable for radioisotope techniques

  13. Cardiovascular benefits of exercise

    Directory of Open Access Journals (Sweden)

    Agarwal SK

    2012-06-01

    Full Text Available Shashi K AgarwalMedical Director, Agarwal Health Center, NJ, USAAbstract: Regular physical activity during leisure time has been shown to be associated with better health outcomes. The American Heart Association, the Centers for Disease Control and Prevention and the American College of Sports Medicine all recommend regular physical activity of moderate intensity for the prevention and complementary treatment of several diseases. The therapeutic role of exercise in maintaining good health and treating diseases is not new. The benefits of physical activity date back to Susruta, a 600 BC physician in India, who prescribed exercise to patients. Hippocrates (460–377 BC wrote “in order to remain healthy, the entire day should be devoted exclusively to ways and means of increasing one's strength and staying healthy, and the best way to do so is through physical exercise.” Plato (427–347 BC referred to medicine as a sister art to physical exercise while the noted ancient Greek physician Galen (129–217 AD penned several essays on aerobic fitness and strengthening muscles. This article briefly reviews the beneficial effects of physical activity on cardiovascular diseases.Keywords: exercise, cardiovascular disease, lifestyle changes, physical activity, good health

  14. Environmental benefits of ethanol

    International Nuclear Information System (INIS)

    1998-11-01

    The environmental benefits of ethanol blended fuels in helping to reduce harmful emissions into the atmosphere are discussed. The use of oxygenated fuels such as ethanol is one way of addressing air pollution concerns such as ozone formation. The state of California has legislated stringent automobile emissions standards in an effort to reduce emissions that contribute to the formation of ground-level ozone. Several Canadian cities also record similar hazardous exposures to carbon monoxide, particularly in fall and winter. Using oxygenated fuels such as ethanol, is one way of addressing the issue of air pollution. The net effect of ethanol use is an overall decrease in ozone formation. For example, use of a 10 per cent ethanol blend results in a 25-30 per cent reduction in carbon monoxide emissions by promoting a more complete combustion of the fuel. It also results in a 6-10 per cent reduction of carbon dioxide, and a seven per cent overall decrease in exhaust VOCs (volatile organic compounds). The environmental implications of feedstock production associated with the production of ethanol for fuel was also discussed. One of the Canadian government's initiatives to address the climate change challenge is its FleetWise initiative, in which it has agreed to a phased-in acquisition of alternative fuel vehicles by the year 2005. 9 refs

  15. Emissions - problems and benefits

    International Nuclear Information System (INIS)

    Rossi, C.; Hurd, P.J.

    1992-01-01

    Air pollution due to emissions arising from the use of biomass in electricity generation is discussed. One of the most attractive aspects of the use of biomass is that there is no net increase of carbon dioxide in the atmosphere. During growth biomass absorbs CO 2 ; during combustion, either directly or as biomass derived fuels, it releases CO 2 , making a closed cycle. Another benefit from the use of biomass is its typically very low sulphur content and the consequent low sulphur oxide emissions from biomass-fired generation plants. Biomass is, however, less satisfactory in relation to nitrogen oxides (NO x ). Control of the nitrogen content of the biomass feedstock, advanced high technology combustion techniques and some post-engine treatment may all be necessary to comply with the legal limits for NO x emissions. The low ash content of biomass, particularly biomass derived oils, makes it possible to limit particulate emission to very low levels. It will be important, though, to bear in mind the need to limit the sodium and potassium content to below 1 ppm by mass in bio-oil to be used in a high temperature gas turbine. Levels of micropollutants will be low if the chlorine content of biomass feedstock is low. However, residence times at peak temperature in typical gas turbines combustors are too short to destroy some micropollutants. (UK)

  16. How isotopes benefit industry

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1967-02-15

    The life of bus engines and the time taken to make beer are not at first sight connected with atomic energy. Yet the first has been considerably lengthened and the second even more considerably shortened in different countries as a result of using nuclear techniques and materials. They are only two examples; there are many others which have improved efficiency in factories, oilfields, chemical plants and other industries. They indicate not only the results of ingenuity but the rewards possible from more widespread use of the new methods. At a symposium on radioisotope tracers in industry and geophysics organized by the Agency and held in Prague during November many reports showed not only what is possible but what is actually being accomplished in a number of industries as a matter of daily routine. The economic benefits were also demonstrated, and although the developments have been mainly in countries already highly industrialized, the potential for new industries in developing countries was clear. Research to improve performance of motorcar, aircraft and tractor engines has been directed at establishing the causes of friction, corrosion and wear. In brewing beer it has been possible to accelerate fermentation. Pollution both of water and air can be reduced and methods of waste disposal improved. Many economies have been effected in oil production. Better quality and lower costs have resulted from work in chemical plants and processes such as glass making, metal refining, plastics and many others. Dams and railways were also mentioned among the great variety of subjects suitable for radioisotope techniques

  17. The benefits of visibility

    International Nuclear Information System (INIS)

    Krupnick, A.; DeWitt, D.

    1994-01-01

    The benefits of visibility improvement (or the damages with additional degradation) refer to increases (or decreases) in utility obtained in three different dimensions. The first of these is associated with the nature of the visibility change. Visual range may be improved so that features of an area become more distinct or the sky becomes clearer. Alternatively, normal features of an area may be marred, say by the site of a power plant or its plume (called plume blight). The second dimension is the location of the change: in an urban area, in a rural setting, or in a recreational area or area of particular beauty, such as the Grand Canyon. The third dimension is the type of value: use or non-use. Thus, a person who visits the Grand Canyon (or may visit it in the future) may hold use values for improving his view of the Canyon or its surroundings and may also old non-use values for improved visibility (whether for altruistic or other reasons) irrespective of present or planned visits. In all, therefore, there are 12 possible combinations of the elements in these three dimension, each of which is logically distinct from the others and which demands attention in the literature to derive willingness to pay (WTP)

  18. The benefits of visibility

    Energy Technology Data Exchange (ETDEWEB)

    Krupnick, A; DeWitt, D

    1994-07-01

    The benefits of visibility improvement (or the damages with additional degradation) refer to increases (or decreases) in utility obtained in three different dimensions. The first of these is associated with the nature of the visibility change. Visual range may be improved so that features of an area become more distinct or the sky becomes clearer. Alternatively, normal features of an area may be marred, say by the site of a power plant or its plume (called plume blight). The second dimension is the location of the change: in an urban area, in a rural setting, or in a recreational area or area of particular beauty, such as the Grand Canyon. The third dimension is the type of value: use or non-use. Thus, a person who visits the Grand Canyon (or may visit it in the future) may hold use values for improving his view of the Canyon or its surroundings and may also old non-use values for improved visibility (whether for altruistic or other reasons) irrespective of present or planned visits. In all, therefore, there are 12 possible combinations of the elements in these three dimension, each of which is logically distinct from the others and which demands attention in the literature to derive willingness to pay (WTP)

  19. The Common Framework for Earth Observation Data

    Science.gov (United States)

    Gallo, J.; Stryker, T. S.; Sherman, R.

    2016-12-01

    Each year, the Federal government records petabytes of data about our home planet. That massive amount of data in turn provides enormous benefits to society through weather reports, agricultural forecasts, air and water quality warnings, and countless other applications. To maximize the ease of transforming the data into useful information for research and for public services, the U.S. Group on Earth Observations released the first Common Framework for Earth Observation Data in March 2016. The Common Framework recommends practices for Federal agencies to adopt in order to improve the ability of all users to discover, access, and use Federal Earth observations data. The U.S. Government is committed to making data from civil Earth observation assets freely available to all users. Building on the Administration's commitment to promoting open data, open science, and open government, the Common Framework goes beyond removing financial barriers to data access, and attempts to minimize the technical impediments that limit data utility. While Earth observation systems typically collect data for a specific purpose, these data are often also useful in applications unforeseen during development of the systems. Managing and preserving these data with a common approach makes it easier for a wide range of users to find, evaluate, understand, and utilize the data, which in turn leads to the development of a wide range of innovative applications. The Common Framework provides Federal agencies with a recommended set of standards and practices to follow in order to achieve this goal. Federal agencies can follow these best practices as they develop new observing systems or modernize their existing collections of data. This presentation will give a brief on the context and content of the Common Framework, along with future directions for implementation and keeping its recommendations up-to-date with developing technology.

  20. Market Valuation of Accrued Social Security Benefits

    OpenAIRE

    John Geanakoplos; Stephen P. Zeldes

    2009-01-01

    One measure of the health of the Social Security system is the difference between the market value of the trust fund and the present value of benefits accrued to date. How should present values be computed for this calculation in light of future uncertainties? We think it is important to use market value. Since claims on accrued benefits are not currently traded in financial markets, we cannot directly observe a market value. In this paper, we use a model to estimate what the market price for...