WorldWideScience

Sample records for benefits observational practice

  1. 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…

  2. 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

  3. 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…

  4. Clinical Practice Informs Secure Messaging Benefits and Best Practices.

    Science.gov (United States)

    Haun, Jolie N; Hathaway, Wendy; Chavez, Margeaux; Antinori, Nicole; Vetter, Brian; Miller, Brian K; Martin, Tracey L; Kendziora, Lisa; Nazi, Kim M; Melillo, Christine

    2017-10-01

    Background Clinical care team members in Department of Veterans' Affairs (VA) facilities nationwide are working to integrate the use of Secure Messaging (SM) into care delivery and identify innovative uses. Identifying best practices for proactive use of SM is a key factor in its successful implementation and sustained use by VA clinical care team members and veterans. Objectives A collaborative project solicited input from VA clinical care teams about their local practices using SM to provide access to proactive patient-centered care for veterans and enhance workflow. Methods This project implemented a single-item cross-sectional qualitative electronic survey via internal e-mail to local coordinators in all 23 Veterans Integrated Service Networks (VISNs). Content analysis was used to manage descriptive data responses. Descriptive statistics described sample characteristics. Results VA clinical care team members across 15 of 23 VISNs responded to the questionnaire. Content analysis of 171 responses produced two global domains: (1) benefits of SM and (2) SM best practices. Benefits of SM use emphasize enhanced and efficient communication and increased access to care. Care team members incorporate SM into their daily clinical practices, using it to provide services before, during, and after clinical encounters as a best practice. SM users suggest improvements in veteran care, clinical team workflow, and efficient use of health resources. Clinical team members invested in the successful implementation of SM integrate SM into their daily practices to provide meaningful and useful veteran-centered care and improve workflow. Conclusion VA clinical care team members can use SM proactively to create an integrated SM culture. With adequate knowledge and motivation to proactively use this technology, all clinical team members within the VA system can replicate best practices shared by other clinical care teams to generate meaningful and useful interactions with SM

  5. 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.

  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....

  7. 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...... systems in industry companies and partly to assess if the objectives suggested are appropriate for describing the impact of product configuration systems and identifying other possible objectives. The empirical study of the com-panies also gives an indication of more overall performance indicators being...

  8. Pathogen reduction co-benefits of nutrient best management practices

    Directory of Open Access Journals (Sweden)

    Jennifer Richkus

    2016-11-01

    Full Text Available Background Many of the practices currently underway to reduce nitrogen, phosphorus, and sediment loads entering the Chesapeake Bay have also been observed to support reduction of disease-causing pathogen loadings. We quantify how implementation of these practices, proposed to meet the nutrient and sediment caps prescribed by the Total Maximum Daily Load (TMDL, could reduce pathogen loadings and provide public health co-benefits within the Chesapeake Bay system. Methods We used published data on the pathogen reduction potential of management practices and baseline fecal coliform loadings estimated as part of prior modeling to estimate the reduction in pathogen loadings to the mainstem Potomac River and Chesapeake Bay attributable to practices implemented as part of the TMDL. We then compare the estimates with the baseline loadings of fecal coliform loadings to estimate the total pathogen reduction potential of the TMDL. Results We estimate that the TMDL practices have the potential to decrease disease-causing pathogen loads from all point and non-point sources to the mainstem Potomac River and the entire Chesapeake Bay watershed by 19% and 27%, respectively. These numbers are likely to be underestimates due to data limitations that forced us to omit some practices from analysis. Discussion Based on known impairments and disease incidence rates, we conclude that efforts to reduce nutrients may create substantial health co-benefits by improving the safety of water-contact recreation and seafood consumption.

  9. THE BENEFITS OF THE SOCIALLY RESPONSIBLE PRACTICES

    Directory of Open Access Journals (Sweden)

    GEORGETA GRIGORE

    2008-01-01

    Full Text Available The beginnings of the concept and practices date back in time but with a greater emphasis during the 20th century. Nowadays, the definition and conceptual delimitations are subject to debate and controversy. According to the type of responsibilities assumed, the enterprise can adopt different attitudes. The socially responsible practices are initiatives that a company takes in order to voluntarily improve the way of operating such that to contribute to the good of the community and to the protection of the environment.

  10. 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.

  11. 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

  12. "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…

  13. 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.

  14. Part 1: An Overview of Mentoring Practices and Mentoring Benefits.

    Science.gov (United States)

    Jakubik, Louise D; Eliades, Aris B; Weese, Meghan M

    2016-01-01

    Mentoring has been proposed as a solution for retention and succession planning in nursing; however, there is a lack of information about "how to" mentor based on evidence. This seven-part leadership series will provide a deep dive into evidence-based mentoring practices and associated mentoring benefits for staff nurses and the organizations in which they work. Part 1 of this series provides an overview of the origins and evolution of mentoring, related definitions, and evidence-based mentoring practices and benefits.

  15. Challenges with the Medicare obesity benefit: practical concerns & proposed solutions.

    Science.gov (United States)

    Batsis, John A; Huyck, Karen L; Bartels, Stephen J

    2015-01-01

    Obesity and the growing population of older adults are significant public health concerns in the United States. In 2011, the Centers for Medicare and Medicaid Services introduced a Medicare benefit for obesity counselling using Intensive Behavioral Therapy that would reimburse structured visits over a 12-month period. Although we applaud this new benefit that addresses the obesity epidemic in older adults, three major shortcomings limit its utility and potential effectiveness: 1) weight loss interventions differ in older and younger adults, yet the benefit relies predominantly on data from interventions studied in younger populations; 2) body mass index is not an accurate measure for identifying obesity; and 3) tying reimbursement to clinician visits may hamper the integration of this benefit into practice. To overcome these shortcomings, we propose: 1) obesity treatment should focus on improving quality of life and physical function and on mitigating muscle and bone loss rather than focusing solely on weight loss; 2) waist circumference or waist-hip ratio should be considered as additional anthropometric measures in ascertaining obesity; and 3) allied health professionals should be reimbursed for providing this benefit. Incorporating these suggestions will improve its usability in clinical practice and increase the chances that this well-meaning benefit will improve patient outcomes.

  16. 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 ...

  17. Importance of observational studies in clinical practice.

    Science.gov (United States)

    Ligthelm, Robert J; Borzì, Vito; Gumprecht, Janusz; Kawamori, Ryuzo; Wenying, Yang; Valensi, Paul

    2007-06-01

    In this era of evidence-based medicine, clinicians require a comprehensive range of well-designed studies to support prescribing decisions and patient management. In recent years, data from observational studies have become an increasingly important source of evidence because of improvements in observational-study methods and advances in statistical analysis. This article reviews the current literature and reports some of the key studies indicating that observational studies can both complement and build on the evidence base established by randomized controlled trials (RCTs). A literature search using the MEDLINE/PubMed database (years: 1966-present) was carried out using the search terms observational or observational study(ies), historical control, nonrandomized, and postmarketing surveillance. All references comparing observational studies with randomized controlled trials were obtained and reviewed and were also hand-checked for studies not identified in the database searches. Observational studies play an important role in investigating treatment outcomes. Data from large observational studies can clarify the tolerability profile of marketed medicines. In particular, observational studies can be of benefit in the study of large, heterogeneous patient populations with complex, chronic diseases such as diabetes mellitus. Observational studies have played a key role in supporting the results of Phase III studies of insulin analogues for the treatment of patients with type 1 and type 2 diabetes. Future observational studies in the field of diabetes such as PREDICTIVE (Predictable Results and Experience in Diabetes through Intensification and Control to Target: an International Variability Evaluation) and IMPROVE will further our understanding of this global pandemic. Well-designed observational studies can play a key role in supporting the evidence base for drugs and therapies. Current evidence suggests that observational studies can be conducted using the same

  18. Mindfulness meditation practice and executive functioning: Breaking down the benefit.

    Science.gov (United States)

    Gallant, Sara N

    2016-02-01

    This paper focuses on evidence for mindfulness meditation-related benefits to executive functioning, processes important for much of human volitional behaviour. Miyake et al. (2000) have shown that executive functions can be fractionated into three distinct domains including inhibition, working memory updating, and mental set shifting. Considering these separable domains, it is important to determine whether the effects of mindfulness can generalize to all three sub-functions or are specific to certain domains. To address this, the current review applied Miyake et al.'s (2000) fractionated model of executive functioning to the mindfulness literature. Empirical studies assessing the benefits of mindfulness to measures tapping the inhibition, updating, and shifting components of executive functioning were examined. Results suggest a relatively specific as opposed to general benefit resulting from mindfulness, with consistent inhibitory improvement, but more variable advantages to the updating and shifting domains. Recommendations surrounding application of mindfulness practice and future research are discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Mnemonic benefits of retrieval practice at short retention intervals.

    Science.gov (United States)

    Rowland, Christopher A; DeLosh, Edward L

    2015-01-01

    The testing effect refers to the retention benefit conferred by prior retrieval of information from memory. Although the testing effect is a robust phenomenon, a common assumption is that reliable memory benefits only emerge after long retention intervals of days or weeks. The present study focused on potential test-induced retention benefits for brief retention intervals on the order of minutes and tens of seconds. Participants in four experiments studied lists of words. Some of the items were subjected to an initial cued recall test, and others were re-presented for additional study. Free recall tests were administered in each experiment following retention intervals ranging from 30 s to 8 min. When initial retrieval practice was successful (Experiments 1 through 3), or feedback compensated for unsuccessful retrieval (Experiment 4), significant testing effects emerged at all retention intervals. Results are discussed in the context of a bifurcated item-distribution model and highlight the importance of initial test performance and the type of analysis employed when examining testing effect data.

  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. 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.

  2. 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.

  3. How Exercise Can Benefit Older Patients. A Practical Approach.

    Science.gov (United States)

    Barry, Henry C.; And Others

    1993-01-01

    Physical activity has preventive and therapeutic benefits for the frail elderly. Physicians must educate patients about exercise benefits. Walking, flexibility, and strength training can prevent muscle weakness and impaired gait and balance. Changes in functional capacity can create greater independence in daily living. Physical activity also…

  4. 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 ...

  5. Visual online control processes are acquired during observational practice.

    Science.gov (United States)

    Hayes, Spencer J; Elliott, Digby; Bennett, Simon J

    2013-07-01

    This experiment examined whether visual online control processes are coded during observational practice. Participants physically practised an aiming sequence while yoked participants either observed (observational practice) or did nothing (control). Two target sizes were used to vary the importance of visual online control processes. Constant error and variable error indicated that participants acquired the timing constraints through physical practice and observational practice. Kinematic data confirmed that the physical practice and observational practice groups executed similar movement control. Physical practice did result in a performance advantage, but only under large target conditions. These findings indicate that visual online control processes can be effectively acquired through observational practice. Copyright © 2013 Elsevier B.V. All rights reserved.

  6. 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...

  7. 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.

  8. 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.

  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. 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

  11. 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

  12. Vaccine safety evaluation: Practical aspects in assessing benefits and risks.

    Science.gov (United States)

    Di Pasquale, Alberta; Bonanni, Paolo; Garçon, Nathalie; Stanberry, Lawrence R; El-Hodhod, Mostafa; Tavares Da Silva, Fernanda

    2016-12-20

    Vaccines are different from most medicines in that they are administered to large and mostly healthy populations including infants and children, so there is a low tolerance for potential risks or side-effects. In addition, the long-term benefits of immunisation in reducing or eliminating infectious diseases may induce complacency due to the absence of cases. However, as demonstrated in recent measles outbreaks in Europe and United States, reappearance of the disease occurs as soon as vaccine coverage falls. Unfounded vaccine scares such as those associating the combined measles-mumps-rubella vaccine with autism, and whole-cell pertussis vaccines with encephalopathy, can also have massive impacts, resulting in reduced vaccine uptake and disease resurgence. The safety assessment of vaccines is exhaustive and continuous; beginning with non-clinical evaluation of their individual components in terms of purity, stability and sterility, continuing throughout the clinical development phase and entire duration of use of the vaccine; including post-approval. The breadth and depth of safety assessments conducted at multiple levels by a range of independent organizations increases confidence in the rigour with which any potential risks or side-effects are investigated and managed. Industry, regulatory agencies, academia, the medical community and the general public all play a role in monitoring vaccine safety. Within these stakeholder groups, the healthcare professional and vaccine provider have key roles in the prevention, identification, investigation and management of adverse events following immunisation (AEFI). Guidelines and algorithms aid in determining whether AEFI may have been caused by the vaccine, or whether it is coincidental to it. Healthcare providers are encouraged to rigorously investigate AEFIs and to report them via local reporting processes. The ultimate objective for all parties is to ensure vaccines have a favourable benefit-risk profile. Copyright

  13. Benefits of ICT adoption and use in regional general medical practices: a pilot study.

    Science.gov (United States)

    MacGregor, Rob; Hyland, Peter; Harvei, Charles; Lee, Boon-Chye; Dalley, Andrew; Ramu, Sangeetha

    This paper presents a pilot study of benefits derived from information and communications technology(ICT) adoption and use in medical practices in regional Australia. The study involved 122 regional medical practitioners. The results show that like the more general small business sector, the perception of certain benefits is associated with the size of the practice (in terms of employee levels) and/or the gender of the respondent practitioner. The data also showed that the level of skill of certain software used within the practice was significantly associated with the level of perceived benefit derived from ICT adoption and use.

  14. NEUROSYPHILIS IN THERAPEUTIC PRACTICE: CLINICAL OBSERVATION

    Directory of Open Access Journals (Sweden)

    N. A. Shostak

    2017-01-01

    Full Text Available Objective: to describe a clinical case of neurosyphilis diagnosed in a therapeutic inpatient facility.Materials and methods. Female patient T., 61, was hospitalized in the therapeutic department of a general hospital with referral diagnosis of “Stage II hypertensive heart disease, risk 4. Hypertensive crisis of 03.12.2015” with complaints of general fatigue, episodes of transient memory loss with full recovery, unstable blood pressure level. The patient was examined: She underwent treponemal and nontreponemal serological tests for antibodies against Treponema рallidum, hepatitis, human immunodeficiency virus; electrocardiogram; angiography of carotid and vertebral arteries; magnetic resonance imaging (MRI  of the brain with contrast; serological and microscopic examinations of the cerebrospinal fluid (CSF.Results. The patient»s medical history described episodes of transient global amnesia with full memory recovery, more frequent in the last year; arterial hypertension; chronic urinary tract infection; and chronic cholecystitis with frequent courses of antibacterial therapy (ceftriaxone. Since 1986, a positive serological reaction for syphilis was observed (Wassermann reaction (WR +++ due to a history of primary syphilis. Considering reliable history of syphilis, positive serum confirmation tests for syphilis (nontreponemal: rapid plasma reagin test 3+; treponemal: passive hemagglutination reaction 4+, antibodies against T. pallidum (total – present, history of neuropsychological symptoms (transient amnesia and acute neurological symptoms before hospitalization (transient ischemic attack, brain MRI data (2 lesions of cerebral circulation disorders of ischemic type in the cortical branches of left and right mesencephalic arteries, a diagnosis of neurosyphilis was proposed, and lumbar puncture was performed for confirmation. Inflammatory characteristics of the CSF (cytosis 19/3, neutrophilia up to 12 cells, insignificant lymphocytosis up

  15. 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.

  16. Management of lifecycle costs and benefits : Lessons from information systems practice

    NARCIS (Netherlands)

    Berghout, E.W.; Nijland, M.; Powell, P.

    Assessing the economic feasibility of information systems (IS) projects and operations remains a challenge for most organizations. This research investigates lifecycle cost and benefit management practices and demonstrates that, overall, although organizations intend to improve their information

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

    NARCIS (Netherlands)

    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

  18. 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.

  19. Costs and benefits of transforming primary care practices: a qualitative study of North Carolina's Improving Performance in Practice.

    Science.gov (United States)

    Reiter, Kristin L; Halladay, Jacqueline R; Mitchell, C Madeline; Ward, Kimberly; Lee, Shoou-Yih D; Steiner, Beat; Donahue, Katrina E

    2014-01-01

    Primary care organizations must transform care delivery to realize the Institute for Healthcare Improvement's Triple Aim of better healthcare, better health, and lower healthcare costs. However, few studies have considered the financial implications for primary care practices engaged in transformation. In this qualitative, comparative case study, we examine the practice-level personnel and nonpersonnel costs and the benefits involved in transformational change among 12 primary care practices participating in North Carolina's Improving Performance in Practice (IPIP) program. We found average annual opportunity costs of $21,550 ($6,659 per full-time equivalent provider) for maintaining core IPIP activities (e.g., data management, form development and maintenance, meeting attendance). This average represents the cost of a 50% full-time equivalent registered nurse or licensed practical nurse. Practices were able to limit transformation costs by scheduling meetings during relatively slow patient care periods and by leveraging resources such as the assistance of IPIP practice coaches. Still, the costs of practice transformation were not trivial and would have been much higher in the absence of these efforts. Benefits of transformation included opportunities for enhanced revenue through reimbursement incentives and practice growth, improved efficiency and care quality, and maintenance of certification. Given the potentially high costs for some practices, policy makers may need to consider reimbursement and other strategies to help primary care practices manage the costs of practice redesign.

  20. Employees’ participation in electronic networks of practice within a corporate group: perceived benefits and costs

    NARCIS (Netherlands)

    Sedighi, M.; Lukosch, S.G.; van Splunter, S.; Brazier, F.M.; Hamedi, Mohsen; van Beers, C.P.

    2017-01-01

    This paper explores benefits and costs of knowledge exchange perceived by individuals in connected electronic networks of practice (ENoP) in a corporate setting. The results of 25 semi-structured interviews show 9 perceived benefits and 5 perceived costs to be of importance for knowledge exchange.

  1. 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.

  2. 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...

  3. User Needs and Assessing the Impact of Low Latency NASA Earth Observation Data Availability on Societal Benefit

    Science.gov (United States)

    Brown, Molly E.; Carroll, Mark L.; Escobar, Vanessa M.

    2014-01-01

    Since the advent of NASA's Earth Observing System, knowledge of the practical benefits of Earth science data has grown considerably. The community using NASA Earth science observations in applications has grown significantly, with increasing sophistication to serve national interests. Data latency, or how quickly communities receive science observations after acquisition, can have a direct impact on the applications and usability of the information. This study was conducted to determine how users are incorporating NASA data into applications and operational processes to benefit society beyond scientific research, as well as to determine the need for data latency of less than 12 h. The results of the analysis clearly show the significant benefit to society of serving the needs of the agricultural, emergency response, environmental monitoring and weather communities who use rapidly delivered, accurate Earth science data. The study also showed the potential of expanding the communities who use low latency NASA science data products to provide new ways of transforming data into information. These benefits can be achieved with a clear and consistent NASA policy on product latency.

  4. Diffusion of Bevacizumab Across Oncology Practices: An Observational Study.

    Science.gov (United States)

    Keating, Nancy L; Huskamp, Haiden A; Schrag, Deborah; McWilliams, John M; McNeil, Barbara J; Landon, Bruce E; Chernew, Michael E; Normand, Sharon-Lise T

    2018-01-01

    Technological advances can improve care and outcomes but are a primary driver of health care spending growth. Understanding diffusion and use of new oncology therapies is important, given substantial increases in prices and spending on such treatments. Examine diffusion of bevacizumab, a novel (in 2004) and high-priced biologic cancer therapy, among US oncology practices during 2005-2012 and assess variation in use across practices. Population-based observational study. A total of 2329 US practices providing cancer chemotherapy. Random 20% sample of 236,304 Medicare fee-for-service beneficiaries aged above 65 years in 2004-2012 undergoing infused chemotherapy for cancer. Diffusion of bevacizumab (cumulative time to first use and 10% use) in practices, variation in use across practices overall and by higher versus lower-value use. We used hierarchical models with practice random effects to estimate the between-practice variation in the probability of receiving bevacizumab and to identify factors associated with use. We observed relatively rapid diffusion of bevacizumab, particularly in independent practices and larger versus smaller practices. We observed substantial variation in use; the adjusted odds ratio (95% confidence interval) of bevacizumab use was 2.90 higher (2.73-3.08) for practices 1 SD above versus one standard deviation below the mean. Variation was less for higher-value [odds ratio=2.72 (2.56-2.89)] than lower-value uses [odds ratio=3.61 (3.21-4.06)]. Use of bevacizumab varied widely across oncology practices, particularly for lower-value indications. These findings suggest that interventions targeted to practices have potential for decreasing low-value use of high-cost cancer therapies.

  5. 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

    of benefits. About 20 percent of the companies associate themselves with four to six  projects on new accounting practices in their organization, which might lead to poor performance and high failure rates. Comments from the respondents also show that companies have mixed feelings concerning the practices......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...

  6. 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 ...

  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. Effective population management practices in diabetes care - an observational study

    DEFF Research Database (Denmark)

    Frølich, Anne; Bellows, Jim; Nielsen, Bo Friis

    2010-01-01

    Of fifteen diabetes care management practices, our data indicate that high performance is most associated with provider alerts and more weakly associated with action plans and with guideline distribution and training. Lack of convergence in the literature on effective care management practices su...... suggests that factors contributing to high performance may be highly context-dependent or that the factors involved may be too numerous or their implementation too nuanced to be reliably identified in observational studies....

  9. 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...

  10. 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.

  11. 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.

  12. 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

  13. Promoting consultation recording practice in oncology: identification of critical implementation factors and determination of patient benefit.

    Science.gov (United States)

    Hack, Thomas F; Ruether, J Dean; Weir, Lorna M; Grenier, Debjani; Degner, Lesley F

    2013-06-01

    The objectives of this implementation study were to (i) address the evidentiary, contextual, and facilitative mechanisms that serve to retard or promote the transfer and uptake of consultation recording use in oncology practice and (ii) follow patients during the first few days following receipt of the consultation recording to document, from the patient's perspective, the benefits realized from listening to the recording. Nine medical and nine radiation oncologists from cancer centers in three Canadian cities (Calgary, Vancouver, and Winnipeg) recorded their primary consultations for 228 patients newly diagnosed with breast (n = 174) or prostate cancer (n = 54). The Digital Recording Use Semi-Structured Interview was conducted at 2 days and 1 week postconsultation. Each oncologist was provided a feedback letter summarizing the consultation recording benefits reported by their patients. Sixty-nine percent of patients listened to at least a portion of the recording within the first week following the consultation. Consultation recording favorableness ratings were high: 93.6% rated the intervention between 75 and 100 on a 100-point scale. Four main areas of benefit were reported: (i) anxiety reduction; (ii) enhanced retention of information; (iii) better informed decision making; and (iv) improved communication with family members. Eight fundamental components of successful implementation of consultation recording practice were identified. Further randomized trials are recommended, using standardized measures of the patient-reported benefit outcomes reported herein, to strengthen the evidence base for consultation recording use in oncology practice. Copyright © 2012 John Wiley & Sons, Ltd.

  14. 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

  15. Integrative review of benefit levers' characteristics for system-wide spread of best healthcare practices.

    Science.gov (United States)

    ten Ham, Wilma; Minnie, Karin; van der Walt, Christa

    2016-01-01

    To critically analyse the characteristics of the benefit levers that are required for effective system-wide spread of evidence-based practice. Evidence-based nursing practice is the cornerstone of quality patient care and merits system-wide implementation. Achieving system-wide spread of evidence-based innovations requires adoption of four benefit levers (the facilitators for spreading innovations), conceptualized by Edwards and Grinspun: alignment, leadership for change, permeation plans and supporting and reinforcing structures. Although these concepts have been explored and described in primary studies, they were only recently identified as benefit levers and their characteristics have not been reviewed in the context of health care using an integrative literature review. An integrative literature review using an adapted Whittemore and Knafl design. A comprehensive search using multiple sites such as Scopus, EBSCOhost, ProQuest, ScienceDirect, Cochrane Library, Nexus, SAePublications, Sabinet, Google Scholar and grey literature was conducted (January-March 2012) and updated (December 2014). After reading the abstracts, titles and full-text articles, forty (N = 40) research and non-research documents met the inclusion criteria. Thirty-five documents remained after critical appraisal. A systematic approach was used to analyse and synthesize the data and formulate concluding statements. Data revealed characteristics about alignment (personal, organizational and contextual attributes), permeation plans (phases), leadership for change (types, strategies, position, attitude and support) and supporting and reinforcing structures (types and requirements). Benefit levers should be used to promote the spread of evidence-based practices. However, more studies concerning benefit levers, specifically regarding 'alignment' and 'permeation plans', are required to promote system-wide spread of best healthcare practices. © 2015 John Wiley & Sons Ltd.

  16. 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.

  17. Observational practice of incentive spirometry in stroke patients.

    Science.gov (United States)

    Lima, Íllia N D F; Fregonezi, Guilherme A F; Florêncio, Rêncio B; Campos, Tânia F; Ferreira, Gardênia H

    Stroke may lead to several health problems, but positive effects can be promoted by learning to perform physical therapy techniques correctly. To compare two different types of observational practice (video instructions and demonstration by a physical therapist) during the use of incentive spirometry (IS). A total of 20 patients with diagnosis of stroke and 20 healthy individuals (56±9.7 years) were allocated into two groups: one with observational practice with video instructions for the use of IS and the other with observational practice with demonstration by a physical therapist. Ten attempts for the correct use of IS were carried out and the number of errors and the magnitude of response were evaluated. The statistic used to compare the results was the three-way ANOVA test. The stroke subjects showed less precision when compared to the healthy individuals (mean difference 1.80±0.38) 95%CI [1.02-2.52], pstroke subjects showed more errors with the video instructions (mean difference 1.5±0.5, 95%CI [0.43-2.56] (p=0.08)) and therapist demonstration (mean difference 2.40±0.52, 95%CI [1.29-3.50] (p=0.00)) when compared to the healthy individuals. The stroke subjects had a worse performance in learning the use of volume-oriented incentive spirometry when compared to healthy individuals; however, there was no difference between the types of observational practice, suggesting that both may be used to encourage the use of learning IS in patients with stroke. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

  18. 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.

  19. 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.

  20. Tai chi chuan: mind-body practice or exercise intervention? Studying the benefit for cancer survivors.

    Science.gov (United States)

    Mansky, Patrick; Sannes, Tim; Wallerstedt, Dawn; Ge, Adeline; Ryan, Mary; Johnson, Laura Lee; Chesney, Margaret; Gerber, Lynn

    2006-09-01

    Tai chi chuan (TCC) has been used as a mind-body practice in Asian culture for centuries to improve wellness and reduce stress and has recently received attention by researchers as an exercise intervention. A review of the English literature on research in TCC published from 1989 to 2006 identified 20 prospective, randomized, controlled clinical trials in a number of populations, including elderly participants (7 studies), patients with cardiovascular complications (3 studies), patients with chronic disease (6 studies), and patients who might gain psychological benefit from TCC practice (2 studies). However, only the studies of TCC in the elderly and 2 studies of TCC for cardiovascular disease had adequate designs and size to allow conclusions about the efficacy of TCC. Most (11 studies) were small and provided limited information on the benefit of TCC in the settings tested. There is growing awareness that cancer survivors represent a population with multiple needs related to physical deconditioning, cardiovascular disease risk, and psychological stress. TCC as an intervention may provide benefit to cancer survivors in these multiple areas of need based on its characteristics of combining aspects of meditation and aerobic exercise. However, little research has been conducted to date to determine the benefit of TCC in this population. We propose a model to study the unique characteristics of TCC compared to physical exercise that may highlight characteristic features of this mind-body intervention in cancer survivors.

  1. Orion Flight Test 1 Architecture: Observed Benefits of a Model Based Engineering Approach

    Science.gov (United States)

    Simpson, Kimberly A.; Sindiy, Oleg V.; McVittie, Thomas I.

    2012-01-01

    This paper details how a NASA-led team is using a model-based systems engineering approach to capture, analyze and communicate the end-to-end information system architecture supporting the first unmanned orbital flight of the Orion Multi-Purpose Crew Exploration Vehicle. Along with a brief overview of the approach and its products, the paper focuses on the observed program-level benefits, challenges, and lessons learned; all of which may be applied to improve system engineering tasks for characteristically similarly challenges

  2. 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

  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.

    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.

  4. 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)

  5. 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.

  6. Systematic neighborhood observations at high spatial resolution: methodology and assessment of potential benefits.

    Directory of Open Access Journals (Sweden)

    Tammy C M Leonard

    Full Text Available There is a growing body of public health research documenting how characteristics of neighborhoods are associated with differences in the health status of residents. However, little is known about how the spatial resolution of neighborhood observational data or community audits affects the identification of neighborhood differences in health. We developed a systematic neighborhood observation instrument for collecting data at very high spatial resolution (we observe each parcel independently and used it to collect data in a low-income minority neighborhood in Dallas, TX. In addition, we collected data on the health status of individuals residing in this neighborhood. We then assessed the inter-rater reliability of the instrument and compared the costs and benefits of using data at this high spatial resolution. Our instrument provides a reliable and cost-effect method for collecting neighborhood observational data at high spatial resolution, which then allows researchers to explore the impact of varying geographic aggregations. Furthermore, these data facilitate a demonstration of the predictive accuracy of self-reported health status. We find that ordered logit models of health status using observational data at different spatial resolution produce different results. This implies a need to analyze the variation in correlative relationships at different geographic resolutions when there is no solid theoretical rational for choosing a particular resolution. We argue that neighborhood data at high spatial resolution greatly facilitates the evaluation of alternative geographic specifications in studies of neighborhood and health.

  7. 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.

  8. Satellite Cloud Data Validation through MAGIC Ground Observation and the S'COOL Project: Scientific Benefits grounded in Citizen Science

    Science.gov (United States)

    Crecelius, S.; Chambers, L. H.; Lewis, P. M.; Rogerson, T.

    2013-12-01

    cruises, and reported data from one complete leg of the experiment. S'COOL received 24 MAGIC observations from September to October of 2012 that correspond to a satellite overpass. Most show exact or very good agreement to the satellite data. This paper will report on the analysis of MAGIC's cloud observations specifically, while highlighting the benefit of citizen science collaborations and contributions to the scientific community. Best practices, challenges, and future plans will be shared from 16 years of the S'COOL Project and 6 years of S'COOL ROVER Citizen Science.

  9. 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.

  10. 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.

  11. Quantifiable risk-benefit assessment of micronutrients: From theory to practice.

    Science.gov (United States)

    Krul, Lisette; Kremer, Bas H A; Luijckx, Niels B Lucas; Leeman, Winfried R

    2017-11-22

    The EU Food Supplements Directive (2002/46/EC) mandates the determination of both maximum and minimum permitted levels (MPLs) for micronutrients. In order to determine MPLs which are feasible for particular population groups, a scientific approach should be used in which risk of high intake, risk of inadequacy and benefits are assessed in an integrated way taking all available data and severity and incidence of effect into account. In 2004, Renwick et al. (ILSI Europe) published a scientifically valid, flexible and pragmatic basis for a risk-benefit approach, which has been further developed here to make it a practical and quantifiable approach to be used by risk managers. The applicability of the approach is demonstrated using demo cases on iron and folate. The proposed approach has the capacity to utilize all relevant data available, including data from human studies, bioavailability data showing variability between specific forms of micronutrients and, in the case of animal studies, data on species comparability. The approach is therefore both practical and flexible, making it well suited to risk managers tasked with determining safe intake levels for micronutrients in different forms and for particular population groups.

  12. 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

  13. Creative uses of blogging in a postgraduate entrepreneurship course: discussion and reflection of benefits, challenges and best practice

    OpenAIRE

    Beaumont, Corrine

    2011-01-01

    Blogging is increasingly being used in the classroom environment. In addition to being a method for recording reflection, blogs can be a useful tool for feedback and building reputation. This paper explores benefits, challenges and best practices through a case study of a postgraduate entrepreneurship course at Kingston University. It identifies the often overlooked benefits for integrating blogging into the student learning experience and gives practical suggestions for how it can be deploye...

  14. 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.

  15. 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.

  16. 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…

  17. 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

  18. 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).

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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

  7. 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

  8. 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

  9. 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

    to assess if: • the research valid? • what are the results? • should we apply the research in our practice? Background GPs often experience difficulties in keeping up-to-date, and at times feel they reach the outer boundaries of their knowledge. The practice of medicine in which the busy physician finds...... will have a tool to assist life-long learning in practice. Based on the questions that arise in daily practice, we can learn by doing. What are the benefits and harms of general health checks? This workshop will invite participants to read the Cochrane review about general health checks and scrutinise...

  10. 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…

  11. Perceptions of how parents of early adolescents will personally benefit from calcium-rich food and beverage parenting practices.

    Science.gov (United States)

    Richards, Rickelle; Reicks, Marla; Wong, Siew Sun; Gunther, Carolyn; Cluskey, Mary; Ballejos, Miriam S; Bruhn, Christine; Johnston, N Paul; Misner, Scottie; Watters, Corilee

    2014-01-01

    To identify and rank perceived personal benefits from parenting practices that promote intake of calcium-rich foods and beverages (CRF/B) by early adolescents. A convenience sample of parents/caregivers (n = 133) of early adolescents (10-13 years) from 6 states (CA, HI, MN, OH, OR, UT) participated in a qualitative study using a Nominal Group Technique process. Benefits identified by parents/caregivers were ranked by importance, given a score weight, and summed to create a total weighted score across states. The top benefit from making CRF/B available was parent emotional rewards. The top benefit perceived by parents from role modeling intake of CRF/B and setting expectations for intake of CRB was child health promotion. Child health promotion and parent emotional rewards were important perceived benefits derived from CRF/B parenting practices, and thus, should be included as the focus of education to increase the frequency of these practices. Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  12. 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,

  13. Benefits of a short, practical questionnaire to measure subjective perception of nasal appearance after aesthetic rhinoplasty.

    Science.gov (United States)

    Lohuis, Peter J F M; Hakim, Sara; Duivesteijn, Wouter; Knobbe, Arno; Tasman, Abel-Jan

    2013-12-01

    The authors tested a short, practically designed questionnaire to assess changes in subjective perception of nasal appearance in patients before and after aesthetic rhinoplasty. A prospective cohort study was conducted in a group of 121 patients who desired aesthetic rhinoplasty and were operated on by one surgeon. The questionnaire contained five questions (E1-E5) based on a five-point Likert scale and a visual analogue scale (range, 0 to 10). Two questions were designed as trick questions to help the surgeon screen for signs of body dysmorphic disorder. All patients rated the appearance of their nose as improved after surgery. The visual analogue scale revealed a Gaussian curve of normal distribution (range, 0.5 to 10) around a significant improvement (mean, 4.36 points, p = 0.018). Also, question E1, question E2, and the sum of questions E1 through E5 showed a statistically significant improvement after surgery (p = 1.74 × 10, p = 4.29 × 10, and p = 9.23 × 10, respectively). The authors found a linear relationship between preoperative score on the trick questions and postoperative increase in visual analogue scale score. Test-retest reliability could be investigated in 74 of 121 patients (61 percent) and showed a positive correlation between postoperative (1 year after surgery) and repostoperative response (2 to 4 years after surgery). The authors concluded that a surgeon performing aesthetic rhinoplasty can benefit from using this questionnaire. It is simple, takes no more than 2 minutes to complete, and provides helpful subjective information regarding patients' preoperative nasal appearance and postoperative surgical outcome. Therapeutic, IV.

  14. 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.

  15. Participant Observation and the Political Scientist: Possibilities, Priorities, and Practicalities

    Science.gov (United States)

    Gillespie, Andra; Michelson, Melissa R.

    2011-01-01

    Surveys, experiments, large-"N" datasets and formal models are common instruments in the political scientist's toolkit. In-depth interviews and focus groups play a critical role in helping scholars answer important political questions. In contrast, participant observation techniques are an underused methodological approach. In this article, we…

  16. Directly-Observed Treatment Strategy implementation practices in a ...

    African Journals Online (AJOL)

    2014-09-09

    Sep 9, 2014 ... The Directly-Observed Treatment Strategy (DOTS) programme is intended to ensure both treatment completion and cure of TB, as well as its evaluation. Despite improved. DOTS coverage – the focus of most DOTS studies – the incidence of drug-resistant TB suggests that issues of non-compliance are ...

  17. 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…

  18. 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,…

  19. A database of synthetic observations for geomagnetic data assimilation practice

    Science.gov (United States)

    Fournier, A.; Aubert, J.; Thebault, E.; Schaeffer, N.

    2012-04-01

    Data assimilation aims at producing an optimal estimate of the state of the dynamical system one is interested in by combining two sources of information : physical laws (in the form of a numerical model) and observations. A mandatory step during the development of a data assimilation framework involves a validation phase using synthetic data. In this well-controlled environment, the true dynamical trajectory of the system is known (it results from the integration of the numerical model), and it is used to generate synthetic observations. Those are subsequently used to assess the efficacy, and to highlight possible shortcomings, of the chosen methodology. Data assimilation has recently come to the fore in geomagnetism (e.g. Fournier et al., 2010), a surge motivated by our increased ability to observe the geomagnetic field (thanks to dedicated satellite missions), and by the concurrent progress in the numerical description of core dynamics. Open questions are related to the type of physical models one should resort to, and to the choice of a suitable algorithm, able to integrate the highly heterogeneous geomagnetic record at our disposal, and to deal with the non-linearities of the problem at hand (e.g. Aubert & Fournier, 2011; Fournier et al., 2011). Here we report on the construction of a database of synthetic observations meant at reproducing the heterogeneity of the geomagnetic record (in terms of temporal and spatial coverage). This database relies on two dynamical trajectories: a long-term dynamical trajectory (spanning the equivalent of the past few millenia) computed from a three-dimensional, convection-driven, dynamo model, able to represent accurately the long-term variability of the geomagnetic field a short-term dynamical trajectory (spanning the equivalent of a few decades), computed from a high-resolution three-dimensional model, able to represent interannual to decadal core processes (e.g. Gillet et al., 2011), and whose basic state is determined from

  20. The Teaching Practices Observation Scale (TPOS): An Observational Taxonomy for Assessing Teacher-Preschooler Interactions during Free Play.

    Science.gov (United States)

    Moulton, Caryn E.; Coplan, Robert J.; Mills, Catherine

    1999-01-01

    This study examined preliminary psychometric properties of the Teaching Practices Observation Scale (TPOS), a newly developed observational taxonomy for assessing teacher behaviors during free play with young children. Behaviors of 42 child caregivers and junior kindergarten teachers were coded using a combination of time-sampling, event-sampling,…

  1. 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.

  2. The Effects of Observing Practices on the Perception of Female College Students towards Preschool Children

    OpenAIRE

    藤田, 文; Aya, Fujita

    1999-01-01

    The purpose of this study was to investigate the effects of observing practices on the perception of female college students towards preschool children. Female college students responded to a questionnaire asking about the perception of children and the communication skills with children and the confidence of communication with them before and after observing practices. They were divided into three groups; (1) high-confidence group that participated in observing practices and have confidence ...

  3. Astronomy with a Budget Telescope An Introduction to Practical Observing

    CERN Document Server

    Moore, Patrick

    2012-01-01

    If you had purchased an inexpensive astronomical telescope a few years ago, disappointment would have been almost guaranteed. In current Internet age, times have changed and most (but not quite all) telescopes have been used to favorable results. Sir Patrick Moore, working with John Watson, has surveyed and tested the best and the worst of today's budget-priced astronomical telescopes. This new edition of Astronomy with a Budget Telescope is the result of their efforts. This book will show you how to recognize the good from the bad in observational ware with essential hints and tips on what to look for when buying both new and used telescopes. Updated and expanded, this latest edition includes budgeting tips for the new generation of digital cameras and 'go-to' telescopes. It provides a step-by-step guide to setting up your telescope, and how to observe the Moon, Sun, planets, stars, nebulae, and galaxies. Inside you'll find full-page finder charts and full-color images showing you what each object should loo...

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

    Science.gov (United States)

    Compeau, Deborah Ruth; Terry, Amanda

    2017-06-30

    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. 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. 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. 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.  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.

  5. 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

  6. A case study in technology utilization: Industrial products and practices. [summary of benefits to national economy resulting from space programs

    Science.gov (United States)

    1973-01-01

    In pursuit of such missions as Apollo, the National Aeronautics and Space Administration has called into being unique equipment that obviously has little direct application beyond the achievement of mission objectives. Yet, to assume that further direct application of space program hardware is somehow a measure of the industrial benefits accruing to the nation is to misunderstand how the creation of new technology affects modern industrial capability. This document presents a profile of the significant ways in which technological developments in response to aerospace mission requirements have been coupled into industrial practice, with the result being that improved products and processes are now being utilized to benefit the nation.

  7. On the benefit of GOSAT observations to the estimation of regional CO2 fluxes

    Energy Technology Data Exchange (ETDEWEB)

    Takagi, H [NIES, Japan; Saeki, T [NIES, Japan; Oda, T [National Institute for Environmental Studies, Japan; Saito, M [National Institute for Environmental Studies, Japan; Valsala, V [National Institute for Environmental Studies, Japan; Belikov, D [NIES, Japan; Saito, R [NIES, Japan; Yoshida, Y [National Institute for Environmental Studies, Japan; Morino, I [NIES, Japan; Uchino, O [NIES, Japan; Andres, Robert Joseph [ORNL; Yokota, T [National Institute for Environmental Studies, Japan; Maksyutov, S [National Institute for Environmental Studies, Japan

    2011-01-01

    We assessed the utility of global CO{sub 2} distributions brought by the Greenhouse gases Observing SATellite (GOSAT) in the estimation of regional CO{sub 2} fluxes. We did so by estimating monthly fluxes and their uncertainty over a one-year period between June 2009 and May 2010 from (1) observational data collected in existing networks of surface CO2 measurement sites (GLOBALVIEWCO2 2010; extrapolated to the year 2010) and (2) both the surface observations and column-averaged dry air mole fractions of CO{sub 2} (X{sub CO2}) retrieved from GOSAT soundings. Monthly means of the surface observations and GOSAT X{sub CO2} retrievals gridded to 5{sup o} x 5{sup o} cells were used here. The estimation was performed for 64 subcontinental-scale regions. We compared these two sets of results in terms of change in uncertainty associated with the flux estimates. The rate of reduction in the flux uncertainty, which represents the degree to which the GOSAT X{sub CO2} retrievals contribute to constraining the fluxes, was evaluated. We found that the GOSAT X{sub CO2} retrievals could lower the flux uncertainty by as much as 48% (annual mean). Pronounced uncertainty reduction was found in the fluxes estimated for regions in Africa, South America, and Asia, where the sparsity of the surface monitoring sites is most evident.

  8. 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

  9. 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

  10. 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

  11. 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.

  12. Remote Sensing Ocean Color Observations from NASA's PACE Mission: Applications and Societal Benefits

    Science.gov (United States)

    Tzortziou, M.; Omar, A. H.; Turner, W.

    2014-12-01

    The PACE (Pre- Aerosol, Clouds and ocean Ecosystems) mission is a strategic Climate Continuity mission, included in NASA's 2010 plan: "Responding to the Challenge of Climate and Environmental Change: NASA's Plan for a Climate-Centric Architecture for Earth Observations and Applications from Space". On a polar orbit, PACE will make climate-quality global measurements that are essential for understanding ocean biology, biogeochemistry and ecology, and determining how the ocean's role in global biogeochemical cycling and ocean ecology both affects and is affected by climate change. With advanced global remote sensing capabilities that include high spectral-resolution imaging, extended spectral coverage to the UV and SWIR, improved spatial resolution in inland, estuarine and coastal waters, enhanced atmospheric correction and higher signal-to-noise, PACE is expected to provide high quality observations that, over the long-term, will contribute to an extended time series of records on inland, coastal, and ocean ecosystems—all of which have substantial value beyond basic science and research. The combination of climate-quality, global atmospheric and oceanic observations provided by the PACE mission will provide a unique capability to help understand changes that affect our ecosystem services, implement science-based management strategies of coastal, marine and inland aquatic resources, and support assessments, policy analyses, and design approaches to plan adaptation and responses to impacts of climate change. Here we discuss the PACE applications program, the new capabilities afforded by this future satellite mission, and how they could potentially advance applications across a range of areas, including Oceans, Climate, Water Resources, Ecological Forecasting, Disasters, Human Health and Air Quality.

  13. 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.

  14. 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.

  15. 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…

  16. 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.

  17. 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.

  18. 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…

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

    NARCIS (Netherlands)

    Tesfaye, Abonesh; Brouwer, Roy; van der Zaag, P.; Negatu, Workneh

    2016-01-01

    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

  20. In the absence of physical practice, observation and imagery do not result in updating of internal models for aiming.

    Science.gov (United States)

    Ong, Nicole T; Larssen, Beverley C; Hodges, Nicola J

    2012-04-01

    The presence of after-effects in adaptation tasks implies that an existing internal model has been updated. Previously, we showed that although observers adapted to a visuomotor perturbation, they did not show after-effects. In this experiment, we tested 2 further observer groups and an actor group. Observers were now actively engaged in watching (encouraged through imagery and movement estimation), with one group physically practising for 25% of the trials (mixed). Participants estimated the hand movements that produced various cursor trajectories and/or their own hand movement from a preceding trial. These trials also allowed us to assess the development of explicit knowledge as a function of the three practice conditions. The pure observation group did not show after-effects, whereas the actor and mixed groups did. The pure observation group improved their ability to estimate hand movement of the video model. Although the actor and mixed groups improved in actual reaching accuracy, they did not improve in explicit estimation. The mixed group was more accurate in reaching during adaptation and showed larger after-effects than the actors. We suggest that observation encourages an explicit mode of learning, enabling performance benefits without corresponding changes to an internal model of the mapping between output and sensory input. However, some physical practice interspersed with observation can change the manner with which learning is achieved, encouraging implicit learning and the updating of an existing internal model.

  1. 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...

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

    Science.gov (United States)

    Kennelly, S; Kennedy, N P; Corish, C A; Flanagan-Rughoobur, G; Glennon-Slattery, C; Sugrue, 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. The intervention involved general practitioners (GPs), practice nurses, nurses in local nursing homes and community nurses. It comprised an education programme together with the provision of a new community dietetics service. Changes in health care professionals' nutrition care practices were determined by examining community dietetics records. ONS prescribing volume and expenditure on ONS were assessed using data from the Primary Care Reimbursement Service of the Irish Health Service Executive. Seven out of 10 principal GPs participated in the nutrition education programme. One year later, screening for malnutrition risk was better, dietary advice was provided more often, referral to the community dietetics service improved and ONS were prescribed for a greater proportion of patients at 'high risk' of malnutrition than before (88% versus 37%; P dietetics intervention improved ONS prescribing practices by GPs and nurses, in accordance with best practice guidelines, without increasing expenditure on ONS during the year after intervention. © 2011 The Authors. Journal of Human Nutrition and Dietetics © 2011 The British Dietetic Association Ltd.

  3. 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

    acquisition had poorer retention performance, particularly for the decreasing choice (4-3-2-1) sequence (p group reported significantly higher overall motivation (p = .007, t(38) = 0.728, d = 0.248) on the IMI as compared to the autonomy-controlling group. Individual benefits of errorless learning and autonomy-supportive practice conditions, with an interaction effect for practice that begins errorless but adds increasing 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 work will continue to examine how assigning a positive versus a negative quality to error provision influences the benefits of errorful learning in a variety of tasks. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. 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

  5. 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

    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...... 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...

  6. 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

  7. E-Learning Practices in North Cyprus Universities: Benefits, Drawbacks and Recommendations for Effective Implementation

    Science.gov (United States)

    Hismanoglu, Murat

    2011-01-01

    The nature of higher education is changing in the world today. Rising tuition fees, reduced budgets, and an increasing need for distance education (New Media Consortium, 2007) are pushing educational institutions to reinvestigate how education is delivered. In line with this shifting context, e-learning is being practiced more and more frequently…

  8. Physical and psychosocial benefits of modified judo practice for blind, mentally retarded children: a pilot study.

    Science.gov (United States)

    Gleser, J M; Margulies, J Y; Nyska, M; Porat, S; Mendelberg, H; Wertman, E

    1992-06-01

    A modified form of judo training was practiced by a class of 7 blind, mentally retarded children with associated neuropsychiatric disturbances. The biweekly training program lasted for 6 months. Analysis indicated improvements in physical fitness, motor skills, and psychosocial attitude. The authors concluded that a modified form of judo can be used as a therapeutic, educational, and recreational tool for multiply handicapped children.

  9. Virtual Relationships and Real Benefits: Using E-Mentoring to Connect Business Students with Practicing Managers

    Science.gov (United States)

    de Janasz, Suzanne C.; Ensher, Ellen A.; Heun, Christian

    2008-01-01

    This article reports the results of our study of electronic mentoring (e-mentoring) in a population of business students. As career paths have become more fluid and less predictable, a growing number of educational and business organizations have implemented traditional and, more recently, e-mentoring programs. But practice is ahead of evaluation…

  10. 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...

  11. 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

  12. An integrated modeling approach for estimating the water quality benefits of conservation practices at the river basin scale.

    Science.gov (United States)

    Santhi, C; Kannan, N; White, M; Di Luzio, M; Arnold, J G; Wang, X; Williams, J R

    2014-01-01

    The USDA initiated the Conservation Effects Assessment Project (CEAP) to quantify the environmental benefits of conservation practices at regional and national scales. For this assessment, a sampling and modeling approach is used. This paper provides a technical overview of the modeling approach used in CEAP cropland assessment to estimate the off-site water quality benefits of conservation practices using the Ohio River Basin (ORB) as an example. The modeling approach uses a farm-scale model, Agricultural Policy Environmental Extender (APEX), and a watershed scale model (the Soil and Water Assessment Tool [SWAT]) and databases in the Hydrologic Unit Modeling for the United States system. Databases of land use, soils, land use management, topography, weather, point sources, and atmospheric depositions were developed to derive model inputs. APEX simulates the cultivated cropland, Conserve Reserve Program land, and the practices implemented on them, whereas SWAT simulates the noncultivated land (e.g., pasture, range, urban, and forest) and point sources. Simulation results from APEX are input into SWAT. SWAT routes all sources, including APEX's, to the basin outlet through each eight-digit watershed. Each basin is calibrated for stream flow, sediment, and nutrient loads at multiple gaging sites and turned in for simulating the effects of conservation practice scenarios on water quality. Results indicate that sediment, nitrogen, and phosphorus loads delivered to the Mississippi River from ORB could be reduced by 16, 15, and 23%, respectively, due to current conservation practices. Modeling tools are useful to provide science-based information for assessing existing conservation programs, developing future programs, and developing insights on load reductions necessary for hypoxia in the Gulf of Mexico. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

  13. Convergence of Observer Ratings and Student Perceptions of Reform Practices in Sixth-Grade Mathematics Classrooms

    Science.gov (United States)

    Ellis, Mark W.; Malloy, Carol E.; Meece, Judith L.; Sylvester, Patricia R.

    2007-01-01

    As part of a research project examining relationships between instructional practices and student cognitive and social outcomes in middle-school mathematics classes, external observers and students reported perceptions of teachers' instructional practices. The extent to which students in classrooms identified by external raters as reform-oriented…

  14. Current sedation and monitoring practice for colonoscopy: an International Observational Study (EPAGE)

    DEFF Research Database (Denmark)

    Froehlich, F; Harris, JK; Wietlisbach, V

    2006-01-01

    in endoscopy centers internationally. PATIENTS AND METHODS: This observational study included consecutive patients referred for colonoscopy at 21 centers in 11 countries. Endoscopists reported sedation and monitoring practice, using a standard questionnaire for each patient. RESULTS: 6004 patients were...

  15. 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.

  16. 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.

  17. 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. 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), 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. Results: 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. PMID:24653699

  18. 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.

  19. The benefits of setting the ground rules and regulating contracting practices.

    Science.gov (United States)

    Kadaï, Abatcha; Sall, Farba Lamine; Andriantsara, Guy; Perrot, Jean

    2006-11-01

    In recent years, health systems have increasingly made use of contracting practices; despite results that are often promising, there have also been failures and occasionally harsh criticism of such practices. This has made it even more necessary to regulate contracting practices. As part of its stewardship function, in other words its responsibility to protect the public interest, the ministry of health has the responsibility of introducing the tools needed for such regulation. Several tools are available to help it do this. Some of them, such as standard contracts or framework contracts, useful as they may be, are nevertheless specific and ad hoc. Contracting policies, when carefully linked to overall health policies, are undoubtedly the most comprehensive of these tools, since they enable contracting to be accommodated within the management of the health system as a whole and thus take into account its potential contribution to improving health system performance. However, the requirements for success are not present automatically and it has to be ensured that there are mechanisms for vitalizing these regulatory mechanisms and that the key actors make proper use of the framework laid down by the ministry of health. The first three authors of this article have participated in the preparation and implementation of national policies on contracting in their own countries, viz. Chad, Madagascar and Senegal.

  20. 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.

  1. 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 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 backyard poultry. © 2016 Blackwell Verlag GmbH.

  2. 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.

  3. Tackling the digitalization challenge: how to benefit from digitalization in practice

    Directory of Open Access Journals (Sweden)

    Päivi Parviainen

    2017-01-01

    Full Text Available Digitalization has been identified as one of the major trends changing society and business. Digitalization causes changes for companies due to the adoption of digital technologies in the organization or in the operation environment. This paper discusses digitalization from the viewpoint of diverse case studies carried out to collect data from several companies, and a literature study to complement the data. This paper describes the first version of the digital transformation model, derived from synthesis of these industrial cases, explaining a starting point for a systematic approach to tackle digital transformation. The model is aimed to help companies systematically handle the changes associated with digitalization. The model consists of four main steps, starting with positioning the company in digitalization and defining goals for the company, and then analyzing the company’s current state with respect to digitalization goals. Next, a roadmap for reaching the goals is defined and implemented in the company. These steps are iterative and can be repeated several times. Although company situations vary, these steps will help to systematically approach digitalization and to take the steps necessary to benefit from it.

  4. Understanding and assessing potential serious adverse events: a practical approach to understanding the benefits and harm of psoriasis treatments.

    Science.gov (United States)

    Papp, Kim; Guenther, Lyn; Shear, Neil; Binder, Carin; Tan, Jerry; Lynde, Charles; Gulliver, Wayne; Stang, Paul

    2013-01-01

    Any therapeutic intervention carries with it the potential for benefit and harm. Generally, benefit is far more common than risk; however, risk aversion drives many of the treatment decisions made by patients and their physicians. To provide guidelines to help clinicians improve their understanding of causality and the interpretation of harm. A group of dermatologists involved in data safety monitoring boards, clinical trial investigators, and a clinical epidemiologist identified the need for practical advice on how to understand and explain causality and harm and combined to share their knowledge. An explanation of how data are collected and the environment that shapes the data seen by clinicians is presented. The article spans an overview of the regulatory environment that informs trial design for regulatory approval to a description of types of designs that inform safety and techniques, such as the rule of three, to provide guidance to clinicians in interpreting the data. Communicating the potential for harm to patients is critical. Placing the potential for rare and serious risks into perspective for the patient is as important as discussing the potential benefits of medication.

  5. Practical Benefits of Aspect-Oriented Programming Paradigm in Discrete Event Simulation

    Directory of Open Access Journals (Sweden)

    Meriem Chibani

    2014-01-01

    Full Text Available Aspect-oriented modeling and simulation is a new approach which uses the separation of concerns principle to enhance the quality of models and simulation tools. It adopts the separation of concerns (SOC principle. Thus, crosscutting concerns such as processes synchronization, steady state detection, and graphical animation could be separated from simulation functional modules. The capture of crosscutting concerns in a modular way is carried out to cope with complexity and to achieve the required engineering quality factors such as robustness, modularity, adaptability, and reusability. This paper provides a summary of aspect-oriented paradigm with its usage in simulation by illustrating the main crosscutting concerns that may infect simulation systems. A practical example is given with the use of the Japrosim discrete event simulation library.

  6. Physical assistance devices in complex motor skill learning: benefits of a self-controlled practice schedule.

    Science.gov (United States)

    Wulf, G; Toole, T

    1999-09-01

    This study examines the effects of a self-controlled use of physical assistance devices on learning a complex motor skill (i.e., producing slalom-type movements on a ski simulator). Physical assistance was provided by ski poles. One group of learners (self-control) was provided with the poles whenever they requested them, whereas another (yoked) group had no influence on the pole/no-pole schedule. While there were no group differences during the practice phase (Days 1 and 2), clear group differences emerged in the retention test without poles (Day 3). The self-control group produced significantly larger amplitudes than the yoked group. These results extend previous findings by showing learning advantages of the self-controlled use of physical assistance devices in complex motor skill learning.

  7. 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.

  8. Iron supplementation during pregnancy: what are the risks and benefits of current practices?

    Science.gov (United States)

    Rioux, France M; LeBlanc, Caroline P

    2007-04-01

    Iron-deficiency anemia is still prevalent among pregnant women living in industrialized countries such as Canada. To prevent this deficiency, iron supplements (30 mg/d) are routinely prescribed to Canadian pregnant women. Recently, dietary reference intakes for iron have increased from 18 and 23 mg/d during the second and third trimesters, respectively, to 27 mg/d throughout the pregnancy for all age groups. Whether this new recommendation implies an increase of iron dosage in supplements has not been answered. Are there any benefits or risks for the mother and her infant associated with iron supplementation during pregnancy? If iron supplementation is recommended, what should be the ideal dosage? This article reviews current knowledge on the potential negative or positive impact of iron supplementation during pregnancy on the outcomes of both infants and mothers. Based on the literature reviewed, a low daily dose of iron (30 mg elemental iron) during pregnancy improves women's iron status and seems to protect their infants from iron-deficiency anemia. Several studies have also shown that a low daily dose of iron may improve birth weight even in non-anemic pregnant women. However, higher dosages are not recommended because of the potential negative effects on mineral absorption, oxidative pathways, and adverse gastrointestinal symptoms. To date, it is still not clear if health professionals should recommend routine or selective supplementation. However, neither routine nor selective iron supplementation during pregnancy is able to eliminate iron-deficiency anemia. Even though the dietary reference intake for iron during pregnancy has been recently increased, we do not recommend higher doses of iron in supplements designed for pregnant women.

  9. 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

  10. 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 < 0.05). Reported pressure to eat (T2) was associated with observed pressure to eat (T2) (r = 0.48, P < 0.01) but only for mothers of girls. Maternal weight concern was associated with reported restriction at T1 (r = 0.29, P < 0.01) and T2 (r = 0.36, P < 0.01), whereas observed restriction (T1) was prospectively associated child BMI at T2 (β = -0.18, P < 0.05). Maternal reports may not always reflect feeding practices performed during mealtimes; it is possible some mothers may not be

  11. 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.

  12. 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.

  13. Use of Anthropometry for the Prediction of Regional Body Tissue Distribution in Adults: Benefits and Limitations in Clinical Practice

    Science.gov (United States)

    Scafoglieri, Aldo; Clarys, Jan Pieter; Cattrysse, Erik; Bautmans, Ivan

    2014-01-01

    Regional body composition changes with aging. Some of the changes in composition are considered major risk factors for developing obesity related chronic diseases which in turn may lead to increased mortality in adults. The role of anthropometry is well recognized in the screening, diagnosis and follow-up of adults for risk classification, regardless of age. Regional body composition is influenced by a number of intrinsic and extrinsic factors. Therapeutic measures recommended to lower cardiovascular disease risk include lifestyle changes. The aim of this review is to systematically summarize studies that assessed the relationships between anthropometry and regional body composition. The potential benefits and limitations of anthropometry for use in clinical practice are presented and suggestions for future research given. PMID:25489489

  14. 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.

  15. Observation of interprofessional collaborative practice in primary care teams: An integrative literature review.

    Science.gov (United States)

    Morgan, Sonya; Pullon, Susan; McKinlay, Eileen

    2015-07-01

    Interprofessional collaboration improves patient care, especially for those patients with complex and/or chronic conditions. Many studies examining collaborative practice in primary care settings have been undertaken, yet identification of essential elements of effective interprofessional collaboration in primary care settings remains obscure. To examine the nature of interprofessional collaboration (including interprofessional collaborative practice) and the key influences that lead to successful models of interprofessional practice in primary care teams, as reported in studies using direct observation methods. Integrative review using Whittemore and Knafl's (2005) five stage framework: problem identification, literature search, data evaluation, data analysis and presentation. Data sources and review method: Primary research studies meeting the search criteria were accessed from MEDLINE, PsycINFO, Scopus, King's Fund and Informit Health Collection databases, and by hand-searching reference lists. From 2005 to 2013, 105 studies closely examining elements of interprofessional collaboration were identified. Of these, 11 studies were identified which incorporated a range of 'real time' direct observation methods where the collaborative practice of health professionals was closely observed. Constant opportunity for effective, frequent, informal shared communication emerged as the overarching theme and most critical factor in achieving and sustaining effective interprofessional collaboration and interprofessional collaborative practice in this review. Multiple channels for repeated (often brief) informal shared communication were necessary for shared knowledge creation, development of shared goals, and shared clinical decision making. Favourable physical space configuration and 'having frequent brief time in common' were key facilitators. This review highlights the need to look critically at the body of research purported to investigate interprofessional collaboration

  16. Observational studies often make clinical practice recommendations: an empirical evaluation of authors' attitudes.

    Science.gov (United States)

    Prasad, Vinay; Jorgenson, Joel; Ioannidis, John P A; Cifu, Adam

    2013-04-01

    Although observational studies provide useful descriptive and correlative information, their role in the evaluation of medical interventions remains contentious. There has been no systematic evaluation of authors' attitudes toward their own nonrandomized studies and how often they recommend specific medical practices. We reviewed all original articles of nonrandomized studies published in 2010 in New England Journal of Medicine, Lancet, Journal of the American Medical Association, and Annals of Internal Medicine. We classified articles based on whether authors recommend a medical practice and whether they state that a randomized trial is needed to support their recommendation. We also examined the types of logical extrapolations used by authors who did advance recommendations. Of the 631 original articles published in 2010, 298 (47%) articles were eligible observational studies. In 167 (56%) of 298 studies, authors recommended a medical practice based on their results. Only 24 (14%) of 167 studies stated that a randomized controlled trial (RCT) should be done to validate the recommendation, whereas the other 143 articles made a total of 149 logical extrapolations to recommend specific medical practices. Recommendations without a call for a randomized trial were most common in studies of modifiable factors (59%), but they were also common in studies reporting incidence or prevalence (51%), studies examining novel tests (41%), and association studies of nonmodifiable factors (32%). The authors of observational studies often extrapolate their results to make recommendations concerning a medical practice, typically without first calling for a RCT. Published by Elsevier Inc.

  17. Observing representational practices in art and anthropology – a transdisciplinary approach

    OpenAIRE

    Preiser, R

    2010-01-01

    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 skil...

  18. 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.

  19. 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.

  20. 41 CFR 60-50.3 - Accommodations to religious observance and practice.

    Science.gov (United States)

    2010-07-01

    ... OPPORTUNITY, DEPARTMENT OF LABOR 50-GUIDELINES ON DISCRIMINATION BECAUSE OF RELIGION OR NATIONAL ORIGIN § 60... observance or practice without undue hardship on the conduct of the employer's business. As part of this... can be made without undue hardship on the conduct of the employer's business. In determining the...

  1. 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

  2. Electronic Health Record Challenges, Workarounds, and Solutions Observed in Practices Integrating Behavioral Health and Primary Care.

    Science.gov (United States)

    Cifuentes, Maribel; Davis, Melinda; Fernald, Doug; Gunn, Rose; Dickinson, Perry; Cohen, Deborah J

    2015-01-01

    This article describes the electronic health record (EHR)-related experiences of practices striving to integrate behavioral health and primary care using tailored, evidenced-based strategies from 2012 to 2014; and the challenges, workarounds and initial health information technology (HIT) solutions that emerged during implementation. This was an observational, cross-case comparative study of 11 diverse practices, including 8 primary care clinics and 3 community mental health centers focused on the implementation of integrated care. Practice characteristics (eg, practice ownership, federal designation, geographic area, provider composition, EHR system, and patient panel characteristics) were collected using a practice information survey and analyzed to report descriptive information. A multidisciplinary team used a grounded theory approach to analyze program documents, field notes from practice observation visits, online diaries, and semistructured interviews. Eight primary care practices used a single EHR and 3 practices used 2 different EHRs, 1 to document behavioral health and 1 to document primary care information. Practices experienced common challenges with their EHRs' capabilities to 1) document and track relevant behavioral health and physical health information, 2) support communication and coordination of care among integrated teams, and 3) exchange information with tablet devices and other EHRs. Practices developed workarounds in response to these challenges: double documentation and duplicate data entry, scanning and transporting documents, reliance on patient or clinician recall for inaccessible EHR information, and use of freestanding tracking systems. As practices gained experience with integration, they began to move beyond workarounds to more permanent HIT solutions ranging in complexity from customized EHR templates, EHR upgrades, and unified EHRs. Integrating behavioral health and primary care further burdens EHRs. Vendors, in cooperation with

  3. Enhancing technical skill learning through interleaved mixed-model observational practice.

    Science.gov (United States)

    Welsher, Arthur; Grierson, Lawrence E M

    2017-12-01

    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): 186-192, 2015), can be facilitated through observational practice. Interestingly, research also reveals that learning via observation is greatest when the learner has the opportunity to view both error-free expert demonstrations and flawed novice demonstrations (Rohbanfard and Proteau in Exp Brain Res 215: 183-197, 2011). In this study, we explored whether the learning that results from the combined viewing of experts and novices is greater when the demonstrations are presented under observation schedules characterized by higher levels of contextual interference. To do so, we engaged participants in an observational learning study of the Fundamentals of Laparoscopic Surgery pots-and-beans task: a simulated procedure in which performers must move objects under precision constraints in the minimal access surgery environment. Each participant was randomized to one of three groups that engaged in identical physical and mixed-model observational practice of this skill, with the only difference being that one group's observation was presented in blocked fashion (low interference) while the other two groups' observations were presented in semi-interleaved (medium interference) and interleaved (high interference) fashions. Total errors and time-to-complete measures taken during physical practice blocks revealed that all three groups improved over the intervention. Further analyses revealed that the low interference group performed better immediately following the physical and observational practice intervention, but that the medium- and high-interference groups were conveyed a performance advantage in a transfer test conducted after a period of retention that

  4. 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

  5. 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 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....... The ratio of intraoperative RBC transfusion to blood loss was computed, and patients grouped by the median into a liberal transfusion practice (ratio equal to or above the median) and a restrictive transfusion practice group (ratio below the median). Results  Surgical site infection occurred in 27...

  6. Chiropractic Observation and Analysis Study (COAST): providing an understanding of current chiropractic practice.

    Science.gov (United States)

    French, Simon D; Charity, Melanie J; Forsdike, Kirsty; Gunn, Jane M; Polus, Barbara I; Walker, Bruce F; Chondros, Patty; Britt, Helena C

    2013-11-18

    COAST (Chiropractic Observation and Analysis Study) aimed to describe the clinical practices of chiropractors in Victoria, Australia. Cross-sectional study using the BEACH (Bettering the Evaluation and Care of Health) methods for general practice. 180 chiropractors in active clinical practice in Victoria were randomly selected from the list of 1298 chiropractors registered on Chiropractors Registration Board of Victoria. Twenty-four chiropractors were ineligible, 72 agreed to participate, and 52 completed the study. Each participating chiropractor documented encounters with up to 100 consecutive patients. For each chiropractor-patient encounter, information collected included patient health profile, patient reasons for encounter, problems and diagnoses, and chiropractic care. Data were collected on 4464 chiropractor-patient encounters from 52 chiropractors between 11 December 2010 and 28 September 2012. In most (71%) encounters, patients were aged 25-64 years; 1% of encounters were with infants (age chiropractic profession in workforce development, education and health care policy.

  7. [Fingolimod: effectiveness and safety in routine clinical practice. An observational, retrospective, multi-centre study in Galicia].

    Science.gov (United States)

    Pato-Pato, A; Midaglia, L; Costa-Arpin, E; Rodriguez-Regal, A; Puy-Nunez, A; Rodriguez-Rodriguez, M; Lopez-Real, A; Llaneza-Gonzalez, M A; Garcia-Estevez, D A; Moreno-Carretero, M J; Escriche-Jaime, D; Aguado-Valcarcel, M L; Munoz, D; Prieto, J M; Lorenzo-Gonzalez, J R; Amigo-Jorrin, M C

    2016-09-05

    The effectiveness and safety of fingolimod in patients with relapsing-remitting multiple sclerosis (RRMS) have been proven in clinical trials. Yet, due to their limitations, it is important to know how it behaves under everyday clinical practice conditions. Hence, the aim of this study is to evaluate the effectiveness and safety of fingolimod after 12 months' usage in clinical practice in Galicia. We conducted a retrospective, multi-centre study (n = 8) of patients with RRMS who were treated with one or more doses of fingolimod, 0.5 mg/day. Effectiveness was assessed -annualised relapse rate (ARR), changes in the score on the Expanded Disability Status Scale (EDSS), percentage of patients free from relapses, free from progression of disability and free from activity in resonance- for the total number of patients and according to previous treatment. Safety was assessed based on the percentage of patients who withdrew and presented adverse side effects. After 12 months' use, fingolimod reduced the ARR by 87% (1.7 to 0.23; p < 0.0001) and, consequently, 81% of patients were free from relapses. The score was reduced by 9%. In all, 91% of patients were free from progression of disability and 72% were free from resonance activity. No signs of disease activity were found in 43% of the patients. Most of the benefits of fingolimod differed depending on previous treatment. About a third of the patients reported adverse side effects, but only 2% of them withdrew for this reason. In clinical practice, most of the results on the effectiveness of the clinical trials conducted with fingolimod were observed during the first 12 months of treatment. A better safety profile was observed than that reported in the clinical trials.

  8. 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.

  9. Demonstration lessons in mathematics education: teachers' observation foci and intended changes in practice

    Science.gov (United States)

    Clarke, Doug; Roche, Anne; Wilkie, Karina; Wright, Vince; Brown, Jill; Downton, Ann; Horne, Marj; Knight, Rose; McDonough, Andrea; Sexton, Matthew; Worrall, Chris

    2013-06-01

    As part of a teacher professional learning project in mathematics education, university mathematics educators taught demonstration lessons in project primary schools. These lessons were part of a "pre-brief, teaching, and debrief" process, in which up to eight teachers observed each lesson. Using brief questionnaires completed in advance of the lesson, during the lesson, following the debrief, and several weeks later, data were collected on teachers' intended and actual observation foci and any anticipated changes in their beliefs and practices arising from the experience. There were several common themes in teachers' intended observations, including a focus on questioning, catering for individual differences, and building student engagement. As evident in other research, teachers' intended and actual observations gave greater attention to teacher actions and decision making than to student learning and thinking. In this paper, we situate demonstration lessons within teacher professional learning models, describe the features of our model, summarise teacher data, and discuss issues arising from our work.

  10. Stability in the feeding practices and styles of low-income mothers: questionnaire and observational analyses.

    Science.gov (United States)

    Silva Garcia, Karina; Power, Thomas G; Beck, Ashley D; Fisher, Jennifer Orlet; Goodell, L Suzanne; Johnson, Susan L; O'Connor, Teresia M; Hughes, Sheryl O

    2018-03-23

    During the last two decades, researchers have devoted considerable attention to the role of maternal feeding behaviors, practices, and styles in the development of obesity in young children. Little is known, however, about the consistency of maternal feeding across settings and time. The purpose of this paper was to provide data on this issue by examining the consistency of observed maternal feeding behavior across multiple eating occasions, as well as examine the consistency of observed and self-reported maternal feeding behavior across 18 months. Videotapes from two studies of low-income mothers and their preschool children were coded for feeding practices, dimensions, and styles: a study of 137 low-income, African American and Latina mothers and their children observed during three meals in their homes over a two to three week period, and a study of 138 low-income, Latina mothers observed during a buffet meal in a laboratory setting on two separate occasions 18 months apart. Videotapes from both studies were coded for a wide range of maternal feeding behaviors and strategies. Mothers in the second study also completed three validated, self-report questionnaires on their feeding practices and styles. Overall, both observed and self-reported feeding practices and styles showed only moderate levels of stability across meals and over time. Maternal attempts to regulate children's eating showed more stability across meals and over time than the content of general mealtime conversation. Also, greater stability was found in what mothers were trying to get their children to do during the meals than in the strategies they used to influence child behavior. Self-reports of feeding showed greater stability over time than observational measures. Across meals and across 18 months, the stability of general feeding styles was between 40% and 50%. The findings demonstrate that maternal feeding behavior was only moderately stable across meals and over time-that is, feeding

  11. [Efficacy and patient benefit of treatment of irritated skin with ointments containing dexpanthenol: health services research (observational study) on self-medication in a pharmaceutical network].

    Science.gov (United States)

    Radtke, M A; Lee-Seifert, C; Rustenbach, S J; Schäfer, I; Augustin, M

    2009-05-01

    Products containing dexpanthenol are used to treat irritated and inflamed skin. So far there is a lack of data for the evidence of patient-relevant benefits. Assessment of the patient-relevant benefit of ointments containing dexpanthenol in the self-medicated therapy of irritated skin. Prospective, observational study in a network of 392 pharmacies. Consecutive recruitment of n=1,886 patients with symptoms of irritated skin, including non-inflammatory intervals of atopic eczema, other xerotic skin conditions and impairment of skin barrier. The patient-relevant benefit was ascertained prior to and 7-10 days after treatment through the patient-benefit index (PBI). The PBI showed that 91.5% of the patients experienced a relevant benefit from treatment. 94.7% directly indicated to have had achieved successful therapeutic results. All symptoms of irritated skin (e.g. xerosis, erythema, desquamation) significantly improved (pbenefits were observed in the treatment of irritated skin with dexpanthenol ointment.

  12. 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.

  13. Self-reported and observed feeding practices of Rhode Island Head Start teachers: Knowing what not to do.

    Science.gov (United States)

    Fallon, Megan; Halloran, Katherine; Gorman, Kathleen; Ward, Dianne; Greene, Geoffrey; Tovar, Alison

    2018-01-01

    Through their feeding practices, adult caregivers play an important role in shaping children's eating behaviors. However, the feeding practices of child care teachers have received little attention. The purpose of this study was to compare child care teachers' self-reported feeding practices and observed feeding practices during a preschool meal. Rhode Island Head Start teachers (n = 85) were observed during breakfast and lunch where feeding practices were coded using a tool adapted from the Environmental Policy Assessment and Observation (EPAO) tool. Teachers completed a questionnaire adapted from the EPAO Self-Report to capture self-reported feeding practices. Agreement between reported and observed was compared by percent agreement. Teachers were predominantly White (89%) and female (98%). There was a higher level of agreement among self-reported and observed controlling feeding practices (78.8-97.6% agreement) compared to healthful feeding practices (11.8-20.0% agreement). Although self-report measures are typically used to capture feeding practices, there are inconsistencies between self-report and observation measures. The inconsistencies found among healthful self-reported and observed feeding practices have implications for future research protocols, measurement refinement, and training of child care teachers. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    1996-06-08

    To examine what is attainable when treating urinary incontinence in women in general practice. 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. General practice in the rural district of Rissa, Norway. 105 women aged 20 or more with urinary incontinence. Treatment with pelvic floor exercises, electrostimulation, oestrogen, anticholinergic drugs, bladder training, and protective pads. Subjective and objective measures of urinary incontinence; number of patients referred to a specialist. After 12 months' follow up 70% (69/99) of the women were cured or much better; the mean score on a 100 mm visual analogue scale decreased from 37 to 20 mm; and the proportion of women who were greatly bothered by their incontinence decreased by 62%. 20% (20/98) of women became continent, and the percentage of women with severe incontinence decreased from 64% (63/99) to 28% (27/98). Mean leakage per 24 hours measured by a pad test decreased from 28 g at the start of treatment to 13 g after 12 months. The number of light weight pads or sanitary towels decreased from 1.6 to 0.6 a day. In all, 17/105 (16%) patients were referred to a specialist. Urinary incontinence in women can be effectively managed in general practice with fairly simple treatment. Most women will be satisfied with the results.

  15. 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.

  16. Exploring the Current Landscape of Intravenous Infusion Practices and Errors (ECLIPSE): protocol for a mixed-methods observational study

    Science.gov (United States)

    Blandford, Ann; Furniss, Dominic; Chumbley, Gill; Iacovides, Ioanna; Wei, Li; Cox, Anna; Mayer, Astrid; Schnock, Kumiko; Bates, David Westfall; Dykes, Patricia C; Bell, Helen; Dean Franklin, Bryony

    2016-01-01

    Introduction Intravenous medication is essential for many hospital inpatients. However, providing intravenous therapy is complex and errors are common. ‘Smart pumps’ incorporating dose error reduction software have been widely advocated to reduce error. However, little is known about their effect on patient safety, how they are used or their likely impact. This study will explore the landscape of intravenous medication infusion practices and errors in English hospitals and how smart pumps may relate to the prevalence of medication administration errors. Methods and analysis This is a mixed-methods study involving an observational quantitative point prevalence study to determine the frequency and types of errors that occur in the infusion of intravenous medication, and qualitative interviews with hospital staff to better understand infusion practices and the contexts in which errors occur. The study will involve 5 clinical areas (critical care, general medicine, general surgery, paediatrics and oncology), across 14 purposively sampled acute hospitals and 2 paediatric hospitals to cover a range of intravenous infusion practices. Data collectors will compare each infusion running at the time of data collection against the patient's medication orders to identify any discrepancies. The potential clinical importance of errors will be assessed. Quantitative data will be analysed descriptively; interviews will be analysed using thematic analysis. Ethics and dissemination Ethical approval has been obtained from an NHS Research Ethics Committee (14/SC/0290); local approvals will be sought from each participating organisation. Findings will be published in peer-reviewed journals and presented at conferences for academic and health professional audiences. Results will also be fed back to participating organisations to inform local policy, training and procurement. Aggregated findings will inform the debate on costs and benefits of the NHS investing in smart pump technology

  17. 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

  18. Social acceptability of dental appearance and benefits of fixed orthodontic treatment: a 17-year observational cohort study.

    Science.gov (United States)

    Arrow, Peter; Brennan, David S; Spencer, John

    2012-01-01

    This study reports on the social acceptability of dental appearance and benefits of fixed orthodontic treatment (FOT) among a cohort of 13-year-old adolescents in 1988/1989 followed through to age 30 years in 2005/2006. Adolescents were categorized into nominal treatment need groups based on the dental aesthetic index (DAI) score at age 13 (DAI: ≤ 25 "No Need"; 26-30, "Elective"; 31-35, "Desirable"; and ≥36, "Mandatory"). At age 30, calibrated examiners again assessed the DAI of traced participants. A reduction in the baseline DAI score of at least five units was considered a benefit. The change in DAI scores was examined by receipt of FOT. The number needed to treat (NNT) was estimated as an indicator of the efficacy of FOT. Of the 421 cohort participants examined at follow-up, 148 had undergone FOT; 34 percent of those with FOT were classified at age 13 as "No Need" (n = 50); 21 percent as "Elective" (n = 31); 17 percent as "Desirable" (n = 26); and 28 percent as "Mandatory Need" (n = 41). The DAI score reduced significantly for those with and without FOT. The NNT from FOT for those individuals in the "No Need" category was 17 [95 percent confidence interval (CI) - 26-6]; "Elective" 6 (95 percent CI - 27-3); "Desirable" 5 (95 percent CI 3-51) and "Mandatory Need" 14 (95 percent CI - 16-4). FOT provided a significant benefit only for individuals in the "Desirable" group at age 13. FOT appeared to offer little long-term benefits in the social acceptability of dental appearance for the majority of individuals who underwent FOT. © 2011 American Association of Public Health Dentistry.

  19. 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…

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

    Science.gov (United States)

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

    2015-04-01

    Clinical prediction rules (CPRs) to identify children with serious infections lack validation in low-prevalence populations, which hampers their implementation in primary care practice. To evaluate the diagnostic value of published CPRs for febrile children in primary care. Observational cohort study among febrile children (cooperatives (GPCs) in the Netherlands. Alarm signs of serious infection and clinical management were extracted from routine clinical practice data and manually recoded with a structured electronic data-entry program. Eight CPRs were selected from literature. CPR-variables were matched with alarm signs and CPRs were applied to the GPC-population. 'Referral to emergency department (ED)' was used as a proxy outcome measure for 'serious infection'. CPR performance was assessed by calibration analyses, sensitivity, specificity, and area under the ROC-curve (ROC-area). A total of 9794 GPC-contacts were eligible, 54% male, median age 2.3 years (interquartile range 1.0-4.6 years) and 8.1% referred to ED. Frequencies of CPR-variables varied from 0.5% (cyanosis, drowsy) to 25% (temperature ≥40°C). Alarm signs frequently included in CPRs were 'ill appearance', 'inconsolable', and 'abnormal circulatory or respiratory signs'. The height of the CPR's predicted risks generally corresponded with being (or not being) referred to the ED in practice. However, calibration-slopes indicated that three CPRs underestimated the risk of serious infection in the GPC-population. Sensitivities ranged from 42% to 54%, specificities from 68% to 89%. ROC-areas ranged from 0.52 to 0.81, with best performance of CPRs for children aged <3 months. Published CPRs performed moderately well in the primary out-of-hours care population. Advice is given on how to improve translation of CPRs to primary care practice. © British Journal of General Practice 2015.

  1. 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.

  2. Medication administration errors and related deviations from safe practice: an observational study.

    Science.gov (United States)

    Blignaut, Alwiena J; Coetzee, Siedine K; Klopper, Hester C; Ellis, Suria M

    2017-11-01

    To determine the incidence of medication administration errors, medication administration-related deviations from safe practice as well as factors associated with these errors in medical and surgical units of public hospitals in the Gauteng Province of South Africa. Several studies have been published on the incidence of medication administration errors, but only a few have studied the incidence of medication administration-related deviations from safe practice. Context-specific research on the incidence of medication administration errors and associated factors (patient acuity, bed occupancy, staffing levels, medication administrators' qualifications, dose calculation skills, level of hospital, unit type, medication administration route and interruptions) within the continent of Africa is lacking. A cross-sectional, observational design. Direct observation was conducted incorporating a previously validated checklist based on basic medication guidelines including the five rights, asepsis and medication documentation. In addition, a knowledge test on dose calculations was performed. Medication administration to 315 patients (1847 medications administered) was observed between February-August 2015 in medical and surgical units from eight public hospitals. Twenty-five medication administrators completed dose calculations. In total, 296 medication errors were identified, of which most were wrong-time errors and omissions. Interruptions and patient acuity were significantly associated with wrong-dose and wrong-route errors, respectively. Most medication administration-related deviations from safe practice were related to patient identification or asepsis. Sixteen of 50 dosage calculations were answered incorrectly. Incorrect answers most often occurred in the calculation of parenteral dosages. Medication administration errors, especially wrong-time errors and omissions, are prevalent in public hospitals in the Gauteng Province. Interruptions lower the risk of wrong

  3. Characterizing Students' Attempts to Explain Observations from Practical Work: Intermediate Phases of Understanding

    Science.gov (United States)

    Mestad, Idar; Kolstø, Stein Dankert

    2017-10-01

    This study aims to characterize a group of students' preliminary oral explanations of a scientific phenomenon produced as part of their learning process. The students were encouraged to use their own wordings to test out their own interpretation of observations when conducting practical activities. They presented their explanations orally in the whole class after having discussed and written down an explanation in a small group. The data consists of transcribed video recordings of the presented explanations, observation notes, and interviews. A genre perspective was used to characterize the students' explanations together with analysis of the students use of scientific terms, gestures, and the language markers "sort of" and "like." Based on the analysis we argue to separate between event-focused explanations, where the students describe how objects move, and object-focused explanations, where the students describe object properties and interactions. The first type uses observable events and few scientific terms, while the latter contains object properties and tentative use of scientific terms. Both types are accompanied by an extensive use of language markers and gestures. A third category, term-focused explanations, is used when the students only provide superficial explanations by expressing scientific terms. Here, the students' use of language markers and gestures are low. The analyses shows how students' explanations can be understood as tentative attempts to build on their current understanding and observations while trying to reach out for a deeper and scientific way of identifying observations and building explanations and new ways of talking.

  4. Interdisciplinary Postdoctoral Training in Global Health Through a Novel Joint Project for Trainees from Diverse Disciplines: Benefits, Risks, and Observations.

    Science.gov (United States)

    Oberhelman, Richard A; Huaynate, Cynthia Anticona; Correa, Malena; Malpartida, Holger Mayta; Pajuelo, Monica; Paz-Soldan, Valerie A; Gilman, Robert H; Zimic, Mirko; Murphy, Laura; Belizan, Jose

    2017-03-01

    Postdoctoral training programs are usually highly individualized arrangements between trainees and a limited number of senior mentors in their field, an approach that contrasts with current trends in public health education that promote interdisciplinary training to spur innovation. Herein, we describe an alternative model for postdoctoral training for a group of fellows from distinct disciplines. Fellows work with mentors from diverse fields to create a joint research project or a group of complementary projects, with the goal of developing a new device, intervention, or innovation to address a global health problem. The perceived benefits, challenges, and limitations of this team approach to interdisciplinary postdoctoral training are presented.

  5. 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’’

  6. Benefit sharing in the Arctic energy sector: Perspectives on corporate policies and practices in Northern Russia and Alaska

    NARCIS (Netherlands)

    Tysyachnyouk, M.; Petrov, Andrey N.

    2018-01-01

    Many transnational energy companies are engaged in the exploration and development of oil reserves in the Arctic, and are facing policy challenges in respect to benefit sharing with the local communities. Benefit sharing arrangements between oil and natural gas companies and indigenous communities

  7. PHARMACOTHERAPY QUALITY IN PATIENTS WITH ARTERIAL HYPERTENSION OBSERVED IN PRIMARY CARE PRACTICE. HYPERTENSION REGISTER DATA

    Directory of Open Access Journals (Sweden)

    O. M. Posnenkova

    2011-01-01

    Full Text Available Aim. To assess (on the basis of Russian national guidelines on arterial hypertension (HT, 2004 quality of pharmacotherapy measures among hypertensive patients observed in primary care practice. Material and methods. Data on 12 604 patients with HT (7 819 women, 4 785 men, aged 59.5±12.0 years from 13 regions of Russia observed in primary care units during 2007 were enrolled in the study. Compliance with recommendations on decision making about pharmacotherapy need (risk category assessment and adequacy were evaluated. Results. 64% of patients with HT had no drug prescriptions in their outpatient card in 2007. 4 880 patients from 12 604 enrolled HT patients (38.7% had all data necessary for risk assessment. 3920 patients (31% of the whole studied group had pharmacotherapy indications (high or very high risk. Only 819 HT patients (6.5% of the whole number of enrolled patients had antihypertensive pharmacotherapy completely corresponding to their clinical status. Conclusion. The quality of pharmacotherapy measures carried out in primary care practice during 2007 did not conform to HT guidelines.

  8. Practice nurse involvement in primary care depression management: an observational cost-effectiveness analysis.

    Science.gov (United States)

    Gray, Jodi; Haji Ali Afzali, Hossein; Beilby, Justin; Holton, Christine; Banham, David; Karnon, Jonathan

    2014-01-14

    Most evidence on the effect of collaborative care for depression is derived in the selective environment of randomised controlled trials. In collaborative care, practice nurses may act as case managers. The Primary Care Services Improvement Project (PCSIP) aimed to assess the cost-effectiveness of alternative models of practice nurse involvement in a real world Australian setting. Previous analyses have demonstrated the value of high level practice nurse involvement in the management of diabetes and obesity. This paper reports on their value in the management of depression. General practices were assigned to a low or high model of care based on observed levels of practice nurse involvement in clinical-based activities for the management of depression (i.e. percentage of depression patients seen, percentage of consultation time spent on clinical-based activities). Linked, routinely collected data was used to determine patient level depression outcomes (proportion of depression-free days) and health service usage costs. Standardised depression assessment tools were not routinely used, therefore a classification framework to determine the patient's depressive state was developed using proxy measures (e.g. symptoms, medications, referrals, hospitalisations and suicide attempts). Regression analyses of costs and depression outcomes were conducted, using propensity weighting to control for potential confounders. Capacity to determine depressive state using the classification framework was dependent upon the level of detail provided in medical records. While antidepressant medication prescriptions were a strong indicator of depressive state, they could not be relied upon as the sole measure. Propensity score weighted analyses of total depression-related costs and depression outcomes, found that the high level model of care cost more (95% CI: -$314.76 to $584) and resulted in 5% less depression-free days (95% CI: -0.15 to 0.05), compared to the low level model. However

  9. Benefit of Modeling the Observation Error in a Data Assimilation Framework Using Vegetation Information Obtained From Passive Based Microwave Data

    Science.gov (United States)

    Bolten, John D.; Mladenova, Iliana E.; Crow, Wade; De Jeu, Richard

    2016-01-01

    A primary operational goal of the United States Department of Agriculture (USDA) is to improve foreign market access for U.S. agricultural products. A large fraction of this crop condition assessment is based on satellite imagery and ground data analysis. The baseline soil moisture estimates that are currently used for this analysis are based on output from the modified Palmer two-layer soil moisture model, updated to assimilate near-real time observations derived from the Soil Moisture Ocean Salinity (SMOS) satellite. The current data assimilation system is based on a 1-D Ensemble Kalman Filter approach, where the observation error is modeled as a function of vegetation density. This allows for offsetting errors in the soil moisture retrievals. The observation error is currently adjusted using Normalized Difference Vegetation Index (NDVI) climatology. In this paper we explore the possibility of utilizing microwave-based vegetation optical depth instead.

  10. 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.

  11. 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

  12. 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.

  13. Real-time observations of lithium battery reactions-operando neutron diffraction analysis during practical operation.

    Science.gov (United States)

    Taminato, Sou; Yonemura, Masao; Shiotani, Shinya; Kamiyama, Takashi; Torii, Shuki; Nagao, Miki; Ishikawa, Yoshihisa; Mori, Kazuhiro; Fukunaga, Toshiharu; Onodera, Yohei; Naka, Takahiro; Morishima, Makoto; Ukyo, Yoshio; Adipranoto, Dyah Sulistyanintyas; Arai, Hajime; Uchimoto, Yoshiharu; Ogumi, Zempachi; Suzuki, Kota; Hirayama, Masaaki; Kanno, Ryoji

    2016-06-30

    Among the energy storage devices for applications in electric vehicles and stationary uses, lithium batteries typically deliver high performance. However, there is still a missing link between the engineering developments for large-scale batteries and the fundamental science of each battery component. Elucidating reaction mechanisms under practical operation is crucial for future battery technology. Here, we report an operando diffraction technique that uses high-intensity neutrons to detect reactions in non-equilibrium states driven by high-current operation in commercial 18650 cells. The experimental system comprising a time-of-flight diffractometer with automated Rietveld analysis was developed to collect and analyse diffraction data produced by sequential charge and discharge processes. Furthermore, observations under high current drain revealed inhomogeneous reactions, a structural relaxation after discharge, and a shift in the lithium concentration ranges with cycling in the electrode matrix. The technique provides valuable information required for the development of advanced batteries.

  14. Real-time observations of lithium battery reactions—operando neutron diffraction analysis during practical operation

    Science.gov (United States)

    Taminato, Sou; Yonemura, Masao; Shiotani, Shinya; Kamiyama, Takashi; Torii, Shuki; Nagao, Miki; Ishikawa, Yoshihisa; Mori, Kazuhiro; Fukunaga, Toshiharu; Onodera, Yohei; Naka, Takahiro; Morishima, Makoto; Ukyo, Yoshio; Adipranoto, Dyah Sulistyanintyas; Arai, Hajime; Uchimoto, Yoshiharu; Ogumi, Zempachi; Suzuki, Kota; Hirayama, Masaaki; Kanno, Ryoji

    2016-01-01

    Among the energy storage devices for applications in electric vehicles and stationary uses, lithium batteries typically deliver high performance. However, there is still a missing link between the engineering developments for large-scale batteries and the fundamental science of each battery component. Elucidating reaction mechanisms under practical operation is crucial for future battery technology. Here, we report an operando diffraction technique that uses high-intensity neutrons to detect reactions in non-equilibrium states driven by high-current operation in commercial 18650 cells. The experimental system comprising a time-of-flight diffractometer with automated Rietveld analysis was developed to collect and analyse diffraction data produced by sequential charge and discharge processes. Furthermore, observations under high current drain revealed inhomogeneous reactions, a structural relaxation after discharge, and a shift in the lithium concentration ranges with cycling in the electrode matrix. The technique provides valuable information required for the development of advanced batteries. PMID:27357605

  15. Clinical benefits of neoadjuvant chemoradiotherapy for adenocarcinoma of the pancreatic head: an observational study using inverse probability of treatment weighting.

    Science.gov (United States)

    Fujii, Tsutomu; Satoi, Sohei; Yamada, Suguru; Murotani, Kenta; Yanagimoto, Hiroaki; Takami, Hideki; Yamamoto, Tomohisa; Kanda, Mitsuro; Yamaki, So; Hirooka, Satoshi; Kon, Masanori; Kodera, Yasuhiro

    2017-01-01

    The efficacy of neoadjuvant chemoradiotherapy (NACRT) and subset of pancreatic ductal adenocarcinoma (PDAC) patients who are most likely to benefit from this strategy remain elusive. The aim of this study was to investigate the effects of NACRT in patients with resectable (R) or borderline resectable (BR) adenocarcinoma of the pancreatic head. BR diseases were classified into two groups: lesions involving exclusively the portal vein system (BR-PV) and those abutting the major artery (BR-A). A total of 504 patients treated with curative intent for PDAC were analyzed (R, n = 273; BR-PV, n = 129; BR-A, n = 102). Patients who underwent upfront surgery and those who underwent NACRT followed by surgery were compared using propensity score-matched and inverse probability of treatment-weighted analyses (UMIN000019719). No significant differences were noted in the incidences of curative resection among the three categories (R, BR-PV and BR-A). Propensity score-weighted logistic regression analysis revealed that the incidence of pathologically positive resection margins was reduced by NACRT only for BR patients. Among the propensity score-matched patients, NACRT rather than upfront surgery significantly prolonged the median survival time of BR-PV patients (28.4 vs. 20.1 months; P = 0.044) but not that of R-PDAC patients (28.6 vs. 33.7 months; P = 0.960). NACRT prolonged the median survival time of BR-A patients (18.1 vs. 10.0 months; P = 0.046), but the results remained unsatisfactory. These findings suggest that NACRT improves R0 rates and increases the survival of patients with BR-PV adenocarcinoma of the pancreatic head but not that of patients with R-PDAC.

  16. 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)

  17. An overview of current practice in external beam radiation oncology with consideration to potential benefits and challenges for nanotechnology.

    Science.gov (United States)

    King, Raymond B; McMahon, Stephen J; Hyland, Wendy B; Jain, Suneil; Butterworth, Karl T; Prise, Kevin M; Hounsell, Alan R; McGarry, Conor K

    2017-01-01

    Over the past two decades, there has been a significant evolution in the technologies and techniques employed within the radiation oncology environment. Over the same period, extensive research into the use of nanotechnology in medicine has highlighted a range of potential benefits to its incorporation into clinical radiation oncology. This short communication describes key tools and techniques that have recently been introduced into specific stages of a patient's radiotherapy pathway, including diagnosis, external beam treatment and subsequent follow-up. At each pathway stage, consideration is given towards how nanotechnology may be combined with clinical developments to further enhance their benefit, with some potential opportunities for future research also highlighted. Prospective challenges that may influence the introduction of nanotechnology into clinical radiotherapy are also discussed, indicating the need for close collaboration between academic and clinical staff to realise the full clinical benefit of this exciting technology.

  18. 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

  19. 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

  20. 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...

  1. 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.

  2. Supporting sleep in early care and education: an assessment of observed sleep times using a sleep practices optimality index.

    Science.gov (United States)

    Staton, Sally; Marriott, Annette; Pattinson, Cassandra; Smith, Simon; Sinclair, Dominique; Thorpe, Karen

    2016-03-01

    The aim was to investigate whether the sleep practices in early childhood education (ECE) settings align with current evidence on optimal practice to support sleep. Internationally, scheduled sleep times are a common feature of daily schedules in ECE settings, yet little is known about the degree to which care practices in these settings align with the evidence regarding appropriate support of sleep. Observations were conducted in 130 Australian ECE rooms attended by preschool children (Mean=4.9years). Of these rooms, 118 had daily scheduled sleep times. Observed practices were scored against an optimality index, the Sleep Environment and Practices Optimality Score, developed with reference to current evidence regarding sleep scheduling, routines, environmental stimuli, and emotional climate. Cluster analysis was applied to identify patterns and prevalence of care practices in the sleep time. Three sleep practices types were identified. Supportive rooms (36%) engaged in practices that maintained regular schedules, promoted routine, reduced environmental stimulation, and maintained positive emotional climate. The majority of ECE rooms (64%), although offering opportunity for sleep, did not engage in supportive practices: Ambivalent rooms (45%) were emotionally positive but did not support sleep; Unsupportive rooms (19%) were both emotionally negative and unsupportive in their practices. Although ECE rooms schedule sleep time, many do not adopt practices that are supportive of sleep. Our results underscore the need for education about sleep supporting practice and research to ascertain the impact of sleep practices in ECE settings on children's sleep health and broader well-being. Copyright © 2016 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

  3. The influence of practical factors on the benefits of condition-based maintenance over time-based maintenance

    International Nuclear Information System (INIS)

    Jonge, Bram de; Teunter, Ruud; Tinga, Tiedo

    2017-01-01

    Recent developments in condition monitoring technology have led to an ongoing shift from time-based maintenance (TBM) to condition-based maintenance (CBM). Although CBM allows for more effectively planned maintenance actions, its relative performance strongly depends on the behavior of the deterioration process, the severity of failures, the required setup time, the accuracy of the condition measurements, and the amount of randomness in the deterioration level at which failure occurs. The contribution of this paper is twofold. First, we review studies that compare CBM with TBM, and studies that consider the above factors in combination with a CBM model. Second, whereas existing studies confine themselves to a few examples, we perform a numerical investigation to derive insights on the effects of the various characteristics on the relative benefit of CBM. The results can be used by companies to decide what factors are most important when considering to implement CBM, and to assess whether the benefit of CBM during the operational phase outweighs the additional costs during the life cycle of equipment. This study allows for follow-up research to quantify and generalize the insights obtained, and to analyze interaction effects. - Highlights: • Condition-based maintenance (CBM) is compared with time-based maintenance (TBM). • An extensive literature review is provided. • Insights are derived on the effects of various characteristics on the relative benefit of CBM.

  4. Prevailing practices in airway management: a prospective single-centre observational study of endotracheal intubation.

    Science.gov (United States)

    Cheong, Geraldine Pei Chin; Kannan, Anusha; Koh, Kwong Fah; Venkatesan, Kumaresh; Seet, Edwin

    2018-03-01

    Airway management during anaesthesia has potential difficulties and risks. We aimed to investigate the utility of routine airway assessment for predicting difficult tracheal intubation, review the prevailing practice of videolaryngoscope use amongst anaesthetists in a teaching hospital and determine the incidence of intraoperative and postoperative airway-related complications. A prospective observational study of 1,654 patients undergoing general anaesthesia with endotracheal intubation over a seven-month period was performed. Data regarding airway and anaesthetic management was collected and analysed. Videolaryngoscopes were used as the first-choice equipment in 60.5% of the cohort. The incidence of difficult intubation was 2.1%, of which 45.7% of cases were unanticipated. The sensitivity of airway assessment was 54.3%, with a positive predictive value of 8.1%. When difficult intubation was anticipated, more videolaryngoscopes were used as the first equipment of choice compared to the Macintosh laryngoscope (p < 0.001). In the Macintosh group, more patients required a change of airway equipment (p = 0.015), but the number of intubation attempts was similar (p = 0.293). The incidence of intraoperative (p = 0.920) and postoperative complications (p = 0.380) were similar in both groups. Using the current predictors of difficult intubation, half of the difficult airways we encountered were unanticipated. Videolaryngoscopes were preferred when difficulty was anticipated and were also used in routine tracheal intubation. Copyright: © Singapore Medical Association.

  5. Ear discharge in children presenting with acute otitis media: observational study from UK general practice.

    Science.gov (United States)

    Smith, Lindsay; Ewings, Paul; Smith, Caroline; Thompson, Matthew; Harnden, Anthony; Mant, David

    2010-02-01

    National Institute for Health and Clinical Excellence (NICE) guidance to treat otitis media in older children immediately with antibiotics only if they have ear discharge is based on limited evidence. To determine the clinical significance and outcome of ear discharge in children with acute otitis media, in routine clinical practice. Observational cohort study of children with acute otitis media comparing those with and without ear discharge at presentation. Primary care in East Somerset. Two hundred and fifty-six children aged 6 months to 10 years were recruited from primary care. Clinical features and other characteristics were recorded at presentation. Follow-up was undertaken at 2 weeks and 3 months. Children with otitis media who present with ear discharge are much more likely to be treated with antibiotics irrespective of age (adjusted odds ratio 15, 95% confidence interval [CI] = 3 to 66). Most with discharge have proven bacterial infection (58%, 95% CI = 42 to 72%). They have a more severe systemic illness, with higher axillary temperature (80% increase in odds of ear discharge for each additional degree centigrade, P = 0.02), pulse rate (9% increase in odds for each extra beat, Pmedia 3.3; hearing difficulty at 3 months 4.7; all Pmedia who are sicker and may be at higher risk of adverse outcome. NICE guidance to treat them with antibiotics is supported.

  6. 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.

  7. 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.

  8. Using a Practical Instructional Development Process to Show That Integrating Lab and Active Learning Benefits Undergraduate Analytical Chemistry

    Science.gov (United States)

    Goacher, Robyn E.; Kline, Cynthia M.; Targus, Alexis; Vermette, Paul J.

    2017-01-01

    We describe how a practical instructional development process helped a first-year assistant professor rapidly develop, implement, and assess the impact on her Analytical Chemistry course caused by three changes: (a) moving the lab into the same semester as the lecture, (b) developing a more collaborative classroom environment, and (c) increasing…

  9. 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.

  10. Practice nurse involvement in primary care depression management: an observational cost-effectiveness analysis

    OpenAIRE

    Gray, Jodi; Haji Ali Afzali, Hossein; Beilby, Justin; Holton, Christine; Banham, David; Karnon, Jonathan

    2014-01-01

    Background Most evidence on the effect of collaborative care for depression is derived in the selective environment of randomised controlled trials. In collaborative care, practice nurses may act as case managers. The Primary Care Services Improvement Project (PCSIP) aimed to assess the cost-effectiveness of alternative models of practice nurse involvement in a real world Australian setting. Previous analyses have demonstrated the value of high level practice nurse involvement in the manageme...

  11. The benefits of working abroad for British General Practice trainee doctors: the London deanery out of programme experience in South Africa.

    Science.gov (United States)

    Reardon, Candice; George, Gavin; Enigbokan, Oluwatobi

    2015-10-14

    The value of international health experience for doctors from developed nations is well recognised. Provisions have been made for medical staff in the United Kingdom to embark on work experiences abroad during their careers in the National Health Service. The London Deanery and Africa Health Placements provide an Out of Programme Experience for British General Practice trainee doctors wanting to work for a year in rural hospitals in South Africa. A qualitative study was conducted among fifteen British General Practice trainees who participated in the programme. The research aim was to understand the perceived benefit and value of their experience and their opinions about the structure of the programme. The data was analysed using thematic analysis. Their experience provided an accelerated year of learning and development that contributed to their professional and personal development. In addition to their general development, their improved ability to work in resource limited settings, enhancement of soft skills, a greater appreciation for the National Health Service and a better understanding of working within foreign health care systems were important gains. The timing of the experience, the security of re-employment on their return, assistance with administrative requirements of destination countries and the opportunity to gain varied, hands-on experience were highly valued components of the Out of Programme Experience. The value and benefits derived from the doctors' experience in South Africa are discussed in relation to another evaluation of the Out of Programme Experience, as well as issues of transferability of skills and competencies and future impacts on career decisions. This study provides evidence to suggest programmes such as the OOPE have the potential to create substantial benefits for trainee doctors, both in terms of their medical skills and competencies and through the development of softer skills. This programme, through the supply of scarce

  12. 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.

  13. 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

  14. Positive Thinking in Dance: The Benefits of Positive Self-Talk Practice in Conjunction with Somatic Exercises for Collegiate Dancers

    OpenAIRE

    Gerena, Christine

    2015-01-01

    Many dance students suffer from low self-confidence and high anxiety as a result of cultural stressors present in the training environment. Particularly, the tradition of authoritarian-style teaching has been shown to hinder the psychological development of students. This thesis researches teaching methodologies that incorporate psychological skills training and aspects of the Franklin method (a somatic practice) into collegiate dance education. The objective is to equip dancers with the posi...

  15. 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

  16. 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

  17. Patients with shoulder syndromes in general and physiotherapy practice : An observational study

    NARCIS (Netherlands)

    Kooijman, M.J.J.; Swinkels, I.C.S.; van Dijk, C.; de Bakker, D.H.; Veenhof, C.

    2013-01-01

    Background Shoulder complaints are commonly seen in general practice and physiotherapy practice. The only complaints for which general practitioners (GPs) refer more patients to the physiotherapist are back and neck pain. However, a substantial group have persistent symptoms. The first goal of this

  18. Patients with shoulder syndromes in general and physiotherapy practice: an observational study.

    NARCIS (Netherlands)

    Kooijman, M.; Swinkels, I.; Dijk, C. van; Bakker, D. de; Veenhof, C.

    2013-01-01

    Background: Shoulder complaints are commonly seen in general practice and physiotherapy practice. The only complaints for which general practitioners (GPs) refer more patients to the physiotherapist are back and neck pain. However, a substantial group have persistent symptoms. The first goal of this

  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. 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.

  1. 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

  2. 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...

  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.

    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

  4. 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

  5. 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

    accepted to the intensive care unit, 1,194 (18%) rejected; 3,795 (49%) were =65 yrs. Refusal rate increased with increasing patient age (18-44: 11%; 45-64: 15%; 65-74: 18%; 75-84: 23%; >84: 36%). Mortality was higher for older patients (18-44: 11%; 45-64: 21%; 65-74: 29%; 75-84: 37%; >84: 48%). Differences......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...... 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...

  6. 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 (0.05benefits 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.

  7. [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

  8. 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.

  9. 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.

  10. Exploiting Expertise and Knowledge Sharing Online for the Benefit of NASA's GN&C Community of Practice

    Science.gov (United States)

    Topousis, Daria E.; Lebsock, Kenneth L.; Dennehy, Cornelius J.

    2010-01-01

    In 2004, NASA faced major knowledge sharing challenges due to geographically isolated field centers that inhibited engineers from sharing their experiences, expertise, ideas, and lessons learned. The necessity to collaborate on complex development projects and the reality of constrained project resources together drove the need for ensuring that personnel at all NASA centers had comparable skill sets and that engineers could find resources in a timely fashion. Mission failures and new directions for the Agency also demanded better collaborative tools for NASA's engineering workforce. In response to these needs, the online NASA Engineering Network (NEN) was formed by the NASA Office of the Chief Engineer to provide a multi-faceted system for overcoming geographic and cultural barriers. NEN integrates communities of practice with a cross-repository search and the Lessons Learned Information System. This paper describes the features of the GN&C engineering discipline CoP site which went live on NEN in May of 2008 as an online means of gathering input and guidance from practitioners. It allows GN&C discipline expertise captured at one field center to be shared in a collaborative way with the larger discipline CoP spread across the entire Agency. The site enables GN&C engineers to find the information they need quickly, to find solutions to questions from experienced engineers, and to connect with other practitioners regardless of geographic location, thus increasing the probability of project success.

  11. 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

  12. Maximizing the clinical benefit of high-pitch, single-heartbeat CT coronary angiography in clinical practice.

    Science.gov (United States)

    St Noble, V; Douraghi-Zadeh, D; Padley, S P G; Rubens, M B; Nicol, E D

    2014-07-01

    To prospectively analyse the occurrence of right coronary artery (RCA) artefact and assess its relationship with patient heart rate (HR) and HR variability (HRV) in order to determine the most appropriate parameters for high-pitch cardiovascular computed tomography (CT) acquisition, minimize the likelihood of artefact, and maximize the clinical benefit in consecutive clinical high-pitch CT coronary angiography (CA) examinations. One hundred and seventy-three patients undergoing high-pitch CTCA were prospectively assessed for the presence of RCA artefact. Median and maximum HR and the difference in predicted and actual acquisition HR (HR difference, HRD) were correlated from the electrocardiograms recorded at the time of acquisition. Sixty-six percent of the cohort was male, with a median age of 54 (range 16-84 years). There were 53 cases of RCA artefact (30.6%); 26 (49.1%) of these required further imaging to fully delineate the RCA. Of the 53 cases with artefact, 81.1% affected the distal RCA and 18.9% were more proximal. Gender was not associated with an increased likelihood of the artefact (p = 0.14). RCA artefact decreased by 2% with each year of increasing age (p = 0.04). When compared with a reference HR of >70 beats/min, univariate analysis demonstrated RCA artefact significantly increased with both increasing median and maximum HR, whilst the incidence of RCA artefact increased for all HRD >1, with a greater likelihood of artefact with increasing HRD. The present results highlight the importance of optimizing patient HR in order to reduce the likelihood of RCA artefact. In addition to aggressive HR control to a median HR of ≤60 beats/min, the present results suggest limiting high-pitch acquisition to patients with HR variability of <3 beats/min. Therefore, use of beta-blockers is of crucial importance to both reduce HR and HR variability to optimize use of high-pitch single-heartbeat CTCA. Copyright © 2014 The Royal College of Radiologists

  13. [Evaluation of effect of indacaterol (Onbrez) and/or glycopyrronium (Seebri) treatment on Quality of Life of COPD patients in medical practice in Poland - observational study (OSQO)].

    Science.gov (United States)

    Płusa, Tadeusz; Physicians From Medical Centers In Poland, Group Of

    2017-10-23

    Indacaterol, as well glycopyronium has been reimbursed lately in Poland, so patients have a greater access to this treatment in medical practice. Physicians do not realize the potential benefit of once daily ultra-LABA indacaterol and/or modern LAMA with fast-acting glycopyrronium on treatment results. The aim of the study was to evaluate the impact of routinely administered treatment with either indacaterol (Onbrez) or glycopyrronium (Seebri) or both on patient reported outcomes in form of the health status (CCQ score - clinical COPD questionnaire) and level of dyspnoea (mMRC - modified Medical Research Council) in treatment naive COPD patients after the change of treatment as addon from any other COPD treatment in "real life" settings. This study was designed as an observational, non-interventional and multicenter project in COPD patients being treated with Onbrez and/or Seebri in 32 medical centers in Poland. The observation period covered 6 months from the first taking of Onbrez and/or Seebri. No diagnostic or monitoring or treatment procedures have been applied to the patients, other than those which are applied in the course of standard, current practice. The total number of enrolled patients was 633. Because of inability of verification the medical records or failure to meet data collection requirements 587 patients enrolled to the registry has been evaluated. Within this number of patients 171 had delayed the time of visits or they had not second visit. Due to therapy change additional 20 patients has been withdrawn. 396 patients were taken for the final analysis. Improvement of mMRC and CCQ scores was observed in all treatment groups e.g. indacaterol solely, glycopyrronium solely and combination therapy of indacaterol and glypyrronium. The study revealed that the best results can be achieved with combination therapy accordingly with clinical recommendation for COPD treatment (GOLD). The results have been achieved in the real world settings, showing that

  14. An Examination of the Association between Observed and Self-Reported Culturally Proficient Teaching Practices

    Science.gov (United States)

    Debnam, Katrina J.; Pas, Elise T.; Bottiani, Jessika; Cash, Anne H.; Bradshaw, Catherine P.

    2015-01-01

    A critical next step in advancing our understanding of teacher practices that can equitably engage and support learning in diverse classrooms is determining the effectiveness of culturally responsive interventions. Yet, quantitative measurement indicators of the effectiveness of culturally responsive teaching interventions are scarce. Most…

  15. 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

  16. An Observation of Classroom Assessment Practices among Lecturers in Selected Malaysian Higher Learning Institutions

    Science.gov (United States)

    Singh, Charanjit Kaur Swaran; Lebar, Othman; Kepol, Napisah; Rahman, Rafiah Abdul; Mukhtar, Kurotol Aini Muhammad

    2017-01-01

    Purpose: The study was aimed at exploring and analysing the current assessment practices of lecturers in selected Malaysian higher learning institution classrooms. The focus was the different modes of assessment used in the classroom and to make recommendations on using a variety of assessment modes that would be well-aligned with the intended…

  17. 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):…

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

    Science.gov (United States)

    Paul, Cassandra; West, Emily

    2018-01-01

    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…

  20. 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

  1. 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.

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

    NARCIS (Netherlands)

    Dillen, S.M.E. 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.

  3. The Practice of Using Evidence in Kindergarten: The Role of Purposeful Observation

    Science.gov (United States)

    Monteira, Sabela F.; Jiménez-Aleixandre, María Pilar

    2016-01-01

    This article examines kindergarten children's (5-6 years old) engagement in scientific practices, with a focus on generating and using evidence to support claims, during a 5-month project about snails. The research questions are as follows: (1) what meanings do kindergarteners construct for what constitutes evidence? How are those meanings…

  4. Grammar Teaching in Secondary School Foreign Language Learning in England: Teachers' Reported Beliefs and Observed Practices

    Science.gov (United States)

    Liviero, Sara

    2017-01-01

    This study investigates teachers' beliefs relating to grammar teaching in modern foreign language (MFL) learning in England. Focus on grammatical form has been consistently supported by linguistic research and teacher practice, and has progressively been reinstated in England's National Curriculum. However, MFL learning assessment in England has…

  5. 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…

  6. 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

  7. 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.

  8. Influence of mental practice and movement observation on motor memory, cognitive function and motor performance in the elderly

    Directory of Open Access Journals (Sweden)

    Caroline D. C. Altermann

    2014-04-01

    Full Text Available BACKGROUND: With aging, it is important to maintain cognitive and motor functions to ensure autonomy and quality of life. During the acquisition of motor skills, it is necessary for the elderly to understand the purpose of the proposed activities. Physical and mental practice, as well as demonstrations, are strategies used to learn movements. OBJECTIVES: To investigate the influence of mental practice and the observation of movement on motor memory and to understand the relationship between cognitive function and motor performance in the execution of a sequence of digital movements in the elderly. METHOD: This was a cross-sectional study conducted with 45 young and 45 aged subjects. The instruments used were Mini-Mental State Examination (MMSE, Manual Preference Inventory and a Digital Motor Task (composed of a training of a sequence of movements, an interval and a test phase. The subjects were divided into three subgroups: control, mental practice and observation of movement. RESULTS: The elderly depend more strongly on mental practice for the acquisition of a motor memory. In comparing the performances of people in different age groups, we found that in the elderly, there was a negative correlation between the MMSE score and the execution time as well as the number of errors in the motor task. CONCLUSIONS: For the elderly, mental practice can advantage motor performance. Also, there is a significant relationship between cognitive function, learning and the execution of new motor skills.

  9. Influence of mental practice and movement observation on motor memory, cognitive function and motor performance in the elderly.

    Science.gov (United States)

    Altermann, Caroline D C; Martins, Alexandre S; Carpes, Felipe P; Mello-Carpes, Pâmela B

    2014-01-01

    With aging, it is important to maintain cognitive and motor functions to ensure autonomy and quality of life. During the acquisition of motor skills, it is necessary for the elderly to understand the purpose of the proposed activities. Physical and mental practice, as well as demonstrations, are strategies used to learn movements. To investigate the influence of mental practice and the observation of movement on motor memory and to understand the relationship between cognitive function and motor performance in the execution of a sequence of digital movements in the elderly. This was a cross-sectional study conducted with 45 young and 45 aged subjects. The instruments used were Mini-Mental State Examination (MMSE), Manual Preference Inventory and a Digital Motor Task (composed of a training of a sequence of movements, an interval and a test phase). The subjects were divided into three subgroups: control, mental practice and observation of movement. The elderly depend more strongly on mental practice for the acquisition of a motor memory. In comparing the performances of people in different age groups, we found that in the elderly, there was a negative correlation between the MMSE score and the execution time as well as the number of errors in the motor task. For the elderly, mental practice can advantage motor performance. Also, there is a significant relationship between cognitive function, learning and the execution of new motor skills.

  10. 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…

  11. Observing Online Instruction: A Formative Practice toward Awareness and Readiness in Online Instructional Design Strategies

    Science.gov (United States)

    Widdall, Christine L.

    2012-01-01

    This qualitative research project used a multiple case study methodology, in connection with observational learning to explore to what degree prospective online secondary teachers achieved an awareness of instructional design strategies as they concurrently observed online instruction in two unique online courses: one with student-centered…

  12. 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.

  13. The difficulty of making psychology research and clinical practice relevant to medicine: experiences and observations.

    Science.gov (United States)

    Kessler, Rodger

    2008-03-01

    Psychology and medicine research and practice have demonstrated substantial and unique bodies of knowledge designed to both improve patient care and respond to contemporary health care needs for use of evidence and cost consciousness. At their full potential they represent a significant paradigm shift in healthcare. Despite impressive successes, it is clear that we are just on the cusp of such a change. These findings have had limited impact and penetration into medical practice, particularly outside of academic medicine and large, organized systems of health care, and there are multiple examples of such limitations in various arenas of health care. There also appear to be common themes to such examples which provide us opportunities to consider how psychologists might move things ahead. They also suggest how our unique position in academic medicine can both limit our impact and provide ways of creating continued shifts in the healthcare paradigm.

  14. 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?

  15. Recent literary theory and criticism in Spanish Anglistics : some observations on its institutional context and practices

    OpenAIRE

    García Landa, José Ángel

    2001-01-01

    This paper addresses the institutional context and academic practices related to the production and use of literary theory and criticism in the Spanish universities, with a special focus on the role of theory in Spanish Anglistics in recent years. The paper assesses interdisciplinary communication, the impact of new theoretical paradigms (feminism, postcolonial studies, etc.) in a specifically Spanish setting, and the disciplinary transformations and new publishing opportunities associated to...

  16. 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.

  17. 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.

  18. Dying at home or in the hospital? An observational study in German general practice.

    Science.gov (United States)

    Gágyor, Ildikó; Himmel, Wolfgang; Pierau, Andrea; Chenot, Jean-François

    2016-01-01

    Although determinants of place of death have been investigated in several studies, there is a lack of knowledge on factors associated with dying at home from the general practice perspective. To identify factors associated with dying at home for patients in German general practice. In a retrospective study, general practitioners of 30 general practices were asked to provide data for all patients aged 18 years or older who died within the last 12 months, using a self-developed questionnaire. 'Dying in hospital' was defined as dying in hospital or hospice and 'dying at home' as dying at one's usual residence including the nursing home. Multiple logistic regression analyses were used to determine factors associated with 'dying at home'; odds ratios (ORs) and their 95% confidence intervals (CI) were calculated as measures of effect size. Of 439 deceased patients, 52.2% died at home, and 47.8% died in hospital or hospice. Determinants for dying at home were patients' care in the last 48 hours of life by family members (OR: 7.8, 95% CI: 3.4-18.0), by general practitioners (GPs) (OR: 7.3, 4.2-12.9) and living in a nursing home (OR: 3.8, 1.7-8.3). In the adjusted model, low comorbidity was positively associated (OR: 3.2, 1.4-7.0), and low functional health status (Karnofsky performance status) was negatively associated with dying at home (OR: 0.3, 0.1-0.7). Apart from patient-related factors such as comorbidity and health status, care by family members and GPs respectively, were determinants of dying at home.

  19. Drug interactions with levothyroxine therapy in patients with hypothyroidism: observational study in general practice.

    Science.gov (United States)

    Trifirò, Gianluca; Parrino, Fabrizio; Sultana, Janet; Giorgianni, Francesco; Ferrajolo, Carmen; Bianchini, Elisa; Medea, Gerardo; Benvenga, Salvatore; Cricelli, Iacopo; Cricelli, Claudio; Lapi, Francesco

    2015-03-01

    Several drugs may interact with levothyroxine and reduce its bioavailability. The aim of this study was to analyse the Italian general practice patients with hypothyroidism from 2002-2011, in terms of variation of thyroid-stimulating hormone (TSH) levels, number of levothyroxine prescriptions and dose of levothyroxine before and during potential drug-drug interactions (DDIs). Data were extracted from the Italian general practice Health Search CSD Longitudinal Patient Database (HSD). Analysis was limited to individuals aged 18 years and older with at least one levothyroxine prescription from 2002 to 2011 and at least one year of clinical history recorded in HSD. A quasi-experimental pre-post analysis was carried out using a self-controlled study design, on an intention-to-treat basis. Overall, 5,426 levothyroxine users (7.5 % of population in HSD) were included in the study. The incidence rate ratio comparing the TSH trend before and during the period of exposure to potential DDI showed a significant increase of TSH levels during initial exposure to potential DDI, which decreased over time. The number of prescriptions and dose of levothyroxine decreased before the potential DDI and increased symmetrically during the period of exposure to potential DDI. The co-prescription of levothyroxine and potentially interacting drugs results in an increased use of levothyroxine. Clinicians should carefully consider adjusting levothyroxine therapy in presence of concomitant drugs, such as proton-pump inhibitors, which may reduce levothyroxine bioavailability.

  20. "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.

  1. 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.

  2. Integrating ecosystem services analysis into scenario planning practice: accounting for street tree benefits with i-Tree valuation in Central Texas.

    Science.gov (United States)

    Hilde, Thomas; Paterson, Robert

    2014-12-15

    Scenario planning continues to gain momentum in the United States as an effective process for building consensus on long-range community plans and creating regional visions for the future. However, efforts to integrate more sophisticated information into the analytical framework to help identify important ecosystem services have lagged in practice. This is problematic because understanding the tradeoffs of land consumption patterns on ecological integrity is central to mitigating the environmental degradation caused by land use change and new development. In this paper we describe how an ecosystem services valuation model, i-Tree, was integrated into a mainstream scenario planning software tool, Envision Tomorrow, to assess the benefits of public street trees for alternative future development scenarios. The tool is then applied to development scenarios from the City of Hutto, TX, a Central Texas Sustainable Places Project demonstration community. The integrated tool represents a methodological improvement for scenario planning practice, offers a way to incorporate ecosystem services analysis into mainstream planning processes, and serves as an example of how open source software tools can expand the range of issues available for community and regional planning consideration, even in cases where community resources are limited. The tool also offers room for future improvements; feasible options include canopy analysis of various future land use typologies, as well as a generalized street tree model for broader U.S. application. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Corrective Feedback in L2 Latvian Classrooms: Teacher Perceptions versus the Observed Actualities of Practice

    Science.gov (United States)

    Dilans, Gatis

    2016-01-01

    This two-part study aims to investigate teacher perceptions about providing oral corrective feedback (CF) to minority students of Latvian as a second language and compare the perceptions to the actual provision of CF in L2 Latvian classrooms. The survey sample represents sixty-six L2 Latvian teachers while the classroom observations involved 13…

  4. 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.

  5. i-gel™ supraglottic airway in clinical practice: a prospective observational multicentre study

    OpenAIRE

    Theiler, L.; Gutzmann, M.; Kleine-Brueggeney, M.; Urwyler, N.; Kaempfen, B.; Greif, R.

    2017-01-01

    Background The i-gel™ supraglottic airway device has been studied in randomized controlled studies, but it has not been evaluated in a large prospective patient cohort. Therefore, we performed this prospective multicentre observational study to evaluate success rates, airway leak pressure, risk factors for i-gel failure, and adverse events. Methods With Ethics Committee approval and waiver of patients' consent, data about anaesthesia providers, patient characteristics, and the performance of ...

  6. Maternal behaviour and feeding practices as determinants of childhood diarrhoea: some observations amongst rural Bengalee mothers.

    Science.gov (United States)

    Ghosh, S; Sengupta, P G; Mandal, S K; Manna, B; Sikder, S N; Sirkar, B K

    1994-01-01

    In India, epidemiologists followed 980 rural families with children less than 3 years old living near Calcutta in West Bengal to identify determinants related to maternal behavior and feeding practices of childhood diarrhea. They identified 570 families with diarrhea cases and 410 families with no diarrhea cases. Children with diarrhea were more likely to live in Kuchcha housing (44.7% vs. 33.9%; p = 0.0006), to have a family income of less than Rs.500/month (44.2% vs. 36.6%; p = 0.016) and a mother who was illiterate (53.5% vs. 45.4%; p = 0.013). Nondiarrheal families were more likely to have a sanitary latrine (63.9% vs. 50.5%; p = 0.000031) and have soap (for ablution, 22.9% vs. 14.4%; p = 0.0005 and, before food handling, 7.1% vs. 3%; p = 0.0046). Mothers with children who did not have diarrhea were more likely to space their births at least 4 years apart than those with children who did have diarrhea (20.5% vs. 14.7%; p = 0.018). Mothers with children who did not have diarrhea were also less likely to practice poor hygiene. Specifically, they would tend not to use leftover food for the next feeding (19.1% vs. 38%; p = 0.02), to have children whose body and clothes were dirty (19.1% vs. 40%; p = 0.01), to dispose of stools indiscriminately (55.3% vs. 73.7%; p = 0.02), to share a common latrine with other villagers (15.9% vs. 36.2%; p = 0.008), and to stop drinking water in a wide mouth container (66% vs. 84.8%; p = 0.008). Mothers with children who did not have diarrhea were also more likely to wash the container used for feeding the children with soap (48.9% vs. 30.4%; p = 0.03).

  7. 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)

  8. Dust mite infestation in cooking flour: experimental observations and practical recommendations.

    Science.gov (United States)

    Suesirisawad, Sasikarn; Malainual, Nat; Tungtrongchitr, Anchalee; Chatchatee, Pantipa; Suratannon, Narissara; Ngamphaiboon, Jarungchit

    2015-06-01

    The first documented case of oral mite anaphylaxis has recently been reported in Thailand, with mites possibly originating from cooking flour. Our study was designed to assess the effects of cooking flours enhancement and storage conditions on mite proliferation and to provide practical recommendations to prevent mite anaphylaxis. In a factorial experiment, six commercial brands of cooking flours were selected and either inoculated or set free of mites and stored in one of the four containers chosen for the study: original package, plastic bag, plastic box and glass bottle. The resulting experimental units where then stored at either room temperature or in a refrigerator (+4C). In order to determine levels of Der f 1 allergen, 0.1 gram of flour was sampled from each experimental unit and tested by ELISA. Sampling was carried out immediately after inoculation and subsequently at week 2, 4, 6, 8, 10, 12, 16 and 20. Levels of Der f 1 allergen in the inoculated samples increased significantly in all conditions 6 weeks after inoculation (p flour, corn flour, wheat flour and tapioca starch, respectively (p flours containing high amounts of wheat at room temperature, particularly after 8 week of storage. According to our results, we thus advise to keep household cooking flour refrigerated and while the type of container does not matter, storage should not exceed 20 weeks.

  9. Antibiotics prescribing practices in oral implantology among jordanian dentists. A cross sectional, observational study

    Directory of Open Access Journals (Sweden)

    Hamdan Ahmad AS

    2011-07-01

    Full Text Available Abstract Background In oral implantology, there is no consensus on the most appropriate regimen for antibiotics prescribing, the decision to prescribe antibiotic is usually based on procedure, patient and clinician related factors. The aim of this study was to investigate the rationale of antibiotic prescribing among Jordanian clinicians who practice oral implantology. Findings The target sample for the study was the 250 Jordan Dental Implant Group members. A five page questionnaire contained 41 questions, both closed and open questions were used to collect data. Statistical analysis was performed using SPSS Windows 16.0 (SPSS Inc., Chicago, IL, USA. Descriptive statistics were generated. The response rate was (70.4% 176/250. Mean age was 37.2 yrs, 49.4% always prescribe antibiotics mainly oral amoxicillin and amoxicillin with clavulinic acid. Antibiotics prescribing increased with flap raising, multiple implants and sinus or bone augmentation. Patient medical condition, periodontitis and oral hygiene were the most important clinical factors in antibiotic prescribing, non-clinical factors were; reading scientific materials, courses and lectures, knowledge gained during training, and the effectiveness and previous experience with the drug. Conclusions Wide variations in antibiotics types, routes, dose and duration of administration were found. Recommendations on antibiotic prescribing are needed to prevent antibiotic overprescribing and misuse.

  10. 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.

  11. Toward realistic and practical ideal observer (IO) estimation for the optimization of medical imaging systems.

    Science.gov (United States)

    He, Xin; Caffo, Brian S; Frey, Eric C

    2008-10-01

    The ideal observer (IO) employs complete knowledge of the available data statistics and sets an upper limit on observer performance on a binary classification task. However, the IO test statistic cannot be calculated analytically, except for cases where object statistics are extremely simple. Kupinski have developed a Markov chain Monte Carlo (MCMC) based technique to compute the IO test statistic for, in principle, arbitrarily complex objects and imaging systems. In this work, we applied MCMC to estimate the IO test statistic in the context of myocardial perfusion SPECT (MPS). We modeled the imaging system using an analytic SPECT projector with attenuation, distant-dependent detector-response modeling and Poisson noise statistics. The object is a family of parameterized torso phantoms with variable geometric and organ uptake parameters. To accelerate the imaging simulation process and thus enable the MCMC IO estimation, we used discretized anatomic parameters and continuous uptake parameters in defining the objects. The imaging process simulation was modeled by precomputing projections for each organ for a finite number of discretely-parameterized anatomic parameters and taking linear combinations of the organ projections based on continuous sampling of the organ uptake parameters. The proposed method greatly reduces the computational burden and allows MCMC IO estimation for a realistic MPS imaging simulation. We validated the proposed IO estimation technique by estimating IO test statistics for a large number of input objects. The properties of the first- and second-order statistics of the IO test statistics estimated using the MCMC IO estimation technique agreed well with theoretical predictions. Further, as expected, the IO had better performance, as measured by the receiver operating characteristic (ROC) curve, than the Hotelling observer. This method is developed for SPECT imaging. However, it can be adapted to any linear imaging system.

  12. Validation practices for satellite-based Earth observation data across communities

    Science.gov (United States)

    Loew, Alexander; Bell, William; Brocca, Luca; Bulgin, Claire E.; Burdanowitz, Jörg; Calbet, Xavier; Donner, Reik V.; Ghent, Darren; Gruber, Alexander; Kaminski, Thomas; Kinzel, Julian; Klepp, Christian; Lambert, Jean-Christopher; Schaepman-Strub, Gabriela; Schröder, Marc; Verhoelst, Tijl

    2017-09-01

    Assessing the inherent uncertainties in satellite data products is a challenging task. Different technical approaches have been developed in the Earth Observation (EO) communities to address the validation problem which results in a large variety of methods as well as terminology. This paper reviews state-of-the-art methods of satellite validation and documents their similarities and differences. First, the overall validation objectives and terminologies are specified, followed by a generic mathematical formulation of the validation problem. Metrics currently used as well as more advanced EO validation approaches are introduced thereafter. An outlook on the applicability and requirements of current EO validation approaches and targets is given.

  13. Understanding on-road practices of electric bike riders: an observational study in a developed city of China.

    Science.gov (United States)

    Du, Wei; Yang, Jie; Powis, Brent; Zheng, Xiaoying; Ozanne-Smith, Joan; Bilston, Lynne; Wu, Ming

    2013-10-01

    Although millions of electric bikes (E-bikes) operate in China and many associated deaths and injuries have been reported, E-bikers' on-road practices are poorly characterized and few direct observational studies have been performed. This study aims to describe riding behaviors among E-bikers and to investigate factors influencing these practices to inform injury prevention. In March 2012, a cross-sectional observational study was conducted at 14 randomly selected intersections in Suzhou during a 7-day period. A pro-forma observation checklist was used to collect data on road riding practice. Adjusted Odds Ratios (OR) and 95% Confidence Intervals (CI) to assess the likelihood of specific riding practices among E-bikers were evaluated using mixed-effects logistic regression. Among 18,150 E-bikers observed, 37.6% rode E-bikes with cycling pedals, 86.0% of E-bikes were registered, 26.6% did not comply with the road rules, and 41.1% wore at least one safety item. The overall prevalence of carrying passengers, riding in a motor vehicle lane, running red lights, riding in opposite directions (i.e., facing oncoming traffic), mobile phone use, and helmet use were 12.4% (95%CI: 11.9-12.9%), 1.9% (95%CI: 1.7-2.1%), 4.8% (95%CI: 4.5-5.1%), 3.4% (95%CI: 3.1-3.7%), 0.4% (95%CI: 0.3-0.5%), and 9.0% (95%CI: 8.5-9.4%), respectively. Male E-bikers was associated with increased helmet use and riding in motor vehicle lanes, whereas riding a registered E-bike was associated with reduced likelihood of carrying passengers. This study demonstrates common road rule violations and low helmet use among E-bikers and supports the urgent need to develop additional regulations and behavioral interventions to improve safety practice among E-bikers in China. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. The GLOBAL Learning and Observations to Benefit the Environment (GLOBE) Collaboration System. Building a robust international collaboration environment for teachers, scientists and students.

    Science.gov (United States)

    Overoye, D.; Lewis, C.

    2016-12-01

    The Global Learning and Observations to Benefit the Environment (GLOBE) Program is a worldwide hands-on, primary and secondary school-based science and education program founded on Earth Day 1995. Implemented in 117 countries, GLOBE promotes the teaching and learning of science, supporting students, teachers and scientists worldwide to collaborate with each other on inquiry-based investigations of the Earth system. As an international platform supporting a large number and variety of stakeholders, the GLOBE Data Information System (DIS) was re-built with the goal of providing users the support needed to foster and develop collaboration between teachers, students and scientists while supporting the collection and visualization of over 50 different earth science investigations (protocols). There have been many challenges to consider as we have worked to prototype and build various tools to support collaboration across the GLOBE community - language, security, time zones, user roles and the Child Online Protection Act (COPA) to name a few. During the last 3 years the re-built DIS has been in operation we have supported user to user collaboration, school to school collaboration, project/campaign to user collaboration and scientist to scientist collaboration. We have built search tools to facilitate finding collaboration partners. The tools and direction continue to evolve based on feedback, evolving needs and changes in technology. With this paper we discuss our approach for dealing with some of the collaboration challenges, review tools built to encourage and support collaboration, and analyze which tools have been successful and which have not. We will review new ideas for collaboration in the GLOBE community that are guiding upcoming development.

  15. 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.

  16. 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.

  17. 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™,

  18. 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.

  19. Socioeconomic benefits

    African Journals Online (AJOL)

    User

    perception on the benefits of shade trees in coffee production systems in southwestern ..... Table 4. Other socioeconomic benefits of coffee shade tree species alluded by the respondents, Southwestern Ethiopia. Mentioned benefits. Responses (%). Yes. No. Firewood ... (fast growth, longevity, possession of thin and small ...

  20. 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

  1. 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

  2. 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

  3. 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.

  4. 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.

  5. 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

  6. 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

  7. 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

  8. An observational study of umbilical cord clamping practices of maternity care providers in a tertiary care center.

    Science.gov (United States)

    Hutton, Eileen K; Stoll, Kathrin; Taha, Natalie

    2013-03-01

    Severing the umbilical cord at birth is likely the oldest intervention, the timing of which remains fraught with controversy. Emerging evidence suggests benefit in delaying cord clamping for both term and preterm infants. The objective of this study was to investigate actual cord clamping time and circumstances at a large tertiary care center in Canada. We used a stopwatch to time the interval from the time the infant was born as far as the umbilicus until the time that the umbilical cord was clamped before cutting. We reported on timing of the umbilical cord clamping overall and by practitioner group (obstetrician, midwife, and family practitioner). A total of 98 women and their practitioners consented to be observed at the British Columbia Women's Hospital and Health Center, Vancouver, Canada. More than one-half (56.2%) of all infants had their umbilical cord clamped within 15 seconds. The median (5th, 95th percentile) clamping time in seconds for the full sample was 12 (4, 402) with practitioner subgroups as follows: obstetricians (12 [3, 107]), family physicians (19 [6, 325]), and midwives (81 [6, undefined]). The median clamping time was likely to be longer when the birth occurred spontaneously, no umbilical cord blood was collected, and no birth or neonatal complications occurred. In our sample taken in 2006 to 2007, most infants had umbilical cords clamped immediately after the birth, with more than one-half clamped within 15 seconds of birth. Since the time of our study, delayed umbilical cord clamping for the healthy term newborn has become a part of recommended management of third stage of labor and resuscitation guidelines. It would be informative to repeat a study like this one to determine compliance with the current standards of care. © 2013, Copyright the Authors Journal compilation © 2013, Wiley Periodicals, Inc.

  9. 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…

  10. 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.

  11. How can students' diagnostic competence benefit most from practice with clinical cases? the effects of structured reflection on future diagnosis of the same and novel diseases

    NARCIS (Netherlands)

    Mamede, Sílvia; Van Gog, Tamara; Sampaio, Alexandre Moura; De Faria, Rosa Malena Delbone; Maria, José Peixoto; Schmidt, Henk G.

    2014-01-01

    PURPOSE: To develop diagnostic competence, students should practice with many examples of clinical problems to build rich mental representations of diseases. How to enhance learning from practice remains unknown. This study investigated the effects of reflection on cases compared with generating a

  12. 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…

  13. An observational study of the effectiveness of practice guideline implementation strategies examined according to physicians' cognitive styles

    Directory of Open Access Journals (Sweden)

    Kowalski Christine P

    2007-12-01

    Full Text Available Abstract Background Reviews of guideline implementation recommend matching strategies to the specific setting, but provide little specific guidance about how to do so. We hypothesized that the highest level of guideline-concordant care would be achieved where implementation strategies fit well with physicians' cognitive styles. Methods We conducted an observational study of the implementation of guidelines for hypertension management among patients with diabetes at 43 Veterans' Health Administration medical center primary care clinics. Clinic leaders provided information about all implementation strategies employed at their sites. Guidelines implementation strategies were classified as education, motivation/incentive, or barrier reduction using a pre-specified system. Physician's cognitive styles were measured on three scales: evidence vs. experience as the basis of knowledge, sensitivity to pragmatic concerns, and conformity to local practices. Doctors' decisions were designated guideline-concordant if the patient's blood pressure was within goal range, or if the blood pressure was out of range and a dose change or medication change was initiated, or if the patient was already using medications from three classes. Results The final sample included 163 physicians and 1,174 patients. All of the participating sites used one or more educational approaches to implement the guidelines. Over 90% of the sites also provided group or individual feedback on physician performance on the guidelines, and over 75% implemented some type of reminder system. A minority of sites used monetary incentives, penalties, or barrier reduction. The only type of intervention that was associated with increased guideline-concordant care in a logistic model was barrier reduction (p Conclusion Guidelines implementation strategies that were designed to reduce physician time pressure and task complexity were the only ones that improved performance. Education may have been

  14. Contrast-induced nephropathy in patients undergoing computed tomography (CONNECT) - a clinical problem in daily practice? A multicenter observational study

    Energy Technology Data Exchange (ETDEWEB)

    Lencioni, Riccardo (Div. of Diagnostic Imaging and Intervention, Dept. of Liver Transplantation, Hepatology, Pisa Univ. Hospital, Pisa (Italy)), e-mail: lencioni@med.unipi.it; Fattori, Rossella (Dept. of Radiology-Cardiovascular Unit, Univ. Hospital S. Orsola, Bologna (Italy)); Morana, Giovanni (Dept. of Radiology, General Hospital ' Ca' Foncello' , Treviso (Italy)); Stacul, Fulvio (Dept. of Radiology, Univ. Hospital of Trieste, Ospedale Maggiore, Trieste (Italy))

    2010-09-15

    Background: Although several studies have examined contrast-induced nephropathy (CIN) following computed tomography (CT) procedures under closely controlled clinical trial conditions, less is known about the incidence of CIN (or its key predictive factors) in a 'real world' clinical setting. Purpose: A multicenter, observational registry study was undertaken in Italian hospital radiology departments to retrospectively assess the incidence of CIN in at-risk patients undergoing iodixanol-enhanced CT procedures. Material and Methods: Each department used center-specific (non standardized) CT protocols. Data were available from 493 at-risk patients; most (76.4%) had 1 risk factor for CIN, 19.8% had 2, and 3.4% had 3. In all, 169 patients (34.3%) had reduced renal function (estimated glomerular filtration rate [eGFR] <60 ml/min/1.73m2). Prophylactic volume expansion was not used in 70.6% of the study population. Results: The overall incidence of CIN (defined as a =44.2 mumol/l [0.5 mg/dl] increase in serum creatinine from baseline 72 h post procedure) was 2.6%; in the subpopulation of patients with renal impairment (with or without other risk factors), CIN incidence was 4.7%. Multivariate analysis identified renal insufficiency as the only risk factor predictive of CIN (relative risk, 3.850; 95% confidence interval, 1.200-12.348; P=0.023). Conclusion: In the clinical setting of hospital CT radiology practice, where guideline-recommended strategies for CIN prevention may not be consistently followed, use of the iso-osmolar agent iodixanol appears to be associated with a low incidence of CIN in at-risk patients. Keywords CT, intravenous contrast agents, kidney, vascular

  15. Characterisation of patients receiving moxifloxacin for acute bacterial rhinosinusitis in clinical practice: results from an international, observational cohort study.

    Directory of Open Access Journals (Sweden)

    Ralph Mösges

    Full Text Available We conducted a prospective, non-controlled, multi-centre Phase IV observational cohort study of patients with acute bacterial rhinosinusitis who were treated with moxifloxacin in clinical practice in 19 countries in Asia Pacific, Europe and the Middle East. With the data collected we evaluated the presentation and course of the current disease episode, particularly in terms of the principal clinical signs and symptoms of acute rhinosinusitis and diagnostic procedures. A final assessment of moxifloxacin therapy was made to evaluate the impact of the sinusitis episode on activities of daily life and on sleep disturbance, and to evaluate the clinical outcome of treatment. A total of 7,090 patients were enrolled, of whom 3909 (57.6% were included in the valid for clinical outcome and safety population. Regional differences were observed in the main symptoms of acute rhinosinusitis and, according to several characteristics, disease episodes appeared to be more severe in patients in Europe than in the Asia Pacific or Middle East regions. The sinusitis episode impacted on daily living for mean (SD periods of 3.6 (3.2, 4.6 (3.9 and 3.1 (3.0 days and disturbed sleep for 3.6 (3.2, 4.6 (3.9 and 3.1 (3.0 nights in the Asia Pacific, Europe and Middle East regions, respectively. With moxifloxacin treatment, the mean (SD time to improvement of symptoms was 3.0 (1.5, 3.4 (1.6 and 3.2 (1.5 days, and the time to resolution of symptoms was 4.8 (2.6 days, 5.7 (2.4 days and 5.5 (2.5 days, in the Asia Pacific, Europe and Middle East regions, respectively. In conclusion, acute rhinosinusitis remains a substantial health burden with significant impact on patients' quality of life, and there are differences between global regions in the clinical presentation, diagnosis and clinical course of disease episodes. Moxifloxacin was an effective and well-tolerated treatment option in the overall population.ClinicalTrials.gov Identifier: NCT00930488.

  16. [How to Increase the Effectiveness of Antihypertensive Therapy in Clinical Practice: Results of the Russian Observational Program FORSAZH].

    Science.gov (United States)

    Glezer, M G; Deev On Behalf Of The Participants Of The Program, A D

    2016-01-01

    im of the study - to evaluate the possibility of increasing the effectiveness of antihypertensive therapy by simplifying regimens, improving knowledge and practical skills of the doctors on the use of modern tactical approaches to treatment as well as patients education methods of measuring blood pressure (BP), the principles of a healthy lifestyle and explain the need to follow the prescribing physician. Post-marketing observational discovery program FORSAZH held in 29 cities of the Russian Federation. Participation in the program received 442 physician (internists and general practitioners), which included 1969 patients with prior failure of combination antihypertensive therapy. Patients in 86% of cases took the free combination, 14% - fixed combinations of drugs. The change of the treatment on reception of a preparation containing a fixed combination of perindopril/indapamide (10 mg/2.5 mg) after 3 months led to decrease in systolic blood pressure by an average of 39.5 mm Hg, diastolic - 18.7 per mm Hg. The frequency of achieving the target BP <140 mm Hg and 90 it was 76%. Marked reduction in BP and frequency to achieve the target BP is not dependent on additional training of physicians and patients, the use of prior therapy in free or fixed combination, but depended on the initial degree of increase in BP and duration of therapy. Predictors of failure to achieve target BP were age, male gender, low initial adherence, good health, a higher baseline BP, elevated cholesterol levels, body weight, heart rate and decreased glomerular filtration rate. Adherence to therapy patients (on a scale of Morisky-Green) and health assessment on a visual analog scale significantly increased. This tactic has been a change of therapy is not only effective but also safe. Adverse events were reported in 28 patients (1.4% of the total number of observed cases) and only 1 case required dose reduction due to development of clinically manifested hypotension. In enhancing the

  17. High School Teachers' Use of Graphing Calculators When Teaching Linear and Quadratic Functions: Professed Beliefs and Observed Practice

    Science.gov (United States)

    Molenje, Levi

    2012-01-01

    This study was designed to explore secondary mathematics teachers' beliefs about graphing calculators, their practices with the graphing calculators when teaching linear and quadratic functions, and the relationship between the teachers' beliefs and their practices. The study was conducted in two phases. In the first phase, 81 teachers…

  18. 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,

  19. 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....

  20. Accelerating time to benefit

    DEFF Research Database (Denmark)

    Svejvig, Per; Geraldi, Joana; Grex, Sara

    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......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...

  1. 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

  2. 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

  3. Potential benefit of physician-staffed helicopter emergency medical service for regional trauma care system activation: An observational study in rural Japan.

    Science.gov (United States)

    Abe, Tomohiro; Nagano, Takehiko; Ochiai, Hidenobu

    2017-05-01

    Objective: Involvement of all regional medical facilities in a trauma system is challenging in rural regions. We hypothesized that the physician-staffed helicopter emergency medical service potentially encouraged local facilities to participate in trauma systems by providing the transport of patients with trauma to those facilities in a rural setting. Materials and Methods: We performed two retrospective observational studies. First, yearly changes in the numbers of patients with trauma and destination facilities were surveyed using records from the Miyazaki physician-staffed helicopter emergency medical service from April 2012 to March 2014. Second, we obtained data from medical records regarding the mechanism of injury, severity of injury, resuscitative interventions performed within 24 h after admission, secondary transports owing to undertriage by attending physicians, and deaths resulting from potentially preventable causes. Data from patients transported to the designated trauma center and those transported to non-designated trauma centers in Miyazaki were compared. Results: In total, 524 patients were included. The number of patients transported to non-designated trauma centers and the number of non-designated trauma centers receiving patients increased after the second year. We surveyed 469 patient medical records (90%). There were 194 patients with major injuries (41%) and 104 patients with multiple injuries (22%), and 185 patients (39%) received resuscitative interventions. The designated trauma centers received many more patients with trauma (366 vs. 103), including many more patients with major injuries (47% vs. 21%, p service potentially encouraged non-designated trauma centers to participate in trauma systems while maintaining patient safety.

  4. 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.

  5. 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

  6. 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

  7. A comparison of different regulatory approaches, analysis of the relative benefits of command and control, reflexive law and social licensing in ensuring oil industry compliance with environmentally sustainable practices and obligations

    Science.gov (United States)

    Ghanaati, Sahar

    This paper explores the relative benefits of command and control, reflexive law and social licensing in ensuring oil industry compliance with environmentally sustainable practices and obligations. Recognizing why oil sands and their development are significant, the background and development are reviewed first, and then the focus is shifted to look at its economics including the benefits, uncertainties and environmental costs of development. This paper examines how lawmakers in Canada have failed to meet their respective obligation. Drawing on environmental provisions, case law and legal scholars’ articles, books and reports, this paper examines the very problematic issue of oil sands regulation. It proposes to provide an in depth analysis of each regulatory forms and their application to the oil sands. It concludes that in order to solve the oil sands regulation challenges, a collaborative stringent enforcement of regulation from both federal and provincial governments, oil industry and public Pressure is required.

  8. Effective Teaching and Student Engagement in the College Classroom: Using the Instructional Practices Inventory (IPI) as a Tool for Peer Observation and Self-Reflection

    Science.gov (United States)

    Hunzicker, J.; Lukowiak, T.

    2012-01-01

    The authors present initial findings from a collaborative self-study exploring student engagement as a measure of teaching effectiveness. Focused on their college classrooms during one semester, the study pilots a peer observation model of the Instructional Practices Inventory (IPI) (Valentine, 2005). Data collection included IPI codes, anecdotal…

  9. The Association between Parent Early Adult Drug Use Disorder and Later Observed Parenting Practices and Child Behavior Problems: Testing Alternate Models

    Science.gov (United States)

    Bailey, Jennifer A.; Hill, Karl G.; Guttmannova, Katarina; Oesterle, Sabrina; Hawkins, J. David; Catalano, Richard F.; McMahon, Robert J.

    2013-01-01

    This study tested the association between parent illicit drug use disorder (DUD) in early adulthood and observed parenting practices at ages 27-28 and examined the following 3 theoretically derived models explaining this link: (a) a disrupted parent adult functioning model,(b) a preexisting parent personality factor model, and (c) a disrupted…

  10. 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

    BACKGROUND: The use and effectiveness of cinacalcet in 'real-world' clinical practice was investigated in a pan-European observational study in dialysis patients with secondary hyperparathyroidism (SHPT) of varying severity. METHODS: Adult patients with chronic kidney disease on dialysis who had...

  11. 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).

  12. 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…

  13. Dentist and practice characteristics associated with restorative treatment of enamel caries in permanent teeth: multiple-regression modeling of observational clinical data from the National Dental PBRN.

    Science.gov (United States)

    Fellows, Jeffrey L; Gordan, Valeria V; Gilbert, Gregg H; Rindal, D Brad; Qvist, Vibeke; Litaker, Mark S; Benjamin, Paul; Flink, Håkan; Pihlstrom, Daniel J; Johnson, Neil

    2014-04-01

    Current evidence in dentistry recommends non-surgical treatment to manage enamel caries lesions. However, surveyed practitioners report they would restore enamel lesions that are confined to the enamel. Actual clinical data were used to evaluate patient, dentist, and practice characteristics associated with restoration of enamel caries, while accounting for other factors. Data from a National Dental Practice-Based Research Network observational study of consecutive restorations placed in previously unrestored permanent tooth surfaces and practice/demographic data from 229 participating network dentists were combined. ANOVA and logistic regression, using generalized estimating equations (GEE) and variable selection within blocks, were used to test the hypothesis that patient, dentist, and practice characteristics were associated with variations in enamel restorations of occlusal and proximal caries compared to dentin lesions, accounting for dentist and patient clustering. Network dentists from five regions placed 6,891 restorations involving occlusal and/or proximal caries lesions. Enamel restorations accounted for 16% of enrolled occlusal caries lesions and 6% of enrolled proximal caries lesions. Enamel occlusal restorations varied significantly (P < 0.05) by patient age and race/ethnicity, dentists' use of caries risk assessment, network region, and practice type. Enamel proximal restorations varied significantly (P < 0.05) by dentist race/ethnicity, network region, and practice type.

  14. '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.

  15. Some observations on the concept of best practicable environmental option (BPEO) in the context of radioactive waste management

    International Nuclear Information System (INIS)

    Smith, R.E.

    2002-01-01

    The term BPEO, introduced in 1976 by the Royal Commission on Environmental Pollution (RCEP), is largely limited to use within the UK. The concept is easy to grasp (and assent to) as a general principle, but more difficult to pin down in practice and detail. The elasticity of the BPEO concept has led to its being invoked in a variety of contexts and interpreted in various ways, with a recent tendency towards more elaborate interpretations. In any practical BPEO assessment, it is necessary to set the scope and boundaries in a clear and well-considered manner. The boundaries are important limitations of the assessment and any conclusions it may reach. Decision-making in radioactive waste management involves an exercise of judgement. Although a practical BPEO assessment will include many judgements, the most important ones need to be explicit in the decision-making process itself. BPEO assessments thus need to be regarded as aids to decision-making rather than exercises that will themselves directly lead to decisions. It is useful to learn lessons from the development and application of the BPEO concept to date. The Environment Agency and the Scottish Environmental Protection Agency (SEPA) have in progress a project to review current BPEO assessment methods for the management and disposal of radioactive waste, and to develop a preferred methodology suitable for use by regulators, site operators and consultants. (author)

  16. Practice changing practices

    DEFF Research Database (Denmark)

    Thomsen, Rikke; Buch, Anders

    2016-01-01

    Based on a concrete practice-based study we discuss how such studies can be an important integrated part of critical participatory action research that spur change from inside a professional practice. We also discuss our roles as researchers (and union activists). We see and explore the potential...... study about the practices of a study administration unit in a university college in Denmark. The study includes ten weeks of participation observation study and five qualitative interviews, both in the central part and in three local study administrations. Managerial initiated organizational change...... in initiating changes within a practice tradition. To make local changes in the practices is to change the world. The majority of practice-based studies are analyzing different kinds of practices, but only few studies have engaged in doing action research in a practice tradition. Our paper explores how practice...

  17. 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.

  18. Do metacognitive judgments alter memory performance beyond the benefits of retrieval practice? A comment on and replication attempt of Dougherty, Scheck, Nelson, and Narens (2005).

    Science.gov (United States)

    Dougherty, Michael R; Robey, Alison M; Buttaccio, Daniel

    2018-01-24

    A central question in the metacognitive literature concerns whether the act of making a metacognitive judgment alters one's memory for the information about which the judgment was made. Dougherty, Scheck, Nelson, and Narens (2005, Memory & Cognition, 33(6), 1096-1115) attempted to address this question by having participants make either retrospective confidence judgments (RCJs; i.e., evaluations of past retrieval success), judgments of learning (JOLs; i.e., predictions of future retrieval success), or no explicit judgments. When comparing final retrieval accuracy they found that accuracy was greater for items where participants had made JOLs compared with items that received RCJs or no judgment, suggesting that simply making a JOL can improve later memory performance. The present article presents results from four separate replication attempts that fail to duplicate this finding. Combined results provide compelling evidence that making a metacognitive judgment, regardless of the type, has no impact on later memory performance above and beyond retrieval practice.

  19. 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...

  20. 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.

  1. 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.

  2. Practical, computer-aided registration of multiple, three-dimensional, magnetic-resonance observations of the human brain

    Energy Technology Data Exchange (ETDEWEB)

    Diegert, C. [Sandia National Labs., Albuquerque, NM (United States); Sanders, J.A.; Orrison, W.W. Jr. [New Mexico Univ., Albuquerque, NM (United States)

    1992-12-31

    Researchers working with MR observations generally agree that far more information is available in a volume (3D) observation than is considered for diagnosis. The key to the new alignment method is in basing it on available information on surfaces. Using the skin surface is effective a robust algorithm can reliably extract this surface from almost any scan of the head, and a human operator`s exquisite sensitivity to facial features is allows him to manually align skin surfaces with precision. Following the definitions, we report on a preliminary experiment where we align three MR observations taken during a single MR examination, each weighting arterial, venous, and tissue features. When accurately aligned, a neurosurgeon can use these features as anatomical landmarks for planning and executing interventional procedures.

  3. 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.

  4. 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.

  5. Surveillance, Performativity and Normalised Practice: The Use and Impact of Graded Lesson Observations in Further Education Colleges

    Science.gov (United States)

    O'Leary, Matt

    2013-01-01

    In little over a decade, the observation of teaching and learning (OTL) has become the cornerstone of Further Education (FE) colleges' quality systems for assuring and improving the professional skills and knowledge base of tutors. Yet OTL remains an under-researched area of inquiry with little known about the impact of its use on the professional…

  6. Observation of health technologies after their introduction into clinical practice: a systematic review on data collection instruments.

    Science.gov (United States)

    Varela-Lema, Leonor; Ruano-Ravina, Alberto; Cerdá Mota, Teresa

    2012-12-01

    Early assessment of health technologies after they are covered by the health system is deemed crucial to promptly identify and analyse unforeseen problems that may arise when these are used in real world settings. This paper aims to describe the various instruments which could be used for collecting information intended for prospective observation of health technologies, so as to choose the specific instrument best suited to each context. Systematic review of the medical literature aimed at retrieving general reference documents on data collection instruments for post-introduction observation of health technologies. A purpose-designed systematic bibliographic search was elaborated for the main three data collection instruments identified. The three instruments are briefly described along with the main results of the studies retrieved, in terms of the advantages, drawbacks and considerations to be borne in mind when it comes to use these tools in post-introduction observation of new technologies. At present, the most appropriate data collection method for conducting post-introduction observation of new technologies is the use of prospective clinical registries. Electronic clinical records may replace clinical registries in the near future, but currently there are still many doubts as to the quality of the information retrieved. © 2011 Blackwell Publishing Ltd.

  7. Radiocesium and radioiodine in soil particles agitated by agricultural practices: field observation after the Fukushima nuclear accident.

    Science.gov (United States)

    Yamaguchi, N; Eguchi, S; Fujiwara, H; Hayashi, K; Tsukada, H

    2012-05-15

    Three weeks after the accident at the Fukushima Daiichi Nuclear Power Plant, we determined the activity concentrations of (131)I, (134)Cs and (137)Cs in atmospheric dust fugitively resuspended from soil particles due to soil surface perturbation by agricultural practices. The atmospheric concentrations of (131)I, (134)Cs and (137)Cs increased because of the agitation of soil particles by a hammer-knife mower and a rotary tiller. Coarse soil particles were primarily agitated by the perturbation of the soil surface of Andosols. For dust particles smaller than 10 μm, the resuspension factors of radiocesium during the operation of agricultural equipment were 16-times higher than those under background condition. Before tillage, most of the radionuclides accumulated within a few cm of the soil surface. Tillage diluted their concentration in the uppermost soil layer. Copyright © 2012 Elsevier B.V. All rights reserved.

  8. "To observe well ... and thence to make himself rules": John Locke's principles and practice of child healthcare.

    Science.gov (United States)

    Williams, A N

    2007-06-01

    It is often forgotten that the philosopher John Locke (1632-1704) was a highly regarded physician with a lifelong interest in medicine and was frequently consulted on medical matters, including the health of children. This child health aspect in Locke's history has been largely ignored, with even modern commentaries on Locke and medicine giving it only a cursory mention. However, it is clear that, in child health, Locke's influence is far more substantial than GF Still's and George Jackson's opinions, which limited Locke solely to Thoughts concerning education (1692/3). That a fundamental reappraisal of Locke's role in child healthcare is necessary and that his place as a pioneer of modern child healthcare needs to be proclaimed are emphasised here. As modern day child healthcare has evolved to embrace advocacy and learning disability, Locke's importance through his influence on paediatrics, child healthcare and human rights becomes more evident. Locke's influence in child healthcare comes not only through his other celebrated philosophical writings, but also through extensive personal correspondence and case records. As well as throwing light onto the 17th century aspects of child healthcare, Locke, through his enquiry and self-evident humility in his correspondence on medical matters, inspires and educates us with his pragmatic approach to the practice of medicine.

  9. 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%.

  10. 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.

  11. 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.

  12. 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...

  13. Assessment of nutrition and physical activity practices using self-report and observation in early care and education across multiple US states.

    Science.gov (United States)

    Smith, Teresa M; Blaser, Casey; Geno Rasmussen, Cristy; Shuell, Julie; Plumlee, Catherine; Yaroch, Amy L

    2017-06-01

    The National Early Care and Education Learning Collaboratives (ECELC) Project aims to promote healthy physical activity and nutrition environments, policies and practices in early care and education (ECE) programmes across multiple states. The present pilot study sought to assess changes to the physical activity and nutrition practices in a sub-sample of ECE programmes participating in the ECELC using the Environment and Policy Assessment and Observation (EPAO). Additionally, it sought to compare results with the Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC). Quasi-experimental pre-post pilot study where paired-sample t tests examined changes to physical activity and nutrition practices from pre-assessment to post-assessment (Passessment to post-assessment (150 (sd 30) to 176 (sd 35)). NAP SACC change scores demonstrated little relationship with EPAO domain change scores, with exceptions in Nutrition Policy and Physical Activity Policy (r=-0·4 and -0·6, respectively). The overall improvements reported through the EPAO suggest participation in the ECELC resulted in changes in critical nutrition- and physical activity-related practices. However, considerable differences in data reported using the NAP SACC compared with the EPAO suggest subjective data should be interpreted with caution and objective measurement should be used when feasible.

  14. 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.

  15. 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.

  16. Which patients may benefit from the use of a decision support system to improve compliance of physician decisions with clinical practice guidelines: a case study with breast cancer involving data mining.

    Science.gov (United States)

    Séroussi, Brigitte; Soulet, Arnaud; Spano, Jean-Philippe; Lefranc, Jean-Pierre; Cojean-Zelek, Isabelle; Blaszka-Jaulerry, Brigitte; Zelek, Laurent; Durieux, Axel; Tournigand, Christophe; Messai, Nizar; Rousseau, Alexandra; Bouaud, Jacques

    2013-01-01

    OncoDoc2 is a guideline-based clinical decision support system (CDSS) for breast cancer management. It has been used as an intervention in a randomized controlled trial carried out to evaluate the impact of using a CDSS upon the compliance with clinical practice guidelines (CPGs) of multidisciplinary staff meeting decisions. Data mining was used to discover multi-criteria regularities as "emerging patterns" (EPs) associated with compliance and non-compliance with CPGs when using and not using OncoDoc2 and to assess which patients may benefit from the use of the CDSS. Decision data was collected from all participating centers. The number of EPs associated with non-compliance is smaller in the intervention arm, which suggests a practice harmonization effect of OncoDoc2. EPs associated with compliant decisions in both arms of the trial correspond to situations well identified in CPGs. EPs associated with non-compliant decisions when the system is not used are associated with compliance when the system is used except in clinical situations where evidence is lacking.

  17. 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.

  18. 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...

  19. 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.

  20. 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.

  1. Sustainable Offices: Small Practices for Big Benefits

    Science.gov (United States)

    2012-05-01

    Plastic trash bags • Printer ribbons • Toner cartridges • Office furniture • Solid plastic binders • Plastic clipboards • Plastic clip...tissue products • Miscellaneous papers • Newsprint • Paperboard and packaging products • Printing and writing papers 9 Product Certifications...Maintain a minimum supply inventory • Use newer technology toner cartridges and paper • Stop mail deliveries to departed personnel • Use tap

  2. Translational Behavior Analysis and Practical Benefits

    Science.gov (United States)

    Pilgrim, Carol

    2011-01-01

    In his article, Critchfield ("Translational Contributions of the Experimental Analysis of Behavior," "The Behavior Analyst," v34, p3-17, 2011) summarizes a previous call (Mace & Critchfield, 2010) for basic scientists to reexamine the inspiration for their research and turn increasingly to translational approaches. Interestingly, rather than…

  3. The association between parent early adult drug use disorder and later observed parenting practices and child behavior problems: testing alternate models.

    Science.gov (United States)

    Bailey, Jennifer A; Hill, Karl G; Guttmannova, Katarina; Oesterle, Sabrina; Hawkins, J David; Catalano, Richard F; McMahon, Robert J

    2013-05-01

    This study tested the association between parent illicit drug use disorder (DUD) in early adulthood and observed parenting practices at ages 27-28 and examined the following 3 theoretically derived models explaining this link: (a) a disrupted parent adult functioning model,(b) a preexisting parent personality factor model, and (c) a disrupted adolescent family process model. Associations between study variables and child externalizing problems also were examined. Longitudinal data linking 2 generations were drawn from the Seattle Social Development Project (SSDP) and The SSDP Intergenerational Project (TIP), and included 167 parents and their 2- to 8-year-old child. Path modeling revealed that parent DUD in early adulthood predicted later observed low-skilled parenting, which was related to child externalizing problems. The preexisting parent personality factor model was supported. Parent negative emotionality accounted for the association between parent early adult DUD and later parenting practices. Parent negative emotionality also was related directly to child externalizing behavior. Limited support for the disrupted transition to adulthood model was found. The disrupted adolescent family process model was not supported. Results suggest that problem drug use that occurs early in adulthood may affect later parenting skills, independent of subsequent parent drug use. Findings highlight the importance of parent negative emotionality in influencing his or her own problem behavior, interactions with his or her child, and his or her child's problem behavior. Prevention and treatment programs targeting young adult substance use, poor parenting practices, and child behavior problems should address parent personality factors that may contribute to these behaviors.

  4. Compliance of energy-dense, small volume oral nutritional supplements in the daily clinical practice on a geriatric ward--an observational study.

    Science.gov (United States)

    Lombard, K; van Steijn, J; Schuur, T; Kuhn, M; Rouws, C; Huinink, E-L; van der Hooft, C; van Asselt, D

    2014-07-01

    Compliance is important in optimizing the clinical effectiveness of oral nutritional supplements (ONS). Small volume, energy-dense ONS (ED-ONS; ≥ 2 kcal/ml) have been shown to improve compliance in clinical trial settings. However, data from clinical practice is still lacking. The aim of the present study was to evaluate the effect of ED-ONS on the compliance in an observational set-up to obtain data from daily clinical practice on a geriatric ward. Geriatric inpatients, undernourished or at risk of undernutrition received two servings of either ED-ONS (125 ml, 2.4 kcal/ml: Nutridrink Compact Energy, Nutricia) or a standard ONS (S-ONS; 200 ml, 1.5 kcal/ml: Nutridrink) as part of their daily routine care. Patients were allocated to a group according to availability of beds and placement on the ward. Compliance (kcal/day and % of prescribed volume) was assessed by weighing returned bottles. Data were analyzed via Mixed Model for Repeated Measures. Forty-seven patients received ED-ONS, and 61 patients received S-ONS. Compliance was significantly higher with ED-ONS in geriatric inpatients compared to S-ONS ( 378 ± 14.0 kcal/day vs. 337 ± 13.6 kcal/day (mean ± SEM), p = 0.039, 63.0 ± 2.34% vs. 56.2 ± 2.26%, p = 0.039). Moreover, a trend (p=0.078) was observed towards an increasing difference in compliance over time. This study shows that compliance to ED-ONS is significantly better than to S-ONS in daily clinical practice. Although small, the difference in compliance seems to increase over time, suggesting clinical relevance with longer treatment.

  5. IT benefits management in local government

    DEFF Research Database (Denmark)

    Nielsen, Kenneth Møller Porto; Nielsen, Peter Axel; Persson, John Stouby

    2012-01-01

    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....

  6. 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.

  7. Realizing e-government benefits with minimal capabilities

    DEFF Research Database (Denmark)

    Pedersen, Keld

    2017-01-01

    Abstract Purpose — The purpose is to increase our understanding of the requirements for public sector organizations to implement benefits realization practices. The research compares benefits realization practices as suggested by the literature with actual practice with the goal of identifying bo...... the research studies benefits realization from an organizational process perspective, and not from the perspective of IT projects. Keywords — Benefits realization, E-government, Local government, Challenges. Paper type — Research paper....

  8. 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 <7.0% after 2 years of follow-up. At the end of the study, 29.5% of patients maintained liraglutide treatment and reached the HbA(1c) target. Mean (±SD) HbA(1c), fasting plasma glucose concentration, body weight and BMI were significantly reduced from baseline [8.46% (±1.46) to 7.44% (±1.20); 180 (±60) to 146 (±44) mg/dL; 95.2 (±20.0) to 91.1 (±19.6) kg; 34.0 (±7.2) to 32.5 (±6.9) kg/m(2); respectively, all P < 0.0001]. Patient treatment satisfaction increased, with the mean diabetes treatment satisfaction questionnaire status version score increasing from 22.17 (±7.64) to 28.55 (±5.79), P < 0.0001. The main adverse event type was gastrointestinal, with a frequency of 10.9%, and the percentage of patients suffering ≥1 hypoglycemic episode decreased from 6.9% to 4.4%. The results of the EVIDENCE study suggest that the 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.

  9. 29 CFR 1625.10 - Costs and benefits under employee benefit plans.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 4 2010-07-01 2010-07-01 false Costs and benefits under employee benefit plans. 1625.10... AGE DISCRIMINATION IN EMPLOYMENT ACT Interpretations § 1625.10 Costs and benefits under employee..., employment agency, or labor organization to observe the terms of * * * any bona fide employee benefit plan...

  10. 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.

  11. 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.

  12. Effect of early infant feeding practices on infection-specific neonatal mortality: an investigation of the causal links with observational data from rural Ghana.

    Science.gov (United States)

    Edmond, Karen M; Kirkwood, Betty R; Amenga-Etego, Seeba; Owusu-Agyei, Seth; Hurt, Lisa S

    2007-10-01

    Strong associations between delayed initiation of breastfeeding and increased neonatal mortality (2-28 d) were recently reported in rural Ghana. Investigation into the biological plausibility of this relation and potential causal pathways is needed. The objective was to assess the effect of early infant feeding practices (delayed initiation, prelacteal feeding, established neonatal breastfeeding) on infection-specific neonatal mortality in breastfed neonates aged 2-28 d. This prospective observational cohort study was based on 10 942 breastfed singleton neonates born between 1 July 2003 and 30 June 2004, who survived to day 2, and whose mothers were visited in the neonatal period. Verbal autopsies were used to ascertain the cause of death. One hundred forty neonates died from day 2 to day 28; 93 died of infection and 47 of noninfectious causes. The risk of death as a result of infection increased with increasing delay in initiation of breastfeeding from 1 h to day 7; overall late initiation (after day 1) was associated with a 2.6-fold risk [adjusted odds ratio (adj OR): 2.61; 95% CI: 1.68, 4.04]. Partial breastfeeding was associated with a 5.7-fold adjusted risk of death as a result of infectious disease (adj OR: 5.73; 95% CI: 2.75, 11.91). No obvious associations were observed between these feeding practices and noninfection-specific mortality. Prelacteal feeding was not associated with infection (adj OR: 1.11; 95% CI: 0.66, 1.86) or noninfection-specific (adj OR: 1.33; 95% CI: 0.55, 3.22) mortality. This study provides the first epidemiologic evidence of a causal association between early breastfeeding and reduced infection-specific neonatal mortality in young human infants.

  13. 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,...

  14. 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.

  15. Use of a primary care online consultation system, by whom, when and why: evaluation of a pilot observational study in 36 general practices in South West England.

    Science.gov (United States)

    Edwards, Hannah B; Marques, Elsa; Hollingworth, William; Horwood, Jeremy; Farr, Michelle; Bernard, Elly; Salisbury, Chris; Northstone, Kate

    2017-11-22

    Evaluation of a pilot study of an online consultation system in primary care. We describe who used the system, when and why, and the National Health Service costs associated with its use. 15-month observational study. Primary care practices in South West England. 36 General practices covering 396 828 patients took part in the pilot. The online consultation website was viewed 35 981 times over the pilot period (mean 9.11 visits per 1000 patients per month). 7472 patients went on to complete an 'e-consultation' (mean 2.00 online consultations per 1000 patients per month). E-consultations were mainly performed on weekdays and during normal working hours. Patient records (n=485) were abstracted for eight practices and showed that women were more likely to use e-consultations than men (64.7% vs 35.3%) and users had a median age of 39 years (IQR 30-50). The most common reason for an e-consultation was an administrative request (eg, test results, letters and repeat prescriptions (22.5%)) followed by infections/immunological issues (14.4%). The majority of patients (65.2%) received a response within 2 days. The most common outcome was a face-to-face (38%) or telephone consultation (32%). The former were more often needed for patients consulting about new conditions (OR 1.56, 95% CI 1.05 to 2.27, p=0.049). The average cost of a practice's response to an e-consultation was £36.28, primarily triage time and resulting face-to-face/telephone consultations needed. Use of e-consultations is very low, particularly at weekends. Unless this can be improved, any impact on staff workload and patient waiting times is likely to be negligible. It is possible that use of e-consultations increases primary care workload and costs. Online consultation systems could be developed to improve efficiency both for staff and patients. These findings have implications for software developers as well as primary care services and policy-makers who are considering investing in online

  16. 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.

  17. 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...

  18. 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

  19. Effective strategies for managing pharmacy benefits.

    Science.gov (United States)

    Jacobson, D

    2001-03-01

    Prescription drug costs are among the fastest-growing healthcare costs. Effective plan design and benefit management strategies can help pharmacy benefit plans manage costs while maintaining quality and customer satisfaction. These strategies include using formulary management, intervention techniques, and cost sharing to encourage the use of generic drugs; employing a mail-service pharmacy benefit for maintenance medications; and implementing concurrent and retrospective review programs to ensure eligibility and plan compliance, identify practice patterns, and encourage appropriate drug selection.

  20. 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...

  1. 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.

  2. 12 CFR 313.140 - Future benefits.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Future benefits. 313.140 Section 313.140 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION PROCEDURE AND RULES OF PRACTICE PROCEDURES FOR CORPORATE DEBT COLLECTION Civil Service Retirement and Disability Fund Offset § 313.140 Future benefits...

  3. Patient, practice and organisational influences on asthma control: observational data from a national study on primary care in the United Kingdom.

    Science.gov (United States)

    Hoskins, Gaylor; Williams, Brian; Jackson, Cathy; Norman, Paul; Donnan, Peter

    2012-05-01

    Achieving asthma control is central to optimising patient quality of life and clinical outcome. Contemporary models of chronic disease management across a variety of countries point to the importance of micro, meso and macro level influences on patient care and outcome. However, asthma outcomes research has almost invariably concentrated on identifying and addressing patient predictors. Little is known about higher level organisational influences. This paper explores the contribution of organisational factors on poor asthma control, allowing for patient factors, at three organisational levels: the individual patient, local service deliverers, and strategic regional providers. Prospective cross-sectional observational cohort study of 64,929 people with asthma from 1205 primary care practices spread throughout the United Kingdom (UK). Patient clinical data were recorded during a routine asthma review. Data were analysed using simple descriptive, multiple regression and complex multi-level modelling techniques, accounting for practice clustering of patients. Poor asthma control was associated with areas of higher deprivation [regression coefficient 0.026 (95% confidence intervals 0.006; 0.046)] and urban practice [-0.155 (-0.275; -0.035)] but not all local and regional variation was explained by the data. In contrast, patient level predictors of poor control were: short acting bronchodilator overuse [2.129 (2.091; 2.164)], days-off due to asthma [1.203 (1.148; 1.258)], PEFRmanagement plan (SMP) [0.554 (0.515; 0.593)], poor inhaler technique [0.53 (0.475; 0.585)], poor medication compliance [0.385 (-0.007; 0.777)], and gender [0.314 (0.281; 0.347)]. Pattern of medication use, smoking history, age, body mass index (BMI), and health service resource use were also significant factors for predicting control. Targeting of health service resource requires knowledge of the factors associated with poor control of asthma symptoms. In the UK the contribution of local and

  4. 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

  5. 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.

  6. Medical students' perception of dyad practice

    DEFF Research Database (Denmark)

    Tolsgaard, Martin G; Rasmussen, Maria Birkvad; Bjørck, Sebastian

    2014-01-01

    . The students felt dyad practice improved their self-efficacy through social interaction with peers, provided useful insight through observation, and contributed with shared memory of what to do, when they forgot essential steps of the physical examination of the patient. However, some students were concerned......Training in pairs (dyad practice) has been shown to improve efficiency of clinical skills training compared with single practice but little is known about students' perception of dyad practice. The aim of this study was to explore the reactions and attitudes of medical students who were instructed...... about decreased hands-on practice and many students preferred to continue practising alone after completing the initial training. Dyad practice is well received by students during initial skills training and is associated with several benefits to learning through peer observation, feedback and cognitive...

  7. 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)

  8. Refactoring and Its Benefits

    International Nuclear Information System (INIS)

    Veerraju, R. P. S. P.; Rao, A. Srinivasa; Murali, G.

    2010-01-01

    Refactoring is a disciplined technique for restructuring an existing body of code, altering its internal structure without changing its external behavior. It improves internal code structure without altering its external functionality by transforming functions and rethinking algorithms. It is an iterative process. Refactoring include reducing scope, replacing complex instructions with simpler or built-in instructions, and combining multiple statements into one statement. By transforming the code with refactoring techniques it will be faster to change, execute, and download. It is an excellent best practice to adopt for programmers wanting to improve their productivity. Refactoring is similar to things like performance optimizations, which are also behavior- preserving transformations. It also helps us find bugs when we are trying to fix a bug in difficult-to-understand code. By cleaning things up, we make it easier to expose the bug. Refactoring improves the quality of application design and implementation. In general, three cases concerning refactoring. Iterative refactoring, Refactoring when is necessary, Not refactor.Mr. Martin Fowler identifies four key reasons to refractor. Refactoring improves the design of software, makes software easier to understand, helps us find bugs and also helps in executing the program faster. There is an additional benefit of refactoring. It changes the way a developer thinks about the implementation when not refactoring. There are the three types of refactorings. 1) Code refactoring: It often referred to simply as refactoring. This is the refactoring of programming source code. 2) Database refactoring: It is a simple change to a database schema that improves its design while retaining both its behavioral and informational semantics. 3) User interface (UI) refactoring: It is a simple change to the UI which retains its semantics. Finally, we conclude the benefits of Refactoring are: Improves the design of software, Makes software

  9. 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.

  10. 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.

  11. 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

  12. Comfort, ease of use and practicality of the pen injector for follitropin α for assisted reproduction: an observational post-marketing study in Egypt.

    Science.gov (United States)

    Yehia, Mohamed; El-Khayat, Waleed; Kortam, Ashraf; Mowafy, Aly Hossam; Aziz Khalifa, Amr A; Awad, Azza; Khattab, Sherif

    2013-11-01

    We evaluated the ease of use of a pen injector for follitropin α (recombinant human follicle-stimulating hormone [r-hFSH]) during assisted reproduction technologies (ARTs) in Egypt. One hundred women undergoing ART completed a questionnaire in a non-interventional, observational study. The primary endpoint was patients' rating of the comfort associated with the injector. The main limitations of the study were the design and lack of knowledge regarding any impact of failure of ART on perceptions of treatment for a minority of patients. Patients rated the follitropin α pen injector as 'very comfortable' (61%), 'comfortable' (29%), or 'somewhat comfortable' (10%). Understanding instructions and using it were 'very easy' or 'easy' for 97-99%; 94% reported 'no' or 'minimal' difficulty with injections, 83% were 'very confident' about altering doses, 77% reported no interference with normal daily activities and 94% reported 'no' or 'minimal' stress using the device. Women with previous experience of ART rated the device as more practical than their previous injection system. Overall, 96% were 'very satisfied' or 'satisfied' with the device and 99% would recommend its use to others. Pregnancy rates were consistent with previous clinical experience. Injection site reactions occurred in 10% (all of mild severity except one moderate event). Positive perceptions of the follitropin α pen injector identify this device as suitable for use for Middle Eastern women undergoing ART.

  13. 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.

  14. [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.

  15. Effect of minodronate on the speed of sound of the calcaneus in postmenopausal women with an increased risk of fractures: A clinical practice-based observational study.

    Science.gov (United States)

    Iwamoto, Jun; Takada, Tetsuya

    2015-10-01

    We previously reported that alendronate and risedronate reduce the urinary levels of cross-linked N-terminal telopeptides of type I collagen (NTX) by 44.9% and 34.7%, respectively, at 3 months after the start of treatment, and increase the speed of sound (SOS) of the calcaneus by 0.6% and 0.65%, respectively, at 12 months after the start of treatment in postmenopausal women with osteoporosis. The aim of the present clinical practice-based observational study was to examine the effect of treatment with minodronate for 12 months on the SOS of the calcaneus and on bone turnover markers in postmenopausal women with an increased risk of fractures. Forty-two postmenopausal women with osteoporosis or osteopenia with a clinical risk factor for fractures who had been treated with minodronate for > 12 months were enrolled in the study. The SOS and bone turnover markers were monitored during treatment with minodronate for 12 months. Compared to their baseline values, the urinary levels of NTX at 3 months and the serum levels of alkaline phosphatase at 12 months were significantly decreased at 47.5% and 25.8%, respectively. At 12 months, the SOS increased modestly, but significantly, by 0.47%, compared to the baseline value. The present study confirmed that minodronate suppressed bone turnover and modestly increased the SOS of the calcaneus in postmenopausal women with an increased risk of fractures. Copyright © 2015. Published by Elsevier Taiwan.

  16. Global added value of flexible benefits.

    Science.gov (United States)

    Koo, Rosaline Chow

    2011-01-01

    Flexible benefits, or "flex," is a strategic human resources solution that can give companies a truly competitive edge in winning the global war for talent and containing costs. Several companies in Asia plan to implement flex in the next few years, and a number of emerging best practices in flexible benefits design are being developed. This article discusses the many advantages of flex, flex best practices emerging across Asia, and important considerations for employers when designing flexible benefits. Finally, the author shows how one global company in Singapore found flex to be an effective differentiator for attracting and retaining talent as well as helping manage employee health care costs.

  17. How important is the role of the physician in the correct use of a drug? An observational cohort study in general practice.

    Science.gov (United States)

    Bradbury, Frank

    2004-10-01

    The correct use of a drug is determined by several important factors. The most significant of these is a correct diagnosis for the choice of the appropriate therapeutic approach, followed by the physician's awareness of each drug's product characteristics--such as indications, contraindications and warnings--and by a careful evaluation of the patient in order to consider possible risk factors, concomitant pathologies and treatments. An adequate knowledge of pharmacological therapy and of the patient's history and disease states could in fact prevent most of the adverse drug reactions attributable to an inappropriate prescription. It is clear that the physician's role in the correct use of a drug is extremely important. Observational studies and surveys evaluating doctors' prescribing habits could be a very useful instrument in identifying medication prescribing errors and the consequent occurrence of adverse events. An open-label, multicentre, observational cohort study, recently performed in Ireland and involving more than 9000 patients, investigated the use of non-steroidal anti-inflammatory drugs (NSAIDs) in general practice, and in particular the use of diclofenac, nimesulide and ibuprofen. These three drugs were shown to be the NSAIDs most frequently prescribed (80% of total prescriptions) by general practitioners in Ireland. The study was designed and powered to detect differences in the general safety profile of the three NSAIDs and to test prescribing physicians' compliance with each drug's Summary of Product Characteristics (SmPC). The study was performed as closely as possible to the normal prescribing habits of the participating physicians. The three drugs were shown to be well tolerated. In the nimesulide group, the percentage of patients who experienced treatment-related adverse events was lower than that of the diclofenac group and similar to that observed with the use of ibuprofen. A more favourable gastrointestinal safety profile was evident for

  18. 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.

  19. 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.

  20. Flexible trial design in practice - stopping arms for lack-of-benefit and adding research arms mid-trial in STAMPEDE: a multi-arm multi-stage randomized controlled trial.

    Science.gov (United States)

    Sydes, Matthew R; Parmar, Mahesh K B; Mason, Malcolm D; Clarke, Noel W; Amos, Claire; Anderson, John; de Bono, Johann; Dearnaley, David P; Dwyer, John; Green, Charlene; Jovic, Gordana; Ritchie, Alastair W S; Russell, J Martin; Sanders, Karen; Thalmann, George; James, Nicholas D

    2012-09-15

    Systemic Therapy for Advanced or Metastatic Prostate cancer: Evaluation of Drug Efficacy (STAMPEDE) is a randomized controlled trial that follows a novel multi-arm, multi-stage (MAMS) design. We describe methodological and practical issues arising with (1) stopping recruitment to research arms following a pre-planned intermediate analysis and (2) adding a new research arm during the trial. STAMPEDE recruits men who have locally advanced or metastatic prostate cancer who are starting standard long-term hormone therapy. Originally there were five research and one control arms, each undergoing a pilot stage (focus: safety, feasibility), three intermediate 'activity' stages (focus: failure-free survival), and a final 'efficacy' stage (focus: overall survival). Lack-of-sufficient-activity guidelines support the pairwise interim comparisons of each research arm against the control arm; these pre-defined activity cut-off becomes increasingly stringent over the stages. Accrual of further patients continues to the control arm and to those research arms showing activity and an acceptable safety profile. The design facilitates adding new research arms should sufficiently interesting agents emerge. These new arms are compared only to contemporaneously recruited control arm patients using the same intermediate guidelines in a time-delayed manner. The addition of new research arms is subject to adequate recruitment rates to support the overall trial aims. (1) Stopping Existing Therapy: After the second intermediate activity analysis, recruitment was discontinued to two research arms for lack-of-sufficient activity. Detailed preparations meant that changes were implemented swiftly at 100 international centers and recruitment continued seamlessly into Activity Stage III with 3 remaining research arms and the control arm. Further regulatory and ethical approvals were not required because this was already included in the initial trial design.(2) Adding New Therapy: An application to

  1. 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

  2. Burden of herpes zoster and postherpetic neuralgia in Japanese adults 60 years of age or older: Results from an observational, prospective, physician practice-based cohort study.

    Science.gov (United States)

    Sato, Keiko; Adachi, Koichi; Nakamura, Hiroyuki; Asano, Kazuhiro; Watanabe, Akihiro; Adachi, Riri; Kiuchi, Mariko; Kobayashi, Keiju; Matsuki, Taizo; Kaise, Toshihiko; Gopala, Kusuma; Holl, Katsiaryna

    2017-04-01

    Approximately one in three persons will develop herpes zoster during their lifetime, and it can lead to serious complications such as postherpetic neuralgia. However, evidence on burden of herpes zoster and postherpetic neuralgia in Japan is limited. This prospective, observational, multicenter, physician practice-based cohort study was conducted in Kushiro, Hokkaido, Japan (Clinicaltrials.gov identifier NCT01873365) to assess the incidence and hospitalization rates of herpes zoster, and the proportion, clinical burden and risk factors for postherpetic neuralgia in adults aged 60 years or more. Within the study area, 800 subjects developed herpes zoster and 412 were eligible for the study. Herpes zoster incidence was 10.2/1000 person-years and higher among women and older subjects. Subjects with herpes zoster required on average 5.7 outpatient consultations. Herpes zoster-associated hospitalization rate was 3.4% (27/800). The proportion of postherpetic neuralgia and other complications was 9.2% (38/412) and 26.5% (109/412), respectively. Statistically significant association with the development of postherpetic neuralgia was male sex (odds ratio [OR], 2.51; 95% confidence interval [CI], 1.17-5.38), age of 70-74 years (OR, 3.51; 95% CI, 1.09-11.3), immunosuppressive therapy (OR, 6.44; 95% CI, 1.26-32.9), severe herpes zoster pain at first consultation (OR, 3.08; 95% CI, 1.10-8.62) and rash on upper arms (vs no rash on upper arms; OR, 3.46; 95% CI, 1.10-10.9). Considerable herpes zoster and postherpetic neuralgia burden exists among elderly in Japan, and there may be predictive factors at the first visit which could be indicative of the risk of developing postherpetic neuralgia. © 2016 The Authors. The Journal of Dermatology published by John Wiley & Sons Australia, Ltd on behalf of Japanese Dermatological Association.

  3. 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.

  4. 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.

  5. 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 a partici......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...... as the idea of the naïve observer becomes a void. Not recognizing and observing oneself as observer and co-producer of empirical data simply leaves the process of observation as the major unobserved absorber of contingency in data production based on participating observation....

  6. 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 a partici......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...... as the idea of the naïve observer becomes a void. Not recognizing and observing oneself as observer and co-producer of empirical data simply leaves the process of observation as the major unobserved absorber of contingency in data production based on participating observation....

  7. [Basal insulin glargine using a basal-bolus regimen in a common clinical practice: observational, non-interventional, multicenter, national project LINDA (Lantus in daily practice - safety and efficacy in basal bolus regimen)].

    Science.gov (United States)

    Zďarská, Denisa Janíčková; Brož, Jan; Křivská, Bohumila; Rušavý, Zdeněk; Kvapil, Milan

    2014-09-01

    To evaluate the safety and efficacy of basal insulin glargine using a basal-bolus regimen in a common clinical practice setting in the Czech Republic. The LINDA project was a non-interventional, multicenter (n = 255), national, observational project. A total of 4,998 patients with Type 1 and 2 diabetes mellitus (T1DM, T2DM) with predominantly insulin therapy (99,7 %), after switch on insulin glargine at basal-bolus regimen, were enrolled in this project. The patients were followed up for 6 months after initiation of the therapy with insulin glargine. The primary objective of the project was to investigate the incidence of severe hypoglycemic episodes during the treatment with basal insulin analogue glargine (Lantus®) in a common clinical practice setting. The se-condary endpoints were changes in glycosylated hemoglobin (HbA1c) levels, fasting plasma glucose (FPG), body weight, insulin dose, change of number of hypoglycemic episodes in comparison the previous therapy and the frequency of adverse effects. Severe hypoglycaemia were observed during treatment with insulin glargine at 0.8 % patients. When comparing the incidence of hypoglycemia with the previous therapy, we demonstrated a clinically and statistically significant reduction in their frequencies. The percentage of patients with hypoglycemic episodes (17.6 %), severe hypoglycemia (0.8 %) and severe nocturnal hypoglycemia (0.3 %) over the last month of treatment with insulin glargine using the basal-bolus regimen was consistently lower compared to the last month of treatment before initiation of this therapy (42.5 %, 17.6 %, and 13.8 % of the patients, respectively). In patients with T1DM, the incidence of hypoglycemia decreased from 37.80 ± 15.95 episodes/patient/year to 8.76 ± 4.38 epi-sodes/patient/year (p < 0.001) for all hypoglycemic episodes; from 5.64 ± 3.27 episodes/patient/year to 0.0396 ± 0.012 episodes/patient/year (p < 0.001) for severe hypoglycemia; and from 3.84 ± 2.04 episodes

  8. Individualized recombinant human follicle-stimulating hormone dosing using the CONSORT calculator in assisted reproductive technology: a large, multicenter, observational study of routine clinical practice.

    Science.gov (United States)

    Naether, Olaf Gj; Tandler-Schneider, Andreas; Bilger, Wilma

    2015-01-01

    This postmarketing surveillance survey was conducted to investigate the utility of the CONsistency in r-FSH Starting dOses for individualized tReatmenT (CONSORT) calculator for individualizing recombinant human follicle-stimulating hormone (r-hFSH) starting doses for controlled ovarian stimulation (COS) in routine clinical practice. This was a 3-year, open-label, observational study evaluating data from women undergoing COS for assisted reproductive technology at 31 German fertility centers. Physicians stated their recommended r-hFSH starting dose, then generated a CONSORT-recommended r-hFSH starting dose. Physicians could prescribe any r-hFSH starting dose. The primary objective was to compare the r-hFSH starting dose recommended by the physician with the CONSORT-calculated dose and that prescribed. Statistical analyses were conducted post hoc. Data were collected from 2,579 patients; the mean (standard deviation [SD]) age was 30.5 (2.93) years (range: 19-40 years). The mean (SD) CONSORT-calculated r-hFSH starting dose was significantly lower than the physician-recommended dose (134.5 [38.0] IU versus 164.6 [47.1] IU; PCONSORT-calculated doses were prescribed for 27.3% (number [n] =677) of patients, and non-CONSORT-calculated doses prescribed for 72.7% (n=1,800). The mean (SD) number of oocytes retrieved per patient was 10.6 (6.15) and 11.4 (6.66) in the CONSORT and non-CONSORT groups, respectively; the mean (SD) number of embryos transferred per patient was 1.98 (0.41) and 2.03 (0.45), respectively. Clinical pregnancy rates per COS cycle were 38.8% (CONSORT) and 34.8% (non-CONSORT) (P=0.142); clinical pregnancy rates per embryos transferred were 45.0% and 39.5%, respectively (P=0.049). Miscarriage occurred in 14.8% of all clinical pregnancies ( 12.5%; non- 15.3%). The rate of grade 3 ovarian hyperstimulation syndrome (OHSS) was 0.3% (n=2) in the CONSORT group and 0.6% (n=11) in the non-CONSORT group. OHSS led to hospitalization in 0.81% (n=21) of cases (CONSORT

  9. Quantifying the benefit of GOSAT total column CO2 observations for constraining the global carbon budget: An inter-comparison study with bottom-up CO2 flux estimates from MsTMIP (Invited)

    Science.gov (United States)

    Chatterjee, A.; Michalak, A. M.; O'Dell, C.; Huntzinger, D. N.; Kawa, S. R.; Oda, T.; Qiu, X.; Schwalm, C. R.; Yadav, V.

    2013-12-01

    Space-based remote sensing observations, such as those available from the Greenhouse gases Observing SATellite 'IBUKI' (GOSAT) hold great promise for improving the scientific understanding of carbon cycle processes and budgets at regional and global scales. The degree to which the GOSAT CO2 total column (XCO2) observations can constrain global fine-scale fluxes with reasonable precision and accuracy, and the degree to which the dense but lower precision GOSAT data provide additional information relative to the high precision but sparse in situ observations, remain topics of ongoing research. In this study, XCO2 observations retrieved via the GOSAT-ACOS B3.3 algorithm, the Total Column Carbon Observing Network (TCCON) XCO2 retrievals, and CO2 measurements from surface flask sites are assimilated using a geostatistical ensemble square root filter (GEnSRF) to estimate global surface fluxes at high spatial and temporal resolutions (spatial: 1° × 1.25°; temporal: daily). Fluxes are estimated over a period of four consecutive years (June 2008 - May 2012), with only the in situ and TCCON observations constraining the first year surface fluxes, while fluxes for the remaining estimation periods are constrained by all three sets of observations. The estimated fluxes are compared with a suite of bottom-up estimates based on a combination of biospheric fluxes from models participating in the Multi-scale Synthesis and Terrestrial Model Intercomparison Project (MsTMIP) plus anthropogenic flux estimates from the Open-source Data Inventory for Anthropogenic CO2 (ODIAC). Because GEnSRF has been designed to estimate fluxes independently of any a priori flux estimates from flux models and/or inventories, this data assimilation tool allows for a completely independent comparison with the bottom-up estimates. GOSAT observations are found to be particularly valuable for constraining fluxes: (a) during the summer season over the land, and (b) across all seasons over the oceans; in

  10. 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...

  11. 'Strategic approach' can reveal benefits.

    Science.gov (United States)

    Baillie, Jonathan

    2011-01-01

    Speaking at last October's Healthcare Estates 2010 conference in Manchester, Peter Haggarty, assistant director, Health Facilities Scotland, outlined some of the key steps and priorities for large healthcare providers seeking to establish and implement an effective asset management strategy, focusing particularly on work ongoing in this area in the Scottish public health service. While any radical change to a large healthcare organisation's existing asset management practices could be "challenging", both for the organisation itself, and for its staff, with "sufficient planning, persistence, and support", such changes could, he told delegates, often result in "unanticipated benefits". HEJ editor Jonathan Baillie reports.

  12. 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...

  13. 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…

  14. 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...

  15. 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.

  16. 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

  17. 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.

  18. 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...

  19. 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.

  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…

  1. 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)

  2. Electronics Environmental Benefits Calculator

    Science.gov (United States)

    The Electronics Environmental Benefits Calculator (EEBC) was developed to assist organizations in estimating the environmental benefits of greening their purchase, use and disposal of electronics.The EEBC estimates the environmental and economic benefits of: Purchasing Electronic Product Environmental Assessment Tool (EPEAT)-registered products; Enabling power management features on computers and monitors above default percentages; Extending the life of equipment beyond baseline values; Reusing computers, monitors and cell phones; and Recycling computers, monitors, cell phones and loads of mixed electronic products.The EEBC may be downloaded as a Microsoft Excel spreadsheet.See https://www.federalelectronicschallenge.net/resources/bencalc.htm for more details.

  3. A 2-Year, Phase IV, Multicentre, Observational Study of Ranibizumab 0.5 mg in Patients with Neovascular Age-Related Macular Degeneration in Routine Clinical Practice: The EPICOHORT Study

    Directory of Open Access Journals (Sweden)

    Sergio Pagliarini

    2014-01-01

    Full Text Available Purpose. To assess the safety profile of ranibizumab 0.5 mg in patients with neovascular age-related macular degeneration (nAMD in routine clinical practice. Methods. This 2-year, multicentre, observational study was conducted to capture real-world early practice and outcomes across Europe, shortly after European licensing of ranibizumab for nAMD. Being observational in nature, the study did not impose diagnostic/therapeutic interventions/visit schedule. Patients were to be treated as per the EU summary of product characteristics (SmPC in effect during the study. Key outcome measures were incidence of selected adverse events (AEs, treatment exposure, bilateral treatment, compliance to the EU SmPC, and best-corrected visual acuity (BCVA over 2 years. Results. 755 of 770 patients received treatment. Ranibizumab was generally well tolerated with low incidence of selected AEs (0%–1.9%. Patients received 6.2 (mean injections and 133 patients received bilateral treatment over 2 years. Protocol deviation to treatment compliance was reported in majority of patients. The observed decline in mean BCVA (Month 12, +1.5; Month 24, –1.3 letters may be associated with undertreatment as suggested by BCVA subgroup analysis. Conclusion. The EPICOHORT study conducted in routine clinical practice reinforces the well-established safety profile of ranibizumab in nAMD. In early European practice it appeared that the nAMD patients were undertreated.

  4. 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.

  5. 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

  6. Benefits of Java

    Science.gov (United States)

    ... health benefits as well. Drinking moderate amounts of coffee (including decaf) has been linked to lower risk of cardiovascular disease, Type 2 diabetes, Parkinson's disease and some cancers. And those antioxidants? Although ...

  7. 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.

  8. Benefits of being biased!

    Indian Academy of Sciences (India)

    Administrator

    Keywords. codon bias; alcohol dehydrogenase; Darwinian fitness; Drosophila melanogaster. RESEARCH COMMENTARY. Benefits of being biased! SUTIRTH DEY*. Evolutionary Biology Laboratory, Evolutionary & Organismal Biology Unit,. Jawaharlal Nehru Centre for Advanced Scientific Research,. Jakkur P.O. Box 6436 ...

  9. 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

  10. 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.

  11. 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.

  12. 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…

  13. 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…

  14. 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.

  15. Addressing the Don't Ask, Don't Tell Practice in Observational Studies: Using Interviews to Understand the Assignment Mechanism

    Science.gov (United States)

    Rickles, Jordan H.

    2010-01-01

    This paper illustrates how information collected through interviews can develop a richer understanding of the assignment mechanism, which can result in more plausible causal effect estimates from observational studies and provides a roadmap for sensitivity analysis. Focusing on the issue of assignment to algebra in 8th grade, the author shows how…

  16. 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

    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...

  17. 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…

  18. Admissions screening: clinical benefits.

    Science.gov (United States)

    Korvin, C C; Pearce, R H; Stanley, J

    1975-08-01

    One thousand patients admitted to a 575-bed general hospital during a 6-month period each underwent 20 chemical and hematologic tests. The potential clinical benefit was assessed. There were 2223 abnormal results found; 675 were predicted on clinical assessment, 1325 did not yield new diagnoses, and the remaining 223 led to 83 new diagnoses in 77 patients. On critical evaluation of the new diagnoses, none were unequivocally beneficial to the patient. Up to 30 patients might have benefited had these abnormal findings been followed up diligently, 39 others had findings or diagnoses of no lasting significance, and in 14 patients asymptomatic mild biochemical diabetes was discovered. Although screening may reveal many abnormal test results, the clinical benefits are not impressive.

  19. 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/

  20. Cost-Benefit Analyses of Transportation Investments

    DEFF Research Database (Denmark)

    Næss, Petter

    2006-01-01

    -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...... and needs among population groups with a low ability to pay. Instead of cost-benefit analyses, impact analyses evaluating the likely effects of project alternatives against a wide range of societal goals is recommended, with quantification and economic valorisation only for impact categories where this can......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...

  1. 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.

  2. 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...

  3. Mutual benefit societies in Colombia

    Directory of Open Access Journals (Sweden)

    Beatriz Castro C.

    2002-01-01

    Full Text Available The article describes the creation and spreading of the diverse congregations whose main purpose was to maintain solidarity among their members. Often these were called mutual benefit companies, during the middle of the XIX century and half of the XX century. These societies embraced handicrafters and small merchants who identified themselves with Christian tradition values. It is easy to observe in them the legate of the colonial confraternity, artisan associations and democratic societies which somehow were an evolution of the European spiritual confraternities of the middle ages.

  4. Patient expectations and experiences of multiple sclerosis interferon β-1a treatment: a longitudinal, observational study in routine UK clinical practice

    Science.gov (United States)

    Syed, Mehmood; Rog, David; Parkes, Laura; Shepherd, Gillian L

    2014-01-01

    Background Premature discontinuation and poor treatment adherence are problems in chronic conditions, such as multiple sclerosis in which patients must take long-term treatment in order to receive maximum benefit from their medication. The Assessing needs In Multiple Sclerosis (AIMS) study explored factors related to premature treatment discontinuation and patients’ experiences of subcutaneous (sc) interferon (IFN) β-1a treatment in the UK. Methods A questionnaire-based survey was integrated into the Bupa Home Healthcare patient-support program, which delivers sc IFN β-1a to patients in their home. Data were collected via patient questionnaires incorporated into routine clinical care and administered upon registration of a new patient by the coordinator, following initial delivery of treatment, prior to each delivery during therapy and at the end of treatment. Univariate and multivariate analyses were performed to identify factors associated with premature discontinuation. Results Data were collected from 2,390 patients (1,267 new; 1,123 existing) from 59 UK prescribing centers (November 2006–April 2011). Following the first delivery of sc IFN β-1a, 94% (1,149/1,225) of patients had received training, and 73% (818/1,120) reported that they had no concerns. In total, 24% of new patients discontinued therapy by the end of the study. In the univariate model, none of the candidate variables tested were significant predictors of treatment discontinuation. The strongest predictors of discontinuation in multivariate analyses were lack of information prior to starting treatment and patients feeling unwell on treatment and geographic region (P<0.05 for each variable). Conclusion This study suggests that patients feeling well on treatment and provision of high-quality information are the main determinants of persistence with sc IFN β-1a therapy. A package of care that targets these issues should therefore be considered when initiating sc IFN β-1a therapy. PMID

  5. 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.

  6. Using the International Classification of Functioning, Disability, and Health Model to Gain Perspective of the Benefits of Yoga in Stroke, Multiple Sclerosis, and Children to Inform Practice for Children with Cerebral Palsy: A Meta-Analysis.

    Science.gov (United States)

    Veneri, Diana; Gannotti, Mary; Bertucco, Matteo; Fournier Hillman, Sarah E

    2018-02-06

    Research pertaining to yoga and children with cerebral palsy (CP) is negligible. The primary purpose of this study was to determine the domains of the International Classification of Functioning, Disability, and Health (ICF) model and levels of evidence for yoga and adults with stroke and multiple sclerosis (MS), and children. A secondary purpose was to decide whether any inferences could be made for children with CP. This study included a meta-analysis. A systematic review was performed of yoga and said populations. Outcome measures were categorized according to the ICF model domains of body structures and function, activity, and quality of life. Effect sizes (ESs) were calculated by using Cohen's d. Since there were few commonalities among outcome measures and reporting of outcomes within and among diagnostic groups, direct comparisons of ESs were difficult. Hence, we chose to evaluate the impact of yoga as compared with the control group or other physical exercise by using a General Linear Mixed Model. There were 5 yoga studies with stroke, 15 with MS, and 12 with children. Studies with children used outcomes related to body structure and function, whereas those with stroke and MS used outcomes across all three domains of the ICF. ESs varied from negligible to medium for stroke, from negligible to large for MS and children. The findings of this meta-analysis indicate that yoga is no better or worse than other exercise modalities as a treatment intervention for adults with stroke and MS, and children. Group yoga classes are typically social environments that can contribute to increased physical progress and feelings that contribute to quality of life, which may benefit individuals with CP. More research on yoga and particularly in children and adults with CP would yield valuable information for creating effective and safe yoga programs with a rich array of benefits.

  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. 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

  9. 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

  10. 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)

  11. Benefits of Breastfeeding

    Medline Plus

    Full Text Available ... It's Only Natural has information for African-American women and their families about the health benefits of ... or duplicated without permission of the Office on Women’s Health in the U.S. Department of Health and ...

  12. Public services, personal benefits

    NARCIS (Netherlands)

    Bob Kuhry; Evert Pommer; Jedid-Jah Jonker; John Stevens

    2006-01-01

    Original title: Publieke productie & persoonlijk profijt. This report looks in detail at the costs of public services (such as care, education, public administration and safety) and the benefits that citizens derive from the government expenditure involved in delivering those services. In

  13. 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...

  14. The Benefits of Latin?

    Science.gov (United States)

    Holliday, Lisa R.

    2012-01-01

    Classicists have long claimed that the study of Latin has benefits that exceed knowledge of the language itself, and in the current economic times, these claims are made with urgency. Indeed, many contend that Latin improves English grammar and writing skills, cognitive abilities, and develops transferable skills necessary for success in the…

  15. Benefits for Gay Couples.

    Science.gov (United States)

    Collison, Michele N-K

    1993-01-01

    Increasingly, colleges are finding it hypocritical to have nondiscrimination policies protecting gay faculty and staff but deny benefits available to married employees. Institutions have adopted different criteria to determine who qualifies as a "spousal equivalent." The standards may face legal challenges from unmarried heterosexual couples. (MSE)

  16. 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 p...

  17. More than a score: a qualitative study of ancillary benefits of performance measurement.

    Science.gov (United States)

    Powell, Adam A; White, Katie M; Partin, Melissa R; Halek, Krysten; Hysong, Sylvia J; Zarling, Edwin; Kirsh, Susan R; Bloomfield, Hanna E

    2014-08-01

    Prior research has examined clinical effects of performance measurement systems. To the extent that non-clinical effects have been researched, the focus has been on negative unintended consequences. Yet, these same systems may also have ancillary benefits for patients and providers--that is, benefits that extend beyond improvements on clinical measures. The purpose of this study is to identify and describe potential ancillary benefits of performance measures as perceived by primary care staff and facility leaders in a large US healthcare system. In-person individual semistructured interviews were conducted with 59 primary care staff and facility leaders at four Veterans Health Administration facilities. Transcribed interviews were coded and organised into thematic categories. Interviewed staff observed that local performance measurement implementation practices can result in increased patient knowledge and motivation. These effects on patients can lead to improved performance scores and additional ancillary benefits. Performance measurement implementation can also directly result in ancillary benefits for the patients and providers. Patients may experience greater satisfaction with care and psychosocial benefits associated with increased provider-patient communication. Ancillary benefits of performance measurement for providers include increased pride in individual or organisational performance and greater confidence that one's practice is grounded in evidence-based medicine. A comprehensive understanding of the effects of performance measurement systems needs to incorporate ancillary benefits as well as effects on clinical performance scores and negative unintended consequences. Although clinical performance has been the focus of most evaluations of performance measurement to date, both patient care and provider satisfaction may improve more rapidly if all three categories of effects are considered when designing and evaluating performance measurement systems

  18. Talking about psychosocial problems: an observational study on changes in doctor-patient communication in general practice between 1977 and 2008.

    Science.gov (United States)

    Butalid, Ligaya; Bensing, Jozien M; Verhaak, Peter F M

    2014-03-01

    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. From a database of 5184 consultations videotaped between 1977 and 2008, 512 consultations assessed by GPs as 'completely psychosocial' were coded with RIAS (Roter Interaction Analysis System). The 121 consultations prior to and 391 consultations after implementation of guidelines were analyzed whether communication styles have changed over time. We found that GPs were more likely to consider consultations to be mainly (17%) or completely (12%) psychosocial after the implementation of guidelines. They gave more biomedical and psychosocial information and advice in the second period compared to the first period. We also found that empathy decreased over time (frequency of empathic statements by GPs changed from 2.9-3.2 to 1.4-1.6 between periods). Communication in psychosocial consultations has changed; GPs have become more focused on task-oriented communication (asking questions, giving information and advice) and less on showing empathy. GPs face the challenge of integrating an evidence-based approach of applying guidelines that promote active symptom exploration with understanding patients' personal contexts and giving room to their emotions. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  19. HIV, hepatitis B and sexual practices in the street-recruited injecting drug users of Calcutta: risk perception versus observed risks.

    Science.gov (United States)

    Panda, S; Chatterjee, A; Bhattacharjee, S; Ray, B; Saha, M K; Bhattacharya, S K

    1998-04-01

    Injecting drug users (IDUs) were recruited from the streets of Calcutta to obtain a baseline biological and behavioural data on risk practices. One-fifth of them (mostly using buprenorphine) tested positive for hepatitis B surface antigen (HBsAg); 4% were reactive to serologic test for syphilis (VDRL: Venereal Disease Research Laboratory). Condom use was insignificant while 74% reported sex with female sex workers and 15% of male IDUs also reported having sex with men. Although, sharing of injecting equipment ('works') was perceived as dangerous by the IDUs, majority of them (90/103) reportedly shared it; cleaning of works before sharing was a concern for intravenous but not for intramuscular drug injecting. Half of the IDUs reported suffering ever from abscess; a proportion (12%) of which had had superadded attack of maggots in it. They were also found to be infected with HIV (1%, 95% CI 0.028-5.97%) at a low prevalence that prompted subsequent launching of needle syringe exchange programme, establishment of cleaning norms before sharing of works, cleaning of injecting site on the body and condom promotion.

  20. 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...

  1. 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

  2. Patient expectations and experiences of multiple sclerosis interferon ß-1a treatment: a longitudinal, observational study in routine UK clinical practice

    Directory of Open Access Journals (Sweden)

    Syed M

    2014-02-01

    Full Text Available Mehmood Syed,1 David Rog,2 Laura Parkes,3 Gillian L Shepherd3 1Bupa Home Healthcare, Harlow, Essex, 2Department of Neurology, Greater Manchester Neurosciences Centre, Salford Royal NHS Foundation Trust, Salford, 3Medical Affairs, Merck Serono Ltd, Feltham, Middlesex, UK Background: Premature discontinuation and poor treatment adherence are problems in chronic conditions, such as multiple sclerosis in which patients must take long-term treatment in order to receive maximum benefit from their medication. The Assessing needs In Multiple Sclerosis (AIMS study explored factors related to premature treatment discontinuation and patients' experiences of subcutaneous (sc interferon (IFN ß-1a treatment in the UK. Methods: A questionnaire-based survey was integrated into the Bupa Home Healthcare patient-support program, which delivers sc IFN ß-1a to patients in their home. Data were collected via patient questionnaires incorporated into routine clinical care and administered upon registration of a new patient by the coordinator, following initial delivery of treatment, prior to each delivery during therapy and at the end of treatment. Univariate and multivariate analyses were performed to identify factors associated with premature discontinuation. Results: Data were collected from 2,390 patients (1,267 new; 1,123 existing from 59 UK prescribing centers (November 2006–April 2011. Following the first delivery of sc IFN ß-1a, 94% (1,149/1,225 of patients had received training, and 73% (818/1,120 reported that they had no concerns. In total, 24% of new patients discontinued therapy by the end of the study. In the univariate model, none of the candidate variables tested were significant predictors of treatment discontinuation. The strongest predictors of discontinuation in multivariate analyses were lack of information prior to starting treatment and patients feeling unwell on treatment and geographic region (P<0.05 for each variable. Conclusion: This

  3. Self-referral psychological treatment centre for young adults: a 2-year observational evaluation of routine practice before and after treatment.

    Science.gov (United States)

    Halje, Karin; Timpka, Toomas; Tylestedt, Petra; Adler, Anna-Karin; Fröberg, Lena; Schyman, Tommy; Johansson, Kristoffer; Dahl, Katarina

    2015-08-17

    To examine a self-referral psychological service provided to young adults with regard to effects on anxiety, depression and psychological distress and to explore client factors predicting non-adherence and non-response. Observational study over a 2-year period. Young Adults Centre providing psychological services by self-referral (preprimary care) to Linköping, Åtvidaberg, and Kinda municipalities (combined population 145,000) in Östergötland county, Sweden. 607 young adults (16-25 years of age); 71% females (n=429). Individually scheduled cognitive behavioural therapy delivered in up to six 45 min sessions structured according to an assessment of the client's mental health problems: anxiety, depression, anxiety and depression combined, or decreased distress without specific anxiety or depression. Pre-post intervention changes in psychological distress (General Health Questionnaire-12, GHQ-12), Hospital Anxiety and Depression Scale Anxiety/Depression (HADS-A/D). 192 clients (32.5%) discontinued the intervention on their own initiative and 39 clients (6.6%) were referred to a psychiatric clinic during the course of the intervention. Intention-to-treat analyses including all clients showed a medium treatment effect size (d=0.64) with regard to psychological distress, and small effect sizes were observed with regard to anxiety (d=0.58) and depression (d=0.57). Restricting the analyses to clients who adhered to the agreed programme, a large effect size (d=1.26) was observed with regard to psychological distress, and medium effect sizes were observed with regard to anxiety (d=1.18) and depression (d=1.19). Lower age and a high initial HADS-A score were the strongest risk factors for non-adherence, and inability to concentrate and thinking of oneself as a worthless person increased the risk for discontinuation. We conclude that provision of psychological services to young people through a self-referral centre has potential to improve long-term mental health in

  4. Distributed generation: definition, benefits and issues

    OpenAIRE

    Guido Pepermans; Johan Driesen; Dries Haeseldonckx

    2003-01-01

    This paper starts from the observation that there is a renewed interest in small-scale electricity generation. The authors start with a survey of existing small-scale generation technologies and then move on with a discussion of the major benefits and issues of small-scale electricity generation. Different technologies are evaluated in terms of their possible contribution to the listed benefits and issues. Small-scale generation is also commonly called distributed generation, embedded generat...

  5. 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.

  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)

    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

  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)

    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

  8. 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.

  9. 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...

  10. Military and Veterans' Benefits: Observations on the Transition Assistance Program

    National Research Council Canada - National Science Library

    Bascetta, Cynthia

    2002-01-01

    .... Transition assistance, including employment and job training services, was established to help such service members make suitable educational and career choices as they readjusted to civilian life...

  11. 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

  12. 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.

  13. 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.)

  14. 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

  15. A Prospective Observational Study for Assessment and Outcome Association of Circulating Endothelial Cells in Clear Cell Renal Cell Carcinoma Patients Who Show Initial Benefit from First-line Treatment. The CIRCLES (CIRCuLating Endothelial cellS) Study (SOGUG-CEC-2011-01).

    Science.gov (United States)

    García-Donas, Jesús; Leon, Luis Angel; Esteban, Emilio; Vidal-Mendez, Maria Jose; Arranz, Jose Angel; Garcia Del Muro, Xavier; Basterretxea, Laura; González Del Alba, Aranzazu; Climent, Miguel Angel; Virizuela, Juan Antonio; Álvarez, Carlos; Sepúlveda, Juan; Anido, Urbano; López, Carlos; Ortiz-Morales, Maria Jose; Pérez, Xavier; Rodriguez-Antona, Cristina; Rodriguez-Moreno, Juan Francisco; Hernando, Susana; Castellano, Daniel

    2017-10-01

    Markers able to predict the response to antiangiogenics in metastatic clear cell renal cell carcinoma (ccRCC) are not available. The development of new treatment options like immunotherapy are reaching the clinic; therefore, predictors of benefit from these different available treatments are increasingly needed. In this study, we prospectively assessed the association of circulating endothelial cells (CECs) in peripheral blood with long-term benefit from first-line treatment in ccRCC. A prospective observational study was designed involving 13 institutions of the Spanish Oncology Genitourinary Group. Adult patients diagnosed with advanced ccRCC who had achieved response or disease stabilization after 3 mo on first-line therapy were eligible. CECs were isolated from peripheral blood, captured with ferrofluids coated with monoclonal antibodies directed against the CD146 antigen, and assessed centrally with an automated standardized system. CECs were defined as 4',6-diamidino-2-phenylindole+, CD105+, and CD45-. Blood samples were systematically taken every 6 wk for 15 mo or until tumor progression, whichever occurred first. Clinical data were externally monitored at all centers. From August 9, 2011, to January 17, 2013, 75 patients were enrolled in the study. Patients with baseline CECs above the median showed a significantly longer progression-free survival than those with low CECs (22.2 mo vs 12.2 mo) with a hazard ratio of 2.5 (95% confidence interval: 1.2-5.3, p=0.016). There was no difference between CEC levels at baseline and at tumor progression (medians of 50 CECs/4ml and 52 CECs/4ml, respectively). Under antiangiogenic treatment, the detection of higher CEC levels is associated with clinical benefit in terms of progression-free survival in ccRCC. Antiangiogenics are the cornerstone of treatment in kidney cancer. Since they target endothelial rather than tumor cells, we studied the correlation between levels of circulating endothelial cells in peripheral blood

  16. 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.

  17. The impact of childhood acute rotavirus gastroenteritis on the parents' quality of life: prospective observational study in European primary care medical practices.

    Science.gov (United States)

    Diez Domingo, Javier; Patrzalek, Marian; Cantarutti, Luigi; Arnould, Benoit; Meunier, Juliette; Soriano-Gabarro, Montse; Meyer, Nadia; Pirçon, Jean-Yves; Holl, Katsiaryna

    2012-05-31

    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. 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 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. 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.

  18. 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 horses, introducing detection error and heterogeneity in a manner that could not be 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.

  19. 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

  20. 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.

    Directory of Open Access Journals (Sweden)

    Bruce C Lubow

    Full Text Available 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 <0.7 standard errors. Precision varied widely, from 6.1% CV to 25.0% CV. In contrast, the pair of surveys conducted around a known management removal produced an estimated change in population between the surveys that was significantly larger than the known reduction. Although the deviation between was only 9.1%, the precision estimate (CV = 1.6% may have been artificially low. It was apparent that use of a helicopter in those surveys perturbed the horses, introducing detection error and heterogeneity in a manner that could not be corrected by our statistical models. Our results validate the hybrid method, highlight its potentially broad applicability, identify some limitations, and provide

  1. The impact of childhood acute rotavirus gastroenteritis on the parents’ quality of life: prospective observational study in European primary care medical practices

    Science.gov (United States)

    2012-01-01

    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 <5 years presenting to a general practitioner or paediatrician for RVGE at centres in Spain, Italy or Poland. RV infection was confirmed by polymerase chain reaction (PCR) testing (n = 264). The questionnaire was validated and used to assess the emotional impact of paediatric RVGE on the parents. 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. PMID:22650611

  2. Variation of employee benefit costs by age.

    Science.gov (United States)

    Rappaport, A

    2000-01-01

    Health care, pension, and disability plans account for the bulk of employers' benefit costs, as defined in this article. Because those costs tend to rise as employees get older, the age structure of the workforce affects not only employers' costs but ultimately their competitiveness in global markets. How much costs vary depends in large part on the structure of the benefits package provided. The method a company chooses to finance benefits generally varies with its size. This article focuses primarily on the benefit practices of large, private employers. In the long run, such employers pay the costs associated with the demographics of their workers, whereas small employers can often pool costs with other companies in the community. In addition, small employers often offer fewer benefits, and the costs and financing of those benefits are subject to the insurance markets and state regulations. The discussion of benefit packages is illustrated by case studies based on benefits that are typical for three types of organizations--a large traditional company such as steel, automobile, and manufacturing; a large financial services company such as a bank or health care organization; and a medium-sized retail organization. The case studies demonstrate the extent to which the costs of typical packages vary and reveal that employers differ radically in the incentives they offer employees to retire at a specific time. An employer can shift the variation in cost by age by changing the structure of the benefit program. The major forces that drive age differences in benefit costs are the time value of money (the period of time available to earn investment income and the operation of compound interest) and rates of health care use, disability, and death. Those forces apply universally, in the United States and elsewhere, and they have not changed in recent years. However, the marketplace and the prevalence of various types of benefit programs have changed, and those changes have

  3. Video-Based Self-Observation as a Component of Developmental Teacher Evaluation

    Science.gov (United States)

    Mercado, Leonardo A.; Baecher, Laura

    2014-01-01

    In this paper, we explore the benefits to teacher evaluation when video-based self-observation is done by teachers as a vehicle for individual, reflective practice. We explore how it was applied systematically at the ICPNA bi-national center among hundreds of EFL teachers within two institution-wide initiatives that have relied on self-observation…

  4. 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.

  5. Recommendations for benefit-risk assessment methodologies and visual representations

    DEFF Research Database (Denmark)

    Hughes, Diana; Waddingham, Ed; Mt-Isa, Shahrul

    2016-01-01

    PURPOSE: The purpose of this study is to draw on the practical experience from the PROTECT BR case studies and make recommendations regarding the application of a number of methodologies and visual representations for benefit-risk assessment. METHODS: Eight case studies based on the benefit...

  6. 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)

  7. 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

  8. 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

  9. Carotid revascularization: risks and benefits

    Directory of Open Access Journals (Sweden)

    O'Brien M

    2014-07-01

    Full Text Available Marlene O'Brien, Ankur Chandra Department of Surgery, Division of Vascular Surgery, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA Abstract: Despite a decline during the recent decades in stroke-related death, the incidence of stroke has remained unchanged or slightly increased, and extracranial carotid artery stenosis is implicated in 20%–30% of all strokes. Medical therapy and risk factor modification are first-line therapies for all patients with carotid occlusive disease. Evidence for the treatment of patients with symptomatic carotid stenosis greater than 70% with either carotid artery stenting (CAS or carotid endarterectomy (CEA is compelling, and several trials have demonstrated a benefit to carotid revascularization in the symptomatic patient population. Asymptomatic carotid stenosis is more controversial, with the largest trials only demonstrating a 1% per year risk stroke reduction with CEA. Although there are sufficient data to advocate for aggressive medical therapy as the primary mode of treatment for asymptomatic carotid stenosis, there are also data to suggest that certain patient populations will benefit from a stroke risk reduction with carotid revascularization. In the United States, consensus and practice guidelines dictate that CEA is reasonable in patients with high-grade asymptomatic stenosis, a reasonable life expectancy, and perioperative risk of less than 3%. Regarding CAS versus CEA, the best-available evidence demonstrates no difference between the two procedures in early perioperative stroke, myocardial infarction, or death, and no difference in 4-year ipsilateral stroke risk. However, because of the higher perioperative risks of stroke in patients undergoing CAS, particularly in symptomatic, female, or elderly patients, it is difficult to recommend CAS over CEA except in populations with prohibitive cardiac risk, previous carotid surgery, or prior neck radiation. Current treatment

  10. 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

  11. 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.

  12. 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

  13. Observational learning by individuals with autism: a review of teaching strategies.

    Science.gov (United States)

    Plavnick, Joshua B; Hume, Kara A

    2014-05-01

    Observational learning is the process used to explain the acquisition of novel behaviors or performance of previously acquired behaviors under novel conditions after observing the behavior of another person and the consequences that follow the behavior. Many learners with autism do not attend to environmental stimuli at a level sufficient to learn a range of prosocial behaviors through observation of others. Modeling, group or dyadic instruction, and explicit observation training can improve the extent to which individuals with autism learn through observation. This article reviews previous research that involved observational learning by individuals with autism and outlines future research that could benefit instructional practices.

  14. Noninterventional studies of depot formulations of LHRH analogues for prostate cancer in routine clinical practice. The launch of an observational program to assess the use of Eligard 45 mg in Russia

    Directory of Open Access Journals (Sweden)

    V. B. Matveev

    2015-03-01

    Full Text Available Open-label observational studies can objectively assess treatment in routine clinical practice, which is important from both the scientific and pharmacoeconomical points of view. In 2013, a multicenter open-label prospective observational EQUILIBRIUM study was initiated to describe the Russian experience with Eligard 45 mg used to treat disseminated prostate cancer (PC in routine clinical practice. A total of 623 patients who had different stages of PC and had been previously treated for this condition were included in the program. The mean age of the patients was 68.9±8.55 years; their mean level of prostate-specific antigen was equal to 42.2 ng/ml and that of testosterone was 89 ng/dl. At the same time, pretreatment testosterone concentrations were measured in only one third of the patients. When included in the program, the patients had a rather high quality of life as evidenced by the EQ-5D-5L questionnaire: its mean index was 0.84±0.18 scores (complete well-being was taken as 1; the mean visual analogue scale health status scores were 75.15±16.5 mm (0, worst health; 100, best health. During the study, most patients received hormone therapy with Eligard 45 for locally advanced PC and distant metastases were detectable in only 15.89 % of the patients. 

  15. Joint audits - benefit or burden?

    DEFF Research Database (Denmark)

    Holm, Claus; Thinggaard, Frank

    In this paper we examine whether there are perceived and observed benefits or burdens from using two audit firms instead of one. In 2005 the mandatory joint audit requirement was abolished in Denmark. This provides a unique setting for studying the consequences and implications of going from...... a joint audit regime to a single auditor/voluntary joint audit regime. The dataset used in this paper has been collected for the full population of non-financial Danish companies listed on the Copenhagen Stock Exchange (CSE) in the years 2004 and 2005. We find that a majority of firms perceive joint...... audits to be a net burden. Furthermore, based on DeAngelo's (1981) initial audit pricing model and legislators' claim that joint audits are an unnecessary economic burden to the companies we predict and find discounts (of around 25%) in audit fees in companies that change to single audits. The primary...

  16. 77 FR 24667 - TANF Assistance and Electronic Benefit Transfer Transactions; Request for Public Comment

    Science.gov (United States)

    2012-04-25

    ... Electronic Benefit Transfer Transactions; Request for Public Comment AGENCY: Department of Health and Human... States have implemented policies and practices to prevent electronic benefit transfer transactions involving TANF assistance in liquor stores, casinos, gambling casinos, or other gaming establishments, and...

  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. Challenges in evaluating influenza vaccine effectiveness and the mortality benefits controversy.

    Science.gov (United States)

    Nichol, Kristin L

    2009-10-23

    Randomized, controlled trials are the gold standard study design. However, ethical constraints and practical considerations may necessitate other types of studies for evaluating influenza vaccine effectiveness in the elderly--a high priority group for annual vaccination in many countries. Observational studies therefore comprise the bulk of the vaccine effectiveness evidence in older persons, but these types of studies can be susceptible to selection bias and residual confounding. All observational studies should utilize strategies to minimize the impact of bias and confounding. Recent studies questioning the plausibility of reported mortality benefits among vaccinated elderly persons may themselves be based on assumptions that are susceptible to important limitations and multiple biases. Future studies that incorporate prospectively collected information on functional status, life expectancy, and other types of data may provide additional insights into these concerns. At present, even after taking into account the potential for residual bias and confounding, most studies confirm the benefits of vaccination among the elderly for reducing hospitalization and death.

  19. Observing Literacy Practices in Neighbor Institutions

    DEFF Research Database (Denmark)

    Reusch, Charlotte

    projects have shown, that Danish preschool teachers are very good at stimulating children’s social and emotional development, but not sufficiently capable of supporting children’s language and literacy development (Bleses et al. 2015, Markussen-Brown, 2015). Considering the importance of early efforts (The...

  20. 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…

  1. 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.

  2. 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)

  3. 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...

  4. External benefits of natural environments

    Science.gov (United States)

    Larry W. Tombaugh

    1971-01-01

    Existing methods of assessing economic benefits arising from certain physical environments left in a relatively natural condition do not include estimates of external benefits. Existence value is one such external benefit that accrues to individuals who have no intention of ever visiting the area in question. A partial measure of the existence value of National Parks...

  5. Participation beyond observation

    DEFF Research Database (Denmark)

    Chimirri, Niklas Alexander

    , however, the researchers typically uphold the notion that all they methodically engage in is participant observation. The paper argues that important aspects of children’s living and understanding may be lost when considering them mere objects of one’s visual and verbal research practices. First I delve...... on investigating children’s perspectives through participant observation, but also ontological and political ones....

  6. 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)

  7. 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)

  8. 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

  9. 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.

  10. 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.

  11. The benefits of respectful interactions: fluid alliancing and inter-occupational information sharing in primary care.

    Science.gov (United States)

    DiCicco-Bloom, Barbara; DiCicco-Bloom, Benjamin

    2016-07-01

    Though inter-occupational interactions in health care have been the focus of increasing attention, we still know little about how such interactions shape information sharing in clinical settings. This is particularly true in primary care where research on teams and collaboration has been based on individual perceptions of work (using surveys and interviews) rather than observing the interactions that directly mediate the inter-occupational flow of information. To explore how interactions shape information sharing, we conducted a secondary analysis of ethnographic data from 27 primary care practices. Ease of information sharing among nurses and doctors is linked to the degree to which practices feature respectful interactions, with practices in the sample falling into one of three categories (those with low, uneven, and high degrees of respectful interactions). Those practices with the highest degree of respectful interactions demonstrate what we describe as fluid-alliancing: flexible interactions between individuals from different occupational groups in which bidirectional information sharing occurs for the benefit of patients and the efficacy of the practice community. We conclude by arguing that this process unlocks the strengths of all practice members, and that leadership should encourage respectful interactions to augment organisational efficacy and the ability of individual practice members to provide quality patient care. © 2016 Foundation for the Sociology of Health & Illness.

  12. 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...

  13. 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.

  14. Deserving social benefits?

    DEFF Research Database (Denmark)

    Esmark, Anders; Richardt Schoop, Sarah

    2017-01-01

    in both years. However, the results also show that the media become less critical and more prone to frame recipients as undeserving along with the changes in political framing. Third, the article shows that media coverage of retrenchment reforms will be more critical under conditions of political conflict...... than in the case of political consensus. However, this result is also qualified by the observation that the media increasingly seek outside sources in order to find alternative voices under conditions approximating political consensus....

  15. 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.

  16. Young Forests and Farming Practices Can Benefit Wildlife.

    Science.gov (United States)

    Katie Greenberg; Kendrick Weeks; Gordon Warburton

    2015-01-01

    There’s a tendency to think of the hardwood forests of the South as pristine, undisturbed, and unchanging places that provide habitat for diverse animal and plant species. Indeed, having large blocks of mature forest is important for many wildlife species. The leafy tree canopy, tall trunks, hard mast, dead trees with holes, cool and shady micro-environment, and thick...

  17. Wisconsin Maternity Leave and Fringe Benefits: Policies, Practices and Problems.

    Science.gov (United States)

    Gerner, Jennifer

    The study examines the economic implications in Wisconsin of the 1972 Equal Employment Opportunity Commission guideline which requires employers to treat maternity leave as a temporary disability. First, the static cost of the maternity leave guideline to employers is estimated for the State of Wisconsin. Second, some examination of the economic…

  18. Systematic Approach to Research Training: Benefits for Counseling Practice.

    Science.gov (United States)

    Loughead, Teri A.; And Others

    1991-01-01

    Synthesizes developments concerning research training in graduate counselor education and presents a systematic approach for training master's and doctoral students in mental health counseling to assimilate, use, and perform research. Suggests diversity of research training strategies for implementation in counselor preparation programs.…

  19. Benefits of Non-Competitive Push-Hands Practice

    Directory of Open Access Journals (Sweden)

    Herman P. Kauz

    2012-07-01

    Full Text Available The 1936 “masters meeting” sponsored by the Ryukyu Newspaper Company—a gathering of karate masters, journalists, and government leaders—gives us some indication of the political realities at play in Japan in the early decades of the 20th century and how they may have affected Okinawan karate. Tradition often seems as though it is a safeguard against change. However, the reality is that a resurgence of nationalism fed an anti-Chinese bias and an effort to assimilate Okinawan culture; both affected karate. With economic hardships in Okinawa and a desire to popularize karate, traditions did change. Some teachers sought ways to preserve traditional Okinawan martial arts within this changing political landscape. But at what cost?

  20. ACOG Practice bulletin no. 133: benefits and risks of sterilization.

    Science.gov (United States)

    2013-02-01

    Female and male sterilization are both safe and effective methods of permanent contraception used by more than 220 million couples worldwide . Approximately 600,000 tubal occlusions and 200,000 vasectomies are performed in the United States annually . For women seeking permanent contraception, sterilization obviates the need for user-dependent contraception throughout their reproductive years and provides an excellent alternative for those with medical contraindications to reversible methods. The purpose of this document is to review the evidence for the safety and effectiveness of female sterilization in comparison with male sterilization and other forms of contraception.