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Sample records for clinical assessment program

  1. Psychological Assessment Training in Clinical Psychology Doctoral Programs.

    Science.gov (United States)

    Mihura, Joni L; Roy, Manali; Graceffo, Robert A

    2017-01-01

    We surveyed American Psychological Association-accredited clinical psychology doctoral programs' (n = 83) training in psychological assessment-specifically, their coverage of various assessment topics and tests in courses and practica, and whether the training was optional or required. We report results overall and separately per training model (clinical science, scientist-practitioner, and practitioner-focused). Overall, our results suggest that psychological assessment training is as active, or even more active, than in previous years. Areas of increased emphasis include clinical interviewing and psychometrics; multimethod, outcomes, health, and collaborative or therapeutic assessment; and different types of cognitive and self-report personality tests. All or almost all practice-focused programs offered training with the Thematic Apperception Test and Rorschach compared to about half of the scientist-practitioner programs and a third of the clinical science programs. Although almost all programs reported teaching multimethod assessment, what constitutes different methods of assessing psychopathology should be clarified in future studies because many programs appear to rely on one method-self-report (especially clinical science programs). Although doctoral programs covered many assessment topics and tests in didactic courses, there appears to be a shortage of program-run opportunities for students to obtain applied assessment training. Finally, we encourage doctoral programs to be familiar with (a) internships' assessment expectations and opportunities, (b) the professional guidelines for assessment training, and (c) the American Psychological Association's requirements for preinternship assessment competencies.

  2. A national clinical quality program for Veterans Affairs catheterization laboratories (from the Veterans Affairs clinical assessment, reporting, and tracking program).

    Science.gov (United States)

    Maddox, Thomas M; Plomondon, Mary E; Petrich, Megan; Tsai, Thomas T; Gethoffer, Hans; Noonan, Gregory; Gillespie, Brian; Box, Tamara; Fihn, Stephen D; Jesse, Robert L; Rumsfeld, John S

    2014-12-01

    A "learning health care system", as outlined in a recent Institute of Medicine report, harnesses real-time clinical data to continuously measure and improve clinical care. However, most current efforts to understand and improve the quality of care rely on retrospective chart abstractions complied long after the provision of clinical care. To align more closely with the goals of a learning health care system, we present the novel design and initial results of the Veterans Affairs (VA) Clinical Assessment, Reporting, and Tracking (CART) program-a national clinical quality program for VA cardiac catheterization laboratories that harnesses real-time clinical data to support clinical care and quality-monitoring efforts. Integrated within the VA electronic health record, the CART program uses a specialized software platform to collect real-time patient and procedural data for all VA patients undergoing coronary procedures in VA catheterization laboratories. The program began in 2005 and currently contains data on 434,967 catheterization laboratory procedures, including 272,097 coronary angiograms and 86,481 percutaneous coronary interventions, performed by 801 clinicians on 246,967 patients. We present the initial data from the CART program and describe 3 quality-monitoring programs that use its unique characteristics-procedural and complications feedback to individual labs, coronary device surveillance, and major adverse event peer review. The VA CART program is a novel approach to electronic health record design that supports clinical care, quality, and safety in VA catheterization laboratories. Its approach holds promise in achieving the goals of a learning health care system. Published by Elsevier Inc.

  3. Implementing an Assessment Clinic in a Residential PTSD Program

    Directory of Open Access Journals (Sweden)

    Joan McDowell

    2014-08-01

    Full Text Available Creating useful treatment plans can help improve services to consumers of mental health services. As more evidence-based practices are implemented, deciding what treatment, at what time, for whom becomes an important factor in facilitating positive outcomes. Readiness for trauma-focused treatments for Posttraumatic Stress Disorder (PTSD such as Cognitive Processing Therapy or Prolonged Exposure Therapy may influence whether an individual can successfully complete either protocol. In addition, components of adjunctive therapies such as Acceptance and Commitment Therapy or Dialectical Behavior Therapy may be useful in moving a particular patient toward readiness and successful completion of treatment. Psychological assessment adds valuable data to inform these types of treatment decisions. This paper describes the implementation of a psychological assessment clinic in a residential PTSD treatment setting. Barriers to implementation, use of the data, and Veterans’ reactions to the feedback provided to them are included.

  4. Assessing Clinical Trial-Associated Workload in Community-Based Research Programs Using the ASCO Clinical Trial Workload Assessment Tool.

    Science.gov (United States)

    Good, Marjorie J; Hurley, Patricia; Woo, Kaitlin M; Szczepanek, Connie; Stewart, Teresa; Robert, Nicholas; Lyss, Alan; Gönen, Mithat; Lilenbaum, Rogerio

    2016-05-01

    Clinical research program managers are regularly faced with the quandary of determining how much of a workload research staff members can manage while they balance clinical practice and still achieve clinical trial accrual goals, maintain data quality and protocol compliance, and stay within budget. A tool was developed to measure clinical trial-associated workload, to apply objective metrics toward documentation of work, and to provide clearer insight to better meet clinical research program challenges and aid in balancing staff workloads. A project was conducted to assess the feasibility and utility of using this tool in diverse research settings. Community-based research programs were recruited to collect and enter clinical trial-associated monthly workload data into a web-based tool for 6 consecutive months. Descriptive statistics were computed for self-reported program characteristics and workload data, including staff acuity scores and number of patient encounters. Fifty-one research programs that represented 30 states participated. Median staff acuity scores were highest for staff with patients enrolled in studies and receiving treatment, relative to staff with patients in follow-up status. Treatment trials typically resulted in higher median staff acuity, relative to cancer control, observational/registry, and prevention trials. Industry trials exhibited higher median staff acuity scores than trials sponsored by the National Institutes of Health/National Cancer Institute, academic institutions, or others. The results from this project demonstrate that trial-specific acuity measurement is a better measure of workload than simply counting the number of patients. The tool was shown to be feasible and useable in diverse community-based research settings. Copyright © 2016 by American Society of Clinical Oncology.

  5. MRI assessment program. Consensus statement on clinical efficacy of MRI

    International Nuclear Information System (INIS)

    1998-05-01

    This consensus statement is largely based on the experience gained at the MRI units at the four hospitals which have operated scanners in the MRI program. It reflects the considered opinion of the radiologists responsible for the MRI services at those hospitals. Account has also been taken of relevant overseas data. This collection of opinion relates particularly to comparison with other imaging modalities. The specific comments will require further consideration as technical developments with MRI become available, additional experience is gained with gadolinium contrast material and additional data are obtained on the influence of MRI on patient management. MRI, at present, is used either to improve diagnostic accuracy when other tests are negative or equivocal, when there is strong clinical suspicion of disease, or to improve surgical or other management planning when the diagnosis known. In some situations (eg syringomyelia, congenital spinal disease, posterior fossa/cerebello-pontine angle tumours) it may entirely replace other tests (eg myelography, air contrast, CT) which are substantially less accurate and/or more invasive. In other situations (eg hemispheric brain tumours, lumbar disc protrusions) when other tests, such as CT, can be as accurate, MRI is not usually or initially indicated because it is currently more expensive and of limited availability. However, balanced against this is the fact that it does not expose the patient to potentially harmful ionising radiation. It is also stressed that MRI images depend on complex, widely variable and, as yet, incompletely understood parameters. There is concern that this may result in false positive diagnoses, especially where MRI is used alone as a screening test, or used as the initial test. For several reasons (availability, cost, medical and diagnostic efficacy), the specific comments on indications for MRI presented are based upon the assumption that MRI is a tertiary and complementary imaging examination

  6. Clinical skills assessment of procedural and advanced communication skills: performance expectations of residency program directors

    Science.gov (United States)

    Langenau, Erik E.; Zhang, Xiuyuan; Roberts, William L.; DeChamplain, Andre F.; Boulet, John R.

    2012-01-01

    Background High stakes medical licensing programs are planning to augment and adapt current examinations to be relevant for a two-decision point model for licensure: entry into supervised practice and entry into unsupervised practice. Therefore, identifying which skills should be assessed at each decision point is critical for informing examination development, and gathering input from residency program directors is important. Methods Using data from previously developed surveys and expert panels, a web-delivered survey was distributed to 3,443 residency program directors. For each of the 28 procedural and 18 advanced communication skills, program directors were asked which clinical skills should be assessed, by whom, when, and how. Descriptive statistics were collected, and Intraclass Correlations (ICC) were conducted to determine consistency across different specialties. Results Among 347 respondents, program directors reported that all advanced communication and some procedural tasks are important to assess. The following procedures were considered ‘important’ or ‘extremely important’ to assess: sterile technique (93.8%), advanced cardiovascular life support (ACLS) (91.1%), basic life support (BLS) (90.0%), interpretation of electrocardiogram (89.4%) and blood gas (88.7%). Program directors reported that most clinical skills should be assessed at the end of the first year of residency (or later) and not before graduation from medical school. A minority were considered important to assess prior to the start of residency training: demonstration of respectfulness (64%), sterile technique (67.2%), BLS (68.9%), ACLS (65.9%) and phlebotomy (63.5%). Discussion Results from this study support that assessing procedural skills such as cardiac resuscitation, sterile technique, and phlebotomy would be amenable to assessment at the end of medical school, but most procedural and advanced communications skills would be amenable to assessment at the end of the first

  7. Anatomy and history of an external quality assessment program for interpretative comments in clinical biochemistry.

    Science.gov (United States)

    Vasikaran, Samuel D

    2015-05-01

    The provision of clinical interpretation of results, either verbally or in the printed report, may be considered an integral part of clinical biochemistry diagnostic service. Proficiency testing or external quality assessment (EQA) of such activity may be useful in education, training, continuing professional development and ensuring the quality of such service. Details of the Patient Report Comments Program (RPCProgram) developed by the Royal College of Pathologists of Australasia (RCPA) Chemical Pathology Quality Assurance Programs Pty Ltd (QAP) is described in this review. The program is aimed at pathologists, clinical scientists and trainees. Registered participants are provided a report with case details and a set of clinical biochemistry results at monthly intervals and submit an interpretative comment for the report. Comments received are broken up into components that are translated into common key phrases. An expert panel evaluates the key phrases, classifies them according to appropriateness and drafts a suggested comment, a case summary and a rationale, which are included in a summary report returned to participants. There is considerable diversity in the quality of interpretative comments received from participants of the PRCProgram. The primary purpose of EQA of interpretative commenting is educational self-assessment, and they are recognized as a continuing professional development activity. Whilst there is some evidence for the utility of interpretative comments in improving patient outcomes, evidence for the utility of EQA in improving quality of comments is awaited. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  8. Using electronic clinical practice audits as needs assessment to produce effective continuing medical education programming.

    Science.gov (United States)

    Klein, Doug; Staples, John; Pittman, Carmen; Stepanko, Cheryl

    2012-01-01

    The traditional needs assessment used in developing continuing medical education programs typically relies on surveying physicians and tends to only capture perceived learning needs. Instead, using tools available in electronic medical record systems to perform a clinical audit on a physician's practice highlights physician-specific practice patterns. The purpose of this study was to test the feasibility of implementing an electronic clinical audit needs assessment process for family physicians in Canada. A clinical audit of 10 preventative care interventions and 10 chronic disease interventions was performed on family physician practices in Alberta, Canada. The physicians used the results from the audit to produce personalized learning needs, which were then translated into educational programming. A total of 26 family practices and 4489 patient records were audited. Documented completion rates for interventions ranged from 13% for ensuring a patient's tetanus vaccine is current to 97% of pregnant patients receiving the recommended prenatal vitamins. Electronic medical record-based needs assessments may provide a better basis for developing continuing medical education than a more traditional survey-based needs assessment. This electronic needs assessment uses the physician's own patient outcome information to assist in determining learning objectives that reflect both perceived and unperceived needs.

  9. Meeting the challenge of assessing clinical competence of occupational therapists within a program management environment.

    Science.gov (United States)

    Salvatori, Penny; Simonavicius, Nijole; Moore, Joan; Rimmer, Georgina; Patterson, Michele

    2008-02-01

    Program management models have raised concerns among occupational therapists about professional standards related to clinical competence, performance review procedures, and quality improvement initiatives. This paper describes how a chart-stimulated recall (CSR) peer-review process and interview tool was revised, implemented, and evaluated as a pilot project to assess the clinical competence of occupational therapy staff at a large urban health centre in southern Ontario. Fourteen pairs (n=28) of occupational therapists representing various practice areas participated in this project. Half served as peer assessors and half as interviewees. Peer assessors conducted an independent chart review followed by a one-hour personal interview with a peer partner to discuss clinical management issues related to the client cases. Each interviewer rated his or her partner's clinical competence in eight areas of performance using a 7-point Likert scale. Results indicated that the CSR tool could discriminate among occupational therapists in terms of overall levels of clinical competence and also identify specific areas of concern that could be targeted for professional development. Feedback from participants was positive. The CSR tool was found to be useful for assessing clinical competence of occupational therapists in this large health centre as a quality improvement initiative within that discipline group. Further research is needed to establish the reliability and validity of the CSR tool.

  10. Does clinical exposure matter? Pilot assessment of patient visits in an urban family medicine residency program.

    Science.gov (United States)

    Iglar, Karl; Murdoch, Stuart; Meaney, Christopher; Krueger, Paul

    2018-01-01

    To determine the number of patient visits, patient demographic information, and diagnoses in an urban ambulatory care setting in a family medicine residency program, and assess the correlation between the number of patient visits and residents' in-training examination (ITE) scores. Retrospective analysis of data from resident practice profiles, electronic medical records, and residents' final ITE scores. Family medicine teaching unit in a community hospital in Barrie, Ont. Practice profile data were from family medicine residents enrolled in the program from July 1, 2013, to June 30, 2014, and electronic medical record and ITE data were from those enrolled in the program from July 1, 2010, to June 30, 2015. Number of patient visits, patient characteristics (eg, sex, age), priority topics addressed in clinic, resident characteristics (eg, age, sex, level of residency), and residents' final ITE scores. Between July 1, 2013, and June 30, 2014, there were 11 115 patient visits. First-year residents had a mean of 5.48 patient visits per clinic, and second-year residents had a mean of 5.98 patient visits per clinic. A Pearson correlation coefficient of 0.68 was found to exist between the number of patients seen and the final ITE scores, with a 10.5% difference in mean score between residents who had 1251 or more visits and those who had 1150 or fewer visits. Three diagnoses (ie, epistaxis, meningitis, and neck pain) deemed important for Certification by the College of Family Physicians of Canada were not seen by any of the residents in clinic. There is a moderate correlation between the number of patients seen by residents in ambulatory care and ITE scores in family medicine. It is important to assess patients' demographic information and diagnoses made in resident practices to ensure an adequate clinical experience. Copyright© the College of Family Physicians of Canada.

  11. Competency-Based Assessment for Clinical Supervisors: Design-Based Research on a Web-Delivered Program

    Science.gov (United States)

    Williams, Lauren Therese; Grealish, Laurie; Jamieson, Maggie

    2015-01-01

    Background Clinicians need to be supported by universities to use credible and defensible assessment practices during student placements. Web-based delivery of clinical education in student assessment offers professional development regardless of the geographical location of placement sites. Objective This paper explores the potential for a video-based constructivist Web-based program to support site supervisors in their assessments of student dietitians during clinical placements. Methods This project was undertaken as design-based research in two stages. Stage 1 describes the research consultation, development of the prototype, and formative feedback. In Stage 2, the program was pilot-tested and evaluated by a purposeful sample of nine clinical supervisors. Data generated as a result of user participation during the pilot test is reported. Users’ experiences with the program were also explored via interviews (six in a focus group and three individually). The interviews were transcribed verbatim and thematic analysis conducted from a pedagogical perspective using van Manen’s highlighting approach. Results This research succeeded in developing a Web-based program, “Feed our Future”, that increased supervisors’ confidence with their competency-based assessments of students on clinical placements. Three pedagogical themes emerged: constructivist design supports transformative Web-based learning; videos make abstract concepts tangible; and accessibility, usability, and pedagogy are interdependent. Conclusions Web-based programs, such as Feed our Future, offer a viable means for universities to support clinical supervisors in their assessment practices during clinical placements. A design-based research approach offers a practical process for such Web-based tool development, highlighting pedagogical barriers for planning purposes. PMID:25803172

  12. [Quality assessment program of the Spanish Society of Infectious Diseases and Clinical Microbiology. Analysis of results. 2005].

    Science.gov (United States)

    Orta Mira, Nieves; Guna Serrano, M del Remedio; Pérez, José L; Gimeno Cardona, Concepción

    2006-10-01

    Quality assurance of the analytical processes performed at the clinical microbiology laboratory is mandatory and should be carried out by using external and internal quality control activities. External quality assessment programs allow intercomparison within laboratories, detection of errors, and evaluation of the suitability of some reagents or diagnostic kits for the purpose for which they were designed; these activities are also useful for continuous education. The program launched 15 years ago by the Spanish Society of Infectious Diseases and Clinical Microbiology is based on sending typified materials along with a clinical and microbiological case related to these control materials. The spectrum of the samples is broad, including bacteriology (monthly and three-monthly), serology, mycology, parasitology, mycobacteria, virology, and molecular microbiology. After receiving the results from the participants, the program organization delivers an individual certificate comparing the results with those of a reference laboratory. Additionally, a report is generated by analyzing all the results sent by the participants; laboratories are also sent review articles on the subject of each assessment as a tool for continuous education in clinical microbiology. In this article, the most relevant conclusions and lessons from the 2005 assessments are presented.

  13. A Clinical Assessment Program to Evaluate the Safety of Patient Care

    National Research Council Canada - National Science Library

    Snow, Richard J; Levine, Martin S; Harper, Dwain L; McGill, Sharon L; Thomas, George; McNerney, Joseph P

    2005-01-01

    .... In this program, data abstracted directly from patients' medical records are analyzed to determine the residents' performance as well as the impact and effectiveness of residency program treatment...

  14. Web-Based Learning System for Developing and Assessing Clinical Diagnostic Skills for Dermatology Residency Program

    Science.gov (United States)

    Kuo, Fan-Ray; Chin, Yi-Ying; Lee, Chao-Hsien; Chiu, Yu-Hsien; Hong, Chien-Hu; Lee, Kuang-Lieh; Ho, Wen-Hsien; Lee, Chih-Hung

    2016-01-01

    Few studies have explored the learning difficulties and misconceptions that students encounter when using information and communication technology for e-learning. To address this issue, this research developed a system for evaluating the learning efficiency of medical students by applying two-tier diagnosis assessment. The effectiveness of the…

  15. European specialist porphyria laboratories: diagnostic strategies, analytical quality, clinical interpretation, and reporting as assessed by an external quality assurance program.

    Science.gov (United States)

    Aarsand, Aasne K; Villanger, Jørild H; Støle, Egil; Deybach, Jean-Charles; Marsden, Joanne; To-Figueras, Jordi; Badminton, Mike; Elder, George H; Sandberg, Sverre

    2011-11-01

    The porphyrias are a group of rare metabolic disorders whose diagnosis depends on identification of specific patterns of porphyrin precursor and porphyrin accumulation in urine, blood, and feces. Diagnostic tests for porphyria are performed by specialized laboratories in many countries. Data regarding the analytical and diagnostic performance of these laboratories are scarce. We distributed 5 sets of multispecimen samples from different porphyria patients accompanied by clinical case histories to 18-21 European specialist porphyria laboratories/centers as part of a European Porphyria Network organized external analytical and postanalytical quality assessment (EQA) program. The laboratories stated which analyses they would normally have performed given the case histories and reported results of all porphyria-related analyses available, interpretative comments, and diagnoses. Reported diagnostic strategies initially showed considerable diversity, but the number of laboratories applying adequate diagnostic strategies increased during the study period. We found an average interlaboratory CV of 50% (range 12%-152%) for analytes in absolute concentrations. Result normalization by forming ratios to the upper reference limits did not reduce this variation. Sixty-five percent of reported results were within biological variation-based analytical quality specifications. Clinical interpretation of the obtained analytical results was accurate, and most laboratories established the correct diagnosis in all distributions. Based on a case-based EQA scheme, variations were apparent in analytical and diagnostic performance between European specialist porphyria laboratories. Our findings reinforce the use of EQA schemes as an essential tool to assess both analytical and diagnostic processes and thereby to improve patient care in rare diseases.

  16. Clinic Health Awareness Program Subsystem -

    Data.gov (United States)

    Department of Transportation — Clinic Health Awareness Program Subystem (CHAPS) is a comprehensive system for recording, reporting, and analyzing a patient’s medical information and managing an...

  17. Classification and clinical assessment

    Directory of Open Access Journals (Sweden)

    F. Cantini

    2012-06-01

    Full Text Available There are at least nine classification criteria for psoriatic arthritis (PsA that have been proposed and used in clinical studies. With the exception of the ESSG and Bennett rules, all of the other criteria sets have a good performance in identifying PsA patients. As the CASPAR criteria are based on a robust study methodology, they are considered the current reference standard. However, if there seems to be no doubt that they are very good to classify PsA patients (very high specificity, they might be not sensitive enough to diagnose patients with unknown early PsA. The vast clinical heterogeneity of PsA makes its assessment very challenging. Peripheral joint involvement is measured by 78/76 joint counts, spine involvement by the instruments used for ankylosing spondylitis (AS, dactylitis by involved digit count or by the Leeds dactylitis index, enthesitis by the number of affected entheses (several indices available and psoriasis by the Psoriasis Area and Severity Index (PASI. Peripheral joint damage can be assessed by a modified van der Heijde-Sharp scoring system and axial damage by the methods used for AS or by the Psoriatic Arthritis Spondylitis Radiology Index (PASRI. As in other arthritides, global evaluation of disease activity and severity by patient and physician and assessment of disability and quality of life are widely used. Finally, composite indices that capture several clinical manifestations of PsA have been proposed and a new instrument, the Psoriatic ARthritis Disease Activity Score (PASDAS, is currently being developed.

  18. NRC performance assessment program

    International Nuclear Information System (INIS)

    Coplan, S.M.

    1986-01-01

    The U.S. Nuclear Regulatory Commission's (NRC) performance assessment program includes the development of guidance to the U.S. Department of Energy (DOE) on preparation of a license application and on conducting the studies to support a license application. The nature of the licensing requirements of 10 CFR Part 60 create a need for performance assessments by the DOE. The NRC and DOE staffs each have specific roles in assuring the adequacy of those assessments. Performance allocation is an approach for determining what testing and analysis will be needed during site characterization to assure that an adequate data base is available to support the necessary performance assessments. From the standpoint of establishing is implementable methodology, the most challenging performance assessment needed for licensing is the one that will be used to determine compliance with the U.S. Environmental Protection Agency's (EPA) containment requirement

  19. MRI assessment program

    International Nuclear Information System (INIS)

    1987-09-01

    The MRI Assessment Program involves installation and operation of five MRI units in Australian public hospitals and the evaluation at each unit of the cost and efficacy of the technology over a period of two years. This first report in a series presents preliminary usage and cost data for the year to 30 June 1987 as well as describing the background and the data set. 6 figs., tabs

  20. MRI assessment program

    International Nuclear Information System (INIS)

    1988-05-01

    Usage, cost and efficacy data from the MRI Assessment Program to 30 March 1988 is presented, as a continuation of an earlier analysis. Analysis has been performed on data from 8565 examinations relating to 7997 patients at 4 hospitals. MRI was used mainly for examination of the head and spine. Some details of the follow up studies being conducted on selected patients and disease categories are given. A consensus statement is included which summaries the view of the Technical Committee on the potential applications of MRI in Australia. The MRI unit quench incident at Royal Adelaide Hospital is described. Refs., 10 figs., tabs

  1. A marketing clinical doctorate programs.

    Science.gov (United States)

    Montoya, Isaac D; Kimball, Olive M

    2007-01-01

    Over the past decade, clinical doctorate programs in health disciplines have proliferated amid both support and controversy among educators, professional organizations, practitioners, administrators, and third-party payers. Supporters argue that the explosion of new knowledge and increasing sophistication of technology have created a need for advanced practice models to enhance patient care and safety and to reduce costs. Critics argue that necessary technological advances can be incorporated into existing programs and believe that clinical doctorates will increase health care costs, not reduce them. Despite the controversy, many health disciplines have advanced the clinical doctorate (the most recent is the doctor of nursing practice in 2004), with some professions mandating the doctorate as the entry-level degree (i.e., psychology, pharmacy, audiology, and so on). One aspect of the introduction of clinical doctoral degrees has been largely overlooked, and that is the marketing aspect. Because of marketing considerations, some clinical doctorates have been more successfully implemented and accepted than others. Marketing is composed of variables commonly known as "the four P's of marketing": product, price, promotion, and place. This report explores these four P's within the context of clinical doctorates in the health disciplines.

  2. Redesigning a clinical mentoring program for improved outcomes in the clinical training of clerks

    OpenAIRE

    Lin, Chia-Der; Lin, Blossom Yen-Ju; Lin, Cheng-Chieh; Lee, Cheng-Chun

    2015-01-01

    Introduction: Mentorship has been noted as critical to medical students adapting to clinical training in the medical workplace. A lack of infrastructure in a mentoring program might deter relationship building between mentors and mentees. This study assessed the effect of a redesigned clinical mentoring program from the perspective of clerks. The objective was to assess the benefits of the redesigned program and identify potential improvements.Methods: A redesigned clinical mentoring program ...

  3. From reactive to proactive: developing a valid clinical ethics needs assessment survey to support ethics program strategic planning (part 1 of 2).

    Science.gov (United States)

    Frolic, Andrea; Jennings, Barb; Seidlitz, Wendy; Andreychuk, Sandy; Djuric-Paulin, Angela; Flaherty, Barb; Peace, Donna

    2013-03-01

    As ethics committees and programs become integrated into the "usual business" of healthcare organizations, they are likely to face the predicament of responding to greater demands for service and higher expectations, without an influx of additional resources. This situation demands that ethics committees and programs allocate their scarce resources (including their time, skills and funds) strategically, rather than lurching from one ad hoc request to another; finding ways to maximize the effectiveness, efficiency, impact and quality of ethics services is essential in today's competitive environment. How can Hospital Ethics Committees (HECs) begin the process of strategic priority-setting to ensure they are delivering services where and how they are most needed? This paper describes the creation of the Clinical Ethics Needs Assessment Survey (CENAS) as a tool to understand interprofessional staff perceptions of the organization's ethical climate, challenging ethical issues and educational priorities. The CENAS was designed to support informed resource allocation and advocacy by HECs. By sharing our process of developing and validating this ethics needs assessment survey we hope to enable strategic priority-setting in other resource-strapped ethics programs, and to empower HECs to shift their focus to more proactive, quality-focused initiatives.

  4. Assessment of the cost-effectiveness and clinical outcomes of a fourth-generation synchronous telehealth program for the management of chronic cardiovascular disease.

    Science.gov (United States)

    Ho, Yi-Lwun; Yu, Jiun-Yu; Lin, Yen-Hung; Chen, Ying-Hsien; Huang, Ching-Chang; Hsu, Tse-Pin; Chuang, Pao-Yu; Hung, Chi-Sheng; Chen, Ming-Fong

    2014-06-10

    Telehealth programs are a growing field in the care of patients. The evolution of information technology has resulted in telehealth becoming a fourth-generation synchronous program. However, long-term outcomes and cost-effectiveness analysis of fourth-generation telehealth programs have not been reported in patients with chronic cardiovascular diseases. We conducted this study to assess the clinical outcomes and cost-effectiveness of a fourth-generation synchronous telehealth program for patients with chronic cardiovascular diseases. We retrospectively analyzed 575 patients who had joined a telehealth program and compared them with 1178 patients matched for sex, age, and Charlson comorbidity index. The program included: (1) instant transmission of biometric data, (2) daily telephone interview, and (3) continuous decision-making support. Data on hospitalization, emergency department (ED) visits, and medical costs were collected from the hospital's database and were adjusted to the follow-up months. The mean age was 64.5 years (SD 16.0). The mean number of monthly ED visits (mean 0.06 SD 0.13 vs mean 0.09 SD 0.23, P<.001), hospitalizations (mean 0.05 SD 0.12 vs mean 0.11 SD 0.21, P<.001), length of hospitalization (mean 0.77 days SD 2.78 vs mean 1.4 SD 3.6, P<.001), and intensive care unit admissions (mean 0.01 SD 0.07 vs mean 0.036 SD 0.14, P<.001) were lower in the telehealth group. The monthly mean costs of ED visits (mean US$20.90 SD 66.60 vs mean US$37.30 SD 126.20, P<.001), hospitalizations (mean US$386.30 SD 1424.30 vs mean US$878.20 SD 2697.20, P<.001), and all medical costs (mean US$587.60 SD 1497.80 vs mean US$1163.60 SD 3036.60, P<.001) were lower in the telehealth group. The intervention costs per patient were US$224.80 per month. Multivariate analyses revealed that age, telehealth care, and Charlson index were the independent factors for ED visits, hospitalizations, and length of hospitalization. A bootstrap method revealed the dominant cost

  5. Implementation of an Electronic Objective Structured Clinical Exam for Assessing Practical Skills in Pre-Professional Physiotherapy and Occupational Therapy Programs: Examiner and Course Coordinator Perspectives

    Science.gov (United States)

    Snodgrass, Suzanne J.; Ashby, Samantha E.; Rivett, Darren A.; Russell, Trevor

    2014-01-01

    Assessment of practical clinical skills is essential in the health fields. Objective Structured Clinical Exams (OSCEs), where examiners assess students performing clinical procedures on simulated patients (actors), are central to the evaluation of practical skills. However, traditional OSCEs require considerable time-investment to administer, and…

  6. State Program Integrity Assessment (SPIA)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The State Program Integrity Assessment (SPIA) is the Centers for Medicare and Medicaid Services (CMS) first national data collection on state Medicaid program...

  7. Clinical training: a simulation program for phlebotomy

    Directory of Open Access Journals (Sweden)

    Araki Toshitaka

    2008-01-01

    Full Text Available Abstract Background Basic clinical skills training in the Japanese medical education system has traditionally incorporated on-the-job training with patients. Recently, the complementary use of simulation techniques as part of this training has gained popularity. It is not known, however, whether the participants view this new type of education program favorably; nor is the impact of this program known. In this study we developed a new simulation-based training program in phlebotomy for new medical residents and assessed their satisfaction with the program Methods The education program comprised two main components: simulator exercise sessions and the actual drawing of blood from other trainees. At the end of the session, we surveyed participant sentiment regarding the program. Results There were 43 participants in total. In general, they were highly satisfied with the education program, with all survey questions receiving scores of 3 or more on a scale of 1–5 (mean range: 4.3 – 4.8, with 5 indicating the highest level of satisfaction. Additionally, their participation as a 'patient' for their co-trainees was undertaken willingly and was deemed to be a valuable experience. Conclusion We developed and tested an education program using a simulator for blood collection. We demonstrated a high satisfaction level among the participants for this unique educational program and expect that it will improve medical training, patient safety, and quality of care. The development and dissemination of similar educational programs involving simulation for other basic clinical skills will be undertaken in the future.

  8. TH-C-18A-06: Combined CT Image Quality and Radiation Dose Monitoring Program Based On Patient Data to Assess Consistency of Clinical Imaging Across Scanner Models

    Energy Technology Data Exchange (ETDEWEB)

    Christianson, O; Winslow, J; Samei, E [Duke University Medical Center, Durham, NC (United States)

    2014-06-15

    Purpose: One of the principal challenges of clinical imaging is to achieve an ideal balance between image quality and radiation dose across multiple CT models. The number of scanners and protocols at large medical centers necessitates an automated quality assurance program to facilitate this objective. Therefore, the goal of this work was to implement an automated CT image quality and radiation dose monitoring program based on actual patient data and to use this program to assess consistency of protocols across CT scanner models. Methods: Patient CT scans are routed to a HIPPA compliant quality assurance server. CTDI, extracted using optical character recognition, and patient size, measured from the localizers, are used to calculate SSDE. A previously validated noise measurement algorithm determines the noise in uniform areas of the image across the scanned anatomy to generate a global noise level (GNL). Using this program, 2358 abdominopelvic scans acquired on three commercial CT scanners were analyzed. Median SSDE and GNL were compared across scanner models and trends in SSDE and GNL with patient size were used to determine the impact of differing automatic exposure control (AEC) algorithms. Results: There was a significant difference in both SSDE and GNL across scanner models (9–33% and 15–35% for SSDE and GNL, respectively). Adjusting all protocols to achieve the same image noise would reduce patient dose by 27–45% depending on scanner model. Additionally, differences in AEC methodologies across vendors resulted in disparate relationships of SSDE and GNL with patient size. Conclusion: The difference in noise across scanner models indicates that protocols are not optimally matched to achieve consistent image quality. Our results indicated substantial possibility for dose reduction while achieving more consistent image appearance. Finally, the difference in AEC methodologies suggests the need for size-specific CT protocols to minimize variability in image

  9. TH-C-18A-06: Combined CT Image Quality and Radiation Dose Monitoring Program Based On Patient Data to Assess Consistency of Clinical Imaging Across Scanner Models

    International Nuclear Information System (INIS)

    Christianson, O; Winslow, J; Samei, E

    2014-01-01

    Purpose: One of the principal challenges of clinical imaging is to achieve an ideal balance between image quality and radiation dose across multiple CT models. The number of scanners and protocols at large medical centers necessitates an automated quality assurance program to facilitate this objective. Therefore, the goal of this work was to implement an automated CT image quality and radiation dose monitoring program based on actual patient data and to use this program to assess consistency of protocols across CT scanner models. Methods: Patient CT scans are routed to a HIPPA compliant quality assurance server. CTDI, extracted using optical character recognition, and patient size, measured from the localizers, are used to calculate SSDE. A previously validated noise measurement algorithm determines the noise in uniform areas of the image across the scanned anatomy to generate a global noise level (GNL). Using this program, 2358 abdominopelvic scans acquired on three commercial CT scanners were analyzed. Median SSDE and GNL were compared across scanner models and trends in SSDE and GNL with patient size were used to determine the impact of differing automatic exposure control (AEC) algorithms. Results: There was a significant difference in both SSDE and GNL across scanner models (9–33% and 15–35% for SSDE and GNL, respectively). Adjusting all protocols to achieve the same image noise would reduce patient dose by 27–45% depending on scanner model. Additionally, differences in AEC methodologies across vendors resulted in disparate relationships of SSDE and GNL with patient size. Conclusion: The difference in noise across scanner models indicates that protocols are not optimally matched to achieve consistent image quality. Our results indicated substantial possibility for dose reduction while achieving more consistent image appearance. Finally, the difference in AEC methodologies suggests the need for size-specific CT protocols to minimize variability in image

  10. The clinical assessment of impulsivity

    Directory of Open Access Journals (Sweden)

    Nagesh Brahmavar Pai

    2018-01-01

    Full Text Available The term impulsivity is often used to describe behavior that is both spontaneous and detrimental. Impulsivity is multidimensional and derives from personality, general psychopathology as well as specific mental disorders. Thus, the construct of impulsivity is important as it is associated with numerous mental disorders as well as socially deviant behaviors ranging from behaviors targeted towards others such as aggression, to behaviors targeted toward oneself, for example, self-harm and suicide. As a clinical construct impulsivity is highly predictive of poor prognosis thus further emphasizing its clinical relevance. Therefore, the need exists for impulsivity to be clinically assessed and this assessment should take place at the same time as the assessment of risk. As risk and impulsivity are interrelated and interact. Although there are existing self-report rating scales for trait-based impulsivity, a dearth exists in regards to assessment of impulsivity in clinical practice that is focused and pragmatic. Thus, a pragmatic rubric to guide the individualized assessment of impulsivity in a clinical population is proposed. The quadrants espoused will assist both with the formulation of questions and categorization of responses to determine the most appropriate interventions for the client.

  11. Defense Programs Transportation Risk Assessment

    International Nuclear Information System (INIS)

    Clauss, D.B.

    1994-01-01

    This paper provides an overview of the methodology used in a probabilistic transportation risk assessment conducted to assess the probabilities and consequences of inadvertent dispersal of radioactive materials arising from severe transportation accidents. The model was developed for the Defense Program Transportation Risk Assessment (DPTRA) study. The analysis incorporates several enhancements relative to previous risk assessments of hazardous materials transportation including newly-developed statistics on the frequencies and severities of tractor semitrailer accidents and detailed route characterization using the 1990 Census data

  12. Marketing Prior Learning Assessment Programs.

    Science.gov (United States)

    Heeger, Gerald A.

    1983-01-01

    Experiential learning programs must be marketed effectively if they are to succeed. The formulation of market strategy is discussed including: strategic planning; identification of a market target; and development of a market mix. A commitment to marketing academic programs is seen as a commitment to self-assessment. (MW)

  13. Referral to Cardiac Rehabilitation After Percutaneous Coronary Intervention, Coronary Artery Bypass Surgery, and Valve Surgery: Data From the Clinical Outcomes Assessment Program.

    Science.gov (United States)

    Beatty, Alexis L; Bradley, Steven M; Maynard, Charles; McCabe, James M

    2017-06-01

    Despite guideline recommendations that patients undergoing percutaneous coronary intervention (PCI), coronary artery bypass surgery, or valve surgery be referred to cardiac rehabilitation, cardiac rehabilitation is underused. The objective of this study was to examine hospital-level variation in cardiac rehabilitation referral after PCI, coronary artery bypass surgery, and valve surgery. We analyzed data from the Clinical Outcomes Assessment Program, a registry of all nonfederal hospitals performing PCI and cardiac surgery in Washington State. We included eligible PCI, coronary artery bypass surgery, and valve surgery patients from 2010 to 2015. We analyzed PCI and cardiac surgery separately by performing multivariable hierarchical logistic regression for the outcome of cardiac rehabilitation referral at discharge, clustered by hospital. Patient-level covariates included age, sex, race/ethnicity, comorbidities, and procedure indication/status. Cardiac rehabilitation referral was reported in 48% (34 047/71 556) of PCI patients and 91% (21 831/23 972) of cardiac surgery patients. The hospital performing the procedure was a stronger predictor of referral than any individual patient characteristic for PCI (hospital referral range 3%-97%; median odds ratio, 5.94; 95% confidence interval, 4.10-9.49) and cardiac surgery (range 54%-100%; median odds ratio, 7.09; 95% confidence interval, 3.79-17.80). Hospitals having an outpatient cardiac rehabilitation program explained only 10% of PCI variation and 0% of cardiac surgery variation. Cardiac rehabilitation referral at discharge was less prevalent after PCI than cardiac surgery. The strongest predictor of cardiac rehabilitation referral was the hospital performing the procedure. Efforts to improve cardiac rehabilitation referral should focus on increasing referral after PCI, especially in low referral hospitals. © 2017 American Heart Association, Inc.

  14. Application of Sigma Metrics Analysis for the Assessment and Modification of Quality Control Program in the Clinical Chemistry Laboratory of a Tertiary Care Hospital.

    Science.gov (United States)

    Iqbal, Sahar; Mustansar, Tazeen

    2017-03-01

    Sigma is a metric that quantifies the performance of a process as a rate of Defects-Per-Million opportunities. In clinical laboratories, sigma metric analysis is used to assess the performance of laboratory process system. Sigma metric is also used as a quality management strategy for a laboratory process to improve the quality by addressing the errors after identification. The aim of this study is to evaluate the errors in quality control of analytical phase of laboratory system by sigma metric. For this purpose sigma metric analysis was done for analytes using the internal and external quality control as quality indicators. Results of sigma metric analysis were used to identify the gaps and need for modification in the strategy of laboratory quality control procedure. Sigma metric was calculated for quality control program of ten clinical chemistry analytes including glucose, chloride, cholesterol, triglyceride, HDL, albumin, direct bilirubin, total bilirubin, protein and creatinine, at two control levels. To calculate the sigma metric imprecision and bias was calculated with internal and external quality control data, respectively. The minimum acceptable performance was considered as 3 sigma. Westgard sigma rules were applied to customize the quality control procedure. Sigma level was found acceptable (≥3) for glucose (L2), cholesterol, triglyceride, HDL, direct bilirubin and creatinine at both levels of control. For rest of the analytes sigma metric was found control levels (8.8 and 8.0 at L2 and L3, respectively). We conclude that analytes with the sigma value quality control procedure. In this study application of sigma rules provided us the practical solution for improved and focused design of QC procedure.

  15. Laboratory Cooperative Program: an assessment

    International Nuclear Information System (INIS)

    1979-11-01

    The Laboratory Cooperative Program (Lab Coop Program) was initiated by the US AEC over 20 years ago to promote the transfer of technical information from the national laboratories to the academic community utilizing the facilities and staff capabilities of the labs. Under the AEC, ERDA and DOE, the goals of the program have broadened gradually. Therefore, the program was examined to determine the extent to which it contributes to the current objectives of the DOE and to develop recommendations for any program changes. The assessment of the Lab Coop Program was based on a combination of review of program activity data and publications, review of general information regarding laboratory operations, and extensive interviews. The major findings of this evaluation were that: the program lacks a clear statement of purpose; program plans, priorities, and procedures are not explicit and operations tend to follow historical patterns; and the program is generally accepted as beneficial, but its benefits are difficult to quantify. It is recommended that the focus of the Lab Coop Program be limited and clearly defined, that performance plans be developed and measured against accomplishments, and that a national informational effort be initiated

  16. Assessing the Effectiveness of a School-Based Dental Clinic on the Oral Health of Children Who Lack Access to Dental Care: A Program Evaluation

    Science.gov (United States)

    Carpino, Rachel; Walker, Mary P.; Liu, Ying; Simmer-Beck, Melanie

    2017-01-01

    This program evaluation examines the effectiveness of a school-based dental clinic. A repeated-measures design was used to longitudinally examine secondary data from participants (N = 293). Encounter intensity was developed to normalize data. Multivariate analysis of variance and Kruskal-Wallis test were used to investigate the effect of encounter…

  17. Waste isolation safety assessment program

    International Nuclear Information System (INIS)

    Brandstetter, A.; Harwell, M.A.

    1979-05-01

    Associated with commercial nuclear power production in the United States is the generation of potentially hazardous radioactive wastes. The Department of Energy (DOE), through the National Waste Terminal Storage (NWTS) Program, is seeking to develop nuclear waste isolation systems in geologic formations that will preclude contact with the biosphere of waste radionuclides in concentrations which are sufficient to cause deleterious impact on humans or their environments. Comprehensive analyses of specific isolation systems are needed to assess the expectations of meeting that objective. The Waste Isolation Safety Assessment Program (WISAP) has been established at the Pacific Northwest Laboratory (operated by Battelle Memorial Institute) for developing the capability of making those analyses. Among the analyses required for isolation system evaluation is the detailed assessment of the post-closure performance of nuclear waste repositories in geologic formations. This assessment is essential, since it is concerned with aspects of the nuclear power program which previously have not been addressed. Specifically, the nature of the isolation systems (e.g., involving breach scenarios and transport through the geosphere), and the time-scales necessary for isolation, dictate the development, demonstration and application of novel assessment capabilities. The assessment methodology needs to be thorough, flexible, objective, and scientifically defensible. Further, the data utilized must be accurate, documented, reproducible, and based on sound scientific principles

  18. Arctic Nuclear Waste Assessment Program

    International Nuclear Information System (INIS)

    Edson, R.

    1995-01-01

    The Arctic Nuclear Waste Assessment Program (ANWAP) was initiated in 1993 as a result of US congressional concern over the disposal of nuclear materials by the former Soviet Union into the Arctic marine environment. The program is comprised of appr. 70 different projects. To date appr. ten percent of the funds has gone to Russian institutions for research and logistical support. The collaboration also include the IAEA International Arctic Seas Assessment Program. The major conclusion from the research to date is that the largest signals for region-wide radionuclide contamination in the Arctic marine environment appear to arise from the following: 1) atmospheric testing of nuclear weapons, a practice that has been discontinued; 2) nuclear fuel reprocessing wastes carried in the Arctic from reprocessing facilities in Western Europe, and 3) accidents such as Chernobyl and the 1957 explosion at Chelyabinsk-65

  19. Assessment and evaluation efficacy of a clinical pharmacist-led inpatient warfarin knowledge education program and follow-up at a Chinese tertiary referral teaching hospital

    Directory of Open Access Journals (Sweden)

    Guy-Armel Bounda

    2013-01-01

    Conclusion: Chinese patients on warfarin therapy should benefit from periodic educational efforts reinforcing key medication safety information. Patient education is not a once-off procedure. A complete patient education program run by a clinical pharmacist in a Cardio-thoracic ward can considerably improve and enhance to reduce the hospital stays and significantly enlighten the role of the patient education in adherence to therapy.

  20. Developing a mentoring program in clinical nutrition.

    Science.gov (United States)

    Martindale, Robert G; McClave, Stephen; Heyland, Daren; August, David

    2010-01-01

    Mentoring programs in nutrition are essential to the survival of clinical nutrition as we know it today. The best method known to maintain an influx of talent to a discipline is by developing an active mentoring program. This paper describes 1 concept for development of a viable mentor program. Mentoring should be flexible and based on mentees' training background. Realistic goals should be set, with written and verbal feedback, to sustain a successful program. Programs should incorporate the Socratic Method whenever possible. Factors that leave doubt about the survival of nutrition as a viable area of focus for physicians include the inability to generate adequate funds to support oneself and limited numbers of mentors available with dedicated time to be a mentor. A healthy, sustainable mentoring program in clinical nutrition will ensure survival of physician-based nutrition programs.

  1. Pacific Northwest regional assessment program

    International Nuclear Information System (INIS)

    Anon.

    1976-01-01

    The Pacific Northwest (comprised of the states of Alaska, Idaho, Montana, Oregon, Washington and Wyoming) can by several measures be regarded as a national warehouse of fossil energy resources. This condition coupled with an evolving national policy stressing utilization of fossil fuels in the near term prior to development of more advanced technologies for energy supply, could result in the imposition of major changes in the region's environmental, socioeconomic and possibly health status. The objective of the Pacific Northwest Regional Assessment Program is to establish and exercise an integrated analytical assessment program for evaluation of these potential changes that may result from various energy development or conservation scenarios. After consideration of a variety of approaches to integrated assessment at a regional level, Pacific Northwest Laboratories (PNL) has concluded that dynamic simulation techniques provide the best available approach to evaluating the issues pertinent to the Northwest. As a result, the PNW Regional Assessment Program has been structured in a framework involving ten sectors. Each of these sectors involve their own submodels that receive information either from outside the model as exogenous inputs or from other sector submodels

  2. An assessment of time involved in pre-test case review and counseling for a whole genome sequencing clinical research program.

    Science.gov (United States)

    Williams, Janet L; Faucett, W Andrew; Smith-Packard, Bethanny; Wagner, Monisa; Williams, Marc S

    2014-08-01

    Whole genome sequencing (WGS) is being used for evaluation of individuals with undiagnosed disease of suspected genetic origin. Implementing WGS into clinical practice will place an increased burden upon care teams with regard to pre-test patient education and counseling about results. To quantitate the time needed for appropriate pre-test evaluation of participants in WGS testing, we documented the time spent by our clinical research group on various activities related to program preparation, participant screening, and consent prior to WGS. Participants were children or young adults with autism, intellectual or developmental disability, and/or congenital anomalies, who have remained undiagnosed despite previous evaluation, and their biologic parents. Results showed that significant time was spent in securing allocation of clinical research space to counsel participants and families, and in acquisition and review of participant's medical records. Pre-enrollment chart review identified two individuals with existing diagnoses resulting in savings of $30,000 for the genome sequencing alone, as well as saving hours of personnel time for genome interpretation and communication of WGS results. New WGS programs should plan for costs associated with additional pre-test administrative planning and patient evaluation time that will be required to provide high quality care.

  3. The DECADE performance assessment program

    International Nuclear Information System (INIS)

    Weber, B.V.; Ottinger, P.F.; Commisso, R.J.; Thompson, J.; Rowley, J.E.; Filios, P.; Babineau, M.A.

    1996-01-01

    Previous analyses of DECADE Module 1 experiments indicated significant current loss between the plasma opening switch (POS) and an electron-beam load. A program was initiated to diagnose and improve the power flow to assess the performance of a multi-module DECADE system. Power flow measurements between the POS and load indicate high vacuum flow, distributed current loss and azimuthal asymmetries. A decreased load impedance reduces the fraction of the load current flowing in vacuum. Improved plasma source symmetry reduces losses near the load for long conduction times. Increased POS impedance is required to significantly improve the power coupling to the load. (author). 6 figs., 9 refs

  4. The DECADE performance assessment program

    Energy Technology Data Exchange (ETDEWEB)

    Weber, B V; Ottinger, P F; Commisso, R J [Naval Research Lab., Washington, DC (United States). Plasma Physics Div.; Goyer, J R; Kortbawi, D [Physics International Co., Berkeley, CA (United States); Thompson, J [Maxwell Labs., San Diego, CA (United States); Rowley, J E; Filios, P [Defense Nuclear Agency, Alexandria, VA (United States); Babineau, M A [Sverdlup Technology, Tullahoma, TN (United States)

    1997-12-31

    Previous analyses of DECADE Module 1 experiments indicated significant current loss between the plasma opening switch (POS) and an electron-beam load. A program was initiated to diagnose and improve the power flow to assess the performance of a multi-module DECADE system. Power flow measurements between the POS and load indicate high vacuum flow, distributed current loss and azimuthal asymmetries. A decreased load impedance reduces the fraction of the load current flowing in vacuum. Improved plasma source symmetry reduces losses near the load for long conduction times. Increased POS impedance is required to significantly improve the power coupling to the load. (author). 6 figs., 9 refs.

  5. Students' Assessment and Self-assessment of Nursing Clinical Faculty Competencies: Important Feedback in Clinical Education?

    Science.gov (United States)

    Lovrić, Robert; Prlić, Nada; Zec, Davor; Pušeljić, Silvija; Žvanut, Boštjan

    2015-01-01

    The students' assessment of clinical faculty competencies and the faculty members' self-assessment can provide important information about nursing clinical education. The aim of this study was to identify the differences between the students' assessment of the clinical faculty member's competencies and the faculty member's self-assessment. These differences can reveal interesting insights relevant for improving clinical practice.

  6. Systematic Assessment for University Sexuality Programming.

    Science.gov (United States)

    Westefeld, John S.; Winkelpleck, Judy M.

    1982-01-01

    Suggests systematic empirical assessment is needed to plan university sexuality programing. Proposes the traditional approach of asking about students' attitudes, knowledge, and behavior is useful for developing specific programing content. Presents an assessment model emphasizing assessment of students' desires for sexuality programing in terms…

  7. Specialization-Specific Course Assessments Integrated for Program Assessment

    OpenAIRE

    Qurban A. Memon; Adnan Harb; Shakeel Khoja

    2012-01-01

    The program assessment process combines assessments from individual courses to generate final program assessment to match accreditation benchmarks. In developing countries, industrial environment is not diversified to allow graduating engineers to seek jobs in all disciplines or specializations of an engineering program. Hence, it seems necessary to seek evolution of an engineering program assessment for specialized requirements of the industry. This paper describes how specialization-specifi...

  8. Assessment Practices in Undergraduate Accounting Programs

    Science.gov (United States)

    Lusher, Anna L.

    2010-01-01

    This study examined accounting program assessment plans at 102 colleges and universities in the United States. The research focused on identifying assessment practices in undergraduate accounting programs by examining the skills and competencies assessed and determining the methods of assessment used. The study also investigated what course and/or…

  9. Assessing student clinical learning experiences.

    Science.gov (United States)

    Nehyba, Katrine; Miller, Susan; Connaughton, Joanne; Singer, Barbara

    2017-08-01

    This article describes the use of an activity worksheet and questionnaire to investigate the learning experience of students on clinical placement. The worksheet measures the amount of time students spend in different learning activities, and the questionnaire explores student satisfaction and preferred learning activities. An activity worksheet and questionnaire … investigate[d] the learning experiences of students on clinical placement METHODS: The activity worksheet and questionnaire were used in a cohort pilot study of physiotherapy students on clinical placement. The activity worksheet provides details of the amount of time students engage in a range of clinical and non-clinical tasks while on placement, such as time spent treating patients, working individually, working with their peers and engaging in reflective practice. In combination with the questionnaire results, it allows clinicians to gain an understanding of the clinical learning environment experienced by their students. The data collected using these tools provide a description of the students' activities while undertaking the clinical placement. This information may guide the refinement of the clinical experience, and offers an opportunity to individualise learning activities to match students' needs and preferences. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  10. Redesigning a clinical mentoring program for improved outcomes in the clinical training of clerks

    Directory of Open Access Journals (Sweden)

    Chia-Der Lin

    2015-09-01

    Full Text Available Introduction: Mentorship has been noted as critical to medical students adapting to clinical training in the medical workplace. A lack of infrastructure in a mentoring program might deter relationship building between mentors and mentees. This study assessed the effect of a redesigned clinical mentoring program from the perspective of clerks. The objective was to assess the benefits of the redesigned program and identify potential improvements. Methods: A redesigned clinical mentoring program was launched in a medical center according to previous theoretical and practical studies on clinical training workplaces, including the elements of mentor qualifications, positive and active enhancers for mentor–mentee relationship building, the timing of mentoring performance evaluation, and financial and professional incentives. A four-wave web survey was conducted, comprising one evaluation of the former mentoring program and three evaluations of the redesigned clinical mentoring program. Sixty-four fifth-year medical students in clerkships who responded to the first wave and to at least two of the three following waves were included in the study. A structured and validated questionnaire encompassing 15 items on mentor performance and the personal characteristics of the clerks was used. Mixed linear models were developed for repeated measurements and to adjust for personal characteristics. Results: The results revealed that the redesigned mentoring program improved the mentors’ performance over time for most evaluated items regarding professional development and personal support provided to the mentees. Conclusions: Our findings serve as an improved framework for the role of the institution and demonstrate how institutional policies, programs, and structures can shape a clinical mentoring program. We recommend the adoption of mentorship schemes for other cohorts of medical students and for different learning and training stages involved in becoming a

  11. Redesigning a clinical mentoring program for improved outcomes in the clinical training of clerks

    Science.gov (United States)

    Lin, Chia-Der; Lin, Blossom Yen-Ju; Lin, Cheng-Chieh; Lee, Cheng-Chun

    2015-01-01

    Introduction Mentorship has been noted as critical to medical students adapting to clinical training in the medical workplace. A lack of infrastructure in a mentoring program might deter relationship building between mentors and mentees. This study assessed the effect of a redesigned clinical mentoring program from the perspective of clerks. The objective was to assess the benefits of the redesigned program and identify potential improvements. Methods A redesigned clinical mentoring program was launched in a medical center according to previous theoretical and practical studies on clinical training workplaces, including the elements of mentor qualifications, positive and active enhancers for mentor–mentee relationship building, the timing of mentoring performance evaluation, and financial and professional incentives. A four-wave web survey was conducted, comprising one evaluation of the former mentoring program and three evaluations of the redesigned clinical mentoring program. Sixty-four fifth-year medical students in clerkships who responded to the first wave and to at least two of the three following waves were included in the study. A structured and validated questionnaire encompassing 15 items on mentor performance and the personal characteristics of the clerks was used. Mixed linear models were developed for repeated measurements and to adjust for personal characteristics. Results The results revealed that the redesigned mentoring program improved the mentors’ performance over time for most evaluated items regarding professional development and personal support provided to the mentees. Conclusions Our findings serve as an improved framework for the role of the institution and demonstrate how institutional policies, programs, and structures can shape a clinical mentoring program. We recommend the adoption of mentorship schemes for other cohorts of medical students and for different learning and training stages involved in becoming a physician. PMID

  12. Tobacco training in clinical social work graduate programs.

    Science.gov (United States)

    Kleinfelder, JoAnn; Price, James H; Dake, Joseph A; Jordan, Timothy R; Price, Joy A

    2013-08-01

    The leading cause of preventable death, in the most vulnerable segments of society, whom social workers often counsel, is cigarette smoking. The purpose of this study was to assess tobacco smoking cessation training in clinical social work programs. A valid 21-item questionnaire was sent to the entire population of 189 clinical graduate social work programs identified by the Council on Social Work Education. A three-wave mailing process was used to maximize the return rate. Directors from 112 clinical social work programs returned completed questionnaires (61 percent). The majority (91 percent) of directors reported having never thought about offering formal smoking cessation training, and only nine of the programs (8 percent) currently provided formal smoking cessation education. The three leading barriers to offering smoking cessation education were as follows: not a priority (60 percent), not enough time (55 percent), and not required by the accrediting body (41 percent). These findings indicate that clinical social work students are not receiving standardized smoking cessation education to assist in improving the well-being of their clients. The national accrediting body for graduate clinical social work programs should consider implementing guidelines for smoking cessation training in the curriculums.

  13. Adaptation of an asthma management program to a small clinic.

    Science.gov (United States)

    Kwong, Kenny Yat-Choi; Redjal, Nasser; Scott, Lyne; Li, Marilyn; Thobani, Salima; Yang, Brian

    2017-07-01

    Asthma management programs, such as the Breathmobile program, have been extremely effective in reducing asthma morbidity and increasing disease control; however, their high start-up costs may preclude their implementation in smaller health systems. In this study, we extended validated asthma disease management principles from the Breathmobile program to a smaller clinic system utilizing existing resources and compared clinical outcomes. Cox-regression analyses were conducted to determine the cumulative probability that a new patient entering the program would achieve improved clinical control of asthma with each subsequent visit to the program. A weekly asthma disease management clinic was initiated in an existing multi-specialty pediatric clinic in collaboration with the Breathmobile program. Existing nursing staff was utilized in conjunction with an asthma specialist provider. Patients were referred from a regional healthcare maintenance organization and patients were evaluated and treated every 2 months. Reduction in emergency department (ED) visits and hospitalizations, and improvements in asthma control were assessed at the end of 1 year. A total of 116 patients were enrolled over a period of 1 year. Mean patient age was 6.4 years at the time of their first visit. Patient ethnicity was self-described predominantly as Hispanic or African American. Initial asthma severity for most patients, classified in accordance with national guidelines, was "moderate persistent." After 1 year of enrollment, there was a 69% and 92% reduction in ED/urgent care visits and hospitalizations, respectively, compared with the year before enrollment. Up to 70% of patients achieved asthma control by the third visit. Thirty-six different patients were seen during 1 year for a total of $15,938.70 in contracted reimbursements. A large-scale successful asthma management program can be adapted to a stationary clinic system and achieve comparable results.

  14. Outcomes assessment of dental hygiene clinical teaching workshops.

    Science.gov (United States)

    Wallace, Juanita S; Infante, Taline D

    2008-10-01

    Faculty development courses related to acquiring clinical teaching skills in the health professions are limited. Consequently, the Department of Dental Hygiene at the University of Texas Health Science Center at San Antonio conducted a series of clinical teaching workshops to address clinical teaching methodology. The goal of these workshops was to promote a problem-solving learning atmosphere for dental hygiene faculty to acquire and share sound clinical teaching strategies. To determine the value of the annual workshops on clinical teaching and evaluation, a web-based qualitative program assessment was developed using software by Survey Tracker. Four open-ended questions were designed to elicit perceptions regarding what significant changes in teaching strategies were achieved, what barriers or challenges were encountered in making these changes, and what strategies were used to overcome the barriers. The assessment was sent to dental hygiene educators representing thirty-eight dental hygiene programs who had participated in two or more of these workshops. Twenty-eight programs provided collective responses to the questions, and the narrative data were analyzed, using a qualitative methodology. Responses revealed that programs had made productive changes to their clinical education curricula and the information gained from the workshops had a positive effect on clinical teaching.

  15. Assessing New Employee Orientation Programs

    Science.gov (United States)

    Acevedo, Jose M.; Yancey, George B.

    2011-01-01

    Purpose: This paper aims to examine the importance of new employee orientation (NEO) programs, the quality of typical NEOs, and how to improve NEOs. Design/methodology/approach: The paper provides a viewpoint of the importance of new employee orientation programs, the quality of typical NEOs, and how to improve NEOs. Findings: Although western…

  16. Industrial Assessment Center Program Impact Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Martin, M.A.

    2000-01-26

    This report presents the results of an evaluation of the U.S. Department of Energy's Industrial Assessment Center (IAC) Program. The purpose of this program is to conduct energy, waste, and productivity assessments for small to medium-sized industrial firms. Assessments are conducted by 30 university-based industrial assessment centers. The purpose of this project was to evaluate energy and cost savings attributable to the assessments, the trained alumni, and the Websites sponsored by this program. How IAC assessments, alumni, and Web-based information may influence industrial energy efficiency decision making was also studied. It is concluded that appreciable energy and cost savings may be attributed to the IAC Program and that the IAC Program has resulted in more active and improved energy-efficiency decision making by industrial firms.

  17. Milestones: a rapid assessment method for the Clinical Competency Committee

    OpenAIRE

    Nabors, Christopher; Forman, Leanne; Peterson, Stephen J.; Gennarelli, Melissa; Aronow, Wilbert S.; DeLorenzo, Lawrence; Chandy, Dipak; Ahn, Chul; Sule, Sachin; Stallings, Gary W.; Khera, Sahil; Palaniswamy, Chandrasekar; Frishman, William H.

    2016-01-01

    Introduction Educational milestones are now used to assess the developmental progress of all U.S. graduate medical residents during training. Twice annually, each program?s Clinical Competency Committee (CCC) makes these determinations and reports its findings to the Accreditation Council for Graduate Medical Education (ACGME). The ideal way to conduct the CCC is not known. After finding that deliberations reliant upon the new milestones were time intensive, our internal medicine residency pr...

  18. Outcomes Assessment in Dental Hygiene Programs.

    Science.gov (United States)

    Grimes, Ellen B.

    1999-01-01

    A survey of 22 dental-hygiene-program directors found that programs routinely and effectively assess student outcomes and use the information for program improvements and to demonstrate accountability. Both policy and faculty/administrative support were deemed important to implementation. Time constraints were a major barrier. Outcomes-assessment…

  19. Assessment of paediatric clinical audit.

    LENUS (Irish Health Repository)

    Perrem, L M

    2012-02-01

    Consultant paediatricians in Ireland were surveyed to evaluate their perceptions of the hospital audit environment and assess their involvement in the audit process. Eighty nine (77%) replied of whom 66 (74%) had an audit department and 23 (26%) did not. Sixteen (18%) felt their hospital was well resourced for audit and 25 (28%) felt the culture was very positive but only 1 (1%) had protected time. For 61 (69%) consultants audit was very important with 38 (43%) being very actively involved in the process. The most frequent trigger for audit was non consultant hospital doctor (NCHD) career development, cited by 77 (87%). The new Professional Competence Scheme and the National Quality and Risk Management Standards will require the deficiencies identified in this survey be addressed.

  20. Defense Acquisitions: Assessments of Selected Weapon Programs

    Science.gov (United States)

    2017-03-01

    Figure 17: Examples of Knowledge Scorecards 61 Page vi GAO-17-333SP Assessments of Selected Weapon Programs...programs. Page 61 GAO-17-333SP Assessments of Selected Weapon Programs Figure 17: Examples of Knowledge Scorecards Pursuant to a...had direct access to the USD AT&L and other senior acquisition officials, and some approval authorities were delegated to lower levels. For example

  1. Tactical Vulnerability Assessment Training Program

    International Nuclear Information System (INIS)

    Al-Ayat, R.A.; Judd, B.R.; Renis, T.A.; Paulus, W.K.; Winblad, A.G.; Graves, B.R.

    1987-01-01

    The Department of Energy sponsors a 9-day training program for individuals who are responsible for evaluating and planning safeguards systems and for preparing DOE Master and Security Agreements (MSSAs). These agreements between DOE headquarters and operations offices establish required levels of protection. The curriculum includes: (1) the nature of potential insider and outsider threats involving theft or diversion of special nuclear material, (2) use of computerized tools for evaluating the effectiveness of physical protection and material control and accountability systems, and (3) methods for analyzing the benefits and costs of safeguards improvements and for setting priorities among proposed upgrades. The training program is varied and high interactive. Presentations are intermixed with class discussions and ''hands-on'' analysis using computer tools. At the end of the program, participants demonstrate what they have learned in a two-and-one-half day ''field exercise,'' which is conducted on a facility scale-model. The training program has been conducted six times and has been attended by representatives of all DOE facilities. Additional sessions are planned at four-month intervals. This paper describes the training program, use of the tools in preparing MSSAs for various DOE sites, and recent extensions and refinements of the evaluation tools

  2. Tactical Vulnerability Assessment Training Program

    International Nuclear Information System (INIS)

    Al-Ayat, R.A.; Judd, B.R.; Renis, T.A.; Paulus, W.K.; Winblad, A.E.; Graves, B.R.

    1987-01-01

    The Department of Energy sponsors a 9-day training program for individual who are responsible for evaluating and planning safeguards systems and for preparing DOE Master and Security Agreements (MSSAs). These agreements between DOE headquarters and operations offices establish required levels of protection. The curriculum includes: (1) the nature of potential insider and outsider threats involving theft or diversion of special nuclear material, (2) use of computerized tools for evaluating the effectiveness of physical protection and material control and acoountability systems, and (3) methods for analyzing the benefits and costs of safeguards improvements and for setting priorities among proposed upgrades. The training program is varied and highly interactive. Presentations are intermixed with class discussions and ''hands-on'' analysis using computer tools. At the end of the program, participants demonstrate what they have learned in a two-and-one-half day ''field excercise,'' which is conducted on a facility scale-model. The training programs has been conducted six times and has been attended by representatives of all DOE facilities. Additional sessions are planned at four-month intervals. This paper describes the training program, use of the tools in preparing MSSAs for various DOE sites, and recent extensions and refinements of the evaluation tools

  3. Reading assessment and training program

    International Nuclear Information System (INIS)

    Lewis, C.L.

    1991-01-01

    The objective was to ensure ourselves and the general public that the workers in the Nuclear Materials Processing Department (NMPD) could read, follow, and understand procedures. Procedures were randomly selected and analyzed for reading levels. A tenth grade reading level was established as the standard for all NMPD employees. Employees were tested to determine reading levels and approximately 12% could not read at the target level. A Procedure Walk-Through Evaluation was administered to each person not reaching tenth grade reading level. This was a job performance measure given to ensure that the worker was competent in his/her present job, and should remain there while completing reading training. A mandatory Reading Training Program utilizing Computer Based Training was established. This program is self-paced, individualized instruction and provided to the worker on Company time. Results of the CBT Program have been very good. Instruction is supplemented with test-taking skills seminars, practice exams, individual conferences with their own reading specialist, and some self-directed study books. This paper describes the program at Savannah River Site

  4. Enhancing clinical skills education: University of Virginia School of Medicine's Clerkship Clinical Skills Workshop Program.

    Science.gov (United States)

    Corbett, Eugene C; Payne, Nancy J; Bradley, Elizabeth B; Maughan, Karen L; Heald, Evan B; Wang, Xin Qun

    2007-07-01

    In 1993, the University of Virginia School of Medicine began a clinical skills workshop program in an effort to improve the preparation of all clerkship students to participate in clinical care. This program involved the teaching of selected basic clinical skills by interested faculty to small groups of third-year medical students. Over the past 14 years, the number of workshops has increased from 11 to 31, and they now involve clerkship faculty from family medicine, internal medicine, and pediatrics. Workshops include a variety of common skills from the communication, physical examination, and clinical test and procedure domains such as pediatric phone triage, shoulder examination, ECG interpretation, and suturing. Workshop sessions allow students to practice skills on each other, with standardized patients, or with models, with the goal of improving competence and confidence in the performance of basic clinical skills. Students receive direct feedback from faculty on their skill performance. The style and content of these workshops are guided by an explicit set of educational criteria.A formal evaluation process ensures that faculty receive regular feedback from student evaluation comments so that adherence to workshop criteria is continuously reinforced. Student evaluations confirm that these workshops meet their skill-learning needs. Preliminary outcome measures suggest that workshop teaching can be linked to student assessment data and may improve students' skill performance. This program represents a work-in-progress toward the goal of providing a more comprehensive and developmental clinical skills curriculum in the school of medicine.

  5. Assessment of clinical residents' needs for ten educational subjects

    Directory of Open Access Journals (Sweden)

    Mansour Razavi

    2002-04-01

    Full Text Available Background Fulfilling the learners' "real needs" will improve medical education. There are subjects that are necessary for any clinical residents not considering their field of specialty. Among the subjects ten seems to be the most important: research methodology and data analysis, computer-based programs, medical recording, cardiopulmonary and cerebral resuscitation, clinical teaching programs, communication skills, clinical ethics, laboratory examinations, reporting special diseases and death certification, and prescription. Purpose This cross-sectional study assessed educational needs of clinical residents for ten educational subjects. Methods A questionnaire prepared by board faculty members consisted of 10 close-ended questions, and one open­ ended question was distributed among 1307 residents from 22 clinical disciplines, who registered for preboard or promotion exam in June 2000. Results Among the subjects three were the most needed: computer-based programs 149 (60%, data collecting system 606 (49%, and clinical ethics 643 (46%. The prescription standard was the least required 177(13%. Conclusion Complementary training courses on these subjects can be an answer to the clinical residents needs. Keywords : research methodology, computer in medicine, cpr, clinical teaching methods, communication in medicine, medical ethics, laboratory ordering, disease coding system, death certificate, prescription writing

  6. Assessment of elementary school safety restraint programs.

    Science.gov (United States)

    1985-06-01

    The purpose of this research was to identify elementary school (K-6) safety belt : education programs in use in the United States, to review their development, and : to make administrative and impact assessments of their use in selected States. : Six...

  7. Colon Cancer Risk Assessment - Gauss Program

    Science.gov (United States)

    An executable file (in GAUSS) that projects absolute colon cancer risk (with confidence intervals) according to NCI’s Colorectal Cancer Risk Assessment Tool (CCRAT) algorithm. GAUSS is not needed to run the program.

  8. Assessing a GTA professional development program

    OpenAIRE

    Alicea-Muñoz, Emily; Masip, Joan Espar; Sullivan, Carol Subiño; Schatz, Michael F.

    2018-01-01

    For the last four years, the School of Physics at Georgia Tech have been preparing new Graduate Teaching Assistants (GTAs) through a program that integrates pedagogy, physics content, and professional development strategies. Here we discuss various assessments we have used to evaluate the program, among them surveys, GTA self-reporting, and end-of-semester student evaluations. Our results indicate that GTAs who participate in the program find its practical activities useful, feel better prepa...

  9. UTAP, U Tailings Assessment Program

    International Nuclear Information System (INIS)

    Holmes, Ron

    1998-01-01

    1 - Description of program or function: UTAP carries out probabilistic analyses of the behaviour and environmental effects of uranium mill tailings, following close-out of milling operations. The models have been designed to allow predictions to be made for distances up to 50 kilometers in all directions from the tailings area. The models include features which include the ability to incorporate different receptors and site characteristics and to deal with input parameters which vary with time. 2 - Method of solution: UTAP is composed of a number of modules. These may be classified as either component or control modules. Component modules (or models) are the programs directly concerned with the simulation of a uranium tailings physical system; that is the computer implementation of the mathematical models representing the uranium tailings pile and surrounding environment. Control modules provide the infrastructure for probabilistic analysis using the component modules. These functions include probabilistic sampling of input parameters such as constant, normal, log-normal, uniform, log-uniform, triangular, Weibull, Beta, arbitrary and correlated. The sampling method used is straight Monte Carlo. The radionuclides modelled are: natural uranium, total thorium, radium-226, radon-222 and lead-210. The pH of the reference uranium tailings site and a chained river-lake system are also modelled. For the afore- mentioned radionuclides the following pathways of dose to the receptors modelled: water consumption, fish consumption, radon inhalation, dust inhalation, vegetable consumption, animal produce consumption and ground-shine. 3 - Restrictions on the complexity of the problem: The maximum number of steps through time allowed is 300

  10. Assessing an Academic Library Professional Development Program

    Science.gov (United States)

    Harker, Karen R.; O'Toole, Erin; Sassen, Catherine

    2018-01-01

    Professional development programs have been established in many academic libraries to support the research and scholarly activities of librarians. Continuous assessment can contribute to the sustainability and effectiveness of these programs. This study describes how measures of need, participation, satisfaction, and impact were employed to assess…

  11. Argonne program to assess superconducting stability

    International Nuclear Information System (INIS)

    Wang, S.T.; Turner, L.R.; Huang, Y.C.; Dawson, J.W.; Harrang, J.; Hilal, M.A.; Lieberg, M.; Gonczy, J.D.; Kim, S.H.

    1978-01-01

    To assess superconductor stability, a complete program is developed to obtain basic information on the effects of local mechanical perturbations on the cryostatic stability. An analytical model for computing the transient recovery following the mechanical perturbation is developed. A test program is undertaken to develop data needed to verify the conclusions reached through the analytical studies

  12. Assessing the clinical probability of pulmonary embolism

    International Nuclear Information System (INIS)

    Miniati, M.; Pistolesi, M.

    2001-01-01

    Clinical assessment is a cornerstone of the recently validated diagnostic strategies for pulmonary embolism (PE). Although the diagnostic yield of individual symptoms, signs, and common laboratory tests is limited, the combination of these variables, either by empirical assessment or by a prediction rule, can be used to express a clinical probability of PE. The latter may serve as pretest probability to predict the probability of PE after further objective testing (posterior or post-test probability). Over the last few years, attempts have been made to develop structured prediction models for PE. In a Canadian multicenter prospective study, the clinical probability of PE was rated as low, intermediate, or high according to a model which included assessment of presenting symptoms and signs, risk factors, and presence or absence of an alternative diagnosis at least as likely as PE. Recently, a simple clinical score was developed to stratify outpatients with suspected PE into groups with low, intermediate, or high clinical probability. Logistic regression was used to predict parameters associated with PE. A score ≤ 4 identified patients with low probability of whom 10% had PE. The prevalence of PE in patients with intermediate (score 5-8) and high probability (score ≥ 9) was 38 and 81%, respectively. As opposed to the Canadian model, this clinical score is standardized. The predictor variables identified in the model, however, were derived from a database of emergency ward patients. This model may, therefore, not be valid in assessing the clinical probability of PE in inpatients. In the PISA-PED study, a clinical diagnostic algorithm was developed which rests on the identification of three relevant clinical symptoms and on their association with electrocardiographic and/or radiographic abnormalities specific for PE. Among patients who, according to the model, had been rated as having a high clinical probability, the prevalence of proven PE was 97%, while it was 3

  13. Smoking cessation results in a clinical lung cancer screening program.

    Science.gov (United States)

    Borondy Kitts, Andrea K; McKee, Andrea B; Regis, Shawn M; Wald, Christoph; Flacke, Sebastian; McKee, Brady J

    2016-07-01

    Lung cancer screening may provide a "teachable moment" for promoting smoking cessation. This study assessed smoking cessation and relapse rates among individuals undergoing follow-up low-dose chest computed tomography (CT) in a clinical CT lung screening program and assessed the influence of initial screening results on smoking behavior. Self-reported smoking status for individuals enrolled in a clinical CT lung screening program undergoing a follow-up CT lung screening exam between 1st February, 2014 and 31st March, 2015 was retrospectively reviewed and compared to self-reported smoking status using a standardized questionnaire at program entry. Point prevalence smoking cessation and relapse rates were calculated across the entire population and compared with exam results. All individuals undergoing screening fulfilled the National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology: Lung Cancer Screening v1.2012(®) high-risk criteria and had an order for CT lung screening. A total of 1,483 individuals underwent a follow-up CT lung screening exam during the study interval. Smoking status at time of follow-up exam was available for 1,461/1,483 (98.5%). A total of 46% (678/1,461) were active smokers at program entry. The overall point prevalence smoking cessation and relapse rates were 20.8% and 9.3%, respectively. Prior positive screening exam results were not predictive of smoking cessation (OR 1.092; 95% CI, 0.715-1.693) but were predictive of reduced relapse among former smokers who had stopped smoking for 2 years or less (OR 0.330; 95% CI, 0.143-0.710). Duration of program enrollment was predictive of smoking cessation (OR 0.647; 95% CI, 0.477-0.877). Smoking cessation and relapse rates in a clinical CT lung screening program rates are more favorable than those observed in the general population. Duration of participation in the screening program correlated with increased smoking cessation rates. A positive exam result correlated with reduced

  14. Setting pass scores for clinical skills assessment.

    Science.gov (United States)

    Liu, Min; Liu, Keh-Min

    2008-12-01

    In a clinical skills assessment, the decision to pass or fail an examinee should be based on the test content or on the examinees' performance. The process of deciding a pass score is known as setting a standard of the examination. This requires a properly selected panel of expert judges and a suitable standard setting method, which best fits the purpose of the examination. Six standard setting methods that are often used in clinical skills assessment are described to provide an overview of the standard setting process.

  15. Setting Pass Scores for Clinical Skills Assessment

    Directory of Open Access Journals (Sweden)

    Min Liu

    2008-12-01

    Full Text Available In a clinical skills assessment, the decision to pass or fail an examinee should be based on the test content or on the examinees' performance. The process of deciding a pass score is known as setting a standard of the examination. This requires a properly selected panel of expert judges and a suitable standard setting method, which best fits the purpose of the examination. Six standard setting methods that are often used in clinical skills assessment are described to provide an overview of the standard setting process.

  16. Trends in the Medical Knowledge and Clinical Competence of Graduates of Internal Medicine Residency Training Programs.

    Science.gov (United States)

    Norcini, John J.; And Others

    1991-01-01

    A study assessed the effectiveness of medical resident training programs during 1983-88 by evaluating students' certification scores and comparing them to the program's evaluation of students' clinical competence. Results are reported and analyzed for top-rated, university-affiliated, and non-university-affiliated programs, focusing on trends over…

  17. Reports of past alcohol and drug use following participation in a motivation enhancing intervention: Implications for clinical assessment and program evaluation

    Directory of Open Access Journals (Sweden)

    Rosengren David B

    2012-05-01

    Full Text Available Abstract Background There is significant interest in the value of motivational approaches that enhance participant readiness to change, but less is known about clients’ self-reports of problematic behavior when participating in such interventions. Methods We examined whether participants in a motivationally-based intervention for DUI offenders changed their reports of substance use at postintervention (when reporting on the same 30 days that they reported on at preintervention. Specifically, Study 1 (N = 8,387 tested whether participants in PRIME For Life (PFL changed their reports about baseline substance levels when asked at postintervention versus at preintervention. Study 2 (N = 192 compared changes in self-reported baseline drinking between PFL and intervention as usual (IAU participants. Results Many participants in Study 1 did not change their reports about how much they used substances during the 30-day period before baseline. Among those who did, the most common change was an increase in reported amounts of baseline drug use, and typical and peak alcohol use. This sample also showed changes in reports of their baseline pattern of high-risk-use (consistent versus occasional. At postintervention, participants who were younger, single, or endorsing more indicators of alcohol dependence were more likely to later report greater frequency of baseline drug use, and greater peak and typical number of baseline drinks. Gender, education, and race were also associated with reporting inconsistency on some behaviors. In Study 2, PFL participants showed greater increases in reports of peak alcohol use compared to IAU, but both conditions showed similar increases for drugs and typical alcohol use. Conclusions In both research and clinical settings, a segment of participants may initially report less substance use than they do when asked later about the same baseline period. These preliminary findings suggest clinicians and researchers may

  18. Assessing clinical competency in the health sciences

    Science.gov (United States)

    Panzarella, Karen Joanne

    To test the success of integrated curricula in schools of health sciences, meaningful measurements of student performance are required to assess clinical competency. This research project analyzed a new performance assessment tool, the Integrated Standardized Patient Examination (ISPE), for assessing clinical competency: specifically, to assess Doctor of Physical Therapy (DPT) students' clinical competence as the ability to integrate basic science knowledge with clinical communication skills. Thirty-four DPT students performed two ISPE cases, one of a patient who sustained a stroke and the other a patient with a herniated lumbar disc. Cases were portrayed by standardized patients (SPs) in a simulated clinical setting. Each case was scored by an expert evaluator in the exam room and then by one investigator and the students themselves via videotape. The SPs scored each student on an overall encounter rubric. Written feedback was obtained from all participants in the study. Acceptable reliability was demonstrated via inter-rater agreement as well as inter-rater correlations on items that used a dichotomous scale, whereas the items requiring the use of the 4-point rubric were somewhat less reliable. For the entire scale both cases had a significant correlation between the Expert-Investigator pair of raters, for the CVA case r = .547, p performances on the ISPE with other independent estimates of students' competence. The unique integration questions of the ISPE were judged to have good content validity from experts and students, suggestive that integration, a most crucial element of clinical competence, while done in the mind of the student, can be practiced, learned and assessed.

  19. Automated Assessment in a Programming Tools Course

    Science.gov (United States)

    Fernandez Aleman, J. L.

    2011-01-01

    Automated assessment systems can be useful for both students and instructors. Ranking and immediate feedback can have a strongly positive effect on student learning. This paper presents an experience using automatic assessment in a programming tools course. The proposal aims at extending the traditional use of an online judging system with a…

  20. Environmental stress and assessment program

    International Nuclear Information System (INIS)

    Adriano, D.C.; Brisbin, I.L.; Gibbons, J.W.

    1981-01-01

    Research progress is reported in sections entitled: Savannah River Plant (SRP) studies provide general models for thermal research; in vivo studies of thermal stabilities of cattail isozymes reveal interspecific differences; thermal regimes in Par Pond have little effect on micronutrient uptake by cattails; continued tree kill in the SRP swamp may have an adverse impact on the swamp's cooling capabilities; Par Pond provides understanding of complexity of lake ecosystems affected by thermal effluents; temperature affects size, species distribution, and emergence date of dragonfly larvae; the midge subcommunity in Par Pond maintains relative integrity across a multi-faceted environmental gradient; temperature does not alter contribution of predators to community stability; habitat affects enzyme activity levels in natural populations of Gambusia affinis; studies of large-mouth bass in Par Pond system reveal lipid cycles; long-term turtle research provides information on survivorship and longevity; data on SRP watersnakes contribute to understanding of sexual dimorphism in animals; terrestrial drift fences and pitfall traps prove to be an effective technique for quantitative sampling of animal populations; and, Steel Creek targeted for environmental assessment

  1. Formative assessment promotes learning in undergraduate clinical ...

    African Journals Online (AJOL)

    Introduction. Clinical clerkships, typically situated in environments lacking educational structure, form the backbone of undergraduate medical training. The imperative to develop strategies that enhance learning in this context is apparent. This study explored the impact of longitudinal bedside formative assessment on ...

  2. Personality Assessment Use by Clinical Neuropsychologists

    Science.gov (United States)

    Smith, Steven R.; Gorske, Tad T.; Wiggins, Chauntel; Little, Jessica A.

    2010-01-01

    The present study is an exploration of the personality assessment practices of clinical neuropsychologists. Professional members of the National Academy of Neuropsychology and the International Neuropsychological Society (N = 404) were surveyed to examine use of several forms of personality, behavior, and emotional function measures. Results…

  3. Triangular model integrating clinical teaching and assessment.

    Science.gov (United States)

    Abdelaziz, Adel; Koshak, Emad

    2014-01-01

    Structuring clinical teaching is a challenge facing medical education curriculum designers. A variety of instructional methods on different domains of learning are indicated to accommodate different learning styles. Conventional methods of clinical teaching, like training in ambulatory care settings, are prone to the factor of coincidence in having varieties of patient presentations. Accordingly, alternative methods of instruction are indicated to compensate for the deficiencies of these conventional methods. This paper presents an initiative that can be used to design a checklist as a blueprint to guide appropriate selection and implementation of teaching/learning and assessment methods in each of the educational courses and modules based on educational objectives. Three categories of instructional methods were identified, and within each a variety of methods were included. These categories are classroom-type settings, health services-based settings, and community service-based settings. Such categories have framed our triangular model of clinical teaching and assessment.

  4. Regional Environmental Monitoring and Assessment Program Data (REMAP)

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Regional Environmental Monitoring and Assessment Program (REMAP) was initiated to test the applicability of the Environmental Monitoring and Assessment Program...

  5. Risk assessment instruments in clinical practice.

    Science.gov (United States)

    Côté, Gilles; Crocker, Anne G; Nicholls, Tonia L; Seto, Michael C

    2012-04-01

    To determine whether the items in one of the most widely validated instruments of violence risk assessment, the Historical-Clinical-Risk Management-20 (HCR-20), are used in review board hearings to assess the risk of violence by people found Not Criminally Responsible on account of Mental Disorder (NCRMD). This study was conducted from October 2004 to August 2006 in Quebec's sole forensic psychiatric hospital and 2 large civil psychiatric hospitals designated for the care of people declared NCRMD in the Montreal metropolitan area. The risk assessments presented by clinicians at annual review board hearings and the boards' rationale for the release or detention of people found NCRMD were contrasted with the risk assessments conducted by the research team using the HCR-20. The final sample was comprised of 96 men. Very few of the risk factors identified by prior research (HCR-20 items) were mentioned in the hearing process, whether in clinical reports, discussions during the hearing, or in the disposition justification. The findings confirm that there remains a significant gap between research evidence and risk assessment practice.

  6. Using systematically observed clinical encounters (SOCEs to assess medical students’ skills in clinical settings

    Directory of Open Access Journals (Sweden)

    George R Bergus

    2010-11-01

    Full Text Available George R Bergus1–3, Jerold C Woodhead4, Clarence D Kreiter2,51Performance Based Assessment Program, Office of Student Affairs and Curriculum, 2Department of Family Medicine, 3Department of Psychiatry, 4Department of Pediatrics, 5Office of Consultation and Research in Medical Education, Roy J and Lucille A Carver College of Medicine, The University of Iowa, Iowa City, IA, USAIntroduction: The Objective Structured Clinical Examination (OSCE is widely used to assess the clinical performance of medical students. However, concerns related to cost, availability, and validity, have led educators to investigate alternatives to the OSCE. Some alternatives involve assessing students while they provide care to patients – the mini-CEX (mini-Clinical Evaluation Exercise and the Long Case are examples. We investigated the psychometrics of systematically observed clinical encounters (SOCEs, in which physicians are supplemented by lay trained observers, as a means of assessing the clinical performances of medical students.Methods: During the pediatrics clerkship at the University of Iowa, trained lay observers assessed the communication skills of third-year medical students using a communication checklist while the students interviewed and examined pediatric patients. Students then verbally presented their findings to faculty, who assessed students’ clinical skills using a standardized form. The reliability of the combined communication and clinical skills scores was calculated using generalizability theory.Results: Fifty-one medical students completed 199 observed patient encounters. The mean combined clinical and communication skills score (out of a maximum 45 points was 40.8 (standard deviation 3.3. The calculated reliability of the SOCE scores, using generalizability theory, from 10 observed patient encounters was 0.81. Students reported receiving helpful feedback from faculty after 97% of their observed clinical encounters.Conclusion: The SOCE can

  7. A Leadership Education and Development Program for Clinical Nurses.

    Science.gov (United States)

    Fitzpatrick, Joyce J; Modic, Mary Beth; Van Dyk, Jennifer; Hancock, K Kelly

    2016-11-01

    The Leadership Education and Development (LEAD) Program was designed to transform care at the bedside by empowering clinical nurses as leaders. The heart of LEAD was enhancing communication skills of clinical nurses with clinical colleagues and, most importantly, patients and families. Key concepts of leadership/management were included: personal awareness, personal leadership skills/abilities, leading change, leading others individually and in teams, enhancing the patient/provider experience, and the leadership role in outcomes management. A quantitative, longitudinal, survey design was used with 2 cohorts. The program consisted of six 4-hour sessions for 3 to 6 months. Leadership practices were measured before program implementation, at the end of the program, and 3 months after program completion. There were significant increases in leadership practices sustained 3 months after program completion. A range of other outcome measures was included. There is a need for additional leadership development programs for clinical nurses.

  8. Triangular model integrating clinical teaching and assessment

    Directory of Open Access Journals (Sweden)

    Abdelaziz A

    2014-03-01

    Full Text Available Adel Abdelaziz,1,2 Emad Koshak3 1Medical Education Development Unit, Faculty of Medicine, Al Baha University, Al Baha, Saudi Arabia; 2Medical Education Department, Faculty of Medicine, Suez Canal University, Egypt; 3Dean and Internal Medicine Department, Faculty of Medicine, Al Baha University, Al Baha, Saudi Arabia Abstract: Structuring clinical teaching is a challenge facing medical education curriculum designers. A variety of instructional methods on different domains of learning are indicated to accommodate different learning styles. Conventional methods of clinical teaching, like training in ambulatory care settings, are prone to the factor of coincidence in having varieties of patient presentations. Accordingly, alternative methods of instruction are indicated to compensate for the deficiencies of these conventional methods. This paper presents an initiative that can be used to design a checklist as a blueprint to guide appropriate selection and implementation of teaching/learning and assessment methods in each of the educational courses and modules based on educational objectives. Three categories of instructional methods were identified, and within each a variety of methods were included. These categories are classroom-type settings, health services-based settings, and community service-based settings. Such categories have framed our triangular model of clinical teaching and assessment. Keywords: curriculum development, teaching, learning, assessment, apprenticeship, community-based settings, health service-based settings

  9. Assessment of Undergraduate and Graduate Programs.

    Science.gov (United States)

    Rybacki, Donald; Lattimore, Dan

    1999-01-01

    Uses data from a national survey and from the 1998 National Communication Association Summer Conference to examine how achievement is measured among public-relations students. Finds that few academic programs assess learning outcomes and used the results to enhance their students' educational experiences. Suggests that educators place too much…

  10. Infectious Disease Clinical Research Program (IDCRP)

    Data.gov (United States)

    Federal Laboratory Consortium — Our mission is to conduct infectious disease clinical research of importance to the military through a unique, adaptive, and collaborative network, to inform health...

  11. Radiation detection technology assessment program (RADTAP)

    International Nuclear Information System (INIS)

    Smith, D.E.

    1998-01-01

    The U.S. Customs Service and the U.S. Department of Energy (DOE) conducted a technical and operational assessment of gamma ray radiation detection equipment during the period May 5-16, 1997 at a testing facility in North Carolina. The effort was entitled, ''Radiation Detection Technology Assessment Program (RADTAP)'', and was conducted for the purpose of assessing the applicability, sensitivity and robustness of a diverse suite of gamma ray detection and identification equipment for possible use by Customs and other law enforcement agencies. Thirteen companies entered 25 instruments into the assessment program. All detection equipment entered had to exhibit a minimum sensitivity of 20 micro-R per hour (background included) from a Cesium-137 point source. Isotope identifying spectrometers entered were man portable and operable at room temperature with read-out that could be interpreted by non-technical personnel. Radioactive sources used in the assessment included special nuclear material, industrial and health isotopes. Evaluators included Customs inspectors and technical experts from DOE and Customs. No conclusions or recommendations were issued based on the quantitative and qualitative test results, however, the results of the program provided law enforcement agencies with the necessary data to select equipment that best meets their operational needs and budgets. (author)

  12. Formative assessment of GP trainees' clinical skills.

    Science.gov (United States)

    Wiener-Ogilvie, Sharon; Begg, Drummond

    2012-03-01

    Clinical skill assessment (CSA) has been an integral part of the Royal College of General Practitioners' membership examination (MRCGP) since 2008. It is an expensive, high-stakes examination with first time pass rates ranging from 76.4 to 81.3. In this paper we describe the South East Scotland Deanery, NHS Education Scotland, pilot of a formative clinical skills assessment (fCSA) using the principles of formative assessment and OSCE. The purpose of the study was to assess the acceptability of the fCSA and to examine whether trainees, identified during the fCSA as 'at risk of failing the MRCGP CSA exam', are more likely to fail the MRCGP CSA exam later on in the year. Trainees were assessed in four clinical skills stations under exam conditions. After each station they were given verbal feedback and subsequently both trainee and their trainer received written feedback. We assessed the value of the exercise through written feedback from trainees and trainers. Each trainee's performance in fCSA was triangulated with trainer assessment to identify 'flagged trainees'. We compared flagged and non-flagged trainees' performance in MRCGP CSA. Both trainees and trainers highly rated the fCSA. Overall 97% of non-flagged trainees have passed the RCGP CSA exam by May of that year in comparison to 80% of flagged trainees who have passed the RCGP CSA (P = 0.005). Trainers and trainees rated the fCSA as excellent and useful. We were able to demonstrate that the fCSA can be used to identify those trainees likely to fail the RCGP CSA. Contrary to reservations about the potential to demoralise trainees, the fCSA was viewed as a useful and a positive experience by both trainees and trainers. In addition, we suggest that feedback from fCSA was useful in triggering appropriate educational interventions. Early intervention with trainees who are predicted to fail the CSA has the potential to reduce deaneries overall fail rate. Preventing one trainee failure could save over £30 000.

  13. Clinical risk assessment in intensive care unit

    Directory of Open Access Journals (Sweden)

    Saeed Asefzadeh

    2013-01-01

    Full Text Available Background: Clinical risk management focuses on improving the quality and safety of health care services by identifying the circumstances and opportunities that put patients at risk of harm and acting to prevent or control those risks. The goal of this study is to identify and assess the failure modes in the ICU of Qazvin′s Social Security Hospital (Razi Hospital through Failure Mode and Effect Analysis (FMEA. Methods: This was a qualitative-quantitative research by Focus Discussion Group (FDG performed in Qazvin Province, Iran during 2011. The study population included all individuals and owners who are familiar with the process in ICU. Sampling method was purposeful and the FDG group members were selected by the researcher. The research instrument was standard worksheet that has been used by several researchers. Data was analyzed by FMEA technique. Results: Forty eight clinical errors and failure modes identified, results showed that the highest risk probability number (RPN was in respiratory care "Ventilator′s alarm malfunction (no alarm" with the score 288, and the lowest was in gastrointestinal "not washing the NG-Tube" with the score 8. Conclusions: Many of the identified errors can be prevented by group members. Clinical risk assessment and management is the key to delivery of effective health care.

  14. CHOOZ-A expert assessment program

    International Nuclear Information System (INIS)

    Bouat, M.; Godin, R.

    1993-01-01

    CHOOZ-A Nuclear Power Plant, the first French-Belgian PWR unit (300 MWe) was definitively shut down at the end of October 1991, after 24 years in operation. Since summer 1991, the steering committee of the French (EDF) Lifetime Project has initiated a large inquiry to the different technical specialists of EDF and external organizations, trying to define a wide expert assessment program on this plant. The aim is to improve the knowledge of aging mechanisms such as those observed on the 52 PWR French nuclear power plants (900 and 1,300 MWe), and contribute to the validation of non-destructive in-service testing methods. This paper presents the retained CHOOZ-A expert assessment program and technical lines followed during its set up. First major project stages are described, then technical choices are explained, and at last the final program is presented with the specific content of each expert assessment. The definitive program is scheduled for a three year period starting at the moment of final shutdown license acquisition, with a provisional total budget of more than US $10 million

  15. Assessment of the NRC Enforcement Program

    International Nuclear Information System (INIS)

    Lieberman, J.; Coblentz, L.

    1995-04-01

    On May 12, 1994, the Executive Director for Operations (EDO) established a Review Team composed of senior NRC managers to re-examine the NRC enforcement program. A copy of the Review Team's charter is enclosed as Appendix A. This report presents the Team's assessment. The purpose of this review effort are: (1) to perform an assessment of the NRC's enforcement program to determine whether the defined purposes of the enforcement program are appropriate; (2) to determine whether the NRC's enforcement practices and procedures for issuing enforcement actions are consistent with those purposes; and (3) to provide recommendations on any changes the Review Team believes advisable. In accordance with its charter, the Review Team considered the following principal issues in conducting its assessment of the enforcement program: the balance between providing deterrence and incentives (both positive and negative) for the identification and correction of violations; the appropriateness of NRC sanctions; whether the commission should seek statutory authority to increase the amount of civil penalties; whether the NRC should use different enforcement policies and practices for different licensees (e.g., materials licensees in contrast to power reactors or large fuel facilities); and whether the commission should establish open enforcement conferences as the normal practice

  16. The radiation safety self-assessment program of Ontario Hydro

    International Nuclear Information System (INIS)

    Armitage, G.; Chase, W.J.

    1987-01-01

    Ontario Hydro has developed a self-assessment program to ensure that high quality in its radiation safety program is maintained. The self-assessment program has three major components: routine ongoing assessment, accident/incident investigation, and detailed assessments of particular radiation safety subsystems or of the total radiation safety program. The operation of each of these components is described

  17. Evaluating Integrative Cancer Clinics With the Claim Assessment Profile: An Example With the InspireHealth Clinic.

    Science.gov (United States)

    Hilton, Lara; Elfenbaum, Pamela; Jain, Shamini; Sprengel, Meredith; Jonas, Wayne B

    2018-03-01

    The evaluation of freestanding integrative cancer clinical programs is challenging and is rarely done. We have developed an approach called the Claim Assessment Profile (CAP) to identify whether evaluation of a practice is justified, feasible, and likely to provide useful information. A CAP was performed in order to (1) clarify the healing claims at InspireHealth, an integrative oncology treatment program, by defining the most important impacts on its clients; (2) gather information about current research capacity at the clinic; and (3) create a program theory and path model for use in prospective research. This case study design incorporates methods from a variety of rapid assessment approaches. Procedures included site visits to observe the program, structured qualitative interviews with 26 providers and staff, surveys to capture descriptive data about the program, and observational data on program implementation. The InspireHealth program is a well-established, multi-site, thriving integrative oncology clinical practice that focuses on patient support, motivation, and health behavior engagement. It delivers patient-centered care via a standardized treatment protocol. There arehigh levels of research interest from staff and resources by which to conduct research. This analysis provides the primary descriptive and claims clarification of an integrative oncology treatment program, an evaluation readiness report, a detailed logic model explicating program theory, and a clinical outcomes path model for conducting prospective research. Prospective evaluation of this program would be feasible and valuable, adding to our knowledge base of integrative cancer therapies.

  18. Electronuclear's safety culture assessment and enhancement program

    International Nuclear Information System (INIS)

    Selvatici, E.; Diaz-Francisco, J.M.; Diniz de Souza, V.

    2002-01-01

    The present paper describes the Eletronuclear's safety culture assessment and enhancement program. The program was launched by the company's top management one year after the creation of Eletronuclear in 1997, from the merging of two companies with different organizational cultures, the design and engineering company Nuclen and the nuclear directorate of the Utility Furnas, Operator of the Angra1 NPP. The program consisted of an assessment performed internally in 1999 with the support and advice of the IAEA. This assessment, performed with the help of a survey, pooled about 80% of the company's employees. The overall result of the assessment was that a satisfactory level of safety culture existed; however, a number of points with a considerable margin for improvement were also identified. These points were mostly related with behavioural matters such as motivation, stress in the workplace, view of mistakes, handling of conflicts, and last but not least a view by a considerable number of employees that a conflict between safety and production might exist. An Action Plan was established by the company managers to tackle these weak points. This Plan was issued as company guideline by the company's Directorate. The subsequent step was to detail and implement the different actions of the Plan, which is the phase that we are at present. In the detailing of the Action Plan, special care was taken to sum up efforts, avoiding duplication of work or competition with already existing programs. In this process it was identified that the company had a considerable number of initiatives directly related to organizational and safety culture improvement, already operational. These initiatives have been integrated in the detailed Action Plan. A new assessment, for checking the effectiveness of the undertaken actions, is planned for 2003. (author)

  19. Perceptions of a National Achievement Assessment Program

    Directory of Open Access Journals (Sweden)

    Marielle Simon

    2002-10-01

    Full Text Available The School Achievement Indicators Program (SAIP has been collecting data across Canada on 13- and 16-year-old student achievement in mathematics, in science, and in reading and writing since 1993. In 1999, it completed its second assessment cycle and was reviewed in Spring 2000. The review design included a survey of officials from all the school boards/districts that participated in the science assessment program held in 1999. The results of this study show that this stakeholder views as the most pressing issue for SAIP to succeed in its mandate, the need for development in four areas: a Increased teacher and student motivation to participate wholeheartedly in the program; b Effective dissemination options; c Leadership through innovation in teaching and in assessment practices despite high accountability orientation; and d Cost-effective, yet rigorous means of providing both snapshot information and longitudinal means of comparisons. Although universally appealing, such approaches have yet to be supported by sound educational theory and methodology.

  20. Clinical outcomes assessment in clinical trials to assess treatment of femoroacetabular impingement

    DEFF Research Database (Denmark)

    Harris-Hayes, Marcie; McDonough, Christine M; Leunig, Michael

    2013-01-01

    Patient-reported outcome measures are an important component of outcomes assessment in clinical trials to assess the treatment of femoroacetabular impingement (FAI). This review of disease-specific measures and instruments used to assess the generic quality of life and physical activity levels...... developed recently and have not been established in the literature. Although currently used generic and activity-level measures have limitations, as well, they should be considered, depending on the specific goals of the study. Additional research is needed to assess the properties of these measures fully...

  1. Bimodal Programming: A Survey of Current Clinical Practice.

    Science.gov (United States)

    Siburt, Hannah W; Holmes, Alice E

    2015-06-01

    The purpose of this study was to determine the current clinical practice in approaches to bimodal programming in the United States. To be specific, if clinicians are recommending bimodal stimulation, who programs the hearing aid in the bimodal condition, and what method is used for programming the hearing aid? An 11-question online survey was created and sent via email to a comprehensive list of cochlear implant programming centers in the United States. The survey was sent to 360 recipients. Respondents in this study represented a diverse group of clinical settings (response rate: 26%). Results indicate little agreement about who programs the hearing aids, when they are programmed, and how they are programmed in the bimodal condition. Analysis of small versus large implant centers indicated small centers are less likely to add a device to the contralateral ear. Although a growing number of cochlear implant recipients choose to wear a hearing aid on the contralateral ear, there is inconsistency in the current clinical approach to bimodal programming. These survey results provide evidence of large variability in the current bimodal programming practices and indicate a need for more structured clinical recommendations and programming approaches.

  2. Year-End Clinic Handoffs: A National Survey of Academic Internal Medicine Programs.

    Science.gov (United States)

    Phillips, Erica; Harris, Christina; Lee, Wei Wei; Pincavage, Amber T; Ouchida, Karin; Miller, Rachel K; Chaudhry, Saima; Arora, Vineet M

    2017-06-01

    While there has been increasing emphasis and innovation nationwide in training residents in inpatient handoffs, very little is known about the practice and preparation for year-end clinic handoffs of residency outpatient continuity practices. Thus, the latter remains an identified, yet nationally unaddressed, patient safety concern. The 2014 annual Association of Program Directors in Internal Medicine (APDIM) survey included seven items for assessing the current year-end clinic handoff practices of internal medicine residency programs throughout the country. Nationwide survey. All internal medicine program directors registered with APDIM. Descriptive statistics of programs and tools used to formulate a year-end handoff in the ambulatory setting, methods for evaluating the process, patient safety and quality measures incorporated within the process, and barriers to conducting year-end handoffs. Of the 361 APDIM member programs, 214 (59%) completed the Transitions of Care Year-End Clinic Handoffs section of the survey. Only 34% of respondent programs reported having a year-end ambulatory handoff system, and 4% reported assessing residents for competency in this area. The top three barriers to developing a year-end handoff system were insufficient overlap between graduating and incoming residents, inability to schedule patients with new residents in advance, and time constraints for residents, attendings, and support staff. Most internal medicine programs do not have a year-end clinic handoff system in place. Greater attention to clinic handoffs and resident assessment of this care transition is needed.

  3. Clinical capabilities of graduates of an outcomes-based integrated medical program

    Directory of Open Access Journals (Sweden)

    Scicluna Helen A

    2012-06-01

    Full Text Available Abstract Background The University of New South Wales (UNSW Faculty of Medicine replaced its old content-based curriculum with an innovative new 6-year undergraduate entry outcomes-based integrated program in 2004. This paper is an initial evaluation of the perceived and assessed clinical capabilities of recent graduates of the new outcomes-based integrated medical program compared to benchmarks from traditional content-based or process-based programs. Method Self-perceived capability in a range of clinical tasks and assessment of medical education as preparation for hospital practice were evaluated in recent graduates after 3 months working as junior doctors. Responses of the 2009 graduates of the UNSW’s new outcomes-based integrated medical education program were compared to those of the 2007 graduates of UNSW’s previous content-based program, to published data from other Australian medical schools, and to hospital-based supervisor evaluations of their clinical competence. Results Three months into internship, graduates from UNSW’s new outcomes-based integrated program rated themselves to have good clinical and procedural skills, with ratings that indicated significantly greater capability than graduates of the previous UNSW content-based program. New program graduates rated themselves significantly more prepared for hospital practice in the confidence (reflective practice, prevention (social aspects of health, interpersonal skills (communication, and collaboration (teamwork subscales than old program students, and significantly better or equivalent to published benchmarks of graduates from other Australian medical schools. Clinical supervisors rated new program graduates highly capable for teamwork, reflective practice and communication. Conclusions Medical students from an outcomes-based integrated program graduate with excellent self-rated and supervisor-evaluated capabilities in a range of clinically-relevant outcomes. The program

  4. Clinical Investigation Program, RCS MED-300 (RI).

    Science.gov (United States)

    1984-10-01

    protocol is a clinical validation study uti - lizing the BIOTRONIK DIPLOS 04 Dual Chamber Pulse Generator. This study is being conducted under an...recurrence-rates, survival-rates, and pattern of recurrence for patients receiving therapy uti - lizing surgery and postoperative radiation vs combined...placed in the treatment qroup or control aroup by the pharmacist . Progress: Terminate. Both the principal and associate investigators have ETS d. 7

  5. Psoriatic arthritis: An assessment of clinical, biochemical and ...

    African Journals Online (AJOL)

    , epidemiological, clinical and radiological studies of South African (SA) patients are scarce. Objectives. To assess clinical, biochemical and radiological features in a single-centre SA cohort. Methods. We conducted a prospective assessment ...

  6. Health risk assessment for program managers

    International Nuclear Information System (INIS)

    Jump, R.A.; Williamson, D.S.

    1994-01-01

    This paper presents the findings of a sensitivity analysis into the independent variables that determine the levels of health risks posed by buried plutonium and americium at a typical contaminated site in an arid region. Environmental Restoration Program Managers often must make decisions concerning cleanup levels, remediation alternatives, schedules, cost estimates, etc. based upon extraordinarily safe assumptions about risk assessment calculation inputs. This study reveals to the Program Manager which variables are major drivers to the calculated levels of risk posed by transuranic radionuclides and which ones have second order effects or less. The findings of this study should indicate which inputs should be the focus of attention during negotiations with regulators and of further empirical investigation

  7. Innovation in Rehabilitation Services and Clinical Programs for Health Care

    Directory of Open Access Journals (Sweden)

    Asghar Dadkhah

    2014-06-01

    Full Text Available Rehabilitation program is a critical piece of clinical care strategy in order to accelerate healing and improve quality of life to the fullest extent possible. An innovated program should have 3 inspiring concepts: Seek inspire and Advance. Seeking and evaluating is a breakthrough technology, innovative methodology and emerging trend in the healthcare industry. The program should inspire clinicians to critically evaluate and implement the highest standards of care. Also an innovated program should advance clinical program development to maximize opportunities for first to market positioning and community partnerships. The scope of program can be from psycho-rehabilitation to predictor in addiction (1-3, Cognitive and motor rehabilitation researchers are quite concerned about system wide biases that may impair development of innovative rehabilitation techniques. In this issue ....

  8. Environmental Hazards Assessment Program. Quarterly report, April--June 1995

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-07-31

    The objectives of this report are to: (1) develop a holistic, national basis for risk assessment, risk management, and risk communication that recognizes the direct impact of environmental hazards, both chemical and radiation, on the health and well-being of all; (2) develop a pool of talented scientists and experts in cleanup activities, especially in human health aspects; and (3) identify needs and develop programs addressing the critical shortage of well-educated, highly-skilled technical and scientific personnel to address the health oriented aspects of environmental restoration and waste management. This report describes the progress made this quarter in the following areas: public and professional outreach; science programs; clinical programs; and information support and access systems.

  9. Program grants for black lung clinics--PHS. Final rule.

    Science.gov (United States)

    1985-02-27

    The Public Health Service hereby revises the regulations governing the grants program for black lung clinics established under section 427(a) of the Federal Mine Safety and Health Act of 1977. The revision is in keeping with the Department of Health and Human Services' desire to remove as many programmatic burdens and restrictions from grantees as possible, while maintaining program integrity.

  10. Assessment of Clinical Criteria for Sepsis

    Science.gov (United States)

    Seymour, Christopher W.; Liu, Vincent X.; Iwashyna, Theodore J.; Brunkhorst, Frank M.; Rea, Thomas D.; Scherag, André; Rubenfeld, Gordon; Kahn, Jeremy M.; Shankar-Hari, Manu; Singer, Mervyn; Deutschman, Clifford S.; Escobar, Gabriel J.; Angus, Derek C.

    2016-01-01

    IMPORTANCE The Third International Consensus Definitions Task Force defined sepsis as “life-threatening organ dysfunction due to a dysregulated host response to infection.” The performance of clinical criteria for this sepsis definition is unknown. OBJECTIVE To evaluate the validity of clinical criteria to identify patients with suspected infection who are at risk of sepsis. DESIGN, SETTINGS, AND POPULATION Among 1.3 million electronic health record encounters from January 1, 2010, to December 31, 2012, at 12 hospitals in southwestern Pennsylvania, we identified those with suspected infection in whom to compare criteria. Confirmatory analyses were performed in 4 data sets of 706 399 out-of-hospital and hospital encounters at 165 US and non-US hospitals ranging from January 1, 2008, until December 31, 2013. EXPOSURES Sequential [Sepsis-related] Organ Failure Assessment (SOFA) score, systemic inflammatory response syndrome (SIRS) criteria, Logistic Organ Dysfunction System (LODS) score, and a new model derived using multivariable logistic regression in a split sample, the quick Sequential [Sepsis-related] Organ Failure Assessment (qSOFA) score (range, 0–3 points, with 1 point each for systolic hypotension [≤100 mm Hg], tachypnea [≥22/min], or altered mentation). MAIN OUTCOMES AND MEASURES For construct validity, pairwise agreement was assessed. For predictive validity, the discrimination for outcomes (primary: in-hospital mortality; secondary: in-hospital mortality or intensive care unit [ICU] length of stay ≥3 days) more common in sepsis than uncomplicated infection was determined. Results were expressed as the fold change in outcome over deciles of baseline risk of death and area under the receiver operating characteristic curve (AUROC). RESULTS In the primary cohort, 148 907 encounters had suspected infection (n = 74 453 derivation; n = 74 454 validation), of whom 6347 (4%) died. Among ICU encounters in the validation cohort (n = 7932 with suspected

  11. Clinical program leadership: skill requirements for contemporary leaders.

    Science.gov (United States)

    Spallina, Joseph M

    2002-01-01

    With knowledge of these leadership requirements and a shrinking base of experienced managers, healthcare organizations and professional societies have little choice in their approach to prepare for the leadership development challenges of the future. Organizations will focus leadership development, training, and continuing management education on integrating business tools and skills into clinical program management. The management requirements for clinical programs will continue to grow in complexity and the number of qualified managers will continue to diminish, New approaches to solving this shortage will evolve. Professional, forprofit companies, healthcare provider organizations, and academic programs will develop clinical program management training tracks. Organizations that create solutions to this management imperative will maintain their competitive edge in the challenging times that will greet the industry in the future.

  12. ITAC, an insider threat assessment computer program

    International Nuclear Information System (INIS)

    Eggers, R.F.; Giese, E.W.

    1988-01-01

    The insider threat assessment computer program, ITAC, is used to evaluate the vulnerability of nuclear material processing facilities to theft of special nuclear material by one or more authorized insider adversaries. The program includes two main parts: one is used to determine the timeliness of nuclear material accounting tests for loss of special nuclear material, and the other determines pathway aggregate detection probabilities for physical protection systems and material control procedures that could detect the theft. Useful features of ITAC include its ability to (1) evaluate and quantify the timeliness of material accounting tests, (2) analyze branching systems of physical pathways and adversary strategies, (3) analyze trickle or abrupt theft situations for combinations of insiders, (4) accept input probabilities and times in the form of ranges rather than discrete points, and (5) simulate input data using Monte Carlo methods to produce statistically distributed aggregate delay times and detection probabilities. The ITAC program was developed by the Security Applications Center of Westinghouse Hanford Comapny and Boeing Computer Services, Richland, WA

  13. 59th Medical Wing Clinical Research Division Clinical Investigations Program Pathology Poster

    Science.gov (United States)

    2017-04-28

    59 MDW/SGVU SUBJECT: Professional Presentation Approval 1. Your paper, entitled 59th Medical Wing Clinical Research Division Clinical Investigations...Program Pathology Poster presented at/published to For hanging in a hallway of the 591h Medical Wing Clinical Research Division, Bldg 4430 in...Graduate Health Sciences Education student and your department has told you they cannot fund your publication, the 59th Clinical Research Division may

  14. Assessment of the Fusion Energy Sciences Program. Final Report

    International Nuclear Information System (INIS)

    2001-01-01

    An assessment of the Office of Fusion Energy Sciences (OFES) program with guidance for future program strategy. The overall objective of this study is to prepare an independent assessment of the scientific quality of the Office of Fusion Energy Sciences program at the Department of Energy. The Fusion Science Assessment Committee (FuSAC) has been appointed to conduct this study

  15. Assessment of hospital pharmacists' clinical knowledge and ...

    African Journals Online (AJOL)

    reproduction in any medium, provided the original work is properly credited. ... drug use, which improves the quality of life. ... balance of clinical knowledge, practical skills, ... Ethical approval ... plans, clinical decision making, and finding the.

  16. Assessment and retrofit program at work

    Energy Technology Data Exchange (ETDEWEB)

    Schuyler, G [Rowan Williams Davies and Irwin Inc., Guelph, ON (Canada); Lethbridge, S [Owens-Corning, Guelph, ON (Canada)

    1993-10-01

    A glass plant in Ontario volunteered for an assessment as part of the Green Industry Assessment Retrofit Program. The project was intended to assess pollution prevention and reduction, water conservation, and energy utilization at the plant. The plant produces glass fibers and is a major user of natural gas and electricity, with a minimum electrical demand of 4 MW. Total waste heat in the flue gas from the gas-fired melting furnaces, relative to 25[degree]C, is over 5 MW. Nitrogen oxides are the predominant air emission at the plant. Glass fiber scrap constitutes the bulk of the solid wastes produced. Conservation opportunities were identified and their payback periods calculated. Options considered to be feasible included heat recovery and power generation from the furnace exhaust gases, and moving the air conditioning system intakes so they draw in cool air instead of hot air from the melter area. Bioremediation was considered to have good potential for treating the glass fiber wastes. Under this concept, the waste would be cycled through reactor cells containing microorganisms that could remove the binders and coatings on the fibers. At the end of this process, the glass fiber would be of sufficient quality that it could be recycled directly to the melter. 1 tab.

  17. Assessment of Student Outcomes in Undergraduate Health Information Administration Programs

    OpenAIRE

    Smith, Jody

    2006-01-01

    The purpose of this research was to a) determine what assessment methods are being used in undergraduate health information administration programs to assess student learning and the usefulness of those methods, b) determine to what extent programs have incorporated good student learning assessment practices. Programs use a variety of assessment tools to measure student learning; the most useful include assessments by the professional practice supervisor, course tests, assignments, presentati...

  18. Physiotherapy Student Clinical Examinations: The Influence of Subjective Judgments on Observational Assessment.

    Science.gov (United States)

    Alexander, Helen A.

    1996-01-01

    A study investigated the role of subjective assessment in the evaluation of physiotherapy students in clinical programs. Clinical teachers, visiting lecturers, and students recorded perceptions of daily events and interactions in journals. Analysis suggests that assessors make subjective judgments about students that influence grades, and…

  19. Translating Theory Into Practice: Implementing a Program of Assessment.

    Science.gov (United States)

    Hauer, Karen E; O'Sullivan, Patricia S; Fitzhenry, Kristen; Boscardin, Christy

    2018-03-01

    A program of assessment addresses challenges in learner assessment using a centrally planned, coordinated approach that emphasizes assessment for learning. This report describes the steps taken to implement a program of assessment framework within a medical school. A literature review on best practices in assessment highlighted six principles that guided implementation of the program of assessment in 2016-2017: (1) a centrally coordinated plan for assessment aligns with and supports a curricular vision; (2) multiple assessment tools used longitudinally generate multiple data points; (3) learners require ready access to information-rich feedback to promote reflection and informed self-assessment; (4) mentoring is essential to facilitate effective data use for reflection and learning planning; (5) the program of assessment fosters self-regulated learning behaviors; and (6) expert groups make summative decisions about grades and readiness for advancement. Implementation incorporated stakeholder engagement, use of multiple assessment tools, design of a coaching program, and creation of a learner performance dashboard. The assessment team monitors adherence to principles defining the program of assessment and gathers and responds to regular feedback from key stakeholders, including faculty, staff, and students. Next steps include systematically collecting evidence for validity of individual assessments and the program overall. Iterative review of student performance data informs curricular improvements. The program of assessment also highlights technology needs that will be addressed with information technology experts. The outcome ultimately will entail showing evidence of validity that the program produces physicians who engage in lifelong learning and provide high-quality patient care.

  20. Environmental Assessment Radioactive Source Recovery Program

    International Nuclear Information System (INIS)

    1995-01-01

    In a response to potential risks to public health and safety, the U.S. Department of Energy (DOE) is evaluating the recovery of sealed neutron sources under the Radioactive Source Recovery Program (RSRP). This proposed program would enhance the DOE's and the U.S. Nuclear Regulatory Commission's (NRC's) joint capabilities in the safe management of commercially held radioactive source materials. Currently there are no federal or commercial options for the recovery, storage, or disposal of sealed neutron sources. This Environmental Assessment (EA) analyzes the potential environmental impacts that would be expected to occur if the DOE were to implement a program for the receipt and recovery at the Los Alamos National Laboratory (LANL), Los Alamos, New Mexico, of unwanted and excess plutonium-beryllium ( 238 Pu-Be) and americium-beryllium ( 241 Am-Be) sealed neutron sources. About 1 kg (2.2 lb) plutonium and 3 kg (6.6 lb) americium would be recovered over a 15-year project. Personnel at LANL would receive neutron sources from companies, universities, source brokers, and government agencies across the country. These neutron sources would be temporarily stored in floor holes at the CMR Hot Cell Facility. Recovery reduces the neutron emissions from the source material and refers to a process by which: (1) the stainless steel cladding is removed from the neutron source material, (2) the mixture of the radioactive material (Pu-238 or Am-241) and beryllium that constitutes the neutron source material is chemically separated (recovered), and (3) the recovered Pu-238 or Am-241 is converted to an oxide form ( 238 PuO 2 or 241 AmO 2 ). The proposed action would include placing the 238 PuO 2 or 241 AmO 2 in interim storage in a special nuclear material vault at the LANL Plutonium Facility

  1. The Assessment of Patient Clinical Outcome: Advantages, Models, Features of an Ideal Model

    Directory of Open Access Journals (Sweden)

    Mou’ath Hourani

    2016-06-01

    Full Text Available Background: The assessment of patient clinical outcome focuses on measuring various aspects of the health status of a patient who is under healthcare intervention. Patient clinical outcome assessment is a very significant process in the clinical field as it allows health care professionals to better understand the effectiveness of their health care programs and thus for enhancing the health care quality in general. It is thus vital that a high quality, informative review of current issues regarding the assessment of patient clinical outcome should be conducted. Aims & Objectives: 1 Summarizes the advantages of the assessment of patient clinical outcome; 2 reviews some of the existing patient clinical outcome assessment models namely: Simulation, Markov, Bayesian belief networks, Bayesian statistics and Conventional statistics, and Kaplan-Meier analysis models; and 3 demonstrates the desired features that should be fulfilled by a well-established ideal patient clinical outcome assessment model. Material & Methods: An integrative review of the literature has been performed using the Google Scholar to explore the field of patient clinical outcome assessment. Conclusion: This paper will directly support researchers, clinicians and health care professionals in their understanding of developments in the domain of the assessment of patient clinical outcome, thus enabling them to propose ideal assessment models.

  2. The Assessment of Patient Clinical Outcome: Advantages, Models, Features of an Ideal Model

    Directory of Open Access Journals (Sweden)

    Mou’ath Hourani

    2016-06-01

    Full Text Available Background: The assessment of patient clinical outcome focuses on measuring various aspects of the health status of a patient who is under healthcare intervention. Patient clinical outcome assessment is a very significant process in the clinical field as it allows health care professionals to better understand the effectiveness of their health care programs and thus for enhancing the health care quality in general. It is thus vital that a high quality, informative review of current issues regarding the assessment of patient clinical outcome should be conducted. Aims & Objectives: 1 Summarizes the advantages of the assessment of patient clinical outcome; 2 reviews some of the existing patient clinical outcome assessment models namely: Simulation, Markov, Bayesian belief networks, Bayesian statistics and Conventional statistics, and Kaplan-Meier analysis models; and 3 demonstrates the desired features that should be fulfilled by a well-established ideal patient clinical outcome assessment model. Material & Methods: An integrative review of the literature has been performed using the Google Scholar to explore the field of patient clinical outcome assessment. Conclusion: This paper will directly support researchers, clinicians and health care professionals in their understanding of developments in the domain of the assessment of patient clinical outcome, thus enabling them to propose ideal assessment models.

  3. Practitioner perspectives on extended clinical placement programs in optometry.

    Science.gov (United States)

    Bentley, Sharon A; Cartledge, Amy; Guest, Daryl J; Cappuccio, Skye; Woods, Craig A

    2016-05-01

    Some universities are looking to provide a more diverse range of clinical learning experiences through extended clinical placement programs. This approach will potentially have a significant impact on practitioners. The aim of this study was to conduct a national survey of optometrists to ascertain their perspectives on participating in extended clinical placement programs. Members of Optometry Australia were invited to participate in a survey conducted during June and July 2014. A total of 268 practitioners participated (six per cent of registered Australian optometrists): 159 were predominantly employees or locums and 109 were owners or managers who identified as the key representative of a practice or organisation for the purpose of this survey. Almost two-thirds (65 per cent) of participants, who were employees or locums were supportive of extended clinical placement programs. Among this group, females were more likely to be supportive than males (p = 0.033). In comparison, just over one-third (34 per cent) of participants who were key decision-makers were supportive, with 30 per cent possibly supportive and 36 per cent not supportive. Among key decision-makers, males were more likely to be supportive (p = 0.009). The top three perceived advantages of supervising a student were: opportunity to mentor early career development, opportunity to give back to the profession and future recruitment. The top three perceived disadvantages were: burden on time, decrease in number of patients examined and burden on support staff. Suggested incentives for supervising students were credit for continuing professional development and financial remuneration. There appears to be moderate support for extended clinical placement programs; however, there are incentives that might engage a larger proportion of the profession in the future. These findings can inform the development of effective and sustainable clinical training programs for optometry students. Additionally

  4. Healthcare reform from the inside: A neurosurgical clinical quality program

    OpenAIRE

    Afsar-Manesh, Nasim; Martin, Neil A.

    2012-01-01

    During the past decade, the U.S. health care system has faced increasing challenges in delivering high quality of care, ensuring patient safety, providing access to care, and maintaining manageable costs. While reform progresses at a national level, health care providers have a responsibility and obligation to advance quality and safety. In 2009, the authors implemented a department-wide Clinical Quality Program. This Program comprised of an inter-disciplinary group of providers and staff wor...

  5. NANA Geothermal Assessment Program Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Jay Hermanson

    2010-06-22

    In 2008, NANA Regional Corporation (NRC) assessed geothermal energy potential in the NANA region for both heat and/or electricity production. The Geothermal Assessment Project (GAP) was a systematic process that looked at community resources and the community's capacity and desire to develop these resources. In October 2007, the US Department of Energy's Tribal Energy Program awarded grant DE-FG36-07GO17075 to NRC for the GAP studies. Two moderately remote sites in the NANA region were judged to have the most potential for geothermal development: (1) Granite Mountain, about 40 miles south of Buckland, and (2) the Division Hot Springs area in the Purcell Mountains, about 40 miles south of Shungnak and Kobuk. Data were collected on-site at Granite Mountain Hot Springs in September 2009, and at Division Hot Springs in April 2010. Although both target geothermal areas could be further investigated with a variety of exploration techniques such as a remote sensing study, a soil geochemical study, or ground-based geophysical surveys, it was recommended that on-site or direct heat use development options are more attractive at this time, rather than investigations aimed more at electric power generation.

  6. Assessment of hospital pharmacists' clinical knowledge and ...

    African Journals Online (AJOL)

    Purpose: To evaluate hospital pharmacists' clinical knowledge and practical skill levels for pharmaceutical care. Methods: A quasi-experimental prospective longitudinal study design was used to evaluate the level of clinical skills with problem-based learning (PBL) sessions. Pharmacists' in three different government ...

  7. Clinical Skills Assessment in the Twenty-First Century.

    Science.gov (United States)

    Elder, Andrew

    2018-05-01

    Clinical skills remain fundamental to the practice of medicine and form a core component of the professional identity of the physician. However, evidence exists to suggest that the practice of some clinical skills is declining, particularly in the United States. A decline in practice of any skill can lead to a decline in its teaching and assessment, with further decline in practice as a result. Consequently, assessment not only drives learning of clinical skills, but their practice. This article summarizes contemporary approaches to clinical skills assessment that, if more widely adopted, could support the maintenance and reinvigoration of bedside clinical skills. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  8. ITRAP. Illicit trafficking radiation detection assessment program

    International Nuclear Information System (INIS)

    Beck, P.

    2001-02-01

    Illicit trafficking in nuclear materials (nuclear criminality) has become more and more a problem, due to the circulation of the a high number of radioactive sources and the big amount of nuclear material, particularly, caused by the changes of the organisational infrastructures to supervise these material within the successor states of the former Soviet Union. The IAEA data base counts at present more than 300 verified cases. The endangering cased thereby ranges from possible health defect for the publication to terrorists activities and production of nuclear weapons. In addition to the primary criminal reasons the illegal deposal of radioactive sources as salvage, scrap and others show a further problem, which has lead to severe accidents and lethal effects in the past (e.g. Goiana, Mexiko). As the study ITRAP (Illicit Trafficking Radiation Assessment Program) can show, also in Austria the cases of partly considerable contaminated scrap transports from neighbouring countries exists. Some countries have already under taken countermeasures (e.g. Monitoring at the Finnish-Russian and German-Polish border, border monitoring in Italy). The International Atomic Energy Agency (IAEA) has reacted on this actual problem by setting up a new program to fight against nuclear criminality and has suggested a pilot study for the practical test of border monitoring systems. Aim of the study was to work out the technical requirements and the practicability of an useful monitoring system at border crossings. The results of the study will be offered by the IAEA to the member states as international recommendations for border monitoring systems. (author)

  9. Environmental hazards assessment program. Annual report, July 1, 1994--June 30, 1995

    International Nuclear Information System (INIS)

    1995-01-01

    This report describes activities and reports on progress for the third year of the DOE grant to support the Environmental Hazards Assessment Program (EHAP). It reports progress against grant objectives and the Program Implementation Plan published at the end of the first year of the grant. As the program has evolved, more projects have been funded and many existing projects have become more complex. Thus, to accomplish better the objectives over the years and retain a solid focus on the total mission, we have reorganized the grant effort from three to five majoe elements: Public and professional outreach; Clinical programs; Science programs; Information systems; and, Program management

  10. Environmental hazards assessment program. Annual report, July 1, 1994--June 30, 1995

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-07-31

    This report describes activities and reports on progress for the third year of the DOE grant to support the Environmental Hazards Assessment Program (EHAP). It reports progress against grant objectives and the Program Implementation Plan published at the end of the first year of the grant. As the program has evolved, more projects have been funded and many existing projects have become more complex. Thus, to accomplish better the objectives over the years and retain a solid focus on the total mission, we have reorganized the grant effort from three to five majoe elements: Public and professional outreach; Clinical programs; Science programs; Information systems; and, Program management.

  11. Program Description: Physical Therapy in a Heart Failure Clinic

    OpenAIRE

    Knocke, Ann

    2012-01-01

    Aerobic exercise and resistance training have been proven to be beneficial for patients with heart failure. Current reimbursement guidelines exclude these patients from our traditional cardiac rehabilitation program, so at Newton Wellesley Hospital a clinic model was developed for the disease management and exercise of heart failure patients.

  12. Optical projects in the Clinic program at Harvey Mudd College

    Science.gov (United States)

    Yang, Q.

    2017-08-01

    Clinic program is the senior capstone program at Harvey Mudd College (HMC). Multidisciplinary and industry-sponsored projects allow a team of students to solve a real-world problem over one academic year. Over its 50 plus years, Clinic program has completed numerous optics related projects. This report gives an overview of the Clinic program, reviews recent optical projects and discusses how this program supports the learning of the HMC engineering students. A few sample optical projects with more details are presented to provide an insight of what challenges that undergraduates can overcome. Students achieve learning within the optics discipline and the related engineering disciplines. The experiences in these optical projects indicate the great potential to bringing optical hands-on projects into the undergraduate level. Because of the general engineering curriculum at HMC, these projects often work the best with a multidisciplinary nature even if the core of the project is optically focused. Students gain leadership training, oral and written communication skills and experiences in team work. Close relationship with the sponsor liaisons allows for the students to gain skills in professional conduct, management of tight schedule and a specified budget, and it well prepares the students to their engineering practice. Optical projects have their own sets of specific challenges, so it needs to be chosen properly to match the undergraduate skill sets such as those of HMC engineering students.

  13. Characteristics of Volunteer Coaches in a Clinical Process Improvement Program.

    Science.gov (United States)

    Morley, Katharine E; Barysauskas, Constance M; Carballo, Victoria; Kalibatas, Orinta; Rao, Sandhya K; Jacobson, Joseph O; Cummings, Brian M

    The Partners Clinical Process Improvement Leadership Program provides quality improvement training for clinicians and administrators, utilizing graduates as volunteer peer coaches for mentorship. We sought to understand the factors associated with volunteer coach participation and gain insight into how to improve and sustain this program. Review of coach characteristics from course database and survey of frequent coaches. Out of 516 Partners Clinical Process Improvement Leadership Program graduates from March 2010 to June 2015, 117 (23%) individuals volunteered as coaches. Sixty-one (52%) individuals coached once, 31 (27%) coached twice, and 25 (21%) coached 3 or more times. There were statistically significant associations between coaching and occupation (P = .005), Partners Clinical Process Improvement Leadership Program course taken (P = .001), and course location (P = .007). Administrators were more likely to coach than physicians (odds ratio: 1.75, P = .04). Reasons for volunteering as a coach included further development of skills, desire to stay involved with program, and enjoying mentoring. Reasons for repeated coaching included maintaining quality improvement skills, expanding skills to a wider variety of projects, and networking. A peer graduate volunteer coach model is a viable strategy for interprofessional quality improvement mentorship. Strategies that support repeat coaching and engage clinicians should be promoted to ensure an experienced and diversified group of coaches.

  14. A CAD (Classroom Assessment Design) of a Computer Programming Course

    Science.gov (United States)

    Hawi, Nazir S.

    2012-01-01

    This paper presents a CAD (classroom assessment design) of an entry-level undergraduate computer programming course "Computer Programming I". CAD has been the product of a long experience in teaching computer programming courses including teaching "Computer Programming I" 22 times. Each semester, CAD is evaluated and modified…

  15. NANA Wind Resource Assessment Program Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Jay Hermanson

    2010-09-23

    NANA Regional Corporation (NRC) of northwest Alaska is located in an area with abundant wind energy resources. In 2007, NRC was awarded grant DE-FG36-07GO17076 by the US Department of Energy's Tribal Energy Program for funding a Wind Resource Assessment Project (WRAP) for the NANA region. The NANA region, including Kotzebue Electric Association (KEA) and Alaska Village Electric Cooperative (AVEC) have been national leaders at developing, designing, building, and operating wind-diesel hybrid systems in Kotzebue (starting in 1996) and Selawik (2002). Promising sites for the development of new wind energy projects in the region have been identified by the WRAP, including Buckland, Deering, and the Kivalina/Red Dog Mine Port Area. Ambler, Shungnak, Kobuk, Kiana, Noorvik & Noatak were determined to have poor wind resources at sites in or very near each community. However, all five of these communities may have better wind resources atop hills or at sites with slightly higher elevations several miles away.

  16. Summative clinical competency assessment: A survey of ultrasound practitioners' views.

    Science.gov (United States)

    Harrison, Gill

    2015-02-01

    Clinical competency and the assessment of core skills is a crucial element of any programme leading to an award with a clinical skills component. This has become a more prominent feature of current reports on quality health care provision. This project aimed to determine ultrasound practitioners' opinions about how best to assess clinical competency. An on-line questionnaire was sent to contacts from the Consortium for the Accreditation of Sonographic Education and details distributed at the British Medical Ultrasound Society conference in 2011. One hundred and sixteen responses were received from a range of clinical staff with an interest in ultrasound assessment. The majority of respondents suggested that competency assessments should take place in the clinical departments with or without an element of assessment at the education centre. Moderation was an important area highlighted by respondents, with 84% of respondents suggesting that two assessors were required and 66% of those stating some element of external moderation should be included. The findings suggest that respondents' preference is for some clinical competency assessments to take place on routine lists within the clinical department, assessed by two people one of which would be an external assessor. In view of recent reports relating to training and assessment of health care professionals, the ultrasound profession needs to begin the debate about how best to assess clinical competence and ensure appropriate first post-competency of anyone undertaking ultrasound examinations.

  17. Clinical Music Study Quality Assessment Scale (MUSIQUAS)

    NARCIS (Netherlands)

    Jaschke, A.C.; Eggermont, L.H.P.; Scherder, E.J.A.; Shippton, M.; Hiomonides, I.

    2013-01-01

    AIMS Quality assessment of studies is essential for the understanding and application of these in systematic reviews and meta analyses, the two “gold standards” of medical sciences. Publications in scientific journals have extensively used assessment scales to address poor methodological quality,

  18. Advanced Science for Kids: Multicultural Assessment and Programming.

    Science.gov (United States)

    Bettac, Teresa; Huckabee, Colleen; Musser, Louise; Patton, Paulette; Yates, Joyce

    1997-01-01

    Describes Advanced Science for Kids (ASK), a multicultural approach to assessment and programming for a middle school advanced science program. ASK is designed to provide alternative approaches to identification and assessment, facilitate authentic instruction and assessment, and provide minority students with academic and social support as they…

  19. Legal aspects associated with dismissal from clinical laboratory education programs.

    Science.gov (United States)

    Legrys, V A; Beck, S J; Laudicina, R J

    1995-01-01

    To review academic dismissals, students' rights in dismissal cases, and several key cases involving academic and disciplinary dismissals. Recent academic literature and legal precedents. Not applicable. Not applicable. Students involved in dismissals are protected under the principles of constitutional law and/or contract law, depending on whether the institution is public or private. The basis for dismissal from educational programs is either academic or disciplinary in nature. In academic dismissals, a student has failed to meet either the cognitive or the noncognitive academic standards of the program. In disciplinary dismissals, a student has violated the institutional rules governing conduct. Policies that affect progress in the program and the dismissal process should be published and distributed to students, as well as reviewed for consistency with institutional policies. The amount of documentation needed in the defense of a dismissal decision has not been specified, but, in general, more is better. Procedures are suggested as a guide to dismissals in clinical laboratory programs.

  20. Clinical Considerations in the Assessment of Adolescent Chemical Dependency.

    Science.gov (United States)

    Winters, Ken

    1990-01-01

    Discusses relevant research findings of clinical assessment of adolescent chemical dependency so that service providers can better address these concerns. Three major issues are discussed: the definition of adolescent chemical dependency, clinical domains of assessment (chemical use problem severity, precipitating and perpetuating risk factors,…

  1. Clinical Reasoning: Survey of Teaching Methods, Integration, and Assessment in Entry-Level Physical Therapist Academic Education.

    Science.gov (United States)

    Christensen, Nicole; Black, Lisa; Furze, Jennifer; Huhn, Karen; Vendrely, Ann; Wainwright, Susan

    2017-02-01

    Although clinical reasoning abilities are important learning outcomes of physical therapist entry-level education, best practice standards have not been established to guide clinical reasoning curricular design and learning assessment. This research explored how clinical reasoning is currently defined, taught, and assessed in physical therapist entry-level education programs. A descriptive, cross-sectional survey was administered to physical therapist program representatives. An electronic 24-question survey was distributed to the directors of 207 programs accredited by the Commission on Accreditation in Physical Therapy Education. Descriptive statistical analysis and qualitative content analysis were performed. Post hoc demographic and wave analyses revealed no evidence of nonresponse bias. A response rate of 46.4% (n=96) was achieved. All respondents reported that their programs incorporated clinical reasoning into their curricula. Only 25% of respondents reported a common definition of clinical reasoning in their programs. Most respondents (90.6%) reported that clinical reasoning was explicit in their curricula, and 94.8% indicated that multiple methods of curricular integration were used. Instructor-designed materials were most commonly used to teach clinical reasoning (83.3%). Assessment of clinical reasoning included practical examinations (99%), clinical coursework (94.8%), written examinations (87.5%), and written assignments (83.3%). Curricular integration of clinical reasoning-related self-reflection skills was reported by 91%. A large number of incomplete surveys affected the response rate, and the program directors to whom the survey was sent may not have consulted the faculty members who were most knowledgeable about clinical reasoning in their curricula. The survey construction limited some responses and application of the results. Although clinical reasoning was explicitly integrated into program curricula, it was not consistently defined, taught, or

  2. New Clinical Faculty Training Program: Transforming Practicing Dentists into Part-Time Dental Faculty Members.

    Science.gov (United States)

    Adams, Brooke N; Kirkup, Michele L; Willis, Lisa H; Reifeis, Paul E

    2017-06-01

    At Indiana University School of Dentistry, a New Clinical Faculty Training (NCFT) program was created with the primary goals of informing new part-time faculty members of clinical policies and assessment guidelines and thus developing qualified and satisfied faculty members. The aim of this study was to determine if participation in the training program improved the participants' satisfaction and competence in comparison to their colleagues who did not participate in the program. Two cohorts were compared: a control group of part-time faculty members who did not receive formal training when they were hired (n=21; response rate 58.3%); and the intervention group, who had participated in the NCFT program (n=12; response rate 80%). A survey of faculty members in the control group gathered information on their experiences when initially hired, and a pretest was administered to measure their knowledge of clinical policies. After the control group was given an overview of the program, their feedback was collected through post surveys, and a posttest identical to the pretest was given that found statistically significant increases on questions one (p=0.003) and four (p=0.025). In February 2014, 15 new faculty members participated in the pilot implementation of the NCFT program. Of those 15, 12 (the intervention group) completed follow-up surveys identical to the pre survey used with the control group. Statistically significant differences were found for the factors clinical teaching (p=0.005) and assessment training (p=0.008) with better responses for the NCFT group. These results suggest that participation in the program was associated with improved clinical teaching knowledge and job satisfaction.

  3. Summary results of an assessment of research projects in the Nuclear Medicine Research program

    International Nuclear Information System (INIS)

    1988-01-01

    In May 1987, OHER management requested the Office of Program Analysis (OPA) to conduct a peer review of the projects of the DOE Nuclear Medicine Research program. This was done using procedures and a quantitative methodology OPA developed for assessing DOE research programs. Sixty-three individual nuclear medicine projects were reviewed by seven panels; one panel on isotopes and radioisotopes, three on radiopharmacology, two on clinical feasibility, and one on instrumentation. Each panel consisted of five to ten knowledgeable reviewers. 5 figs

  4. A clinical assessment tool used for physiotherapy students--is it reliable?

    Science.gov (United States)

    Lewis, Lucy K; Stiller, Kathy; Hardy, Frances

    2008-01-01

    Educational institutions providing professional programs such as physiotherapy must provide high-quality student assessment procedures. To ensure that assessment is consistent, assessment tools should have an acceptable level of reliability. There is a paucity of research evaluating the reliability of clinical assessment tools used for physiotherapy students. This study evaluated the inter- and intrarater reliability of an assessment tool used for physiotherapy students during a clinical placement. Five clinical educators and one academic participated in the study. Each rater independently marked 22 student written assessments that had been completed by students after viewing a videotaped patient physiotherapy assessment. The raters repeated the marking process 7 weeks later, with the assessments provided in a randomised order. The interrater reliability (Intraclass Correlation Coefficient) for the total scores was 0.32, representing a poor level of reliability. A high level of intrarater reliability (percentage agreement) was found for the clinical educators, with a difference in section scores of one mark or less on 93.4% of occasions. Further research should be undertaken to reevaluate the reliability of this clinical assessment tool following training. The reliability of clinical assessment tools used in other areas of physiotherapy education should be formally measured rather than assumed.

  5. [Clinical tools for assessing hair loss].

    Science.gov (United States)

    del Marmol, V; Jouanique, C

    2004-09-01

    The complaint of hair loss is quite frequent but merits close attention because it can be very stressful to the patient. A simple examination will allow in most cases to define the origin of the hair loss and reassure the patient rapidly as to its likely evolution if it is reversible. The examination must take into account the medical, chirurgical, gynaecological and dietary antecedents and the cosmetic habits. These elements must be situated in time and complemented by a clinical examination to define the loss as diffuse or localised and in the latter case, expose scar damage. The clinical examination will be associated with a trichogram and in certain cases with a biopsy or a squam prelevement. Further, the blood can be analysed for different metabolically and hormonal elements. Finally, the treatments already administered must be known in order to identify the beneficial and secondary effects, which will allow the definition of a new treatment, if required.

  6. Clinical Assessment Applications of Ambulatory Biosensors

    Science.gov (United States)

    Haynes, Stephen N.; Yoshioka, Dawn T.

    2007-01-01

    Ambulatory biosensor assessment includes a diverse set of rapidly developing and increasingly technologically sophisticated strategies to acquire minimally disruptive measures of physiological and motor variables of persons in their natural environments. Numerous studies have measured cardiovascular variables, physical activity, and biochemicals…

  7. Generic Assessment Rubrics for Computer Programming Courses

    Science.gov (United States)

    Mustapha, Aida; Samsudin, Noor Azah; Arbaiy, Nurieze; Mohammed, Rozlini; Hamid, Isredza Rahmi

    2016-01-01

    In programming, one problem can usually be solved using different logics and constructs but still producing the same output. Sometimes students get marked down inappropriately if their solutions do not follow the answer scheme. In addition, lab exercises and programming assignments are not necessary graded by the instructors but most of the time…

  8. Clinical experimental stress studies: methods and assessment.

    Science.gov (United States)

    Bali, Anjana; Jaggi, Amteshwar Singh

    2015-01-01

    Stress is a state of threatened homeostasis during which a variety of adaptive processes are activated to produce physiological and behavioral changes. Stress induction methods are pivotal for understanding these physiological or pathophysiological changes in the body in response to stress. Furthermore, these methods are also important for the development of novel pharmacological agents for stress management. The well-described methods to induce stress in humans include the cold pressor test, Trier Social Stress Test, Montreal Imaging Stress Task, Maastricht Acute Stress Test, CO2 challenge test, Stroop test, Paced Auditory Serial Addition Task, noise stress, and Mannheim Multicomponent Stress Test. Stress assessment in humans is done by measuring biochemical markers such as cortisol, cortisol awakening response, dexamethasone suppression test, salivary α-amylase, plasma/urinary norepinephrine, norepinephrine spillover rate, and interleukins. Physiological and behavioral changes such as galvanic skin response, heart rate variability, pupil size, and muscle and/or skin sympathetic nerve activity (microneurography) and cardiovascular parameters such as heart rate, blood pressure, and self-reported anxiety are also monitored to assess stress response. This present review describes these commonly employed methods to induce stress in humans along with stress assessment methods.

  9. Conceptual Models and Guidelines for Clinical Assessment of Financial Capacity.

    Science.gov (United States)

    Marson, Daniel

    2016-09-01

    The ability to manage financial affairs is a life skill of critical importance, and neuropsychologists are increasingly asked to assess financial capacity across a variety of settings. Sound clinical assessment of financial capacity requires knowledge and appreciation of applicable clinical conceptual models and principles. However, the literature has presented relatively little conceptual guidance for clinicians concerning financial capacity and its assessment. This article seeks to address this gap. The article presents six clinical models of financial capacity : (1) the early gerontological IADL model of Lawton, (2) the clinical skills model and (3) related cognitive psychological model developed by Marson and colleagues, (4) a financial decision-making model adapting earlier decisional capacity work of Appelbaum and Grisso, (5) a person-centered model of financial decision-making developed by Lichtenberg and colleagues, and (6) a recent model of financial capacity in the real world developed through the Institute of Medicine. Accompanying presentation of the models is discussion of conceptual and practical perspectives they represent for clinician assessment. Based on the models, the article concludes by presenting a series of conceptually oriented guidelines for clinical assessment of financial capacity. In summary, sound assessment of financial capacity requires knowledge and appreciation of clinical conceptual models and principles. Awareness of such models, principles and guidelines will strengthen and advance clinical assessment of financial capacity. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  10. Residency Programs and Clinical Leadership Skills Among New Saudi Graduate Nurses.

    Science.gov (United States)

    Al-Dossary, Reem Nassar; Kitsantas, Panagiota; Maddox, P J

    2016-01-01

    Nurse residency programs have been adopted by health care organizations to assist new graduate nurses with daily challenges such as intense working environments, increasing patient acuity, and complex technologies. Overall, nurse residency programs are proven beneficial in helping nurses transition from the student role to independent practitioners and bedside leaders. The purpose of this study was to assess the impact of residency programs on leadership skills of new Saudi graduate nurses who completed a residency program compared to new Saudi graduate nurses who did not participate in residency programs. The study design was cross-sectional involving a convenience sample (n = 98) of new graduate nurses from three hospitals in Saudi Arabia. The Clinical Leadership Survey was used to measure the new graduate nurses' clinical leadership skills based on whether they completed a residency program or not. Descriptive statistics, correlation, and multiple linear regression analyses were conducted to examine leadership skills in this sample of new Saudi graduate nurses. A significant difference was found between residents and nonresidents in their leadership skills (t = 10.48, P = .000). Specifically, residents were significantly more likely to show higher levels of leadership skills compared to their counterparts. Attending a residency program was associated with a significant increase in clinical leadership skills. The findings of this study indicate that there is a need to implement more residency programs in hospitals of Saudi Arabia. It is imperative that nurse managers and policy makers in Saudi Arabia consider these findings to improve nurses' leadership skills, which will in turn improve patient care. Further research should examine how residency programs influence new graduate nurses' transition from student to practitioner with regard to clinical leadership skills in Saudi Arabia. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Meta-Review: Systematic Assessment of Program Review

    Science.gov (United States)

    Harlan, Brian

    2012-01-01

    Over 20 years ago, Robert J. Barak and Barbara E. Breier suggested incorporating a regular assessment of the entire program review system into the review schedule in order to ensure that the system itself is as efficient and effective as the programs under review. Barak and Breier's seminal book on the goals and processes of program review has…

  12. Fiduciary Systems Assessment : Maharashtra Rural Water Supply and Sanitation Program

    OpenAIRE

    World Bank

    2014-01-01

    A fiduciary systems assessment (FSA) was carried out to evaluate the arrangements relevant to the program and to determine whether they provide reasonable assurance that the program funds will be used for their intended purpose. Taking into account the improvements required and the agreement on the actions required to strengthen the systems (which are reflected in the program action plan (...

  13. Fatality Assessment and Control Evaluation (FACE) Program

    Data.gov (United States)

    U.S. Department of Health & Human Services — Each day, between 12 to 13 U.S. workers die as a result of a traumatic injury on the job. Investigations conducted through the FACE program allow the identification...

  14. 78 FR 59866 - New Car Assessment Program (NCAP)

    Science.gov (United States)

    2013-09-30

    ... further commented that additional consideration should be given to autonomous vehicle controls that may... [Docket No. NHTSA-2013-0076] New Car Assessment Program (NCAP) AGENCY: National Highway Traffic Safety... Car Assessment Program (NCAP) that the agency announced in its June 26, 2013 request for comments (78...

  15. Outcomes Assessment in Accredited Health Information Management Programs

    Science.gov (United States)

    Bennett, Dorine

    2010-01-01

    The purpose of this study was to determine the use and perceived usefulness of outcomes assessment methods in health information management programs. Additional characteristics of the outcomes assessment practices were recognized. The findings were evaluated for significant differences in results based on age of the program, type of institution,…

  16. Assessment of military population-based psychological resilience programs.

    Science.gov (United States)

    Morgan, Brenda J; Bibb, Sandra C Garmon

    2011-09-01

    Active duty service members' (ADSMs) seemingly poor adaptability to traumatic stressors is a risk to force health. Enhancing the psychological resilience of ADSMs has become a key focus of Department of Defense (DoD) leaders and the numbers of military programs for enhancing psychological resilience have increased. The purpose of this article is to describe the results of an assessment conducted to determine comprehensiveness of current psychological resilience building programs that target ADSMs. A modified six-step, population-based needs assessment was used to evaluate resilience programs designed to meet the psychological needs of the ADSM population. The assessment results revealed a gap in published literature regarding program outcomes. DoD leaders may benefit from targeted predictive research that assesses program effectiveness outcomes. The necessity of including preventive, evidence-based interventions in new programs, such as positive emotion interventions shown to enhance psychological resilience in civilian samples, is also recommended.

  17. Learning clinical communication skills: outcomes of a program for professional practitioners.

    Science.gov (United States)

    Carvalho, Irene P; Pais, Vanessa G; Almeida, Susana S; Ribeiro-Silva, Raquel; Figueiredo-Braga, Margarida; Teles, Ana; Castro-Vale, Ivone; Mota-Cardoso, Rui

    2011-07-01

    To assess the effects of a communication skills program on professional practitioners' performance and self-confidence in clinical interviewing. Twenty-five health professionals took 3 months of basic communication skills followed by 3 months of advanced communication skills. An additional quarter dealt with self-awareness and communication in special situations. Participants' performances were evaluated in clinical interviews with standardized patients before, during and after the program by external observers and standardized patients, using standardized instruments. Participants assessed their own confidence in their communication skills before and after the program. Data were analysed using GLM repeated-measures procedures in SPSS. Basic communication skills and self-confidence improved throughout the 6 months; competencies declined but self-confidence continued to increase 4 months later. Compared with taking no course, differences were statistically significant after the 6 months (external observers only) and 4 months later (external observers and participants). The program effectively improved communication skills, although significantly only when assessed by external observers. Four months later, effects were significant in communication skills (external observers), despite the decline and in self-confidence. While periodical enrollment in programs for the practice of communication skills may help maintain performance, more knowledge on communication and self-awareness may enhance self-confidence. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  18. Assessing the effects of employee assistance programs: a review of employee assistance program evaluations.

    OpenAIRE

    Colantonio, A.

    1989-01-01

    Employee assistance programs have grown at a dramatic rate, yet the effectiveness of these programs has been called into question. The purpose of this paper was to assess the effectiveness of employee assistance programs (EAPs) by reviewing recently published EAP evaluations. All studies evaluating EAPs published since 1975 from peer-reviewed journals in the English language were included in this analysis. Each of the articles was assessed in the following areas: (a) program description (subj...

  19. Self-assessment program and actions in ANAV

    International Nuclear Information System (INIS)

    2004-01-01

    Since 1999, the Association Nuclear Asco-Vandellos II, AIE (ANAV) has a self-assessment program in place and controls and tracks the actions with the support of different databases. This article describes the improvements made in the self-assessment programs and actions of ANAV between 1999 up to the present, all the fruit of the experience gained in the application of these programs, Sector guidelines and international trends, as well as standardization with the other Spanish nuclear power plants. (Author)

  20. Clinical Significance: a Therapeutic Approach Topsychological Assessment in Treatment Planning

    Directory of Open Access Journals (Sweden)

    Afolabi Olusegun Emmanuel

    2015-06-01

    Full Text Available Psychological assessment has long been reported as a key component of clinical psychology. This paper examines the complexities surrounding the clinical significance of therapeutic approach to treatment planning. To achieve this objective, the paper searched and used the PsycINFO and PubMed databases and the reference sections of chapters and journal articles to analysed, 1 a strong basis for the usage of therapeutic approach to psychological assessment in treatment plans, 2 explained the conceptual meaning of clinical significant change in therapeutic assessment, 3 answered some of the questions regarding practicability and the clinical significance of therapeutic approach to treatment plans, particularly during or before treatment, 4 linked therapeutic assessment to change in clients’ clinical impression, functioning and therapeutic needs 5 analysed the empirically documenting clinically significant change in therapeutic assessment. Finally, the study suggested that though therapeutic assessment is not sufficient for the systematic study of psychotherapy outcome and process, it is still consistent with both the layman and professional expectations regarding treatment outcome and also provides a precise method for classifying clients as ‘changed’ or ‘unchanged’ on the basis of clinical significance criteria.

  1. The impact of family planning clinic programs on adolescent pregnancy.

    Science.gov (United States)

    Forrest, J D; Hermalin, A I; Henshaw, S K

    1981-01-01

    During the 1970s, there was a decline in adolescent childbearing in the United States and, among teenagers who were sexually active, there was a decline in pregnancy rates as well. To what extent was increased enrollment by teenagers in federally funded family planning clinics responsible for these declines? Areal multivariate analysis reveals that adolescent birthrates were reduced between 1970 and 1975 as the result of enrollment by teenagers in family planning clinics, independent of the effects of other factors also affecting fertility, such as poverty status, education and urbanization. Using a model which controls for differences in adolescent sexual activity in different areas in 1970 and 1975, the analysis found that for every 10 teenage patients enrolled in family planning clinics in 1975, about one birth was averted in 1976. Other multivariate models, which did not control for differences in sexual activity, showed changes in the same direction, though of smaller dimension. Since the family planning program averts not only births but also pregnancies that result in abortions and miscarriages, an estimate was made of the total number of pregnancies averted by the program. Based on the proportion of unintended pregnancies among adolescents that resulted in live births in 1976 (36 percent), it was estimated that for every 10 teen patients enrolled in 1975, almost three pregnancies were averted in the following year. Over the 1970s, an estimated 2.6 million unintended adolescent pregnancies were averted by the program--944,000 births, 1,376,000 abortions and 326,000 miscarriages. In 1979 alone, an estimated 417,000 unintended pregnancies were prevented by the program.

  2. Assessment of obese children and adolescents: a survey of pediatric obesity-management programs.

    Science.gov (United States)

    Eisenmann, Joey C

    2011-09-01

    This article provides descriptive information on the assessments conducted in stage 3 or 4 pediatric obesity-management programs associated with National Association of Children's Hospital and Related Institutions hospitals enrolled in FOCUS on a Fitter Future. Eighteen institutions completed a survey that considered the following assessments: patient/family medical history; physical examination; blood pressure; body size and composition; blood chemistry; aerobic fitness; resting metabolic rate; muscle strength and flexibility; gross motor function; spirometry; sedentary behavior and physical activity; dietary behavior and nutrition; and psychological assessments. Frequency distributions were determined for each question. Overall, the results indicate that most programs that participated in this survey were following 2007 Expert Committee assessment recommendations; however, a variety of measurement tools were used. The variation in assessment tools, protocols, etc is partially caused by the program diversity dictated by personnel, both in terms of number and duties. It also shows the challenges in standardizing methodologies across clinics if we hope to establish a national registry for pediatric obesity clinics. In addition to providing a better understanding of the current assessment practices in pediatric obesity-management programs, the results provided herein should assist other clinics/hospitals that are developing pediatric obesity programs.

  3. Assessing Interdisciplinary Education in U.S. Dental Hygiene Programs.

    Science.gov (United States)

    Holt, Lorie; Bray, Kimberly; Mayberry, Bill; Overman, Pamela

    2000-01-01

    Survey responses from 136 of 216 dental hygiene programs indicated that 31% included interdisciplinary activities in the curriculum; only 15% included both clinical and instructional interdisciplinary coursework. However, 74% felt that students would benefit from interdisciplinary experiences. (SK)

  4. 75 FR 4827 - Submission for OMB Review; Comment Request Clinical Trials Reporting Program (CTRP) Database (NCI)

    Science.gov (United States)

    2010-01-29

    ... subsequent comment concerning corruption in clinical trials conducted by large pharmaceutical companies. The... Collection: Title: Clinical Trials Reporting Program (CTRP) Database. Type of Information Collection Request... institutions. Type of Respondents: Clinical research administrators on behalf of clinical investigators. The...

  5. Second Line of Defense Spares Program Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Henderson, Dale L.; Muller, George; Mercier, Theresa M.; Brigantic, Robert T.; Perkins, Casey J.; Cooley, Scott K.

    2012-11-20

    The Office of the Second Line of Defense (SLD) is part of the Department of Energy‘s (DOE) National Nuclear Security Administration (NNSA). The SLD Program accomplishes its critical global security mission by forming cooperative relationships with partner countries to install passive radiation detection systems that augment traditional inspection and law enforcement measures by alerting border officials to the presence of special nuclear or other radiological materials in cross-border traffic. An important tenet of the program is to work collaboratively with these countries to establish the necessary processes, procedures, infrastructure and conditions that will enable them to fully assume the financial and technical responsibilities for operating the equipment. As the number of operational deployments grows, the SLD Program faces an increasingly complex logistics process to promote the timely and efficient supply of spare parts.

  6. USNRC severe core damage assessment program

    Energy Technology Data Exchange (ETDEWEB)

    Hanson, J E [EG and G Idaho, Inc., Idaho Falls (USA); Johnston, W V; Kelber, C N [Nuclear Regulatory Commission, Washington, DC (USA)

    1981-01-01

    The accident at the Three Mile Island nuclear power station has significantly altered the perception of the importance of beyond-design-basis accidents in licensing and safety reviews of light-water reactors in the USA. Increased consideration will be given by the United States Nuclear Regulatory Commission to low-probability, high-risk core melt accidents in future licensing proceedings. To this end, the USNRC is mounting experimental and analytic methods development programs to provide the technical basis for future LWR design and licensing criteria related to class-9 accidents. The scope, objectives, and content of five major new programs addressing safety and licensing issues for beyond-design-basis accidents are reviewed and the rationale and logic for formulation of the programs is discussed.

  7. 76 FR 45271 - Review and Qualification of Clinical Outcome Assessments; Public Workshop

    Science.gov (United States)

    2011-07-28

    ... announcing a public workshop to discuss measurement principles for clinical outcome assessments (COAs) for... appropriate drug development program. Because the qualification process is separate from the drug marketing... other DDTs. This workshop will focus on FDA review principles specific to all type of COAs, i.e., PRO...

  8. Establishing a Campus-Based Assessment Program.

    Science.gov (United States)

    Ewell, Peter T.

    1987-01-01

    Assessment has at two purposes--to improve teaching and learning and to promote greater external accountability. Determining an appropriate assessment approach depends on clear knowledge of what is intended, solid research about available instruments and about the experiences of other institutions, and a diagnosis of the local organizational and…

  9. Clinical Assessment of Mineral Trioxide Aggregate in the Treatment ...

    African Journals Online (AJOL)

    2017-05-22

    May 22, 2017 ... (OH)2 (n = 49) or MTA (n = 51) and restored with composite resin in 73 patients. Periapical ... Clinical Assessment of Mineral Trioxide Aggregate in the Treatment of .... materials, light-cured glass ionomer cement base (Riva.

  10. Assessing nursing clinical skills competence through objective structured clinical examination (OSCE) for open distance learning students in Open University Malaysia.

    Science.gov (United States)

    Oranye, Nelson Ositadimma; Ahmad, Che'an; Ahmad, Nora; Bakar, Rosnida Abu

    2012-06-01

    The objective structured clinical skills examination (OSCE) has over the years emerged as a method of evaluating clinical skills in most medical and allied professions. Although its validity and objectivity has evoked so much debate in the literature, little has been written about its application in non-traditional education systems such as in distance learning. This study examined clinical skills competence among practising nursing students who were enrolled in a distance learning programme. The study examined the effect of work and years of nursing practice on nurses' clinical skills competence. This study used observational design whereby nursing students' clinical skills were observed and scored in five OSCE stations. Two instruments were used for the data collection - A self-administered questionnaire on the students' bio-demographic data, and a check list on the clinical skills which the examiners rated on a four point scale. The findings revealed that 14% of the nurses had level four competence, which indicated that they could perform the tasks correctly and complete. However, 12% failed the OSCE, even though they had more than 10 years experience in nursing and post basic qualifications. Inter-rater reliability was 0.92 for the five examiners. Factor analysis indicated that five participant factors accounted for 74.1% of the variations in clinical skills performance. An OSCE is a necessary assessment tool that should be continuously applied in nursing education, regardless of the mode of the education program, the student's years of experience or his/her clinical placement. This study validates the need for OSCE in both the design of tertiary nursing degree programs and the assessment of nurses' clinical competency level.

  11. Clinical assessment of suspected child physical abuse

    International Nuclear Information System (INIS)

    Rohrer, T.

    2009-01-01

    Violence against children has many faces. Child physical abuse, neglect, sexual abuse and interparental violence can cause acute and permanent damage and affect children's development and their life plans in the long term. In industrialized nations almost 1 child in 10 is affected. Up to 10% of child physical abuse cases involve the central nervous system with 80% of these cases occurring during the first year of life. Worldwide more than 50,000 children die as a result of violence, abuse and neglect every year, according to the United Nations Children's Fund UNICEF. In Germany, there are about 120 cases of non-accidental head injury per year. In addition to the officially known cases there is a large grey area for all forms of violence. Recognition of these cases and the provision of help for the victims require an appropriate suspicion and understanding of the pertinent pathophysiology. Suspicion must be based on a well-documented medical history and multidisciplinary diagnostic assessment. Medical confidentiality prevents the disclosure of such information making early detection networks and guidelines for collaboration absolutely indispensable. (orig.) [de

  12. Using the Program Sustainability Assessment Tool to Assess and Plan for Sustainability

    Science.gov (United States)

    Mainor, Avia; Moreland-Russell, Sarah; Maier, Ryan C.; Brossart, Laura; Luke, Douglas A.

    2014-01-01

    Implementing and growing a public health program that benefits society takes considerable time and effort. To ensure that positive outcomes are maintained over time, program managers and stakeholders should plan and implement activities to build sustainability capacity within their programs. We describe a 3-part sustainability planning process that programs can follow to build their sustainability capacity. First, program staff and stakeholders take the Program Sustainability Assessment Tool to measure their program’s sustainability across 8 domains. Next, managers and stakeholders use results from the assessment to inform and prioritize sustainability action planning. Lastly, staff members implement the plan and keep track of progress toward their sustainability goals. Through this process, staff can more holistically address the internal and external challenges and pressures associated with sustaining a program. We include a case example of a chronic disease program that completed the Program Sustainability Assessment Tool and engaged in program sustainability planning. PMID:24456644

  13. Secondary Vocational Horticulture Programs--An Assessment.

    Science.gov (United States)

    Burnett, Michael F.; Smith, Charles W.

    1983-01-01

    The objectives of the study were to determine characteristics of secondary horticulture teachers, the structure of horticulture departments, funding sources, nature and scope of facilities, types of supervised occupational experience programs in which horticulture students participated, and curriculum characteristics of vocational horticulture…

  14. Defense Acquisitions: Assessments of Selected Weapon Programs

    Science.gov (United States)

    2015-03-01

    is designed to detect, acquire, intercept , and destroy a range of airborne threats. Block II includes hardware and software upgrades intended to... moisture intrusion and degraded performance. Additionally, the program has made changes to the Global Positioning System (GPS) receivers, due to a...preliminary design review in fiscal year 2017. An Independent Review Team identified three critical technologies, advanced inlet particle separator

  15. Web-Based Programs Assess Cognitive Fitness

    Science.gov (United States)

    2009-01-01

    The National Space Biomedical Research Institute, based in Houston and funded by NASA, began funding research for Harvard University researchers to design Palm software to help astronauts monitor and assess their cognitive functioning. The MiniCog Rapid Assessment Battery (MRAB) was licensed by the Criteria Corporation in Los Angeles and adapted for Web-based employment testing. The test battery assesses nine different cognitive functions and can gauge the effect of stress-related deficits, such as fatigue, on various tasks. The MRAB can be used not only for pre-employment testing but also for repeat administrations to measure day-to-day job readiness in professions where alertness is critical.

  16. Retaining minorities in engineering: Assessment of a program prototype

    Science.gov (United States)

    Good, Jennifer Marie (Phillips)

    Program assessment is an essential part of healthy program development. Assessment should include multiple considerations, dimensions, and outcomes that match the program's objectives. As a newly formed retention program, the Auburn University Minority Engineering Program, designed to help pre-engineering minority students make the transition into their freshman year of university studies, incorporated evaluation and assessment into all three components of the program (the interactive learning laboratory, critical-thinking workshops, and Sunday-evening tutorials) from the program's inception. If students successfully adapted to the university environment and the demands of the pre-engineering course of study, then retention of minority students in the College of Engineering should improve. Data were gathered on the students involved in the various program components. Students who entered the Minority Engineering Program were pre- and posttested on three standardized subtests (critical thinking, mathematics, and science reasoning) of the Collegiate Assessment of Academic Proficiency. The first-quarter grade-point averages of the students were also gathered to compare their grades to freshman students in previous quarters within the College of Engineering. Qualitative data were also gathered on this same group of students. An analysis of the data revealed that student achievement is affected by involvement in the Minority Engineering Program. Specifically, the first quarter grade point averages of students involved in the program exceeded those of their peers in earlier years of study prior to the program's existence. In addition, mathematics and science reasoning scores on standardized tests increased pre- to postintervention. Comments collected in journals and files also demonstrated use of critical-thinking and problem-solving skills employed by the students. Recommendations for alterations of the program were made based on the outcome of the program evaluation

  17. Performance Assessment Strategy Plan for the Geologic Repository Program

    International Nuclear Information System (INIS)

    1990-01-01

    Performance assessment is a major constituent of the program being conducted by the US Department of Energy (DOE) to develop a geologic repository. Performance assessment is the set of activities needed for quantitative evaluations to assess compliance with the performance requirements in the regulations for a geologic repository and to support the development of the repository. The strategy for these evaluations has been documented in the Performance Assessment Strategy Plan (DOE, 1989). The implementation of the performance assessment strategy is defined in this document. This paper discusses the scope and objectives of the implementation plan, the relationship of the plan to other program plans, summarizes the performance assessment areas and the integrated strategy of the performance assessment program. 1 fig., 3 tabs

  18. Automated Clinical Assessment from Smart home-based Behavior Data

    Science.gov (United States)

    Dawadi, Prafulla Nath; Cook, Diane Joyce; Schmitter-Edgecombe, Maureen

    2016-01-01

    Smart home technologies offer potential benefits for assisting clinicians by automating health monitoring and well-being assessment. In this paper, we examine the actual benefits of smart home-based analysis by monitoring daily behaviour in the home and predicting standard clinical assessment scores of the residents. To accomplish this goal, we propose a Clinical Assessment using Activity Behavior (CAAB) approach to model a smart home resident’s daily behavior and predict the corresponding standard clinical assessment scores. CAAB uses statistical features that describe characteristics of a resident’s daily activity performance to train machine learning algorithms that predict the clinical assessment scores. We evaluate the performance of CAAB utilizing smart home sensor data collected from 18 smart homes over two years using prediction and classification-based experiments. In the prediction-based experiments, we obtain a statistically significant correlation (r = 0.72) between CAAB-predicted and clinician-provided cognitive assessment scores and a statistically significant correlation (r = 0.45) between CAAB-predicted and clinician-provided mobility scores. Similarly, for the classification-based experiments, we find CAAB has a classification accuracy of 72% while classifying cognitive assessment scores and 76% while classifying mobility scores. These prediction and classification results suggest that it is feasible to predict standard clinical scores using smart home sensor data and learning-based data analysis. PMID:26292348

  19. Using information management to implement a clinical resource management program.

    Science.gov (United States)

    Rosenstein, A H

    1997-12-01

    This article provides a consultant's account of a 250-bed community hospital's experience in implementing the Clinical Resource Management (CRM) program, a four-stage process of using information to identify opportunities for improvement, developing an effective resource management team, implementing process improvement activities, and measuring the impact on outcomes of care. CASE STUDY EXAMPLE--CONGESTIVE HEART FAILURE: The chair of the departments of internal medicine and family practice selected congestive heart failure for in-depth study. A task force focused on treatment and patient disposition in the emergency room (ER), where most of the nonelective admissions originated. A set of standardized ER orders was developed that emphasized rapid and effective diuresis through the initiation of a progressive diuretic dosing schedule directly linked to patient response. Factors critical to the success of the CRM program included allocating adequate time to promote and sell the value and importance of the program, as well as securing the support of both information systems and physicians. The main barriers to success involved limitations in the information system infrastructure and delays attributable to committee review. Short-term results from the CRM program were encouraging, with average lengths of stay reduced by 0.5 days and average costs of care reduced by 12% for the ten diagnoses studied with no adverse results. Nonstudy diagnoses showed no notable improvement. Recognizing the growing importance of information management not only for clinical decision support but for accommodating all the necessary internal and external reporting requirements will require a significant commitment and investment in technology and personnel resources.

  20. Clinical and financial considerations for implementing an ICU telemedicine program.

    Science.gov (United States)

    Kruklitis, Robert J; Tracy, Joseph A; McCambridge, Matthew M

    2014-06-01

    As the population in the United States increases and ages, the need to provide high-quality, safe, and cost-effective care to the most critically ill patients will be of great importance. With the projected shortage of intensivists, innovative changes to improve efficiency and increase productivity will be necessary. Telemedicine programs in the ICUs (tele-ICUs) are a successful strategy to improve intensivist access to critically ill patients. Although significant capital and maintenance costs are associated with tele-ICUs, these costs can be offset by indirect financial benefits, such as decreased length of stay. To achieve the positive clinical outcomes desired, tele-ICUs must be carefully designed and implemented. In this article, we discuss the clinical benefits of tele-ICUs. We review the financial considerations, including direct and indirect reimbursement and development and maintenance costs. Finally, we review design and implementation considerations for tele-ICUs.

  1. Defense Acquisitions: Assessments of Selected Weapon Programs

    Science.gov (United States)

    2017-03-01

    decision out to the third quarter of fiscal year 2018. In the fiscal year 2017 budget , the Marine Corps funded ACV Increment 1.1 to the level identified...option. The program noted the Air Force will need to make a preliminary decision on an Increment 2 by summer 2017 for budgeting purposes, though the...Armored Multi-Purpose Vehicle (AMPV) 67 Common Infrared Countermeasure (CIRCM) 69 Indirect Fire Protection Capability Increment 2-Intercept Block 1

  2. Validation of a clinical assessment tool for spinal anaesthesia.

    LENUS (Irish Health Repository)

    Breen, D

    2011-07-01

    There is a need for a procedure-specific means of assessment of clinical performance in anaesthesia. The aim of this study was to devise a tool for assessing the performance of spinal anaesthesia, which has both content and construct validity.

  3. The Fertility Assessment and Counselling Clinic - does the concept work?

    DEFF Research Database (Denmark)

    Petersen, Kathrine Birch; Maltesen, Thomas; Forman, Julie L.

    2017-01-01

    INTRODUCTION: The Fertility Assessment and Counselling (FAC) Clinic was initiated to provide women information about their current fertility status to prevent infertility and smaller families than desired. The aim was to study the predictive value of a risk assessment score based on known fertili...

  4. The portfolio approach to competency-based assessment at the Cleveland Clinic Lerner College of Medicine.

    Science.gov (United States)

    Dannefer, Elaine F; Henson, Lindsey C

    2007-05-01

    Despite the rapid expansion of interest in competency-based assessment, few descriptions of assessment systems specifically designed for a competency-based curriculum have been reported. The purpose of this article is to describe the design of a portfolio approach to a comprehensive, competency-based assessment system that is fully integrated with the curriculum to foster an educational environment focused on learning. The educational design goal of the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University was to create an integrated educational program-curriculum and instructional methods, student assessment processes, and learning environment-to prepare medical students for success in careers as physician investigators. The first class in the five-year program matriculated in 2004. To graduate, a student must demonstrate mastery of nine competencies: research, medical knowledge, communication, professionalism, clinical skills, clinical reasoning, health care systems, personal development, and reflective practice. The portfolio provides a tool for collecting and managing multiple types of assessment evidence from multiple contexts and sources within the curriculum to document competence and promote reflective practice skills. This article describes how the portfolio was developed to provide both formative and summative assessment of student achievement in relation to the program's nine competencies.

  5. Challenges in Measuring Benefit of Clinical Research Training Programs--the ASH Clinical Research Training Institute Example.

    Science.gov (United States)

    Sung, Lillian; Crowther, Mark; Byrd, John; Gitlin, Scott D; Basso, Joe; Burns, Linda

    2015-12-01

    The American Society of Hematology developed the Clinical Research Training Institute (CRTI) to address the lack of training in patient-oriented research among hematologists. As the program continues, we need to consider metrics for measuring the benefits of such a training program. This article addresses the benefits of clinical research training programs. The fundamental and key components are education and mentorship. However, there are several other benefits including promotion of collaboration, job and advancement opportunities, and promotion of work-life balance. The benefits of clinical research training programs need to be measured so that funders and society can judge if they are worth the investment in time and resources. Identification of elements that are important to program benefit is essential to measuring the benefit of the program as well as program planning. Future work should focus on the constructs which contribute to benefits of clinical research training programs such as CRTI.

  6. Clinical reasoning in nursing: teaching strategies and assessment tools

    Directory of Open Access Journals (Sweden)

    Emília Campos de Carvalho

    Full Text Available ABSTRACT Objective: To present the concept and development of teaching strategies and the assessment tools regarding clinical reasoning for accurate practice. Method: This is a theoretical reflection based on scientific studies. Results: Comprehension of the essential concepts of the thought process and its articulation with the different teaching strategies and the assessment tools which has allowed presenting ways to improve the process of diagnostic or therapeutic clinical reasoning. Conclusion: The use of new strategies and assessment tools should be encouraged in order to contribute to the development of skills that lead to safe and effective decision making.

  7. Large observer variation of clinical assessment of dyspnoeic wheezing children.

    Science.gov (United States)

    Bekhof, Jolita; Reimink, Roelien; Bartels, Ine-Marije; Eggink, Hendriekje; Brand, Paul L P

    2015-07-01

    In children with acute dyspnoea, the assessment of severity of dyspnoea and response to treatment is often performed by different professionals, implying that knowledge of the interobserver variation of this clinical assessment is important. To determine intraobserver and interobserver variation in clinical assessment of children with dyspnoea. From September 2009 to September 2010, we recorded a convenience sample of 27 acutely wheezing children (aged 3 months-7 years) in the emergency department of a general teaching hospital in the Netherlands, on video before and after treatment with inhaled bronchodilators. These video recordings were independently assessed by nine observers scoring wheeze, prolonged expiratory phase, retractions, nasal flaring and a general assessment of dyspnoea on a Likert scale (0-10). Assessment was repeated after 2 weeks to evaluate intraobserver variation. We analysed 972 observations. Intraobserver reliability was the highest for supraclavicular retractions (κ 0.84) and moderate-to-substantial for other items (κ 0.49-0.65). Interobserver reliability was considerably worse, with κ3 points) was larger than the minimal important change (meaning that in 69% of observations a clinically important change after treatment cannot be distinguished from measurement error. Intraobserver variation is modest, and interobserver variation is large for most clinical findings in children with dyspnoea. The measurement error induced by this variation is too large to distinguish potentially clinically relevant changes in dyspnoea after treatment in two-thirds of observations. The poor interobserver reliability of clinical dyspnoea assessment in children limits its usefulness in clinical practice and research, and highlights the need to use more objective measurements in these patients. 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.

  8. The Nordic safety program on accident consequence assessment

    International Nuclear Information System (INIS)

    Tveten, U.

    1988-01-01

    One important part of Nordic cooperation is partially funded by the Nordic Council of Ministers, namely the work performed within the Nordic Safety Program (often referred to as the NKA projects). NKA is the Nordic abbreviation of the Nordic Liaison Committee on Atomic Energy. One program area in the present four-year period is concerned with problems related to reactor accident consequence assessment, and contains almost twenty projects covering a wide range of subjects. The author is program coordinator for this program area. The program will be completed in 1989. The program was strongly influenced by Chernobyl, and a number of new projects were included in the program in 1986. Involved in the program are these Nordic institutions: Riso National Laboratory (Denmark). Technical Research Centre of Finland. Finnish Centre for Radiation and Nuclear Safety. Finnish Meteorological Institute. Institute for Energy Technology (Norway). Agricultural University of Norway. Meteorological Institute of Norway. Studsvik Energiteknik AB (Sweden). National Defence Research Laboratory (Sweden)

  9. Effectiveness of a structured training program in psychotherapeutic skills used in clinical interviews for psychiatry and clinical psychology residents.

    Science.gov (United States)

    Fernandez-Liria, Alberto; Rodriguez-Vega, Beatriz; Ortiz-Sanchez, Deborah; Baldor Tubet, Isabel; Gonzalez-Juarez, Carlos

    2010-01-01

    The authors evaluated a training program based on a structured manual of psychotherapeutic skills, using a randomized controlled design. The experimental group consisted of 135 residents from 12 teaching units in Spain. To control the improvement in therapeutic skills that could be attributed to the training received during the residency, the authors compared the experimental group with a control group of 35 residents from three teaching units. Two types of assessment instruments were used: a paper-and-pencil questionnaire based on clinical cases and a videotape of a role-playing interview. Both were given before and after the experimental group attended the training program. The experimental group shows a statistically significant improvement compared with the control group in both measurements.

  10. National Acid Precipitation Assessment Program: 1990 Integrated Assessment report

    International Nuclear Information System (INIS)

    1991-11-01

    The document, the 'Integrated Assessment,' is a summary of the causes and effects of acidic deposition and a comparison of the costs and effectiveness of alternative emission control scenarios. In developing the 'Integrated Assessment,' it was NAPAP's goal to produce a structured compilation of policy-relevant technical information. The Integrated Assessment is based on findings and data from a series of twenty-seven State-of-Science/Technology Reports (SOS/T) on acidic deposition published by NAPAP in 1990. The scope of the documents includes: (1) emissions, atmospheric processes and deposition; (2) effects on surface waters, forests, agricultural crops, exposed materials, human health, and visibility; and (3) control technologies, future emissions, and effects valuation

  11. [New medical device hospital assessment: what kind of clinical data?].

    Science.gov (United States)

    Beaussier, H; Junot, H; Lancrenon, S; Faure, P

    2012-01-01

    Since 2003, the AP-HP medical devices committee (CODIMS) assess the therapeutic relevance of innovated medical device (MD) for the French AP-HP hospitals' group. To accomplish this task, the CODIMS asks manufacturers to bring out clinical arguments to justify the use of their MD in hospital. This work analyses retrospectively after 8years, all assessed MD until March 2011 and the scientific quality of the clinical data submitted by manufacturers to the CODIMS to purchase their MD. All MD were classed according to their certification's level (I, IIa, IIb, III, DMIA). The quality of available clinical studies (CS) provided by manufacturers for each case was assessed and classed according to five clinical relevance levels based on the evidence-based medecine standards (1-2: high methodology; 3-5: low methodology). One hundred and three MD files (80 % of class IIb and III MD) were analysed by the CODIMS (630CS). Our results highlight the lack of relevance of files that are provided to assess innovated MD: 29 files without any CS; concerning class IIb (32DMS, 221CS) and III (50, 342CS) MD, only 6 % of CS presented a correct clinical relevance level. And the situation did not get better during this assessment period. The CODIMS deplore the poor clinical relevance of files provided to assess MD (wrong comparator, inappropriate ends-points, insufficient follow-up to assess long-term security, small population studied). Future legislative developments for MD assessment are expected to improve this situation. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  12. Navy radon assessment and mitigation program: Final report

    International Nuclear Information System (INIS)

    1994-10-01

    This final report encompasses the events from the beginning of the Navy Radon Assessment and Mitigation Program to the closure of the program on October 31, 1994. Included in the report are discussions of the phases of the program including screening, assessment, mitigation, and post-mitigation. The primary discussion involves screening and assessment. The report addresses recommendations made to the Naval Facilities Engineering Command by the Hazardous Waste Remedial Actions Program of Martin Marietta Energy Systems, Inc., and the final decisions that were made. Special emphasis is placed on quality assurance/quality control (QA/QC), since QA/QC was given top priority during the implementation of this program. Included in the discussion on QA/QC are ana overview of the measurement process, positive and negative controls, replicated measurements, and application of chamber exposures to data calibration. The report concludes with a discussion of testing considerations for naval facilities and radon mitigation considerations for the Department of the Navy

  13. Needs assessment for collaborative network in pediatric clinical research and education.

    Science.gov (United States)

    Ishiguro, Akira; Sasaki, Hatoko; Yahagi, Naohisa; Kato, Hitoshi; Kure, Shigeo; Mori, Rintaro

    2017-01-01

    A collaborative network for pediatric research has not been fully established in Japan. To identify the network infrastructure, we conducted a survey on the support and education for clinical research currently available in children's hospitals. In November 2014, a 27-question survey was distributed to 31 hospitals belonging to the Japanese Association of Children's Hospitals and Related Institutions (JACHRI) to assess clinical research support, research education, research achievements, and their expectations. All the hospitals responded to the survey. Overall, 74.2% of hospitals had clinical research support divisions. Although all hospitals had ethics committees, manager, intellectual property management unit, biostatistician, and English-language editor. Seven hospitals had education programs for clinical research. The number of seminars and workshops for clinical research had significant correlations with the number of physicians (r = 0.927), pediatricians (r = 0.922), and clinical trial management physicians (r = 0.962). There was a significant difference in the number of clinical trials initiated by physicians between hospitals with research education programs and those without (P leader to establish a collaborative network for clinical research. Important factors for creating a collaborative system for pediatric research in Japan were identified. Human resources to support clinical research are a key factor to improve clinical research education and research achievements. © 2016 Japan Pediatric Society.

  14. MRI for clinically suspected pediatric appendicitis: an implemented program

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Michael M.; Gustas, Cristy N.; Choudhary, Arabinda K.; Methratta, Sosamma T.; Hulse, Michael A.; Eggli, Kathleen D.; Boal, Danielle K.B. [Penn State Milton S. Hershey Medical Center, Department of Radiology, Mail Code H066, 500 University Drive, P.O. Box 850, Hershey, PA (United States); Geeting, Glenn [Penn State Milton S. Hershey Medical Center, Department of Emergency Medicine, Hershey, PA (United States)

    2012-09-15

    Emergent MRI is now a viable alternative to CT for evaluating appendicitis while avoiding the detrimental effects of ionizing radiation. However, primary employment of MRI in the setting of clinically suspected pediatric appendicitis has remained significantly underutilized. To describe our institution's development and the results of a fully implemented clinical program using MRI as the primary imaging evaluation for children with suspected appendicitis. A four-sequence MRI protocol consisting of coronal and axial single-shot turbo spin-echo (SS-TSE) T2, coronal spectral adiabatic inversion recovery (SPAIR), and axial SS-TSE T2 with fat saturation was performed on 208 children, ages 3 to 17 years, with clinically suspected appendicitis. No intravenous or oral contrast material was administered. No sedation was administered. Data collection includes two separate areas: time parameter analysis and MRI diagnostic results. Diagnostic accuracy of MRI for pediatric appendicitis indicated a sensitivity of 97.6% (CI: 87.1-99.9%), specificity 97.0% (CI: 93.2-99.0%), positive predictive value 88.9% (CI: 76.0-96.3%), and negative predictive value 99.4% (CI: 96.6-99.9%). Time parameter analysis indicated clinical feasibility, with time requested to first sequence obtained mean of 78.7 +/- 52.5 min, median 65 min; first-to-last sequence time stamp mean 14.2 +/- 8.8 min, median 12 min; last sequence to report mean 57.4 +/- 35.2 min, median 46 min. Mean age was 11.2 +/- 3.6 years old. Girls represented 57% of patients. MRI is an effective and efficient method of imaging children with clinically suspected appendicitis. Using an expedited four-sequence protocol, sensitivity and specificity are comparable to CT while avoiding the detrimental effects of ionizing radiation. (orig.)

  15. Teaching and Assessing Professionalism in Ophthalmology Residency Training Programs

    NARCIS (Netherlands)

    Lee, Andrew G.; Beaver, Hilary A.; Boldt, H. Culver; Olson, Richard; Oetting, Thomas A.; Abramoff, Michael; Carter, Keith

    2007-01-01

    The Accreditation Council for Graduate Medical Education (ACGME) has mandated that all residency training programs teach and assess new competencies including professionalism. This article reviews the literature on medical professionalism, describes good practices gleaned from published works, and

  16. Environmental Monitoring and Assessment Program (EMAP) National Coastal Database

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Environmental Monitoring and Assessment Program (EMAP) National Coastal Database contains estuarine and coastal data that EMAP and Regional-EMAP have collected...

  17. 2014 Rural Clinical School Training and Support Program Snapshot survey.

    Science.gov (United States)

    Mendis, Kumara; Greenhill, Jennene; Walker, Judi; Bailey, Jannine; Croft, Amanda; Doyle, Zelda; McCrossin, Timothy; Stevens, Wendy

    2015-01-01

    The Rural Clinical Training and Support (RCTS) program is an Australian Government initiative to address the shortage of medical practitioners within rural and remote Australia. There is a large amount of published information about the RCTS program and rural medical student cohorts who have undertaken short- and long-term rotations. However, very little is known about the academic and professional staff involved in the program, a knowledge gap that may impact workforce and succession planning. To address this, the Federation of Rural Australian Medical Educators (FRAME) initiated the pilot 2014 RCTS Snapshot survey to obtain data on the current RCTS workforce. All professional, academic and clinical academic staff (fixed-term and continuing, regardless of fraction) employed through the RCTS program were invited to complete a short, web-based survey. The survey was conducted from March to June 2014. The quantitative variables in the survey included demographics (age and gender), rural background and exposure, employment history in rural/regional areas and at rural clinical schools (RCS), experience and expertise, reasons for working at RCS, and future employment intentions. The last three questions also were of a qualitative open-ended format to allow respondents to provide additional details regarding their reasons for working at RCSs and their future intentions. The estimated total RCTS workforce was 970. A total of 413 responses were received and 316 (40.9%) complete responses analysed. The majority of respondents were female (71%), the 40-60-year age group was predominant (28%), and professional staff constituted the majority (62%). The below 40-year age group had more professionals than academics (21% vs 12%) and more than 62% of academics were aged above 50 years. Notably, there were no academics aged less than 30 years. The percentage of professional staff with a rural background was higher (62%) than that of academics with a rural background (42%). However

  18. A needs assessment for an employee assistance program

    OpenAIRE

    2012-01-01

    M.A. Employee Assistance Programs (EAP) can be defined as programs, sponsored by management and labor, that are specifically designed to identify and assist employees and their families with various difficulties that impair personal and occupational functioning. Adventist Community Services (ACS) is a welfare organization that identified the need within the organization for such a program. A needs assessment to determine the specific needs of employees and volunteers with regard to such a ...

  19. Pspace: a program that assesses protein space

    Directory of Open Access Journals (Sweden)

    Zhou Ming-Ming

    2007-10-01

    Full Text Available Abstract Background We describe a computer program named Pspace designed to a obtain a reliable basis for the description of three-dimensional structures of a given protein family using homology modeling through selection of an optimal subset of the protein family whose structure would be determined experimentally; and b aid in the search of orthologs by matching two sets of sequences in three different ways. Methods The prioritization is established dynamically as new sequences and new structures are becoming available through ranking proteins by their value in providing structural information about the rest of the family set. The matching can give a list of potential orthologs or it can deduce an overall optimal matching of two sets of sequences. Results The various covering strategies and ortholog searches are tested on the bromodomain family. Conclusion The possibility of extending this approach to the space of all proteins is discussed.

  20. Assessment of acquired capability for suicide in clinical practice.

    Science.gov (United States)

    Rimkeviciene, Jurgita; Hawgood, Jacinta; O'Gorman, John; De Leo, Diego

    2016-12-01

    The Interpersonal Psychological Theory of suicide proposes that the interaction between Thwarted Belongingness, Perceived Burdensomeness, and Acquired Capability for Suicide (ACS) predicts proximal risk of death by suicide. Instruments to assess all three constructs are available. However, research on the validity of one of them, the acquired capability for suicide scale (ACSS), has been limited, especially in terms of its clinical relevance. This study aimed to explore the utility of the different versions of the ACSS in clinical assessment. Three versions of the scale were investigated, the full 20-item version, a 7-item version and a single item version representing self-perceived capability for suicide. In a sample of patients recruited from a clinic specialising in the treatment of suicidality and in a community sample, all versions of the ACSS were found to show reasonable levels of reliability and to correlate as expected with reports of suicidal ideation, self-harm, and attempted suicide. The item assessing self-perceived acquired capacity for suicide showed highest correlations with all levels of suicidal behaviour. However, no version of the ACSS on its own showed a capacity to indicate suicide attempts in the combined sample. It is concluded that the versions of the scale have construct validity, but their clinical utility is limited. An assessment using a single item on self-perceived ACS outperforms the full and shortened versions of ACSS in clinical settings and can be recommended with caution for clinicians interested in assessing this characteristic.

  1. 76 FR 74723 - New Car Assessment Program (NCAP); Safety Labeling

    Science.gov (United States)

    2011-12-01

    ... [Docket No. NHTSA 2010-0025] RIN 2127-AK51 New Car Assessment Program (NCAP); Safety Labeling AGENCY... NHTSA's regulation on vehicle labeling of safety rating information to reflect the enhanced NCAP ratings... Traffic Safety Administration under the enhanced NCAP testing and rating program. * * * * * (e) * * * (4...

  2. Assessing Community Needs for Expanding Environmental Education Programming

    Science.gov (United States)

    Hintz, Carly J.; Lackey, Brenda K.

    2017-01-01

    Based on increased demand for educational programming, leadership at Schmeeckle Reserve, a campus natural area in Stevens Point, WI explored the needs for expanded environmental education efforts. In 2014, a three-phased needs assessment framework was employed to explore educational programming offered in the community. Results from interviews and…

  3. Income Tax Preparation Assistance Service Learning Program: A Multidimensional Assessment

    Science.gov (United States)

    Aldridge, Richard; Callahan, Richard A.; Chen, Yining; Wade, Stacy R.

    2015-01-01

    The authors present a multidimensional assessment of the outcomes and benefits of an income tax preparation assistance (ITPA) service learning program. They measure the perceived proximate benefits at the delivery of the service program, the actual learning outcome benefits prior to graduation, and the perceived long-term benefits from a…

  4. Evaluation assessment of Rail Freight Transportation Research and Development Program

    Energy Technology Data Exchange (ETDEWEB)

    1983-02-01

    This report presents an evaluation assessment of the Canadian Rail Freight Transportation Research and Development (R and D) Program. The assessment was to assist in preparing for an evaluation of the Program and to stimulate a better understanding of the broader issues and problems of evaluating R and D programs. In general, the objectives of the program are aimed at improving rail freight productivity, capacity, safety, cost, and the domestic and foreign competitive position of railway suppliers. This is to be acccomplished by stimulating a stronger industry commitment to R and D and inducing investment in new technology through joint federal-industry funding and participation in rail freight R and D projects. In view of the low funding levels of the Program, it is unlikely that it will have a significant direct impact upon these ultimate objectives. Impacts will likely only be achieved through the Program's ability to stimulate increased industrial R and D and investment in new technology. A model of the Program developed in the report shows that the critical linkages between the activities and objectives of the Program are the leadership or advocacy functions performed by the Program's managers and of the results of projects supported under the Program; and the processes of program planning and project selection. An assessment of the Program's structure indicates that there are no significant issues that would make the evaluation of the Program or its major components inadvisable. Twelve potential evaluation questions and the basic approaches required to address each of them are presented in the report. 5 figs., 10 tabs.

  5. Fire fighting capability assessment program Darlington NGS

    International Nuclear Information System (INIS)

    1995-05-01

    This is a report on the completion of work relating to the assessment of the capability of Darlington NGS to cope with a large fire incident. This included an evaluation of an exercise scenario that would simulate a large fire incident and of their fire plans and procedures which became the subject of interim reports as part of the process of preparing for the fire fighting and rescue exercise. Finally the execution of fire plans by Darlington Nuclear Generating Station (NGS), as demonstrated by their application of human and material resources during a simulated large fire, was observed. 1 tab., 1 fig

  6. Assessing functional diversity by program slicing

    International Nuclear Information System (INIS)

    Wallace, D.R.; Lyle, J.R.; Gallagher, K.B.; Ippolito, L.M.

    1994-01-01

    A responsibility of the Nuclear Regulatory Commission auditors is to provide assessments of the quality of the safety systems. For software, the audit process as currently implemented is a slow, tedious, manual process prone to human errors. While auditors cannot possibly examine all components of the system in complete detail, they do check for implementation of specific principles like functional diversity. This paper describes an experimental prototype Computer Aided Software Engineering (CASE) tool, UNRAVEL, designed to enable auditors to check for functional diversity and aid an auditor in examining software by extracting all code relevant to a computation identified for detailed inspection

  7. Cognitive Assessment of Elderly Inpatients: A Clinical Audit

    Directory of Open Access Journals (Sweden)

    Elizabeth Shermon

    2015-01-01

    Full Text Available Background: Comprehensive geriatric assessment including cognitive assessment results in better outcomes and quality of life through facilitating access to support and further care. The National Audit of Dementia Care revealed too few patients were being assessed for cognition and therefore failing to receive adequate care. Methods: This was a retrospective clinical audit in a district general hospital with systematic sampling of the clinical records of 50 inpatients on an elderly care ward. A descriptive analysis of the results was performed. Results: Despite guidance that cognitive assessment should be performed on admission, this was only documented in 22% of the medical notes. However, this rate improved to 56% by discharge. The most commonly used tool was the Abbreviated Mental Test (AMT 10. Assessment completion was independent of gender or social support, but only patients aged over 75 years were assessed. Of those, 75% had some level of cognitive impairment and 36.8% received a new or suspected diagnosis of dementia. Discussion: Cognitive assessment rates continue to be low. Our findings support the need for increased education regarding the importance and benefits of assessment as well as how to complete and document the assessment correctly. Conclusion: Cognitive assessment rates need to be further improved to promote better outcomes for patients with dementia.

  8. Environmental Assessment : Squawfish Management Program : Final.

    Energy Technology Data Exchange (ETDEWEB)

    United States. Bonneville Power Administration.

    1992-05-01

    Bonneville Power Administration (BPA) proposes to decrease the number of northern squawfish (Ptychocheilus oregonensis) in reservoirs in the Columbia River system. The goal of the Squawfish Management Program is to reduce losses of outmigrating juvenile salmon and steelhead (salmonids) to northern squawfish predation. The objective is to reduce the number of northern squawfish that feed on juvenile salmonids (smolts) by 10 to 20 percent to alter the age and size structure of the northern squawfish population. The hypothesis, based on computer modeling, indicates that sustained northern squawfish harvest (5 to 10 years) and the resultant population restructuring may reduce losses of juvenile salmonids to predation by up to 50 percent or more within 10 years. The proposed action would target northern squawfish 11 inches and longer, the size in which northern squawfish being preying significantly on juvenile salmonids. BPA proposes to fund three types of fisheries to harvest northern squawfish. BPA also proposes to fund monitoring activities of these fisheries to determine whether desired or other results occur. The three fisheries methods proposed are: (1) commercial Tribal fishing; (2) sport reward fishing; and (3) fishing from restricted areas of each dam ( dam angling''). These fisheries were tested in 1990 and 1991.

  9. Patents Assessed through Sectoral Operational Programs

    Directory of Open Access Journals (Sweden)

    Paula – Angela VIDRAȘCU

    2014-06-01

    Full Text Available According to the International Accounting Standards – IAS 38 „Intangible assets”; these assets are identifiable non-monetary assets under construction were considered without physical substance. Lack actual physical form must not be understood that an intangible asset would have no material support, because the presence of any intangible asset can be demonstrated only by a support material form. Exmple: frequently encounter compact-disc (in case a software, legal documentation (in the case of licences, trade marks and patents of invention, contracts, permits and licences, technical documentation or films. Nowadays we are constantly subjected to the changing flow of information that is found in a perpetual technological change which started the emergence of a new stage in the society development that which carries the name of knowledge. The object of my research is the patent for the structural funds reimbursable project submitted in the "Operational Program, Economic Competitiveness" Operation 2.3.1. "Support for start-ups and innovative spin-offs. Patent is an official document certifying the inventor, the exclusive right to produce a certain good or product or use a particular process. Remember that evaluation of intangible assets is the most complex and systematic procedure.

  10. Using generalizability theory to develop clinical assessment protocols.

    Science.gov (United States)

    Preuss, Richard A

    2013-04-01

    Clinical assessment protocols must produce data that are reliable, with a clinically attainable minimal detectable change (MDC). In a reliability study, generalizability theory has 2 advantages over classical test theory. These advantages provide information that allows assessment protocols to be adjusted to match individual patient profiles. First, generalizability theory allows the user to simultaneously consider multiple sources of measurement error variance (facets). Second, it allows the user to generalize the findings of the main study across the different study facets and to recalculate the reliability and MDC based on different combinations of facet conditions. In doing so, clinical assessment protocols can be chosen based on minimizing the number of measures that must be taken to achieve a realistic MDC, using repeated measures to minimize the MDC, or simply based on the combination that best allows the clinician to monitor an individual patient's progress over a specified period of time.

  11. Assessment of surgical competence in North American graduate periodontics programs: a survey of current practices.

    Science.gov (United States)

    Ghiabi, Edmond; Taylor, K Lynn

    2010-08-01

    This cross-sectional study was designed to document the methods utilized by North American graduate periodontics programs in assessing their residents' surgical skills. A survey of clinical skills assessment was mailed to directors of all fifty-eight graduate periodontics programs in Canada and the United States. Thirty-four programs (59 percent) responded. The data collected were analyzed using SPSS version 15.0. The results demonstrate that the most common practice for providing feedback and documenting residents' surgical skills in the programs surveyed was daily one-on-one verbal feedback given by an instructor. The next two most commonly reported methods were a standard checklist developed at program level and a combination of a checklist and verbal comments. The majority of the programs reported that the instructors met collectively once per term to evaluate the residents' progress. The results suggest that graduate periodontics programs provide their residents frequent opportunities for daily practice with verbal feedback from instructors. However, assessment strategies identified in other health professions as beneficial in fostering the integration of clinical skills practices are not employed.

  12. Mentoring in Clinical-Translational Research: A Study of Participants in Master's Degree Programs.

    Science.gov (United States)

    McGinn, Aileen P; Lee, Linda S; Baez, Adriana; Zwanziger, Jack; Anderson, Karl E; Seely, Ellen W; Schoenbaum, Ellie

    2015-12-01

    Research projects in translational science are increasingly complex and require interdisciplinary collaborations. In the context of training translational researchers, this suggests that multiple mentors may be needed in different content areas. This study explored mentoring structure as it relates to perceived mentoring effectiveness and other characteristics of master's-level trainees in clinical-translational research training programs. A cross-sectional online survey of recent graduates of clinical research master's program was conducted. Of 73 surveys distributed, 56.2% (n = 41) complete responses were analyzed. Trainees were overwhelmingly positive about participation in their master's programs and the impact it had on their professional development. Overall the majority (≥75%) of trainees perceived they had effective mentoring in terms of developing skills needed for conducting clinical-translational research. Fewer trainees perceived effective mentoring in career development and work-life balance. In all 15 areas of mentoring effectiveness assessed, higher rates of perceived mentor effectiveness was seen among trainees with ≥2 mentors compared to those with solo mentoring (SM). In addition, trainees with ≥2 mentors perceived having effective mentoring in more mentoring aspects (median: 14.0; IQR: 12.0-15.0) than trainees with SM (median: 10.5; IQR: 8.0-14.5). Results from this survey suggest having ≥2 mentors may be beneficial in fulfilling trainee expectations for mentoring in clinical-translational training. © 2015 Wiley Periodicals, Inc.

  13. Suicide Risk Assessment Training for Psychology Doctoral Programs: Core Competencies and a Framework for Training

    OpenAIRE

    Cramer, Robert J.; Johnson, Shara M.; McLaughlin, Jennifer; Rausch, Emilie M.; Conroy, Mary Alice

    2013-01-01

    Clinical and counseling psychology programs currently lack adequate evidence-based competency goals and training in suicide risk assessment. To begin to address this problem, this article proposes core competencies and an integrated training framework that can form the basis for training and research in this area. First, we evaluate the extent to which current training is effective in preparing trainees for suicide risk assessment. Within this discussion, sample and methodological issues are ...

  14. Clinically assessed mediolateral knee motion: impact on gait

    DEFF Research Database (Denmark)

    Thorlund, Jonas Bloch; Creaby, Mark W; Simic, Milena

    2011-01-01

    Mediolateral knee movement can be assessed visually with clinical tests. A knee-medial-to-foot position is associated with an increased risk of knee injuries and pathologies. However, the implications of such findings on daily tasks are not well understood. The aim of this study was to investigat...... if a knee-medial-to-foot position assessed during a clinical test was associated with altered hip and knee joint kinematics and knee joint kinetics during gait compared with those with a knee-over-foot position....

  15. School Indoor Air Quality Assessment and Program Implementation.

    Science.gov (United States)

    Prill, R.; Blake, D.; Hales, D.

    This paper describes the effectiveness of a three-step indoor air quality (IAQ) program implemented by 156 schools in the states of Washington and Idaho during the 2000-2001 school year. An experienced IAQ/building science specialist conducted walk-through assessments at each school. These assessments documented deficiencies and served as an…

  16. Office of Academic Assessment provides workshops on the program assessment process

    OpenAIRE

    Williams, Meghan

    2008-01-01

    The Office of Academic Assessment is once again providing a series of workshops on the program assessment process during the spring semester. The workshops will offer a wide range of resources to assist faculty and administrators as they focus on teaching and learning in their programs.

  17. Communication Skills assessed at OSCE are not affected by Participation in the Adolescent Healthy Sexuality Program

    Directory of Open Access Journals (Sweden)

    Deborah Penava

    2002-12-01

    Full Text Available We proposed that first year medical students who voluntarily participated in the Healthy Sexuality adolescent program would perform better than their peers on an adolescent counseling station at the year-end OSCE (Objective Structured Clinical Examination. In addition we compared medical students’ communication skills at the time of the program as assessed by self, peers and participating adolescents. Methods: Nineteen first year medical students voluntarily participated in the ongoing Healthy Sexuality program. Adolescent participants, medical student peer participants and medical students assessed communication components on a 7-point Likert scale at the end of the program. At the year-end OSCE, all first year medical students at the University of Western Ontario were assessed at an adolescent counseling station by a standardized patient (SP and a physician examiner. Statistical analysis examined differences between the two groups. Results: Students who participated in the Healthy Sexuality program did not perform better than their colleagues on the year-end OSCE. A statistically significant correlation between physician examiner and SP evaluations was found (r = 0.62. Adolescent participants communication skills assessments in the Healthy Sexuality Program demonstrated no significant correlation with medical student assessments (self or peer. Conclusions:Voluntary intervention with adolescents did not result in improved communication skills at the structured year-end examination. Further investigation will be directed towards delineating differences between SP and physician examiner assessments.

  18. Using dreams to assess clinical change during treatment.

    Science.gov (United States)

    Glucksman, Myron L; Kramer, Milton

    2004-01-01

    This article describes several studies that examine the relationship between the manifest content of selected dreams reported by patients and their clinical progress during psychoanalytic and psychodynamically oriented treatment. There are a number of elements that dreaming and psychotherapy have in common: affect regulation; conflict resolution; problem-solving; self-awareness; mastery and adaptation. Four different studies examined the relationship between the manifest content of selected dreams and clinical progress during treatment. In each study, the ratings of manifest content and clinical progress by independent observers were rank-ordered and compared. In three of the four studies there was a significant correlation between the rankings of manifest content and the rankings of clinical progress. This finding suggests that the manifest content of dreams can be used as an independent variable to assess clinical progress during psychoanalytic and psychodynamically oriented treatment.

  19. Industrial assessment center program. Final Report

    International Nuclear Information System (INIS)

    Ahmad R. Ganji, Ph.D., P.E., IAC DIrector

    2007-01-01

    The Industrial Assessment Center (IAC) at San Francisco State University (SFSU) has served the cause of energy efficiency as a whole, and in particular for small and medium-sized manufacturing facilities in northern and central California, within a approximately 150 miles (radial) of San Francisco since 1992. In the current reporting period (September 1, 2002 through November 31, 2006) we have had major accomplishments, which include but are not limited to: Performing a total of 94 energy efficiency and waste minimization audit days of 87 industrial plants; Recommending and analysis of 809 energy efficiency measures; Training 22 energy engineers, most of whom have joined energy services companies in California; Disseminating energy efficiency information among local manufacturers; Acting as an information source for energy efficiency for local manufacturers and utilizes; Cooperating with local utilities and California Energy Commission in their energy efficiency projects; Performing various assignments by DOE such as dissemination of information on SEN initiative, conducting workshops on energy efficiency issues, contacting large energy user plants--Establishing a course on 'Energy: Resources, Alternatives and Conservation' as a general education course at SFSU; Bringing energy issues to the attention of students in classrooms

  20. Chronic pelvic pain syndrome: role of a thorough clinical assessment.

    Science.gov (United States)

    Quaghebeur, Jörgen; Wyndaele, Jean-Jacques

    2015-04-01

    Chronic pelvic pain syndrome (CPPS) presents with a variety of symptoms affecting multiple systems. There is no universal treatment that can be given to all patients with CPPS. The results of treatment depend greatly on an accurate diagnosis. A thorough clinical assessment, including a "four-step plan", should include paying special attention to the musculoskeletal system. This assessment is not difficult to perform and provides valuable information on possible muscular problems and neuropathy.

  1. Strengthening Chronic Disease Prevention Programming: the Toward Evidence-Informed Practice (TEIP) Program Assessment Tool

    Science.gov (United States)

    Albert, Dayna; Fortin, Rebecca; Lessio, Anne; Herrera, Christine; Hanning, Rhona; Rush, Brian

    2013-01-01

    Best practices identified solely on the strength of research evidence may not be entirely relevant or practical for use in community-based public health and the practice of chronic disease prevention. Aiming to bridge the gap between best practices literature and local knowledge and expertise, the Ontario Public Health Association, through the Toward Evidence-Informed Practice initiative, developed a set of resources to strengthen evidence-informed decision making in chronic disease prevention programs. A Program Assessment Tool, described in this article, emphasizes better processes by incorporating review criteria into the program planning and implementation process. In a companion paper, “Strengthening Chronic Disease Prevention Programming: The Toward Evidence-Informed Practice (TEIP) Program Evidence Tool,” we describe another tool, which emphasizes better evidence by providing guidelines and worksheets to identify, synthesize, and incorporate evidence from a range of sources (eg, peer-reviewed literature, gray literature, local expertise) to strengthen local programs. The Program Assessment Tool uses 19 criteria derived from literature on best and promising practices to assess and strengthen program planning and implementation. We describe the benefits, strengths, and challenges in implementing the tool in 22 community-based chronic disease prevention projects in Ontario, Canada. The Program Assessment Tool helps put best processes into operation to complement adoption and adaptation of evidence-informed practices for chronic disease prevention. PMID:23721789

  2. Implementing an effective self-assessment program at Millstone Station

    International Nuclear Information System (INIS)

    Venable, J.M.

    1996-01-01

    The nuclear industry is becoming ever more reliant on self-assessments to ensure operational safety and to meet our increasingly competitive business challenges. This trend includes utility assessments modeled after major U.S. Nuclear Regulatory Commission (NRC) inspections such as safety system functional inspections (SSFI). Utility conducted SSFIs leveraged the limited resources of the NRC, making possible many evaluations that simply would not have been conducted otherwise. This report describes a self-assessment program at the Millstone Station plant

  3. Grepafloxacin Clinical Program for Lower Respiratory Tract Infections

    Directory of Open Access Journals (Sweden)

    Arne C Rodloff

    1998-01-01

    Full Text Available The present paper evaluates the clinical trial program in lower respiratory tract infections treated with a new fluoroquinolone antibiotic, grepafloxacin. Unlike older quinolones, grepafloxacin has excellent activity against Gram-positive organisms, which include Streptococcus pneumoniae and “atypical” pathogens Legionella species. Mycoplasma pneumoniae and Chlamydia pneumoniae. Grepafloxacin has a long half-life of 12 to 15 h, which allows once daily dosing. Six studies have been conducted regarding community-acquired lower respiratory tract infections (LRTls, four about community-acquired pneumonia (CAP and two about acute bacterial exacerbations of chronic bronchitis (ABECB . In these studies, grepafloxacin demonstrated clinical equivalence with standard therapies. but, in patients with documented infections. grepafloxacin was statistically superior to amoxycillin in both CAP and ABECB. The new fluoroquinolone has a good safety profile, comparable with that of ciprofloxacin. The most common adverse effects of grepafloxacin were nausea and a metallic taste; however, these effects resulted in only a few discontinuations of therapy. With the increasing prevalence of resistance in pathogens isolated from community-acquired LRTIs, grepafloxacin offers a good alternative for monotherapy in these patients.

  4. Structured assessment of microsurgery skills in the clinical setting.

    Science.gov (United States)

    Chan, WoanYi; Niranjan, Niri; Ramakrishnan, Venkat

    2010-08-01

    Microsurgery is an essential component in plastic surgery training. Competence has become an important issue in current surgical practice and training. The complexity of microsurgery requires detailed assessment and feedback on skills components. This article proposes a method of Structured Assessment of Microsurgery Skills (SAMS) in a clinical setting. Three types of assessment (i.e., modified Global Rating Score, errors list and summative rating) were incorporated to develop the SAMS method. Clinical anastomoses were recorded on videos using a digital microscope system and were rated by three consultants independently and in a blinded fashion. Fifteen clinical cases of microvascular anastomoses performed by trainees and a consultant microsurgeon were assessed using SAMS. The consultant had consistently the highest scores. Construct validity was also demonstrated by improvement of SAMS scores of microsurgery trainees. The overall inter-rater reliability was strong (alpha=0.78). The SAMS method provides both formative and summative assessment of microsurgery skills. It is demonstrated to be a valid, reliable and feasible assessment tool of operating room performance to provide systematic and comprehensive feedback as part of the learning cycle. Copyright 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  5. Do pressure ulcer risk assessment scales improve clinical practice?

    Directory of Open Access Journals (Sweden)

    Jan Kottner

    2010-07-01

    Full Text Available Jan Kottner1, Katrin Balzer21Department of Nursing Science, Charité-Universitätsmedizin Berlin, Germany; 2Nursing Research Group, Institute for Social Medicine, Universitätsklinikum Schleswig-Holstein, Lübeck, GermanyAbstract: Standardized assessment instruments are deemed important for estimating pressure ulcer risk. Today, more than 40 so-called pressure ulcer risk assessment scales are available but still there is an ongoing debate about their usefulness. From a measurement point of view pressure ulcer (PU risk assessment scales have serious limitations. Empirical evidence supporting the validity of PU risk assessment scale scores is weak and obtained scores contain varying amounts of measurement error. The concept of pressure ulcer risk is strongly related to the general health status and severity of illness. A clinical impact due do the application of these scales could also not be demonstrated. It is questionable whether completion of standardized pressure ulcer risk scales in clinical practice is really needed.Keywords: Braden pressure ulcer, prevention, risk assessment, nursing assessment, predictive value, clinical effectiveness, review

  6. Environmental Hazards Assessment Program annual report, [June 1992--June 1993

    Energy Technology Data Exchange (ETDEWEB)

    1993-10-01

    This report, the Environment Hazards Assessment Program (EHAP) Annual Report, is the second of three reports that document activities under the EHAP grant and details progress made during the first year of the grant. The first year was devoted to the development of a working program implementation plan. During the developmental process some key objectives were achieved such as developing a Doctor of Philosophy degree program in Environmental Studies at MUSC (Medical University of South Carolina) and conducting the first Crossroads of Humanity series Round Table Forum. The PIP (Program Implementation Program) details the objectives, management and budgetary basis for the overall management and control of the grant over the next four years, the yearly program plans provide the monthly and day-to-day programmatic and budgetary control by which the PIP was developed.

  7. Environmental Hazards Assessment Program annual report, [June 1992--June 1993

    International Nuclear Information System (INIS)

    1993-10-01

    This report, the Environment Hazards Assessment Program (EHAP) Annual Report, is the second of three reports that document activities under the EHAP grant and details progress made during the first year of the grant. The first year was devoted to the development of a working program implementation plan. During the developmental process some key objectives were achieved such as developing a Doctor of Philosophy degree program in Environmental Studies at MUSC (Medical University of South Carolina) and conducting the first Crossroads of Humanity series Round Table Forum. The PIP (Program Implementation Program) details the objectives, management and budgetary basis for the overall management and control of the grant over the next four years, the yearly program plans provide the monthly and day-to-day programmatic and budgetary control by which the PIP was developed

  8. Assessing Program Learning Objectives to Improve Undergraduate Physics Education

    Science.gov (United States)

    Menke, Carrie

    2014-03-01

    Our physics undergraduate program has five program learning objectives (PLOs) focusing on (1) physical principles, (2) mathematical expertise, (3) experimental technique, (4) communication and teamwork, and (5) research proficiency. One PLO is assessed each year, with the results guiding modifications in our curriculum and future assessment practices; we have just completed our first cycle of assessing all PLOs. Our approach strives to maximize the ease and applicability of our assessment practices while maintaining faculty's flexibility in course design and delivery. Objectives are mapped onto our core curriculum with identified coursework collected as direct evidence. We've utilized mostly descriptive rubrics, applying them at the course and program levels as well as sharing them with the students. This has resulted in more efficient assessment that is also applicable to reaccreditation efforts, higher inter-rater reliability than with other rubric types, and higher quality capstone projects. We've also found that the varied quality of student writing can interfere with our assessment of other objectives. This poster outlines our processes, resources, and how we have used PLO assessment to strengthen our undergraduate program.

  9. Environmental hazards assessment program. Summary report, June 23, 1992--September 30, 1997

    International Nuclear Information System (INIS)

    1997-01-01

    This summary report describes activities and reports for the grant period from June 1992 to September 1997. It reports progress against grant objectives and the Program Implementation Plan published during the first year of the grant program. The program consists of six major elements: (1) public and professional outreach, (2) clinical science, (3) biomedical research, (4) information systems, (5) education, and (6) community development. Research is focused on toxicological and epidemiological investigation into environmental problems that pose a direct risk to human health, and methods to translate basic research into risk assessment and preventive medicine applications for health care providers

  10. Integrating an internet-mediated walking program into family medicine clinical practice: a pilot feasibility study

    Directory of Open Access Journals (Sweden)

    Sen Ananda

    2011-06-01

    Full Text Available Abstract Background Regular participation in physical activity can prevent many chronic health conditions. Computerized self-management programs are effective clinical tools to support patient participation in physical activity. This pilot study sought to develop and evaluate an online interface for primary care providers to refer patients to an Internet-mediated walking program called Stepping Up to Health (SUH and to monitor participant progress in the program. Methods In Phase I of the study, we recruited six pairs of physicians and medical assistants from two family practice clinics to assist with the design of a clinical interface. During Phase II, providers used the developed interface to refer patients to a six-week pilot intervention. Provider perspectives were assessed regarding the feasibility of integrating the program into routine care. Assessment tools included quantitative and qualitative data gathered from semi-structured interviews, surveys, and online usage logs. Results In Phase I, 13 providers used SUH and participated in two interviews. Providers emphasized the need for alerts flagging patients who were not doing well and the ability to review participant progress. Additionally, providers asked for summary views of data across all enrolled clinic patients as well as advertising materials for intervention recruitment. In response to this input, an interface was developed containing three pages: 1 a recruitment page, 2 a summary page, and 3 a detailed patient page. In Phase II, providers used the interface to refer 139 patients to SUH and 37 (27% enrolled in the intervention. Providers rarely used the interface to monitor enrolled patients. Barriers to regular use of the intervention included lack of integration with the medical record system, competing priorities, patient disinterest, and physician unease with exercise referrals. Intention-to-treat analyses showed that patients increased walking by an average of 1493 steps

  11. An approach to the clinical assessment and management of ...

    African Journals Online (AJOL)

    Syncope, defined as a brief loss of consciousness due to an abrupt fall in cerebral perfusion, remains a frequent reason for medical presentation. The goals of the clinical assessment of a patient with syncope are twofold: (i) to identify the precise cause in order to implement a mechanism-specific and effective therapeutic ...

  12. Clinical Evaluation of a Novel and Mobile Autism Risk Assessment

    Science.gov (United States)

    Duda, Marlena; Daniels, Jena; Wall, Dennis P.

    2016-01-01

    The Mobile Autism Risk Assessment (MARA) is a new, electronically administered, 7-question autism spectrum disorder (ASD) screen to triage those at highest risk for ASD. Children 16 months-17 years (N = 222) were screened during their first visit in a developmental-behavioral pediatric clinic. MARA scores were compared to diagnosis from the…

  13. Evidence-Based Clinical Voice Assessment: A Systematic Review

    Science.gov (United States)

    Roy, Nelson; Barkmeier-Kraemer, Julie; Eadie, Tanya; Sivasankar, M. Preeti; Mehta, Daryush; Paul, Diane; Hillman, Robert

    2013-01-01

    Purpose: To determine what research evidence exists to support the use of voice measures in the clinical assessment of patients with voice disorders. Method: The American Speech-Language-Hearing Association (ASHA) National Center for Evidence-Based Practice in Communication Disorders staff searched 29 databases for peer-reviewed English-language…

  14. Assessment of graduate orthodontic programs in North America.

    Science.gov (United States)

    Burk, Thomas; Orellana, Maria

    2013-04-01

    This study collected information on four main aspects of U.S. and Canadian orthodontic programs: demographic profiles of residents, requirements for graduation, graduate curriculum, and number of faculty and staff members. Program directors at seventy U.S. and Canadian orthodontic programs were invited to participate in a twenty-question survey and to distribute a ten-question survey to their residents. Twenty program directors and eighty-four residents completed the anonymous, online surveys on Qualtrics.com in July-August 2010. The average age of surveyed residents was 29.6 years of age; 73 percent were non-Hispanic white, with 14 percent Asian/Asian-American, 5 percent Hispanic, and 1 percent African American. A small percentage of residents (13 percent) were foreign-trained. The majority of residents (64 percent) were male. There was a wide variety of clinical and didactic requirements in the programs. Almost all programs emphasized treatment with functional appliances and clear aligners. An average of three full-time and ten part-time faculty members were dedicated to each residency program. This survey reveals a potential shortage of minority orthodontic residents currently being trained in orthodontic programs, in addition to several commonalities and differences among the programs' curricula, graduation requirements, and numbers of faculty and staff members. This preliminary survey will hopefully inspire measures to address the discrepancies revealed, particularly the lack of minority students and full-time faculty members.

  15. International Code Assessment and Applications Program: Annual report

    International Nuclear Information System (INIS)

    Ting, P.; Hanson, R.; Jenks, R.

    1987-03-01

    This is the first annual report of the International Code Assessment and Applications Program (ICAP). The ICAP was organized by the Office of Nuclear Regulatory Research, United States Nuclear Regulatory Commission (USNRC) in 1985. The ICAP is an international cooperative reactor safety research program planned to continue over a period of approximately five years. To date, eleven European and Asian countries/organizations have joined the program through bilateral agreements with the USNRC. Seven proposed agreements are currently under negotiation. The primary mission of the ICAP is to provide independent assessment of the three major advanced computer codes (RELAP5, TRAC-PWR, and TRAC-BWR) developed by the USNRC. However, program activities can be expected to enhance the assessment process throughout member countries. The codes were developed to calculate the reactor plant response to transients and loss-of-coolant accidents. Accurate prediction of normal and abnormal plant response using the codes enhances procedures and regulations used for the safe operation of the plant and also provides technical basis for assessing the safety margin of future reactor plant designs. The ICAP is providing required assessment data that will contribute to quantification of the code uncertainty for each code. The first annual report is devoted to coverage of program activities and accomplishments during the period between April 1985 and March 1987

  16. The NIAID Division of AIDS enterprise information system: integrated decision support for global clinical research programs

    Science.gov (United States)

    Gupta, Nitin; Varghese, Suresh; Virkar, Hemant

    2011-01-01

    The National Institute of Allergy and Infectious Diseases (NIAID) Division of AIDS (DAIDS) Enterprise Information System (DAIDS-ES) is a web-based system that supports NIAID in the scientific, strategic, and tactical management of its global clinical research programs for HIV/AIDS vaccines, prevention, and therapeutics. Different from most commercial clinical trials information systems, which are typically protocol-driven, the DAIDS-ES was built to exchange information with those types of systems and integrate it in ways that help scientific program directors lead the research effort and keep pace with the complex and ever-changing global HIV/AIDS pandemic. Whereas commercially available clinical trials support systems are not usually disease-focused, DAIDS-ES was specifically designed to capture and incorporate unique scientific, demographic, and logistical aspects of HIV/AIDS treatment, prevention, and vaccine research in order to provide a rich source of information to guide informed decision-making. Sharing data across its internal components and with external systems, using defined vocabularies, open standards and flexible interfaces, the DAIDS-ES enables NIAID, its global collaborators and stakeholders, access to timely, quality information about NIAID-supported clinical trials which is utilized to: (1) analyze the research portfolio, assess capacity, identify opportunities, and avoid redundancies; (2) help support study safety, quality, ethics, and regulatory compliance; (3) conduct evidence-based policy analysis and business process re-engineering for improved efficiency. This report summarizes how the DAIDS-ES was conceptualized, how it differs from typical clinical trial support systems, the rationale for key design choices, and examples of how it is being used to advance the efficiency and effectiveness of NIAID's HIV/AIDS clinical research programs. PMID:21816958

  17. [Development of a portfolio for competency-based assessment in a clinical clerkship curriculum].

    Science.gov (United States)

    Roh, HyeRin; Lee, Jong-Tae; Yoon, Yoo Sang; Rhee, Byoung Doo

    2015-12-01

    The purpose of this report was to describe our experience in planning and developing a portfolio for a clinical clerkship curriculum. We have developed a portfolio for assessing student competency since 2007. During an annual workshop on clinical clerkship curricula, clerkship directors from five Paik hospitals of Inje University met to improve the assessment of the portfolio. We generated templates for students to record their activities and reflection and receive feedback. We uploaded these templates to our school's website for students to download freely. Annually, we have held a faculty development seminar and a workshop for portfolio assessment and feedback. Also, we established an orientation program on how to construct a learning portfolio for students. Future actions include creating a ubiquitous portfolio system, extending the portfolio to the entire curriculum, setting up an advisor system, and managing the quality of the portfolio. This study could be helpful for medical schools that plan to improve their portfolio assessment with an outcome-based approach.

  18. The accountability of clinical education: its definition and assessment.

    Science.gov (United States)

    Murray, E; Gruppen, L; Catton, P; Hays, R; Woolliscroft, J O

    2000-10-01

    Medical education is not exempt from increasing societal expectations of accountability. Competition for financial resources requires medical educators to demonstrate cost-effective educational practice; health care practitioners, the products of medical education programmes, must meet increasing standards of professionalism; the culture of evidence-based medicine demands an evaluation of the effect educational programmes have on health care and service delivery. Educators cannot demonstrate that graduates possess the required attributes, or that their programmes have the desired impact on health care without appropriate assessment tools and measures of outcome. To determine to what extent currently available assessment approaches can measure potentially relevant medical education outcomes addressing practitioner performance, health care delivery and population health, in order to highlight areas in need of research and development. Illustrative publications about desirable professional behaviour were synthesized to obtain examples of required competencies and health outcomes. A MEDLINE search for available assessment tools and measures of health outcome was performed. There are extensive tools for assessing clinical skills and knowledge. Some work has been done on the use of professional judgement for assessing professional behaviours; scholarship; and multiprofessional team working; but much more is needed. Very little literature exists on assessing group attributes of professionals, such as clinical governance, evidence-based practice and workforce allocation, and even less on examining individual patient or population health indices. The challenge facing medical educators is to develop new tools, many of which will rely on professional judgement, for assessing these broader competencies and outcomes.

  19. Caries assessment: establishing mathematical link of clinical and benchtop method

    Science.gov (United States)

    Amaechi, Bennett T.

    2009-02-01

    It is well established that the development of new technologies for early detection and quantitative monitoring of dental caries at its early stage could provide health and economic benefits ranging from timely preventive interventions to reduction of the time required for clinical trials of anti-caries agents. However, the new technologies currently used in clinical setting cannot assess and monitor caries using the actual mineral concentration within the lesion, while a laboratory-based microcomputed tomography (MCT) has been shown to possess this capability. Thus we envision the establishment of mathematical equations relating the measurements of each of the clinical technologies to that of MCT will enable the mineral concentration of lesions detected and assessed in clinical practice to be extrapolated from the equation, and this will facilitate preventitive care in dentistry to lower treatment cost. We utilize MCT and the two prominent clinical caries assessment devices (Quantitative Light-induced Fluorescence [QLF] and Diagnodent) to longitudinally monitor the development of caries in a continuous flow mixed-organisms biofilm model (artificial mouth), and then used the collected data to establish mathematical equation relating the measurements of each of the clinical technologies to that of MCT. A linear correlation was observed between the measurements of MicroCT and that of QLF and Diagnodent. Thus mineral density in a carious lesion detected and measured using QLF or Diagnodent can be extrapolated using the developed equation. This highlights the usefulness of MCT for monitoring the progress of an early caries being treated with therapeutic agents in clinical practice or trials.

  20. Clinical application of Assessment of Parenting Competencies (APC)

    DEFF Research Database (Denmark)

    Jacobsen, Stine Lindahl

    This paper is part of a symposium on music therapy with families with Kirsi Tuomi as Chair. It revolves around the clinical application of a new music therapy assessment model on parent-child interaction and parenting competencies. APC was developed for emotional neglected children and their pare......This paper is part of a symposium on music therapy with families with Kirsi Tuomi as Chair. It revolves around the clinical application of a new music therapy assessment model on parent-child interaction and parenting competencies. APC was developed for emotional neglected children......, child somatic hospitals, centers for refuges and other populations where it would be clinical relevant to assess the parent-child interaction. APC is an observational and improvisational based assessment model evaluating dyads of parent and child (child age range is 5-12). It produces information...... (numbers, graphs, and descriptions) of parent-child interaction and parenting competencies including nonverbal communication, level of attunement in the dyad, and level of emotional support from the parent. It is based on video analysis and a fixed assessment protocol. It was developed through a completed...

  1. Transfer of communication skills to the workplace during clinical rounds: impact of a program for residents.

    Science.gov (United States)

    Liénard, Aurore; Merckaert, Isabelle; Libert, Yves; Bragard, Isabelle; Delvaux, Nicole; Etienne, Anne-Marie; Marchal, Serge; Meunier, Julie; Reynaert, Christine; Slachmuylder, Jean-Louis; Razavi, Darius

    2010-08-26

    Communication with patients is a core clinical skill in medicine that can be acquired through communication skills training. Meanwhile, the importance of transfer of communication skills to the workplace has not been sufficiently studied. This study aims to assess the efficacy of a 40-hour training program designed to improve patients' satisfaction and residents' communication skills during their daily clinical rounds. Residents were randomly assigned to the training program or to a waiting list. Patients' satisfaction was assessed with a visual analog scale after each visit. Transfer of residents' communication skills was assessed in audiotaped actual inpatient visits during a half-day clinical round. Transcripted audiotapes were analyzed using content analysis software (LaComm). Training effects were tested with Mann-Whitney tests and generalized linear Poisson regression models. Eighty-eight residents were included. First, patients interacting with trained residents reported a higher satisfaction with residents' communication (Median=92) compared to patients interacting with untrained residents (Median=88) (p=.046). Second, trained residents used more assessment utterances (Relative Risk (RR)=1.17; 95% Confidence intervals (95%CI)=1.02-1.34; p=.023). Third, transfer was also observed when residents' training attendance was considered: residents' use of assessment utterances (RR=1.01; 95%CI=1.01-1.02; p=.018) and supportive utterances (RR=0.99; 95%CI=0.98-1.00; p=.042) (respectively 1.15 (RR), 1.08-1.23 (95%CI), ptransfer of residents' communication skills learning to the workplace. Transfer was directly related to training attendance but remained limited. Future studies should therefore focus on the improvement of the efficacy of communication skills training in order to ensure a more important training effect size on transfer.

  2. COPD management: role of symptom assessment in routine clinical practice

    Science.gov (United States)

    van der Molen, Thys; Miravitlles, Marc; Kocks, Janwillem WH

    2013-01-01

    Patients with chronic obstructive pulmonary disease (COPD) present with a variety of symptoms that significantly impair health-related quality of life. Despite this, COPD treatment and its management are mainly based on lung function assessments. There is increasing evidence that conventional lung function measures alone do not correlate well with COPD symptoms and their associated impact on patients’ everyday lives. Instead, symptoms should be assessed routinely, preferably by using patient-centered questionnaires that provide a more accurate guide to the actual burden of COPD. Numerous questionnaires have been developed in an attempt to find a simple and reliable tool to use in everyday clinical practice. In this paper, we review three such patient-reported questionnaires recommended by the latest Global Initiative for Chronic Obstructive Lung Disease guidelines, ie, the modified Medical Research Council questionnaire, the clinical COPD questionnaire, and the COPD Assessment Test, as well as other symptom-specific questionnaires that are currently being developed. PMID:24143085

  3. [Environmental Hazards Assessment Program annual report, June 1992--June 1993

    International Nuclear Information System (INIS)

    1993-01-01

    The Medical University of South Carolina (MUSC) and the University of Charleston, South Carolina (UCSC) propose to offer the degree of Master of Science in Environmental Studies. The proposed starting date is August 1994. The purpose of this interdisciplinary program is to offer nationally and internationally recognized graduate level training in the areas of environmental policy, science, and health risk assessment. Special emphasis will be placed on human health. Included in this proposal are a needs assessment for environmental science professionals along with employment projections and salary expectations. The Environmental Science program is described and its relationship to other programs within MUSC and UCSC, as well as its relation to similar programs at other institutions are examined. Enrollment is discussed, admission requirements and standards outlined, and the curriculum is described. Academic and physical resources are examined and estimated costs are given

  4. ASSESSMENT OF PERDA, E-COMMUNITY PROGRAM, PULAU PINANG

    OpenAIRE

    Cheah Fee Lian; Musa Abu Hassan; Jusang Bolong

    2011-01-01

    The purpose of this paper is to assess the e-community program launched by Penang Regional Development Authority (PERDA) based on participants. 276 survey forms were distributed randomly throughout four zones Multimedia Training Centers in Penang. Generally, the respondents admitted that PERDA’s e-community program had positive elements towards them. It was found that interpersonal source such as peers, neighbours and family members were main sources to provided information regarding PE...

  5. Integrating interdisciplinary pain management into primary care: development and implementation of a novel clinical program.

    Science.gov (United States)

    Dorflinger, Lindsey M; Ruser, Christopher; Sellinger, John; Edens, Ellen L; Kerns, Robert D; Becker, William C

    2014-12-01

    The aims of this study were to develop and implement an interdisciplinary pain program integrated in primary care to address stakeholder-identified gaps. Program development and evaluation project utilizing a Plan-Do-Study-Act (PDSA) approach to address the identified problem of insufficient pain management resources within primary care. A large Healthcare System within the Veterans Health Administration, consisting of two academically affiliated medical centers and six community-based outpatients clinics. An interprofessional group of stakeholders participated in a Rapid Process Improvement Workshop (RPIW), a consensus-building process to identify systems-level gaps and feasible solutions and obtain buy-in. Changes were implemented in 2012, and in a 1-year follow-up, we examined indicators of engagement in specialty and multimodal pain care services as well as patient and provider satisfaction. In response to identified barriers, RPIW participants proposed and outlined two readily implementable, interdisciplinary clinics embedded within primary care: 1) the Integrated Pain Clinic, providing in-depth assessment and triage to targeted resources; and 2) the Opioid Reassessment Clinic, providing assessment and structured monitoring of patients with evidence of safety, efficacy, or misuse problems with opioids. Implementation of these programs led to higher rates of engagement in specialty and multimodal pain care services; patients and providers reported satisfaction with these services. Our PDSA cycle engaged an interprofessional group of stakeholders that recommended introduction of new systems-based interventions to better integrate pain resources into primary care to address reported barriers. Early data suggest improved outcomes; examination of additional outcomes is planned. Wiley Periodicals, Inc.

  6. Management assessments of Quality Assurance Program implementation effectiveness

    International Nuclear Information System (INIS)

    Snyder, D.A.

    1984-01-01

    This paper describes a method currently being used by UNC Nuclear Industries, Richland, Washington, to help assure the effectiveness of Quality Assurance (QA) Program implementation. Assessments are conducted annually by management in each department, and the results summarized to the president and his staff. The purpose of these assessments is to review the adequacy of the department's implementing procedures, training/instruction on implementing procedures, and procedure implementation effectiveness. The primary purpose is to assess effectiveness and take improvement action where the need is indicated. The QA organization provides only general guidance in conducting the assessments

  7. Assessment of specialized educational programs for licensed nuclear reactor operators

    International Nuclear Information System (INIS)

    Melber, B.D.; Saari, L.M.; White, A.S.; Geisendorfer, C.L.; Huenefeld, J.C.

    1986-02-01

    This report assesses the job-relatedness of specialized educational programs for licensed nuclear reactor operators. The approach used involved systematically comparing the curriculum of specialized educational programs for college credit, to academic knowledge identified as necessary for carrying out the jobs of licenses reactor operators. A sample of eight programs, including A.S. degree, B.S. degree, and coursework programs were studied. Subject matter experts in the field of nuclear operations curriculum and training determined the extent to which individual program curricula covered the identified job-related academic knowledge. The major conclusions of the report are: There is a great deal of variation among individual programs, ranging from coverage of 15% to 65% of the job-related academic knowledge. Four schools cover at least half, and four schools cover less than one-third of this knowledge content; There is no systematic difference in the job-relatedness of the different types of specialized educational programs, A.S. degree, B.S. degree, and coursework; and Traditional B.S. degree programs in nuclear engineering cover as much job-related knowledge (about one-half of this knowledge content) as most of the specialized educational programs

  8. NON-COMMUNICABLE DISEASE PROGRAM IN AMPANGAN HEALTH CLINIC

    Directory of Open Access Journals (Sweden)

    MASTURA I

    2010-01-01

    Full Text Available Non-communicable diseases (NCDs represent among the most common and debilitating conditions seen in primary care. Patients’ care will often involves multiple providers and follow-up requires persistence by patients and clinicians alike, therefore ideal outcomes are often difficult to achieve. The need for better disease management policies and practice is growing. This is due to the changing demographic profile of the population, the increasing cost of managing people in acute care hospitals and the availability of new technologies and services. All these changes enable a different care paradigm which is more cost effective and provides people with chronic conditions an improved quality of life. Management of the NCDs therefore offers an excellent opportunity to practice chronic disease management - a systems approach designed to ensure excellent care. The NCD team has developed a comprehensive approach to chronic disease care. We would like to describe the NCD Program in Ampangan Health Clinic which represents many typical government health clinics in Malaysia and the processes by which it was developed. Included are specific examples of the tools and how they can be used by individual clinicians incaring for patients. The integration of Chronic Disease Management Services into health care systems is the direction being undertaken to tackle the burden of chronic disease. Disease management supports the shift in healthcare from an emphasis on managing the acute episode to managing the entire disease course, highlighting both prevention and maintenance of wellbeing for patients with chronic diseases. Disease management promotes better integration and coordination of care across all aspects of the health sector.

  9. A Community-Supported Clinic-Based Program for Prevention of Violence against Pregnant Women in Rural Kenya

    Directory of Open Access Journals (Sweden)

    Janet M. Turan

    2013-01-01

    Full Text Available Objective. Pregnant women are especially vulnerable to adverse outcomes related to HIV infection and gender-based violence (GBV. We aimed at developing a program for prevention and mitigation of the effects of GBV among pregnant women at an antenatal clinic in rural Kenya. Methods. Based on formative research with pregnant women, male partners, and service providers, we developed a GBV program including comprehensive clinic training, risk assessments in the clinic, referrals supported by community volunteers, and community mobilization. To evaluate the program, we analyzed data from risk assessment forms and conducted focus groups (n=2 groups and in-depth interviews (n=25 with healthcare workers and community members. Results. A total of 134 pregnant women were assessed during a 5-month period: 49 (37% reported violence and of those 53% accepted referrals to local support resources. Qualitative findings suggested that the program was acceptable and feasible, as it aided pregnant women in accessing GBV services and raised awareness of GBV. Community collaboration was crucial in this low-resource setting. Conclusion. Integrating GBV programs into rural antenatal clinics has potential to contribute to both primary and secondary GBV prevention. Following further evaluation, this model may be deemed applicable for rural communities in Kenya and elsewhere in East Africa.

  10. Health Literacy Assessment in an Otolaryngology Clinic Population.

    Science.gov (United States)

    Megwalu, Uchechukwu C; Lee, Jennifer Y

    2016-12-01

    To assess health literacy in an adult tertiary care otolaryngology clinic population and to explore potential determinants of inadequate health literacy. Cross-sectional study. Tertiary care otolaryngology clinic. The study population included all adult patients treated at 3 of Stanford University's adult otolaryngology clinic sites between March 1 and 11, 2016. Data were collected via an anonymous questionnaire. Health literacy was assessed with the Brief Health Literacy Screen. Ten percent of patients had inadequate health literacy. White race (odds ratio [OR], 0.23) and having English as the primary language (OR, 0.12) were associated with adequate health literacy, while high school or lower level of education (OR, 3.2) was associated with inadequate health literacy. Age, sex, and Hispanic ethnicity were not associated with health literacy. Our study highlights the need for health literacy screening in the otolaryngology clinic setting and identifies sociodemographic risk factors for inadequate health literacy. Further studies are needed to assess the impact of health literacy on patient outcomes and to test specific interventions to address health literacy and health outcomes. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  11. Security Measures in Automated Assessment System for Programming Courses

    Directory of Open Access Journals (Sweden)

    Jana Šťastná

    2015-12-01

    Full Text Available A desirable characteristic of programming code assessment is to provide the learner the most appropriate information regarding the code functionality as well as a chance to improve. This can be hardly achieved in case the number of learners is high (500 or more. In this paper we address the problem of risky code testing and availability of an assessment platform Arena, dealing with potential security risks when providing an automated assessment for a large set of source code. Looking at students’ programs as if they were potentially malicious inspired us to investigate separated execution environments, used by security experts for secure software analysis. The results also show that availability issues of our assessment platform can be conveniently resolved with task queues. A special attention is paid to Docker, a virtual container ensuring no risky code can affect the assessment system security. The assessment platform Arena enables to regularly, effectively and securely assess students' source code in various programming courses. In addition to that it is a motivating factor and helps students to engage in the educational process.

  12. NASA Occupational Health Program FY98 Self-Assessment

    Science.gov (United States)

    Brisbin, Steven G.

    1999-01-01

    The NASA Functional Management Review process requires that each NASA Center conduct self-assessments of each functional area. Self-Assessments were completed in June 1998 and results were presented during this conference session. During FY 97 NASA Occupational Health Assessment Team activities, a decision was made to refine the NASA Self-Assessment Process. NASA Centers were involved in the ISO registration process at that time and wanted to use the management systems approach to evaluate their occupational health programs. This approach appeared to be more consistent with NASA's management philosophy and would likely confer status needed by Senior Agency Management for the program. During FY 98 the Agency Occupational Health Program Office developed a revised self-assessment methodology based on the Occupational Health and Safety Management System developed by the American Industrial Hygiene Association. This process was distributed to NASA Centers in March 1998 and completed in June 1998. The Center Self Assessment data will provide an essential baseline on the status of OHP management processes at NASA Centers. That baseline will be presented to Enterprise Associate Administrators and DASHO on September 22, 1998 and used as a basis for discussion during FY 99 visits to NASA Centers. The process surfaced several key management system elements warranting further support from the Lead Center. Input and feedback from NASA Centers will be essential to defining and refining future self assessment efforts.

  13. Program SYVAC, for stochastic assessment of nuclear fuel waste disposal

    International Nuclear Information System (INIS)

    Sherman, G.R.; Hoffman, K.J.; Donahue, D.C.

    1985-01-01

    In this paper, the computer program SYVAC, used to assess concepts for the disposal of nuclear fuel waste, is described with regard to the development approach, the basic program structure, and quality assurance. The interrelationships of these aspects are illustrated by detailed descriptions of two concepts of fundamental importance to the program: the method of selecting parameter values from input probability density functions, and the numerical evaluation of the convolution integral. Quality assurance procedures, including different types of comparisons and peer review, are presented

  14. Onsite assessments for the Department of Energy Laboratory Accreditation Program

    International Nuclear Information System (INIS)

    McMahan, K.L.

    1992-01-01

    For Department of Energy (DOE) facilities, compliance with DOE Order 5480.11 became a requirement in January 1989. One of the requirements of this Order is that personal external dosimetry programs be accredited under the Department of Energy's Laboratory Accreditation Program (DOELAP) in Personnel Dosimetry. The accreditation process, from the facility's perspective, is two-fold: dosimeters must meet performance criteria in radiation categories appropriate for each facility, and personnel administering and carrying out the program must demonstrate good operating practices. The DOELAP onsite assessment is designed to provide an independent evaluation of the latter

  15. An international basic science and clinical research summer program for medical students.

    Science.gov (United States)

    Ramjiawan, Bram; Pierce, Grant N; Anindo, Mohammad Iffat Kabir; Alkukhun, Abedalrazaq; Alshammari, Abdullah; Chamsi, Ahmad Talal; Abousaleh, Mohannad; Alkhani, Anas; Ganguly, Pallab K

    2012-03-01

    An important part of training the next generation of physicians is ensuring that they are exposed to the integral role that research plays in improving medical treatment. However, medical students often do not have sufficient time to be trained to carry out any projects in biomedical and clinical research. Many medical students also fail to understand and grasp translational research as an important concept today. In addition, since medical training is often an international affair whereby a medical student/resident/fellow will likely train in many different countries during his/her early training years, it is important to provide a learning environment whereby a young medical student experiences the unique challenges and value of an international educational experience. This article describes a program that bridges the gap between the basic and clinical research concepts in a unique international educational experience. After completing two semester curricula at Alfaisal University in Riyadh, Kingdom of Saudi Arabia, six medical students undertook a summer program at St. Boniface Hospital Research Centre, in Winnipeg, MB, Canada. The program lasted for 2 mo and addressed advanced training in basic science research topics in medicine such as cell isolation, functional assessment, and molecular techniques of analysis and manipulation as well as sessions on the conduct of clinical research trials, ethics, and intellectual property management. Programs such as these are essential to provide a base from which medical students can decide if research is an attractive career choice for them during their clinical practice in subsequent years. An innovative international summer research course for medical students is necessary to cater to the needs of the medical students in the 21st century.

  16. Assessing Professionalism: A Theoretical Framework for Defining Clinical Rotation Assessment Criteria.

    Science.gov (United States)

    Armitage-Chan, Elizabeth

    Although widely accepted as an important graduate competence, professionalism is a challenging outcome to define and assess. Clinical rotations provide an excellent opportunity to develop student professionalism through the use of experiential learning and effective feedback, but without appropriate theoretical frameworks, clinical teachers may find it difficult to identify appropriate learning outcomes. The adage "I know it when I see it" is unhelpful in providing feedback and guidance for student improvement, and criteria that are more specifically defined would help students direct their own development. This study sought first to identify how clinical faculty in one institution currently assess professionalism, using retrospective analysis of material obtained in undergraduate teaching and faculty development sessions. Subsequently, a faculty workshop was held in which a round-table type discussion sought to develop these ideas and identify how professionalism assessment could be improved. The output of this session was a theoretical framework for teaching and assessing professionalism, providing example assessment criteria and ideas for clinical teaching. This includes categories such as client and colleague interaction, respect and trust, recognition of limitations, and understanding of different professional identities. Each category includes detailed descriptions of the knowledge, skills, and behaviors expected of students in these areas. The criteria were determined by engaging faculty in the development of the framework, and therefore they should represent a focused development of criteria already used to assess professionalism, and not a novel and unfamiliar set of assessment guidelines. The faculty-led nature of this framework is expected to facilitate implementation in clinical teaching.

  17. Clinical observations of a Cantonese cognitive-behavioral treatment program for Chinese immigrants.

    Science.gov (United States)

    Shen, Edward K; Alden, Lynn E; Söchting, Ingrid; Tsang, Pheobe

    2006-01-01

    In this article, the authors describe our clinical observations about the process of delivering a Cantonese-language cognitive- behavioral therapy program to treat depression in Hong Kong immigrants to Vancouver, Canada. Our experiences indicated that standard referral and assessment procedures were not optimal for this population. Other factors that required consideration were how to convert Cantonese terms for dysphoric affect into English equivalents and how to implement cognitive modification strategies when dealing with culture-syntonic beliefs about social relationships. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  18. Clinical assessment of transthoracic echocardiography skills: a generalizability study

    DEFF Research Database (Denmark)

    Nielsen, Dorte Guldbrand; O'Neill, Lotte; Jensen, Signe

    2015-01-01

    Context: Transthoracic echocardiography (TTE) is a widely used cardiac imaging technique that all cardiologists should be able to perform competently. Traditionally, TTE competence has been assessed by unstructured observation or in test situations separated from daily clinical practice. An objec......Context: Transthoracic echocardiography (TTE) is a widely used cardiac imaging technique that all cardiologists should be able to perform competently. Traditionally, TTE competence has been assessed by unstructured observation or in test situations separated from daily clinical practice....... An objective assessment instrument for TTE technical proficiency including a global rating score and a checklist score has previously been shown reliability and validity in a standardised setting. Objectives: As clinical test situations typically have several sources of error giving rise to variance in scores......, a more thorough examination of the generalizability of the test scores is needed. Methods Nine physicians performed a TTE scan on the same three patients. Then, two raters rated all 27 TTE scans using the TTE technical assessment in a fully crossed generalizability study. Estimated variance components...

  19. Research training among pediatric residency programs: a national assessment.

    Science.gov (United States)

    Abramson, Erika L; Naifeh, Monique M; Stevenson, Michelle D; Todd, Christopher; Henry, Emilie D; Chiu, Ya-Lin; Gerber, Linda M; Li, Su-Ting T

    2014-12-01

    The Accreditation Council for Graduate Medical Education (ACGME) states that "residents should participate in scholarly activity." However, there is little guidance for effectively integrating scholarly activity into residency. This study was conducted to understand how pediatric residency programs meet ACGME requirements and to identify characteristics of successful programs. The authors conducted an online cross-sectional survey of all pediatric residency program directors in October 2012, assessing program characteristics, resident participation in scholarly activity, program infrastructure, barriers, and outcomes. Multivariate logistic regression was used to identify characteristics of programs in the top quartile for resident scholarly activity participation. The response rate was 52.8% (105/199 programs). Seventy-seven (78.6%) programs required scholarly activity, although definitions were variable. When including only original research, systematic reviews or meta-analyses, and case reports or series with references, resident participation averaged 56% (range 0%-100%). Characteristics associated with high-participation programs included a scholarly activity requirement (odds ratio [OR] = 5.5, 95% confidence interval [CI] = 1.03-30.0); program director belief that all residents should present work regionally or nationally (OR = 4.7, 95% CI = 1.5-15.1); and mentorship by >25% of faculty (OR = 3.6, CI = 1.2-11.4). Only 47.1% (41) of program directors were satisfied with resident participation, and only 30.7% (27) were satisfied with the quality of research training provided. The findings suggest that resident scholarly activity experience is highly variable and suboptimal. Identifying characteristics of successful programs can improve the resident research training experience.

  20. Evolutions in clinical reasoning assessment: The Evolving Script Concordance Test.

    Science.gov (United States)

    Cooke, Suzette; Lemay, Jean-François; Beran, Tanya

    2017-08-01

    Script concordance testing (SCT) is a method of assessment of clinical reasoning. We developed a new type of SCT case design, the evolving SCT (E-SCT), whereby the patient's clinical story is "evolving" and with thoughtful integration of new information at each stage, decisions related to clinical decision-making become increasingly clear. We aimed to: (1) determine whether an E-SCT could differentiate clinical reasoning ability among junior residents (JR), senior residents (SR), and pediatricians, (2) evaluate the reliability of an E-SCT, and (3) obtain qualitative feedback from participants to help inform the potential acceptability of the E-SCT. A 12-case E-SCT, embedded within a 24-case pediatric SCT (PaedSCT), was administered to 91 pediatric residents (JR: n = 50; SR: n = 41). A total of 21 pediatricians served on the panel of experts (POE). A one-way analysis of variance (ANOVA) was conducted across the levels of experience. Participants' feedback on the E-SCT was obtained with a post-test survey and analyzed using two methods: percentage preference and thematic analysis. Statistical differences existed across levels of training: F = 19.31 (df = 2); p decision-making process. The E-SCT demonstrated very good reliability and was effective in distinguishing clinical reasoning ability across three levels of experience. Participants found the E-SCT engaging and representative of real-life clinical reasoning and decision-making processes. We suggest that further refinement and utilization of the evolving style case will enhance SCT as a robust, engaging, and relevant method for the assessment of clinical reasoning.

  1. Benefit-cost assessment programs: Costa Rica case study

    International Nuclear Information System (INIS)

    Clark, A.L.; Trocki, L.K.

    1991-01-01

    An assessment of mineral potential, in terms of types and numbers of deposits, approximate location and associated tonnage and grades, is a valuable input to a nation's economic planning and mineral policy development. This study provides a methodology for applying benefit-cost analysis to mineral resource assessment programs, both to determine the cost effectiveness of resource assessments and to ascertain future benefits to the nation. In a case study of Costa Rica, the benefit-cost ratio of a resource assessment program was computed to be a minimum of 4:1 ($10.6 million to $2.5 million), not including the economic benefits accuring from the creation of 800 mining sector and 1,200 support services jobs. The benefit-cost ratio would be considerably higher if presently proposed revisions of mineral policy were implemented and benefits could be defined for Costa Rica

  2. Formerly Utilized Sites Remedial Action Program environmental compliance assessment checklists

    Energy Technology Data Exchange (ETDEWEB)

    Levine, M.B.; Sigmon, C.F.

    1989-09-29

    The purpose of the Environmental Compliance Assessment Program is to assess the compliance of Formerly Utilized Site Remedial Action Program (FUSRAP) sites with applicable environmental regulations and Department of Energy (DOE) Orders. The mission is to identify, assess, and decontaminate sites utilized during the 1940s, 1950s, and 1960s to process and store uranium and thorium ores in support of the Manhattan Engineer District and the Atomic Energy Commission. To conduct the FUSRAP environmental compliance assessment, checklists were developed that outline audit procedures to determine the compliance status of the site. The checklists are divided in four groups to correspond to these regulatory areas: Hazardous Waste Management, PCB Management, Air Emissions, and Water Discharges.

  3. Formerly Utilized Sites Remedial Action Program environmental compliance assessment checklists

    International Nuclear Information System (INIS)

    Levine, M.B.; Sigmon, C.F.

    1989-01-01

    The purpose of the Environmental Compliance Assessment Program is to assess the compliance of Formerly Utilized Site Remedial Action Program (FUSRAP) sites with applicable environmental regulations and Department of Energy (DOE) Orders. The mission is to identify, assess, and decontaminate sites utilized during the 1940s, 1950s, and 1960s to process and store uranium and thorium ores in support of the Manhattan Engineer District and the Atomic Energy Commission. To conduct the FUSRAP environmental compliance assessment, checklists were developed that outline audit procedures to determine the compliance status of the site. The checklists are divided in four groups to correspond to these regulatory areas: Hazardous Waste Management, PCB Management, Air Emissions, and Water Discharges

  4. Assessing undergraduate nursing students in clinical practice: do preceptors use assessment strategies?

    Science.gov (United States)

    McCarthy, Bridie; Murphy, Siobhan

    2008-04-01

    Health care organisations such as the World Health Organisation (WHO) and An Bord Altranais (ABA, The Irish Nursing Registration Board) demand higher standards of new graduate nurses than heretofore. This is in conjunction with the implementation of degree programmes for undergraduate nurse education. These organisations stipulate that graduates must be well-educated, accountable, and can demonstrate the skills of a safe, caring and competent decision-making practitioner. The Bachelor of Science (BSc) four-year degree programme for undergraduate nurse education was introduced in Ireland in 2002, and is provided in universities and colleges of higher education throughout The Republic of Ireland. During the implementation process, each university and college of higher education developed a range of assessment strategies to clinically assess students. Preceptor nurses were subsequently assigned the responsibility of clinically assessing students, a remit previously undertaken by Clinical Ward/Unit Nurse Managers. Preceptors are qualified nurses, working in clinical units who are specially prepared to support BSc students during clinical placements. The purpose of this study was to explore to what extent preceptor nurses use the devised assessment strategies to clinically assess BSc students in one university in The Republic of Ireland. Data were collected by using a questionnaire distributed to all known preceptors in General, Psychiatric and Intellectual Disability nursing, during year four of the first cycle of the BSc programme. Findings from this descriptive study revealed that many preceptors were inexperienced, did not fully comprehend the assessment process and were not applying all of the recommended assessment strategies when assessing students in clinical practice. In light of these findings suggestions are made in the context of further research, management and education.

  5. A Systematic Review of the Effects of Continuing Education Programs on Providing Clinical Community Pharmacy Services

    Science.gov (United States)

    Marques dos Reis, Tiago; Guidoni, Camilo Molino; Girotto, Edmarlon; Guerra, Marisabelle Lima; de Oliveira Baldoni, André; Leira Pereira, Leonardo Régis

    2016-01-01

    Objective. To summarize the effects of media methods used in continuing education (CE) programs on providing clinical community pharmacy services and the methods used to evaluate the effectiveness of these programs. Methods. A systematic review was performed using Medline, SciELO, and Scopus databases. The timeline of the search was 1990 to 2013. Searches were conducted in English, Portuguese, and Spanish. Results. Nineteen articles of 3990 were included. Fourteen studies used only one media method, and the live method (n=11) was the most frequent (alone or in combination). Only two studies found that the CE program was ineffective or partially effective; these studies used only the live method. Most studies used nonrobust, nonvalidated, and nonstandardized methods to measure effectiveness. The majority of studies focused on the effect of the CE program on modifying the knowledge and skills of the pharmacists. One study assessed the CE program’s benefits to patients or clients. Conclusion. No evidence was obtained regarding which media methods are the most effective. Robust and validated methods, as well as assessment standardization, are required to clearly determine whether a particular media method is effective. PMID:27402991

  6. Job analysis and student assessment tool: perfusion education clinical preceptor.

    Science.gov (United States)

    Riley, Jeffrey B

    2007-09-01

    The perfusion education system centers on the cardiac surgery operating room and the perfusionist teacher who serves as a preceptor for the perfusion student. One method to improve the quality of perfusion education is to create a valid method for perfusion students to give feedback to clinical teachers. The preceptor job analysis consisted of a literature review and interviews with preceptors to list their critical tasks, critical incidents, and cognitive and behavioral competencies. Behaviorally anchored rating traits associated with the preceptors' tasks were identified. Students voted to validate the instrument items. The perfusion instructor rating instrument with a 0-4, "very weak" to "very strong" Likert rating scale was used. The five preceptor traits for student evaluation of clinical instruction (SECI) are as follows: The clinical instructor (1) encourages self-learning, (2) encourages clinical reasoning, (3) meets student's learning needs, (4) gives continuous feedback, and (5) represents a good role model. Scores from 430 student-preceptor relationships for 28 students rotating at 24 affiliate institutions with 134 clinical instructors were evaluated. The mean overall good preceptor average (GPA) was 3.45 +/- 0.76 and was skewed to the left, ranging from 0.0 to 4.0 (median = 3.8). Only 21 of the SECI relationships earned a GPA SECI are methods to provide valid information to improve the quality of a perfusion education program.

  7. Technology needs assessment for DOE environmental restoration programs

    International Nuclear Information System (INIS)

    Duray, J.R.; Carlson, T.J.; Carpenter, C.E.; Cummins, L.E.; Daub, G.J.

    1992-01-01

    The 'Technology Needs Assessment Final Report' describes current and planned environmental restoration activity, identifies technologies intended to be used or under consideration, and ranks technology deficiencies in the U.S. Department of Energy's environmental restoration program. Included in the ranking are treatment technologies, characterization technologies, and non-technology issues that affect environmental restoration. Data used for the assessment was gathered during interviews in the spring of 1991 with DOE site personnel responsible for the environmental restoration work. (author)

  8. Why providers participate in clinical trials: considering the National Cancer Institute's Community Clinical Oncology Program.

    Science.gov (United States)

    McAlearney, Ann Scheck; Song, Paula H; Reiter, Kristin L

    2012-11-01

    The translation of research evidence into practice is facilitated by clinical trials such as those sponsored by the National Cancer Institute's Community Clinical Oncology Program (CCOP) that help disseminate cancer care innovations to community-based physicians and provider organizations. However, CCOP participation involves unsubsidized costs and organizational challenges that raise concerns about sustained provider participation in clinical trials. This study was designed to improve our understanding of why providers participate in the CCOP in order to inform the decision-making process of administrators, clinicians, organizations, and policy-makers considering CCOP participation. We conducted a multi-site qualitative study of five provider organizations engaged with the CCOP. We interviewed 41 administrative and clinician key informants, asking about what motivated CCOP participation, and what benefits they associated with involvement. We deductively and inductively analyzed verbatim interview transcripts, and explored themes that emerged. Interviewees expressed both "altruistic" and "self-interested" motives for CCOP participation. Altruistic reasons included a desire to increase access to clinical trials and feeling an obligation to patients. Self-interested reasons included the desire to enhance reputation, and a need to integrate disparate cancer care activities. Perceived benefits largely matched expressed motives for CCOP participation, and included internal and external benefits to the organization, and quality of care benefits for both patients and participating physicians. The motives and benefits providers attributed to CCOP participation are consistent with translational research goals, offering evidence that participation can contribute value to providers by expanding access to innovative medical care for patients in need. Copyright © 2012 Elsevier Inc. All rights reserved.

  9. Evaluating the Accreditation Council on Graduate Medical Education core clinical competencies: techniques and feasibility in a urology training program.

    Science.gov (United States)

    Miller, David C; Montie, James E; Faerber, Gary J

    2003-10-01

    We describe several traditional and novel techniques for teaching and evaluating the Accreditation Council on Graduate Medical Education (ACGME) core clinical competencies in a urology residency training program. The evolution and underpinnings of the ACGME Outcome Project were reviewed. Several publications related to the evaluation of clinical competencies as well as current assessment techniques at our institution were also analyzed. Several tools for the assessment of clinical competencies have been developed and refined in response to the ACGME Outcome project. Standardized patient encounters and expanded patient satisfaction surveys may prove useful with regard to assessing resident professionalism, patient care and communication skills. A feasible and possibly undervalued technique for evaluating a number of core competencies is the implementation of formal written appraisals of the nature and quality of resident performance at departmental conferences. The assessment of competency in practice based learning and systems based practice may be achieved through innovative exercises, such as practice guideline development, that assess the evidence for various urologic interventions as well as the financial and administrative aspects of such care. We describe several contemporary methods for teaching and evaluating the core clinical competencies in a urology training program. While the techniques described are neither comprehensive nor feasible for every program, they nevertheless provide an important starting point for a meaningful exchange of ideas in the urological graduate medical education community.

  10. Assessment of diabetic teleretinal imaging program at the Portland Department of Veterans Affairs Medical Center.

    Science.gov (United States)

    Tsan, Grace L; Hoban, Keely L; Jun, Weon; Riedel, Kevin J; Pedersen, Amy L; Hayes, John

    2015-01-01

    We conducted a retrospective chart review of 200 diabetic patients who had teleretinal imaging performed between January 1, 2010, and January 1, 2011, at Portland Department of Veterans Affairs (VA) Medical Center outpatient clinics to assess the effectiveness of the diabetic teleretinal imaging program. Twenty patients (10%) had diabetic retinopathy. Ninety percent of the available teleretinal imaging studies were of adequate quality for interpretation. In accordance with local VA policy at that time, all teleretinal imaging patients should have been referred for a dilated retinal examination the following year. Image readers referred 97.5% of the patients to eye clinics for subsequent eye examinations, but the imagers scheduled appointments for only 80% of these patients. The redundancy rate, i.e., patients who had an eye examination within the past 6 mo, was 11%; the duplicate recall rate, i.e., patients who had a second teleretinal imaging performed within 1 yr of the eye examination, was 37%. Rates of timely diabetic eye examinations at clinics with teleretinal imaging programs, particularly when teleretinal imaging and eye clinics were colocated at the same community-based outpatient clinic, were higher than those without a teleretinal imaging program. We concluded that the Portland VA Medical Center's teleretinal imaging program was successful in increasing the screening rate for diabetic retinopathy.

  11. The visibility of QSEN competencies in clinical assessment tools in Swedish nurse education.

    Science.gov (United States)

    Nygårdh, Annette; Sherwood, Gwen; Sandberg, Therese; Rehn, Jeanette; Knutsson, Susanne

    2017-12-01

    Prospective nurses need specific and sufficient knowledge to be able to provide quality care. The Swedish Society of Nursing has emphasized the importance of the six quality and safety competencies (QSEN), originated in the US, in Swedish nursing education. To investigate the visibility of the QSEN competencies in the assessment tools used in clinical practice METHOD: A quantitative descriptive method was used to analyze assessment tools from 23 universities. Teamwork and collaboration was the most visible competency. Patient-centered care was visible to a large degree but was not referred to by name. Informatics was the least visible, a notable concern since all nurses should be competent in informatics to provide quality and safety in care. These results provide guidance as academic and clinical programs around the world implement assessment of how well nurses have developed these essential quality and safety competencies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Clinical evaluation of automated processing of electrocardiograms by the Veterans Administration program (AVA 3.4).

    Science.gov (United States)

    Brohet, C R; Richman, H G

    1979-06-01

    Automated processing of electrocardiograms by the Veterans Administration program was evaluated for both agreement with physician interpretation and interpretative accuracy as assessed with nonelectrocardiographic criteria. One thousand unselected electrocardiograms were analyzed by two reviewer groups, one familiar and the other unfamiliar with the computer program. A significant number of measurement errors involving repolarization changes and left axis deviation occurred; however, interpretative disagreements related to statistical decision were largely language-related. Use of a printout with a more traditional format resulted in agreement with physician interpretation by both reviewer groups in more than 80 percent of cases. Overall sensitivity based on agreement with nonelectrocardiographic criteria was significantly greater with use of the computer program than with use of the conventional criteria utilized by the reviewers. This difference was particularly evident in the subgroup analysis of myocardial infarction and left ventricular hypertrophy. The degree of overdiagnosis of left ventricular hypertrophy and posteroinferior infarction was initially unacceptable, but this difficulty was corrected by adjustment of probabilities. Clinical acceptability of the Veterans Administration program appears to require greater physician education than that needed for other computer programs of electrocardiographic analysis; the flexibility of interpretation by statistical decision offers the potential for better diagnostic accuracy.

  13. Initial Readability Assessment of Clinical Trial Eligibility Criteria

    Science.gov (United States)

    Kang, Tian; Elhadad, Noémie; Weng, Chunhua

    2015-01-01

    Various search engines are available to clinical trial seekers. However, it remains unknown how comprehensible clinical trial eligibility criteria used for recruitment are to a lay audience. This study initially investigated this problem. Readability of eligibility criteria was assessed according to (i) shallow and lexical characteristics through the use of an established, generic readability metric; (ii) syntactic characteristics through natural language processing techniques; and (iii) health terminological characteristics through an automated comparison to technical and lay health texts. We further stratified clinical trials according to various study characteristics (e.g., source country or study type) to understand potential factors influencing readability. Mainly caused by frequent use of technical jargons, a college reading level was found to be necessary to understand eligibility criteria text, a level much higher than the average literacy level of the general American population. The use of technical jargons should be minimized to simplify eligibility criteria text. PMID:26958204

  14. Assessing Use of Cognitive Heuristic Representativeness in Clinical Reasoning

    OpenAIRE

    Payne, Velma L.; Crowley, Rebecca S.

    2008-01-01

    We performed a pilot study to investigate use of the cognitive heuristic Representativeness in clinical reasoning. We tested a set of tasks and assessments to determine whether subjects used the heuristics in reasoning, to obtain initial frequencies of heuristic use and related cognitive errors, and to collect cognitive process data using think-aloud techniques. The study investigates two aspects of the Representativeness heuristic - judging by perceived frequency and representativeness as ca...

  15. Assessing biocomputational modelling in transforming clinical guidelines for osteoporosis management.

    Science.gov (United States)

    Thiel, Rainer; Viceconti, Marco; Stroetmann, Karl

    2011-01-01

    Biocomputational modelling as developed by the European Virtual Physiological Human (VPH) Initiative is the area of ICT most likely to revolutionise in the longer term the practice of medicine. Using the example of osteoporosis management, a socio-economic assessment framework is presented that captures how the transformation of clinical guidelines through VPH models can be evaluated. Applied to the Osteoporotic Virtual Physiological Human Project, a consequent benefit-cost analysis delivers promising results, both methodologically and substantially.

  16. A quality assessment tool for markup-based clinical guidelines.

    Science.gov (United States)

    Shalom, Erez; Shahar, Yuval; Taieb-Maimon, Meirav; Lunenfeld, Eitan

    2008-11-06

    We introduce a tool for quality assessment of procedural and declarative knowledge. We developed this tool for evaluating the specification of mark-up-based clinical GLs. Using this graphical tool, the expert physician and knowledge engineer collaborate to perform scoring, using pre-defined scoring scale, each of the knowledge roles of the mark-ups, comparing it to a gold standard. The tool enables scoring the mark-ups simultaneously at different sites by different users at different locations.

  17. Counselor Competence, Performance Assessment, and Program Evaluation: Using Psychometric Instruments

    Science.gov (United States)

    Tate, Kevin A.; Bloom, Margaret L.; Tassara, Marcel H.; Caperton, William

    2014-01-01

    Psychometric instruments have been underutilized by counselor educators in performance assessment and program evaluation efforts. As such, we conducted a review of the literature that revealed 41 instruments fit for such efforts. We described and critiqued these instruments along four dimensions--"Target Domain," "Format,"…

  18. Quality Assurance--Best Practices for Assessing Online Programs

    Science.gov (United States)

    Wang, Qi

    2006-01-01

    Educators have long sought to define quality in education. With the proliferation of distance education and online learning powered by the Internet, the tasks required to assess the quality of online programs become even more challenging. To assist educators and institutions in search of quality assurance methods to continuously improve their…

  19. Waste isolation safety assessment program. Summary of FY-77 progress

    International Nuclear Information System (INIS)

    Burkholder, H.C.; Greenborg, J.; Stottlemyre, J.A.; Bradley, D.J.; Raymond, J.R.; Serne, R.J.

    1977-11-01

    Objective is to provide long-term safety information for the National Waste Terminal Storage Program. Work in FY 77 supported the development of the generic assessment method (release scenario analysis, release consequence analysis) and of the generic data base (waste form release rate data, radionuclide geochemical interaction data)

  20. Social assessment for the Colville National Forest CROP program.

    Science.gov (United States)

    Angela J. Findley; Matthew S. Carroll; Keith A. Blatner

    2000-01-01

    A qualitative social assessment targeted salient issues connected to the Colville National Forest creating opportunities (CROP) research program that examines forest management alternatives for small-diameter stands in northeastern Washington. Research spanned various communities in three counties and investigated the diversity of fundamental values people attach to...

  1. Laboratory Directed Research and Development Program Assessment for FY 2015

    Energy Technology Data Exchange (ETDEWEB)

    Hatton, Diane [Brookhaven National Lab. (BNL), Upton, NY (United States); Barkigia, K. [Brookhaven National Lab. (BNL), Upton, NY (United States); Giacalone, P. [Brookhaven National Lab. (BNL), Upton, NY (United States)

    2016-03-01

    This report provides an overview of the BNL LDRD program and a summary of the management processes, project peer review, a financial overview, and the relation of the portfolio of LDRD projects to BNL's mission, initiatives, and strategic plan. Also included are a summary of success indicators and a self-assessment.

  2. Assessment of the Business Administration and Business Management Programs.

    Science.gov (United States)

    Forestieri, Kathleen; Karlen, Janice; Coiro, Robert; Gabriel, Theodore; Leff, Elaine; Silverman, Barry; Wertheimer, David

    This document presents City University of New York LaGuardia Community College's Department of Accounting and Managerial Studies assessment of its business and administration and business management programs report, and includes the following items: (1) a description of the mission and goals of the Department of Accounting and Managerial Studies;…

  3. 78 FR 14912 - International Aviation Safety Assessment (IASA) Program Change

    Science.gov (United States)

    2013-03-08

    ... Aviation Safety Assessment (IASA) Program Change AGENCY: Federal Aviation Administration (FAA), DOT. ACTION..., into the U.S., or codeshare with a U.S. air carrier, complies with international aviation safety... subject to that country's aviation safety oversight can serve the United States using its own aircraft or...

  4. Environmental Hazards Assessment Program. Quarterly report, July 1994--September 1994

    International Nuclear Information System (INIS)

    1994-01-01

    The objectives of the Environmental Hazards Assessment Program (EHAP) stated in the proposal to DOE are as follows: Development of a holistic, national basis for risk assessment, risk management, and risk communication that recognizes the direct impact of environmental hazards on the health and well-being of all; development of a pool of talented scientist and experts in cleanup activities, especially in human health aspects; identification of needs and development of programs addressing the critical shortage of well-educated, highly-skilled technical and scientific personnel to address the health oriented aspects of environmental restoration and waste management. This is a progress report of the first quarter of the third year of the grant. It reports progress against these grant objectives and the Program Implementation Plan (published at the end of the first year of the grant)

  5. Environmental Hazards Assessment Program. Quarterly report, July--September 1995

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-10-31

    This report describes activities and reports on progress for the first quarter (July--September) of the fourth year of the grant to support the Environmental Hazards Assessment Program (EHAP) at the Medical University of South Carolina. It reports progress against the grant objectives and the Program Implementation Plan published at the end of the first year of the grant. The objectives of EHAP stated in the proposal to DOE are to: (1) develop a holistic, national basis for risk assessment, risk management, and risk communication that recognizes the direct impact of environmental hazards on the health and well-being of all; (2) develop a pool of talented scientists and experts in cleanup activities, especially in human health aspects; and (3) identify needs and develop programs addressing the critical shortage of well-educated, highly-skilled technical and scientific personnel to address the health-oriented aspects of environmental restoration and waste management.

  6. Teledermatology: quality assessment by user satisfaction and clinical efficiency.

    Science.gov (United States)

    Klaz, Itay; Wohl, Yonit; Nathansohn, Nir; Yerushalmi, Nir; Sharvit, Sharon; Kochba, Ilan; Brenner, Sarah

    2005-08-01

    The Israel Defense Forces implemented a pilot teledermatology service in primary clinics. To assess user satisfaction and clinical short-term effectiveness of a computerized store and forward teledermatology service in urban and rural units. A multi-center prospective uncontrolled cohort pilot trial was conducted for a period of 6 months. Primary care physicians referred patients to a board-certified dermatologist using text email accompanied by digital photographs. Diagnosis, therapy and management were sent back to the referring PCP. Patients were asked to evaluate the level of the CSAFTD service, effect of the service on accessibility to dermatologists, respect for privacy, availability of drugs, health improvement and overall satisfaction. PCPs assessed the quality of the teledermatology consultations they received, the contribution to their knowledge, and their overall satisfaction. Tele-diagnosis alone was possible for 95% (n=413) of 435 CSAFTD referrals; 22% (n=95) of referrals also required face-to-face consultation, Satisfaction with CSAFTD was high among patients in both rural and urban clinics, with significantly higher scores in rural units. Rural patients rated the level of service, accessibility and overall satisfaction higher than did urban patients. PCPs were satisfied with the quality of the service and its contribution to their knowledge. Rural physicians rated level of service and overall satisfaction higher than did urban physicians. Tele-referrals were completed more efficiently than referral for face-to-face appointments. CSAFTD provided efficient, high quality medical service to rural and urban military clinics in the IDF.

  7. Alflutop clinical efficacy assessment in osteoarthritis (two-years study

    Directory of Open Access Journals (Sweden)

    V. N. Chodyrev

    2003-01-01

    Full Text Available Objective. To assess alflutop clinical efficacy and safety during long-term course treatment of knee osteoarthritis. Methods. 51 pts with definite knee osteoarthritis of I-III stage according to Kellgren-Lawrence classification were included in an open controlled study. 20 pts received 6 intra-articular injections of alflutop 2 ml with subsequent intramuscular treatment during 3 months. Such courses were repeated 6 months apart for 2 years. 31 pts of control group received nonsteroidal anti-inflammatory drugs (NSAID only. Pain on visual analog scale, Leken functional score, changes of NSAID treatment and radiological picture were used for assessment of efficacy. Clinical examination was performed before and after every treatment course and 3 months after the last course. Results. Every alflutop treatment course provided significant stepwise decrease of pain with improvement of mobility, reduction of NSAID requirement and absence of osteoarthritis radiological progression. Doctor and pts clinical efficacy and safety assessment coincided. Conclusion. Alflutop is an effective drug for knee osteoarthritis treatment. It has anti-inflammatory and probably chondroprotective activity with good safety.

  8. FY11 Facility Assessment Study for Aeronautics Test Program

    Science.gov (United States)

    Loboda, John A.; Sydnor, George H.

    2013-01-01

    This paper presents the approach and results for the Aeronautics Test Program (ATP) FY11 Facility Assessment Project. ATP commissioned assessments in FY07 and FY11 to aid in the understanding of the current condition and reliability of its facilities and their ability to meet current and future (five year horizon) test requirements. The principle output of the assessment was a database of facility unique, prioritized investments projects with budgetary cost estimates. This database was also used to identify trends for the condition of facility systems.

  9. The Off-Campus Clinical Program of the College of Optometry, Ferris State College.

    Science.gov (United States)

    Paramore, James E.

    1982-01-01

    The clinical education program at Ferris State College, College of Optometry, and the various clinics affiliated with the college are described. To ensure quality, all individuals with the responsibility of teaching the students are faculty of Ferris State. (MLW)

  10. Brain imaging with synthetic MR in children: clinical quality assessment

    Energy Technology Data Exchange (ETDEWEB)

    Betts, Aaron M.; Serai, Suraj [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Leach, James L.; Jones, Blaise V. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); University of Cincinnati College of Medicine, Cincinnati, OH (United States); Zhang, Bin [Cincinnati Children' s Hospital Medical Center, Biostatistics and Epidemiology, Cincinnati, OH (United States)

    2016-10-15

    Synthetic magnetic resonance imaging is a quantitative imaging technique that measures inherent T1-relaxation, T2-relaxation, and proton density. These inherent tissue properties allow synthesis of various imaging sequences from a single acquisition. Clinical use of synthetic MR imaging has been described in adult populations. However, use of synthetic MR imaging has not been previously reported in children. The purpose of this study is to report our assessment of diagnostic image quality using synthetic MR imaging in children. Synthetic MR acquisition was obtained in a sample of children undergoing brain MR imaging. Image quality assessments were performed on conventional and synthetic T1-weighted, T2-weighted, and FLAIR images. Standardized linear measurements were performed on conventional and synthetic T2 images. Estimates of patient age based upon myelination patterns were also performed. Conventional and synthetic MR images were evaluated on 30 children. Using a 4-point assessment scale, conventional imaging performed better than synthetic imaging for T1-weighted, T2-weighted, and FLAIR images. When the assessment was simplified to a dichotomized scale, the conventional and synthetic T1-weighted and T2-weighted images performed similarly. However, the superiority of conventional FLAIR images persisted in the dichotomized assessment. There were no statistically significant differences between linear measurements made on T2-weighted images. Estimates of patient age based upon pattern of myelination were also similar between conventional and synthetic techniques. Synthetic MR imaging may be acceptable for clinical use in children. However, users should be aware of current limitations that could impact clinical utility in the software version used in this study. (orig.)

  11. A program to assess microbial impacts on nuclear waste containment

    International Nuclear Information System (INIS)

    Horn, J.; Meike, A.

    1996-01-01

    In this paper we discuss aspects of a comprehensive program to identify and bound potential effects of microorganisms on long-term nuclear waste containment, using as examples, studies conducted within the Yucca Mountain Project. A comprehensive program has been formulated which cuts across standard disciplinary lines to address the specific concerns of microbial activity in a radioactive waste repository. Collectively, this program provides bounding parameters of microbial activities that modify the ambient geochemistry and hydrology, modify corrosion rates, and transport and transform radionuclides under conditions expected to be encountered after geological waste emplacement. This program is intended to provide microbial reaction rates and bounding conditions in a form that can be integrated into existing chemical and hydrological models. The inclusion of microbial effects will allow those models to more accurately assess long term repository integrity

  12. A self-assessment program for Commonwealth Edison Company

    International Nuclear Information System (INIS)

    Garner, D.; Krowzak, F.; Wishau, R.

    1987-01-01

    This paper explains the assessment program developed by Commonwealth Edison Company (CECo) to evaluate the effectiveness of technical activities at its nuclear generating stations. The technical activities evaluated are in the areas of chemistry, emergency planning, radiation protection, and radioactive waste operations. The stations have technical programs for each of these areas and are set up to comply with applicable governmental laws and regulations, industry guidelines, and corporate policies and procedures. Reviews and audits need to be performed to ensure that technical program objectives are being met and that the programs are progressing as intended. Many organizations, including the Institute of Nuclear Power Operations, U.S. Nuclear Regulatory Commission, American Nuclear Insurers, and the CECo Quality Assurance Department perform such reviews and audits, which generate a wide variety of information on the stations' activities

  13. Program for rapid dose assessment in criticality accident, RADAPAS

    International Nuclear Information System (INIS)

    Takahashi, Fumiaki

    2006-09-01

    In a criticality accident, a person near fissile material can receive extremely high dose which can cause acute health effect. For such a case, medical treatment should be carried out for the exposed person, according to severity of the exposure. Then, radiation dose should be rapidly assessed soon after an outbreak of an accident. Dose assessment based upon the quantity of induced 24 Na in human body through neutron exposure is expected as one of useful dosimetry techniques in a criticality accident. A dose assessment program, called RADAPAS (RApid Dose Assessment Program from Activated Sodium in Criticality Accidents), was therefore developed to assess rapidly radiation dose to exposed persons from activity of induced 24 Na. RADAPAS consists of two parts; one is a database part and the other is a part for execution of dose calculation. The database contains data compendiums of energy spectra and dose conversion coefficients from specific activity of 24 Na induced in human body, which had been derived in a previous analysis using Monte Carlo calculation code. Information for criticality configuration or characteristics of radiation in the accident field is to be interactively given with interface displays in the dose calculation. RADAPAS can rapidly derive radiation dose to the exposed person from the given information and measured 24 Na specific activity by using the conversion coefficient in database. This report describes data for dose conversions and dose calculation in RADAPAS and explains how to use the program. (author)

  14. Adherence to Radiology Recommendations in a Clinical CT Lung Screening Program.

    Science.gov (United States)

    Alshora, Sama; McKee, Brady J; Regis, Shawn M; Borondy Kitts, Andrea K; Bolus, Christopher C; McKee, Andrea B; French, Robert J; Flacke, Sebastian; Wald, Christoph

    2018-02-01

    Assess patient adherence to radiologist recommendations in a clinical CT lung cancer screening program. Patients undergoing CT lung cancer screening between January 12, 2012, and June 12, 2013, were included in this institutional review board-approved retrospective review. Patients referred from outside our institution were excluded. All patients met National Comprehensive Cancer Network Guidelines Lung Cancer Screening high-risk criteria. Full-time program navigators used a CT lung screening program management system to schedule patient appointments, generate patient result notification letters detailing the radiologist follow-up recommendation, and track patient and referring physician notification of missed appointments at 30, 60, and 90 days. To be considered adherent, patients could be no more than 90 days past due for their next recommended examination as of September 12, 2014. Patients who died, were diagnosed with cancer, or otherwise became ineligible for screening were considered adherent. Adherence rates were assessed across multiple variables. During the study interval, 1,162 high-risk patients were screened, and 261 of 1,162 (22.5%) outside referrals were excluded. Of the remaining 901 patients, 503 (55.8%) were male, 414 (45.9%) were active smokers, 377 (41.8%) were aged 65 to 73, and >95% were white. Of the 901 patients, 772 (85.7%) were adherent. Most common reasons for nonadherence were patient refusal of follow-up exam (66.7%), inability to successfully contact the patient (20.9%), and inability to obtain the follow-up order from the referring provider (7.8%); 23 of 901 (2.6%) were discharged for other reasons. High rates of adherence to radiologist recommendations are achievable for in-network patients enrolled in a clinical CT lung screening program. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  15. Designing and Assessing the Validity and Reliability of the Hospital Readiness Assessment Tools to Conducting Quality Improvement Program

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    Kamal Gholipoor

    2016-09-01

    Full Text Available Background and objectives : Identifying the readiness of hospital and its strengths and weaknesses can be useful in developing appropriate planning and situation analyses and management to getting effective in clinical audit programs. The aim of this study was to design and assess the validity of the Hospital Readiness Assessment Tools to conduct quality improvement and clinical audit programs. Material and Methods: In this study, based on the results of a systematic review of literature, an initial questionnaire with 77 items was designed. Questionnaire content validity was reviewed by experts in the field of hospital management and quality improvement in Tabriz University of Medical Sciences. For this purpose, 20 questionnaires were sent to experts. Finally, 15 participants returned completed questionnaire. Questionnaire validity was reviewed and confirmed based on Content Validity Index and Content Validity Ratio. Questionnaire reliability was confirmed based on Cronbach's alpha index (α = 0.96 in a pilot study by participation of 30 hospital managers. Results: The results showed that the final questionnaire contains 54 questions as nine category as: data and information (9 items, teamwork (12 questions, resources (5 questions, patient and education (5, intervention design and implementation (5 questions, clinical audit management (4 questions, human resources (6 questions, evidence and standard (4 items and evaluation and feedback (4 items. The final questionnaire content validity index was 0.91 and final questionnaire Cronbach's alpha coefficient was 0.96. Conclusion: Considering the relative good validity and reliability of the designed tool in this study, it appears that the questionnaire can be used to identify and assess the readiness of hospitals for quality improvement and clinical audit program implementation

  16. ASSESSMENT OF PERDA, E-COMMUNITY PROGRAM, PULAU PINANG

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    Cheah Fee Lian

    2011-12-01

    Full Text Available The purpose of this paper is to assess the e-community program launched by Penang Regional Development Authority (PERDA based on participants. 276 survey forms were distributed randomly throughout four zones Multimedia Training Centers in Penang. Generally, the respondents admitted that PERDA’s e-community program had positive elements towards them. It was found that interpersonal source such as peers, neighbours and family members were main sources to provided information regarding PERDA’s e-community program to the respondents. The results showed that most respondents had positive attitude towards competence, ability to try and complexity of computer and the Internet after going through the program. However, there were respondents which had negative attitudes towards their ability to try using the computer and Internet after involving in this program. The results also found that features in PERDA’s ecommunity program become the core into such involvement. Therefore, efforts are needed now and then in order to enhance the quality of this program thus encouraging more participation in the future.

  17. Assessment of residency program outcomes via alumni surveys.

    Science.gov (United States)

    Lüer, Sonja; Aebi, Christoph

    2017-01-01

    One trend in medical education is outcomes-oriented training. Outcomes usually refer to individuals' acquisition of competencies, for example, during training in residency programs. However, little is known about outcomes of these programs. In order to fill this gap, human resource (HR) data were analyzed and alumni of a pediatric residency program were surveyed at the Department of Pediatrics, Bern University Hospital, Switzerland. Residency program outcomes (demographics, career choices, part-time or full-time work status, competencies, feedback) were assessed through in-house HR databases, publicly available data on the Internet (physician directory and practice homepages), and 2 alumni surveys (S1, S2). In all, 109 alumni met the inclusion criteria. Retention rate at the hospital was low (14%). Forty-six alumni (42%) in private practice were eligible for alumni surveys. Response rates were 87% (S1) and 61% (S2). Time intervals between 2 career decisions (selecting specialty of pediatrics vs selecting setting of private practice) varied widely (late-training decision to enter private practice). Mean employment level in private practice was 60% (range 20%-100%). Most valued rotation was emergency medicine; most desired competencies in future colleagues were the ability to work in a team, proficiency in pediatrics, and working economically. A broadened view on outcomes - beyond individuals' competency acquisition - provides informative insights into a training program, can allow for informed program updates, and guide future program development.

  18. Technical and clinical view on ambulatory assessment in Parkinson's disease.

    Science.gov (United States)

    Hobert, M A; Maetzler, W; Aminian, K; Chiari, L

    2014-09-01

    With the progress of technologies of recent years, methods have become available that use wearable sensors and ambulatory systems to measure aspects of--particular axial--motor function. As Parkinson's disease (PD) can be considered a model disorder for motor impairment, a significant number of studies have already been performed with these patients using such techniques. In general, motion sensors such as accelerometers and gyroscopes are used, in combination with lightweight electronics that do not interfere with normal human motion. A fundamental advantage in comparison with usual clinical assessment is that these sensors allow a more quantitative, objective, and reliable evaluation of symptoms; they have also significant advantages compared to in-lab technologies (e.g., optoelectronic motion capture) as they allow long-term monitoring under real-life conditions. In addition, based on recent findings particularly from studies using functional imaging, we learned that non-motor symptoms, specifically cognitive aspects, may be at least indirectly assessable. It is hypothesized that ambulatory quantitative assessment strategies will allow users, clinicians, and scientists in the future to gain more quantitative, unobtrusive, and everyday relevant data out of their clinical evaluation and can also be designed as pervasive (everywhere) and intensive (anytime) tools for ambulatory assessment and even rehabilitation of motor and (partly) non-motor symptoms in PD. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Self-assessment and students’ study strategies in a community of clinical practice: A qualitative study

    Science.gov (United States)

    Al-Kadri, Hanan M.; Al-Moamary, Mohamed S.; Al-Takroni, Habib; Roberts, Chris; van der Vleuten, Cees P. M.

    2012-01-01

    Background Self-assessment is recognized as a necessary skill for lifelong learning. It is widely reported to offer numerous advantages to the learner. The research evaluated the impact of students’ and supervisors’ self-assessment and feedback training on students’ perceptions and practices of self-assessment. Moreover, it evaluated the effect of self-assessment process on students’ study strategies within a community of clinical practice. Methods We conducted a qualitative phenomenological study from May 2008 to December 2009. We held 37 semi-structured individual interviews with three different cohorts of undergraduate medical students until we reached data saturation. The cohorts were exposed to different contexts while experiencing their clinical years’ assessment program. In the interviews, students’ perceptions and interpretations of ‘self-assessment practice’ and ‘supervisor-provided feedback’ within different contexts and the resulting study strategies were explored. Results The analysis of interview data with the three cohorts of students yielded three major themes: strategic practice of self-assessment, self-assessment and study strategies, and feedback and study strategies. It appears that self-assessment is not appropriate within a summative context, and its implementation requires cultural preparation. Despite education and orientation on the two major components of the self-assessment process, feedback was more effective in enhancing deeper study strategies. Conclusion This research suggests that the theoretical advantages linked to the self-assessment process are a result of its feedback component rather than the practice of self-assessment isolated from feedback. Further research exploring the effects of different contextual and personal factors on students’ self-assessment is needed. PMID:22355241

  20. Self-assessment and students' study strategies in a community of clinical practice: a qualitative study.

    Science.gov (United States)

    Al-Kadri, Hanan M; Al-Moamary, Mohamed S; Al-Takroni, Habib; Roberts, Chris; van der Vleuten, Cees P M

    2012-01-01

    Self-assessment is recognized as a necessary skill for lifelong learning. It is widely reported to offer numerous advantages to the learner. The research evaluated the impact of students' and supervisors' self-assessment and feedback training on students' perceptions and practices of self-assessment. Moreover, it evaluated the effect of self-assessment process on students' study strategies within a community of clinical practice. We conducted a qualitative phenomenological study from May 2008 to December 2009. We held 37 semi-structured individual interviews with three different cohorts of undergraduate medical students until we reached data saturation. The cohorts were exposed to different contexts while experiencing their clinical years' assessment program. In the interviews, students' perceptions and interpretations of 'self-assessment practice' and 'supervisor-provided feedback' within different contexts and the resulting study strategies were explored. The analysis of interview data with the three cohorts of students yielded three major themes: strategic practice of self-assessment, self-assessment and study strategies, and feedback and study strategies. It appears that self-assessment is not appropriate within a summative context, and its implementation requires cultural preparation. Despite education and orientation on the two major components of the self-assessment process, feedback was more effective in enhancing deeper study strategies. This research suggests that the theoretical advantages linked to the self-assessment process are a result of its feedback component rather than the practice of self-assessment isolated from feedback. Further research exploring the effects of different contextual and personal factors on students' self-assessment is needed.

  1. A comprehensive clinical competency-based assessment in periodontics.

    Science.gov (United States)

    Shiloah, J; Scarbecz, M; Bland, P S; Hottel, T L

    2017-05-01

    Traditional periodontics clinical examinations in dental education frequently assess a narrow set of clinical skills and do not adequately assess the ability of students to independently manage a periodontal patient. As an alternative, the authors developed a comprehensive periodontics competency case experience (CCCE) for senior dental students and surveyed students regarding their experience with the CCCE. Students challenging the CCCE must treat a patient with moderate periodontitis and must independently decide when a state of periodontal and oral health has been achieved. Students are also required to conduct an oral presentation to periodontology faculty. Dental students who completed the CCCE had a favourable impression of the experience, compared with the traditional clinical examinations taken in the junior year. The majority of students rated all the components of the CCCE as 'somewhat' or 'very helpful'. About 72.4% of students felt that being able to work independently on the examination was very helpful for learning about the clinical management of patients with periodontal disease, followed by 'simulation of care in private practice' (65.5%), and oral photography experience (55.2%). The greatest difficulty reported by students was finding an acceptable patient. About 62.1% of students rated 'finding the right patient' as very difficult. Students reported having to screen a mean of 5.9 patients (SD: 4.5) to find a qualified patient. The results of the survey will be useful in improving the examination as an assessment tool in periodontal therapy. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Assessing clinical reasoning abilities of medical students using clinical performance examination

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    Sunju Im

    2016-03-01

    Full Text Available Purpose: The purpose of this study is to investigate the reliability and validity of new clinical performance examination (CPX for assessing clinical reasoning skills and evaluating clinical reasoning ability of the students. Methods: Third-year medical school students (n=313 in Busan-Gyeongnam consortium in 2014 were included in the study. One of 12 stations was developed to assess clinical reasoning abilities. The scenario and checklists of the station were revised by six experts. Chief complaint of the case was rhinorrhea, accompanied by fever, headache, and vomiting. Checklists focused on identifying of the main problem and systematic approach to the problem. Students interviewed the patient and recorded subjective and objective findings, assessments, plans (SOAP note for 15 minutes. Two professors assessed students simultaneously. We performed statistical analysis on their scores and survey. Results: The Cronbach α of subject station was 0.878 and Cohen κ coefficient between graders was 0.785. Students agreed on CPX as an adequate tool to evaluate students’ performance, but some graders argued that the CPX failed to secure its validity due to their lack of understanding the case. One hundred eight students (34.5% identified essential problem early and only 58 (18.5% performed systematic history taking and physical examination. One hundred seventy-three of them (55.3% communicated correct diagnosis with the patient. Most of them had trouble in writing SOAP notes. Conclusion: To gain reliability and validity, interrater agreement should be secured. Students' clinical reasoning skills were not enough. Students need to be trained on problem identification, reasoning skills and accurate record-keeping.

  3. Transfer of communication skills to the workplace during clinical rounds: impact of a program for residents.

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    Aurore Liénard

    2010-08-01

    Full Text Available Communication with patients is a core clinical skill in medicine that can be acquired through communication skills training. Meanwhile, the importance of transfer of communication skills to the workplace has not been sufficiently studied. This study aims to assess the efficacy of a 40-hour training program designed to improve patients' satisfaction and residents' communication skills during their daily clinical rounds.Residents were randomly assigned to the training program or to a waiting list. Patients' satisfaction was assessed with a visual analog scale after each visit. Transfer of residents' communication skills was assessed in audiotaped actual inpatient visits during a half-day clinical round. Transcripted audiotapes were analyzed using content analysis software (LaComm. Training effects were tested with Mann-Whitney tests and generalized linear Poisson regression models.Eighty-eight residents were included. First, patients interacting with trained residents reported a higher satisfaction with residents' communication (Median=92 compared to patients interacting with untrained residents (Median=88 (p=.046. Second, trained residents used more assessment utterances (Relative Risk (RR=1.17; 95% Confidence intervals (95%CI=1.02-1.34; p=.023. Third, transfer was also observed when residents' training attendance was considered: residents' use of assessment utterances (RR=1.01; 95%CI=1.01-1.02; p=.018 and supportive utterances (RR=0.99; 95%CI=0.98-1.00; p=.042 (respectively 1.15 (RR, 1.08-1.23 (95%CI, p<.001 for empathy and 0.95 (RR, 0.92-0.99 (95%CI, p=.012 for reassurance was proportional to the number of hours of training attendance.The training program improved patients' satisfaction and allowed the transfer of residents' communication skills learning to the workplace. Transfer was directly related to training attendance but remained limited. Future studies should therefore focus on the improvement of the efficacy of communication skills

  4. Clinical assessment tools identify functional deficits in fragility fracture patients

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    Ames TD

    2016-05-01

    Full Text Available Tyler D Ames,1 Corinne E Wee,1 Khoi M Le,1 Tiffany L Wang,1 Julie Y Bishop,2 Laura S Phieffer,2 Carmen E Quatman2 1The Ohio State University College of Medicine, 2Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH, USA Purpose: To identify inexpensive, noninvasive, portable, clinical assessment tools that can be used to assess functional performance measures that may put older patients at risk for falls such as balance, handgrip strength, and lumbopelvic control.Patients and methods: Twenty fragility fracture patients and 21 healthy control subjects were evaluated using clinical assessment tools (Nintendo Wii Balance Board [WBB], a handheld dynamometer, and an application for the Apple iPod Touch, the Level Belt that measure functional performance during activity of daily living tasks. The main outcome measurements were balance (WBB, handgrip strength (handheld dynamometer, and lumbopelvic control (iPod Touch Level Belt, which were compared between fragility fracture patients and healthy controls.Results: Fragility fracture patients had lower scores on the vertical component of the WBB Torso Twist task (P=0.042 and greater medial–lateral lumbopelvic sway during a 40 m walk (P=0.026 when compared to healthy controls. Unexpectedly, the fracture patients had significantly higher scores on the left leg (P=0.020 and total components (P=0.010 of the WBB Single Leg Stand task as well as less faults during the left Single Leg Stand task (P=0.003.Conclusion: The clinical assessment tools utilized in this study are relatively inexpensive and portable tools of performance measures capable of detecting differences in postural sway between fragility fracture patients and controls. Keywords: fall risk, geriatric fracture, Nintendo Wii Balance Board, Level Belt, fragility fracture

  5. A clinical clerkship collaborative program in Taiwan: Acquiring core clinical competencies through patient care responsibility

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    Yong A. Wang

    2016-06-01

    Conclusion: This pilot collaborative program presented a successful model for clinical education in the teaching of core clinical competencies through direct patient care responsibilities at the clerkship stage. It is hoped that the project will become a catalyst for medical education reform in Taiwan and regions with similar traditions.

  6. Assessing clinically meaningful treatment effects in controlled trials: chronic migraine as an example.

    Science.gov (United States)

    Dodick, David W; Turkel, Catherine C; DeGryse, Ronald E; Diener, Hans-Christoph; Lipton, Richard B; Aurora, Sheena K; Nolan, Marissa E; Silberstein, Stephen D

    2015-02-01

    In addition to headache, persons with chronic migraine (CM) experience multiple symptoms, both ictal and interictal, that may contribute to their suffering. Translating clinical trial results into practice requires assessment of the results' clinical meaningfulness. When examining treatment benefit in this disabled patient population, multiple headache-symptom measures should be considered to fully reflect clinical relevance. Currently, only onabotulinumtoxinA is approved specifically for headache prophylaxis in adults with CM. Topiramate is the only other therapeutic agent with double-blind, placebo-controlled evidence in this population. Herein we evaluate the clinical meaningfulness of onabotulinumtoxinA and topiramate as headache prophylaxis in CM by comparing primary endpoints from the placebo-controlled, double-blind phase of the Phase 3 REsearch Evaluating Migraine Prophylaxis Therapy (PREEMPT) clinical program and the topiramate clinical trial (frequency of headache days [primary endpoint in PREEMPT; secondary in topiramate trial] and migraine/migrainous days [primary in topiramate trial, or "migraine/probable-migraine days"; secondary in PREEMPT]). Additionally, outcome measures such as responder rates, health-related quality of life, discontinuation rates, safety, and tolerability profiles are important clinical considerations. The clinical data indicate that statistically significant, clinically relevant treatment benefits exist for both onabotulinumtoxinA and topiramate. These data support these treatments as meaningful headache prophylaxis in adults with CM. CM is a chronic pain condition. We sought to determine the clinical relevance of recent trials in this disabled population. Clinical data indicate that statistically significant, clinically relevant treatment benefits exist for both onabotulinumtoxinA and topiramate, and support use of these treatments as meaningful headache prophylaxis in CM. Copyright © 2015 American Pain Society. Published

  7. Parthenium dermatitis severity score to assess clinical severity of disease

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    Kaushal K Verma

    2017-01-01

    Full Text Available Background: Parthenium dermatitis is the most common type of airborne contact dermatitis in India. It is a chronic disease of a remitting and relapsing course with significant morbidity and distress, but there is no scoring system to assess its severity. Aim: To design a scoring system for the assessment of clinical severity of disease in Parthenium dermatitis and to use this scoring system in various studies to determine its sensitivity, specificity, and reproducibility. Methods and Results: In our first few studies on Parthenium dermatitis, we designed and used a basic clinical severity scoring system based on itching, morphology of the lesions, and areas involved. However, in subsequent studies, we modified it to the present scoring system as Parthenium dermatitis severity score (PDSS. Our studies showed the high sensitivity of PDSS in characterization of the disease severity at the given point of time, as well as to determine the efficacy of a prescribed treatment modality which was reliable and reproducible. Conclusion: Thus, PDSS may be used by clinicians for appropriate scoring of the clinical severity of Parthenium dermatitis and in monitoring the disease response to therapy.

  8. Clinical pharmacology quality assurance program: models for longitudinal analysis of antiretroviral proficiency testing for international laboratories.

    Science.gov (United States)

    DiFrancesco, Robin; Rosenkranz, Susan L; Taylor, Charlene R; Pande, Poonam G; Siminski, Suzanne M; Jenny, Richard W; Morse, Gene D

    2013-10-01

    Among National Institutes of Health HIV Research Networks conducting multicenter trials, samples from protocols that span several years are analyzed at multiple clinical pharmacology laboratories (CPLs) for multiple antiretrovirals. Drug assay data are, in turn, entered into study-specific data sets that are used for pharmacokinetic analyses, merged to conduct cross-protocol pharmacokinetic analysis, and integrated with pharmacogenomics research to investigate pharmacokinetic-pharmacogenetic associations. The CPLs participate in a semiannual proficiency testing (PT) program implemented by the Clinical Pharmacology Quality Assurance program. Using results from multiple PT rounds, longitudinal analyses of recovery are reflective of accuracy and precision within/across laboratories. The objectives of this longitudinal analysis of PT across multiple CPLs were to develop and test statistical models that longitudinally: (1) assess the precision and accuracy of concentrations reported by individual CPLs and (2) determine factors associated with round-specific and long-term assay accuracy, precision, and bias using a new regression model. A measure of absolute recovery is explored as a simultaneous measure of accuracy and precision. Overall, the analysis outcomes assured 97% accuracy (±20% of the final target concentration of all (21) drug concentration results reported for clinical trial samples by multiple CPLs). Using the Clinical Laboratory Improvement Act acceptance of meeting criteria for ≥2/3 consecutive rounds, all 10 laboratories that participated in 3 or more rounds per analyte maintained Clinical Laboratory Improvement Act proficiency. Significant associations were present between magnitude of error and CPL (Kruskal-Wallis P Kruskal-Wallis P < 0.001).

  9. Effects of an experiential learning program on the clinical reasoning and critical thinking skills of occupational therapy students.

    Science.gov (United States)

    Coker, Patty

    2010-01-01

    This study examined the effects of participation in a 1-week, experiential, hands-on learning program on the critical thinking and clinical reasoning skills of occupational therapy students. A quasi-experimental, nonrandomized pre- and post-test design was used with a sample of 25 students. The students had completed three semesters of didactic lecture coursework in a master's level OT educational program prior to participation in a hands-on therapy program for children with hemiplegic cerebral palsy. Changes in critical thinking and clinical reasoning skills were evaluated using the following dependent measures: Self-Assessment of Clinical Reflection and Reasoning (SACRR) and the California Critical Thinking Skills Test (CCTST). Changes in pretest and posttest scores on the SACRR and the CCTST were statistically significant (p>0.05) following completion of the experiential learning program. This study supports the use of hands-on learning to develop clinical reasoning and critical thinking skills in healthcare students, who face ever more diverse patient populations upon entry-level practice. Further qualitative and quantitative investigations are needed to support the results of this study and determine which components of experiential learning programs are essential for developing clinical reasoning and critical thinking skills in future allied health professionals.

  10. Radiology education. The evaluation and assessment of clinical competence

    International Nuclear Information System (INIS)

    Hibbert, Kathryn M.; Van Deven, Teresa; Chhem, Rethy K.; Nagasaki Univ.; Wang, Shih-chang; Royal Australian and New Zealand College of Radiologists, Sydney

    2012-01-01

    Third volume of a trilogy devoted to radiology education and improvement of medical imaging students' learning, teaching, and scholarship. Reviews the philosophies, theories, and principles that underpin assessment and evaluation in radiology education. Includes a series of rich case studies. Written by an international group of experienced educators and medical professionals. This book reviews the philosophies, theories, and principles that underpin assessment and evaluation in radiology education, highlighting emerging practices and work done in the field. The sometimes conflicting assessment and evaluation needs of accreditation bodies, academic programs, trainees, and patients are carefully considered. The final section of the book examines assessment and evaluation in practice, through the development of rich case studies reflecting the implementation of a variety of approaches. This is the third book in a trilogy devoted to the scholarship of radiology education and is the culmination of an important initiative to improve medical imaging students' learning, teaching, and scholarship by bringing together experienced educators and medical professionals. The previous two books focused on the culture and the learning organizations in which our future radiologists are educated and on the application of educational principles in the education of radiologists. Here, the trilogy comes full circle: attending to the assessment and evaluation of the education of its members has much to offer back to the learning of the organization.

  11. Assessment of clinical depression comorbid with posttraumatic stress disorder

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    Simonović Maja

    2008-01-01

    Full Text Available Background/Aim. Comorbidity of the posttraumatic stress disorder (PTSD and depression is often recognized in the clinical practice. The aim of the paper was to determine the severity of depression and the group of symptoms which are the most prominent in clinical depression comorbid with PTSD. Methods. Totally 60 patients were assessed and divided into the experimental and control group using the Structured Clinical Interview for DSM-IV Axis I Disorders, Investigator Version (SCID-I, modified (SCID for DSM-IV and ICD-10 diagnostic criteria. The presence and the severity of the disorders were assessed by means of the following instruments: Clinician-Administrated PTSD Scale for DSM-IV (CAPS-DX, Montgomery-Asberg Depression Rating Scale (MADRS and 17-item Hamilton Rating Scale for Depression (HAMD. The differences between groups were evaluated using Student t test and by means of the correlation analysis of the data with p < 0.05. Results. The obtained results showed that depression witch was comorbid with PTSD was of significant clinical severity with 31.20 score on HAMD and 30.43 score on MADRS in PTSD-D group. The group of the symptoms: lassitude, inability to feel, suicidal thoughts and inner tension contributed mostly to the global severity of the comorbid clinical depression on MADRS. The group of the symptoms: suicide and somatic symptoms, gastrointestinal, guilt, hypochondriasis, work and activity, anxiety psychic, agitation, and weight loss, genital symptoms and anxiety somatic contributed mostly to the global severity of comorbid clinical depression on HAMD. The average score was 16.03 and 16.97 on HAMD and MADRS, respectively in PTSD group. Conclusion. Depression which is comorbid with posttraumatic stress disorder represents significant clinical entity with domination of the different groups of symptoms between the groups PTSD and PTSD-D on HAMD. Identification of aforementioned severity of illness and delineated group of symptoms lead

  12. An institutional review board-based clinical research quality assurance program.

    Science.gov (United States)

    Lad, Pramod M; Dahl, Rebecca

    2013-01-01

    Despite the acknowledged importance of quality assurance in the clinical research process, the problem of how such a program should be implemented at the level of an academic teaching hospital or a similar institution has not been addressed in the literature. Despite the fact that quality assurance is expected in programs which certify and accredit Institutional Review Boards (IRBs), very little is known about the role of the IRB in programs of clinical research quality assurance. In this article we consider the definition of clinical research quality assurance, and describe a program designed to achieve it. The key elements of such a program are education at the site level, which has both mandatory and voluntary components, and an auditing and monitoring program, which reinforces the education on quality assurance. The role of the IRB in achieving the program goals and the organizational placement of the quality assurance program within the IRB structure and function are important items of discussion.

  13. COPD management: role of symptom assessment in routine clinical practice

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    van der Molen T

    2013-10-01

    Full Text Available Thys van der Molen,1,2 Marc Miravitlles,3 Janwillem WH Kocks1,21Department of General Practice, 2GRIAC (Groningen Research Institute for Asthma and COPD, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; 3Pneumology Department, Hospital Universitari Vall d'Hebron, Biomedical Research Networking Centre in Respiratory Diseases (CIBERES, Barcelona, SpainAbstract: Patients with chronic obstructive pulmonary disease (COPD present with a variety of symptoms that significantly impair health-related quality of life. Despite this, COPD treatment and its management are mainly based on lung function assessments. There is increasing evidence that conventional lung function measures alone do not correlate well with COPD symptoms and their associated impact on patients' everyday lives. Instead, symptoms should be assessed routinely, preferably by using patient-centered questionnaires that provide a more accurate guide to the actual burden of COPD. Numerous questionnaires have been developed in an attempt to find a simple and reliable tool to use in everyday clinical practice. In this paper, we review three such patient-reported questionnaires recommended by the latest Global Initiative for Chronic Obstructive Lung Disease guidelines, ie, the modified Medical Research Council questionnaire, the clinical COPD questionnaire, and the COPD Assessment Test, as well as other symptom-specific questionnaires that are currently being developed.Keywords: chronic obstructive pulmonary disease, symptoms, questionnaires

  14. MR imaging assessment of clinical problems in rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Narvaez, Jose A.; Roca, Yolanda; Aguilera, Carlos [Department of CT and MR Imaging, Hospital Duran i Reynals, Universitaria de Bellvitge, Barcelona (Spain); Narvaez, Javier [Department of Medicine, Delfos Medical Center, Barcelona (Spain)

    2002-07-01

    Although MR imaging has been increasingly recognized as a useful tool in the diagnosis of early rheumatoid arthritis (RA) and in the assessment of disease activity, these applications have not yet been usually included in the routine management of this condition. Our goal is to review the current role of MRI in the everyday clinical management of patients with RA. The usefulness of MRI in the evaluation of articular and para-articular changes in specific locations, mainly the craniocervical region and the temporomandibular joint, are reviewed. Clinical problems derived from local extra-articular involvement, such as tenosynovitis, ''rice-bodies'' bursitis, and Baker's cyst rupture, are also described. Finally, we also review the value of MRI in evaluation of some complications of RA such as tendinous rupture, osteonecrosis, stress fracture, and septic arthritis/osteomyelitis. (orig.)

  15. The process of clinical assessment: cognitions of the evaluator

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    Carmelo Ibáñez Aguirre

    2013-08-01

    Full Text Available The cognitive paradigm of the past few decades opens several new possibilities for psychological evaluation.  The objective of this essay is to emphasize the possibilities related to the quality of self-evaluation, specifically professional self-assessment, meaning a critical analysis of one’s own evaluation process. In this essay, metacognition activities and strategies are examined, as are the ways in which these activities and strategies relate to metacognition and cognitive skills. The intent of this theoretical essay is to offer answers to the clinical evaluator’s professional experience. The results indicate that the clinical professional must consider strategies to improve metacognition and cognitive skills through reflection, self-analysis and self-criticism to improve the quality and efficiency of their work.

  16. MR imaging assessment of clinical problems in rheumatoid arthritis

    International Nuclear Information System (INIS)

    Narvaez, Jose A.; Roca, Yolanda; Aguilera, Carlos; Narvaez, Javier

    2002-01-01

    Although MR imaging has been increasingly recognized as a useful tool in the diagnosis of early rheumatoid arthritis (RA) and in the assessment of disease activity, these applications have not yet been usually included in the routine management of this condition. Our goal is to review the current role of MRI in the everyday clinical management of patients with RA. The usefulness of MRI in the evaluation of articular and para-articular changes in specific locations, mainly the craniocervical region and the temporomandibular joint, are reviewed. Clinical problems derived from local extra-articular involvement, such as tenosynovitis, ''rice-bodies'' bursitis, and Baker's cyst rupture, are also described. Finally, we also review the value of MRI in evaluation of some complications of RA such as tendinous rupture, osteonecrosis, stress fracture, and septic arthritis/osteomyelitis. (orig.)

  17. The value of assessments in Lawrence Livermore National Laboratory's Waste Certification Programs

    International Nuclear Information System (INIS)

    Ryan, E.M.

    1995-05-01

    This paper will discuss the value of assessments in Lawrence Livermore National Laboratory's Waste Certification Programs by: introducing the organization and purpose of the LLNL Waste Certification Programs for transuranic, low-level, and hazardous waste; examining the differences in internal assessment/audit requirements for these programs; discussing the values and costs of assessments in a waste certification program; presenting practical recommendations to maximize the value of your assessment programs; and presenting improvements in LLNL's waste certification processes that resulted from assessments

  18. Service quality assessment of workers compensation health care delivery programs in New York using SERVQUAL.

    Science.gov (United States)

    Arunasalam, Mark; Paulson, Albert; Wallace, William

    2003-01-01

    Preferred provider organizations (PPOs) provide healthcare services to an expanding proportion of the U.S. population. This paper presents a programmatic assessment of service quality in the workers' compensation environment using two different models: the PPO program model and the fee-for-service (FFS) payor model. The methodology used here will augment currently available research in workers' compensation, which has been lacking in measuring service quality determinants and assessing programmatic success/failure of managed care type programs. Results indicated that the SERVQUAL tool provided a reliable and valid clinical quality assessment tool that ascertained that PPO marketers should focus on promoting physician outreach (to show empathy) and accessibility (to show reliability) for injured workers.

  19. Improving clinical research and cancer care delivery in community settings: evaluating the NCI community cancer centers program

    Directory of Open Access Journals (Sweden)

    Fennell Mary L

    2009-09-01

    Full Text Available Abstract Background In this article, we describe the National Cancer Institute (NCI Community Cancer Centers Program (NCCCP pilot and the evaluation designed to assess its role, function, and relevance to the NCI's research mission. In doing so, we describe the evolution of and rationale for the NCCCP concept, participating sites' characteristics, its multi-faceted aims to enhance clinical research and quality of care in community settings, and the role of strategic partnerships, both within and outside of the NCCCP network, in achieving program objectives. Discussion The evaluation of the NCCCP is conceptualized as a mixed method multi-layered assessment of organizational innovation and performance which includes mapping the evolution of site development as a means of understanding the inter- and intra-organizational change in the pilot, and the application of specific evaluation metrics for assessing the implementation, operations, and performance of the NCCCP pilot. The assessment of the cost of the pilot as an additional means of informing the longer-term feasibility and sustainability of the program is also discussed. Summary The NCCCP is a major systems-level set of organizational innovations to enhance clinical research and care delivery in diverse communities across the United States. Assessment of the extent to which the program achieves its aims will depend on a full understanding of how individual, organizational, and environmental factors align (or fail to align to achieve these improvements, and at what cost.

  20. Improving clinical research and cancer care delivery in community settings: evaluating the NCI community cancer centers program.

    Science.gov (United States)

    Clauser, Steven B; Johnson, Maureen R; O'Brien, Donna M; Beveridge, Joy M; Fennell, Mary L; Kaluzny, Arnold D

    2009-09-26

    In this article, we describe the National Cancer Institute (NCI) Community Cancer Centers Program (NCCCP) pilot and the evaluation designed to assess its role, function, and relevance to the NCI's research mission. In doing so, we describe the evolution of and rationale for the NCCCP concept, participating sites' characteristics, its multi-faceted aims to enhance clinical research and quality of care in community settings, and the role of strategic partnerships, both within and outside of the NCCCP network, in achieving program objectives. The evaluation of the NCCCP is conceptualized as a mixed method multi-layered assessment of organizational innovation and performance which includes mapping the evolution of site development as a means of understanding the inter- and intra-organizational change in the pilot, and the application of specific evaluation metrics for assessing the implementation, operations, and performance of the NCCCP pilot. The assessment of the cost of the pilot as an additional means of informing the longer-term feasibility and sustainability of the program is also discussed. The NCCCP is a major systems-level set of organizational innovations to enhance clinical research and care delivery in diverse communities across the United States. Assessment of the extent to which the program achieves its aims will depend on a full understanding of how individual, organizational, and environmental factors align (or fail to align) to achieve these improvements, and at what cost.

  1. Development of a Clinical Pharmacology Graduate Program at the University of Kentucky.

    Science.gov (United States)

    Blouin, Robert A.; And Others

    1994-01-01

    The structure, components, and anticipated outcomes of a University of Kentucky doctoral program in pharmacology are described. The program is designed to develop pharmacy-trained specialists who are interested in rigorous, intensive clinical experience, state-of-the-art coursework, and integrated laboratory-based and clinical dissertation…

  2. Assessing the readability of ClinicalTrials.gov.

    Science.gov (United States)

    Wu, Danny T Y; Hanauer, David A; Mei, Qiaozhu; Clark, Patricia M; An, Lawrence C; Proulx, Joshua; Zeng, Qing T; Vydiswaran, V G Vinod; Collins-Thompson, Kevyn; Zheng, Kai

    2016-03-01

    ClinicalTrials.gov serves critical functions of disseminating trial information to the public and helping the trials recruit participants. This study assessed the readability of trial descriptions at ClinicalTrials.gov using multiple quantitative measures. The analysis included all 165,988 trials registered at ClinicalTrials.gov as of April 30, 2014. To obtain benchmarks, the authors also analyzed 2 other medical corpora: (1) all 955 Health Topics articles from MedlinePlus and (2) a random sample of 100,000 clinician notes retrieved from an electronic health records system intended for conveying internal communication among medical professionals. The authors characterized each of the corpora using 4 surface metrics, and then applied 5 different scoring algorithms to assess their readability. The authors hypothesized that clinician notes would be most difficult to read, followed by trial descriptions and MedlinePlus Health Topics articles. Trial descriptions have the longest average sentence length (26.1 words) across all corpora; 65% of their words used are not covered by a basic medical English dictionary. In comparison, average sentence length of MedlinePlus Health Topics articles is 61% shorter, vocabulary size is 95% smaller, and dictionary coverage is 46% higher. All 5 scoring algorithms consistently rated CliniclTrials.gov trial descriptions the most difficult corpus to read, even harder than clinician notes. On average, it requires 18 years of education to properly understand these trial descriptions according to the results generated by the readability assessment algorithms. Trial descriptions at CliniclTrials.gov are extremely difficult to read. Significant work is warranted to improve their readability in order to achieve CliniclTrials.gov's goal of facilitating information dissemination and subject recruitment. Published by Oxford University Press on behalf of the American Medical Informatics Association 2015. This work is written by US Government

  3. Transportation System Risk Assessment on DOE Defense Program shipments

    International Nuclear Information System (INIS)

    Brumburgh, G.P.; Kimura, C.Y.; Alesso, H.P.; Prassinos, P.G.

    1992-01-01

    Substantial effort has been expended concerning the level of safety provided to persons, property, and the environment from the hazards associated with transporting radioactive material. This work provided an impetus for the Department of Energy to investigate the use of probabilistic risk assessment techniques to supplement the deterministic approach to transportation safety. The DOE recently decided to incorporate the methodologies associated with PRAs in the process for authorizing the transportation of nuclear components, special assemblies, and radioactive materials affiliated with the DOE Defense Program. Accordingly, the LLNL, sponsored by the DOE/AL, is tasked with developing a safety guide series to provide guidance to preparers performing a transportation system risk assessment

  4. A behavior setting assessment for community programs and residences.

    Science.gov (United States)

    Perkins, D V; Baker, F

    1991-10-01

    Using the concept of person-environment fit to determine the effectiveness of residential and program placements for chronic psychiatric clients requires systematic and concrete information about these community environments in addition to information about the clients themselves. The conceptual and empirical development of the Behavior Setting Assessment (BSA), a measure based on Barker's behavior setting theory, is described. Use of the BSA with 28 residences (117 settings) and 11 programs (176 settings) from two community support systems demonstrated that all 293 settings assessed could be described and analyzed in terms of differences in their demands for self-care skills, food preparation and consumption, verbal/cognitive responses, and solitary or group activities. The BSA is an efficient measure for obtaining specific, concrete information about the behavioral demands of important community environments.

  5. Assessing Program Efficiency: A Time and Motion Study of the Mental Health Emergency Care — Rural Access Program in NSW Australia

    Directory of Open Access Journals (Sweden)

    Emily Saurman

    2014-07-01

    Full Text Available The Mental Health Emergency Care-Rural Access Program (MHEC-RAP is a telehealth solution providing specialist emergency mental health care to rural and remote communities across western NSW, Australia. This is the first time and motion (T&M study to examine program efficiency and capacity for a telepsychiatry program. Clinical services are an integral aspect of the program accounting for 6% of all activities and 50% of the time spent conducting program activities, but half of this time is spent completing clinical paperwork. This finding emphasizes the importance of these services to program efficiency and the need to address variability of service provision to impact capacity. Currently, there is no efficiency benchmark for emergency telepsychiatry programs. Findings suggest that MHEC-RAP could increase its activity without affecting program responsiveness. T&M studies not only determine activity and time expenditure, but have a wider application assessing program efficiency by understanding, defining, and calculating capacity. T&M studies can inform future program development of MHEC-RAP and similar telehealth programs, both in Australia and overseas.

  6. Clinical Assessment and Diagnosis of Germline Predisposition to Hematopoietic Malignancies: The University of Chicago Experience

    Directory of Open Access Journals (Sweden)

    Ami V. Desai

    2017-12-01

    Full Text Available With the increasing use of clinical genomics to guide cancer treatment and management, there is a rise in the identification of germline cancer predisposition syndromes and a critical need for patients with germline findings to be referred for surveillance and care. The University of Chicago Hematopoietic Malignancies Cancer Risk Team has established a unique approach to patient care for individuals with hereditary hematologic malignancies through close communication and coordination between our pediatric and adult programs. Dedicated program members, including physicians, nurses, genetic counselors, and clinical research assistants, screen individuals for cancer predisposition at initial diagnosis through survivorship, in addition to testing individuals with an established family history of a cancer predisposition syndrome. Sample procurement, such as a skin biopsy at the time of bone marrow aspirate/biopsy in individuals with a positive screen, has facilitated timely identification of clinical germline findings or has served as a pipeline for translational research. Our integrated translational research program has led to the identification of novel syndromes in collaboration with other investigators, which have been incorporated iteratively into our clinical pipeline. Individuals are referred for clinical assessment based on personal and family history, identification of variants in susceptibility genes via molecular tumor testing, and during evaluation for matched related allogeneic stem cell transplantation. Upon referral, genetic counseling incorporates education with mindfulness of the psychosocial issues surrounding germline testing at different ages. The training and role of genetic counselors continues to grow, with the discovery of new predisposition syndromes, in the age of improved molecular diagnostics and new models for service delivery, such as telemedicine. With the identification of new syndromes that may predispose individuals

  7. Kenya; Ex Post Assessment of Longer-Term Program Engagement

    OpenAIRE

    International Monetary Fund

    2008-01-01

    This paper discusses key findings of the Ex Post Assessment (EPA) of Longer-Term Program Engagement paper for Kenya. This EPA focuses on 1993–2007, when Kenya was engaged in four successive IMF arrangements. Macroeconomic policy design was broadly appropriate, and implementation was generally sound. Growth slowed in the 1990s, but picked up after the 2002 elections, reflecting buoyant global conditions, structural reforms, and a surge of private capital inflows. Monetary policies were complic...

  8. Steam generator deposit control program assessment at Comanche Peak

    International Nuclear Information System (INIS)

    Stevens, J.; Fellers, B.; Orbon, S.

    2002-01-01

    Comanche Peak has employed a variety of methods to assess the effectiveness of the deposit control program. These include typical methods such as an extensive visual inspection program and detailed corrosion product analysis and trending. In addition, a recently pioneered technique, low frequency eddy current profile analysis (LFEC) has been utilized. LFEC provides a visual mapping of the magnetite deposit profile of the steam generator. Analysis of the LFEC results not only provides general area deposition rates, but can also provide local deposition patterns, which is indicative of steam generator performance. Other techniques utilized include trending of steam pressure, steam generator hideout-return, and flow assisted corrosion (FAC) results. The sum of this information provides a comprehensive assessment of the deposit control program effectiveness and the condition of the steam generator. It also provides important diagnostic and predictive information relative to steam generator life management and mitigative strategies, such as special cleaning procedures. This paper discusses the techniques employed by Comanche Peak Chemistry to monitor the effectiveness of the deposit control program and describes how this information is used in strategic planning. (authors)

  9. Assessing the use of cognitive heuristic representativeness in clinical reasoning.

    Science.gov (United States)

    Payne, Velma L; Crowley, Rebecca S; Crowley, Rebecca

    2008-11-06

    We performed a pilot study to investigate use of the cognitive heuristic Representativeness in clinical reasoning. We tested a set of tasks and assessments to determine whether subjects used the heuristics in reasoning, to obtain initial frequencies of heuristic use and related cognitive errors, and to collect cognitive process data using think-aloud techniques. The study investigates two aspects of the Representativeness heuristic - judging by perceived frequency and representativeness as causal beliefs. Results show that subjects apply both aspects of the heuristic during reasoning, and make errors related to misapplication of these heuristics. Subjects in this study rarely used base rates, showed significant variability in their recall of base rates, demonstrated limited ability to use provided base rates, and favored causal data in diagnosis. We conclude that the tasks and assessments we have developed provide a suitable test-bed to study the cognitive processes underlying heuristic errors.

  10. Assessing Use of Cognitive Heuristic Representativeness in Clinical Reasoning

    Science.gov (United States)

    Payne, Velma L.; Crowley, Rebecca S.

    2008-01-01

    We performed a pilot study to investigate use of the cognitive heuristic Representativeness in clinical reasoning. We tested a set of tasks and assessments to determine whether subjects used the heuristics in reasoning, to obtain initial frequencies of heuristic use and related cognitive errors, and to collect cognitive process data using think-aloud techniques. The study investigates two aspects of the Representativeness heuristic - judging by perceived frequency and representativeness as causal beliefs. Results show that subjects apply both aspects of the heuristic during reasoning, and make errors related to misapplication of these heuristics. Subjects in this study rarely used base rates, showed significant variability in their recall of base rates, demonstrated limited ability to use provided base rates, and favored causal data in diagnosis. We conclude that the tasks and assessments we have developed provide a suitable test-bed to study the cognitive processes underlying heuristic errors. PMID:18999140

  11. PERSONALITY AND CLINICAL TESTS IN SPANISH FOR ASSESSING JUVENILE OFFENDERS

    Directory of Open Access Journals (Sweden)

    Lorena Wenger

    2016-05-01

    Full Text Available The psychological assessment of offenders throughout the different stages in the juvenile justice system is essential. It ensures the adequacy of the legal and educational measures to be applied in the process. This paper reviews the main tests of psychological assessment available in Spanish, suitable for use by psychology professionals who work with young offenders in the juvenile justice services in Spanish-speaking countries. We classify these tools into three groups: a personological, i.e. generic tools, suitable for any professional context in psychology, b clinical, i.e. tools whose initial use has been limited to working with adolescents with mental health needs, and c forensic, tools that have been specially developed for use in the juvenile justice population. This last group is described in the second part of this article (which appears in this same issue. The most important instruments of proven utility are presented and reviewed for each group.

  12. Integrating Interactive Web-Based Technology to Assess Adherence and Clinical Outcomes in Pediatric Sickle Cell Disease

    Directory of Open Access Journals (Sweden)

    Lori E. Crosby

    2012-01-01

    Full Text Available Research indicates that the quality of the adherence assessment is one of the best predictors for improving clinical outcomes. Newer technologies represent an opportunity for developing high quality standardized assessments to assess clinical outcomes such as patient experience of care but have not been tested systematically in pediatric sickle cell disease (SCD. The goal of the current study was to pilot an interactive web-based tool, the Take-Charge Program, to assess adherence to clinic visits and hydroxyurea (HU, barriers to adherence, solutions to overcome these barriers, and clinical outcomes in 43 patients with SCD age 6–21 years. Results indicate that the web-based tool was successfully integrated into the clinical setting while maintaining high patient satisfaction (>90%. The tool provided data consistent with the medical record, staff report, and/or clinical lab data. Participants reported that forgetting and transportation were major barriers for adherence to both clinic attendance and HU. A greater number of self-reported barriers (P<.01 and older age (P<.05 were associated with poorer clinic attendance and HU adherence. In summary, the tool represents an innovative approach to integrate newer technology to assess adherence and clinical outcomes for pediatric patients with SCD.

  13. SRNL PHASE 1 Assessment Of The WTP Waste Qualification Program

    International Nuclear Information System (INIS)

    Peeler, D.; Hansen, E.; Herman, C.; Marra, S.; Wilmarth, B.

    2012-01-01

    The Hanford Tank Waste Treatment and Immobilization Plant (WTP) Project is currently transitioning its emphasis from an engineering design and construction phase toward facility completion, start-up and commissioning. With this transition, the WTP Project has initiated more detailed assessments of the requirements that must be met during the actual processing of the Hanford Site tank waste. One particular area of interest is the waste qualification program. In general, the waste qualification program involves testing and analysis to demonstrate compliance with waste acceptance criteria, determine waste processability, and demonstrate laboratory-scale unit operations to support WTP operations. The testing and analysis are driven by data quality objectives (DQO) requirements necessary for meeting waste acceptance criteria for transfer of high-level wastes from the tank farms to the WTP, and for ensuring waste processability including proper glass formulations during processing within the WTP complex. Given the successful implementation of similar waste qualification efforts at the Savannah River Site (SRS) which were based on critical technical support and guidance from the Savannah River National Laboratory (SRNL), WTP requested subject matter experts (SMEs) from SRNL to support a technology exchange with respect to waste qualification programs in which a critical review of the WTP program could be initiated and lessons learned could be shared. The technology exchange was held on July 18-20, 2011 in Richland, Washington, and was the initial step in a multi-phased approach to support development and implementation of a successful waste qualification program at the WTP. The 3-day workshop was hosted by WTP with representatives from the Tank Operations Contractor (TOC) and SRNL in attendance as well as representatives from the US DOE Office of River Protection (ORP) and the Defense Nuclear Facility Safety Board (DNFSB) Site Representative office. The purpose of the

  14. Laboratory Directed Research and Development Program Assessment for FY 2008

    Energy Technology Data Exchange (ETDEWEB)

    Looney, J P; Fox, K J

    2008-03-31

    BNL to respond new scientific opportunities within existing mission areas, as well as to develop new research mission areas in response to DOE and National needs. As the largest expense in BNL's LDRD program is the support graduate students, post-docs, and young scientists, LDRD provides base for continually refreshing the research staff as well as the education and training of the next generation of scientists. The LDRD Program Assessment Report contains a review of the program. The report includes a summary of the management processes, project peer review, and the portfolio's relatedness to BNL's mission, initiatives and strategic plans. Also included are a metric of success indicators and Self Assessment.

  15. Clinically speaking: A communication skills program for students from non-English speaking backgrounds.

    Science.gov (United States)

    Miguel, Caroline San; Rogan, Fran; Kilstoff, Kathleen; Brown, Di

    2006-09-01

    This paper reports on the design, delivery and evaluation of an innovative oral communication skills program for first year students in a Bachelor of Nursing degree at an Australian university. This program was introduced in 2004 to meet the needs of first year undergraduate students from non-English speaking backgrounds who had experienced difficulties with spoken English while on clinical placement. The program consisted of early identification of students in need of communication development, a series of classes incorporated into the degree program to address students' needs, followed by a clinical placement block. This paper describes the structure of the program, discusses some of the major problems encountered by students in the clinical setting and presents some of the teaching strategies used to address these problems. Evaluations of the program suggest that students' communication skills and confidence improved, resulting in a more positive clinical experience for the majority of students.

  16. The Waste Isolation Pilot Plant Performance Assessment Program

    International Nuclear Information System (INIS)

    Myers, J.; Coons, W.E.; Eastmond, R.; Morse, J.; Chakrabarti, S.; Zurkoff, J.; Colton, I.D.; Banz, I.

    1986-01-01

    The Waste Isolation Pilot Plant (WIPP) Performance Assessment Program involves a comprehensive analysis of the WIPP project with respect to the recently finalized Environmental Protection Agency regulations regarding the long-term geologic isolation of radioactive wastes. The performance assessment brings together the results of site characterization, underground experimental, and environmental studies into a rigorous determination of the performance of WIPP as a disposal system for transuranic radioactive waste. The Program consists of scenario development, geochemical, hydrologic, and thermomechanical support analyses and will address the specific containment and individual protection requirements specified in 40 CFR 191 sub-part B. Calculated releases from these interrelated analyses will be reported as an overall probability distribution of cumulative release resulting from all processes and events occurring over the 10,000 year post-closure period. In addition, results will include any doses to the public resulting from natural processes occurring over the 1,000 year post-closure period. The overall plan for the WIPP Performance Assessment Program is presented along with approaches to issues specific to the WIPP project

  17. Risk assessment in the DOE Assurance Program for Remedial Action

    International Nuclear Information System (INIS)

    Marks, S.; Cross, F.T.; Denham, D.H.; Kennedy, W.E.; Stenner, R.D.

    1985-08-01

    This document provides information obtained during the performance of risk assessment tasks in support of the Assurance Program for Remedial Action (APRA) sponsored by the Office of Operational Safety of the Department of Energy. We have presented a method for the estimation of projected health effects at properties in the vicinity of uranium mill tailing piles due to transported tailings or emissions from the piles. Because radon and radon daughter exposure is identified as the principal factor contributing to health effects at such properties, the basis for estimating lung cancer risk as a result of such exposure is discussed in detail. Modeling of health risk due to a secondary pathway, ingestion of contaminated, home-grown food products, is also discussed since it is a potentially important additional source of exposure in certain geographic locations. Risk assessment methods used in various mill tailings reports are reviewed. The protocols for radiological surveys conducted in DOE-sponsored remedial action programs are critically reviewed with respect to their relevance to the needs of health risk estimation. The relevance of risk assessment to the APRA program is discussed briefly

  18. Stochastic integer programming for multi-disciplinary outpatient clinic planning

    NARCIS (Netherlands)

    Leeftink, A. G.; Vliegen, I. M.H.; Hans, E. W.

    2017-01-01

    Scheduling appointments in a multi-disciplinary clinic is complex, since coordination between disciplines is required. The design of a blueprint schedule for a multi-disciplinary clinic with open access requirements requires an integrated optimization approach, in which all appointment schedules are

  19. Implementing the objective structured clinical examination in a geriatrics fellowship program-a 3-year experience.

    Science.gov (United States)

    Avelino-Silva, Thiago J; Gil, Luiz A; Suemoto, Claudia K; Kikuchi, Elina L; Lin, Sumika M; Farias, Luciana L; Jacob-Filho, Wilson

    2012-07-01

    The Objective Structured Clinical Examination (OSCE) appears to be an effective alternative for assessing not only medical knowledge, but also clinical skills, including effective communication and physical examination skills. The purpose of the current study was to implement an OSCE model in a geriatrics fellowship program and to compare the instrument with traditional essay examination. Seventy first- and second-year geriatric fellows were initially submitted to a traditional essay examination and scored from 0 to 10 by a faculty member. The same fellows subsequently underwent an OSCE with eight 10-minute stations covering a wide range of essential aspects of geriatric knowledge. Each OSCE station had an examiner responsible for its evaluation according to a predefined checklist. Checklist items were classified for analysis purposes as clinical knowledge items (CKI) and communication skills items (CSI); fellow responses were scored from 0 to 10.Although essay examinations took from 30 to 45 minutes to complete, 180-200 minutes were required to evaluate fellows using the proposed OSCE method. Fellows scored an average of 6.2 ± 1.2 on the traditional essay examination and 6.6 ± 1.0 on the OSCE (P examination was similar to their performance on CKI (P = .13). Second-year fellows performed better than first-year fellows on the essay examination (P geriatrics fellowship program. Combining different testing modalities may provide the best assessment of competence for various domains of knowledge, skills, and behavior. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

  20. Assessment of the psychopathological effects of a horticultural therapy program in patients with schizophrenia.

    Science.gov (United States)

    Oh, Yun-Ah; Park, Sin-Ae; Ahn, Byung-Eun

    2018-02-01

    This study assessed the psychopathological effects of participation in a 10-session horticultural therapy program in patients with schizophrenia. The study design was pre and post test design of experimental and control groups. Twenty-eight Korean patients with schizophrenia, recruited from a mental health clinic and two mental health rehabilitation centers in Suwon, South Korea, were voluntarily assigned to either a control group (average age: 33.4±9.4years) or a horticultural therapy group (average age: 42.1±13.0years). The participants in the horticultural therapy group participated in a 10-session horticultural therapy program designed around various plant cultivating activities. The horticultural therapy program involved sessions once a week from April 2017 to June 2017. A psychiatrist evaluated the psychopathological symptoms of schizophrenic patients in both groups. To assess the clinical psychopathological effects, the Korean version of the Positive and Negative Syndrome Scale (PANSS) and Brief Psychiatric Rating Scale (BPRS) were used. The horticultural therapy group significantly improved in terms of positive, negative, and general symptoms on the PANSS after the 10-session horticultural therapy program. Moreover, the horticultural therapy group significantly improved in terms of clinical symptoms of schizophrenia in BPRS after the 10-session horticultural therapy program. However, there was no change in the PANSS and BPRS scores in the control group. This study showed the potential of horticultural therapy in improving psychopathological symptoms in psychiatric patients. Future studies should investigate the effects of long-term horticultural therapy program on the chronic symptoms of patients with schizophrenia. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Clinical assessment of organizational strategy: An examination of healthy adults.

    Science.gov (United States)

    Banerjee, Pia; White, Desirée A

    2015-06-01

    During the assessment of patients with cognitive difficulties, clinicians often examine strategic processing, particularly the ability to use organization-based strategies to efficiently complete various tasks. Several commonly used neuropsychological tasks are currently thought to provide measures of organizational strategic processing, but empirical evidence for the construct validity of these strategic measures is needed before interpreting them as measuring the same underlying ability. This is particularly important for the assessment of organizational strategic processing because the measures span cognitive domains (e.g., memory strategy, language strategy) as well as types of organization. In the present study, 200 adults were administered cognitive tasks commonly used in clinical practice to assess organizational strategic processing. Factor analysis was used to examine whether these measures of organizational strategic processing, which involved different cognitive domains and types of organization, could be operationalized as measuring a unitary construct. A very good-fitting model of the data demonstrated no significant shared variance among any of the strategic variables from different tasks (root mean square error of approximation strategic processing is highly specific to the demands and goals of individual tasks even when tasks share commonalities such as involving the same cognitive domain. In the design of neuropsychological batteries involving the assessment of organizational strategic processing, it is recommended that various strategic measures across cognitive domains and types of organizational processing are selected as guided by each patient's individual cognitive difficulties. (c) 2015 APA, all rights reserved).

  2. Promoting Assessment Efficacy through an Integrated System for Online Clinical Assessment of Practical Skills

    Science.gov (United States)

    Hay, Peter J.; Engstrom, Craig; Green, Anita; Friis, Peter; Dickens, Sue; Macdonald, Doune

    2013-01-01

    This paper presents evaluation outcomes from an externally funded research project involving the online clinical assessment of practical skills (eCAPS) using web-based video technologies within a university medical programme. eCAPS was implemented to trial this web-based approach for promoting the efficacy of "practical" skills…

  3. Major national human biomonitoring programs in chemical exposure assessment

    Directory of Open Access Journals (Sweden)

    Judy Choi

    2015-07-01

    Full Text Available Human biomonitoring (HBM programs have been established in several countries around the world in order to monitor the levels of chemical exposures in the general population and qualify health risk assessment of national and international interest. Study design, population, sample collection, and chemical analysis must be considered when comparing and interpreting the results. In this review, the objectives and brief descriptions of the major national HBM programs in North America, Europe, and Asia are provided. Similarities and differences observed from a comparative analysis among these programs, including the stratification of data according to age, sex, socioeconomic background, etc. as well as the identification of chemical exposure associated with food intake, are discussed. Overall, although there are some discrepancies in the study designs among the reviewed national HBM programs, results from the programs can provide useful information such as chemical levels found within the general population of a country that can be compared. Furthermore, the results can be used by regulatory authorities or the government to enforce legislations in order to reduce the exposure of chemicals into the human body.

  4. Designing and Implementing a Mentoring Program to Support Clinically-Based Teacher Education

    Science.gov (United States)

    Henning, John E.; Gut, Dianne; Beam, Pamela

    2015-01-01

    This article describes one teacher preparation program's approach to designing and implementing a mentoring program to support clinically-based teacher education. The design for the program is based on an interview study that compared the mentoring experiences of 18 teachers across three different contexts: student teaching, early field…

  5. Assessment of residency program outcomes via alumni surveys

    Directory of Open Access Journals (Sweden)

    Lüer S

    2017-04-01

    Full Text Available Sonja Lüer, Christoph Aebi Department of Pediatrics, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland Background: One trend in medical education is outcomes-oriented training. Outcomes usually refer to individuals’ acquisition of competencies, for example, during training in residency programs. However, little is known about outcomes of these programs. In order to fill this gap, human resource (HR data were analyzed and alumni of a pediatric residency program were surveyed at the Department of Pediatrics, Bern University Hospital, Switzerland.Methods: Residency program outcomes (demographics, career choices, part-time or full-time work status, competencies, feedback were assessed through in-house HR databases, publicly available data on the Internet (physician directory and practice homepages, and 2 alumni surveys (S1, S2. Results: In all, 109 alumni met the inclusion criteria. Retention rate at the hospital was low (14%. Forty-six alumni (42% in private practice were eligible for alumni surveys. Response rates were 87% (S1 and 61% (S2. Time intervals between 2 career decisions (selecting specialty of pediatrics vs selecting setting of private practice varied widely (late-training decision to enter private practice. Mean employment level in private practice was 60% (range 20%–100%. Most valued rotation was emergency medicine; most desired competencies in future colleagues were the ability to work in a team, proficiency in pediatrics, and working economically.Conclusion: A broadened view on outcomes – beyond individuals’ competency acquisition – provides informative insights into a training program, can allow for informed program updates, and guide future program development. Keywords: medical education, career choice, pediatrics, private practice

  6. Augmenting Predictive Modeling Tools with Clinical Insights for Care Coordination Program Design and Implementation.

    Science.gov (United States)

    Johnson, Tracy L; Brewer, Daniel; Estacio, Raymond; Vlasimsky, Tara; Durfee, Michael J; Thompson, Kathy R; Everhart, Rachel M; Rinehart, Deborath J; Batal, Holly

    2015-01-01

    The Center for Medicare and Medicaid Innovation (CMMI) awarded Denver Health's (DH) integrated, safety net health care system $19.8 million to implement a "population health" approach into the delivery of primary care. This major practice transformation builds on the Patient Centered Medical Home (PCMH) and Wagner's Chronic Care Model (CCM) to achieve the "Triple Aim": improved health for populations, care to individuals, and lower per capita costs. This paper presents a case study of how DH integrated published predictive models and front-line clinical judgment to implement a clinically actionable, risk stratification of patients. This population segmentation approach was used to deploy enhanced care team staff resources and to tailor care-management services to patient need, especially for patients at high risk of avoidable hospitalization. Developing, implementing, and gaining clinical acceptance of the Health Information Technology (HIT) solution for patient risk stratification was a major grant objective. In addition to describing the Information Technology (IT) solution itself, we focus on the leadership and organizational processes that facilitated its multidisciplinary development and ongoing iterative refinement, including the following: team composition, target population definition, algorithm rule development, performance assessment, and clinical-workflow optimization. We provide examples of how dynamic business intelligence tools facilitated clinical accessibility for program design decisions by enabling real-time data views from a population perspective down to patient-specific variables. We conclude that population segmentation approaches that integrate clinical perspectives with predictive modeling results can better identify high opportunity patients amenable to medical home-based, enhanced care team interventions.

  7. Comparison of international guideline programs to evaluate and update the Dutch program for clinical guideline development in physical therapy.

    Science.gov (United States)

    Van der Wees, Philip J; Hendriks, Erik J M; Custers, Jan W H; Burgers, Jako S; Dekker, Joost; de Bie, Rob A

    2007-11-23

    Clinical guidelines are considered important instruments to improve quality in health care. Since 1998 the Royal Dutch Society for Physical Therapy (KNGF) produced evidence-based clinical guidelines, based on a standardized program. New developments in the field of guideline research raised the need to evaluate and update the KNGF guideline program. Purpose of this study is to compare different guideline development programs and review the KNGF guideline program for physical therapy in the Netherlands, in order to update the program. Six international guideline development programs were selected, and the 23 criteria of the AGREE Instrument were used to evaluate the guideline programs. Information about the programs was retrieved from published handbooks of the organizations. Also, the Dutch program for guideline development in physical therapy was evaluated using the AGREE criteria. Further comparison the six guideline programs was carried out using the following elements of the guideline development processes: Structure and organization; Preparation and initiation; Development; Validation; Dissemination and implementation; Evaluation and update. Compliance with the AGREE criteria of the guideline programs was high. Four programs addressed 22 AGREE criteria, and two programs addressed 20 AGREE criteria. The previous Dutch program for guideline development in physical therapy lacked in compliance with the AGREE criteria, meeting only 13 criteria. Further comparison showed that all guideline programs perform systematic literature searches to identify the available evidence. Recommendations are formulated and graded, based on evidence and other relevant factors. It is not clear how decisions in the development process are made. In particular, the process of translating evidence into practice recommendations can be improved. As a result of international developments and consensus, the described processes for developing clinical practice guidelines have much in common

  8. Comparison of international guideline programs to evaluate and update the Dutch program for clinical guideline development in physical therapy

    Directory of Open Access Journals (Sweden)

    Burgers Jako S

    2007-11-01

    Full Text Available Abstract Background Clinical guidelines are considered important instruments to improve quality in health care. Since 1998 the Royal Dutch Society for Physical Therapy (KNGF produced evidence-based clinical guidelines, based on a standardized program. New developments in the field of guideline research raised the need to evaluate and update the KNGF guideline program. Purpose of this study is to compare different guideline development programs and review the KNGF guideline program for physical therapy in the Netherlands, in order to update the program. Method Six international guideline development programs were selected, and the 23 criteria of the AGREE Instrument were used to evaluate the guideline programs. Information about the programs was retrieved from published handbooks of the organizations. Also, the Dutch program for guideline development in physical therapy was evaluated using the AGREE criteria. Further comparison the six guideline programs was carried out using the following elements of the guideline development processes: Structure and organization; Preparation and initiation; Development; Validation; Dissemination and implementation; Evaluation and update. Results Compliance with the AGREE criteria of the guideline programs was high. Four programs addressed 22 AGREE criteria, and two programs addressed 20 AGREE criteria. The previous Dutch program for guideline development in physical therapy lacked in compliance with the AGREE criteria, meeting only 13 criteria. Further comparison showed that all guideline programs perform systematic literature searches to identify the available evidence. Recommendations are formulated and graded, based on evidence and other relevant factors. It is not clear how decisions in the development process are made. In particular, the process of translating evidence into practice recommendations can be improved. Conclusion As a result of international developments and consensus, the described processes

  9. Heart and liver T2* assessment for iron overload using different software programs

    Energy Technology Data Exchange (ETDEWEB)

    Fernandes, Juliano L. [University of Campinas, Unicamp, Campinas (Brazil); Radiologia Clinica de Campinas, Campinas (Brazil); Cardiology, Department of Internal Medicine, Campinas, SP (Brazil); Sampaio, Erika Fontana; Coelho, Otavio R. [University of Campinas, Unicamp, Campinas (Brazil); Verissimo, Monica; Pereira, Fabricio B. [Centro Infantil Boldrini, Campinas (Brazil); Silva, Jose Alvaro da; Figueiredo, Gabriel S. de; Kalaf, Jose M. [Radiologia Clinica de Campinas, Campinas (Brazil)

    2011-12-15

    To assess the level of agreement and interchangeability among different software programs for calculation of T2* values for iron overload. T2* images were analysed in 60 patients with thalassaemia major using the truncation method in three software programs. Levels of agreement were assessed using Pearson correlation and Bland-Altman plots. Categorical classification for levels of iron concentration by each software program was also compared. For the heart, all correlation coefficients were significant among the software programs (P < 0.001 for all coefficients). The mean differences and 95% limits of agreement were 0.2 (-4.73 to 5.0); 0.1 (-4.0 to 3.9); and -0.1 (-4.3 to 4.8). For the liver all correlations were also significant with P < 0.001. Bland-Altman plots showed differences of -0.02 (-0.7 to 0.6); 0.01 (-0.4 to 0.4); and -0.02 (-0.6 to 0.6). There were no significant differences in clinical classification among the software programs. All tools used in this study provided very good agreement among heart and liver T2* values. The results indicate that interpretation of T2* data is interchangeable with any of the software programs tested. (orig.)

  10. Assessment of microwave-based clinical waste decontamination unit.

    Science.gov (United States)

    Hoffman, P N; Hanley, M J

    1994-12-01

    A clinical waste decontamination unit that used microwave-generated heat was assessed for operator safety and efficacy. Tests with loads artificially contaminated with aerosol-forming particles showed that no particles were detected outside the machine provided the seals and covers were correctly seated. Thermometric measurement of a self-generated steam decontamination cycle was used to determine the parameters needed to ensure heat disinfection of the waste reception hopper, prior to entry for maintenance or repair. Bacterial and thermometric test pieces were passed through the machine within a full load of clinical waste. These test pieces, designed to represent a worst case situation, were enclosed in aluminium foil to shield them from direct microwave energy. None of the 100 bacterial test pieces yielded growth on culture and all 100 thermal test pieces achieved temperatures in excess of 99 degrees C during their passage through the decontamination unit. It was concluded that this method may be used to render safe the bulk of of ward-generated clinical waste.

  11. Imaging findings and referral outcomes of rapid assessment stroke clinics

    International Nuclear Information System (INIS)

    Widjaja, E.; Manuel, D.; Hodgson, T.J.; Connolly, D.J.A.; Coley, S.C.; Romanowski, C.A.J.; Gaines, P.; Cleveland, T.; Thomas, S.; Griffiths, P.D.; Doyle, C.; Venables, G.S.

    2005-01-01

    AIM: A rapid assessment stroke clinic (RASC) was established to provide a rapid diagnostic service to individuals with suspected transient cerebral or ocular ischaemia or recovered non-hospitalized strokes. In this report we review imaging findings and clinical outcomes of patients proceeding to the carotid surgery programme. METHODS: Between October 2000 and December 2002, 1339 people attended the RASC. The findings of head CT and carotid Doppler ultrasound of the 1320 patients who underwent brain and carotid imaging were reviewed, and the number subsequently proceeding to carotid angiography and intervention was reported. RESULTS: CT head scans were normal in 57% of cases; 38% demonstrated ischaemia or infarction; and 3% yielded incidental or other significant findings not related to ischaemia. On screening with carotid Doppler ultrasound, 7.5% showed greater than 50% stenosis on the symptomatic side. A total of 83 patients (6.2%) proceeded to cerebral angiography and 65 (4.8%) underwent carotid endarterectomy or endovascular repair. CONCLUSION: Rapid-access neurovascular clinics are efficient in selecting patients for carotid intervention, but this is at a cost and the number of potential strokes prevented is small. Alternative management pathways based on immediate medical treatment need to be evaluated

  12. LABORATORY DIRECTED RESEARCH AND DEVELOPMENT PROGRAM ASSESSMENT FOR FY 2006.

    Energy Technology Data Exchange (ETDEWEB)

    FOX,K.J.

    2006-01-01

    science and technology ideas, which becomes a major factor in achieving and maintaining staff excellence and a means to address national needs within the overall mission of the DOE and BNL. The LDRD Program Assessment Report contains a review of the program. The report includes a summary of the management processes, project peer review, and the portfolio's relatedness to BNL's mission, initiatives and strategic plans. Also included is a metric of success indicators and Self Assessment.

  13. Laboratory Directed Research and Development Program Assessment for FY 2007

    Energy Technology Data Exchange (ETDEWEB)

    Newman,L.; Fox, K.J.

    2007-12-31

    becomes a major factor in achieving and maintaining staff excellence and a means to address national needs within the overall mission of the DOE and BNL. The LDRD Program Assessment Report contains a review of the program. The report includes a summary of the management processes, project peer review, and the portfolio's relatedness to BNL's mission, initiatives and strategic plans. Also included are a metric of success indicators and Self Assessment.

  14. The Italian pilot external quality assessment program for cystic fibrosis sweat test.

    Science.gov (United States)

    Salvatore, Marco; Floridia, Giovanna; Amato, Annalisa; Censi, Federica; Carta, Claudio; de Stefano, Maria Chiara; Ferrari, Gianluca; Tosto, Fabrizio; Capoluongo, Ettore; Caruso, Ubaldo; Castaldo, Giuseppe; Cirilli, Natalia; Corbetta, Carlo; Padoan, Rita; Raia, Valeria; Taruscio, Domenica

    2016-05-01

    Sweat chloride test is the gold standard test for cystic fibrosis (CF) diagnosis. In 2014 the Istituto Superiore di Sanità established the Italian pilot external quality assessment program for CF sweat test (IEQA-ST). Ten laboratories, included among the 33 Italian CF Referral Centers, were selected and enrolled on the basis of their attitude to perform sweat test (ST) analysis by using methods recommended by the Italian Guidelines. They received three different sweat-like samples (normal, borderline and pathologic chloride concentration), with mock clinical indications, for analysis according to routine procedures. Assessment, performed by a panel of experts, covered analytical performance, interpretation and reporting of results; categories of "poor" and "satisfactory" performance were not defined. All data were managed through a web utility. The program identified important areas of interest and, in some case, of concern. It is important to underline that results are referred to a small proportion, i.e. about 30%, of Italian laboratories performing CF ST in the context of the Referral Centers. Data collected highlight the importance of participation in EQA programs as it may improve laboratory/clinical performance; our study represents a model for the setting up of a large-scale EQA scheme for ST. Copyright © 2016 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  15. Computer assisted Objective structured clinical examination versus Objective structured clinical examination in assessment of Dermatology undergraduate students

    Directory of Open Access Journals (Sweden)

    Richa Chaudhary

    2017-01-01

    Conclusions: Computer assisted objective structured clinical examination was found to be a valid, reliable and effective format for dermatology assessment, being rated as the preferred format by examiners.

  16. Current status of clinical education in paramedic programs: a descriptive research project.

    Science.gov (United States)

    Grubbs, K C

    1997-01-01

    Development of competence in exercising therapeutic judgment skills represents the goal of clinical education. Time (clock hours) is not a valid predictor of attainment of competence in paramedic clinical education. Quantity of patient contact experiences facilitates development of judgment skills, and offers a valid measure of progress toward competence. This project uses national survey data from accredited programs to describe the availability and accessibility of patient contact experiences within paramedic clinical education. Data from this local program supplements the national survey results. The components of clinical judgment are enumerated, and strategies to teach and evaluate clinical judgment skills are discussed.

  17. Clinical and economic outcomes assessment in nuclear cardiology

    International Nuclear Information System (INIS)

    Shaw, L.J.; Miller, D.D.; Berman, D.S.; Hachamovitch, R.

    2000-01-01

    The future of nuclear medicine procedures, as understood within our current economic climate, depends upon its ability to provide relevant clinical information at similar or lower comparative costs. With an ever-increasing emphasis on cost containment, outcome assessment forms the basis of preserving the quality of patient care. Today, outcomes assessment encompasses a wide array of subjects including clinical, economic, and humanistic (i.e., quality of life) outcomes. For nuclear cardiology, evidence-based medicine would require a threshold level of evidence in order to justify the added cost of any test in a patient's work-up. This evidence would include large multicenter, observational series as well as randomized trial data in sufficiently large and diverse patient populations. The new movement in evidence-based medicine is also being applied to the introduction of new technologies, in particular when comparative modalities exist. In the past 5 years, it has seen a dramatic shift in the quality of outcomes data published in nuclear cardiology. This includes the use of statistically rigorous risk-adjusted techniques as well as large populations (i.e., >500 patients) representing multiple diverse medical care settings. This has been the direct result of the development of multiple outcomes databases that have now amassed thousands of patients worth of data. One of the benefits of examining outcomes in large patient datasets is the ability to assess individual endpoints (e.g., cardiac death) as compared with smaller datasets that often assess combined endpoints (e.g., death, myocardial infarction, or unstable angina). New technologies for the diagnosis of coronary artery disease have contributed to the rising costs of care. In the United States and in Europe, costs of care have risen dramatically, consuming an ever-increasing amount of available resources. The overuse of diagnostic angiography often leads to unnecessary revascularization that does not lead to

  18. The Effect of Peer-Mentoring Program on Nursing Students’ Clinical Environment Stressors

    Directory of Open Access Journals (Sweden)

    F Sardari Kashkooli

    2014-01-01

    Results: There was a significant difference between stress scores before and after of the intervention in both groups (p=0.00. Mean difference of clinical environment stress factors in two groups were not statistically significant (p=0.99. Conclusions: Peer-mentoring program is not significant effective on clinical environment stress reduction. Key Words: Nursing Education, Peer Mentoring, Clinical Environment Stressors

  19. Ecological momentary assessment in a behavioral drinking moderation training program.

    Science.gov (United States)

    Collins, R L; Morsheimer, E T; Shiffman, S; Paty, J A; Gnys, M; Papandonatos, G D

    1998-08-01

    We assessed predictors of self-reported excessive drinking (> 5 drinks) in a sample of heavy drinkers. Participants were randomly assigned to moderation training or a waiting-list control condition. They were trained in ecological momentary assessment (EMA) involving self-monitoring of drinking and other variables on a small hand-held computer, the electronic diary (ED). During the 8-week study, participants were compliant in their use of the ED for both random prompts and the entry of data related to specific drinking episodes. Generalized estimating equations were used to fit models involving predictors related to past history of drinking, aspects of the training program, drinking restraint, and episode-specific mood. The models indicated robust predictors of decreased and increased drinking. Our results suggest that EMA is a useful methodology for assessing drinking and related behaviors.

  20. NASA Aviation Safety Program Systems Analysis/Program Assessment Metrics Review

    Science.gov (United States)

    Louis, Garrick E.; Anderson, Katherine; Ahmad, Tisan; Bouabid, Ali; Siriwardana, Maya; Guilbaud, Patrick

    2003-01-01

    The goal of this project is to evaluate the metrics and processes used by NASA's Aviation Safety Program in assessing technologies that contribute to NASA's aviation safety goals. There were three objectives for reaching this goal. First, NASA's main objectives for aviation safety were documented and their consistency was checked against the main objectives of the Aviation Safety Program. Next, the metrics used for technology investment by the Program Assessment function of AvSP were evaluated. Finally, other metrics that could be used by the Program Assessment Team (PAT) were identified and evaluated. This investigation revealed that the objectives are in fact consistent across organizational levels at NASA and with the FAA. Some of the major issues discussed in this study which should be further investigated, are the removal of the Cost and Return-on-Investment metrics, the lack of the metrics to measure the balance of investment and technology, the interdependencies between some of the metric risk driver categories, and the conflict between 'fatal accident rate' and 'accident rate' in the language of the Aviation Safety goal as stated in different sources.

  1. Achieving low anastomotic leak rates utilizing clinical perfusion assessment.

    Science.gov (United States)

    Kream, Jacob; Ludwig, Kirk A; Ridolfi, Timothy J; Peterson, Carrie Y

    2016-10-01

    Anastomotic leak after colorectal resection increases morbidity, mortality, and in the setting of cancer, increases recurrences rates and reduces survival odds. Recent reports suggest that fluorescence evaluation of perfusion after colorectal anastomosis creation is associated with low anastomotic leak rates (1.4%). The purpose of this work was to evaluate whether a similar low anastomotic leak rate after left-sided colorectal resections could be achieved using standard assessment of blood flow to the bowel ends. We performed a retrospective chart review at an academic tertiary referral center, evaluating 317 consecutive patients who underwent a pelvic anastomosis after sigmoid colectomy, left colectomy, or low anterior resection. All operations were performed by a single surgeon from March 2008 to January 2015 with only standard clinical measures used to assess perfusion to the bowel ends. The primary outcome measure was the anastomotic leak rate as diagnosed by clinical symptoms, exam, or routine imaging. The average patient age was 59.7 years with an average body mass index of 28.8 kg/m(2). Rectal cancer (128, 40.4%) was the most common indication for operation while hypertension (134, 42.3%) was the most common comorbidity. In total, 177 operations were laparoscopic (55.8%), 13 were reoperative resections (4.1%), and 108 were protected with a loop ileostomy (34.1%). Preoperative chemotherapy was administered to 25 patients (7.9%) while preoperative chemo/radiation was administered to 64 patients (20.2%). The anastomotic leak rate was 1.6% (5/317). Our data suggests that standard, careful evaluation of adequate blood flow via inspection and confirmation of pulsatile blood flow to the bowel ends and meticulous construction of the colorectal or coloanal anastomoses can result in very low leak rates, similar to the rate reported when intraoperative imaging is used to assess perfusion. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Osteogenesis imperfecta: clinical diagnosis, nomenclature and severity assessment.

    Science.gov (United States)

    Van Dijk, F S; Sillence, D O

    2014-06-01

    Recently, the genetic heterogeneity in osteogenesis imperfecta (OI), proposed in 1979 by Sillence et al., has been confirmed with molecular genetic studies. At present, 17 genetic causes of OI and closely related disorders have been identified and it is expected that more will follow. Unlike most reviews that have been published in the last decade on the genetic causes and biochemical processes leading to OI, this review focuses on the clinical classification of OI and elaborates on the newly proposed OI classification from 2010, which returned to a descriptive and numerical grouping of five OI syndromic groups. The new OI nomenclature and the pre-and postnatal severity assessment introduced in this review, emphasize the importance of phenotyping in order to diagnose, classify, and assess severity of OI. This will provide patients and their families with insight into the probable course of the disorder and it will allow physicians to evaluate the effect of therapy. A careful clinical description in combination with knowledge of the specific molecular genetic cause is the starting point for development and assessment of therapy in patients with heritable disorders including OI. © 2014 The Authors. American Journal of Medical Genetics Published by Wiley Periodicals, Inc. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. © 2014 The Authors. American Journal of Medical Genetics Part A Published by Wiley Periodicals, Inc.

  3. Translation, reliability, and clinical utility of the Melbourne Assessment 2.

    Science.gov (United States)

    Gerber, Corinna N; Plebani, Anael; Labruyère, Rob

    2017-10-12

    The aims were to (i) provide a German translation of the Melbourne Assessment 2 (MA2), a quantitative test to measure unilateral upper limb function in children with neurological disabilities and (ii) to evaluate its reliability and aspects of clinical utility. After its translation into German and approval of the back translation by the original authors, the MA2 was performed and videotaped twice with 30 children with neuromotor disorders. For each participant, two raters scored the video of the first test for inter-rater reliability. To determine test-retest reliability, one rater additionally scored the video of the second test while the other rater repeated the scoring of the first video to evaluate intra-rater reliability. Time needed for rater training, test administration, and scoring was recorded. The four subscale scores showed excellent intra-, inter-rater, and test-retest reliability with intraclass correlation coefficients of 0.90-1.00 (95%-confidence intervals 0.78-1.00). Score items revealed substantial to almost perfect intra-rater reliability (weighted kappa k w  = 0.66-1.00) for the more affected side. Score item inter-rater and test-retest reliability of the same extremity were, with one exception, moderate to almost perfect (k w  = 0.42-0.97; k w  = 0.40-0.89). Furthermore, the MA2 was feasible and acceptable for patients and clinicians. The MA2 showed excellent subscale and moderate to almost perfect score item reliability. Implications for Rehabilitation There is a lack of high-quality studies about psychometric properties of upper limb measurement tools in the neuropediatric population. The Melbourne Assessment 2 is a promising tool for reliable measurement of unilateral upper limb movement quality in the neuropediatric population. The Melbourne Assessment 2 is acceptable and practicable to therapists and patients for routine use in clinical care.

  4. Assessment of Clinical Practices for Crushing Medication in Geriatric Units.

    Science.gov (United States)

    Fodil, M; Nghiem, D; Colas, M; Bourry, S; Poisson-Salomon, A-S; Rezigue, H; Trivalle, C

    2017-01-01

    To assess the modification of the form of medication and evaluate staff observance of good clinical practices. One-day assessment of clinical practices. 17 geriatrics units in the 3 Teaching Hospitals of Paris-Sud (APHP), France. Elderly in-patients with difficulties swallowing capsules and tablets. Assessment of target-patient prescriptions and direct observation of nurses' medical rounds. 155/526 in-patients (29.5%) were unable to swallow tablets or capsules: 98 (40.3%) in long-term care, 46 patients (23.8%) in the rehabilitation unit and 11 (12.2%) in the acute care unit (p = .005). In thirty-nine (27.3%) of the 143 prescriptions studied all tablets were safe to crush and all capsules were safe to open. In 104 cases, at least one medication could not be safely modified, including 26 cases (18.2%) in which none of the prescribed drugs were safe to crush or open. In 48.2% of the 110 medications that were crushed, crushing was forbidden, and presented a potential threat in 12.7% of cases or a reduced efficacy in 8.2% of cases. Crushing methods were rarely appropriate: no specific protective equipment was used (81.8%), crushing equipment was shared between patients without cleaning (95.1%), medications were spilled or lost (69.9%). The method of administration was appropriate (water, jellified water) in 25% of the cases, questionable (soup, coffee, compote, juice, cream) in 55% of the cases and unacceptable (laxative) in 21% of the cases. Management of drug prescriptions in patients with swallowing difficulties is not optimal, and may even have iatrogenic effects. In this study, 12.7% of the modifications of the drug form could have been harmful. Doctors, pharmacists and nurses need to reevaluate their practices.

  5. Assessing the effects of employee assistance programs: a review of employee assistance program evaluations.

    Science.gov (United States)

    Colantonio, A

    1989-01-01

    Employee assistance programs have grown at a dramatic rate, yet the effectiveness of these programs has been called into question. The purpose of this paper was to assess the effectiveness of employee assistance programs (EAPs) by reviewing recently published EAP evaluations. All studies evaluating EAPs published since 1975 from peer-reviewed journals in the English language were included in this analysis. Each of the articles was assessed in the following areas: (a) program description (subjects, setting, type of intervention, format), (b) evaluation design (research design, variables measured, operational methods), and (c) program outcomes. Results indicate numerous methodological and conceptual weaknesses and issues. These weaknesses included lack of controlled research designs and short time lags between pre- and post-test measures. Other problems identified are missing information regarding subjects, type of intervention, how variables are measured (operational methods), and reliability and validity of evaluation instruments. Due to the aforementioned weaknesses, positive outcomes could not be supported. Recommendations are made for future EAP evaluations.

  6. Clinical audits in a postgraduate general practice training program: an evaluation of 8 years' experience.

    Directory of Open Access Journals (Sweden)

    Abeer Al-Baho

    Full Text Available BACKGROUND: Clinical audit can be of valuable assistance to any program which aims to improve the quality of health care and its delivery. Yet without a coherent strategy aimed at evaluating audits' effectiveness, valuable opportunities will be overlooked. Clinical audit projects are required as a part of the formative assessment of trainees in the Family Medicine Residency Program (FMRP in Kuwait. This study was undertaken to draw a picture of trainees' understanding of the audit project with attention to the knowledge of audit theory and its educational significance and scrutinize the difficulties confronted during the experience. METHODOLOGY/PRINCIPAL FINDINGS: The materials included the records of 133 audits carried out by trainees and 165 post course questionnaires carried out between 2004 and 2011. They were reviewed and analyzed. The majority of audit projects were performed on diabetic (44.4% and hypertensive (38.3% care. Regarding audits done on diabetic care, they were carried out to assess doctors' awareness about screening for smoking status (8.6%, microalbuminuria (19.3%, hemoglobin A1c (15.5%, retinopathy (10.3%, dyslipidemia (15.8%, peripheral neuropathy (8.8%, and other problems (21.7%. As for audits concerning hypertensive care, they were carried out to assess doctors' awareness about screening for smoking status (38.0%, obesity (26.0%, dyslipidemia (12.0%, microalbuminuria (10.0% and other problems (14.0%. More than half the participants (68.48% who attended the audit course stated that they 'definitely agreed' about understanding the meaning of clinical audit. Most of them (75.8% 'definitely agreed' about realizing the importance of clinical audit in improving patients' care. About half (49.7% of them 'agreed' that they can distinguish between 'criteria' and 'standards'. CONCLUSION: The eight years of experience were beneficial. Trainees showed a good understanding of the idea behind auditing the services provided. They

  7. Objective Structured Clinical Examination as an Assessment Tool for Clinical Skills in Dermatology.

    Science.gov (United States)

    Saceda-Corralo, D; Fonda-Pascual, P; Moreno-Arrones, Ó M; Alegre-Sánchez, A; Hermosa-Gelbard, Á; Jiménez-Gómez, N; Vañó-Galván, S; Jaén-Olasolo, P

    2017-04-01

    Objective Structured Clinical Evaluation (OSCE) is an excellent method to evaluate student's abilities, but there are no previous reports implementing it in dermatology. To determine the feasibility of implementation of a dermatology OSCE in the medical school. Five stations with standardized patients and image-based assessment were designed. A specific checklist was elaborated in each station with different items which evaluated one competency and were classified into five groups (medical history, physical examination, technical skills, case management and prevention). A total of 28 students were tested. Twenty-five of them (83.3%) passed the exam globally. Concerning each group of items tested: medical interrogation had a mean score of 71.0; physical examination had a mean score of 63.0; management had a mean score of 58.0; and prevention had a mean score of 58.0 points. The highest results were obtained in interpersonal skills items with 91.8 points. Testing a small sample of voluntary students may hinder generalization of our study. OSCE is an useful tool for assessing clinical skills in dermatology and it is possible to carry it out. Our experience enhances that medical school curriculum needs to establish OSCE as an assessment tool in dermatology. Copyright © 2016 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Environmental Hazards Assessment Program quarterly report, January--March 1995

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-04-30

    The objectives of the Environmental Hazards Assessment Program (EHAP) stated in the proposal to DOE are to: develop a holistic, national basis for risk assessment, risk management, and risk communication that recognizes the direct impact of environmental hazards on the health and well-being of all; develop a pool of talented scientists and experts in cleanup activities, especially in human health aspects; and identify needs and develop programs addressing the critical shortage of well-educated, highly-skilled technical and scientific personnel to address the health oriented aspects of environmental restoration and waste management. This report describes activities and reports on progress for the third quarter (January--March) of the third year of the grant. It reports progress against these grant objectives and the Program Implementation Plan published at the end of the first year of the grant. Questions, comments, or requests for further information concerning the activities under this grant can be forwarded to Jack Davis in the EHAP office of the Medical University of South Carolina at (803) 727-6450.

  9. Research on effectiveness assessment programs for physical protection system

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Janghoon; Yoo, Hosik; Ham, Taekyu [Korea Institute of Nuclear Non-proliferation and Control, Daejeon (Korea, Republic of)

    2015-05-15

    PPS (Physical Protection System) is an integrated set of procedures, installation and human resources to protect valuable assets from physical attack of potential adversaries. Since nuclear facilities or radioactive materials can be attractive targets for terrorists, PPS should be installed and maintained throughout the entire lifecycle of nuclear energy systems. One of key ingredients for effective protection is a reliable assessment procedure of the PPS capability. Due to complexity of possible threat categories and pathways, several pathway analysis programs have been developed to ease analysis or visualization. ASSESS using ASD approach runs fast and adopts a relatively simple modeling process for facility elements. But uncertainty due to assumptions used in modeling might complicate the interpretation of results. On the other hand, 2D pathway program such as TESS can utilize more self-consistent detection probability and delay time since actual pathway on 2D map is available. Also, this pathway visualization helps users understand analysis result more intuitively. But, in general, 2D pathway programs require strong computational power and careful optimization. Another possible difference between two approaches is response force deployment and RFT.

  10. A Computer Program for Assessing Nuclear Safety Culture Impact

    Energy Technology Data Exchange (ETDEWEB)

    Han, Kiyoon; Jae, Moosung [Hanyang Univ., Seoul (Korea, Republic of)

    2014-10-15

    Through several accidents of NPP including the Fukushima Daiichi in 2011 and Chernobyl accidents in 1986, a lack of safety culture was pointed out as one of the root cause of these accidents. Due to its latent influences on safety performance, safety culture has become an important issue in safety researches. Most of the researches describe how to evaluate the state of the safety culture of the organization. However, they did not include a possibility that the accident occurs due to the lack of safety culture. Because of that, a methodology for evaluating the impact of the safety culture on NPP's safety is required. In this study, the methodology for assessing safety culture impact is suggested and a computer program is developed for its application. SCII model which is the new methodology for assessing safety culture impact quantitatively by using PSA model. The computer program is developed for its application. This program visualizes the SCIs and the SCIIs. It might contribute to comparing the level of the safety culture among NPPs as well as improving the management safety of NPP.

  11. Flammability Assessment Methodology Program Phase I: Final Report

    Energy Technology Data Exchange (ETDEWEB)

    C. A. Loehr; S. M. Djordjevic; K. J. Liekhus; M. J. Connolly

    1997-09-01

    The Flammability Assessment Methodology Program (FAMP) was established to investigate the flammability of gas mixtures found in transuranic (TRU) waste containers. The FAMP results provide a basis for increasing the permissible concentrations of flammable volatile organic compounds (VOCs) in TRU waste containers. The FAMP results will be used to modify the ''Safety Analysis Report for the TRUPACT-II Shipping Package'' (TRUPACT-II SARP) upon acceptance of the methodology by the Nuclear Regulatory Commission. Implementation of the methodology would substantially increase the number of drums that can be shipped to the Waste Isolation Pilot Plant (WIPP) without repackaging or treatment. Central to the program was experimental testing and modeling to predict the gas mixture lower explosive limit (MLEL) of gases observed in TRU waste containers. The experimental data supported selection of an MLEL model that was used in constructing screening limits for flammable VOC and flammable gas concentrations. The MLEL values predicted by the model for individual drums will be utilized to assess flammability for drums that do not meet the screening criteria. Finally, the predicted MLEL values will be used to derive acceptable gas generation rates, decay heat limits, and aspiration time requirements for drums that do not pass the screening limits. The results of the program demonstrate that an increased number of waste containers can be shipped to WIPP within the flammability safety envelope established in the TRUPACT-II SARP.

  12. Research on effectiveness assessment programs for physical protection system

    International Nuclear Information System (INIS)

    Seo, Janghoon; Yoo, Hosik; Ham, Taekyu

    2015-01-01

    PPS (Physical Protection System) is an integrated set of procedures, installation and human resources to protect valuable assets from physical attack of potential adversaries. Since nuclear facilities or radioactive materials can be attractive targets for terrorists, PPS should be installed and maintained throughout the entire lifecycle of nuclear energy systems. One of key ingredients for effective protection is a reliable assessment procedure of the PPS capability. Due to complexity of possible threat categories and pathways, several pathway analysis programs have been developed to ease analysis or visualization. ASSESS using ASD approach runs fast and adopts a relatively simple modeling process for facility elements. But uncertainty due to assumptions used in modeling might complicate the interpretation of results. On the other hand, 2D pathway program such as TESS can utilize more self-consistent detection probability and delay time since actual pathway on 2D map is available. Also, this pathway visualization helps users understand analysis result more intuitively. But, in general, 2D pathway programs require strong computational power and careful optimization. Another possible difference between two approaches is response force deployment and RFT

  13. What is the impact of a clinically related readmission measure on the assessment of hospital performance?

    Science.gov (United States)

    Khouri, Roger K; Hou, Hechuan; Dhir, Apoorv; Andino, Juan J; Dupree, James M; Miller, David C; Ellimoottil, Chad

    2017-11-28

    The Hospital Readmission Reduction Program (HRRP) penalizes hospitals for high all-cause unplanned readmission rates. Many have expressed concern that hospitals serving patient populations with more comorbidities, lower incomes, and worse self-reported health status may be disproportionately penalized by readmissions that are not clinically related to the index admission. The impact of including clinically unrelated readmissions on hospital performance is largely unknown. We sought to determine if a clinically related readmission measure would significantly alter the assessment of hospital performance. We analyzed Medicare claims for beneficiaries in Michigan admitted for pneumonia and joint replacement from 2011 to 2013. We compared each hospital's 30-day readmission rate using specifications from the HRRP's all-cause unplanned readmission measure to values calculated using a clinically related readmission measure. We found that the mean 30-day readmission rates were lower when calculated using the clinically related readmission measure (joint replacement: all-cause 5.8%, clinically related 4.9%, p impact hospital performance in the HRRP.

  14. Implementing effective and sustainable multidisciplinary clinical thoracic oncology programs.

    Science.gov (United States)

    Osarogiagbon, Raymond U; Freeman, Richard K; Krasna, Mark J

    2015-08-01

    Three models of care are described, including two models of multidisciplinary care for thoracic malignancies. The pros and cons of each model are discussed, the evidence supporting each is reviewed, and the need for more (and better) research into care delivery models is highlighted. Key stakeholders in thoracic oncology care delivery outcomes are identified, and the need to consider stakeholder perspectives in designing, validating and implementing multidisciplinary programs as a vehicle for quality improvement in thoracic oncology is emphasized. The importance of reconciling stakeholder perspectives, and identify meaningful stakeholder-relevant benchmarks is also emphasized. Metrics for measuring program implementation and overall success are proposed.

  15. Relationship Between the Number of Clinical Sites in Radiography Programs and Job Placement Rates of Graduates.

    Science.gov (United States)

    Harrell, Angela; Matthews, Eric

    2016-07-01

    To determine whether a relationship exists between the number of clinical sites available in radiography programs accredited by the Joint Review Committee on Education in Radiologic Technology and the job placement rates of graduates. We performed a secondary analysis of data on job placement rates and the number of clinical sites available in 438 degree-granting radiography programs from January 2015 to March 2015. A weak, negative, nonsignificant correlation existed between the number of clinical sites and the job placement rate (Spearman's rho = -.113, n = 438, P = .018). The coefficient of determination was 1.28%.Discussion Research evaluating factors contributing to graduate employability is limited but indicates no need for radiography program administrators to adjust clinical site numbers solely on the basis of improving graduate employability. The number of clinical sites available in a radiography program is not related to the job placement rate of its graduates. ©2016 American Society of Radiologic Technologists.

  16. Clinical Digital Libraries Project: design approach and exploratory assessment of timely use in clinical environments.

    Science.gov (United States)

    Maccall, Steven L

    2006-04-01

    The paper describes and evaluates the use of Clinical Digital Libraries Project (CDLP) digital library collections in terms of their facilitation of timely clinical information seeking. A convenience sample of CDLP Web server log activity over a twelve-month period (7/2002 to 6/2003) was analyzed for evidence of timely information seeking after users were referred to digital library clinical topic pages from Web search engines. Sample searches were limited to those originating from medical schools (26% North American and 19% non-North American) and from hospitals or clinics (51% North American and 4% non-North American). Timeliness was determined based on a calculation of the difference between the timestamps of the first and last Web server log "hit" during each search in the sample. The calculated differences were mapped into one of three ranges: less than one minute, one to three minutes, and three to five minutes. Of the 864 searches analyzed, 48% were less than 1 minute, 41% were 1 to 3 minutes, and 11% were 3 to 5 minutes. These results were further analyzed by environment (medical schools versus hospitals or clinics) and by geographic location (North America versus non-North American). Searches reflected a consistent pattern of less than 1 minute in these environments. Though the results were not consistent on a month-by-month basis over the entire time period, data for 8 of 12 months showed that searches shorter than 1 minute predominated and data for 1 month showed an equal number of less than 1 minute and 1 to 3 minute searches. The CDLP digital library collections provided timely access to high-quality Web clinical resources when used for information seeking in medical education and hospital or clinic environments from North American and non-North American locations and consistently provided access to the sought information within the documented two-minute standard. The limitations of the use of Web server data warrant an exploratory assessment. This

  17. Clinical Digital Libraries Project: design approach and exploratory assessment of timely use in clinical environments*

    Science.gov (United States)

    MacCall, Steven L.

    2006-01-01

    Web server data warrant an exploratory assessment. This research also suggests the need for further investigation in the area of timely digital library collection services to clinical environments. PMID:16636712

  18. An airborne dispersion/dose assessment computer program. Phase 1

    International Nuclear Information System (INIS)

    Scott, C.K.; Kennedy, E.R.; Hughs, R.

    1991-05-01

    The Atomic Energy Control Board (AECB) staff have a need for an airborne dispersion-dose assessment computer programme for a microcomputer. The programme must be capable of analyzing the dispersion of both radioactive and non-radioactive materials. A further requirement of the programme is that it be implemented on the AECB complex of microcomputers and that it have an advanced graphical user interface. A survey of computer programs was conducted to determine which, if any, could meet the AECB's requirements in whole or in part. Ten programmes were selected for detailed review including programs for nuclear and non-radiological emergencies. None of the available programmes for radiation dose assessment meets all the requirements for reasons of user interaction, method of source term estimation or site specificity. It is concluded that the best option for meeting the AECB requirements is to adopt the CAMEO programme (specifically the ALOHA portion) which has a superior graphical user interface and add the necessary models for radiation dose assessment

  19. Patient Experiences with the Preoperative Assessment Clinic (PEPAC): validation of an instrument to measure patient experiences

    NARCIS (Netherlands)

    Edward, G. M.; Lemaire, L. C.; Preckel, B.; Oort, F. J.; Bucx, M. J. L.; Hollmann, M. W.; de Haes, J. C. J. M.

    2007-01-01

    Background. Presently, no comprehensive and validated questionnaire to measure patient experiences of the preoperative assessment clinic (PAC) is available. We developed and validated the Patient Experiences with the Preoperative Assessment Clinic (PEPAC) questionnaire, which can be used for

  20. Establishing a family risk assessment clinic for breast cancer.

    LENUS (Irish Health Repository)

    Mulsow, Jurgen

    2012-02-01

    Breast cancer is the most common cancer affecting European women and the leading cause of cancer-related death. A total of 15-20% of women who develop breast cancer have a family history and 5-10% a true genetic predisposition. The identification and screening of women at increased risk may allow early detection of breast cancer and improve prognosis. We established a family risk assessment clinic in May 2005 to assess and counsel women with a family history of breast cancer, to initiate surveillance, and to offer risk-reducing strategies for selected high-risk patients. Patients at medium or high risk of developing breast cancer according to NICE guidelines were accepted. Family history was determined by structured questionnaire and interview. Lifetime risk of developing breast cancer was calculated using Claus and Tyrer-Cuzick scoring. Risk of carrying a breast cancer-related gene mutation was calculated using the Manchester system. One thousand two hundred and forty-three patients have been referred. Ninety-two percent were at medium or high risk of developing breast cancer. Formal assessment of risk has been performed in 368 patients, 73% have a high lifetime risk of developing breast cancer, and 72% a Manchester score >or=16. BRCA1\\/2 mutations have been identified in 14 patients and breast cancer diagnosed in two. Our initial experience of family risk assessment has shown there to be a significant demand for this service. Identification of patients at increased risk of developing breast cancer allows us to provide individuals with accurate risk profiles, and enables patients to make informed choices regarding their follow-up and management.

  1. Methyldibromo glutaronitrile: clinical experience and exposure-based risk assessment.

    Science.gov (United States)

    Zachariae, Claus; Rastogi, Suresh; Devantier, Charlotte; Menné, Torkil; Johansen, Jeanne Duus

    2003-03-01

    In the year 2000, the level of methyldibromo glutaronitrile (MDGN) allergy in dermatology clinics in Europe exceeded the level of allergies to all other preservatives, with a prevalence of 3.5%. In the present study, cases of primary sensitization and elicitation to MDGN due to cosmetic products were collected over an 8-month period at the Department of Dermatology, Gentofte University Hospital. The aim was to identify the products related to hand eczema, assess exposure to MDGN in these products and relate the findings to results from a newly developed updated risk assessment model for contact allergy. Out of 24 patients with a positive patch test to MDGN, 17 patients with hand eczema were identified. In 11 of these patients, cosmetic products used in relation to the onset of the disease were shown to contain MDGN (65%). In 8 of these 11 cases, primary sensitization was probable, 5 due to hand/body lotions and 3 due to lotions and/or liquid hand soap. Chemical analysis of 12 products showed that lotions contained 149-390 ppm of MDGN, liquid hand soap 144-399 ppm, a rinsing cream 293 ppm and shampoos 78-79 ppm. The shampoo exposure was not of certain relevance to the eczema. Applying the newly developed updated risk assessment model showed that the concentrations of MDGN in lotions of 149-390 ppm exceeded the calculated maximum acceptable exposure level for MDGN, which would be expected to lead to sensitization in consumers using such products, as seen in the current study. The present cases and updated exposure-based risk assessment process add to the evidence and need for re-defining safe-use concentrations of MDGN in cosmetic products.

  2. Audit of the informed consent process as a part of a clinical research quality assurance program.

    Science.gov (United States)

    Lad, Pramod M; Dahl, Rebecca

    2014-06-01

    Audits of the informed consent process are a key element of a clinical research quality assurance program. A systematic approach to such audits has not been described in the literature. In this paper we describe two components of the audit. The first is the audit of the informed consent document to verify adherence with federal regulations. The second component is comprised of the audit of the informed consent conference, with emphasis on a real time review of the appropriate communication of the key elements of the informed consent. Quality measures may include preparation of an informed consent history log, notes to accompany the informed consent, the use of an informed consent feedback tool, and the use of institutional surveys to assess comprehension of the informed consent process.

  3. The Workshop Program on Authentic Assessment for Science Teachers

    Science.gov (United States)

    Rustaman, N. Y.; Rusdiana, D.; Efendi, R.; Liliawati, W.

    2017-02-01

    A study on implementing authentic assessment program through workshop was conducted to investigate the improvement of the competence of science teachers in designing performance assessment in real life situation at school level context. A number of junior high school science teachers and students as participants were involved in this study. Data was collected through questionnaire, observation sheets, and pre-and post-test during 4 day workshop. This workshop had facilitated them direct experience with seventh grade junior high school students during try out. Science teachers worked in group of four and communicated each other by think-pair share in cooperative learning approach. Research findings show that generally the science teachers’ involvement and their competence in authentic assessment improved. Their knowledge about the nature of assessment in relation to the nature of science and its instruction was improved, but still have problem in integrating their design performance assessment to be implemented in their lesson plan. The 7th grade students enjoyed participating in the science activities, and performed well the scientific processes planned by group of science teachers. The response of science teachers towards the workshop was positive. They could design the task and rubrics for science activities, and revised them after the implementation towards the students. By participating in this workshop they have direct experience in designing and trying out their ability within their professional community in real situation towards their real students in junior high school.

  4. Effective vulnerability assessments for physical security devices, systems, and programs

    International Nuclear Information System (INIS)

    Johnston, R.G.; Garcia, A.R.E.

    2002-01-01

    Full text: The efficacy of devices, systems, and programs used for physical security depend critically on having periodic and effective vulnerability assessments. Effective vulnerability assessments, in turn, require certain conditions and attributes. These include: a proper understanding of their purpose; not confusing vulnerability assessments with other kinds of metrics, analyses, tests, and security exercises; the view that vulnerabilities are inevitable, and that finding them is good news (since they can then be mitigated), not bad news; rejection of findings of no vulnerabilities; avoidance of mere 'compliance mode' rubber stamping; the use of the proper outside, independent, imaginative personnel; psychologically predisposed to finding and demonstrating problems; the absence of conflicts of interest; no unrealistic constraints on the possible attack tools, procedures, personnel, or strategies; efforts to not just find and demonstrate vulnerabilities, but also to suggest possible countermeasures; proper context; input and buy-in from ALL facility security personnel, especially low-level personnel; emphasis on the simplest, most relevant attacks first; no underestimation of potential adversaries; consideration of fault analysis attacks; awareness of Rohrbach's Maxim and Shannon's Maxim. In addition to these factors, we will cover some of the complex issues and problems associated with the design of vulnerability assessments. There will also be suggestions on how to conduct effective vulnerability assessments on a severely limited budget. We will conclude with a discussion of both conventional and unconventional ways of reporting results. (author)

  5. From Clinical-Developmental Theory to Assessment: The Holistic Student Assessment Tool

    Directory of Open Access Journals (Sweden)

    Gil Noam

    2012-12-01

    Full Text Available A description and test of the Holistic Student Assessment Tool (HSA, an assessment tool to measure children’s and adolescents’ resiliencies in relation to externalizing and internalizing problem behaviors. The HSA is based on the authors’ research-based clinical-developmental Clover Leaf Model of resilience and psychopathology, and is one of the first attempts at closing the gap between risk and resilience approaches in developmental assessment. The HSA was tested in a cross-sectional sample of 423 children and adolescents.The results lend support to the HSA as a valid measure of children’s and adolescents’ resiliencies. Furthermore, the resilience scales mostly exhibited the theoretically expected convergent and divergent relationships with the psychopathology scales. In addition, we show how the resilience scales predict adolescents’ externalizing and internalizing symptoms. We contend that evidence-based intervention to address youth aggression needs to be based on sounddevelopmental assessment.

  6. Teaching communication skills in clinical settings: comparing two applications of a comprehensive program with standardized and real patients.

    Science.gov (United States)

    Carvalho, Irene P; Pais, Vanessa G; Silva, Filipa R; Martins, Raquel; Figueiredo-Braga, Margarida; Pedrosa, Raquel; Almeida, Susana S; Correia, Luís; Ribeiro-Silva, Raquel; Castro-Vale, Ivone; Teles, Ana; Mota-Cardoso, Rui

    2014-05-09

    Communication is important for the quality of clinical practice, and programs have been implemented to improve healthcare providers' communication skills. However, the consistency of programs teaching communication skills has received little attention, and debate exists about the application of acquired skills to real patients. This study inspects whether (1) results from a communication program are replicated with different samples, and (2) results with standardized patients apply to interviews with real patients. A structured, nine-month communication program was applied in two consecutive years to two different samples of healthcare professionals (25 in the first year, 20 in the second year). Results were assessed at four different points in time, each year, regarding participants' confidence levels (self-rated), basic communication skills in interviews with standardized patients, and basic communication skills in interviews with real patients. Data were analyzed using GLM Repeated-Measures procedures. Improvements were statistically significant in both years in all measures except in simulated patients' assessment of the 2008 group. Differences between the two samples were non-significant. Differences between interviews with standardized and with real patients were also non-significant. The program's positive outcomes were replicated in different samples, and acquired skills were successfully applied to real-patient interviews. This reinforces this type of program structure as a valuable training tool, with results translating into real situations. It also adds to the reliability of the assessment instruments employed, though these may need adaptation in the case of real patients.

  7. Clinical Investigation Program. Annual Progress Report. Volume 1

    Science.gov (United States)

    1994-01-20

    Components Surgical Day, Bethesda, MD, in April 1993. 2. Planned for FY-94 The Department of Clinical Investigation hopes to maintain the essence of the...sclerosing cholangitis after choledochojejun- ostomy : radiographic and biochemical improvement with antibiotic therapN. Am J Gastroenterol 1993;88:1635

  8. Assessing clinical reasoning in optometry using the script concordance test.

    Science.gov (United States)

    Faucher, Caroline; Dufour-Guindon, Marie-Pier; Lapointe, Gabrielle; Gagnon, Robert; Charlin, Bernard

    2016-05-01

    Clinical reasoning is central to any health profession but its development among learners is difficult to assess. Over the last few decades, the script concordance test (SCT) has been developed to solve this dilemma and has been used in many health professions; however, no study has been published on the use of the script concordance test in optometry. The purpose of this study was to develop and validate a script concordance test for the field of optometry. A 101-question script concordance test (27 short clinical scenarios) was developed and administered online to a convenience sample of 23 second-year and 19 fourth-year students of optometry. It was also administered to a reference panel of 12 experienced optometrists to develop the scoring key. An item-total correlation was calculated for each question. Cronbach's alpha coefficient was used to evaluate the script concordance test reliability and a t-test compared the two groups. A final 77-question script concordance test was created by eliminating questions with low item-total correlation. Cronbach's alpha for this optimised 77-question script concordance test was 0.80. A group comparison revealed that the second-year students' scores (n = 23; mean score = 66.4 ± 7.87 per cent) were statistically lower (t = -4.141; p Optometry © 2016 Optometry Australia.

  9. Rapid assessment breast clinics--evolution through audit.

    Science.gov (United States)

    Toomey, D P; Cahill, R A; Birido, N; Jeffers, M; Loftus, B; McInerney, D; Rothwell, J; Geraghty, J G

    2006-11-01

    This observational, cohort study aimed to examine the potential utility of Rapid Assessment Breast Clinics (RABC) beyond cancer detection at presentation. One thousand four hundred and twenty nine women were studied over an 18 month period. 154 (10.7%) had breast cancer - 87.7% of whom were seen expediently with 92.9% being diagnosed at one attendance. One hundred and forty three (10%) of those with a benign diagnosis were found by routine questioning to have significant familial risk separate to their reason for referral. Despite careful triage, considerable contamination of appointment allotment occurred with many who were correctly triaged as non-urgent being seen 'urgently'. One hundred and seventy six attendees (12.3%) had neither the symptom that triggered referral, nor breast lump, nipple discharge nor family history of breast cancer, while 283 (19.8%) had no objective clinical or radiological abnormality. Although RABC reliably categorise malignant versus non-malignant diagnoses despite cluttering by low risk women, a significant proportion of non-cancer patients still require address of future risk rather than reassurance of their present status alone.

  10. Early clinical assessment for harsh child discipline strategies.

    Science.gov (United States)

    Gaffney, Kathleen F; Barndt-Maglio, Bonnie; Myers, Sue; Kollar, Shelley J

    2002-01-01

    To examine the relationships among four maternal variables: 1) prenatal report of discipline expectant mothers received when they were children, 2) prenatal intentions for disciplining one's own child, 3) report of intended child discipline strategies when infant is 8 months old, and 4) observed maternal role sufficiency behaviors. Replication and extension study; 3-wave prospective longitudinal design. The procedure consisted of prenatal clinic interviews in which women (N = 185) reported how their mothers handled specific child behaviors and how they intended to handle the same behaviors with their children. During a home visit when their babies were 8 months old, the mothers (n = 126) were again asked how they intended to handle these behaviors, and observations were made of maternal role sufficiency behaviors. Correlation and regression analyses were performed with data generated from an adaptation of the Ways of Handling Irritating Behavior scale, the NCAST Teaching Scale, and the HOME scale. A significant relationship was found between mothers' prenatal reports of discipline received as a child and prenatal reports of intentions for disciplining their own children. For mothers of infants, reported intentions for future child discipline strategies were predicted by their prenatal reports. Mothers with clinically at-risk scores on the NCAST Teaching Scale and HOME scale reported more intended harsh child discipline strategies than those not at-risk. Assessment for harsh, nonnurturing child discipline strategies during prenatal and well-baby health maintenance checks may assist in uncovering "red flags" for early intervention to reduce the risk of later child abuse and neglect.

  11. Quality assurance of radiotherapy and its clinical assessment

    International Nuclear Information System (INIS)

    Inoue, Toshihiko

    2002-01-01

    We investigated the clinical quality assurance (QA) of radiotherapy in Japan since 1981. The aim of this study was to establish the QA of a radiotherapy system and its clinical assessment in Japan. We introduced the Patterns of Care Study (PCS) into Japan to perform this study in 1996. The PCS is a retrospective study designed to establish the national practice for cancer patients during a specific period and should be a complementary study to a prospective randomized controlled study. We collected precise data for 4399 patients with carcinomas of the breast, cervix, esophagus, lung and prostate by means of external audits for 96 institutes from 1998 through 2001. Patients were randomly sampled with two-stage cluster sampling. We stratified 556 institutes into four categories according to the academic condition and annual number of radiotherapy patients. National and regional averages of various factors of radiotherapy could be calculated and were used to measure QA of radiotherapy. Using a standard score, we could compare the process of individual institutions with national averages and feed back the evaluation score to each institution. With a PCS process survey, we could observe the dissemination of the treatment method under evidence-based medicine from the prospective randomized controlled study. We proposed future prediction of the number of radiotherapy patients and a counter plan for equipment and personnel. The first US-Japan PCS Workshop was held at San Francisco in 2001. We could establish QA of a radiotherapy system using PCS 1995-97 in Japan. (author)

  12. Feedback and assessment for clinical placements: achieving the right balance

    Directory of Open Access Journals (Sweden)

    Burgess A

    2015-05-01

    Full Text Available Annette Burgess, Craig Mellis Central Clinical School, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia Abstract: During clinical placements, the provision of feedback forms an integral part of the learning process and enriches students' learning experiences. The purpose of feedback is to improve the learner's knowledge, skills, or behavior. Receipt of accurate feedback can help to narrow the gap between actual and desired performance. Effective and regular feedback has the potential to reinforce good practice and motivate the learner toward the desired outcome. Despite the obvious role of feedback in effective teaching and learning, a common complaint from students is that they do not receive adequate feedback. Unfortunately, skills in giving and receiving feedback are rarely taught to students or clinicians. This study aims to provide an understanding of the role of feedback within the learning process, consider consequences of inadequate or poorly given feedback, consider the barriers to the feedback process, provide practical guidelines for providing feedback, and consider the need for student and faculty development in feedback skills. Keywords: medical students, formative, summative, assessment

  13. Severe accident sequence assessment for boiling water reactors: program overview

    International Nuclear Information System (INIS)

    Fontana, M.H.

    1980-10-01

    The Severe Accident Sequence Assessment (SASA) Program was started at the Oak Ridge National Laboratory (ORNL) in June 1980. This report documents the initial planning, specification of objectives, potential uses of the results, plan of attack, and preliminary results. ORNL was assigned the Brown's Ferry Unit 1 Plant with the station blackout being the initial sequence set to be addressed. This set includes: (1) loss of offsite and onsite ac power with no coolant injection; and (2) loss of offsite and onsite ac power with high pressure coolant injection (HPCI) and reactor core isolation cooling (RCIC) as long as dc power supply lasts. This report includes representative preliminary results for the former case

  14. Assessment of pathology instruction in U.S. Dental hygiene educational programs.

    Science.gov (United States)

    Jacobs, Barbara B; Lazar, Ann A; Rowe, Dorothy J

    2015-04-01

    To assess the instruction of pathology content in entry-level and advanced practitioner dental hygiene educational programs and the program directors' perceptions whether their graduates are adequately prepared to meet the increasingly complex medical and oral health needs of the public. A 28-question survey of instructional content and perceptions was developed and distributed using Qualtrics® software to the 340 directors of entry-level and advanced practitioner dental hygiene programs in the US. Respondents rated their level of agreement to a series of statements regarding their perceptions of graduates' preparation to perform particular dental hygiene services associated with pathology. Descriptive statistics for all 28 categorical survey questions were calculated and presented as the frequency (percentage). Of the 340 directors surveyed, 130 (38%) responded. Most entry-level respondents (53%) agreed or strongly agreed (29%) that their graduates were adequately prepared to meet the complex medical and oral health needs of the public, while all respondents of advanced practitioner programs strongly agreed. More respondents strongly agreed to statements related to clinical instruction than to didactic courses. While 64% of respondents agreed that their graduates were prepared to practice unsupervised, if it were legally allowed, 21% were ambivalent. The extent of pathology instruction in entry-level programs varied, but most used traditional formats of instruction, educational resources and assessments of educational outcomes. Advanced practitioner programs emphasized histological and clinical examination of oral lesions and patient case studies. Strengthening pathology instruction would ensure that future generations of dental hygienists would be adequately prepared to treat medically compromised patients. Copyright © 2015 The American Dental Hygienists’ Association.

  15. A health equity impact assessment umbrella program (AAPRISS) to tackle social inequalities in health: program description.

    Science.gov (United States)

    Lang, Thierry; Bidault, Elsa; Villeval, Mélanie; Alias, François; Gandouet, Benjamin; Servat, Martine; Theis, Ivan; Breton, Eric; Haschar-Noé, Nadine; Grosclaude, Pascale

    2016-09-01

    The failure to simultaneously address two objectives (increasing the average health of the population and reducing health inequalities) may have led to what has been observed in France so far: an overall decrease in mortality and increase in inequality. The Apprendre et Agir pour Réduire les Inégalités Sociales de Santé (AAPRISS) methodology is to analyze and modify interventions that are already underway in terms of their potential impact on health inequalities. It relies on partnership between researchers and actors in the health field, as well as policy makers. In this paper, we describe the program and discuss its feasibility and acceptability. This program is not a single intervention, but a process aiming at assessing and reshaping existing health programs, therefore acting as a kind of meta-intervention. The program develops scientific and methodological support stemming from co-construction methods aimed at increasing equity within the programs. Stakeholders from prevention policy-making and the health care system, as well as researchers, collaborate in defining interventions, monitoring their progress, and choosing indicators, methods and evaluation procedures. The target population is mainly the population of the greater Toulouse area. The steps of the process are described: (1) establishment of AAPRISS governance and partnerships; (2) inclusion of projects; and (3) the projects' process. Many partners have rallied around this program, which has been shown to be feasible and acceptable by partners and health actors. A major challenge is understanding each partner's expectations in terms of temporality of interventions, expected outcomes, assessment methods and indicators. Analyzing the projects has been quite feasible, and some modifications have been implemented in them in order to take inequalities in health into account. © The Author(s) 2015.

  16. [Transference Focused Psychotherapy for Borderline-Adolescents in a Day Clinic Treatment Program].

    Science.gov (United States)

    Krischer, Maya; Ponton-Rodriguez, Tamara; Gooran, Ghazal Rostami; Bender, Stephan

    2017-07-01

    Transference Focused Psychotherapy for Borderline-Adolescents in a Day Clinic Treatment Program This paper focuses on the concept of transference focused psychotherapy (TFP) modified for juvenile borderline patients. Adolescents with borderline developmental personality disorder (bpd) have an essential deficit in their personality structure that leads to oscillations in their self-esteem and in a "split" perception of the world. They suffer from a variety of symptoms and severe impairments on their own and their families' quality of life. Their fragmented perception of themselves and others make relationships almost unbearable for them. Relationships are mostly marked by severe anxiety of resentment and rejection. For these patients this causes intolerable trouble at school where every day conflicts take place. Self-mutilation and suicidal thoughts often seem the only way out. By now, there is an agreement that an early specialized assessment and treatment is necessary in order to stop the typical consequences of their self-mutilative and dysfunctional behavior. Still, in contrast to adult age, empirical evidence is missing which proves the effectiveness of treating adolescent borderline patients. In this paper we present a research project on the effectiveness of transference focused psychotherapy with adolescent borderline patients (TFP-A) in a day clinic setting, combining TFP with group skills training as known from dialectic behavior therapy (DBT). Furthermore, we give first results on analyzing the effectiveness of our day clinic treatment program based on TFP-A, focusing on improving core symptoms such as affective problems, aggressive behavior against self and others and interpersonal problems.

  17. Mock Pages Are a Valid Construct for Assessment of Clinical Decision Making and Interprofessional Communication.

    Science.gov (United States)

    Boehler, Margaret L; Schwind, Cathy J; Markwell, Stephen J; Minter, Rebecca M

    2017-01-01

    Answering pages from nurses about patients in need of immediate attention is one of the most difficult challenges a resident faces during their first days as a physician. A Mock Page program has been developed and adopted into a national surgical resident preparatory curriculum to prepare senior medical students for this important skill. The purpose of this study is to assess standardized mock page cases as a valid construct to assess clinical decision making and interprofessional communication skills. Mock page cases (n = 16) were administered to 213 senior medical students from 12 medical schools participating in a national surgical resident preparatory curriculum in 2013 and 2014. Clinical decision making and interprofessional communication were measured by case-specific assessments evaluating these skills which have undergone rigorous standard-setting to determine pass/fail cut points. Students' performance improved in general for both communication and clinical decision making over the 4-week course. Cases have been identified that seem to be best suited for differentiating high- from low-performing students. Chest pain, pulmonary embolus, and mental status change cases posed the greatest difficulty for student learners. Simulated mock pages demonstrate an innovative technique for training students in both effective interprofessional communication and management of common postoperative conditions they will encounter as new surgical interns.

  18. Field Assessment of Energy Audit Tools for Retrofit Programs

    Energy Technology Data Exchange (ETDEWEB)

    Edwards, J. [Univ. of Minnesota, St. Paul, MN (United States); Bohac, D. [Univ. of Minnesota, St. Paul, MN (United States); Nelson, C. [Univ. of Minnesota, St. Paul, MN (United States); Smith, I. [Univ. of Minnesota, St. Paul, MN (United States)

    2013-07-01

    This project focused on the use of home energy ratings as a tool to promote energy retrofits in existing homes. A home energy rating provides a quantitative appraisal of a home’s energy performance, usually compared to a benchmark such as the average energy use of similar homes in the same region. Rating systems based on energy performance models, the focus of this report, can establish a home’s achievable energy efficiency potential and provide a quantitative assessment of energy savings after retrofits are completed, although their accuracy needs to be verified by actual measurement or billing data. Ratings can also show homeowners where they stand compared to their neighbors, thus creating social pressure to conform to or surpass others. This project field-tested three different building performance models of varying complexity, in order to assess their value as rating systems in the context of a residential retrofit program: Home Energy Score, SIMPLE, and REM/Rate.

  19. Power plant system assessment. Final report. SP-100 Program

    International Nuclear Information System (INIS)

    Anderson, R.V.; Atkins, D.F.; Bost, D.S.

    1983-01-01

    The purpose of this assessment was to provide system-level insights into 100-kWe-class space reactor electric systems. Using these insights, Rockwell was to select and perform conceptual design studies on a ''most attractive'' system that met the preliminary design goals and requirements of the SP-100 Program. About 4 of the 6 months were used in the selection process. The remaining 2 months were used for the system conceptual design studies. Rockwell completed these studies at the end of FY 1983. This report summarizes the results of the power plant system assessment and describes our choice for the most attractive system - the Rockwell SR-100G System (Space Reactor, 100 kWe, Growth) - a lithium-cooled UN-fueled fast reactor/Brayton turboelectric converter system

  20. Clinical assessment of the accuracy of blood glucose measurement devices.

    Science.gov (United States)

    Pfützner, Andreas; Mitri, Michael; Musholt, Petra B; Sachsenheimer, Daniela; Borchert, Marcus; Yap, Andrew; Forst, Thomas

    2012-04-01

    Blood glucose meters for patient self-measurement need to comply with the accuracy standards of the ISO 15197 guideline. We investigated the accuracy of the two new blood glucose meters BG*Star and iBG*Star (Sanofi-Aventis) in comparison to four other competitive devices (Accu-Chek Aviva, Roche Diagnostics; FreeStyle Freedom Lite, Abbott Medisense; Contour, Bayer; OneTouch Ultra 2, Lifescan) at different blood glucose ranges in a clinical setting with healthy subjects and patients with type 1 and type 2 diabetes. BGStar and iBGStar are employ dynamic electrochemistry, which is supposed to result in highly accurate results. The study was performed on 106 participants (53 female, 53 male, age (mean ± SD): 46 ± 16 years, type 1: 32 patients, type 2: 34 patients, and 40 healthy subjects). Two devices from each type and strips from two different production lots were used for glucose assessment (∼200 readings/meter). Spontaneous glucose assessments and glucose or insulin interventions under medical supervision were applied to perform measurements in the different glucose ranges in accordance with the ISO 15197 requirements. Sample values 400 mg/dL were prepared by laboratory manipulations. The YSI glucose analyzer (glucose oxidase method) served as the standard reference method which may be considered to be a limitation in light of glucose hexokinase-based meters. For all devices, there was a very close correlation between the glucose results compared to the YSI reference method results. The correlation coefficients were r = 0.995 for BGStar and r = 0.992 for iBGStar (Aviva: 0.995, Freedom Lite: 0.990, Contour: 0.993, Ultra 2: 0.990). Error-grid analysis according to Parkes and Clarke revealed both 100% of the readings to be within the clinically acceptable areas (Clarke: A + B with BG*Star (100 + 0), Aviva (97 + 3), and Contour (97 + 3); and 99.5% with iBG*Star (97.5 + 2), Freedom Lite (98 + 1.5), and Ultra 2 (97.5 + 2

  1. Assessing Clinical Research Capacity in Vietnam: A Framework for Strengthening Capability for Clinical Trials in Developing Countries.

    Science.gov (United States)

    Kagan, Jonathan; Giang, Dao Duc; Iademarco, Michael F; Phung, Van Tt; Lau, Chuen-Yen; Quang, Nguyen Ngo

    2016-01-01

    Although improving health systems promises important benefits, most developing nations lack the resources to support nationally driven clinical research. Strengthened clinical research capacity can advance national health goals by supporting greater autonomy in aligning research with national priorities. From March through June 2010, we assessed six elements of clinical research capacity in Vietnam: research agenda; clinical investigators and biostatisticians; donors and sponsors; community involvement; scientific, ethical, safety, and quality oversight; and clinical research institutions. Assessments were drawn from interviews with investigators, Ministry of Health staff members, nongovernment organizations, and U.S. Mission staff members, and document review. Observations and recommendations were shared with collaborators. Reassessment in 2015 found growth in the number of clinical trials, improved regulation in human subjects protection and community engagement, and modest advances in research agenda setting. Training and investment in institutions remain challenging. A framework for assessing clinical research capacity can affirm strengths and weaknesses and guide the coordination of capacity-building efforts.

  2. [Assessment of a preconception preventive program in a community].

    Science.gov (United States)

    Sánchez, B; Mendoza, M E; Avila Rosas, H

    2000-01-01

    Primary Health Care (PHC) is the basic health support that includes health promotion and disease prevention, considering social and developmental factors. It is the main axis to pregestational health programs with the basic elements for the women's self-care. This study evaluated the impact on health behavior and adherence to a community based pregestational preventive program in 224 women of reproductive age from Mexico City. The women were exposed to a health education intervention for twelve months, with free clinical examination every six months in a mobile screening unit close to their homes. Food and hygiene one to one orientation was offered, together with anthropometric, blood pressure and biochemical evaluations. Program adherence was 55%. Most of the women were less than 25 years of age, education above nine years, non-single, housework occupation as housewives, from an extended family, with social security and two or less live children and desire for more. No differences were found in the evaluated factors between those who continued and those who left the program. When comparing initial and final data, a significant larger proportion did breast self-examination, while this was not the case for the Pap smear test, no differences were found in prevalence of anemia or overweight. Drop-out was mainly due to a lack of interest, school or work problems and change of address. While breast self examination showed a positive effect, the negative or no effect on the other factors requires the intervention of other health professionals and implies more effort from the women. If one of the objectives of the PHC is health promotion, nurse intervention is a prominent role in the community.

  3. Assessing hospitals' clinical risk management: Development of a monitoring instrument

    Directory of Open Access Journals (Sweden)

    Pfeiffer Yvonne

    2010-12-01

    Full Text Available Abstract Background Clinical risk management (CRM plays a crucial role in enabling hospitals to identify, contain, and manage risks related to patient safety. So far, no instruments are available to measure and monitor the level of implementation of CRM. Therefore, our objective was to develop an instrument for assessing CRM in hospitals. Methods The instrument was developed based on a literature review, which identified key elements of CRM. These elements were then discussed with a panel of patient safety experts. A theoretical model was used to describe the level to which CRM elements have been implemented within the organization. Interviews with CRM practitioners and a pilot evaluation were conducted to revise the instrument. The first nationwide application of the instrument (138 participating Swiss hospitals was complemented by in-depth interviews with 25 CRM practitioners in selected hospitals, for validation purposes. Results The monitoring instrument consists of 28 main questions organized in three sections: 1 Implementation and organizational integration of CRM, 2 Strategic objectives and operational implementation of CRM at hospital level, and 3 Overview of CRM in different services. The instrument is available in four languages (English, German, French, and Italian. It allows hospitals to gather comprehensive and systematic data on their CRM practice and to identify areas for further improvement. Conclusions We have developed an instrument for assessing development stages of CRM in hospitals that should be feasible for a continuous monitoring of developments in this important area of patient safety.

  4. Assessing hospitals' clinical risk management: Development of a monitoring instrument.

    Science.gov (United States)

    Briner, Matthias; Kessler, Oliver; Pfeiffer, Yvonne; Wehner, Theo; Manser, Tanja

    2010-12-13

    Clinical risk management (CRM) plays a crucial role in enabling hospitals to identify, contain, and manage risks related to patient safety. So far, no instruments are available to measure and monitor the level of implementation of CRM. Therefore, our objective was to develop an instrument for assessing CRM in hospitals. The instrument was developed based on a literature review, which identified key elements of CRM. These elements were then discussed with a panel of patient safety experts. A theoretical model was used to describe the level to which CRM elements have been implemented within the organization. Interviews with CRM practitioners and a pilot evaluation were conducted to revise the instrument. The first nationwide application of the instrument (138 participating Swiss hospitals) was complemented by in-depth interviews with 25 CRM practitioners in selected hospitals, for validation purposes. The monitoring instrument consists of 28 main questions organized in three sections: 1) Implementation and organizational integration of CRM, 2) Strategic objectives and operational implementation of CRM at hospital level, and 3) Overview of CRM in different services. The instrument is available in four languages (English, German, French, and Italian). It allows hospitals to gather comprehensive and systematic data on their CRM practice and to identify areas for further improvement. We have developed an instrument for assessing development stages of CRM in hospitals that should be feasible for a continuous monitoring of developments in this important area of patient safety.

  5. Patient quality of life in the Mayo Clinic Care Transitions program: a survey study

    Directory of Open Access Journals (Sweden)

    Faucher J

    2016-08-01

    Full Text Available Joshua Faucher,1 Jordan Rosedahl,2 Dawn Finnie,3 Amy Glasgow,3 Paul Takahashi4 1Mayo Medical School, Mayo Clinic College of Medicine, 2Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic, 3Center for the Science of Health Care Delivery, 4Division of Primary Care Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA Background: Transitional care programs are common interventions aimed at reducing medical complications and associated readmissions for patients recently discharged from the hospital. While organizations strive to reduce readmissions, another important related metric is patient quality of life (QoL. Aims: To compare the relationship between QoL in patients enrolled in the Mayo Clinic Care Transitions (MCCT program versus usual care, and to determine if QoL changed in MCCT participants between baseline and 1-year follow-up. Methods: A baseline survey was mailed to MCCT enrollees in March 2013. Those who completed a baseline survey were sent a follow-up survey 1 year later. A cross-sectional survey of usual care participants was mailed in November 2013. We included in our analysis 199 participants (83 in the MCCT and 116 in usual care aged over 60 years with multiple comorbidities and receiving primary care. Primary outcomes were self-rated QoL; secondary outcomes included self-reported general, physical, and mental health. Intra- and intergroup comparisons of patients were evaluated using Pearson’s chi-squared analysis. Results: MCCT participants had more comorbidities and higher elder risk assessment scores than those receiving usual care. At baseline, 74% of MCCT participants reported responses of good-to-excellent QoL compared to 64% after 1 year (P=0.16. Between MCCT and usual care, there was no significant difference in self-reported QoL (P=0.21. Between baseline and follow-up in MCCT patients, and compared to usual care, there were no significant

  6. Student´s self-assessment of clinical competence and objective clinical performance in OSCE evaluation

    OpenAIRE

    Jünger, J; Schellberg, D; Nikendei, C

    2006-01-01

    [english] Overestimating one's clinical competence can be dangerous to patient's safety. Therefore the goal of this study was to identify students with high confidence in their own clinical competence but low performance in objective assessment. 171 students in the 14 week course in internal medicine completed the clinical skills-related self-assessment expectations (SE) and were tested in a 12 station OSCE. Both measures were obtained within three days. In total we identified 16% of students...

  7. Undergraduate nursing students' perspectives on clinical assessment at transition to practice.

    Science.gov (United States)

    Wu, Xi Vivien; Wang, Wenru; Pua, Lay Hoon; Heng, Doreen Gek Noi; Enskär, Karin

    2015-01-01

    Assessment of clinical competence requires explicitly defined standards meeting the national standards of the nursing profession. This is a complex process because of the diverse nature of nursing practice. To explore the perceptions of final-year undergraduate nursing students regarding clinical assessment at transition to practice. An exploratory qualitative approach was adopted. Twenty-four students participated in three focus group discussions. Thematic analysis was conducted. Five themes emerged: the need for a valid and reliable clinical assessment tool, the need for a flexible style of reflection and specific feedback, the dynamic clinical learning environment, students' efforts in learning and assessment, and the unclear support system for preceptors. Workload, time, resource availability, adequate preparation of preceptors, and the provision of valid and reliable clinical assessment tools were deemed to influence the quality of students' clinical learning and assessment. Nursing leadership in hospitals and educational institutions has a joint responsibility in shaping the clinical learning environment and providing clinical assessments for the students.

  8. Clinical Investigation Program Report, RCS MED-300 (R1).

    Science.gov (United States)

    1986-10-31

    handpieces . Technical Approach: The study will be conducted in vitro using the palatal roots of human maxillary molar teeth which previously extracted due...109 1985 Histoplasmosis Seroconversion Study. (T) 110 1986 A Comparative Study of Fetal Movement Perceptions in the Third Trimester of Multiparous and...Hartwell G, Portell FR: Clinical management of middle mesial root canals in mandibular molars : Two case reports. Submitted to J Am Dent Assn. DeFiore

  9. National Assessment of Quality Programs in Emergency Medical Services.

    Science.gov (United States)

    Redlener, Michael; Olivieri, Patrick; Loo, George T; Munjal, Kevin; Hilton, Michael T; Potkin, Katya Trudeau; Levy, Michael; Rabrich, Jeffrey; Gunderson, Michael R; Braithwaite, Sabina A

    2018-01-01

    This study aims to understand the adoption of clinical quality measurement throughout the United States on an EMS agency level, the features of agencies that do participate in quality measurement, and the level of physician involvement. It also aims to barriers to implementing quality improvement initiatives in EMS. A 46-question survey was developed to gather agency level data on current quality improvement practices and measurement. The survey was distributed nationally via State EMS Offices to EMS agencies nation-wide using Surveymonkey©. A convenience sample of respondents was enrolled between August and November, 2015. Univariate, bivariate and multiple logistic regression analyses were conducted to describe demographics and relationships between outcomes of interest and their covariates using SAS 9.3©. A total of 1,733 surveys were initiated and 1,060 surveys had complete or near-complete responses. This includes agencies from 45 states representing over 6.23 million 9-1-1 responses annually. Totals of 70.5% (747) agencies reported dedicated QI personnel, 62.5% (663) follow clinical metrics and 33.3% (353) participate in outside quality or research program. Medical director hours varied, notably, 61.5% (649) of EMS agencies had quality measures compared to fire-based agencies. Agencies in rural only environments were less likely to follow clinical quality metrics. (OR 0.47 CI 0.31 -0.72 p quality improvement resources, medical direction and specific clinical quality measures. More research is needed to understand the impact of this variation on patient care outcomes.

  10. Assessment of a strain 19 brucellosis vaccination program in elk

    Science.gov (United States)

    Maichak, Eric J.; Scurlock, Brandon M.; Cross, Paul C.; Rogerson, Jared D.; Edwards, William H.; Wise, Benjamin; Smith, Scott G.; Kreeger, Terry J.

    2017-01-01

    Zoonotic diseases in wildlife present substantial challenges and risks to host populations, susceptible domestic livestock populations, and affected stakeholders. Brucellosis, a disease caused by the bacterium Brucella abortus, is endemic among elk (Cervus canadensis) attending winter feedgrounds and adjacent areas of western Wyoming, USA. To minimize transmission of brucellosis from elk to elk and elk to livestock, managers initiated a B. abortus strain 19 ballistic vaccination program in 1985. We used brucellosis prevalence (1971–2015) and reproductive outcome (2006–2015) data collected from female elk attending feedgrounds to assess efficacy of the strain 19 program while controlling for potentially confounding factors such as site and age. From our generalized linear models, we found that seroprevalence of brucellosis was 1) not lower following inception of vaccination; 2) not inversely associated with proportion of juveniles vaccinated over time; 3) not inversely associated with additional yearlings and adults vaccinated over time; and 4) associated more with feeding end-date than proportion of juveniles vaccinated. Using vaginal implant transmitters in adult females that were seropositive for brucellosis, we found little effect of vaccination coverage at reducing reproductive failures (i.e., abortion or stillbirth). Because we found limited support for efficacy of the strain 19 program, we support research to develop an oral vaccine and suggest that continuing other spatio-temporal management actions will be most effective to minimize transmission of brucellosis and reduce dependency of elk on supplemental winter feeding.

  11. Evaluation of analytical results on DOE Quality Assessment Program Samples

    International Nuclear Information System (INIS)

    Jaquish, R.E.; Kinnison, R.R.; Mathur, S.P.; Sastry, R.

    1985-01-01

    Criteria were developed for evaluating the participants analytical results in the DOE Quality Assessment Program (QAP). Historical data from previous QAP studies were analyzed using descriptive statistical methods to determine the interlaboratory precision that had been attained. Performance criteria used in other similar programs were also reviewed. Using these data, precision values and control limits were recommended for each type of analysis performed in the QA program. Results of the analysis performed by the QAP participants on the November 1983 samples were statistically analyzed and evaluated. The Environmental Measurements Laboratory (EML) values were used as the known values and 3-sigma precision values were used as control limits. Results were submitted by 26 participating laboratories for 49 different radionuclide media combinations. The participants reported 419 results and of these, 350 or 84% were within control limits. Special attention was given to the data from gamma spectral analysis of air filters and water samples. both normal probability and box plots were prepared for each nuclide to help evaluate the distribution of the data. Results that were outside the expected range were identified and suggestions made that laboratories check calculations, and procedures on these results

  12. Shyness Clinic: A Social Development Program for Adolescents and Young Adults.

    Science.gov (United States)

    Barrow, John; Hayashi, Judy

    1980-01-01

    Shyness clinic groups were offered in a university counseling center. The program focused on anxiety management, assertiveness in social relationships, and development of conversational skills. Participants improved in social skills and ability to manage anxiety. (Author)

  13. Addiction Competencies in the 2009 CACREP Clinical Mental Health Counseling Program Standards

    Science.gov (United States)

    Lee, Tiffany K.; Craig, Stephen E.; Fetherson, Bianca T. L.; Simpson, C. Dennis

    2013-01-01

    The Council for Accreditation of Counseling and Related Educational Programs developed addiction competencies for clinical mental health counseling students. This article highlights these competencies, provides an overview of current addiction training, and describes methods to integrate addiction education into curricula.

  14. Automotive Stirling engine development program. [fuel economy assessment

    Science.gov (United States)

    Kitzner, E. W.

    1978-01-01

    The Ford/DOE automotive Stirling engine development program is directed towards establishing the technological and developmental base that would enable a decision on whether an engineering program should be directed at Stirling engine production. The fuel economy assessment aims to achieve, with a high degree of confidence, the ERDA proposal estimate of 20.6 MPG (gasoline) for a 4500 lb 1WC Stirling engine passenger car. The current M-H fuel economy projection for the 170 HP Stirling engine is 15.7 MPG. The confidence level for this projection is 32%. A confidence level of 29% is projected for a 22.1 MPG estimate. If all of the planned analyses and test work is accomplished at the end of the one year effort, and the projected improvements are substantiated, the confidence levels would rise to 59% for the 20.6 MPG projection and 54% for the 22.1 MPG projection. Progress achieved thus far during the fuel economy assessment is discussed.

  15. Final Environmental assessment for the Uranium Lease Management Program

    International Nuclear Information System (INIS)

    1995-07-01

    The US Department of Energy (DOE) has prepared a programmatic environmental assessment (EA) of the proposed action to continue leasing withdrawn lands and DOE-owned patented claims for the exploration and production of uranium and vanadium ores. The Domestic Uranium Program regulation, codified at Title 10, Part 760.1, of the US Code of Federal Regulations (CFR), gives DOE the flexibility to continue leasing these lands under the Uranium Lease Management Program (ULMP) if the agency determines that it is in its best interest to do so. A key element in determining what is in DOE's ''best interest'' is the assessment of the environmental impacts that may be attributable to lease tract operations and associated activities. On the basis of the information and analyses presented in the EA for the ULMP, DOE has determined that the proposed action does not constitute a major Federal action significantly affecting the quality of the human environment, as defined in the National Environmental Policy Act (NEPA) of 1969 (42 United States Code 4321 et seq.), as amended.Therefore, preparation of an environmental impact statement is not required for the ULMP,and DOE is issuing this Finding, of No Significant Impact (FONSI)

  16. Final Environmental assessment for the Uranium Lease Management Program

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-07-01

    The US Department of Energy (DOE) has prepared a programmatic environmental assessment (EA) of the proposed action to continue leasing withdrawn lands and DOE-owned patented claims for the exploration and production of uranium and vanadium ores. The Domestic Uranium Program regulation, codified at Title 10, Part 760.1, of the US Code of Federal Regulations (CFR), gives DOE the flexibility to continue leasing these lands under the Uranium Lease Management Program (ULMP) if the agency determines that it is in its best interest to do so. A key element in determining what is in DOE`s ``best interest`` is the assessment of the environmental impacts that may be attributable to lease tract operations and associated activities. On the basis of the information and analyses presented in the EA for the ULMP, DOE has determined that the proposed action does not constitute a major Federal action significantly affecting the quality of the human environment, as defined in the National Environmental Policy Act (NEPA) of 1969 (42 United States Code 4321 et seq.), as amended.Therefore, preparation of an environmental impact statement is not required for the ULMP,and DOE is issuing this Finding, of No Significant Impact (FONSI).

  17. Nevada Risk Assessment/Management Program scientific peer review

    International Nuclear Information System (INIS)

    Bentz, E.J. Jr.; Bentz, C.B.; O'Hora, T.D.; Chen, S.Y.

    1997-01-01

    The 1,350 square-mile Nevada Test Site and additional sites in Nevada served as the continental sites for US nuclear weapons testing from 1951 to 1992. The Nevada Risk Assessment/Management Program (NRAMP) is a currently on-going effort of the Harry Reid Center for Environmental Studies at the University of Nevada, Las Vegas (UNLV) and the firm of E. J. Bentz and Associates, Inc., in cooperation with the US Department of Energy (DOE) Environmental Management Program. Argonne National Laboratory is one of several public and private organizations supporting personnel appointed by the NRAMP to the NRAMP Scientific Peer Review Panel. The NRAMP is part of a national effort by the DOE to develop new sources of information and approaches to risk assessment, risk management, risk communication, and public outreach relevant to the ecological and human health effects of radioactive and hazardous materials management and site remediation activities. This paper describes the development, conduct, and current results of the scientific peer review process which supports the goals of the NRAMP

  18. TRECII: a computer program for transportation risk assessment

    International Nuclear Information System (INIS)

    Franklin, A.L.

    1980-05-01

    A risk-based fault tree analysis method has been developed at the Pacific Northwest Laboratory (PNL) for analysis of nuclear fuel cycle operations. This methodology was developed for the Department of Energy (DOE) as a risk analysis tool for evaluating high level waste management systems. A computer package consisting of three programs was written at that time to assist in the performance of risk assessment: ACORN (draws fault trees), MFAULT (analyzes fault trees), and RAFT (calculates risk). This methodology evaluates release consequences and estimates the frequency of occurrence of these consequences. This document describes an additional risk calculating code which can be used in conjunction with two of the three codes for transportation risk assessment. TRECII modifies the definition of risk used in RAFT (prob. x release) to accommodate release consequences in terms of fatalities. Throughout this report risk shall be defined as probability times consequences (fatalities are one possible health effect consequence). This methodology has been applied to a variety of energy material transportation systems. Typically the material shipped has been radioactive, although some adaptation to fossil fuels has occurred. The approach is normally applied to truck or train transport systems with some adaptation to pipelines and aircraft. TRECII is designed to be used primarily in conjunction with MFAULT; however, with a moderate amount of effort by the user, it can be implemented independent of the risk analysis package developed at PNL. Code description and user instructions necessary for the implementation of the TRECII program are provided

  19. Adolescent bariatric surgery program characteristics: the Teen Longitudinal Assessment of Bariatric Surgery (Teen-LABS) study experience.

    Science.gov (United States)

    Michalsky, Marc P; Inge, Thomas H; Teich, Steven; Eneli, Ihuoma; Miller, Rosemary; Brandt, Mary L; Helmrath, Michael; Harmon, Carroll M; Zeller, Meg H; Jenkins, Todd M; Courcoulas, Anita; Buncher, Ralph C

    2014-02-01

    The number of adolescents undergoing weight loss surgery (WLS) has increased in response to the increasing prevalence of severe childhood obesity. Adolescents undergoing WLS require unique support, which may differ from adult programs. The aim of this study was to describe institutional and programmatic characteristics of centers participating in Teen Longitudinal Assessment of Bariatric Surgery (Teen-LABS), a prospective study investigating safety and efficacy of adolescent WLS. Data were obtained from the Teen-LABS database, and site survey completed by Teen-LABS investigators. The survey queried (1) institutional characteristics, (2) multidisciplinary team composition, (3) clinical program characteristics, and (4) clinical research infrastructure. All centers had extensive multidisciplinary involvement in the assessment, pre-operative education, and post-operative management of adolescents undergoing WLS. Eligibility criteria and pre-operative clinical and diagnostic evaluations were similar between programs. All programs have well-developed clinical research infrastructure, use adolescent-specific educational resources, and maintain specialty equipment, including high weight capacity diagnostic imaging equipment. The composition of clinical team and institutional resources is consistent with current clinical practice guidelines. These characteristics, coupled with dedicated research staff, have facilitated enrollment of 242 participants into Teen-LABS. © 2013 Published by Elsevier Inc.

  20. Overview of the National Water-Quality Assessment Program

    Science.gov (United States)

    Leahy, P.P.; Thompson, T.H.

    1994-01-01

    The Nation's water resources are the basis for life and our economic vitality. These resources support a complex web of human activities and fishery and wildlife needs that depend upon clean water. Demands for good-quality water for drinking, recreation, farming, and industry are rising, and as a result, the American public is concerned about the condition and sustainability of our water resources. The American public is asking: Is it safe to swim in and drink water from our rivers or lakes? Can we eat the fish that come from them? Is our ground water polluted? Is water quality degrading with time, and if so, why? Has all the money we've spent to clean up our waters, done any good? The U.S. Geological Survey's National Water-Quality Assessment (NAWQA) Program was designed to provide information that will help answer these questions. NAWQA is designed to assess historical, current, and future water-quality conditions in representative river basins and aquifers nationwide. One of the primary objectives of the program is to describe relations between natural factors, human activities, and water-quality conditions and to define those factors that most affect water quality in different parts of the Nation. The linkage of water quality to environmental processes is of fundamental importance to water-resource managers, planners, and policy makers. It provides a strong and unbiased basis for better decisionmaking by those responsible for making decisions that affect our water resources, including the United States Congress, Federal, State, and local agencies, environmental groups, and industry. Information from the NAWQA Program also will be useful for guiding research, monitoring, and regulatory activities in cost effective ways.

  1. SU-F-J-116: Clinical Experience-Based Verification and Improvement of a 4DCT Program

    Energy Technology Data Exchange (ETDEWEB)

    Fogg, P; West, M; Aland, T [Genesis Cancer Care, Auchenflower, Qld (Australia)

    2016-06-15

    Purpose: To demonstrate the role of continuous improvement fulfilled by the Medical Physicist in clinical 4DCT and CBCT scanning. Methods: Lung (SABR and Standard) patients’ 4D respiratory motion and image data were reviewed over a 3, 6 and 12 month period following commissioning testing. By identifying trends of clinically relevant parameters and respiratory motions, variables were tested with a programmable motion phantom and assessed. Patient traces were imported to a motion phantom and 4DCT and CBCT imaging were performed. Cos6 surrogate and sup-inf motion was also programmed into the phantom to simulate the long exhale of patients for image contrast tests. Results: Patient surrogate motion amplitudes were 9.9+5.2mm (3–35) at 18+6bpm (6–30). Expiration/Inspiration time ratios of 1.4+0.5second (0.6–2.9) showed image contrast effects evident in the AveCT and 3DCBCT images. Small differences were found for patients with multiple 4DCT data sets. Patient motion assessments were simulated and verified with the phantom within 2mm. Initial image reviews to check for reconstructed artefacts and data loss identified a small number of patients with irregularities in the automatic placement of inspiration and expiration points. Conclusion: The Physicist’s involvement in the continuous improvements of a clinically commissioned technique, processes and workflows continues beyond the commissioning stage of a project. Our experience with our clinical 4DCT program shows that Physics presence is required at the clinical 4DCT scan to assist with technical aspects of the scan and also for clinical image quality assessment prior to voluming. The results of this work enabled the sharing of information from the Medical Physics group with the Radiation Oncologists and Radiation Therapists. This results in an improved awareness of clinical patient respiration variables and how they may affect 4D simulation images and also may also affect the treatment verification images.

  2. Developing an evaluation framework for clinical redesign programs: lessons learnt.

    Science.gov (United States)

    Samaranayake, Premaratne; Dadich, Ann; Fitzgerald, Anneke; Zeitz, Kathryn

    2016-09-19

    Purpose The purpose of this paper is to present lessons learnt through the development of an evaluation framework for a clinical redesign programme - the aim of which was to improve the patient journey through improved discharge practices within an Australian public hospital. Design/methodology/approach The development of the evaluation framework involved three stages - namely, the analysis of secondary data relating to the discharge planning pathway; the analysis of primary data including field-notes and interview transcripts on hospital processes; and the triangulation of these data sets to devise the framework. The evaluation framework ensured that resource use, process management, patient satisfaction, and staff well-being and productivity were each connected with measures, targets, and the aim of clinical redesign programme. Findings The application of business process management and a balanced scorecard enabled a different way of framing the evaluation, ensuring measurable outcomes were connected to inputs and outputs. Lessons learnt include: first, the importance of mixed-methods research to devise the framework and evaluate the redesigned processes; second, the need for appropriate tools and resources to adequately capture change across the different domains of the redesign programme; and third, the value of developing and applying an evaluative framework progressively. Research limitations/implications The evaluation framework is limited by its retrospective application to a clinical process redesign programme. Originality/value This research supports benchmarking with national and international practices in relation to best practice healthcare redesign processes. Additionally, it provides a theoretical contribution on evaluating health services improvement and redesign initiatives.

  3. How does the medical graduates' self-assessment of their clinical competency differ from experts' assessment?

    Science.gov (United States)

    2013-01-01

    Background The assessment of the performance of medical school graduates during their first postgraduate years provides an early indicator of the quality of the undergraduate curriculum and educational process. The objective of this study was to assess the clinical competency of medical graduates, as perceived by the graduates themselves and by the experts. Methods This is a hospital based cross-sectional study. It covered 105 medical graduates and 63 experts selected by convenient sampling method. A self-administered questionnaire covering the different areas of clinical competency constructed on a five-point Likert scale was used for data collection. Data processing and analysis were performed using the Statistical Package for Social Science (SPSS) 16.0. The mean, frequency distribution, and percentage of the variables were calculated. A non-parametric Kruskal Wallis test was applied to verify whether the graduates' and experts' assessments were influenced by the graduates' variables such as age, gender, experience, type of hospital, specialty and location of work at a (p ≤ 0.05) level of significance. Results The overall mean scores for experts' and graduates' assessments were 3.40 and 3.63, respectively (p= 0.035). Almost 87% of the graduates perceived their competency as good and very good in comparison with only 67.7% by experts. Female and male graduates who rated themselves as very good were 33.8% and 25% respectively. More than 19% of the graduates in the age group > 30 years perceived their clinical competency as inadequate in contrast with only 6.2% of the graduates in the youngest age group. Experts rated 40% of the female graduates as inadequate versus 20% of males, (p= 0.04). More than 40% of the graduates in younger age group were rated by experts as inadequate, versus 9.7% of the higher age group >30 years (p = 0.03). Conclusion There was a wide discrepancy between the graduates' self-assessment and experts' assessment, particularly in the level

  4. Assessing the health, functional characteristics, and health needs of youth attending a noncategorical transition support program.

    Science.gov (United States)

    Woodward, Jason F; Swigonski, Nancy L; Ciccarelli, Mary R

    2012-09-01

    To assess the health, functional characteristics, and health care service needs of youth and young adults with special health care needs attending a comprehensive, noncategorical transition program. A self-administered survey was developed from national health surveys and clinical experience to assess concepts identified as important for successful transition to adulthood. Surveys were mailed to 198 parents of youth and young adults with special health care needs attending the transition clinic. Parents were asked about the youth's health, functional status, and health care services needed. The clinical database provided demographic and patient health characteristics. Results were compared against the 2005-2006 National Survey of Children with Special Health Care Needs. Forty-four percent of surveys were returned. Average age of youth was 17.5 (11-22) years old and diagnoses included cerebral palsy (36%), spina bifida (10%), developmental delay or Down syndrome (17%), and autism (6%). Most youth needed assistance with personal care (69%) and routine needs (91%) and used assistive devices (59%). Compared with the 2005-2006 National Survey of Children with Special Health Care Needs, parents reported higher needs for all services except mental health care and tobacco or substance use counseling. Forty three percent reported at least one unmet health need. Few parents reported the need for counseling on substance use (1%), sexual health screening (16%), nutrition (34%), and exercise (41%). Youth attending our transition program had more functional limitations, poorer reported health status, different diagnosis distribution, and higher levels of needed health services. Few parents identified needs for other recommended adolescent preventive services. Transition programs should assess patient health characteristics and service needs to design effective patient-centered services. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All

  5. Supporting adherence and healthy lifestyles in leg ulcer patients: systematic development of the Lively Legs program for dermatology outpatient clinics.

    Science.gov (United States)

    Heinen, Maud M; Bartholomew, L Kay; Wensing, Michel; van de Kerkhof, Peter; van Achterberg, Theo

    2006-05-01

    The objective of our project was to develop a lifestyle program for leg ulcer patients at outpatient clinics for dermatology. We used the intervention-mapping (IM) framework for systematically developing theory and evidence based health promotion programs. We started with a needs-assessment. A multidisciplinary project group of health care workers and patients was involved in all five IM steps; formulating proximal program objectives, selecting methods and strategies, producing program components, planning for adoption and implementation and planning for evaluation. Several systematic literature reviews and original studies were performed to support this process. Social Cognitive Theory was selected as the main theory behind the program 'Lively Legs' and was combined with elements of Goal-Setting Theory, the precaution adoption model and motivational interviewing. The program is conducted through health counseling by dermatology nurses and was successfully pre-tested. Also, an implementation and evaluation plan were made. Intervention mapping helped us to succeed in developing a lifestyle program with clear goals and methods, operational strategies and materials and clear procedures. Coaching leg ulcer patients towards adherence with compression therapy and healthy lifestyles should be taken on without delay. Systematic development of lifestyle programs for other patient groups should be encouraged.

  6. Clinically significant discrepancies between sleep problems assessed by standard clinical tools and actigraphy

    Directory of Open Access Journals (Sweden)

    Kjersti Marie Blytt

    2017-10-01

    Full Text Available Abstract Background Sleep disturbances are widespread among nursing home (NH patients and associated with numerous negative consequences. Identifying and treating them should therefore be of high clinical priority. No prior studies have investigated the degree to which sleep disturbances as detected by actigraphy and by the sleep-related items in the Cornell Scale for Depression in Dementia (CSDD and the Neuropsychiatric Inventory – Nursing Home version (NPI-NH provide comparable results. Such knowledge is highly needed, since both questionnaires are used in clinical settings and studies use the NPI-NH sleep item to measure sleep disturbances. For this reason, insight into their relative (disadvantages is valuable. Method Cross-sectional study of 83 NH patients. Sleep was objectively measured with actigraphy for 7 days, and rated by NH staff with the sleep items in the CSDD and the NPI-NH, and results were compared. McNemar's tests were conducted to investigate whether there were significant differences between the pairs of relevant measures. Cohen's Kappa tests were used to investigate the degree of agreement between the pairs of relevant actigraphy, NPI-NH and CSDD measures. Sensitivity and specificity analyses were conducted for each of the pairs, and receiver operating characteristics (ROC curves were designed as a plot of the true positive rate against the false positive rate for the diagnostic test. Results Proxy-raters reported sleep disturbances in 20.5% of patients assessed with NPI-NH and 18.1% (difficulty falling asleep, 43.4% (multiple awakenings and 3.6% (early morning awakenings of patients had sleep disturbances assessed with CSDD. Our results showed significant differences (p<0.001 between actigraphy measures and proxy-rated sleep by the NPI-NH and CSDD. Sensitivity and specificity analyses supported these results. Conclusions Compared to actigraphy, proxy-raters clearly underreported NH patients' sleep disturbances as assessed

  7. Lymphoplasmacytic sclerosing cholangitis: assessment of clinical, CT, and pathological findings

    Energy Technology Data Exchange (ETDEWEB)

    Itoh, S., E-mail: shigekimiyo@luck.ocn.ne.j [Department of Technical Radiology, Nagoya University School of Health Sciences, Nagoya (Japan); Nagasaka, T. [Department of Pathology, Nagoya University Graduate School of Medicine, Nagoya (Japan); Suzuki, K.; Satake, H.; Ota, T.; Naganawa, S. [Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya (Japan)

    2009-11-15

    Aim: To assess the clinical, computed tomography (CT), and pathological findings in patients with lymphoplasmacytic sclerosing cholangitis. Materials and methods: Fifteen consecutive patients (four women and 11 men, mean age 71 years) with lymphoplasmacytic sclerosing cholangitis and without the characteristic features of underlying disorders causing benign biliary strictures were retrospectively recruited. Two radiologists evaluated multiphase contrast-enhanced CT images acquired with 0.5 or 1-mm collimation. One pathologist performed all histological examinations, including IgG4 immunostaining. Results: The intrahepatic biliary ducts showed dilatation in all 15 patients, but only seven presented with jaundice. Although laboratory data were not available in all patients, serum gammaglobulin and IgG levels were elevated in five of six patients and six of eight patients, respectively. Anti-nuclear antibody was detected in three of six patients. The involved biliary ducts showed the following CT findings: involvement of the hilar biliary duct (14/15), a mean wall thickness of 4.9 mm, a smooth margin (10/15), a narrow but visible lumen (6/15), hyper-attenuation during the late arterial phase (9/15), homogeneous hyper-attenuation during the delayed phase (11/11), and no vascular invasion (14/15). Abnormal findings in the pancreas and urinary tract were detected in eight of 15 patients. In 13 patients with adequate specimens, moderate to severe lymphoplasmacytic infiltration associated with dense fibrosis was observed. Infiltration of IgG4-positive plasma cells was moderate or severe in nine patients and minimal or absent in four patients. Conclusion: Lymphoplasmacytic sclerosing cholangitis exhibits relatively characteristic clinical and CT findings, although they are not sufficiently specific for differentiation from other biliary diseases.

  8. Lymphoplasmacytic sclerosing cholangitis: assessment of clinical, CT, and pathological findings

    International Nuclear Information System (INIS)

    Itoh, S.; Nagasaka, T.; Suzuki, K.; Satake, H.; Ota, T.; Naganawa, S.

    2009-01-01

    Aim: To assess the clinical, computed tomography (CT), and pathological findings in patients with lymphoplasmacytic sclerosing cholangitis. Materials and methods: Fifteen consecutive patients (four women and 11 men, mean age 71 years) with lymphoplasmacytic sclerosing cholangitis and without the characteristic features of underlying disorders causing benign biliary strictures were retrospectively recruited. Two radiologists evaluated multiphase contrast-enhanced CT images acquired with 0.5 or 1-mm collimation. One pathologist performed all histological examinations, including IgG4 immunostaining. Results: The intrahepatic biliary ducts showed dilatation in all 15 patients, but only seven presented with jaundice. Although laboratory data were not available in all patients, serum gammaglobulin and IgG levels were elevated in five of six patients and six of eight patients, respectively. Anti-nuclear antibody was detected in three of six patients. The involved biliary ducts showed the following CT findings: involvement of the hilar biliary duct (14/15), a mean wall thickness of 4.9 mm, a smooth margin (10/15), a narrow but visible lumen (6/15), hyper-attenuation during the late arterial phase (9/15), homogeneous hyper-attenuation during the delayed phase (11/11), and no vascular invasion (14/15). Abnormal findings in the pancreas and urinary tract were detected in eight of 15 patients. In 13 patients with adequate specimens, moderate to severe lymphoplasmacytic infiltration associated with dense fibrosis was observed. Infiltration of IgG4-positive plasma cells was moderate or severe in nine patients and minimal or absent in four patients. Conclusion: Lymphoplasmacytic sclerosing cholangitis exhibits relatively characteristic clinical and CT findings, although they are not sufficiently specific for differentiation from other biliary diseases.

  9. Clinical Assessment of a New Stereoscopic Digital Angiography System

    International Nuclear Information System (INIS)

    Moll, Thierry; Douek, Philippe; Finet, Gerard; Turjman, Francis; Picard, Catherine; Revel, Didier; Amiel, Michel

    1998-01-01

    Purpose: To assess the clinical feasibility of an experimental modified angiographic system capable of real-time digital stereofluoroscopy and stereography in X-ray angiography, using a twin-focus tube and a stereoscopic monitor. Methods: We report the experience obtained in 37 patients with a well-documented examination. The patients were examined for coronary angiography (11 cases), aortography (7 cases), pulmonary angiography (6 cases), inferior vena cava filter placement (2 cases), and cerebral angiography (11 cases). Six radiologists were asked to use stereoscopic features for fluoroscopy and angiography. A questionnaire was designed to record their subjective evaluation of stereoscopic image quality, ergonomics of the system, and its medical interest. Results: Stereofluoroscopy was successfully used in 25 of 37 cases; diplopia and/or ghost images were reported in 6 cases. It was helpful for aortic catheterization in 10 cases and for selective catheterization in 5 cases. In stereoangiography, depth was easily and accurately perceived in 27 of 37 cases; diplopia and/or ghost images were reported in 4 cases. A certain gain in the three-dimensional evaluation of the anatomy and relation between vessels and lesions was noted. As regards ergonomic considerations, polarized spectacles were not considered cumbersome. Visual fatigue and additional work were variously reported. Stereoshift tuning before X-ray acquisition was not judged to be a limiting factor. Conclusion: A twin-focus X-ray tube and a polarized shutter for stereoscopic display allowed effective real-time three-dimensional perception of angiographic images. Our clinical study suggests no clear medical interest for diagnostic examinations, but the field of interventional radiology needs to be investigated

  10. The development of the clinical pion program at TRIUMF

    International Nuclear Information System (INIS)

    Goodman, G.B.; Dixon, P.; Flores, A.; Harrison, R.W.; Lam, G.K.Y.; Ludgate, C.M.

    1985-01-01

    The authors have been treating brain and pelvic cancers with pions at TRIUMF since May, 1982. Studies focussed on dose optimization strategies, evolution of techniques, assessment of normal tissue and tumour responses and patient accruals. This presentation illustrates innovations using MRI and PET scanning in brain tumours and endoscopic photography and biopsy for bowel cancer. Results are presented to December, 1984 for 32 glioblastoma multiforme and 35 incurable pelvic cancer using a spot-san mode. Growth delay and survival curves is presented

  11. Drug delivery system innovation and Health Technology Assessment: Upgrading from Clinical to Technological Assessment.

    Science.gov (United States)

    Panzitta, Michele; Bruno, Giorgio; Giovagnoli, Stefano; Mendicino, Francesca R; Ricci, Maurizio

    2015-11-30

    Health Technology Assessment (HTA) is a multidisciplinary health political instrument that evaluates the consequences, mainly clinical and economical, of a health care technology; the HTA aim is to produce and spread information on scientific and technological innovation for health political decision making process. Drug delivery systems (DDS), such as nanocarriers, are technologically complex but they have pivotal relevance in therapeutic innovation. The HTA process, as commonly applied to conventional drug evaluation, should upgrade to a full pharmaceutical assessment, considering the DDS complexity. This is useful to study more in depth the clinical outcome and to broaden its critical assessment toward pharmaceutical issues affecting the patient and not measured by the current clinical evidence approach. We draw out the expertise necessary to perform the pharmaceutical assessment and we propose a format to evaluate the DDS technological topics such as formulation and mechanism of action, physicochemical characteristics, manufacturing process. We integrated the above-mentioned three points in the Evidence Based Medicine approach, which is data source for any HTA process. In this regard, the introduction of a Pharmaceutics Expert figure in the HTA could be fundamental to grant a more detailed evaluation of medicine product characteristics and performances and to help optimizing DDS features to overcome R&D drawbacks. Some aspects of product development, such as manufacturing processes, should be part of the HTA as innovative manufacturing processes allow new products to reach more effectively patient bedside. HTA so upgraded may encourage resource allocating payers to invest in innovative technologies and providers to focus on innovative material properties and manufacturing processes, thus contributing to bring more medicines in therapy in a sustainable manner. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. Assessment of clinical guidelines for continuation treatment in major depression.

    Science.gov (United States)

    Nuijten, M J

    2001-01-01

    The primary objective of this study was to assess the appropriateness of the existing Dutch clinical guidelines for the treatment of depression from a health-economic perspective. The existing guidelines recommend continuation treatment for a period up to 9 months. The assessment was based on a Markov model using decision-analytic techniques. For this analysis we defined six mutually exclusive states defined by the existence of depression and type of treatment. The outcomes for the model were defined as: time without depression (TWD), quality-adjusted life years (QALYs), direct medical costs, and cost of lost productivity. The primary perspective of the study was that of the third-party payer, while the secondary perspective was that of the society in 1999. The probabilities of clinical events and therapeutic choices as well as the utilities were based on published literature. The medical resource use related to each state was abstracted from published literature and expert opinion. The associated 1999 unit costs of the used medical resources were derived from official Dutch tariff lists of allowable reimbursements. Indirect costs in this model were based on lost productivity only. The results of the primary analysis showed that the use of the guidelines is not cost-effective. Continuation treatment for a period of 9 months increases the total direct medical costs (NLG 1276 vs. NLG 474), decreases the costs resulting from lost productivity (NLG 304 vs. NLG 909), increases total costs (NLG 1580 vs. NLG 1383) and increases TWD (96.9% vs. 86.4%). However, continuation treatment does not change the utility outcomes (0.60 vs. 0.61 QALYs) for both treatment strategies. Hence continuation treatment is not cost-effective from either a third-party payer perspective or a societal perspective. A scenario analysis showed that an extension of the continuation treatment to maintenance treatment might result in a favorable cost-effectiveness outcome of the treatment guideline. In

  13. Teaching Statistics in APA-Accredited Doctoral Programs in Clinical and Counseling Psychology: A Syllabi Review

    Science.gov (United States)

    Ord, Anna S.; Ripley, Jennifer S.; Hook, Joshua; Erspamer, Tiffany

    2016-01-01

    Although statistical methods and research design are crucial areas of competency for psychologists, few studies explore how statistics are taught across doctoral programs in psychology in the United States. The present study examined 153 American Psychological Association-accredited doctoral programs in clinical and counseling psychology and aimed…

  14. Program grants for black lung clinics--PHS. Notice of proposed rulemaking.

    Science.gov (United States)

    1983-11-01

    The Public Health Service proposed to revise the regulations governing the grants program for black lung clinics established under section 427(a) of the Federal Mine Safety and Health Act of 1977. The revision is in keeping with the Department of Health and Human Services' desire to remove as many programmatic burdens and restrictions from grantees as possible, while maintaining program integrity.

  15. Teaching communication skills in clinical settings: comparing two applications of a comprehensive program with standardized and real patients

    Science.gov (United States)

    2014-01-01

    Background Communication is important for the quality of clinical practice, and programs have been implemented to improve healthcare providers’ communication skills. However, the consistency of programs teaching communication skills has received little attention, and debate exists about the application of acquired skills to real patients. This study inspects whether (1) results from a communication program are replicated with different samples, and (2) results with standardized patients apply to interviews with real patients. Methods A structured, nine-month communication program was applied in two consecutive years to two different samples of healthcare professionals (25 in the first year, 20 in the second year). Results were assessed at four different points in time, each year, regarding participants’ confidence levels (self-rated), basic communication skills in interviews with standardized patients, and basic communication skills in interviews with real patients. Data were analyzed using GLM Repeated-Measures procedures. Results Improvements were statistically significant in both years in all measures except in simulated patients’ assessment of the 2008 group. Differences between the two samples were non-significant. Differences between interviews with standardized and with real patients were also non-significant. Conclusions The program’s positive outcomes were replicated in different samples, and acquired skills were successfully applied to real-patient interviews. This reinforces this type of program structure as a valuable training tool, with results translating into real situations. It also adds to the reliability of the assessment instruments employed, though these may need adaptation in the case of real patients. PMID:24886341

  16. The relevance of qualitative research for clinical programs in psychiatry.

    Science.gov (United States)

    Goering, Paula; Boydell, Katherine M; Pignatiello, Antonio

    2008-03-01

    It is time to move beyond education about qualitative research theory and methods to using them to understand and improve psychiatric practice. There is a good fit between this agenda and current thinking about research use that broadens definitions of evidence beyond the results of experiments. This paper describes a qualitative program evaluation to illustrate what kind of useful knowledge is generated and how it can be created through a clinician-researcher partnership. The linkage and exchange model of effective knowledge translation described involves interaction between clinicians and researchers throughout the research process and results in mutual learning through the planning, disseminating, and application of existing or new qualitative research in decision making.

  17. Differentiating progress in a clinical group of fibromyalgia patients during and following a multicomponent treatment program.

    Science.gov (United States)

    Van Den Houte, Maaike; Luyckx, Koen; Van Oudenhove, Lukas; Bogaerts, Katleen; Van Diest, Ilse; De Bie, Jozef; Van den Bergh, Omer

    2017-07-01

    Treatments including multiple nonpharmacological components have beneficial effects on the key symptoms of fibromyalgia, although effects are limited and often do not persist. In this study, we examined different patterns of clinical progress and the dynamic interplay between predictors and outcomes over time. Fibromyalgia patients (N=153; 135 women) followed a multidisciplinary group program spanning 12weeks, aimed at "regaining control over daily functioning". Anxiety, depression, pain coping and kinesiophobia were used as predictor variables. Outcome variables were pain severity, pain-related disability, physical functioning and functional interference. All variables were assessed at 3 moments: on the first and last day of treatment, and 12weeks after the last day of treatment. Overall treatment effects were analyzed using mixed model analyses. Latent class growth analysis identifying different treatment trajectory classes was used to investigate individual differences in treatment effects. Finally, cross-lagged structural equation models were used to investigate the dynamic interplay between predictors and outcomes over time. Only a fourth to a third of the total group showed improvement on the outcome variables. These patients had lower baseline anxiety, depression and kinesiophobia, and improved more on anxiety, depression and kinesiophobia. Physical well-being had a stronger effect on anxiety and depression than vice versa. Physical functioning predicted relative changes in kinesiophobia, while kinesiophobia predicted relative changes in pain-related disability. The results emphasize the importance of tailoring treatments to individual needs in order to improve overall effectiveness of treatment programs. Copyright © 2017. Published by Elsevier Inc.

  18. 77 FR 59930 - Clinical Development Programs for Disease-Modifying Agents for Peripheral Neuropathy; Public...

    Science.gov (United States)

    2012-10-01

    ...] Clinical Development Programs for Disease-Modifying Agents for Peripheral Neuropathy; Public Workshop... to the clinical development of disease-modifying agents for the treatment of peripheral neuropathy... disease-modifying products for the management of peripheral neuropathy. Date and Time: The public workshop...

  19. Modeling Clinic for Industrial Mathematics: A Collaborative Project Under Erasmus+ Program

    DEFF Research Database (Denmark)

    Jurlewicz, Agnieszka; Nunes, Claudia; Russo, Giovanni

    2018-01-01

    Modeling Clinic for Industrial Mathematics (MODCLIM) is a Strategic Partnership for the Development of Training Workshops and Modeling Clinic for Industrial Mathematics, funded through the European Commission under the Erasmus Plus Program, Key Action 2: Cooperation for innovation and the exchang...

  20. Monetary Value of a Prescription Assistance Program Service in a Rural Family Medicine Clinic

    Science.gov (United States)

    Whitley, Heather P.

    2011-01-01

    Purpose: To quantify the monetary value of medications provided to rural Alabamians through provision of pharmaceutical manufacturer-sponsored prescription assistance programs (PAPs) provided by a clinical pharmacist in a private Black Belt family medicine clinic during 2007 and 2008. Methods: Patients struggling to afford prescription medications…

  1. The effect of supervised Tai Chi intervention compared to a physiotherapy program on fall-related clinical outcomes: a randomized clinical trial.

    Science.gov (United States)

    Tousignant, Michel; Corriveau, Hélène; Roy, Pierre-Michel; Desrosiers, Johanne; Dubuc, Nicole; Hébert, Réjean; Tremblay-Boudreault, Valérie; Beaudoin, Audrée-Jeanne

    2012-01-01

    To assess some fall-related clinical variables (balance, gait, fear of falling, functional autonomy, self-actualization and self-efficacy) that might explain the fact that supervised Tai Chi has a better impact on preventing falls compared to a conventional physiotherapy program. The participants (152 older adults over 65 who were admitted to a geriatric day hospital program) were randomly assigned to either a supervised Tai Chi group or the usual physiotherapy. The presence of the clinical variables related to falls was evaluated before the intervention (T1), immediately after (T2), and 12 months after the end of the intervention (T3). Both exercise programs significantly improved fall-related outcomes but only the Tai Chi intervention group decreased the incidence of falls. For both groups, most variables followed the same pattern, i.e. showed significant improvement with the intervention between T1 and T2, and followed by a statistically significant decrease at the T3 evaluation. However, self-efficacy was the only variable that improved solely with the Tai Chi intervention (p = 0.001). The impact of supervised Tai Chi on fall prevention can not be explained by a differential effect on balance, gait and fear of falling. It appeared to be related to an increase of general self-efficacy, a phenomenon which is not seen in the conventional physiotherapy program.

  2. Medical school accreditation in Australia: Issues involved in assessing major changes and new programs

    Directory of Open Access Journals (Sweden)

    Michael J. Field

    2011-06-01

    Full Text Available The Australian Medical Council (AMC is an independent company for quality assurance and quality improvement in medical education in Australia and New Zealand. Accreditation procedures for the 20 medical schools in these two countries are somewhat different for three different circumstances or stages of school development: existing medical schools, established courses undergoing major changes, and new schools. This paper will outline some issues involved in major changes to existing courses, and new medical school programs. Major changes have included change from a 6 year undergraduate course to a 5 year undergraduate course or 4 year graduate-entry course, introduction of a lateral graduate-entry stream, new domestic site of course delivery, offshore course delivery, joint program between two universities, and major change to curriculum. In the case of a major change assessment, accreditation of the new or revised course may be granted for a period up to two years after the full course has been implemented. In the assessment of proposals for introduction of new medical courses, six issues needing careful consideration have arisen: forward planning, academic staffing, adequate clinical experience, acceptable research program, adequacy of resources, postgraduate training program and employment.

  3. The development, implementation, and assessment of an innovative faculty mentoring leadership program.

    Science.gov (United States)

    Tsen, Lawrence C; Borus, Jonathan F; Nadelson, Carol C; Seely, Ellen W; Haas, Audrey; Fuhlbrigge, Anne L

    2012-12-01

    Effective mentoring is an important component of academic success. Few programs exist to both improve the effectiveness of established mentors and cultivate a multispecialty mentoring community. In 2008, in response to a faculty survey on mentoring, leaders at Brigham and Women's Hospital developed the Faculty Mentoring Leadership Program as a peer learning experience for midcareer and senior faculty physician and scientist mentors to enhance their skills and leadership in mentoring and create a supportive community of mentors. A planning group representing key administrative, educational, clinical, and research mentorship constituencies designed the nine-month course.Participants met monthly for an hour and a half during lunchtime. Two cofacilitators engaged the diverse group of 16 participants in interactive discussions about cases based on the participants' experiences. While the cofacilitators discussed with the participants the dyadic mentor-mentee relationship, they specifically emphasized the value of engaging multiple mentors and establishing mentoring networks. In response to postsession and postcourse (both immediately and after six months) self-assessments, participants reported substantive gains in their mentoring confidence and effectiveness, experienced a renewed sense of enthusiasm for mentoring, and took initial steps to build a diverse network of mentoring relationships.In this article, the authors describe the rationale, design, implementation, assessment, and ongoing impact of this innovative faculty mentoring leadership program. They also share lessons learned for other institutions that are contemplating developing a similar faculty mentoring program.

  4. Clinical Investigation Program Report Control Symbol MED 300.

    Science.gov (United States)

    1982-10-01

    Preeclampsia as an Aid to Further Management. (C) (PR) 41 1961 Use of C-Reactive Protein in Prediction of ARD Prog- nosiS, (C) (PR) 42 1981 The Assessment...with fTactures of the long bones and/or severe trauma. The etiological mechanism of this syndrome is still unsettled. The two mechanisms most widely...37 Status: Completed * Title: Routine Use of Serum Uric Acid Levels at 36 Weeks Gestation as Screening Test for Preeclampsia as an Aid to Further

  5. [Effectiveness of Varenicline with counseling programs on smoking cessation in a targeted clinical setting in China].

    Science.gov (United States)

    Jiang, Bin; He, Yao; Zuo, Fang; Wu, Lei; Liu, Qinghui; Zhang, Li; Zhou, Changxi; Cheng, Kk; Chan, Sc; Lam, Th

    2014-12-01

    To evaluate the effectiveness of Varenicline for smoking cessation in a community-based smoking-cessation-clinic (SCC) in Chinese smokers. A prospective observational study was conducted in Beijing, China. 799 smokers (762 men and 37 women) were assessed on data gathered from structured questionnaires at baseline and follow up programs at 1, 3 and 6 months. Trained physician counselors provided free individual counseling and follow-up interviews with brief counseling for all the subjects. 272 subjects were additionally prescribed Varenicline according to their own choice and reported data were compared to those without Varenicline. Outcomes were self-reported, regarding the 7-day point prevalence on abstinence rate and continuous abstinence rates at 1, 3 and 6 month follow-up periods. At 6-month and by intention-to-treat, the 7-day point prevalence on abstinence rate with Varenicline and counseling, was significantly higher than the group with counseling only (34.6% versus 23.1%; OR = 1.75, 95% CI: 1.27-2.42;P group with Varenicline(31.3% versus 18.2% ;OR = 2.04, 95% CI:1.46-2.86;P < 0.001). Varenicline also showed better outcomes at 1 and 3 month follow-up. Varenicline prescription in the smoking cessation clinic appeared to be effective that doubled the rates of quitting among Chinese smokers in the practice at a community-based SCC.

  6. Assessing RN-to-RN peer review on clinical units.

    Science.gov (United States)

    Pfeiffer, Judith A; Wickline, Mary A; Deetz, Jill; Berry, Elise S

    2012-04-01

    The primary purpose of this study was to measure informal registered nurse (RN)-to-RN peer review (defined as collegial communication about the quality of nursing care) at the work-unit level. Survey design with cluster sampling of 28 hospital or ambulatory care units (n = 541 respondents). Results were compared with existing patient safety and satisfaction data. A chi-squared test was used to compare responses against nurse characteristics. Nurses agreed that RN-to-RN peer review takes place on their units, but no correlation with patient safety and satisfaction data was found. Misunderstandings about the meaning of peer review were evident. Open-ended comments revealed barriers to peer review: fear of retribution, language barriers and lack of professionalism. Nurses need clarification of peer review. Issues with common language in a professional environment need to be addressed and nurses can learn collaboration from each other's cultures. Managers should support RN-to-RN peer review on clinical units. Methods used here may be useful to assess current departmental nurse peer review. © 2011 Blackwell Publishing Ltd.

  7. Nigerian Dental Students' Assessment of their Clinical Learning ...

    African Journals Online (AJOL)

    Clinical learning in medical and dental education provides students with ... clinical learning opportunities and environment, level of patient care experience and ... the stress of fulfilling procedural requirements were identified as weaknesses of ...

  8. Environmental hazards assessment program. Quarterly report, July 1996--September 1996

    International Nuclear Information System (INIS)

    1996-01-01

    On June 23, 1992, the United States Department of Energy (DOE) signed Assistance Instrument Number DE-FG01-92EW50625 with the Medical University of South Carolina (MUSC) to support the Environmental Hazards Assessment Program (EHAP). Dr. James B. Edwards, President of the Medical University of South Carolina, suggested, open-quotes Good health is not the result of good doctoring but the result of a healthy society in a healthy, economic, political and biological environment.close quotes To further good health, it is appropriate that an educational institution such as MUSC utilize grant funds to help people from all walks of life understand better what truly does affect human health, what does not, and why

  9. The wind resource assessment program in Quebec Canada

    Energy Technology Data Exchange (ETDEWEB)

    Kahawita, R.; Bilodeau, L.; Gaudette, M.; Gratton, Y.; Noel, R.; Quach, T.T.

    1982-09-01

    This paper provides an overview of the wind resource assessment programme undertaken by the provincial power utility Hydro-Quebec, in Quebec, Canada. The methodology used in different phases of the project is enunciated and explained and the results discussed. Supplementary studies of airflow over complex terrain using numerical modelling are described and the results evaluated. Since the program is still far from completion, conclusive statements cannot, at this time, be made about the viability of the wind energy resource. However, tentative conclusions are that wind energy as an alternate source of energy for the province is likely to be commerciaally viable since two of the most important requirements viz, the presence of a good wind regime and the availability of suitable land are satisfied in many regions.

  10. Ageing airplane repair assessment program for Airbus A300

    Science.gov (United States)

    Gaillardon, J. M.; Schmidt, HANS-J.; Brandecker, B.

    1992-01-01

    This paper describes the current status of the repair categorization activities and includes all details about the methodologies developed for determination of the inspection program for the skin on pressurized fuselages. For inspection threshold determination two methods are defined based on fatigue life approach, a simplified and detailed method. The detailed method considers 15 different parameters to assess the influences of material, geometry, size location, aircraft usage, and workmanship on the fatigue life of the repair and the original structure. For definition of the inspection intervals a general method is developed which applies to all concerned repairs. For this the initial flaw concept is used by considering 6 parameters and the detectable flaw sizes depending on proposed nondestructive inspection methods. An alternative method is provided for small repairs allowing visual inspection with shorter intervals.

  11. Five-year review of an international clinical research-training program

    Science.gov (United States)

    Suemoto, Claudia Kimie; Ismail, Sherine; Corrêa, Paulo César Rodrigues Pinto; Khawaja, Faiza; Jerves, Teodoro; Pesantez, Laura; Germani, Ana Claudia Camargo Gonçalves; Zaina, Fabio; dos Santos, Augusto Cesar Soares; de Oliveira Ferreira, Ricardo Jorge; Singh, Priyamvada; Paulo, Judy Vicente; Matsubayashi, Suely Reiko; Vidor, Liliane Pinto; Andretta, Guilherme; Tomás, Rita; Illigens, Ben MW; Fregni, Felipe

    2015-01-01

    The exponential increase in clinical research has profoundly changed medical sciences. Evidence that has accumulated in the past three decades from clinical trials has led to the proposal that clinical care should not be based solely on clinical expertise and patient values, and should integrate robust data from systematic research. As a consequence, clinical research has become more complex and methods have become more rigorous, and evidence is usually not easily translated into clinical practice. Therefore, the instruction of clinical research methods for scientists and clinicians must adapt to this new reality. To address this challenge, a global distance-learning clinical research-training program was developed, based on collaborative learning, the pedagogical goal of which was to develop critical thinking skills in clinical research. We describe and analyze the challenges and possible solutions of this course after 5 years of experience (2008–2012) with this program. Through evaluation by students and faculty, we identified and reviewed the following challenges of our program: 1) student engagement and motivation, 2) impact of heterogeneous audience on learning, 3) learning in large groups, 4) enhancing group learning, 5) enhancing social presence, 6) dropouts, 7) quality control, and 8) course management. We discuss these issues and potential alternatives with regard to our research and background. PMID:25878518

  12. Five-year review of an international clinical research-training program.

    Science.gov (United States)

    Suemoto, Claudia Kimie; Ismail, Sherine; Corrêa, Paulo César Rodrigues Pinto; Khawaja, Faiza; Jerves, Teodoro; Pesantez, Laura; Germani, Ana Claudia Camargo Gonçalves; Zaina, Fabio; Dos Santos, Augusto Cesar Soares; de Oliveira Ferreira, Ricardo Jorge; Singh, Priyamvada; Paulo, Judy Vicente; Matsubayashi, Suely Reiko; Vidor, Liliane Pinto; Andretta, Guilherme; Tomás, Rita; Illigens, Ben Mw; Fregni, Felipe

    2015-01-01

    The exponential increase in clinical research has profoundly changed medical sciences. Evidence that has accumulated in the past three decades from clinical trials has led to the proposal that clinical care should not be based solely on clinical expertise and patient values, and should integrate robust data from systematic research. As a consequence, clinical research has become more complex and methods have become more rigorous, and evidence is usually not easily translated into clinical practice. Therefore, the instruction of clinical research methods for scientists and clinicians must adapt to this new reality. To address this challenge, a global distance-learning clinical research-training program was developed, based on collaborative learning, the pedagogical goal of which was to develop critical thinking skills in clinical research. We describe and analyze the challenges and possible solutions of this course after 5 years of experience (2008-2012) with this program. Through evaluation by students and faculty, we identified and reviewed the following challenges of our program: 1) student engagement and motivation, 2) impact of heterogeneous audience on learning, 3) learning in large groups, 4) enhancing group learning, 5) enhancing social presence, 6) dropouts, 7) quality control, and 8) course management. We discuss these issues and potential alternatives with regard to our research and background.

  13. [Environmental Hazards Assessment Program annual report, June 1992--June 1993

    International Nuclear Information System (INIS)

    Voit, E.O.

    1993-01-01

    It is becoming increasingly clear that human health is intricately related to our chemical and physical surroundings. Recognizing the interdependence between health and environment, the Medical University of South Carolina has begun to implement a graduate program in Environmental Risk Assessment. While the infrastructure for such a program had been in place for quite a while, providing education in biostatistics, epidemiology, and mathematical modeling, specific courses in risk assessment were not available. To expedite the educational process in this area, the Department of Biometry and Epidemiology offered the course Special Topics in Risk Analysis in the Spring semester of 1993. This course was intended as an introduction for graduate students, but one faculty and one postdoctoral fellow also enrolled. The course was organized in the form of a seminar, with students or faculty presenting selected materials from the literature that covered some of the central issues in risk analysis. The presentations were subsequently written up as reports and revised according to suggestions by the instructor. This technical report comprises the presentations and reflects what has been learned in the course Special Topics in Risk Analysis. It also may serve as an easy to read introduction to the complex area of risk analysis. By the very nature of the course and this report, most of the presented material is not original. It does not necessarily reflect the authors' or the editor's opinion and is not intended for citation. Nonetheless, the students and the instructor have paid attention to citing relevant literature in order to enable the reader to trace ideas back to the original sources. As an Appendix, this volume contains the course syllabus as well as hand-out material that the students prepared independently and that has not been edited or revised

  14. The development of a clinical outcomes survey research application: Assessment Center.

    Science.gov (United States)

    Gershon, Richard; Rothrock, Nan E; Hanrahan, Rachel T; Jansky, Liz J; Harniss, Mark; Riley, William

    2010-06-01

    The National Institutes of Health sponsored Patient-Reported Outcome Measurement Information System (PROMIS) aimed to create item banks and computerized adaptive tests (CATs) across multiple domains for individuals with a range of chronic diseases. Web-based software was created to enable a researcher to create study-specific Websites that could administer PROMIS CATs and other instruments to research participants or clinical samples. This paper outlines the process used to develop a user-friendly, free, Web-based resource (Assessment Center) for storage, retrieval, organization, sharing, and administration of patient-reported outcomes (PRO) instruments. Joint Application Design (JAD) sessions were conducted with representatives from numerous institutions in order to supply a general wish list of features. Use Cases were then written to ensure that end user expectations matched programmer specifications. Program development included daily programmer "scrum" sessions, weekly Usability Acceptability Testing (UAT) and continuous Quality Assurance (QA) activities pre- and post-release. Assessment Center includes features that promote instrument development including item histories, data management, and storage of statistical analysis results. This case study of software development highlights the collection and incorporation of user input throughout the development process. Potential future applications of Assessment Center in clinical research are discussed.

  15. Longitudinal assessment of clinical risk factors for depression in schizophrenia spectrum disorders.

    Science.gov (United States)

    Onwuameze, Obiora E; Uga, Aghaegbulam; Paradiso, Sergio

    2016-08-01

    During initial assessment of individuals with schizophrenia and related disorders (schizophrenia spectrum disorders [SSDs]), clinicians tend to pay greater attention to psychotic symptoms than mood symptoms, including depression. Depression is reported to influence the course of SSDs, but not much is known about the risk factors for depression in SSDs. In the present study, we examined clinical predictors of depression in SSDs. The sample included 71 patients with SSDs followed in a modified Assertive Community Treatment program, the Community Support Network of Springfield, Illinois. The study design was naturalistic, prospective, and longitudinal (mean follow-up = 8.3 years; SD = 7.3). The GENMOD procedure appropriate for repeated measures analysis with dichotomous outcome variables followed longitudinally was computed. Rates of depression ranged from 18% to 41% over the differing assessment periods. Schizophrenia and schizoaffective disorder did not vary by depression rate. Depression independent of SSD diagnosis was associated with greater hospitalization rates. Clinical variables predict- ing depression were auditory hallucinations, delusions, poor insight, and poor judgment. Psychotic symptoms in the course of SSDs are risk factors for depression. As a consequence, the mental status examination of patients with SSDs with active psychosis should include assessment of mood changes. Further research is warranted to determine if treatment of depression among patients with SSDs may reduce their rates of hospitalization.

  16. Clinic-based intervention projects: STD and family planning programs get involved. Intervention model.

    Science.gov (United States)

    Finger, W R

    1991-06-01

    The sexually transmitted disease (STD) program in Udorn, a popular Thai tourist city, has worked closely with 750 prostitutes for 15 years, incorporating the concerns of brothel managers and prostitutes into service delivery. The program in Udorn is part of a nationwide network of STD clinics. The level of person-to-person interaction was increased once it was determined by 1989 that HIV had infected 6% of prostitutes in the city's brothels. Outreach educators were recruited and trained to ensure that all prostitutes in Udorn had the basic facts about HIV and AIDS. Over the last 2 years, the STD program has trained outreach educators to work in 8 brothels, started a local AIDS prevention foundation supported by local businessmen, and taken other steps to incorporate AIDS prevention into its clinic structure. Such clinic-based programs are an important way of targeting groups at high risk of HIV transmission.

  17. Developing a comprehensive scale to assess college multicultural programming.

    Science.gov (United States)

    Mallinckrodt, Brent; Miles, Joseph R; Bhaskar, Tripti; Chery, Nicole; Choi, Gahee; Sung, Mi-Ra

    2014-01-01

    A barrier to assessing effectiveness of multicultural programming is lack of a relatively brief instrument to measure the wide range of intended outcomes. A frequent goal of programming is to increase cultural empathy, but this is rarely the only intended outcome. We conducted focus groups of campus administrators, student affairs staff, and undergraduate instructors who identified a full range of racial/ethnic multicultural competencies that undergraduates should possess. An 84-item pool generated from these focus groups was combined with the 31-item Scale of Ethnocultural Empathy (SEE; Wang et al., 2003). These 115 items, together with instruments used to gauge concurrent validity, were administered to White undergraduate students in introductory psychology courses at the midpoint (n = 602) and end (n = 676) of fall semester. Exploratory factor analysis suggested 6 subscales for the Everyday Multicultural Competencies/Revised SEE (EMC/RSEE): (a) Cultural Openness and Desire to Learn; (b) Resentment and Cultural Dominance; (c) Anxiety and Lack of Multicultural Self-Efficacy; (d) Empathic Perspective-Taking; (e) Awareness of Contemporary Racism and Privilege; and (f) Empathic Feeling and Acting as an Ally. Item response theory principles guided final selection of subscale items. Analyses suggested good factor stability, reliability, and discriminant validity of the 48-item EMC/RSEE in these undergraduate samples. EMC/RSEE subscales were not strongly correlated with a measure of impression management and were significantly associated with measures of Openness to Diversity Challenge, and Universal-Diverse Orientation. (c) 2014 APA, all rights reserved.

  18. Field Assessment of Energy Audit Tools for Retrofit Programs

    Energy Technology Data Exchange (ETDEWEB)

    Edwards, J.; Bohac, D.; Nelson, C.; Smith, I.

    2013-07-01

    This project focused on the use of home energy ratings as a tool to promote energy retrofits in existing homes. A home energy rating provides a quantitative appraisal of a home's asset performance, usually compared to a benchmark such as the average energy use of similar homes in the same region. Home rating systems can help motivate homeowners in several ways. Ratings can clearly communicate a home's achievable energy efficiency potential, provide a quantitative assessment of energy savings after retrofits are completed, and show homeowners how they rate compared to their neighbors, thus creating an incentive to conform to a social standard. An important consideration is how rating tools for the retrofit market will integrate with existing home energy service programs. For residential programs that target energy savings only, home visits should be focused on key efficiency measures for that home. In order to gain wide adoption, a rating tool must be easily integrated into the field process, demonstrate consistency and reasonable accuracy to earn the trust of home energy technicians, and have a low monetary cost and time hurdle for homeowners. Along with the Home Energy Score, this project also evaluated the energy modeling performance of SIMPLE and REM/Rate.

  19. The Global Seismic Hazard Assessment Program (GSHAP - 1992/1999

    Directory of Open Access Journals (Sweden)

    D. Giardini

    1999-06-01

    Full Text Available The United Nations, recognizing natural disasters as a major threat to human life and development, designed the 1990-1999 period as the International Decade for Natural Disaster Reduction (UN/IDNDR; UN Res. 42/169/ 1987. Among the IDNDR Demonstration Projects is the Global Seismic Hazard Assessment Program (GSHAP, launched in 1992 by the International Lithosphere Program (ILP and implemented in the 1992-1999 period. In order to mitigate the risk associated to the recurrence of earthquakes, the GSHAP promoted a regionally coordinated, homogeneous approach to seismic hazard evaluation. To achieve a global dimension, the GSHAP established initially a mosaic of regions and multinational test areas, then expanded to cover whole continents and finally the globe. The GSHAP Global Map of Seismic Hazard integrates the results obtained in the regional areas and depicts Peak-Ground-Acceleration (PGA with 10% chance of exceedance in 50 years, corresponding to a return period of 475 years. All regional results and the Global Map of Seismic Hazard are published in 1999 and available on the GSHAP homepage on http://seismo.ethz.ch/GSHAP/.

  20. Technology Assessment and Roadmap for the Emergency Radiation Dose Assessment Program

    Energy Technology Data Exchange (ETDEWEB)

    Turteltaub, K W; Hartman-Siantar, C; Easterly, C; Blakely, W

    2005-10-03

    A Joint Interagency Working Group (JIWG) under the auspices of the Department of Homeland Security Office of Research and Development conducted a technology assessment of emergency radiological dose assessment capabilities as part of the overall need for rapid emergency medical response in the event of a radiological terrorist event in the United States. The goal of the evaluation is to identify gaps and recommend general research and development needs to better prepare the Country for mitigating the effects of such an event. Given the capabilities and roles for responding to a radiological event extend across many agencies, a consensus of gaps and suggested development plans was a major goal of this evaluation and road-mapping effort. The working group consisted of experts representing the Departments of Homeland Security, Health and Human Services (Centers for Disease Control and the National Institutes of Health), Food and Drug Administration, Department of Defense and the Department of Energy's National Laboratories (see appendix A for participants). The specific goals of this Technology Assessment and Roadmap were to: (1) Describe the general context for deployment of emergency radiation dose assessment tools following terrorist use of a radiological or nuclear device; (2) Assess current and emerging dose assessment technologies; and (3) Put forward a consensus high-level technology roadmap for interagency research and development in this area. This report provides a summary of the consensus of needs, gaps and recommendations for a research program in the area of radiation dosimetry for early response, followed by a summary of the technologies available and on the near-term horizon. We then present a roadmap for a research program to bring present and emerging near-term technologies to bear on the gaps in radiation dose assessment and triage. Finally we present detailed supporting discussion on the nature of the threats we considered, the status of

  1. Technology Assessment and Roadmap for the Emergency Radiation Dose Assessment Program

    International Nuclear Information System (INIS)

    Turteltaub, K W; Hartman-Siantar, C; Easterly, C; Blakely, W

    2005-01-01

    A Joint Interagency Working Group (JIWG) under the auspices of the Department of Homeland Security Office of Research and Development conducted a technology assessment of emergency radiological dose assessment capabilities as part of the overall need for rapid emergency medical response in the event of a radiological terrorist event in the United States. The goal of the evaluation is to identify gaps and recommend general research and development needs to better prepare the Country for mitigating the effects of such an event. Given the capabilities and roles for responding to a radiological event extend across many agencies, a consensus of gaps and suggested development plans was a major goal of this evaluation and road-mapping effort. The working group consisted of experts representing the Departments of Homeland Security, Health and Human Services (Centers for Disease Control and the National Institutes of Health), Food and Drug Administration, Department of Defense and the Department of Energy's National Laboratories (see appendix A for participants). The specific goals of this Technology Assessment and Roadmap were to: (1) Describe the general context for deployment of emergency radiation dose assessment tools following terrorist use of a radiological or nuclear device; (2) Assess current and emerging dose assessment technologies; and (3) Put forward a consensus high-level technology roadmap for interagency research and development in this area. This report provides a summary of the consensus of needs, gaps and recommendations for a research program in the area of radiation dosimetry for early response, followed by a summary of the technologies available and on the near-term horizon. We then present a roadmap for a research program to bring present and emerging near-term technologies to bear on the gaps in radiation dose assessment and triage. Finally we present detailed supporting discussion on the nature of the threats we considered, the status of technology

  2. Predictive validity of measurements of clinical competence using the team objective structured bedside assessment (TOSBA): assessing the clinical competence of final year medical students.

    LENUS (Irish Health Repository)

    Meagher, Frances M

    2009-11-01

    The importance of valid and reliable assessment of student competence and performance is gaining increased recognition. Provision of valid patient-based formative assessment is an increasing challenge for clinical teachers in a busy hospital setting. A formative assessment tool that reliably predicts performance in the summative setting would be of value to both students and teachers.

  3. Developing an Interdisciplinary, Team-Based Quality Improvement Leadership Training Program for Clinicians: The Partners Clinical Process Improvement Leadership Program.

    Science.gov (United States)

    Rao, Sandhya K; Carballo, Victoria; Cummings, Brian M; Millham, Frederick; Jacobson, Joseph O

    Although there has been tremendous progress in quality improvement (QI) education for students and trainees in recent years, much less has been published regarding the training of active clinicians in QI. The Partners Clinical Process Improvement Leadership Program (CPIP) is a 6-day experiential program. Interdisciplinary teams complete a QI project framed by didactic sessions, interactive exercises, case-based problem sessions, and a final presentation. A total of 239 teams composed of 516 individuals have graduated CPIP. On completion, participant satisfaction scores average 4.52 (scale 1-5) and self-reported understanding of QI concepts improved. At 6 months after graduation, 66% of survey respondents reported sustained QI activity. Three opportunities to improve the program have been identified: (1) increasing faculty participation through online and tiered course offerings, (2) integrating the faculty-focused program with the trainee curriculum, and (3) developing a postgraduate curriculum to address the challenges of sustained improvement.

  4. Developing a rural transitional care community case management program using clinical nurse specialists.

    Science.gov (United States)

    Baldwin, Kathleen M; Black, Denice; Hammond, Sheri

    2014-01-01

    This quality improvement project developed a community nursing case management program to decrease preventable readmissions to the hospital and emergency department by providing telephonic case management and, if needed, onsite assessment and treatment by a clinical nurse specialist (CNS) with prescriptive authority. As more people reach Medicare age, the number of individuals with worsening chronic diseases with dramatically increases unless appropriate disease management programs are developed. Care transitions can result in breakdown in continuity of care, resulting in increased preventable readmissions, particularly for indigent patients. The CNS is uniquely educated to managing care transitions and coordination of community resources to prevent readmissions. After a thorough SWOT (strengths, weaknesses, opportunities, and threats) analysis, we developed and implemented a cost-avoidance model to prevent readmissions in our uninsured and underinsured patients. The project CNS used a wide array of interventions to decrease readmissions. In the last 2 years, there have been a total of 22 less than 30-day readmissions to the emergency department or hospital in 13 patients, a significant decrease from readmissions in these patients prior to the program. Three of them required transfer to a larger hospital for a higher level of care. Using advanced practice nurses in transitional care can prevent readmissions, resulting in cost avoidance. The coordination of community resources during transition from hospital to home is a job best suited to CNSs, because they are educated to work within organizations/systems. The money we saved with this project more than justified the cost of hiring a CNS to lead it. More research is needed into this technology. Guidelines for this intervention need to be developed. Replicating our cost-avoidance transitional care model can help other facilities limit that loss.

  5. [Update of clinical programs using hadrontherapy 2008-2012].

    Science.gov (United States)

    Habrand, J-L; Datchary, J; Alapetite, C; Bolle, S; Calugaru, V; Feuvret, L; Helfre, S; Stefan, D; Delacroix, S; Demarzi, L; Dendale, R

    2013-10-01

    Hadrontherapy, a type of radiation therapy dealing with heavy charged particles, has become for the past decade one of the most sophisticated and attractive approach in the management of cancer. This is related with major technological innovations that have made available, at a relatively cheap cost, compact proton accelerators equipped with rotational gantries. The implementation of pencil beam scanning should also make treatment planning and delivery much easier and faster than conventional approaches. Until now, approximately 100,000 patients have been treated with protons worldwide. Due to more complex technological and biological challenges, light ion therapy - mainly carbon ions - has developed at a lower pace, except in Japan where most of the 15,000 treated patients have been enrolled. Current indications for protons include firstly, locally aggressive tumours non or incompletely resected, that are located close to critical normal structures: ocular melanomas, skull base and spinal canal low grade sarcomas, selected ENT carcinomas (like adenoid cystic); secondly, improvement of tolerance to radiations: delayed, mainly in paediatric malignancies, due to the exquisite sensitivity of organs under development (including to carcinogenesis); immediate, on bone marrow, mucosae… mainly in concomitant radiation-chemotherapy interactions (tested in esophagus, and lung). Most promising indications for carbon ions include inoperable highly radioresistant primaries, such as mucosal melanomas, high grade bone and soft part sarcomas, and pancreatic carcinomas. Altered fractionations are also of interests that could translate in clinical and economical benefits. Controversies have risen whether more common indications, like prostate, should also be explored. Copyright © 2013. Published by Elsevier SAS.

  6. Standardized Patients Provide a Reliable Assessment of Athletic Training Students' Clinical Skills

    Science.gov (United States)

    Armstrong, Kirk J.; Jarriel, Amanda J.

    2016-01-01

    Context: Providing students reliable objective feedback regarding their clinical performance is of great value for ongoing clinical skill assessment. Since a standardized patient (SP) is trained to consistently portray the case, students can be assessed and receive immediate feedback within the same clinical encounter; however, no research, to our…

  7. Exploring a New Simulation Approach to Improve Clinical Reasoning Teaching and Assessment: Randomized Trial Protocol.

    Science.gov (United States)

    Pennaforte, Thomas; Moussa, Ahmed; Loye, Nathalie; Charlin, Bernard; Audétat, Marie-Claude

    2016-02-17

    simulation approach designed to enhance clinical reasoning. By assessing more closely reasoning processes throughout a simulation session, we believe that Simulation with Iterative Discussions will be an interesting and more effective approach for students. The findings of the study will benefit medical educators, education programs, and medical students.

  8. National Acid Precipitation Assessment Program Report to Congress: An Integrated Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Uhart, M.; et al,

    2005-08-01

    Under Title IX of the 1990 Clean Air Act Amendments, Congress reauthorized the National Acid Precipitation Assessment Program (NAPAP) to continue coordinating acid rain research and monitoring, as it had done during the previous decade, and to provide Congress with periodic reports. In particular, Congress asked NAPAP to assess all available data and information to answer two questions: (1) What are the costs, benefits, and effectiveness of Title IV? This question addresses the costs and economic impacts of complying with the Acid Rain Program as well as benefit analyses associated with the various human health and welfare effects, including reduced visibility, damages to materials and cultural resources, and effects on ecosystems. (2) What reductions in deposition rates are needed to prevent adverse ecological effects? This complex questions addresses ecological systems and the deposition levels at which they experience harmful effects. The results of the assessment of the effects of Title IV and of the relationship between acid deposition rates and ecological effects were to be reported to Congress quadrennially, beginning with the 1996 report to Congress. The objective of this Report is to address the two main questions posed by Congress and fully communicate the results of the assessment to decision-makers. Given the primary audience, most of this report is not written as a technical document, although information supporting the conclusions is provided along with references.

  9. Re-thinking clinical assessment: What can we learn from the medical literature?

    International Nuclear Information System (INIS)

    Yielder, Jill; Thompson, Andrea; De Bueger, Tracy

    2012-01-01

    This article explores the literature available in the field of medical education on the topic of clinical assessment, in order to suggest different ways of assessing clinical experience that may not have been considered within undergraduate radiography programmes. The medical literature is contrasted with the clinical assessment currently being used in a medical imaging programme in New Zealand, with the aim of offering suggestions that may benefit the assessment of the clinical and professional elements of radiography programmes more generally. The authors conclude that ideally students need to be assessed in the clinical domain by multiple assessors, with varied assessment methods used repeatedly over a period of time and with the provision of frequent and constructive feedback. Various methods of clinical assessment are suggested and it is emphasised that the methods selected need to be valid, reliable and psychometrically supported. This encourages an evidence-based practice approach that is supportive of on-going programme development and change.

  10. [Impact of education program and clinical posting in psychiatry on medical students' stigmatizing attitudes towards psychiatry and psychiatric disorders].

    Science.gov (United States)

    Simon, N; Verdoux, H

    2017-06-09

    The aim of the study was to explore whether a medical student education program and clinical posting in psychiatry had an impact on medical students' stigmatizing attitudes towards psychiatry and psychiatric disorders. Medical students from the University of Bordeaux were recruited during their 4-year course at the beginning of the academic education program in psychiatry. Medical students who were concomitantly in a clinical posting in wards of psychiatry or neurology were invited to participate in the study. The medical student version of the scale Mental Illness: Clinicians' Attitudes (MICA) was used to measure their attitudes towards psychiatry and persons with psychiatric disorder. This 16-item scale is designed to measure attitudes of health care professionals towards people with mental illness, a higher score indicating more stigmatizing attitudes. Items exploring history of psychiatric disorders in close persons were added at the end of the MICA scale. The questionnaire was completed twice by each student, at the beginning and the end of the 11-week clinical posting. All questionnaires were strictly anonymized. Multivariate linear regression analyses were used to identify the variables independently associated with MICA total score. At the beginning of the education program and clinical posting, 174 students completed the MICA scale: the mean MICA total score was equal to 46.4 (SD 6.9) in students in clinical posting in psychiatry (n=72) and 45.1 (SD 7.01) in those in neurology (n=102). At the end of the academic and clinical training, 138 students again completed the questionnaire, with mean MICA total scores equal to 41.4 (SD 8.1) in students in clinical posting in psychiatry (n=51) and 43.5 (SD 7.3) in those in neurology (n=87). Multivariate analyses showed that lower total MICA scores were independently associated with the time of assessment (lower scores at the end of education program and clinical posting) (b=-2.8; P=0.001), female gender (b=-1.8; P=0

  11. Vending Assessment and Program Implementation in Four Iowa Worksites.

    Science.gov (United States)

    Lillehoj, Catherine J; Nothwehr, Faryle; Shipley, Kala; Voss, Carol

    2015-11-01

    The worksite food environment, including vending options, has been explored as an important contributor to dietary decisions made every day. The current study describes the vending environment, and efforts to change it, in four Iowa worksites using a series of case studies. Data were gathered by local coordinators as part of the Iowa Community Transformation Grant project. Data were collected from three sources. First, the Nutrition Environment Measures Survey-Vending was used to assess healthy vending options in worksite machines before and after the intervention. Second, employee vending behavior was evaluated with a pre-, post-intervention survey. Items assessed attitudes and behaviors regarding vending, plus awareness and reaction to intervention activities. Third, program coordinators documented vending machine intervention strategies used, such as social marketing materials and product labels. The Nutrition Environment Measures Survey-Vending documented that the majority of vending options did not meet criteria for healthfulness. The vending survey found that employees were generally satisfied with the healthier items offered. Some differences were noted over time at the four worksites related to employee behavior and attitudes concerning healthy options. There were also differences in intervention implementation and the extent of changes made by vending companies. Overall, findings demonstrate that a large percentage of employees are constrained in their ability to access healthy foods due to limited worksite vending options. There also remain challenges to making changes in this environment. Findings have implications for public health practitioners to consider when designing healthy vending interventions in worksites. © 2015 Society for Public Health Education.

  12. North American Pediatric Gastroenterology Fellowship Needs Assessment in Inflammatory Bowel Disease: Trainee and Program Director Perspectives.

    Science.gov (United States)

    Dotson, Jennifer L; Falaiye, Tolulope; Bricker, Josh B; Strople, Jennifer; Rosh, Joel

    2016-07-01

    Pediatric inflammatory bowel disease (IBD) care is complex and rapidly evolving. The Crohn's and Colitis Foundation of America and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition cosponsored a needs assessment survey of pediatric gastroenterology trainees and program directors (PDs) to inform on educational programming. A Web-based, self-completed survey was provided to North American trainees and PDs during the 2013-2014 academic year. Standard descriptive statistics summarized demographics and responses. One hundred sixty-six of 326 (51%) trainees (62% female) and 37 of 74 (50%) PDs responded. Median trainees per program = 5 and median total faculty = 10 (3 IBD experts); 15% of programs did not have a self-identified "IBD expert" faculty member. Sixty-nine percent of trainees were confident/somewhat confident in their IBD inpatient training, whereas 54% were confident/somewhat confident in their outpatient training. Trainees identified activities that would most improve their education, including didactics (55%), interaction with national experts (50%), trainee-centered IBD Web resources (42%), and increased patient exposure (42%). Trainees were most confident in managing inpatient active Crohn's disease/ulcerative colitis, phenotype classification, managing biological therapies, and using clinical disease activity indices. They were least confident in managing J-pouch complications, performing pouchoscopy, managing extraintestinal manifestations, and ostomy-related complications. Eighty-five percent would like an IBD-focused training elective. Most directors (86%) would allow trainees to do electives at other institutions. This IBD needs assessment survey of pediatric gastroenterology trainees and PDs demonstrated a strong resource commitment to IBD training and clinical care. Areas for educational enrichment emerged, including pouch and ostomy complications.

  13. A clinical nutritional information system with personalized nutrition assessment.

    Science.gov (United States)

    Kuo, Su-E; Lai, Hui-San; Hsu, Jen-Ming; Yu, Yao-Chang; Zheng, Dong-Zhe; Hou, Ting-Wei

    2018-03-01

    Traditional nutrition evaluations not only require the use of numerous tables and lists to provide sufficient recommendations for patients' diets but are also very time-consuming due to cross-referencing and calculations. To personalize patient assessments, this study implemented a Clinical Nutritional Information System (CNIS) to help hospital dietitians perform their daily work more effectively in terms of time management and paper work. The CNIS mainly targets in-patients who require cancer-nutrition counselling. The development of the CNIS occurred in three phases. Phase 1 included system design and implementation based on the Nutrition Care Process and Model (NCPM) and the Patient Nutrition Care Process. Phase 2 involved a survey to characterize the efficiency, quality and accuracy of the CNIS. In Phase 3, a second survey was conducted to determine how well dietitians had adapted to the system and the extent of improvement in efficiency after the CNIS had been available online for three years. The work time requirements decreased by approximately 58% with the assistance of the CNIS. Of the dietitians who used the CNIS, 95% reported satisfaction, with 91.66% indicating that the CNIS was really helpful in their work. However, some shortcomings were also evident according to the results. Dietitians favoured the standardization of nutritional intervention and monitoring. The CNIS meets the needs of dietitians by increasing the quality of nutritional interventions by providing accurate calculations and cross-referencing for information regarding patients' conditions, with the benefit of decreasing the processing time, such as handwritten documentation. In addition, the CNIS also helps dietitians statistically analyse each patient's personal nutritional needs to achieve nutritional improvement. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. LEFT ATRIAL FUNCTION: MODERN ASSESSMENT METHODS AND CLINICAL SIGNIFICANCE

    Directory of Open Access Journals (Sweden)

    E. N. Pavlyukova

    2017-01-01

    Full Text Available Assessment of the left atrial (LA function is important aspect of comprehensive cardiovascular system estimation. Many cardiac diseases make an impact to LA work either by direct affect on myocardium or hemodynamic condition changing. It is considered, LA and left ventricle diastolic pressure is interrelated, thus without mitral valve disease LA expanding is a sign of LV filling pressure augmentation. Examination of LA size and function by analysis of atrial reservoir, conduit, and booster pump can predict cardiovascular outcomes in patients with cardiomyopathy, ischemic heart disease and valvular heart disease. The last two decades gave new technologies to accurate and comprehensive LA mechanics estimation, in the first place related to tissue Doppler imaging. Atrial strain and strain rate obtained using two-dimensional speckle-tracking echocardiography have proved to be feasible and reproducible techniques to evaluate LA mechanics.In physiological settings, LA is a highly expandable chamber with relatively low pressures. However in the presence of acute and chronic injury, LA wall stretches. LA stretching is a hallmark of structure changing with myocardial fibrosis and has influence on LA strain and strain rate. LA strain estimation could be useful in the prediction of sinus rhythm restoration and maintenance after cardioversion and catheter ablation. Low values of global longitudinal LA strain indicate irreversible LA remodeling and are related to the atrial fibrillation progression from paroxysmal to permanent forms. The most interesting in these circumstances is the potential contribution of echocardiography to thromboembolic risk stratification in atrial fibrillation and invasive procedures such as atrial ablation. Therefore, at present, the main task is to understand the ways of clinical application of data  obtained during the LA study.

  15. An assessment of the Italian smart gas metering program

    International Nuclear Information System (INIS)

    Di Castelnuovo, Matteo; Fumagalli, Elena

    2013-01-01

    The introduction of smart metering is one of the core elements in recent European policies targeting environmental sustainability and competitiveness of energy markets. Following the roll-out of smart electricity meters, in 2008 the Italian regulator designed an ambitious deployment program also for smart gas meters, that was recently modified in both scope and timing. This paper assesses Italy's original and current deployment plans, with a specific focus on the results of its cost–benefit analysis. In light of the evidence derived from the literature, we observe that the case for the roll-out of smart gas meters in Italy was not supported by a strong emphasis on energy savings but rather focused on increasing efficiency of the Italian gas market; in this respect, we argue that options other than smart gas metering should also be considered. Moreover the Italian cost–benefit analysis, which mostly dealt with the potential cost savings for distributors and suppliers, led to ambiguous results in terms of net present values; thus, we believe that an updated assessment would be extremely useful. Finally, in terms of technological choices, our analysis positively evaluates the regulator's recent proposal to consider a dual-fuel solution for the mass market deployment. - Highlights: • This paper assesses Italy's original and current deployment plans for smart gas meters. • The plan was not supported by a strong emphasis on energy savings. • A focus on increasing efficiency of the Italian gas market appears only partly justifiable. • The business case for adopting smart gas meters should be updated. • Our analysis positively evaluates the a dual-fuel solution for the mass market

  16. Development, validation and clinical assessment of a short questionnaire to assess disease-related knowledge in inflammatory bowel disease patients.

    LENUS (Irish Health Repository)

    Keegan, Denise

    2013-02-01

    Only two inflammatory bowel disease (IBD) knowledge scales are available, both primarily aimed at evaluating the effectiveness of clinical education programs. The aim of this study was to develop and validate a short knowledge questionnaire for clinical and academic research purposes.

  17. 59th Medical Wing Clinical Research Division Clinical Investigations Program Posters (Count: 2)

    Science.gov (United States)

    2017-05-08

    Investigations Program Posters (Count: 2) presented at/published to Graduate School Faculty Development and Research Symposium, Gateway Club, JBSA...copy of your abstract, paper. poster and other supporting documentation. 5. Save and forward, via email, the processing form and all supporting...you a final letter of approval or disapproval. g, Once your manuscript, poster or presentation has been approved for a one-lime public release, you may

  18. Clinical and imaging assessment of cognitive dysfunction in multiple sclerosis

    DEFF Research Database (Denmark)

    Rocca, Maria A; Amato, Maria P; De Stefano, Nicola

    2015-01-01

    In patients with multiple sclerosis (MS), grey matter damage is widespread and might underlie many of the clinical symptoms, especially cognitive impairment. This relation between grey matter damage and cognitive impairment has been lent support by findings from clinical and MRI studies. However...... that causes clinical symptoms to trigger. Findings on cortical reorganisation support the contribution of brain plasticity and cognitive reserve in limiting cognitive deficits. The development of clinical and imaging biomarkers that can monitor disease development and treatment response is crucial to allow...

  19. Assessment of a pharmacist-led comprehensive medication management and wellness program

    Directory of Open Access Journals (Sweden)

    Daniel L. Janovick

    2015-01-01

    Full Text Available Background: Pharmacists are currently providing comprehensive medication management in the outpatient setting. However, there is little documented evidence demonstrating pharmacists are generating further improved health outcomes utilizing non-pharmacologic support, such as fitness and nutrition counseling. The objective of this study is to determine if a pharmacist-led wellness program with medication management and lifestyle modifications through fitness and nutrition coaching can lead to improved biometric markers. Methods: The wellness program targeted corporate employees and was offered in a corporate headquarters' setting with an on-site workout facility. The program was expected to recruit approximately 15 patients into the wellness program consisting of two treatment arms. The standard group featured nutrition-based classes, medication therapy management and fitness education. The intervention group performed the standard group's activities plus direct, supervised fitness training once weekly. Measured biometric markers were assessed at baseline, 3.5 months, and 7 months and included body mass index (BMI, waist circumference (WC, fasting blood glucose (FBG, systolic and diastolic blood pressure (SBP and DBP, and full lipid panel (TC, TG, HDL, and LDL. Results: Seventeen patients were enrolled in the study. The standard group (n = 11 and intervention group (n = 6 had relatively similar biometric markers at baseline. Seven total patients completed the study (4 from standard group, 3 from intervention group. The majority of biometric markers improved in both groups, and BP and LDL control was maintained for all who completed the study. Conclusion: These data suggest that a licensed pharmacist with certified personal trainer credentials may be capable of maintaining biometric markers at healthy levels and improving where necessary in an employee wellness program through one-on-one medication, fitness and nutrition support. Additional, large

  20. The Influence of an Orthopedic, Manual Therapy Residency Program on Improved Knowledge, Psychomotor Skills, and Clinical Reasoning in Nairobi, Kenya.

    Science.gov (United States)

    Cunningham, Shala; McFelea, Joni

    2017-01-01

    The purpose of this study was to describe the influence of a post-graduate orthopedic manual therapy residency program in Kenya on the development of physical therapists' (PTs) knowledge and clinical reasoning related to the performance of a musculoskeletal examination and evaluation as compared to an experience-matched control group of PTs waiting to enter the program. A cross-sectional design was utilized in which 12 graduating residents and 10 PTs entering the residency program completed a live-patient practical examination to assess the knowledge, clinical reasoning, and psychomotor skills related to the examination and evaluation of musculoskeletal conditions. The assessment utilized was based on the tasks, procedures, and knowledge areas identified as important to advanced clinicians in the US as outlined by the Orthopaedic Description of Specialty Practice. Inclusion criteria included participation in or acceptance to the residency program, practice as a PT between 3 and 25 years, and 50% of workday being involved in direct patient care. Overall pass rates were analyzed using the Pearson chi-square and Fisher's exact tests to determine if the graduating residents achieved significantly higher scores than experience-matched controls consisting of PTs entering the residency program. PTs completing a post-graduate orthopedic manual therapy residency in Nairobi, Kenya, achieved higher scores and passing rates compared to their colleagues who had not completed a residency program as determined by a live-patient practical examination. Graduating residents demonstrated statistically significant higher scores in the categories of examination, evaluation, and diagnosis. The average live-patient practical examination score for PTs without residency training was 38.2%, and their pass rate was 0.0%. The average live-patient practical examination score for residency-trained PTs was 83.4%, and their pass rate was 92.3%. These findings are statistically significant ( p

  1. Clinical Assessment of the Palmaris Longus – Accuracy of common ...

    African Journals Online (AJOL)

    tending the orthopaedic surgical outpatient clinic. The subjects were recruited consecutively and subjected to 10 tests to detect the presence of the Palmaris Longus. The patients were examined by a resident in orthopaedics as- sisted by two students of clinical medicine (equivalent of physician assistant) who had all been ...

  2. Assessment and Evaluation of the Utah Master Naturalist Program: Implications for Targeting Audiences

    Science.gov (United States)

    Larese-Casanova, Mark

    2011-01-01

    The Utah Master Naturalist Program trains citizens who provide education, outreach, and service to promote citizen stewardship of natural resources within their communities. In 2007-2008, the Watersheds module of the program was evaluated for program success, and participant knowledge was assessed. Assessment and evaluation results indicated that…

  3. Integrating Program Assessment and a Career Focus into a Research Methods Course

    Science.gov (United States)

    Senter, Mary Scheuer

    2017-01-01

    Sociology research methods students in 2013 and 2016 implemented a series of "real world" data gathering activities that enhanced their learning while assisting the department with ongoing program assessment and program review. In addition to the explicit collection of program assessment data on both students' development of sociological…

  4. Electronic Engineering Technology Program Exit Examination as an ABET and Self-Assessment Tool

    Science.gov (United States)

    Thomas, Gary; Darayan, Shahryar

    2018-01-01

    Every engineering, computing, and engineering technology program accredited by the Accreditation Board for Engineering and Technology (ABET) has formulated many and varied self-assessment methods. Methods used to assess a program for ABET accreditation and continuous improvement are for keeping programs current with academic and industrial…

  5. 40 CFR 52.1080 - Photochemical Assessment Monitoring Stations (PAMS) Program.

    Science.gov (United States)

    2010-07-01

    ... Stations (PAMS) Program. 52.1080 Section 52.1080 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... § 52.1080 Photochemical Assessment Monitoring Stations (PAMS) Program. On March 24, 1994 Maryland's... Assessment Monitoring Stations (PAMS) Program as a state implementation plan (SIP) revision, as required by...

  6. 40 CFR 52.2426 - Photochemical Assessment Monitoring Stations (PAMS) Program.

    Science.gov (United States)

    2010-07-01

    ... Stations (PAMS) Program. 52.2426 Section 52.2426 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... § 52.2426 Photochemical Assessment Monitoring Stations (PAMS) Program. On November 23, 1994 Virginia's... Photochemical Assessment Monitoring Stations (PAMS) Program as a state implementation plan (SIP) revision, as...

  7. Assessment of the Japanese Energy Efficiency Standards Program

    Directory of Open Access Journals (Sweden)

    Jun Arakawa

    2015-03-01

    Full Text Available Japanese energy efficiency standards program for appliances is a unique program which sets and revises mandatory standards based on the products of the highest energy efficiency on the markets. This study assessed the cost-effectiveness of the standard settings for air conditioner as a major residential appliance or typical example in the program. Based on analyses of empirical data, the net costs and effects from 1999 to 2040 were estimated. When applying a discount rate of 3%, the cost of abating CO2 emissions realized through the considered standards was estimated to be -13700 JPY/t-CO2. The sensitivity analysis, however, showed the cost turns into positive at a discount rate of 26% or higher. The authors also revealed that the standards’ “excellent” cost-effectiveness largely depends on that of the 1st standard setting, and the CO2 abatement cost through the 2nd standard was estimated to be as high as 26800 JPY/t-CO2. The results imply that the government is required to be careful about the possible economic burden imposed when considering introducing new, additional standards.

  8. Impact of the University of Colorado's Advanced Clinical Training and Service (ACTS) Program on dental students' clinical experience and cognitive skills, 1994-2006.

    Science.gov (United States)

    Berg, Rob; Call, Richard L; Maguire, Kerry; Berkey, Douglas B; Karshmer, Bernard A; Guyton, Brad; Tawara-Jones, Karen

    2010-04-01

    The University of Colorado Denver School of Dental Medicine has operated a community-based dental education program for all of its students since 1985. A database of student productivity has been maintained in a standardized format, capable of multiyear compilation, since 1994. This study utilizes twelve years of these data to profile the type and amount of clinical treatment that can be provided by a typical fourth-year dental student during a 100-day community-based training experience. Between 1994 and 2006, the school's 423 graduates provided a mean of 922 treatment procedures per student at a mean of 498 patient visits per student. During a typical four-week clinical affiliation, each student provided a mean of approximately twenty-seven restorations on permanent teeth, sixteen restorations on primary teeth, and twenty-four oral surgery procedures (extractions). Students also gained considerable experience in periodontics, fixed and removable prosthodontics, and endodontics. Self-assessed competency ratings tended to increase after completing the program, as did willingness to treat underserved populations after graduation. About 16 percent of graduates reported planning to practice in the public sector after completing dental school. A community-based experience such as this appears to offer an opportunity to substantially augment dental students' clinical training experiences.

  9. Clinical Validity of the Counseling Center Assessment of Psychological Symptoms-62 (CCAPS-62): Further Evaluation and Clinical Applications

    Science.gov (United States)

    McAleavey, Andrew A.; Nordberg, Samuel S.; Hayes, Jeffrey A.; Castonguay, Louis G.; Locke, Benjamin D.; Lockard, Allison J.

    2012-01-01

    Self-report instruments of psychological symptoms are increasingly used in counseling centers but rely on rigorous evaluation of their clinical validity. Three studies reported here (total N = 26,886) investigated the validity of the Counseling Center Assessment of Psychological Symptoms-62 (CCAPS-62; Locke et al., 2011) as an assessment and…

  10. Expanding the Aperture of Psychological Assessment: Introduction to the Special Section on Innovative Clinical Assessment Technologies and Methods

    Science.gov (United States)

    Trull, Timothy J.

    2007-01-01

    Contemporary psychological assessment is dominated by tried-and-true methods like clinical interviewing, self-report questionnaires, intellectual assessment, and behavioral observation. These approaches have served as the mainstays of psychological assessment for decades. To be sure, these methods have survived over the years because clinicians…

  11. Effects of 12-week proprioception training program on postural stability, gait, and balance in older adults: a controlled clinical trial.

    Science.gov (United States)

    Martínez-Amat, Antonio; Hita-Contreras, Fidel; Lomas-Vega, Rafael; Caballero-Martínez, Isabel; Alvarez, Pablo J; Martínez-López, Emilio

    2013-08-01

    The purpose of this study was to evaluate the effect of a 12-week-specific proprioceptive training program on postural stability, gait, balance, and fall prevention in adults older than 65 years. The present study was a controlled clinical trial. Forty-four community dwelling elderly subjects (61-90 years; mean age, 78.07 ± 5.7 years) divided into experimental (n = 20) and control (n = 24) groups. The participants performed the Berg balance test before and after the training program, and we assessed participants' gait, balance, and the risk of falling, using the Tinetti scale. Medial-lateral plane and anterior-posterior plane displacements of the center of pressure, Sway area, length and speed, and the Romberg quotient about surface, speed, and distance were calculated in static posturography analysis (EPS pressure platform) under 2 conditions: eyes open and eyes closed. After a first clinical evaluation, patients were submitted to 12 weeks proprioception training program, 2 sessions of 50 minutes every week. This program includes 6 exercises with the BOSU and Swiss ball as unstable training tools that were designed to program proprioceptive training. The training program improved postural balance of older adults in mediolateral plane with eyes open (p 0.05). After proprioception training, gait (Tinetti), and balance (Berg) test scores improved 14.66% and 11.47% respectively. These results show that 12 weeks proprioception training program in older adults is effective in postural stability, static, and dynamic balance and could lead to an improvement in gait and balance capacity, and to a decrease in the risk of falling in adults aged 65 years and older.

  12. Actinide partitioning-transmutation program final report. I. Overall assessment

    International Nuclear Information System (INIS)

    Croff, A.G.; Blomeke, J.O.; Finney, B.C.

    1980-06-01

    This report is concerned with an overall assessment of the feasibility of and incentives for partitioning (recovering) long-lived nuclides from fuel reprocessing and fuel refabrication plant radioactive wastes and transmuting them to shorter-lived or stable nuclides by neutron irradiation. The principal class of nuclides considered is the actinides, although a brief analysis is given of the partitioning and transmutation (P-T) of 99 Tc and 129 I. The results obtained in this program permit us to make a comparison of the impacts of waste management with and without actinide recovery and transmutation. Three major conclusions concerning technical feasibility can be drawn from the assessment: (1) actinide P-T is feasible, subject to the acceptability of fuels containing recycle actinides; (2) technetium P-T is feasible if satisfactory partitioning processes can be developed and satisfactory fuels identified (no studies have been made in this area); and (3) iodine P-T is marginally feasible at best because of the low transmutation rates, the high volatility, and the corrosiveness of iodine and iodine compounds. It was concluded on the basis of a very conservative repository risk analysis that there are no safety or cost incentives for actinide P-T. In fact, if nonradiological risks are included, the short-term risks of P-T exceed the long-term benefits integrated over a period of 1 million years. Incentives for technetium and iodine P-T exist only if extremely conservative long-term risk analyses are used. Further RD and D in support of P-T is not warranted

  13. Family Medicine needs assessment: Studying the clinical work of ...

    African Journals Online (AJOL)

    admin

    Abstract. Background and Objective: Some universities in sub-Saharan Africa have initiated Family Medicine (FM) residency programs. ... were for information technology (78%) and HIV (46%) training. Conclusion: ..... Emergency medicine. 32.

  14. Assessing clinical significance of treatment outcomes using the DASS-21.

    Science.gov (United States)

    Ronk, Fiona R; Korman, James R; Hooke, Geoffrey R; Page, Andrew C

    2013-12-01

    Standard clinical significance classifications are based on movement between the "dysfunctional" and "functional" distributions; however, this dichotomy ignores heterogeneity within the "dysfunctional" population. Based on the methodology described by Tingey, Lambert, Burlingame, and Hansen (1996), the present study sought to present a 3-distribution clinical significance model for the 21-item version of the Depression Anxiety Stress Scales (DASS-21; P. F. Lovibond & Lovibond, 1995) using data from a normative sample (n = 2,914), an outpatient sample (n = 1,000), and an inpatient sample (n = 3,964). DASS-21 scores were collected at pre- and post-treatment for both clinical samples, and patients were classified into 1 of 5 categories based on whether they had made a reliable change and whether they had moved into a different functional range. Evidence supported the validity of the 3-distribution model for the DASS-21, since inpatients who were classified as making a clinically significant change showed lower symptom severity, higher perceived quality of life, and higher clinician-rated functioning than those who did not make a clinically significant change. Importantly, results suggest that the new category of recovering is an intermediate point between recovered and making no clinically significant change. Inpatients and outpatients have different treatment goals and therefore use of the concept of clinical significance needs to acknowledge differences in what constitutes a meaningful change. (c) 2013 APA, all rights reserved.

  15. Impact of a Comprehensive Early Clinical Exposure Program for Preclinical Year Medical Students

    Directory of Open Access Journals (Sweden)

    Sumitra Govindarajan

    2018-06-01

    Full Text Available Purpose: To study the impact of an early clinical exposure program designed to provide a wide variety (cognitive, affective and psychomotor of learning experiences for the preclinical year students. Method: One hundred and fifty preclinical students were posted in small groups to selected departments – Transfusion medicine, Catheterization lab, Simulation lab, Radiology, Neurology, Nephrology, Respiratory medicine and General surgery. Each student had atleast ten hours  of clinical exposure under this program. The program was evaluated through a series of pre and post-test questionnaires, which were designed based on the learning objectives of each session. Students who wished to participate in the program evaluation gave informed consent, took up the pre / post test and were also asked to give their written open comments about the program. Results: There was a significant increase in the post-test scores (ranging from 9.14±2.67 to 36.65±6.62 when compared to the pre-test scores (ranging from 7.94±2.31 to 28.69±6.11 for all the sessions (p value <0.001, n=144. Analysis of the open feedback showed that the program had significant impact on the cognitive, psychomotor and affective domains. “Application of basic sciences in clinical practice”, “motivation to learn”, “got familiar with various specialties”, “insight about what the patient undergoes” were the themes identified from the open comments. Conclusion: The innovative use of early clinical exposure program to teach/learn clinical skills like phlebotomy and Basic Life Support had been well appreciated by the students. The present design involving a variety of learning experiences has been successful in introducing the various dimensions of medical profession like scientific, ethical, interpersonal, professional and social to the new entrants in addition to enhancing their motivation to learn. Keywords: Attitude, Learning, Simulation lab, Medical education, Curriculum

  16. Creating physicians of the 21st century: assessment of the clinical years

    Directory of Open Access Journals (Sweden)

    Vanderbilt AA

    2017-06-01

    Full Text Available Allison A Vanderbilt,1 Sara Q Perkins,2 Moriah K Muscaro,2 Thomas J Papadimos,3 Reginald F Baugh4 1Department of Family Medicine, 2College of Medicine and Life Sciences, University of Toledo, 3Department of Anesthesiology, 4Department of Surgery, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA Abstract: Medical education has been under a constant state of revision for the past several years. The overarching theme of the curriculum revisions for medical schools across the USA has been creating better physicians for the 21st century, with the same end result: graduating medical students at the optimal performance level when entering residency. We propose a robust, thorough assessment process that will address the needs of clerkships, residents, students, and, most importantly, medical schools to best measure and improve clinical reasoning skills that are required for the learning outcomes of our future physicians. The Accreditation Council for Graduate Medical Education (ACGME evaluates and accredits medical school graduates based on competency-based outcomes and the assessment of specialty-specific milestones; however, there is some evidence that medical school graduates do not consistently meet the Level 1 milestones prior to entering/beginning residency, thus starting their internship year underprepared and overwhelmed. Medical schools should take on the responsibility to provide competency-based assessments for their students during the clinical years. These assessments should be geared toward preparing them with the cognitive competencies and skills needed to successfully transition to residency. Then, medical schools can produce students who will ultimately be prepared for transition to their residency programs to provide quality care. Keywords: ACGME Core Competencies, milestones, clerkships, medical education, evaluation 

  17. Risk assessment to an integrated planning model for UST programs

    International Nuclear Information System (INIS)

    Ferguson, K.W.

    1993-01-01

    The US Postal Service maintains the largest civilian fleet in the United States totaling approximately 180,000 vehicles. To support the fleets daily energy requirements, the Postal Service also operates one of the largest networks of underground storage tanks nearly 7,500 nationwide. A program to apply risk assessment to planning, budget development and other management actions was implemented during September, 1989. Working closely with a consultant, the postal service developed regulatory and environmental risk criteria and weighting factors for a ranking model. The primary objective was to identify relative risks for each underground tank at individual facilities. Relative risks at each facility were determined central to prioritizing scheduled improvements to the tank network. The survey was conducted on 302 underground tanks in the Northeast Region of the US. An environmental and regulatory risk score was computed for each UST. By ranking the tanks according to their risk score, tanks were classified into management action categories including, but the limited to, underground tank testing, retrofit, repair, replacement and closure

  18. Consumer involvement in the health technology assessment program.

    Science.gov (United States)

    Royle, Jane; Oliver, Sandy

    2004-01-01

    This study aims to describe a cycle of development leading to sustainable methods for involving consumers in the management of a program commissioning health technology assessment. Staff time was dedicated to developing procedures for recruiting and briefing consumers to participate in prioritizing, commissioning, and reporting research. Resources and support were developed in light of early feedback from consumers and those working with them. These were piloted and amended before being used routinely. Over 4 years, procedures and resources have been developed to support six consumers attending seven to eight prioritization meetings a year; thirty to forty-five consumers each year commenting on research need for particular topics; thirty consumers a year commenting on research proposals, and twenty a year commenting on research reports. The procedures include clear job descriptions, induction and development days, clear briefing materials, payment for substantial tasks, and regularly seeking feedback to improve procedures. Explicit, inclusive, and reproducible methods for supporting consumer involvement that satisfy National Health Service policy recommendations for involving consumers in research require dedicated staff time to support a cycle of organizational development.

  19. Demonstration of SLUMIS: a clinical database and management information system for a multi organ transplant program.

    OpenAIRE

    Kurtz, M.; Bennett, T.; Garvin, P.; Manuel, F.; Williams, M.; Langreder, S.

    1991-01-01

    Because of the rapid evolution of the heart, heart/lung, liver, kidney and kidney/pancreas transplant programs at our institution, and because of a lack of an existing comprehensive database, we were required to develop a computerized management information system capable of supporting both clinical and research requirements of a multifaceted transplant program. SLUMIS (ST. LOUIS UNIVERSITY MULTI-ORGAN INFORMATION SYSTEM) was developed for the following reasons: 1) to comply with the reportin...

  20. A review of standardized patients in clinical education: Implications for speech-language pathology programs.

    Science.gov (United States)

    Hill, Anne E; Davidson, Bronwyn J; Theodoros, Deborah G

    2010-06-01

    The use of standardized patients has been reported as a viable addition to traditional models of professional practice education in medicine, nursing and allied health programs. Educational programs rely on the inclusion of work-integrated learning components in order to graduate competent practitioners. Allied health programs world-wide have reported increasing difficulty in attaining sufficient traditional placements for students within the workplace. In response to this, allied health professionals are challenged to be innovative and problem-solving in the development and maintenance of clinical education placements and to consider potential alternative learning opportunities for students. Whilst there is a bank of literature describing the use of standardized patients in medicine and nursing, reports of its use in speech-language pathology clinical education are limited. Therefore, this paper aims to (1) provide a review of literature reporting on the use of standardized patients within medical and allied health professions with particular reference to use in speech-language pathology, (2) discuss methodological and practical issues involved in establishing and maintaining a standardized patient program and (3) identify future directions for research and clinical programs using standardized patients to build foundation clinical skills such as communication, interpersonal interaction and interviewing.