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Sample records for expertise based trial

  1. A systematic review of the use of an expertise-based randomised controlled trial design.

    Science.gov (United States)

    Cook, Jonathan A; Elders, Andrew; Boachie, Charles; Bassinga, Ted; Fraser, Cynthia; Altman, Doug G; Boutron, Isabelle; Ramsay, Craig R; MacLennan, Graeme S

    2015-05-30

    Under a conventional two-arm randomised trial design, participants are allocated to an intervention and participating health professionals are expected to deliver both interventions. However, health professionals often have differing levels of expertise in a skill-based interventions such as surgery or psychotherapy. An expertise-based approach to trial design, where health professionals only deliver an intervention in which they have expertise, has been proposed as an alternative. The aim of this project was to systematically review the use of an expertise-based trial design in the medical literature. We carried out a comprehensive search of nine databases--AMED, BIOSIS, CENTRAL, CINAHL, Cochrane Methodology Register, EMBASE, MEDLINE, Science Citation Index, and PsycINFO--from 1966 to 2012 and performed citation searches using the ISI Citation Indexes and Scopus. Studies that used an expertise-based trial design were included. Two review authors independently screened the titles and abstracts and assessed full-text reports. Data were extracted and summarised on the study characteristics, general and expertise-specific study methodology, and conduct. In total, 7476 titles and abstracts were identified, leading to 43 included studies (54 articles). The vast majority (88%) used a pure expertise-based design; three (7%) adopted a hybrid design, and two (5%) used a design that was unclear. Most studies compared substantially different interventions (79%). In many cases, key information relating to the expertise-based design was absent; only 12 (28%) reported criteria for delivering both interventions. Most studies recruited the target sample size or very close to it (median of 101, interquartile range of 94 to 118), although the target was reported for only 40% of studies. The proportion of participants who received the allocated intervention was high (92%, interquartile range of 82 to 99%). While use of an expertise-based trial design is growing, it remains uncommon

  2. Protocol of an expertise based randomized trial comparing surgical Venae Sectio versus radiological Puncture of Vena Subclavia for insertion of Totally Implantable Access Port in oncological patients

    Directory of Open Access Journals (Sweden)

    Radeleff Boris

    2008-10-01

    Full Text Available Abstract Background Totally Implantable Access Ports (TIAP are being extensively used world-wide and can be expected to gain further importance with the introduction of new neoadjuvant and adjuvant treatments in oncology. Two different techniques for the implantation can be selected: A direct puncture of a central vein and the utilization of a Seldinger device or the surgical Venae sectio. It is still unclear which technique has the optimal benefit/risk ratio for the patient. Design A single-center, expertise based randomized, controlled superiority trial to compare two different TIAP implantation techniques. 100 patients will be included and randomized pre-operatively. All patients aged 18 years or older scheduled for primary elective implantation of a TIAP under local anesthesia who signed the informed consent will be included. The primary endpoint is the primary success rate of the randomized technique. Control Intervention: Venae Sectio will be employed to insert a TIAP by a surgeon; Experimental intervention: Punction of V. Subclavia will be used to place a TIAP by a radiologist. Duration of study: Approximately 10 months, follow up time: 90 days. Organisation/Responsibility The PORTAS 2 – Trial will be conducted in accordance with the protocol and in compliance with the moral, ethical, and scientific principles governing clinical research as set out in the Declaration of Helsinki (1989 and Good Clinical Practice (GCP. The Center of Clinical Trials at the Department of Surgery, University Hospital Heidelberg is responsible for design and conduct of the trial including randomization and documentation of patients' data. Data management and statistical analysis will be performed by the independent Institute for Medical Biometry and Informatics (IMBI, University of Heidelberg. Trial Registration The trial is registered at ClinicalTrials.gov (NCT00600444.

  3. Cognitive and neuronal bases of expertise

    OpenAIRE

    Campitelli, Guillermo

    2003-01-01

    This thesis examines the cognitive and neural bases of expertise. In so doing, several psychological phenomena were investigated-imagery. memory and thinking-using different tasks, and a variety of techniques of data gathering, including standard behavioural experiments, questionnaires, eye-movement recording, and functional magnetic resonance imaging (fMRI). Chess players participated in all the studies, and chess tasks were used. The data confirmed the versatility and power of chess as ...

  4. A prospective randomized trial of content expertise versus process expertise in small group teaching.

    Science.gov (United States)

    Peets, Adam D; Cooke, Lara; Wright, Bruce; Coderre, Sylvain; McLaughlin, Kevin

    2010-10-14

    Effective teaching requires an understanding of both what (content knowledge) and how (process knowledge) to teach. While previous studies involving medical students have compared preceptors with greater or lesser content knowledge, it is unclear whether process expertise can compensate for deficient content expertise. Therefore, the objective of our study was to compare the effect of preceptors with process expertise to those with content expertise on medical students' learning outcomes in a structured small group environment. One hundred and fifty-one first year medical students were randomized to 11 groups for the small group component of the Cardiovascular-Respiratory course at the University of Calgary. Each group was then block randomized to one of three streams for the entire course: tutoring exclusively by physicians with content expertise (n = 5), tutoring exclusively by physicians with process expertise (n = 3), and tutoring by content experts for 11 sessions and process experts for 10 sessions (n = 3). After each of the 21 small group sessions, students evaluated their preceptors' teaching with a standardized instrument. Students' knowledge acquisition was assessed by an end-of-course multiple choice (EOC-MCQ) examination. Students rated the process experts significantly higher on each of the instrument's 15 items, including the overall rating. Students' mean score (±SD) on the EOC-MCQ exam was 76.1% (8.1) for groups taught by content experts, 78.2% (7.8) for the combination group and 79.5% (9.2) for process expert groups (p = 0.11). By linear regression student performance was higher if they had been taught by process experts (regression coefficient 2.7 [0.1, 5.4], p teach first year medical students within a structured small group environment; preceptors with process expertise result in at least equivalent, if not superior, student outcomes in this setting.

  5. The impact of radiologists' expertise on screen results decisions in a CT lung cancer screening trial

    International Nuclear Information System (INIS)

    Heuvelmans, Marjolein A.; Vliegenthart, Rozemarijn; Oudkerk, Matthijs; Jong, Pim A. de; Mali, Willem P.; Groen, Harry J.M.

    2015-01-01

    To evaluate the impact of radiological expertise on screen result decisions in a CT lung cancer screening trial. In the NELSON lung cancer screening trial, the baseline CT result was based on the largest lung nodule's volume. The protocol allowed radiologists to manually adjust screen results in cases of high suspicion of benign or malignant nodule nature. Participants whose baseline CT result was based on a solid or part-solid nodule were included in this study. Adjustments by radiologists at baseline were evaluated. Histology was the reference for diagnosis or to confirm benignity and stability on subsequent CT examinations. A total of 3,318 participants (2,796 male, median age 58.0 years) were included. In 195 participants (5.9 %) the initial baseline screen result was adjusted by the radiologist. Adjustment was downwards from positive or indeterminate to negative in two and 119 participants, respectively, and from positive to indeterminate in 65 participants. None of these nodules turned out to be malignant. In 9/195 participants (4.6 %) the screen result was adjusted upwards from negative to indeterminate or indeterminate to positive; two nodules were malignant. In one in 20 cases of baseline lung cancer screening, nodules were reclassified by the radiologist, leading to a reduction of false-positive screen results. (orig.)

  6. Do authors report surgical expertise in open spine surgery related randomized controlled trials? A systematic review on quality of reporting

    NARCIS (Netherlands)

    van Oldenrijk, Jakob; van Berkel, Youri; Kerkhoffs, Gino M. M. J.; Bhandari, Mohit; Poolman, Rudolf W.

    2013-01-01

    A systematic review of published trials in orthopedic spine literature. To determine the quality of reporting in open spine surgery randomized controlled trials (RCTs) between 2005 and 2010 with special focus on the reporting of surgical skill or expertise. In technically demanding procedures such

  7. An Agent Based Approach To Finding Expertise In The Engineering Design Environment

    OpenAIRE

    Crowder, Richard; Hughes, Gareth; Hall, Wendy

    2003-01-01

    During the engineering design process people need to locate colleagues with knowledge to resolve a problem. As identified by discussions with practicing designers the use of computer based systems that assist users with finding such expertise will become increasingly important. In this paper we discuss the development of an agent based Expertise Finder suitable for use within an engineering design environment. A key feature of our approach is that the Expertise Finder returns both recommended...

  8. Example-Based Learning: Effects of Model Expertise in Relation to Student Expertise

    Science.gov (United States)

    Boekhout, Paul; van Gog, Tamara; van de Wiel, Margje W. J.; Gerards-Last, Dorien; Geraets, Jacques

    2010-01-01

    Background: Worked examples are very effective for novice learners. They typically present a written-out ideal (didactical) solution for learners to study. Aims: This study used worked examples of patient history taking in physiotherapy that presented a "non"-didactical solution (i.e., based on actual performance). The effects of model expertise…

  9. Implementing Expertise-Based Training Methods to Accelerate the Development of Peer Academic Coaches

    Science.gov (United States)

    Blair, Lisa

    2016-01-01

    The field of expertise studies offers several models from which to develop training programs that accelerate the development of novice performers in a variety of domains. This research study implemented two methods of expertise-based training in a course to develop undergraduate peer academic coaches through a ten-week program. An existing…

  10. The impact of radiologists' expertise on screen results decisions in a CT lung cancer screening trial

    Energy Technology Data Exchange (ETDEWEB)

    Heuvelmans, Marjolein A.; Vliegenthart, Rozemarijn [University of Groningen, University Medical Center Groningen, Center for Medical Imaging - North East Netherlands, Groningen (Netherlands); University of Groningen / University Medical Center Groningen, Department of Radiology, Groningen (Netherlands); Oudkerk, Matthijs [University of Groningen, University Medical Center Groningen, Center for Medical Imaging - North East Netherlands, Groningen (Netherlands); Jong, Pim A. de; Mali, Willem P. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Groen, Harry J.M. [University of Groningen, University Medical Center Groningen, Department of Pulmonology, Groningen (Netherlands)

    2014-11-04

    To evaluate the impact of radiological expertise on screen result decisions in a CT lung cancer screening trial. In the NELSON lung cancer screening trial, the baseline CT result was based on the largest lung nodule's volume. The protocol allowed radiologists to manually adjust screen results in cases of high suspicion of benign or malignant nodule nature. Participants whose baseline CT result was based on a solid or part-solid nodule were included in this study. Adjustments by radiologists at baseline were evaluated. Histology was the reference for diagnosis or to confirm benignity and stability on subsequent CT examinations. A total of 3,318 participants (2,796 male, median age 58.0 years) were included. In 195 participants (5.9 %) the initial baseline screen result was adjusted by the radiologist. Adjustment was downwards from positive or indeterminate to negative in two and 119 participants, respectively, and from positive to indeterminate in 65 participants. None of these nodules turned out to be malignant. In 9/195 participants (4.6 %) the screen result was adjusted upwards from negative to indeterminate or indeterminate to positive; two nodules were malignant. In one in 20 cases of baseline lung cancer screening, nodules were reclassified by the radiologist, leading to a reduction of false-positive screen results. (orig.)

  11. A constraints-based approach to the acquisition of expertise in outdoor adventure sports

    NARCIS (Netherlands)

    Davids, Keith; Brymer, Eric; Seifert, Ludovic; Orth, Dominic

    2013-01-01

    A constraints-based framework enables a new understanding of expertise in outdoor adventure sports by considering performer-environment couplings through emergent and self-organizing behaviours in relation to interacting constraints. Expert adventure athletes, conceptualized as complex, dynamical

  12. A case-based assistant for clinical psychiatry expertise.

    OpenAIRE

    Bichindaritz, I.

    1994-01-01

    Case-based reasoning is an artificial intelligence methodology for the processing of empirical knowledge. Recent case-based reasoning systems also use theoretic knowledge about the domain to constrain the case-based reasoning. The organization of the memory is the key issue in case-based reasoning. The case-based assistant presented here has two structures in memory: cases and concepts. These memory structures permit it to be as skilled in problem-solving tasks, such as diagnosis and treatmen...

  13. A case-based assistant for clinical psychiatry expertise.

    Science.gov (United States)

    Bichindaritz, I

    1994-01-01

    Case-based reasoning is an artificial intelligence methodology for the processing of empirical knowledge. Recent case-based reasoning systems also use theoretic knowledge about the domain to constrain the case-based reasoning. The organization of the memory is the key issue in case-based reasoning. The case-based assistant presented here has two structures in memory: cases and concepts. These memory structures permit it to be as skilled in problem-solving tasks, such as diagnosis and treatment planning, as in interpretive tasks, such as clinical research. A prototype applied to clinical work about eating disorders in psychiatry, reasoning from the alimentary questionnaires of these patients, is presented as an example of the system abilities.

  14. Re-inscribing Gender in New Modes of Medical Expertise: The Investigator–Coordinator Relationship in the Clinical Trials Industry

    Science.gov (United States)

    Fisher, Jill A.

    2011-01-01

    This article analyses the ways in which research coordinators forge professional identities in the highly gendered organizational context of the clinic. Drawing upon qualitative research on the organization of the clinical trials industry (that is, the private sector, for profit auxiliary companies that support pharmaceutical drug studies), this article explores the relationships between predominantly male physician-investigators and female research coordinators and the constitution of medical expertise in pharmaceutical drug development. One finding is that coordinators actively seek to establish relationships with investigators that mirror traditional doctor–nurse relationships, in which the feminized role is subordinated and devalued. Another finding is that the coordinators do, in fact, have profound research expertise that is frequently greater than that of the investigators. The coordinators develop expertise on pharmaceutical products and diseases through their observations of the patterns that occur in patient–participants’ responses to investigational drugs. The article argues, however, that the nature of the relationships between coordinators and investigators renders invisible the coordinators’ expertise. In this context, gender acts as a persistent social structure shaping both coordinators’ and investigators’ perceptions of who can be recognized as having authority and power in the workplace. PMID:21394219

  15. Knowledge Based Components of Expertise in Medical Diagnosis.

    Science.gov (United States)

    1981-09-01

    the ability to ac- cess and use knowledge that one "has" is situationally dependent (e.g., Melton, 1963)1 Tulving and Pearlstone , 1966). For example...Londons Wiley, 1976. Tulving , E., & Pearlstone , E. Availability versus accessibility of information in memory for words. Journal of Verbal Learning...encounter (c.f.Flexser’and Tulving , 19781 Tulving ., 1976). Expert-based instructional devices (computer assisted instruction or decision support sys

  16. An Abstraction Hierarchy based mobile PC display design in NPP maintenance considering the level of expertise

    International Nuclear Information System (INIS)

    Yim, Ho Bin; Kim, In; Seong, Poong Hyun

    2011-01-01

    Research highlights: → Six levels of Abstraction Hierarchy based information for maintenance were proposed. → Errors and workload with AH based information display were reduced for LL subjects. → Design concerns discovered can be applied to practical use of mobile maintenance aids. - Abstract: Recently, the importance of effective maintenance in nuclear power plants (NPPs) has been emphasized and research into effective maintenance by adopting mobile maintenance aids (MMAs) have been attempted. For improved and effective use of an MMA display design method based on the hierarchy is proposed and its design considerations are discussed in this study. Six levels of hierarchy are proposed in this paper to classify the maintenance information. By classifying and organizing maintenance information using the hierarchy, maintenance information can be used effectively by users with either high or low levels of expertise. When information classification has been finished, the information for MMA design is selected and designed. With the considerations of MMA design analysis and guidelines, a hierarchy-based MMA is designed for the maintenance tasks. An experiment is conducted using the hierarchy-based MMA in order to estimate the effectiveness of the proposed method for the maintenance tasks and to identify design considerations to enhance the proposed MMAs. The result indicated that a hierarchy-based manual was more effective than a conventional manual in terms of task completion time and number of errors. The workload for the hierarchy-based manual was estimated less than the conventional manual for subjects with low level of expertise. As the level of expertise increases, subjects tended to follow more abstract information while the number of navigations decreased. It is believed that when mobile devices become pervasive in NPP maintenance fields, the hierarchy model applied MMAs can be used as an effective maintenance supporting tool.

  17. Security Expertise

    DEFF Research Database (Denmark)

    systematic study of security expertise and opens up a productive dialogue between science and technology studies and security studies to investigate the character and consequences of this expertise. In security theory, the study of expertise is crucial to understanding whose knowledge informs security making......This volume brings together scholars from different fields to explore the power, consequences and everyday practices of security expertise. Expertise mediates between different forms of knowledge: scientific and technological, legal, economic and political knowledge. This book offers the first...... and to reflect on the impact and responsibility of security analysis. In science and technology studies, the study of security politics adds a challenging new case to the agenda of research on expertise and policy. The contributors investigate cases such as academic security studies, security think tanks...

  18. Understanding the Validity of Data: A Knowledge-Based Network Underlying Research Expertise in Scientific Disciplines

    Science.gov (United States)

    Roberts, Ros

    2016-01-01

    This article considers what might be taught to meet a widely held curriculum aim of students being able to understand research in a discipline. Expertise, which may appear as a "chain of practice," is widely held to be underpinned by networks of understanding. Scientific research expertise is considered from this perspective. Within…

  19. Emergent Expertise?

    Science.gov (United States)

    McGivern, Patrick

    2014-01-01

    The concept of emergence appears in various places within the literature on expertise and expert practice. Here, I examine some of these applications of emergence in the light of two prominent accounts of emergence from the philosophy of science and philosophy of mind. I evaluate these accounts with respect to several specific contexts in which…

  20. Expertise seeking

    DEFF Research Database (Denmark)

    Hertzum, Morten

    2014-01-01

    used sources. Studies repeatedly show the influence of the social network – of friendships and personal dislikes – on the expertise-seeking network of organisations. In addition, people are no less prominent than documentary sources, in work contexts as well as daily-life contexts. The relative...

  1. Teacher expertise

    DEFF Research Database (Denmark)

    Rasmussen, Jens

    Teacher Expertise: How to improve the relationship between Theory and Practice in Teacher Education Jens Rasmussen, Department of Education, Aarhus University In several studies and reports it has been nailed over and over that teachers’ matter. So this is not the question in this study. The ques......Teacher Expertise: How to improve the relationship between Theory and Practice in Teacher Education Jens Rasmussen, Department of Education, Aarhus University In several studies and reports it has been nailed over and over that teachers’ matter. So this is not the question in this study....... The question is how teacher preparation leads to effective teachers. The study Expert in Teaching paid special attention to the intention of connecting coursework more directly to practice in pre-service teacher education. The overall objective of the study was to strengthen the relationship between theory...... that the three parties (college teachers, practice teachers and teacher students) found it difficult to perform and maintain their different roles....

  2. Using Network-Based Language Analysis to Bridge Expertise and Cultivate Sensitivity to Differentiated Language Use in Interdisciplinary Geoscience Research

    Science.gov (United States)

    Hannah, M. A.; Simeone, M.

    2017-12-01

    On interdisciplinary teams, expertise is varied, as is evidenced by differences in team members' language use. Developing strategies to combine that expertise and bridge differentiated language practices is especially difficult between geoscience subdisciplines as researchers assume they use a shared language—vocabulary, jargon, codes, linguistic styles. In our paper, we discuss a network-based approach used to identify varied expertise and language practices between geoscientists (n=29) on a NSF team funded to study how deep and surface Earth processes worked together to give rise to the Great Oxygenation Event. We describe how we modeled the team's expertise from a language corpus consisting of 220 oxygen-related terms frequently used by team members and then compared their understanding of the terms to develop interventions to bridge the team's expertise. Corpus terms were identified via team member interviews, observations of members' interactions at research meetings, and discourse analysis of members' publications. Comparisons of members' language use were based on a Likert scale survey that asked members to assess how they understood a term; how frequently they used a term; and whether they conceptualized a term as an object or process. Rather than use our method as a communication audit tool (Zwijze-Koning & de Jong, 2015), teams can proactively use it in a project's early stages to assess the contours of the team's differentiated expertise and show where specialized knowledge resides in the team, where latent or non-obvious expertise exists, where expertise overlaps, and where gaps are in the team's knowledge. With this information, teams can make evidence based recommendations to forward their work such as allocating resources; identifying and empowering members to serve as connectors and lead cross-functional project initiatives; and developing strategies to avoid communication barriers. The method also generates models for teaching language

  3. Predicting stabilizing treatment outcomes for complex posttraumatic stress disorder and dissociative identity disorder: an expertise-based prognostic model

    NARCIS (Netherlands)

    Baars, E.W.; van der Hart, O.; Nijenhuis, E.R.S.; Chu, J.A.; Glas, G.; Draaijer, N.

    2011-01-01

    The purpose of this study was to develop an expertise-based prognostic model for the treatment of complex posttraumatic stress disorder (PTSD) and dissociative identity disorder (DID).We developed a survey in 2 rounds: In the first round we surveyed 42 experienced therapists (22 DID and 20 complex

  4. Influence of tutors' subject-matter expertise on student effort and achievement in problem-based learning

    NARCIS (Netherlands)

    H.G. Schmidt (Henk); A. van der Arend (Arie); J.H.C. Moust (Jos); I. Kokx (Irma); L. Boon (Louis)

    1993-01-01

    textabstractPurpose. To investigate the effects of tutors' subject-matter expertise on students' levels of academic achievement and study effort in a problem-based health sciences curriculum. Also, to study differences in turors' behaviors and the influences of these differences on students'

  5. Teachers’ Professional Development in Context-based Chemistry Education : Strategies to Support Teachers in Developing Domain-specific Expertise

    NARCIS (Netherlands)

    Dolfing, R.

    2013-01-01

    The international trend of redesigning science curricula in terms of meaningful context-based programmes, involves a tremendous change in teachers’ practices. The successful implementation of such new curricula requires that teachers develop new domain-specific expertise in teaching innovative

  6. Are Tutor Behaviors in Problem-Based Learning Stable? A Generalizability Study of Social Congruence, Expertise and Cognitive Congruence

    Science.gov (United States)

    Williams, Judith C.; Alwis, W. A. M.; Rotgans, Jerome I.

    2011-01-01

    The purpose of this study was to investigate the stability of three distinct tutor behaviors (1) use of subject-matter expertise, (2) social congruence and (3) cognitive congruence, in a problem-based learning (PBL) environment. The data comprised the input from 16,047 different students to a survey of 762 tutors administered in three consecutive…

  7. Expertise-based peer selection in Peer-to-Peer networks

    NARCIS (Netherlands)

    Haase, Peter; Siebes, Ronny; Harmelen, van Frank

    2007-01-01

    Peer-to-Peer systems have proven to be an effective way of sharing data. Modern protocols are able to efficiently route a message to a given peer. However, determining the destination peer in the first place is not always trivial. We propose a model in which peers advertise their expertise in

  8. Beyond Faces and Expertise

    Science.gov (United States)

    Zhao, Mintao; Bülthoff, Heinrich H.; Bülthoff, Isabelle

    2016-01-01

    Holistic processing—the tendency to perceive objects as indecomposable wholes—has long been viewed as a process specific to faces or objects of expertise. Although current theories differ in what causes holistic processing, they share a fundamental constraint for its generalization: Nonface objects cannot elicit facelike holistic processing in the absence of expertise. Contrary to this prevailing view, here we show that line patterns with salient Gestalt information (i.e., connectedness, closure, and continuity between parts) can be processed as holistically as faces without any training. Moreover, weakening the saliency of Gestalt information in these patterns reduced holistic processing of them, which indicates that Gestalt information plays a crucial role in holistic processing. Therefore, holistic processing can be achieved not only via a top-down route based on expertise, but also via a bottom-up route relying merely on object-based information. The finding that facelike holistic processing can extend beyond the domains of faces and objects of expertise poses a challenge to current dominant theories. PMID:26674129

  9. Prescribing safety, negotiating expertise

    International Nuclear Information System (INIS)

    Rolina, Gregory

    2010-01-01

    Owing to their presumed impact on the safety of high-risk installations, the interactions between regulators and the regulated are a major but seldom explored subject of research in risk management. A study by experts on human and organizational factors in nuclear safety sheds light on the various phases (and their effects) of the process whereby experts produce assessments. Light is shed on a 'negotiated expertise' typical of the French style of safety regulations in nuclear installations. It is based on an ongoing technical dialog between experts and operators ('French cooking' for Anglo-Saxons). This analysis of 'expertise' and thus of the 'logics of action' implemented by experts proposes a typology of actions that can be transposed to other sorts of risk or other fields of activity. It hands us the keys for understanding a very contemporary activity. (author)

  10. Encountering the Expertise Reversal Effect with a Computer-Based Environment on Electrical Circuit Analysis

    Science.gov (United States)

    Reisslein, Jana; Atkinson, Robert K.; Seeling, Patrick; Reisslein, Martin

    2006-01-01

    This study examined the effectiveness of a computer-based environment employing three example-based instructional procedures (example-problem, problem-example, and fading) to teach series and parallel electrical circuit analysis to learners classified by two levels of prior knowledge (low and high). Although no differences between the…

  11. Deep Learning towards Expertise Development in a Visualization-Based Learning Environment

    Science.gov (United States)

    Yuan, Bei; Wang, Minhong; Kushniruk, Andre W.; Peng, Jun

    2017-01-01

    With limited problem-solving capability and practical experience, novices have difficulties developing expert-like performance. It is important to make the complex problem-solving process visible to learners and provide them with necessary help throughout the process. This study explores the design and effects of a model-based learning approach…

  12. The paradox of scientific expertise

    DEFF Research Database (Denmark)

    Alrøe, Hugo Fjelsted; Noe, Egon

    2011-01-01

    Modern societies depend on a growing production of scientific knowledge, which is based on the functional differentiation of science into still more specialised scientific disciplines and subdisciplines. This is the basis for the paradox of scientific expertise: The growth of science leads to a f...... cross-disciplinary research and in the collective use of different kinds of scientific expertise, and thereby make society better able to solve complex, real-world problems.......Modern societies depend on a growing production of scientific knowledge, which is based on the functional differentiation of science into still more specialised scientific disciplines and subdisciplines. This is the basis for the paradox of scientific expertise: The growth of science leads...... to a fragmentation of scientific expertise. To resolve this paradox, the present paper investigates three hypotheses: 1) All scientific knowledge is perspectival. 2) The perspectival structure of science leads to specific forms of knowledge asymmetries. 3) Such perspectival knowledge asymmetries must be handled...

  13. Expertise and contra expertise independence and transparency

    International Nuclear Information System (INIS)

    Abarnou, G.; Ades, Y.; Ancelin, G.; Balle, St.; Bardy, J.Ch.; Beringer, F.; Blanc, M.; Bontoux, J.; Bovy, M.; Brunet, F.; Calafat, A.; Cartier, M.; Constant, H.; Delcourt, R.; Duvert, J.C.; Eichholtzer, F.; Fernandez, P.; Fernex, S.; Foechterle, A.; Gatesoupe, J.P.; Geneau, Ch.; Goerg, C.; Gourod, A.; Graschaire, G.; Hubscher Ibert, J.; Jaegert, M.; Lacoste, A.C.; Lacote, J.P.; Laroche, D.; Lazar, Ph.; Lelievre, D.; Levasseur, E.; Levent, L.; Louvat, D.; Manon, Ch.; Maugein, J.; Melguen, M.; Mouchet, Ch.; Mourat, J.P.; Naegelen, L.; Niquet, G.; Perves, J.P.; Potelet, P.; Regent, A.; Romann, J.M.; Rossa, N.; Saut, C.; Sazy, Ch.; Schmitt, P.; Sene, M.; Sene, Raymond; Sornein, J.F.; Sugier, A.; Tfibel, V.; Uhart, M.; Vidal, J.; Vieillard Baron, B.; Vigny, P.; Walgenwitz, G.; Wiest, A.; Wisselmann, R.; Zuberbuhler, A.

    2006-01-01

    About sixty participants: members of C.L.I., academics, elected representatives, manufacturers, representatives of association, institutional, crossed their experiences. The debate was mainly centred on the role of the expert, the limits of its intervention and its independence. The presented titles are following: experiences of two C.L.I. in expertise; the work of communication of the nuclear experts; interest and limits of the expertise; presentation of the I.R.S.N. and the D.G.S.N.R.; expertise: problems and experiences; presentation of the works realised in work group; the considerations of the C.S.S.I.N.. (N.C.)

  14. Competence and Professional Expertise

    NARCIS (Netherlands)

    Evers, A.T.; Heijden, B.I.J.M. van der; Mulder, M.

    2017-01-01

    Theoretical and empirical controversies exist about the understanding and potentials of the concepts of competence and professional expertise. In this chapter, both concepts will be thoroughly conceptualised and discussed. Competence and professional expertise are important as all professionals need

  15. Competence and Professional Expertise

    NARCIS (Netherlands)

    Evers, Arnoud; Van der Heijden, Beatrice

    2018-01-01

    Theoretical and empirical controversies exist about the understanding and potentials of the concepts competence and professional expertise. In this chapter, both concepts will be thoroughly conceptualised and discussed. Competence and professional expertise are important as all professionals need to

  16. [Effects of attitude formation, persuasive message, and source expertise on attitude change: an examination based on the Elaboration Likelihood Model and the Attitude Formation Theory].

    Science.gov (United States)

    Nakamura, M; Saito, K; Wakabayashi, M

    1990-04-01

    The purpose of this study was to investigate how attitude change is generated by the recipient's degree of attitude formation, evaluative-emotional elements contained in the persuasive messages, and source expertise as a peripheral cue in the persuasion context. Hypotheses based on the Attitude Formation Theory of Mizuhara (1982) and the Elaboration Likelihood Model of Petty and Cacioppo (1981, 1986) were examined. Eighty undergraduate students served as subjects in the experiment, the first stage of which involving manipulating the degree of attitude formation with respect to nuclear power development. Then, the experimenter presented persuasive messages with varying combinations of evaluative-emotional elements from a source with either high or low expertise on the subject. Results revealed a significant interaction effect on attitude change among attitude formation, persuasive message and the expertise of the message source. That is, high attitude formation subjects resisted evaluative-emotional persuasion from the high expertise source while low attitude formation subjects changed their attitude when exposed to the same persuasive message from a low expertise source. Results exceeded initial predictions based on the Attitude Formation Theory and the Elaboration Likelihood Model.

  17. Corrosion in PWR stainless steel components: a TSO perspective based on operating experience and expertises

    International Nuclear Information System (INIS)

    Curieres, I. de

    2015-01-01

    Stainless steels are used commonly in many circuits of a nuclear power plant. Particularly, they are the prime materials for the inside surface of the primary circuit. Their operating experience has been good, though a number of cases of degradations due to corrosion have been reported the last ten years. This number of events is increasing and many studies of damaged parts become available. Based on the operating experience and these studies, IRSN will provide its perspective on the safety-related issues associated with the corrosion of stainless steel components. It appears that today's knowledge is not sufficient to define relevant criteria or to determine the exact set of parameters which leads to SCC (Stress Corrosion Cracking) of stainless steels. As a consequence, the best strategy remains an inspection and repair/replacement one. Moreover many cases show the influence of pollutants in the SCC events. This emphasizes the fact that chemistry parameters are strongly connected to safety issues, with respect to the stainless steels integrity

  18. Difference in Agility, Strength, and Flexibility in Competitive Figure Skaters Based on Level of Expertise and Skating Discipline.

    Science.gov (United States)

    Slater, Lindsay V; Vriner, Melissa; Zapalo, Peter; Arbour, Kat; Hart, Joseph M

    2016-12-01

    Slater, LV, Vriner, M, Zapalo, P, Arbour, K, and Hart, JM. Difference in agility, strength, and flexibility in competitive figure skaters based on level of expertise and skating discipline. J Strength Cond Res 30(12): 3321-3328, 2016-Figure skating is an extremely difficult sport that requires a combination of grace, artistry, flexibility, speed, and power. Although many skaters are involved with strength and conditioning programs, there is no current information about differences in off-ice performance measures based on skating discipline and level. The purpose of this study was to compare agility, strength, and flexibility performance based on skating discipline and level. A total of 343 figure skaters from 4 different disciplines (singles, dance, pair, and synchronized skating) and 3 different levels (novice, junior, and senior) completed combine testing with the United States Figure Skating Association. All subjects completed the hexagon agility test, t-test, triple bound jumps, vertical jump, timed tuck jumps, push-ups, v-ups, hand press, front split, seated reach, and stork pose. A multivariate analysis of variance with Scheffe's post hoc was used to identify differences in performance based on skating discipline and level. Mean differences, Cohen's d effect sizes, and 95% confidence intervals were reported for all significant differences. Senior and junior skaters tended to be faster and stronger than novice skaters. Singles, dance, and pair skaters tended to be more agile, stronger, and flexible than synchronized skaters, however, senior synchronized skaters tended to perform better than senior skaters in other disciplines. These results indicate that strength and conditioning professionals should consider skating discipline and level when designing strengthening programs for figure skaters.

  19. Predicting stabilizing treatment outcomes for complex posttraumatic stress disorder and dissociative identity disorder: an expertise-based prognostic model.

    Science.gov (United States)

    Baars, Erik W; van der Hart, Onno; Nijenhuis, Ellert R S; Chu, James A; Glas, Gerrit; Draijer, Nel

    2011-01-01

    The purpose of this study was to develop an expertise-based prognostic model for the treatment of complex posttraumatic stress disorder (PTSD) and dissociative identity disorder (DID). We developed a survey in 2 rounds: In the first round we surveyed 42 experienced therapists (22 DID and 20 complex PTSD therapists), and in the second round we surveyed a subset of 22 of the 42 therapists (13 DID and 9 complex PTSD therapists). First, we drew on therapists' knowledge of prognostic factors for stabilization-oriented treatment of complex PTSD and DID. Second, therapists prioritized a list of prognostic factors by estimating the size of each variable's prognostic effect; we clustered these factors according to content and named the clusters. Next, concept mapping methodology and statistical analyses (including principal components analyses) were used to transform individual judgments into weighted group judgments for clusters of items. A prognostic model, based on consensually determined estimates of effect sizes, of 8 clusters containing 51 factors for both complex PTSD and DID was formed. It includes the clusters lack of motivation, lack of healthy relationships, lack of healthy therapeutic relationships, lack of other internal and external resources, serious Axis I comorbidity, serious Axis II comorbidity, poor attachment, and self-destruction. In addition, a set of 5 DID-specific items was constructed. The model is supportive of the current phase-oriented treatment model, emphasizing the strengthening of the therapeutic relationship and the patient's resources in the initial stabilization phase. Further research is needed to test the model's statistical and clinical validity.

  20. Powering Ideas through Expertise

    DEFF Research Database (Denmark)

    Seabrooke, Leonard; Wigan, Duncan

    2016-01-01

    This contribution discusses how ideas are powered through expertise and moral authority. Professionals compete with each other to power ideas by linking claims to expertise, how things best work, to moral claims about how things should be. To show how, we draw on a case of battles over global tax...... reporting multinational corporations should provide to ensure they pay their fair share of tax. Ideas powered by expertise contain shared causal beliefs, as well as principled beliefs about value systems. We demonstrate that professionals can contest the established order when demonstrations of expertise...

  1. One Small Droplet: News Media Coverage of Peer-Reviewed and University-Based Education Research and Academic Expertise

    Science.gov (United States)

    Yettick, Holly

    2015-01-01

    Most members of the American public will never read this article. Instead, they will obtain much of their information about education from the news media. Yet little academic research has examined the type or quality of education research and expertise they will find there. Through the lens of gatekeeping theory, this mixed-methods study aims to…

  2. Rituals of environmental expertise

    DEFF Research Database (Denmark)

    Petersen, Lars Kjerulf

    2008-01-01

    Use of experts in media reports about the environment is not confined to its information function. Voices of expertise also serve a ritual function in societal communication by enacting collective sentiments and common world views cast around consensus as well as conflict. This article presents...... theoretical discussions and examples from a case study of Danish television news coverage of the environment supporting such an understanding of expertise in broadcast media. And adds to the discussion of expertise a discussion of the opposing category of lay knowledge....

  3. Expertise and contra expertise independence and transparency; Expertises -contre expertises independance et transparence

    Energy Technology Data Exchange (ETDEWEB)

    Abarnou, G; Ades, Y; Ancelin, G; Balle, St; Bardy, J Ch; Beringer, F; Blanc, M; Bontoux, J; Bovy, M; Brunet, F; Calafat, A; Cartier, M; Constant, H; Delcourt, R; Duvert, J C; Eichholtzer, F; Fernandez, P; Fernex, S; Foechterle, A; Gatesoupe, J P; Geneau, Ch; Goerg, C; Gourod, A; Graschaire, G; Hubscher Ibert, J; Jaegert, M; Lacoste, A C; Lacote, J P; Laroche, D; Lazar, Ph; Lelievre, D; Levasseur, E; Levent, L; Louvat, D; Manon, Ch; Maugein, J; Melguen, M; Mouchet, Ch; Mourat, J P; Naegelen, L; Niquet, G; Perves, J P; Potelet, P; Regent, A; Romann, J M; Rossa, N; Saut, C; Sazy, Ch; Schmitt, P; Sene, M; Sene, Raymond; Sornein, J F; Sugier, A; Tfibel, V; Uhart, M; Vidal, J; Vieillard Baron, B; Vigny, P; Walgenwitz, G; Wiest, A; Wisselmann, R; Zuberbuhler, A

    2006-07-01

    About sixty participants: members of C.L.I., academics, elected representatives, manufacturers, representatives of association, institutional, crossed their experiences. The debate was mainly centred on the role of the expert, the limits of its intervention and its independence. The presented titles are following: experiences of two C.L.I. in expertise; the work of communication of the nuclear experts; interest and limits of the expertise; presentation of the I.R.S.N. and the D.G.S.N.R.; expertise: problems and experiences; presentation of the works realised in work group; the considerations of the C.S.S.I.N.. (N.C.)

  4. Developing expertise in surgery.

    Science.gov (United States)

    Alderson, David

    2010-01-01

    The concept of expertise is widely embraced but poorly defined in surgery. Dictionary definitions differentiate between authority and experience, while a third view sees expertise as a mind-set rather than a status. Both absolute and relative models of expertise have been developed, and each allows a richer understanding of the application of these concepts to emerge. Trainees must develop both independent and interdependent expertise, and an appreciation of the essentially constructivist and uncertain nature of medical knowledge. Approach may be more important than innate talent; the concepts of 'flow', sustained 'deliberate practice' and 'adaptive expertise' are examples of expert approaches to learning. Non-analytical reasoning plays a key role in decision making at expert levels of practice. A technically gifted surgeon may be seen as a safety hazard rather than an expert if inter-dependent expertise has not been developed. Key roles of a surgical educator are to facilitate the development of an expert approach to education and to enable entry into and movement towards the centre of an expert community of practice.

  5. Science, expertise, and democracy.

    Science.gov (United States)

    Weinberg, Justin; Elliott, Kevin C

    2012-06-01

    The combination of government's significant involvement in science, science's significant effects on the public, and public ignorance (of both politics and science) raise important challenges for reconciling scientific expertise with democratic governance. Nevertheless, there have recently been a variety of encouraging efforts to make scientific activity more responsive to social values and to develop citizens' capacity to engage in more effective democratic governance of science. This essay introduces a special issue of the Kennedy Institute of Ethics Journal, "Science, Expertise, and Democracy," consisting of five papers that developed from the inaugural Three Rivers Philosophy conference held at the University of South Carolina in April 2011. The pieces range from a general analysis of the in-principle compatibility of scientific expertise and democracy to much more concrete studies of the intersection between scientific practices and democratic values in areas such as weight-of-evidence analysis, climate science, and studies of locally undesirable land uses.

  6. Powering Ideas through Expertise

    DEFF Research Database (Denmark)

    Seabrooke, Leonard; Wigan, Duncan

    2016-01-01

    policy. Corporate reporting for tax purposes is an area where the European Union, Organization for Economic Co-operation and Development, the United Nations, large global accountancy firms and non-governmental organizations have been active. The point of contention here is what form of financial...... reporting multinational corporations should provide to ensure they pay their fair share of tax. Ideas powered by expertise contain shared causal beliefs, as well as principled beliefs about value systems. We demonstrate that professionals can contest the established order when demonstrations of expertise...

  7. Anticorruption expertise of law-enforcement acts

    Directory of Open Access Journals (Sweden)

    Sergey B. Polyakov

    2015-12-01

    Full Text Available Objective to substantiate public necessity to define the subject methodological and organizational capabilities of anticorruption expertise of law enforcement acts. Methods universal dialecticmaterialistic method was used to study the needs in anticorruption expertise of law enforcement acts in the mechanism of legal regulation based on it general scientific and special formal legal and comparative legal methods of research used for the definition of subjectmatter of the proposed expertise. Results the value of anticorruption expertise of law enforcement was shown corruption factors and corruption indicators enabling legislation were identified ways of conducting such examinations were proposed. Scientific novelty the article examines the need and the subject proposes methods of a new type of anticorruption expertise. Practical significance the conditions of corruption are defined which are created in law enforcement activities and methods for their detection are proposed. nbsp

  8. Expertise in chess

    OpenAIRE

    Gobet, F

    2006-01-01

    This chapter provides an overview of research into chess expertise. After an historical background and a brief description of the game and the rating system, it discusses the information processes enabling players to choose good moves, and in particular the trade-offs between knowledge and search. Other topics include blindfold chess, talent, and the role of deliberate practice and tournament experience.

  9. Programs and Expertise

    CERN Document Server

    2001-01-01

    Description of programs and expertise implemented by Radiation Protection Centre is presented. RPC implements study assessing the doses received by air crew members of Lithuanian Airlines. In 2001 RPC started measurements of indoor radon concentrations in the houses of regions with karst formations, commenced new program analyzing amounts of radionuclides in typical diet of hospital patients.

  10. Thoughts on Expertise.

    Science.gov (United States)

    Glaser, Robert

    This paper briefly reviews research on tasks in knowledge-rich domains including developmental studies, work in artificial intelligence, studies of expert/novice problem solving, and information processing analysis of aptitude test tasks that have provided increased understanding of the nature of expertise. Particularly evident is the finding that…

  11. Trait-Based Cue Utilization and Initial Skill Acquisition: Implications for Models of the Progression to Expertise

    Directory of Open Access Journals (Sweden)

    Mark eWiggins

    2014-06-01

    Full Text Available The primary aim of this study was to examine the role of cue utilization in the initial acquisition of psychomotor skills. Two experiments were undertaken, the first of which examined the relationship between cue utilization typologies and levels of accuracy following four simulated, power-off landing trials in a light aircraft simulator. The results indicated that higher levels of cue utilization were associated with a greater level of landing accuracy following training exposure. In the second study, participants’ levels of cue utilization were assessed prior to two 15 minute periods during which they practiced take-offs and landings using a simulated Unmanned Aerial Vehicle (UAV. Consistent with Study 1, the outcomes of Study 2 revealed a statistically significant relationship between levels of cue utilization and the number of trials to criterion on the take-off task, and the proportion of successful trials during both take-off and landing. In combination, the results suggest that the capacity for the acquisition and the subsequent utilization of cues is an important predictor of skill acquisition, particularly during the initial stages of the process. The implications for theory and applied practice are discussed.

  12. Powering Ideas through Expertise

    DEFF Research Database (Denmark)

    Seabrooke, Leonard; Wigan, Duncan

    2016-01-01

    This contribution discusses how ideas are powered through expertise and moral authority. Professionals compete with each other to power ideas by linking claims to expertise, how things best work, to moral claims about how things should be. To show how, we draw on a case of battles over global tax...... policy. Corporate reporting for tax purposes is an area where the European Union, Organization for Economic Co-operation and Development, the United Nations, large global accountancy firms and non-governmental organizations have been active. The point of contention here is what form of financial...... can be fused with claims to moral authority. Such a constellation is more likely when political conditions are favourable....

  13. Digital gaming expertise

    DEFF Research Database (Denmark)

    Toft-Nielsen, Claus

    In a digitally saturated environment digital media users of all kinds, engaged in different areas of activity, are increasingly categorized in terms of their ability to appropriate and use digital media – they are regarded as non-users, experts, natives, or literates for instance. Within communic......In a digitally saturated environment digital media users of all kinds, engaged in different areas of activity, are increasingly categorized in terms of their ability to appropriate and use digital media – they are regarded as non-users, experts, natives, or literates for instance. Within...... communication and game studies there are multiple understandings of how digital expertise is expressed and performed, and subsequently how these expressions and performances can be valued, understood and theorized within the research community. Among other things expertise with and within digital games has......-of-game (Schrøder, 2003) in a three-year-long study of men and women (couples and singles) playing the largest Massively Multiplayer Online Role-Playing Game to date, World of Warcraft. In focusing on how different aspects of gaming expertise are articulated, negotiated, and performed, I aim to illustrate how...

  14. Reciprocal learning with task cards for teaching Basic Life Support (BLS): investigating effectiveness and the effect of instructor expertise on learning outcomes. A randomized controlled trial.

    Science.gov (United States)

    Iserbyt, Peter; Mols, Liesbet; Charlier, Nathalie; De Meester, Sophie

    2014-01-01

    Basic Life Support (BLS) education in secondary schools and universities is often neglected or outsourced because teachers indicate not feeling competent to teach this content. Investigate reciprocal learning with task cards as instructional model for teaching BLS and the effect of instructor expertise in BLS on learning outcomes. There were 175 students (mean age = 18.9 years) randomized across a reciprocal/BLS instructor (RBI) group, a reciprocal/non-BLS instructor (RNI) group, and a traditional/BLS instructor group (TBI). In the RBI and RNI group, students were taught BLS through reciprocal learning with task cards. The instructor in the RBI group was certified in BLS by the European Resuscitation Council. In the TBI, students were taught BLS by a certified instructor according to the Belgian Red Cross instructional model. Student performance was assessed 1 day (intervention) and 3 weeks after intervention (retention). At retention, significantly higher BLS performances were found in the RBI group (M = 78%), p = 0.007, ES = 0.25, and the RNI group (M = 80%), p < 0.001, Effect Size (ES) = .36, compared to the TBI (M = 73%). Significantly more students remembered and performed all BLS skills in the experimental groups at intervention and retention. No differences in BLS performance were found between the reciprocal groups. Ventilation volumes and flow rates were significantly better in the TBI at intervention and retention. Reciprocal learning with task cards is a valuable model for teaching BLS when instructors are not experienced or skilled in BLS. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Relational Expertise in Participatory Design

    DEFF Research Database (Denmark)

    Dindler, Christian; Iversen, Ole Sejer

    2014-01-01

    This paper positions relation expertise as a core competence in participatory design. It is an expertise that demands the participatory designer to stimulate the emergence of loosely coupled knotworks, and obtain symbiotic agreement between participants disregarding their professional and social...

  16. The mediatization of health expertise

    DEFF Research Database (Denmark)

    Christensen, Christa Lykke

    2016-01-01

    , the article is informed by ‘mediatization’ theory and demonstrates how television influences changes to the discursive construction of Health and health expertise in factual programming in this 20-year period. The analysis demonstrates how early factual programmes were dominated by information on illness......This article concerns the Danish public service broadcaster, Danmark Radio, and the programmes on health it produced from 1990 to 2010. It applies a historical perspective and, methodologically, the study is based on a qualitative content analysis of selected health programmes. Theoretically...

  17. Democracy and expertise

    International Nuclear Information System (INIS)

    Sundqvist, G.

    1992-01-01

    In the middle of the 1970s when Sweden had realized half of its planned nuclear power programme (six reactors of twelve), nuclear power came up on the top of the political agenda. This paper reports that the new government, who had to make the final decisions about the programme, was divided and disagreed about the future use of nuclear power. When the crucial decisions had to be made the government consulted both the expertise and the general public (in a referendum), but the outcome of these consultations were used only to legitimate the government's decisions

  18. Early Engagement of Safety and Mission Assurance Expertise Using Systems Engineering Tools: A Risk-Based Approach to Early Identification of Safety and Assurance Requirements

    Science.gov (United States)

    Darpel, Scott; Beckman, Sean

    2016-01-01

    Decades of systems engineering practice have demonstrated that the earlier the identification of requirements occurs, the lower the chance that costly redesigns will needed later in the project life cycle. A better understanding of all requirements can also improve the likelihood of a design's success. Significant effort has been put into developing tools and practices that facilitate requirements determination, including those that are part of the model-based systems engineering (MBSE) paradigm. These efforts have yielded improvements in requirements definition, but have thus far focused on a design's performance needs. The identification of safety & mission assurance (S&MA) related requirements, in comparison, can occur after preliminary designs are already established, yielding forced redesigns. Engaging S&MA expertise at an earlier stage, facilitated by the use of MBSE tools, and focused on actual project risk, can yield the same type of design life cycle improvements that have been realized in technical and performance requirements.

  19. Wine Expertise Predicts Taste Phenotype.

    Science.gov (United States)

    Hayes, John E; Pickering, Gary J

    2012-03-01

    Taste phenotypes have long been studied in relation to alcohol intake, dependence, and family history, with contradictory findings. However, on balance - with appropriate caveats about populations tested, outcomes measured and psychophysical methods used - an association between variation in taste responsiveness and some alcohol behaviors is supported. Recent work suggests super-tasting (operationalized via propylthiouracil (PROP) bitterness) not only associates with heightened response but also with more acute discrimination between stimuli. Here, we explore relationships between food and beverage adventurousness and taste phenotype. A convenience sample of wine drinkers (n=330) were recruited in Ontario and phenotyped for PROP bitterness via filter paper disk. They also filled out a short questionnaire regarding willingness to try new foods, alcoholic beverages and wines as well as level of wine involvement, which was used to classify them as a wine expert (n=110) or wine consumer (n=220). In univariate logisitic models, food adventurousness predicted trying new wines and beverages but not expertise. Likewise, wine expertise predicted willingness to try new wines and beverages but not foods. In separate multivariate logistic models, willingness to try new wines and beverages was predicted by expertise and food adventurousness but not PROP. However, mean PROP bitterness was higher among wine experts than wine consumers, and the conditional distribution functions differed between experts and consumers. In contrast, PROP means and distributions did not differ with food adventurousness. These data suggest individuals may self-select for specific professions based on sensory ability (i.e., an active gene-environment correlation) but phenotype does not explain willingness to try new stimuli.

  20. Expertise, Ethics Expertise, and Clinical Ethics Consultation: Achieving Terminological Clarity

    Science.gov (United States)

    Iltis, Ana S.; Sheehan, Mark

    2016-01-01

    The language of ethics expertise has become particularly important in bioethics in light of efforts to establish the value of the clinical ethics consultation (CEC), to specify who is qualified to function as a clinical ethics consultant, and to characterize how one should evaluate whether or not a person is so qualified. Supporters and skeptics about the possibility of ethics expertise use the language of ethics expertise in ways that reflect competing views about what ethics expertise entails. We argue for clarity in understanding the nature of expertise and ethics expertise. To be an ethics expert, we argue, is to be an expert in knowing what ought to be done. Any attempt to articulate expertise with respect to knowing what ought to be done must include an account of ethics that specifies the nature of moral truth and the means by which we access this truth or a theoretical account of ethics such that expertise in another domain is linked to knowing or being better at judging what ought to be done and the standards by which this “knowing” or “being better at judging” is determined. We conclude with a discussion of the implications of our analysis for the literature on ethics expertise in CEC. We do think that there are clear domains in which a clinical ethics consultant might be expert but we are skeptical about the possibility that this includes ethics expertise. Clinical ethics consultants should not be referred to as ethics experts. PMID:27256848

  1. Student Perceptions of Facilitators' Social Congruence, Use of Expertise and Cognitive Congruence in Problem-Based Learning

    Science.gov (United States)

    Yew, Elaine H. J.; Yong, Janice J. Y.

    2014-01-01

    In problem-based learning (PBL), the role of a tutor or facilitator is different from what is typically considered as the role of a traditional teacher. In addition to being a subject-matter expert, the facilitator is also expected to be "socially" and "cognitively congruent". In this study, we analyze the survey responses from…

  2. Utilization of lunar materials and expertise for large scale operations in space: Abstracts. [lunar bases and space industrialization

    Science.gov (United States)

    Criswell, D. R. (Editor)

    1976-01-01

    The practicality of exploiting the moon, not only as a source of materials for large habitable structures at Lagrangian points, but also as a base for colonization is discussed in abstracts of papers presented at a special session on lunar utilization. Questions and answers which followed each presentation are included after the appropriate abstract. Author and subject indexes are provided.

  3. In Transition towards Sustainability: Bridging the Business and Education Sectors of Regional Centre of Expertise Greater Sendai Using Education for Sustainable Development-Based Social Learning

    Directory of Open Access Journals (Sweden)

    Paul Ofei-Manu

    2012-07-01

    Full Text Available This article discusses a business-school collaborative learning partnership in the Regional Centre of Expertise (RCE on Education for Sustainable Development (ESD in Greater Sendai. This partnership is further linked to a broader context of multi-stakeholder public participation in the RCE that was set up to advance the ESD agenda in the region. The authors propose a conceptual framework for multi-stakeholder, ESD-based social learning within the RCE with the aim of enabling the creation of a sustainability-literate society. This proposal is based on the results of students’ prior experience in ESD activities, optimal age for ESD learning and future job choices presented in this paper, together with a reported article that the levels of sustainability of the two sectoral organizations were mixed and hence need improvement. The paper argues that it will be good to focus on bridging the business and education sectors by building ESD capacity of the children and youth in the formal education sector. It contends this could be done through collaborative learning using the government-mandated “Period of Integrated Studies” (PIS in the Japanese primary and secondary school curriculum. Additionally, it will be appropriate for the RCE Greater Sendai Steering Committee to facilitate and coordinate the learning processes and also promote networking and cooperative interactions among the actors and stakeholders in the region. Recommendations for improvement of the learning partnerships in RCE Greater Sendai are made for consideration at the local and national policy levels.

  4. Expertise and Intuitions about Reference

    Directory of Open Access Journals (Sweden)

    Edouard Machery

    2012-01-01

    Full Text Available Many philosophers hold that experts’ semantic intuitions are more reliable and provide better evidence than lay people’s intuitions—a thesis commonly called “the Expertise Defense.” Focusing on the intuitions about the reference of proper names, this article critically assesses the Expertise Defense.

  5. From Formal Expertise to Co-expertise: Experience in the Field of Protection against Radiation

    International Nuclear Information System (INIS)

    Lochard, Jacques

    2002-01-01

    As a result of the growing difficulties confronting the heads of public and private high-risk activities, expertise practices have changed radically over the past years in the areas of risk assessment and management. In answer to the erosion of the credibility and legitimacy of traditional 'scientific' expertise, new forms of expertise based on citizen participation have emerged, particularly in fields involving public trust. The author's aim is to analyse the main changes in the field of radiological protection, on the basis of his 25 years of experience in the field. In conclusion, the author discusses the independence of expert assessment, an issue central to the present debate on the organization and practice of expertise in the field of high-risk activities

  6. A new rejection of moral expertise.

    Science.gov (United States)

    Cowley, Christopher

    2005-01-01

    There seem to be two clearly-defined camps in the debate over the problem of moral expertise. On the one hand are the "Professionals", who reject the possibility entirely, usually because of the intractable diversity of ethical beliefs. On the other hand are the "Ethicists", who criticise the Professionals for merely stipulating science as the most appropriate paradigm for discussions of expertise. While the subject matter and methodology of good ethical thinking is certainly different from that of good clinical thinking, they argue, this is no reason for rejecting the possibility of a distinctive kind of expertise in ethics, usually based on the idea of good justification. I want to argue that both are incorrect, partly because of the reasons given by one group against the other, but more importantly because both neglect what is most distinctive about ethics: that it is personal in a very specific way, without collapsing into relativism.

  7. The politics of expertise in participatory forestry

    DEFF Research Database (Denmark)

    Green, Kathryn E.; Lund, Jens Friis

    2015-01-01

    In this paper, we show how the framing of a community-based forest management (CBFM) intervention implies the professionalization of forest management and the privileging of certain forms of knowledge in a village in Tanzania. We describe how the framing of CBFM in technical and procedural terms......, and the subsequent construction of expertise by implementers through training, combine with existing signifiers of social stratification to shape struggles over participation and access to benefits from forest use and management. We also describe how the perceived necessity of expertise is not questioned by village...

  8. Classroom Application of a Trial-Based Functional Analysis

    Science.gov (United States)

    Bloom, Sarah E.; Iwata, Brian A.; Fritz, Jennifer N.; Roscoe, Eileen M.; Carreau, Abbey B.

    2011-01-01

    We evaluated a trial-based approach to conducting functional analyses in classroom settings. Ten students referred for problem behavior were exposed to a series of assessment trials, which were interspersed among classroom activities throughout the day. Results of these trial-based functional analyses were compared to those of more traditional…

  9. Smart grids - French Expertise

    International Nuclear Information System (INIS)

    2015-11-01

    The adaptation of electrical systems is the focus of major work worldwide. Bringing electricity to new territories, modernizing existing electricity grids, implementing energy efficiency policies and deploying renewable energies, developing new uses for electricity, introducing electric vehicles - these are the challenges facing a multitude of regions and countries. Smart Grids are the result of the convergence of electrical systems technologies with information and communications technologies. They play a key role in addressing the above challenges. Smart Grid development is a major priority for both public and private-sector actors in France. The experience of French companies has grown with the current French electricity system, a system that already shows extensive levels of 'intelligence', efficiency and competitiveness. French expertise also leverages substantial competence in terms of 'systems engineering', and can provide a tailored response to meet all sorts of needs. French products and services span all the technical and commercial building blocks that make up the Smart Grid value chain. They address the following issues: Improving the use and valuation of renewable energies and decentralized means of production, by optimizing the balance between generation and consumption. Strengthening the intelligence of the transmission and distribution grids: developing 'Supergrid', digitizing substations in transmission networks, and automating the distribution grids are the focus of a great many projects designed to reinforce the 'self-healing' capacity of the grid. Improving the valuation of decentralized flexibilities: this involves, among others, deploying smart meters, reinforcing active energy efficiency measures, and boosting consumers' contribution to grid balancing, via practices such as demand response which implies the aggregation of flexibility among residential, business, and/or industrial sites. Addressing current technological challenges, in

  10. Expertise in physiological breech birth: A mixed-methods study.

    Science.gov (United States)

    Walker, Shawn; Parker, Pam; Scamell, Mandie

    2018-06-01

    The safety of vaginal breech birth depends on the expertise of birth attendants, yet the meaning of "expertise" remains unclear and subjectively defined. The objective of this study was to define expertise and the roles experts may play in expanding access to this service. We performed an integrative analysis of two strands of data concerning expertise in physiological breech birth, including the following: survey data from a Delphi study involving 26 very experienced clinicians (mean experience = 135 breech births) and 2 service user representatives, and interviews from a grounded theory study of 14 clinicians more moderately experienced with physiological methods (5-30 upright breech births). Data were pooled and analyzed using constant comparative methods. Expertise is defined by its ongoing function, the generation of comparatively good outcomes, and confidence and competence among colleagues. Although clinical experience is important, expertise is developed and expressed in social clinical roles, which expand as experience grows: clinician, mentor, specialist, and expert. To develop expertise within a service, clinicians who have an interest in breech birth should be supported to perform these roles within specialist teams. Specialist breech teams may facilitate the development of expertise within maternity care settings. Evaluation of expertise based on enablement of women and colleagues, as well as outcomes, will potentially avoid the pitfalls of alienation produced by some forms of specialist authority. © 2017 Wiley Periodicals, Inc.

  11. Assessing Expertise in Introductory Physics Using Categorization Task

    Science.gov (United States)

    Mason, Andrew; Singh, Chandralekha

    2011-01-01

    The ability to categorize problems based upon underlying principles, rather than surface features or contexts, is considered one of several proxy predictors of expertise in problem solving. With inspiration from the classic study by Chi, Feltovich, and Glaser, we assess the distribution of expertise among introductory physics students by asking…

  12. Prescribing safety, negotiating expertise. Building of nuclear safety human factors expertise

    International Nuclear Information System (INIS)

    Rolina, Gregory

    2008-01-01

    This Ph.D thesis is dedicated to a specific type of expertise, the safety of nuclear installations in the field of human and organisational factors. Empirical work is at the foundation of this thesis: the monitoring of experts 'in action', allowed a detailed reconstruction of three cases they were examining. The analysis, at the core of which lies the definition of what an efficient expertise can be, emphasizes the incompleteness of the knowledge that links together the nuclear facilities' organisational characteristics and their safety. This leads us to identify the expert's three ranges of actions (rhetorical, cognitive, operative). Defined from objectives and constraints likely to influence the expert's behaviour, those three ranges each require specific skills. A conception of expertise based on these ranges seems adaptable to other sectors and allows an enrichment of models of expertise cited in literature. Historical elements from French institutions of nuclear safety are also called upon to take into consideration some of the determinants of the expertise; its efficiency relies on the upholding of a continuous dialogue between the regulators (the experts and the control authority) and the regulated (the operators). This type of historically inherited regulation makes up a specificity of the French system of external control of nuclear risks. (author) [fr

  13. IRSN's expertise about nuclear medicine hospital effluents

    International Nuclear Information System (INIS)

    2009-01-01

    This brief note aims at presenting the radioactivity follow up of hospital effluents performed by the French Institute of Radiation Protection and Nuclear Safety (IRSN). This follow up concerns the radioactive compounds and radiopharmaceuticals used in nuclear medicine, and principally technetium 99 and iodine 131. The IRSN has developed a network of remote measurement systems for the monitoring of sewers and waste water cleaning facilities. Data are compiled in a data base for analysis and subsequent expertise. (J.S.)

  14. Understanding Expertise from Elite Badminton Coaches

    Science.gov (United States)

    Sheu, Feng-Ru

    2011-01-01

    Badminton is a growing sport with a limited amount of expertise both in players and coaches so attempts are being made to extend the expertise internationally. The purpose of this study is to gain an understanding of coaching expertise in badminton because such an understanding might have implications for a more general understanding of expertise,…

  15. Rethinking global health research: towards integrative expertise

    Directory of Open Access Journals (Sweden)

    MacLachlan Malcolm

    2009-07-01

    Full Text Available Abstract The Bamako Call for Action on Research for Health stresses the importance of inter-disciplinary, inter-ministerial and inter-sectoral working. This challenges much of our current research and postgraduate research training in health, which mostly seeks to produce narrowly focused content specialists. We now need to compliment this type of research and research training, by offering alternative pathways that seek to create expertise, not only in specific narrow content areas, but also in the process and context of research, as well as in the interaction of these different facets of knowledge. Such an approach, developing 'integrative expertise', could greatly facilitate better research utilisation, helping policy makers and practitioners work through more evidence-based practice and across traditional research boundaries.

  16. Digital Student Expertise in the Making

    DEFF Research Database (Denmark)

    Stenbøg, Sofie

    student (e.g. Bennett et. al. 2008, Helsper & Eynon 2009). In this paper I go beyond the idea of digital expertise as something intrinsic. Building on STS’s central notion of performativity (e.g. Law & Singleton 2000) the paper argues that digital expertise should be studied as a temporary achievement......Digital Natives, iGens’ or New Millennium Learners (Prensky 2001, Raphelson 2014, OECD 2008). There are many labels for the generation of young (western) citizens who have grown up with digital, web based technologies as a crucial part of their everyday life. This genera-tion now inhabits schools...... all around the world and their entry has not escaped the attention from teachers, school managers and policy makers. A current trend within education management, in Denmark as well as internationally, is to incorporate the students’ digital skills or ‘expertise’ as a resource in teaching, e.g. through...

  17. A data grid for imaging-based clinical trials

    Science.gov (United States)

    Zhou, Zheng; Chao, Sander S.; Lee, Jasper; Liu, Brent; Documet, Jorge; Huang, H. K.

    2007-03-01

    Clinical trials play a crucial role in testing new drugs or devices in modern medicine. Medical imaging has also become an important tool in clinical trials because images provide a unique and fast diagnosis with visual observation and quantitative assessment. A typical imaging-based clinical trial consists of: 1) A well-defined rigorous clinical trial protocol, 2) a radiology core that has a quality control mechanism, a biostatistics component, and a server for storing and distributing data and analysis results; and 3) many field sites that generate and send image studies to the radiology core. As the number of clinical trials increases, it becomes a challenge for a radiology core servicing multiple trials to have a server robust enough to administrate and quickly distribute information to participating radiologists/clinicians worldwide. The Data Grid can satisfy the aforementioned requirements of imaging based clinical trials. In this paper, we present a Data Grid architecture for imaging-based clinical trials. A Data Grid prototype has been implemented in the Image Processing and Informatics (IPI) Laboratory at the University of Southern California to test and evaluate performance in storing trial images and analysis results for a clinical trial. The implementation methodology and evaluation protocol of the Data Grid are presented.

  18. Beyond Faces and Expertise: Facelike Holistic Processing of Nonface Objects in the Absence of Expertise.

    Science.gov (United States)

    Zhao, Mintao; Bülthoff, Heinrich H; Bülthoff, Isabelle

    2016-02-01

    Holistic processing-the tendency to perceive objects as indecomposable wholes-has long been viewed as a process specific to faces or objects of expertise. Although current theories differ in what causes holistic processing, they share a fundamental constraint for its generalization: Nonface objects cannot elicit facelike holistic processing in the absence of expertise. Contrary to this prevailing view, here we show that line patterns with salient Gestalt information (i.e., connectedness, closure, and continuity between parts) can be processed as holistically as faces without any training. Moreover, weakening the saliency of Gestalt information in these patterns reduced holistic processing of them, which indicates that Gestalt information plays a crucial role in holistic processing. Therefore, holistic processing can be achieved not only via a top-down route based on expertise, but also via a bottom-up route relying merely on object-based information. The finding that facelike holistic processing can extend beyond the domains of faces and objects of expertise poses a challenge to current dominant theories. © The Author(s) 2015.

  19. E-expertise modern collective intelligence

    CERN Document Server

    Gubanov, Dmitry; Novikov, Dmitry; Raikov, Alexander

    2014-01-01

      This book focuses on organization and mechanisms of expert decision-making support using modern information and communication technologies, as well as information analysis and collective intelligence technologies (electronic expertise or simply e-expertise). Chapter 1 (E-Expertise) discusses the role of e-expertise in decision-making processes. The procedures of e-expertise are classified, their benefits and shortcomings are identified, and the efficiency conditions are considered. Chapter 2 (Expert Technologies and Principles) provides a comprehensive overview of modern expert technologies. A special emphasis is placed on the specifics of e-expertise. Moreover, the authors study the feasibility and reasonability of employing well-known methods and approaches in e-expertise. Chapter 3 (E-Expertise: Organization and Technologies) describes some examples of up-to-date technologies to perform e-expertise. Chapter 4 (Trust Networks and Competence Networks) deals with the problems of expert finding and grouping...

  20. Implementing a low-cost web-based clinical trial management system for community studies: a case study.

    Science.gov (United States)

    Geyer, John; Myers, Kathleen; Vander Stoep, Ann; McCarty, Carolyn; Palmer, Nancy; DeSalvo, Amy

    2011-10-01

    Clinical trials with multiple intervention locations and a single research coordinating center can be logistically difficult to implement. Increasingly, web-based systems are used to provide clinical trial support with many commercial, open source, and proprietary systems in use. New web-based tools are available which can be customized without programming expertise to deliver web-based clinical trial management and data collection functions. To demonstrate the feasibility of utilizing low-cost configurable applications to create a customized web-based data collection and study management system for a five intervention site randomized clinical trial establishing the efficacy of providing evidence-based treatment via teleconferencing to children with attention-deficit hyperactivity disorder. The sites are small communities that would not usually be included in traditional randomized trials. A major goal was to develop database that participants could access from computers in their home communities for direct data entry. Discussed is the selection process leading to the identification and utilization of a cost-effective and user-friendly set of tools capable of customization for data collection and study management tasks. An online assessment collection application, template-based web portal creation application, and web-accessible Access 2007 database were selected and customized to provide the following features: schedule appointments, administer and monitor online secure assessments, issue subject incentives, and securely transmit electronic documents between sites. Each tool was configured by users with limited programming expertise. As of June 2011, the system has successfully been used with 125 participants in 5 communities, who have completed 536 sets of assessment questionnaires, 8 community therapists, and 11 research staff at the research coordinating center. Total automation of processes is not possible with the current set of tools as each is loosely

  1. Expertise synthesis on the CSPE

    International Nuclear Information System (INIS)

    Blonde, G.; Poizat, F.

    2008-01-01

    This document presents a synthesis of the results of an expertise realized on the CSPE, the compensation tax of the electric public service. This tax concerns the management of the electricity production additional costs in isolated areas, the solidarity, a policy to favor the energy efficiency and the renewable energies. The document explains the historical aspects of the tax elaboration, its financial importance, the consequences and the impacts on the competition. (A.L.B.)

  2. Segmentation of dance movement: Effects of expertise, visual familiarity, motor experience and music

    Directory of Open Access Journals (Sweden)

    Bettina E. Bläsing

    2015-01-01

    Full Text Available According to event segmentation theory, action perception depends on sensory cues and prior knowledge, and the segmentation of observed actions is crucial for understanding and memorizing these actions. While most activities in everyday life are characterized by external goals and interaction with objects or persons, this does not necessarily apply to dance-like actions. We investigated to what extent visual familiarity of the observed movement and accompanying music influence the segmentation of a dance phrase in dancers of different skill level and non-dancers. In Experiment 1, dancers and non-dancers repeatedly watched a video clip showing a dancer performing a choreographed dance phrase and indicated segment boundaries by key press. Dancers generally defined less segment boundaries than non-dancers, specifically in the first trials in which visual familiarity with the phrase was low. Music increased the number of segment boundaries in the non-dancers and decreased it in the dancers. The results suggest that dance expertise reduces the number of perceived segment boundaries in an observed dance phrase, and that the ways visual familiarity and music affect movement segmentation are modulated by dance expertise. In a second experiment, motor experience was added as factor, based on empirical evidence suggesting that action perception is modified by visual and motor expertise in different ways. In Experiment 2, the same task as in Experiment 1 was performed by dance amateurs, and was repeated by the same participants after they had learned to dance the presented dance phrase. Less segment boundaries were defined in the middle trials after participants had learned to dance the phrase, and music reduced the number of segment boundaries before learning. The results suggest that specific motor experience of the observed movement influences its perception and anticipation and makes segmentation broader, but not to the same degree as dance expertise

  3. From deep to superficial categorization with increasing expertise.

    OpenAIRE

    Ormerod, Thomas C.; Fritz, Catherine O.; Ridgway, James

    1999-01-01

    An experimental study of task design expertise is reported wherein a set of 12 mathematics tasks were sorted by specialist designers of mathematics tasks and by experienced mathematics teachers without specialist design experience. Contrary to the frequent finding of increasing conceptual depth with increasing expertise, conceptual depth did not differ between groups. Teachers sorted on the basis of mathematical content earlier than designers, and were more specific in their content-based cat...

  4. Trial-Based Functional Analysis Informs Treatment for Vocal Scripting.

    Science.gov (United States)

    Rispoli, Mandy; Brodhead, Matthew; Wolfe, Katie; Gregori, Emily

    2018-05-01

    Research on trial-based functional analysis has primarily focused on socially maintained challenging behaviors. However, procedural modifications may be necessary to clarify ambiguous assessment results. The purposes of this study were to evaluate the utility of iterative modifications to trial-based functional analysis on the identification of putative reinforcement and subsequent treatment for vocal scripting. For all participants, modifications to the trial-based functional analysis identified a primary function of automatic reinforcement. The structure of the trial-based format led to identification of social attention as an abolishing operation for vocal scripting. A noncontingent attention treatment was evaluated using withdrawal designs for each participant. This noncontingent attention treatment resulted in near zero levels of vocal scripting for all participants. Implications for research and practice are presented.

  5. 40 CFR 1508.26 - Special expertise.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Special expertise. 1508.26 Section 1508.26 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY TERMINOLOGY AND INDEX § 1508.26 Special expertise. Special expertise means statutory responsibility, agency mission, or related program...

  6. Adults' and Children's Understanding of How Expertise Influences Learning.

    Science.gov (United States)

    Danovitch, Judith H; Shenouda, Christine K

    2018-01-01

    Adults and children use information about expertise to infer what a person is likely to know, but it is unclear whether they realize that expertise also has implications for learning. We explore adults' and children's understanding that expertise in a particular category supports learning about a closely related category. In four experiments, 5-year-olds and adults (n = 160) judged which of two people would be better at learning about a new category. When faced with an expert and a nonexpert, adults consistently indicated that expertise supports learning in a closely related category; however, children's judgments were inconsistent and were strongly influenced by the description of the nonexpert. The results suggest that although children understand what it means to be an expert, they may judge an individual's learning capacity based on different considerations than adults.

  7. Smart blood cell and microvesicle-based Trojan horse drug delivery: Merging expertise in blood transfusion and biomedical engineering in the field of nanomedicine.

    Science.gov (United States)

    Wu, Yu-Wen; Goubran, Hadi; Seghatchian, Jerard; Burnouf, Thierry

    2016-04-01

    Therapeutic and diagnostic applications of nanomedicine are playing increasingly important roles in human health. Various types of synthetic nanoparticles, including liposomes, micelles, and other nanotherapeutic platforms and conjugates, are being engineered to encapsulate or carry drugs for treating diseases such as cancer, cardiovascular disorders, neurodegeneration, and inflammations. Nanocarriers are designed to increase the half-life of drugs, decrease their toxicity and, ideally, target pathological sites. Developing smart carriers with the capacity to deliver drugs specifically to the microenvironment of diseased cells with minimum systemic toxicity is the goal. Blood cells, and potentially also the liposome-like micro- and nano-vesicles they generate, may be regarded as ideally suited to perform such specific targeting with minimum immunogenic risks. Blood cell membranes are "decorated" with complex physiological receptors capable of targeting and communicating with other cells and tissues and delivering their content to the surrounding pathological microenvironment. Blood cells, such as erythrocytes, have been developed as permeable carriers to release drugs to diseased tissues or act as biofactory allowing enzymatic degradation of a pathological substrate. Interestingly, attempts are also being made to improve the targeting capacity of synthetic nanoparticles by "decorating" their surface with blood cell membrane receptor-like biochemical structures. Research is needed to further explore the benefits that blood cell-derived microvesicles, as a Trojan horse delivery systems, can bring to the arsenal of therapeutic micro- and nanotechnologies. This short review focuses on the therapeutic roles that red blood cells and platelets can play as smart drug-delivery systems, and highlights the benefits that blood transfusion expertise can bring to this exciting and novel biomedical engineering field. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Communication is the key to success in pragmatic clinical trials in Practice-based Research Networks (PBRNs).

    Science.gov (United States)

    Bertram, Susan; Graham, Deborah; Kurland, Marge; Pace, Wilson; Madison, Suzanne; Yawn, Barbara P

    2013-01-01

    Effective communication is the foundation of feasibility and fidelity in practice-based pragmatic research studies. Doing a study with practices spread over several states requires long-distance communication strategies, including E-mails, faxes, telephone calls, conference calls, and texting. Compared with face-to-face communication, distance communication strategies are less familiar to most study coordinators and research teams. Developing and ensuring comfort with distance communications requires additional time and use of different talents and expertise than those required for face-to-face communication. It is necessary to make sure that messages are appropriate for the medium, clearly crafted, and presented in a manner that facilitates practices receiving and understanding the information. This discussion is based on extensive experience of 2 groups who have worked collaboratively on several large, federally funded, pragmatic trials in a practice-based research network. The goal of this article is to summarize lessons learned to facilitate the work of other research teams.

  9. Developing the experts we need: Fostering adaptive expertise through education.

    Science.gov (United States)

    Mylopoulos, Maria; Kulasegaram, Kulamakan; Woods, Nicole N

    2018-03-08

    In this era of increasing complexity, there is a growing gap between what we need our medical experts to do and the training we provide them. While medical education has a long history of being guided by theories of expertise to inform curriculum design and implementation, the theories that currently underpin our educational programs do not account for the expertise necessary for excellence in the changing health care context. The more comprehensive view of expertise gained by research on both clinical reasoning and adaptive expertise provides a useful framing for re-shaping physician education, placing emphasis on the training of clinicians who will be adaptive experts. That is, have both the ability to apply their extensive knowledge base as well as create new knowledge as dictated by patient needs and context. Three key educational approaches have been shown to foster the development of adaptive expertise: learning that emphasizes understanding, providing students with opportunities to embrace struggle and discovery in their learning, and maximizing variation in the teaching of clinical concepts. There is solid evidence that a commitment to these educational approaches can help medical educators to set trainees on the path towards adaptive expertise. © 2018 John Wiley & Sons, Ltd.

  10. A web-based endpoint adjudication system for interim analyses in clinical trials.

    Science.gov (United States)

    Nolen, Tracy L; Dimmick, Bill F; Ostrosky-Zeichner, Luis; Kendrick, Amy S; Sable, Carole; Ngai, Angela; Wallace, Dennis

    2009-02-01

    A data monitoring committee (DMC) is often employed to assess trial progress and review safety data and efficacy endpoints throughout a trail. Interim analyses performed for the DMC should use data that are as complete and verified as possible. Such analyses are complicated when data verification involves subjective study endpoints or requires clinical expertise to determine each subject's status with respect to the study endpoint. Therefore, procedures are needed to obtain adjudicated data for interim analyses in an efficient manner. In the past, methods for handling such data included using locally reported results as surrogate endpoints, adjusting analysis methods for unadjudicated data, or simply performing the adjudication as rapidly as possible. These methods all have inadequacies that make their sole usage suboptimal. For a study of prophylaxis for invasive candidiasis, adjudication of both study eligibility criteria and clinical endpoints prior to two interim analyses was required. Because the study was expected to enroll at a moderate rate and the sponsor required adjudicated endpoints to be used for interim analyses, an efficient process for adjudication was required. We created a web-based endpoint adjudication system (WebEAS) that allows for expedited review by the endpoint adjudication committee (EAC). This system automatically identifies when a subject's data are complete, creates a subject profile from the study data, and assigns EAC reviewers. The reviewers use the WebEAS to review the subject profile and submit their completed review form. The WebEAS then compares the reviews, assigns an additional review as a tiebreaker if needed, and stores the adjudicated data. The study for which this system was originally built was administratively closed after 10 months with only 38 subjects enrolled. The adjudication process was finalized and the WebEAS system activated prior to study closure. Some website accessibility issues presented initially. However

  11. Perceptual learning and human expertise.

    Science.gov (United States)

    Kellman, Philip J; Garrigan, Patrick

    2009-06-01

    We consider perceptual learning: experience-induced changes in the way perceivers extract information. Often neglected in scientific accounts of learning and in instruction, perceptual learning is a fundamental contributor to human expertise and is crucial in domains where humans show remarkable levels of attainment, such as language, chess, music, and mathematics. In Section 2, we give a brief history and discuss the relation of perceptual learning to other forms of learning. We consider in Section 3 several specific phenomena, illustrating the scope and characteristics of perceptual learning, including both discovery and fluency effects. We describe abstract perceptual learning, in which structural relationships are discovered and recognized in novel instances that do not share constituent elements or basic features. In Section 4, we consider primary concepts that have been used to explain and model perceptual learning, including receptive field change, selection, and relational recoding. In Section 5, we consider the scope of perceptual learning, contrasting recent research, focused on simple sensory discriminations, with earlier work that emphasized extraction of invariance from varied instances in more complex tasks. Contrary to some recent views, we argue that perceptual learning should not be confined to changes in early sensory analyzers. Phenomena at various levels, we suggest, can be unified by models that emphasize discovery and selection of relevant information. In a final section, we consider the potential role of perceptual learning in educational settings. Most instruction emphasizes facts and procedures that can be verbalized, whereas expertise depends heavily on implicit pattern recognition and selective extraction skills acquired through perceptual learning. We consider reasons why perceptual learning has not been systematically addressed in traditional instruction, and we describe recent successful efforts to create a technology of perceptual

  12. Perceptual learning and human expertise

    Science.gov (United States)

    Kellman, Philip J.; Garrigan, Patrick

    2009-06-01

    We consider perceptual learning: experience-induced changes in the way perceivers extract information. Often neglected in scientific accounts of learning and in instruction, perceptual learning is a fundamental contributor to human expertise and is crucial in domains where humans show remarkable levels of attainment, such as language, chess, music, and mathematics. In Section 2, we give a brief history and discuss the relation of perceptual learning to other forms of learning. We consider in Section 3 several specific phenomena, illustrating the scope and characteristics of perceptual learning, including both discovery and fluency effects. We describe abstract perceptual learning, in which structural relationships are discovered and recognized in novel instances that do not share constituent elements or basic features. In Section 4, we consider primary concepts that have been used to explain and model perceptual learning, including receptive field change, selection, and relational recoding. In Section 5, we consider the scope of perceptual learning, contrasting recent research, focused on simple sensory discriminations, with earlier work that emphasized extraction of invariance from varied instances in more complex tasks. Contrary to some recent views, we argue that perceptual learning should not be confined to changes in early sensory analyzers. Phenomena at various levels, we suggest, can be unified by models that emphasize discovery and selection of relevant information. In a final section, we consider the potential role of perceptual learning in educational settings. Most instruction emphasizes facts and procedures that can be verbalized, whereas expertise depends heavily on implicit pattern recognition and selective extraction skills acquired through perceptual learning. We consider reasons why perceptual learning has not been systematically addressed in traditional instruction, and we describe recent successful efforts to create a technology of perceptual

  13. The unrivalled expertise for Pu recycling

    International Nuclear Information System (INIS)

    Fournier, W.; Pouilloux, M.

    1997-01-01

    Relying on the outstanding performances of the reprocessing facilities and the growing fabrication facilities, the in-reactor Pu recycling program in France and in other European countries is steadily implemented and has reached full-scale industrial operation. The RCR strategy -Reprocessing, Conditioning and Recycling- developed by COGEMA is now a well proven industrial reality. In 1997, plutonium recycling through MOX fuel is a mature industry, with successful operational experience and large-scale fabrication plants. In this field, COGEMA is the main actor, on operating simultaneously three complete multidesign fuel production plants: MELOX plant (in Marcoule), CADARACHE plant and DESSEL plant (in Belgium). Present MOX production capacity available to COGEMA fits 175 tHM per year and will be extended to reach about 325 tHM in the year 2000, that will represent 75% of the total MOX fabrication capacity in Europe. The industrial mastery and the high production level in MOX production assured by high technology processes confers COGEMA an unrivalled expertise for Pu recycling. This allows COGEMA to be a major actor in Pu-based fuels in the coming second nuclear era with advanced fuel cycles. The paper depicts the steps of the progressive advance of COGEMA to reach the Pu recycling expertise. (author)

  14. Studying Real-World Perceptual Expertise

    Directory of Open Access Journals (Sweden)

    Jianhong eShen

    2014-08-01

    Full Text Available Significant insights into visual cognition have come from studying real-world perceptual expertise. Many have previously reviewed empirical findings and theoretical developments from this work. Here we instead provide a brief perspective on approaches, considerations, and challenges to studying real-world perceptual expertise. We discuss factors like choosing to use real-world versus artificial object domains of expertise, selecting a target domain of real-world perceptual expertise, recruiting experts, evaluating their level of expertise, and experimentally testing experts in the lab and online. Throughout our perspective, we highlight expert birding (also called birdwatching as an example, as it has been used as a target domain for over two decades in the perceptual expertise literature.

  15. Musical expertise and second language learning.

    Science.gov (United States)

    Chobert, Julie; Besson, Mireille

    2013-06-06

    Increasing evidence suggests that musical expertise influences brain organization and brain functions. Moreover, results at the behavioral and neurophysiological levels reveal that musical expertise positively influences several aspects of speech processing, from auditory perception to speech production. In this review, we focus on the main results of the literature that led to the idea that musical expertise may benefit second language acquisition. We discuss several interpretations that may account for the influence of musical expertise on speech processing in native and foreign languages, and we propose new directions for future research.

  16. [Traumatic brain injuries--forensic and expertise aspects].

    Science.gov (United States)

    Vuleković, Petar; Simić, Milan; Misić-Pavkov, Gordana; Cigić, Tomislav; Kojadinović, Zeljko; Dilvesi, Dula

    2008-01-01

    Traumatic brain injuries have major socio-economic importance due to their frequency, high mortality and serious consequences. According to their nature the consequences of these injuries may be classified as neurological, psychiatric and esthetic. Various lesions of brain structures cause neurological consequences such as disturbance of motor functions, sensibility, coordination or involuntary movements, speech disturbances and other deviations, as well as epilepsy. Psychiatric consequences include cognitive deficit, emotional disturbances and behavior disturbances. CRIMINAL-LEGAL ASPECT OF TRAUMATIC BRAIN INJURIES AND LITIGATION: Criminal-legal aspect of traumatic brain injuries expertise understands the qualification of these injuries as mild, serious and qualified serious body injuries as well as the expertise about the mechanisms of their occurrence. Litigation expertise includes the estimation of pain, fear, diminished, i.e. lost vital activity and disability, esthetic marring, and psychological suffer based on the diminished general vital activity and esthetic marring. Evaluation of consequences of traumatic brain injuries should be performed only when it can be positively confirmed that they are permanent, i.e. at least one year after the injury. Expertise of these injuries is interdisciplinary. Among clinical doctors the most competent medical expert is the one who is in charge for diagnostics and injury treatment, with the recommendation to avoid, if possible, the doctor who conducted treatment. For the estimation of general vital activity, the neurological consequences, pain and esthetic marring expertise, the most competent doctors are neurosurgeon and neurologist. Psychological psychiatric consequences and fear expertise have to be performed by the psychiatrist. Specialists of forensic medicine contribute with knowledge of criminal low and legal expertise.

  17. Does tutor subject-matter expertise influence student achievement in ...

    African Journals Online (AJOL)

    Objective. To establish whether or not tutor subject-matter expertise influences student achievement in content-based examinations in the problem-based learning (PBL) curriculum at the University of Transkei (UNITRA) Medical School. Design. A retrospective study of MB ChB III student achievement in end-of-block ...

  18. Designing Education for Professional Expertise Development

    Science.gov (United States)

    Elvira, Quincy; Imants, Jeroen; Dankbaar, Ben; Segers, Mien

    2017-01-01

    How to facilitate learning by novices (students) on their road to expertise has attracted the attention of a vast number of researchers in cognitive and educational psychology as well in the field of learning and instruction. Although many studies have investigated the phenomenon of expertise development, the implications of the findings for…

  19. The Interaction Effects of Working Memory Capacity, Gaming Expertise, and Scaffolding Design on Attention and Comprehension in Digital Game Based Learning

    Science.gov (United States)

    Lee, Yu-Hao

    2013-01-01

    Educational digital games are often complex problem-solving experiences that can facilitate systematic comprehension. However, empirical studies of digital game based learning (DGBL) have found mixed results regarding DGBL's effect in improving comprehension. While learners generally enjoyed the DGBL learning experience, they often failed to…

  20. An Expert Instructor's Use of Social Congruence, Cognitive Congruence, and Expertise in an Online Case-Based Instructional Design Course

    Science.gov (United States)

    Watson, Sunnie Lee; Koehler, Adrie A.; Ertmer, Peggy; Kim, WooRi; Rico, Rudy

    2018-01-01

    Promoting and sustaining effective discussion--that which contributes to learning--is a skill that eludes many instructors (Darling-Hammond, 2008; Ge, Yamashiro, & Lee, 2000). This study explored the role and strategies of an expert instructor in an online advanced instructional design (ID) course that utilized a case-based learning (CBL)…

  1. Should We Value Knowledge and Expertise? (editorial

    Directory of Open Access Journals (Sweden)

    Denise Koufogiannakis

    2011-09-01

    Full Text Available As I write this editorial, I am on an airplane, reflecting on the EBLIP6 conference, held June 27-30, 2011 in Salford, U.K. In my personal opinion, the conference was a great success. There were a wide variety of concurrent paper sessions from an international group of delegates, thought provoking keynotes, and just the right amount of social activity, including the main conference dinner at the Manchester United Football Club! This journal will have a Feature section in our next issue (December that highlights the conference, including keynote presentations, some of the papers that were presented, and commentaries from attendees about the conference itself. So for now, I’ll just offer my warmest congratulations to the organizers.As I left Salford and tried to reflect on what I had learned and discussed with others, there were many things that came to mind. Immediate things that stood out for me had to do with impact, reflection, and the complexity of decision making. The theme of EBLIP6 was “Valuing Knowledge and Expertise”. This is a somewhat controversial theme for an evidence based practice conference, where research evidence and its implementation are the focus, and expert opinion is not generally held in high regard. None of the keynote speakers’ presentations spoke directly to the theme, however several paper presentations did include some reference to the importance of professional knowledge.Expertise is a loaded word, filled with notions of snobbery and over-confidence, even close-mindedness. If anything, those involved with EBLIP remove themselves as far from the notion of “expert” as they can. But if we consider an expert to be someone who has built up a significant amount of professional knowledge (both through experience and research on a topic, then the EBLIP movement should not simply dismiss this notion of “expert”. Perhaps, we more appropriately should consider expert voices (knowledgeable, reasonable

  2. Embracing model-based designs for dose-finding trials.

    Science.gov (United States)

    Love, Sharon B; Brown, Sarah; Weir, Christopher J; Harbron, Chris; Yap, Christina; Gaschler-Markefski, Birgit; Matcham, James; Caffrey, Louise; McKevitt, Christopher; Clive, Sally; Craddock, Charlie; Spicer, James; Cornelius, Victoria

    2017-07-25

    Dose-finding trials are essential to drug development as they establish recommended doses for later-phase testing. We aim to motivate wider use of model-based designs for dose finding, such as the continual reassessment method (CRM). We carried out a literature review of dose-finding designs and conducted a survey to identify perceived barriers to their implementation. We describe the benefits of model-based designs (flexibility, superior operating characteristics, extended scope), their current uptake, and existing resources. The most prominent barriers to implementation of a model-based design were lack of suitable training, chief investigators' preference for algorithm-based designs (e.g., 3+3), and limited resources for study design before funding. We use a real-world example to illustrate how these barriers can be overcome. There is overwhelming evidence for the benefits of CRM. Many leading pharmaceutical companies routinely implement model-based designs. Our analysis identified barriers for academic statisticians and clinical academics in mirroring the progress industry has made in trial design. Unified support from funders, regulators, and journal editors could result in more accurate doses for later-phase testing, and increase the efficiency and success of clinical drug development. We give recommendations for increasing the uptake of model-based designs for dose-finding trials in academia.

  3. Perceptions and Predictions of Expertise in Advanced Musical Learners

    Science.gov (United States)

    Papageorgi, Ioulia; Creech, Andrea; Haddon, Elizabeth; Morton, Frances; De Bezenac, Christophe; Himonides, Evangelos; Potter, John; Duffy, Celia; Whyton, Tony; Welch, Graham

    2010-01-01

    The aim of this article was to compare musicians' views on (a) the importance of musical skills and (b) the nature of expertise. Data were obtained from a specially devised web-based questionnaire completed by advanced musicians representing four musical genres (classical, popular, jazz, Scottish traditional) and varying degrees of professional…

  4. The committee of scientific expertise coordination

    International Nuclear Information System (INIS)

    2003-01-01

    Placed under the MIES control, the Committee of scientific expertise coordination defines the needs, the contain and the planing of expertises realized in function of Climate national and international decisions and negotiations calendars. The Committee verifies the different expertises and offers the administrations, scientific tools and techniques useful for the negotiations. It can also define long-dated research needs which require the scientific community mobilization. This paper provides some document of the Committee: objectives, operating and priorities of the Committee, scenarios ''Factor 4'' and ''crack technology'', perceptions and practices, developing countries (China, India...), Euromed. (A.L.B.)

  5. The Importance of Domain-Specific Expertise in Creativity

    Science.gov (United States)

    Baer, John

    2015-01-01

    Although creativity and expertise are related, they are nonetheless very different things. Expertise does not usually require creativity, but creativity generally does require a certain level of expertise. There are similarities in the relationships of both expertise and creativity to domains, however. Research has shown that just as expertise in…

  6. How to attain expertise in clinical communication?

    NARCIS (Netherlands)

    Wouda, Jan C.; van de Wiel, Harry B. M.

    2013-01-01

    Several factors complicate the attainment of expertise in clinical communication. Medical curricula and postgraduate training insufficiently provide the required learning conditions of deliberate practice to overcome these obstacles. In this paper we provide recommendations for learning objectives

  7. Preserving skills and expertise for nuclear safety

    International Nuclear Information System (INIS)

    Storey, P.

    2002-01-01

    Full text: For many decades to come the international nuclear sector will require a wide range of highly trained, experienced and competent personnel. However, with the decline in the availability of nuclear expertise which is being felt in many countries, maintaining safety competence for both the industry and the regulator becomes a difficult challenge. Assessing the extent of the decline now and predicting what is the likely need for expertise in the future is an important task for all countries. Assessment should take account of likely scenarios for change in the nuclear industry and should aim to identify areas of expertise most likely to be at risk. International Agencies are playing a key role in raising awareness about regulatory concern and are starting to coordinate response and exchange good practice. Regulatory responsibility for preserving skills and expertise and International Agency leadership are essential for a successful outcome to the issue. (author)

  8. [The Medical Examination - Between Desire and Reality - Analysis of Consensus Between the Second Part of the Medical Licensing Exam (IMPP) and the National Catalogue of Expertise-based Learning Goals in Surgery (NKLC)].

    Science.gov (United States)

    Sterz, Jasmina; Rüsseler, Miriam; Britz, Vanessa; Stefanescu, Christina; Hoefer, Sebastian H; Adili, Farzin; Schreckenbach, Teresa; Schleicher, Iris; Weber, Roxane; Hofmann, Hans-Stefan; Voß, Friedericke; König, Sarah; Heinemann, Markus K; Kadmon, Martina

    2017-12-01

    Background The working party of the German Society for Surgery (DGCH) on undergraduate surgical education has developed a national expertise-based catalogue of learning goals in surgery (NKLC). This study analyses the extent to which the questions of the German second medical licensing examination compiled by the IMPP are congruent with the NKLC and which thematic focus is emphasised. Materials and Methods Firstly, a guideline and evaluation sheet were developed in order to achieve documentation of the individual examination questions of the second licensing examination with respect to the learning goals of the NKLC. In a retrospective analysis from autumn 2009 to autumn 2014, eleven licensing examinations in human medicine were screened independently by three different reviewers. In accordance with the guideline, the surgical questions were identified and subsequently matched to the learning goals of the NKLC. The analysis included the number of surgical learning goals as well as the number of surgical questions for each examination, learning goal, and different levels of expertise (LE). Results Thirteen reviewers from six surgical disciplines participated in the analysis. On average, reviewers agreed on the differentiation between surgical and non-surgical questions in 79.1% of all 3480 questions from 11 licensing examinations. For each examination (n = 320 questions), 98.8 ± 22.6 questions (min.: 69, max.: 150) were rated as surgical. For each surgical learning goal addressed, 2.2 ± 0.3 questions (min.: 1, max.: 16) were asked. For each examination, 23.5 ± 6.3 questions (min.: 11; max.: 31) referred to learning goals of LE 3, 52.5 ± 16.7 questions (min.: 34; max.: 94) addressed learning goals of LE 2 and 22.8 ± 7.7 questions (min.: 9; max.: 34) were related to learning goals of LE 1. 64 learning goals (27.8% of all learning goals of the NKLC) were not reflected in the examinations. With a total of 70 questions, the most frequently

  9. The contribution of research on expertise to understanding of expert thinking

    Directory of Open Access Journals (Sweden)

    Krnjaić Zora

    2013-01-01

    Full Text Available Expertise is determined based on the high level of mastery of knowledge and skills in different areas of human activities (science, art, sports and other less formal domains. This paper explores the contribution of empirical research on expertise to understanding of the nature of expert thinking. For that purpose we have compiled an overview and performed an analysis of the findings of relevant research on expertise based on different approaches and paradigms. We have included the studies that researched experts singled out based on their exceptional performances in different domains (absolute expertise and the studies based on comparing experts with novices (relative expertise. We have analyzed the studies using different paradigms: psychometric and cognitive paradigms, as well as the new offshoot, the paradigm based on viewing giftedness as developing expertise. Research results provide empirically grounded findings on the characteristics of expert thinking and consistently point to the fact that knowledge is the core of expertise. The characteristics of expert knowledge are operationalized via the quantity and organization of knowledge and the mastery of deep contents and knowledge systems, which enables the recognition of rules, models and information sets, as well as the use of knowledge in further studying, detecting and solving different problems. It can be concluded that research findings on expertise are one of the foundations in the conceptualization of expert thinking. They significantly contribute to obtaining an insight into the way in which knowledge shapes thought and into understanding the mechanisms of demonstrating knowledge in the mental processes of experts.

  10. The appraisal rationalisation of real estate expertise

    Directory of Open Access Journals (Sweden)

    Marina Ciuna

    2013-12-01

    Full Text Available The Italian appraisal practice is characterized by valuations developed in subjective opinions formulated by the valuers, according to the experience and the competence rather than on the survey of the market data of comparable properties. This practice makes up for the lack of information on the real estate market and to the consequent absence of systematic collections of market data. This tradition is in the cadastral appraisal for the rural (1886 and urban properties (1939. The assessed income is appraised for a representative property and wide to all the other properties with arbitrary scores (pure number. The assessed value is derived from the income with fixed multipliers. The reform of the cadastral appraisals (2013 provides the employment of predetermined statistic functions rather than the automated valuation models applied in the mass appraisal. There are therefore ample spaces to rationalize the Italian valuations. For the market appraisal the process of rationalization is based on the comparison between the expertise and the market comparison approach. For the cadastral appraisal the process of rationalization is based on the statistic application to the fixed functions with the survey of a sample of market prices and the ratios study according to the valuation standards.

  11. A Population-Based Clinical Trial of Irinotecan and Carboplatin

    Directory of Open Access Journals (Sweden)

    Derick Lau

    2009-01-01

    Full Text Available Purpose. Phase I trials of anticancer drugs are commonly conducted using the method of modified Fibonacci. We have developed a population-based design for phase I trials of combining anticancer drugs such as irinotecan and carboplatin. Patients and Methods. Intrapatient dose escalation of irinotecan and carboplatin was performed according to a predetermined schema to reach individual dose-limiting toxicity (DLT in 50 patients with solid tumors refractory to previous chemotherapy. The individual toxicity-limiting dose levels were analyzed for normal distribution using the method of Ryan-Joiner and subsequently used to determine a population-based maximum tolerated dose (pMTD. For comparison, a simulation study was performed using the method of modified Fibonacci. Results. The most common dose-limiting toxicities (DLTs included neutropenia (58%, thrombocytopenia (16%, and diarrhea (8%. The frequency of individual toxicity-limiting dose levels of 50 patients approximated a normal distribution. The dose levels associated with individual limiting toxicities ranged from level 1 (irinotecan 100 mg/m2 and carboplatin AUC = 4 mg/mL x min to level 8 (irinotecan 350 mg/m2 and carboplatin AUC = 6. The pMTD was determined to be dose level 3 (150 mg/m2 for irinotecan and AUC = 5 for carboplatin. In contrast, the MTD was determined to be dose level 4 (200 mg/m2 for irinotecan and AUC 5 for carboplatin by modified-Fibonacci simulation. Conclusions. The population-based design of phase I trial allows optimization of dose intensity and derivation of a pMTD. The pMTD has been applied in phase II trial of irinotecan and carboplatin in patients with small-cell lung cancer.

  12. E-Commerce Audit Judgment Expertise: Does Expertise in System Change Management and Information Technology Auditing Mediate E-Commerce Audit Judgment Expertise?

    Directory of Open Access Journals (Sweden)

    Jagdish PATHAK

    2010-01-01

    Full Text Available A global survey of 203 E-commerce auditors was conducted to investigate the perceptions about the potential determinants of expertise in E-commerce audits. We hypothesize and find evidence indicating that information technology and communication expertise are positively related to expertise in E-commerce audit judgment. We also find that system change management expertise and information technology audit expertise mediate this relationship.

  13. Perceptual expertise in forensic facial image comparison.

    Science.gov (United States)

    White, David; Phillips, P Jonathon; Hahn, Carina A; Hill, Matthew; O'Toole, Alice J

    2015-09-07

    Forensic facial identification examiners are required to match the identity of faces in images that vary substantially, owing to changes in viewing conditions and in a person's appearance. These identifications affect the course and outcome of criminal investigations and convictions. Despite calls for research on sources of human error in forensic examination, existing scientific knowledge of face matching accuracy is based, almost exclusively, on people without formal training. Here, we administered three challenging face matching tests to a group of forensic examiners with many years' experience of comparing face images for law enforcement and government agencies. Examiners outperformed untrained participants and computer algorithms, thereby providing the first evidence that these examiners are experts at this task. Notably, computationally fusing responses of multiple experts produced near-perfect performance. Results also revealed qualitative differences between expert and non-expert performance. First, examiners' superiority was greatest at longer exposure durations, suggestive of more entailed comparison in forensic examiners. Second, experts were less impaired by image inversion than non-expert students, contrasting with face memory studies that show larger face inversion effects in high performers. We conclude that expertise in matching identity across unfamiliar face images is supported by processes that differ qualitatively from those supporting memory for individual faces. © 2015 The Author(s).

  14. Mixture-based gatekeeping procedures in adaptive clinical trials.

    Science.gov (United States)

    Kordzakhia, George; Dmitrienko, Alex; Ishida, Eiji

    2018-01-01

    Clinical trials with data-driven decision rules often pursue multiple clinical objectives such as the evaluation of several endpoints or several doses of an experimental treatment. These complex analysis strategies give rise to "multivariate" multiplicity problems with several components or sources of multiplicity. A general framework for defining gatekeeping procedures in clinical trials with adaptive multistage designs is proposed in this paper. The mixture method is applied to build a gatekeeping procedure at each stage and inferences at each decision point (interim or final analysis) are performed using the combination function approach. An advantage of utilizing the mixture method is that it enables powerful gatekeeping procedures applicable to a broad class of settings with complex logical relationships among the hypotheses of interest. Further, the combination function approach supports flexible data-driven decisions such as a decision to increase the sample size or remove a treatment arm. The paper concludes with a clinical trial example that illustrates the methodology by applying it to develop an adaptive two-stage design with a mixture-based gatekeeping procedure.

  15. Using Highlighting to Train Attentional Expertise.

    Science.gov (United States)

    Roads, Brett; Mozer, Michael C; Busey, Thomas A

    2016-01-01

    Acquiring expertise in complex visual tasks is time consuming. To facilitate the efficient training of novices on where to look in these tasks, we propose an attentional highlighting paradigm. Highlighting involves dynamically modulating the saliency of a visual image to guide attention along the fixation path of a domain expert who had previously viewed the same image. In Experiment 1, we trained naive subjects via attentional highlighting on a fingerprint-matching task. Before and after training, we asked subjects to freely inspect images containing pairs of prints and determine whether the prints matched. Fixation sequences were automatically scored for the degree of expertise exhibited using a Bayesian discriminative model of novice and expert gaze behavior. Highlighted training causes gaze behavior to become more expert-like not only on the trained images but also on transfer images, indicating generalization of learning. In Experiment 2, to control for the possibility that the increase in expertise is due to mere exposure, we trained subjects via highlighting of fixation sequences from novices, not experts, and observed no transition toward expertise. In Experiment 3, to determine the specificity of the training effect, we trained subjects with expert fixation sequences from images other than the one being viewed, which preserves coarse-scale statistics of expert gaze but provides no information about fine-grain features. Observing at least a partial transition toward expertise, we obtain only weak evidence that the highlighting procedure facilitates the learning of critical local features. We discuss possible improvements to the highlighting procedure.

  16. Development of professional expertise in optometry.

    Science.gov (United States)

    Faucher, Caroline

    2011-04-01

    Development of professional expertise is the gradual transition from novice to expert within a profession. Studies on expertise in the profession of optometry have never been published. However, many studies have been performed in other health professions (e.g., nursing, medicine, physical therapy, occupational therapy). This report is an overview of the development of professional expertise that will highlight some applications for optometry. A 5-level scale of professional expertise development, divided into 2 parts, is described. The first part is the progression of students during their professional studies (novice, intermediate, competent). The second part is the professional development occurring during the practice years (advanced, expert). Personal and collective efforts are required to foster the progression toward expertise. Great interest for the profession, motivation, and deliberate practice are individual attitudes that help this progression. The "optometric community of practice," by means of university (professional) training, continuing education, and collaboration between colleagues, also contributes to this process. Professional development is an integral part of the Optometric Oath. Each clinical case is a potential learning experience contributing to one's professional development. Optometrists' attitudes are predominant factors in the progression from one level to another. Copyright © 2011 American Optometric Association. Published by Elsevier Inc. All rights reserved.

  17. Assessing expertise in introductory physics using categorization task

    Directory of Open Access Journals (Sweden)

    Andrew Mason

    2011-10-01

    Full Text Available The ability to categorize problems based upon underlying principles, rather than surface features or contexts, is considered one of several proxy predictors of expertise in problem solving. With inspiration from the classic study by Chi, Feltovich, and Glaser, we assess the distribution of expertise among introductory physics students by asking three introductory physics classes, each with more than a hundred students, to categorize mechanics problems based upon similarity of solution. We compare their categorization with those of physics graduate students and faculty members. To evaluate the effect of problem context on students’ ability to categorize, two sets of problems were developed for categorization. Some problems in one set included those available from the prior study by Chi et al. We find a large overlap between calculus-based introductory students and graduate students with regard to their categorizations that were assessed as “good.” Our findings, which contrast with those of Chi et al., suggest that there is a wide distribution of expertise in mechanics among introductory and graduate students. Although the categorization task is conceptual, introductory students in the calculus-based course performed better than those in the algebra-based course. Qualitative trends in categorization of problems are similar between the non-Chi problems and problems available from the Chi study used in our study although the Chi problems used are more difficult on average.

  18. Expertise for Teaching Biology Situated in the Context of Genetic Testing

    Science.gov (United States)

    Van der Zande, Paul; Akkerman, Sanne F.; Brekelmans, Mieke; Waarlo, Arend Jan; Vermunt, Jan D.

    2012-07-01

    Contemporary genomics research will impact the daily practice of biology teachers who want to teach up-to-date genetics in secondary education. This article reports on a research project aimed at enhancing biology teachers' expertise for teaching genetics situated in the context of genetic testing. The increasing body of scientific knowledge concerning genetic testing and the related consequences for decision-making indicate the societal relevance of an educational approach based on situated learning. What expertise do biology teachers need for teaching genetics in the personal health context of genetic testing? This article describes the required expertise by exploring the educational practice. Nine experienced teachers were interviewed about the pedagogical content, moral and interpersonal expertise areas concerning how to teach genetics in the personal health context of genetic testing, and the lessons of five of them were observed. The findings showed that the required teacher expertise encompasses specific pedagogical content expertise, interpersonal expertise and a preference for teacher roles and teaching approaches for the moral aspects of teaching in this context. A need for further development of teaching and learning activities for (reflection on) moral reasoning came to the fore. Suggestions regarding how to apply this expertise into context-based genetics education are discussed.

  19. Coaching Expertise: Science or Skills?

    Directory of Open Access Journals (Sweden)

    Alexander PAVLOV

    2015-06-01

    Full Text Available Today in most of Russian sport universit ies, the biological disciplines are carried out in accordance with traditional old - fashion ideas that have been formed half a century ago and do not correspond to reality. The sport theory and methods fundamentals are taught only in accordance with the the ory of periodization. Sporting theorists neglect many facts of low efficiency in the use of training periodization theory and results of research. They do not take into account the research of some sports specialists who developed and implemented more effe ctive method of training for elite athletes. One of the main aspects that a coach works with is the human organism. The foundation of the training process should be based on the law of development and human adaptation. Most of nowadays existing concepts of sports training ignore system laws of organism functions construction and existing laws adaptation. The laws of adaptation provide a basis for science - based integrated construction of training process. The modern theory and methodology of sports should be built on the basis of current scientific knowledge about the laws of functioning, adaptation, and development of the human organism. Adaptation laws provide opportunities for effective preparation of the athletes .

  20. Development of the CAI system for inheritance of maintenance expertise

    International Nuclear Information System (INIS)

    Hanafusa, Hidemitsu; Chigusa, Naoki; Furuta, Kazuo

    2002-01-01

    High quality maintenance is required in order to secure the safety of nuclear power plants. The engineers engaged in maintenance activities have to master various knowledge, including the explicit and tacit knowledge of experienced experts, through education and training. Moreover, it is also very important to prevent these knowledge from getting scattered and lost with a change of generation and to share the knowledge or expertise. The purpose of this study is to develop a support system for the next generation experts to help them master and make use of the knowledge of their predecessors. The knowledge or expertise consist of ''knowledge about the maintenance tasks'', ''knowledge about structure/function of plant system/equipment'', and ''individual knowledge based on trouble experience etc.''. The ways this knowledge could be represented were considered first, then this support system was developed based on such representation. (author)

  1. The Development of Sport Expertise: From Leeds to MVP Legend.

    Science.gov (United States)

    Thomas, Katherine Thomas

    1994-01-01

    Contributions of motor skill and cognition to sport performance change across age, expertise, and sports. Knowledge and decision making should not limit the development of expertise. Specific strategies for teachers may help students develop expertise. The paper discusses the contribution of knowledge and skill to expertise and its development.…

  2. Separation of time-based and trial-based accounts of the partial reinforcement extinction effect.

    Science.gov (United States)

    Bouton, Mark E; Woods, Amanda M; Todd, Travis P

    2014-01-01

    Two appetitive conditioning experiments with rats examined time-based and trial-based accounts of the partial reinforcement extinction effect (PREE). In the PREE, the loss of responding that occurs in extinction is slower when the conditioned stimulus (CS) has been paired with a reinforcer on some of its presentations (partially reinforced) instead of every presentation (continuously reinforced). According to a time-based or "time-accumulation" view (e.g., Gallistel and Gibbon, 2000), the PREE occurs because the organism has learned in partial reinforcement to expect the reinforcer after a larger amount of time has accumulated in the CS over trials. In contrast, according to a trial-based view (e.g., Capaldi, 1967), the PREE occurs because the organism has learned in partial reinforcement to expect the reinforcer after a larger number of CS presentations. Experiment 1 used a procedure that equated partially and continuously reinforced groups on their expected times to reinforcement during conditioning. A PREE was still observed. Experiment 2 then used an extinction procedure that allowed time in the CS and the number of trials to accumulate differentially through extinction. The PREE was still evident when responding was examined as a function of expected time units to the reinforcer, but was eliminated when responding was examined as a function of expected trial units to the reinforcer. There was no evidence that the animal responded according to the ratio of time accumulated during the CS in extinction over the time in the CS expected before the reinforcer. The results thus favor a trial-based account over a time-based account of extinction and the PREE. This article is part of a Special Issue entitled: Associative and Temporal Learning. Copyright © 2013 Elsevier B.V. All rights reserved.

  3. Computer-Based Driving in Dementia Decision Tool With Mail Support: Cluster Randomized Controlled Trial.

    Science.gov (United States)

    Rapoport, Mark J; Zucchero Sarracini, Carla; Kiss, Alex; Lee, Linda; Byszewski, Anna; Seitz, Dallas P; Vrkljan, Brenda; Molnar, Frank; Herrmann, Nathan; Tang-Wai, David F; Frank, Christopher; Henry, Blair; Pimlott, Nicholas; Masellis, Mario; Naglie, Gary

    2018-05-25

    Physicians often find significant challenges in assessing automobile driving in persons with mild cognitive impairment and mild dementia and deciding when to report to transportation administrators. Care must be taken to balance the safety of patients and other road users with potential negative effects of issuing such reports. The aim of this study was to assess whether a computer-based Driving in Dementia Decision Tool (DD-DT) increased appropriate reporting of patients with mild dementia or mild cognitive impairment to transportation administrators. The study used a parallel-group cluster nonblinded randomized controlled trial design to test a multifaceted knowledge translation intervention. The intervention included a computer-based decision support system activated by the physician-user, which provides a recommendation about whether to report patients with mild dementia or mild cognitive impairment to transportation administrators, based on an algorithm derived from earlier work. The intervention also included a mailed educational package and Web-based specialized reporting forms. Specialists and family physicians with expertise in dementia or care of the elderly were stratified by sex and randomized to either use the DD-DT or a control version of the tool that required identical data input as the intervention group, but instead generated a generic reminder about the reporting legislation in Ontario, Canada. The trial ran from September 9, 2014 to January 29, 2016, and the primary outcome was the number of reports made to the transportation administrators concordant with the algorithm. A total of 69 participating physicians were randomized, and 36 of these used the DD-DT; 20 of the 35 randomized to the intervention group used DD-DT with 114 patients, and 16 of the 34 randomized to the control group used it with 103 patients. The proportion of all assessed patients reported to the transportation administrators concordant with recommendation did not differ

  4. Learning and Development Expertise: An Australian Analysis

    Science.gov (United States)

    Hodge, Steven; Harvey, Jack

    2015-01-01

    Learning and development (L&D) practitioners draw on a distinctive range of knowledge, skills and techniques in their work. Over the years, there have been attempts to capture this range and identify typical L&D roles. The research presented here was undertaken to identify characteristic areas of expertise (AOEs) of L&D practice in…

  5. Introduction: Recent advances in expertise research.

    NARCIS (Netherlands)

    Rikers, Remy; Paas, Fred

    2007-01-01

    During the 55th meeting of the American Educational Research Association (AERA, 2004) in San Diego, a symposium was organized on Recent Advances in Expertise Research. Most papers in this special issue of Applied Cognitive Psychology were presented in this symposium. The aim of this special issue is

  6. Expertise effects in cutaneous wind perception

    NARCIS (Netherlands)

    Pluijms, Joost P.; Cañal-Bruland, Rouwen; Bergmann Tiest, Wouter M.; Mulder, F.A.; Savelsbergh, Geert J.P.

    2015-01-01

    We examined whether expertise effects are present in cutaneous wind perception. To this end, we presented wind stimuli consisting of different wind directions and speeds in a wind simulator. The wind simulator generated wind stimuli from 16 directions and with three speeds by means of eight

  7. Application of teleoperator expertise to robotics

    International Nuclear Information System (INIS)

    Grisham, D.L.; Lambert, J.E.

    1985-01-01

    This paper will briefly describe the evolution of Monitor remote handling system and its present capabilities and accomplishments. It will also suggest that the equipment and operational expertise can be applied to robotic systems in radioactive and other hostile environments. The Monitor methods of operation, tooling devised and employed, and the applications of these methods to robotic systems will be described

  8. On the assessment of expertise profiles

    NARCIS (Netherlands)

    Berendsen, R.; Rijke, M. de; Balog, K.; Bogers, T.; Bosch, A.P.J. van den

    2013-01-01

    Expertise retrieval has attracted significant interest in the field of information retrieval. Expert finding has been studied extensively, with less attention going to the complementary task of expert profiling, that is, automatically identifying topics about which a person is knowledgeable. We

  9. Universities and the Public Recognition of Expertise

    Science.gov (United States)

    Arnoldi, Jakob

    2007-01-01

    This article argues that new sites of knowledge production, increasingly cultivated by the mass media, are threatening the role of academics and universities as traditional sources of expertise. Drawing upon the conceptual categories of Pierre Bourdieu, the article suggests an alternative way of understanding this "crisis of legitimacy."

  10. Financial Expertise as an Arms Race

    NARCIS (Netherlands)

    Glode, V.; Green, R.C.; Lowery, R.

    2010-01-01

    We propose a model in which rms involved in trading securities overinvest in financial expertise. Intermediaries or traders in the model meet and bargain over a financial asset. As in the bargaining model in Dang (2008), counterparties endogenously decide whether to acquire information, and improve

  11. Financial Expertise as an Arms Race

    NARCIS (Netherlands)

    Glode, V.; Green, R.C.; Lowery, R.

    2010-01-01

    We propose a model in which firms involved in trading securities overinvest in financial expertise. Intermediaries or traders in the model meet and bargain over a financial asset. As in the bargaining model in Dang (2008), counterparties endogenously decide whether to acquire information, and

  12. Educational Expertise, Advocacy, and Media Influence

    Science.gov (United States)

    Malin, Joel R.; Lubienski, Christopher

    2015-01-01

    The efforts of many advocacy organizations to advance their preferred policies despite conflicting evidence of the effectiveness of these policies raise questions about factors that shape successful policy promotion. While many may like to think that expertise on an issue in question is an essential prerequisite for influence in public policy…

  13. Processes mediating expertise in air traffic control

    NARCIS (Netherlands)

    Van Meeuwen, Ludo; Jarodzka, Halszka; Brand-Gruwel, Saskia; Van Merriënboer, Jeroen; De Bock, Jeano; Kirschner, Paul A.

    2010-01-01

    Van Meeuwen, L., Jarodzka, H., Brand-Gruwel, S., Van Merriënboer, J. J. G., De Bock, J. J. P. R., & Kirschner, P. A. (2010, August). Processes mediating expertise in air traffic control. Meeting of the EARLI SIG6/7 Instructional Design and Learning and Instruction with Computers, Ulm, Germany.

  14. Psychological Factors Associated with Paranursing Expertise.

    Science.gov (United States)

    Brammer, Robert; Haller, Katherine

    The psychological factors associated with paranursing expertise were examined in a study of 135 certified nursing assistants (CNAs) at a geriatric nursing facility in Amarillo, Texas. Data were collected through a project-developed screening tool called the Geriatric Employee Screening Tool (GEST), which is a true-false instrument patterned after…

  15. Processes mediating expertise in air traffic control

    NARCIS (Netherlands)

    Van Meeuwen, Ludo; Jarodzka, Halszka; Brand-Gruwel, Saskia; Van Merriënboer, Jeroen; De Bock, Jeano; Kirschner, Paul A.

    2011-01-01

    Van Meeuwen, L. W., Jarodzka, H., Brand-Gruwel, S., Van Merriënboer, J. J. G., De Bock, J. J. P. R., & Kirschner, P. A. (2010, September). Processes mediating expertise in air traffic control. Poster presented at the European Association for Aviation Psychology Conference, Budapest.

  16. Organizational change and human expertise in nuclear power plants

    International Nuclear Information System (INIS)

    Masson, M.; Malaisc, N.

    1992-01-01

    Reliability and safety are two very important goals, which depend on technical and organizational factors, but also on human expertise. How to ensure a safe functioning of a nuclear power plant in a changing context, and what might be the role and aspects of training and transfer of knowledge? These are the questions we shall deal with in this paper, on the basis of two field studies. The two field studies stress the needs for setting up case based training, which best ensure the acquisition of know-how. Furthermore, as shown by the second one, gaining expertise involves developing large repertoires of highly skilled, semi-routinized activities. Supporting expert operators not only should tackle problem solving activities but should thus also include the prevention of routine errors, which go along with skill acquisition. (author)

  17. Teachers’ Shared Expertise at a Multidisciplinary University of Applied Sciences

    Directory of Open Access Journals (Sweden)

    Arto O. Salonen

    2015-07-01

    Full Text Available Shared expertise, team teaching, and cooperation among lecturers from different fields have become more and more important in promoting learning and achieving more innovative learning outcomes in multidisciplinary universities. To increase and improve sharing expertise between teachers from different faculties and disciplines, we wanted, on one hand, to identify skills and competences that teachers have in common and, on the other hand, to find areas in which they identify that they need complementation. As a framework for this research, we applied Lee Shulman’s (1986 seven categories of teachers’ knowledge base including the theory of pedagogical content knowledge (PCK. The data were collected by group discussions. The teachers (N = 22 represented all seven faculties of Helsinki Metropolia University of Applied Sciences (UAS, that is, Business School, Civil Engineering and Building Services, Culture and Creative Industries, Health Care and Nursing, School of Information and Communication Technology (ICT, Industrial Engineering, and Welfare and Human Functioning. The data were analyzed using theory-based content analysis. According to our data, the mutual core competence of a teacher is the capacity to interact effectively. It is a basis for shared expertise. Interaction skills are necessary in collaborative construction of knowledge as students, teachers of different fields, and their partners inside and outside the organization co-operate. Multidisciplinary co-operation among colleagues also helps to maintain subject matter knowledge, as it supports peer learning and encourages everyone to move out of their comfort zones.

  18. Exploring Integration in Action: Competencies as Building Blocks of Expertise.

    Science.gov (United States)

    Mylopoulos, Maria; Borschel, Debaroti Tina; O'Brien, Tara; Martimianakis, Sofia; Woods, Nicole N

    2017-12-01

    Competency frameworks such as the CanMEDS roles and the ACGME core competencies may lead to the implicit assumption that physicians can learn and practice individual competencies in isolation. In contrast, models of adaptive expertise suggest that the integration of competencies reflects the capabilities of an expert physician. Thus, educational programming aimed at teaching discrete roles or competencies might overlook expert physician capabilities that are central to patient care. To develop expertise, learning opportunities must reflect expert capabilities. To better understand the relationship between competency-based medical education and expert development, the authors sought to explore how integrated competencies are enacted during patient care by postgraduate medical trainees. Using a cognitive ethnographic approach, in 2014-2015 the authors conducted observations and-to refine and elaborate these observations-ad hoc informal interviews with 13 postgraduate trainee participants. Data collection resulted in 92 hours of observation, 26 patient case portraits, and a total of 220 pages of field notes for analysis. Through analysis, the authors identified and examined moments when postgraduate trainees appeared to be simultaneously enacting multiple competencies. The authors identified two key expert capabilities in moments of integrated competence: finding complexity and being patient-centered. They described two mechanisms for these forms of integration: valuing the patient's narrative of their illness, and integrated understanding. Understanding integrated competencies as the building blocks of expert capabilities, along with recognizing the importance of mechanisms that support integration, offers an opportunity to use existing competency-based frameworks to understand and teach adaptive expertise.

  19. Effects of expertise on football betting

    Directory of Open Access Journals (Sweden)

    Khazaal Yasser

    2012-05-01

    Full Text Available Abstract Background Football (soccer is one of the most popular sports in the world, including Europe. It is associated with important betting activities. A common belief, widely spread among those who participate in gambling activities, is that knowledge and expertise on football lead to better prediction skills for match outcomes. If unfounded, however, this belief should be considered as a form of “illusion of control.” The aim of this study was to examine whether football experts are better than nonexperts at predicting football match scores. Methods Two hundred and fifty-eight persons took part in the study: 21.3% as football experts, 54.3% as laypersons (non-initiated to football, and 24.4% as football amateurs. They predicted the scores of the first 10 matches of the 2008 UEFA European Football Championship. Logistic regressions were carried out to assess the link between the accuracy of the forecasted scores and the expertise of the participants (expert, amateur, layperson, controlling for age and gender. Results The variables assessed did not predict the accuracy of scoring prognosis (R2 ranged from 1% to 6%. Conclusions Expertise, age, and gender did not appear to have an impact on the accuracy of the football match prognoses. Therefore, the belief that football expertise improves betting skills is no more than a cognitive distortion called the “illusion of control.” Gamblers may benefit from psychological interventions that target the illusion of control related to their believed links between betting skills and football expertise. Public health policies may need to consider the phenomenon in order to prevent problem gambling related to football betting.

  20. Effects of expertise on football betting.

    Science.gov (United States)

    Khazaal, Yasser; Chatton, Anne; Billieux, Joël; Bizzini, Lucio; Monney, Grégoire; Fresard, Emmanuelle; Thorens, Gabriel; Bondolfi, Guido; El-Guebaly, Nady; Zullino, Daniele; Khan, Riaz

    2012-05-11

    Football (soccer) is one of the most popular sports in the world, including Europe. It is associated with important betting activities. A common belief, widely spread among those who participate in gambling activities, is that knowledge and expertise on football lead to better prediction skills for match outcomes. If unfounded, however, this belief should be considered as a form of "illusion of control." The aim of this study was to examine whether football experts are better than nonexperts at predicting football match scores. Two hundred and fifty-eight persons took part in the study: 21.3% as football experts, 54.3% as laypersons (non-initiated to football), and 24.4% as football amateurs. They predicted the scores of the first 10 matches of the 2008 UEFA European Football Championship. Logistic regressions were carried out to assess the link between the accuracy of the forecasted scores and the expertise of the participants (expert, amateur, layperson), controlling for age and gender. The variables assessed did not predict the accuracy of scoring prognosis (R2 ranged from 1% to 6%). Expertise, age, and gender did not appear to have an impact on the accuracy of the football match prognoses. Therefore, the belief that football expertise improves betting skills is no more than a cognitive distortion called the "illusion of control." Gamblers may benefit from psychological interventions that target the illusion of control related to their believed links between betting skills and football expertise. Public health policies may need to consider the phenomenon in order to prevent problem gambling related to football betting.

  1. Using Highlighting to Train Attentional Expertise.

    Directory of Open Access Journals (Sweden)

    Brett Roads

    Full Text Available Acquiring expertise in complex visual tasks is time consuming. To facilitate the efficient training of novices on where to look in these tasks, we propose an attentional highlighting paradigm. Highlighting involves dynamically modulating the saliency of a visual image to guide attention along the fixation path of a domain expert who had previously viewed the same image. In Experiment 1, we trained naive subjects via attentional highlighting on a fingerprint-matching task. Before and after training, we asked subjects to freely inspect images containing pairs of prints and determine whether the prints matched. Fixation sequences were automatically scored for the degree of expertise exhibited using a Bayesian discriminative model of novice and expert gaze behavior. Highlighted training causes gaze behavior to become more expert-like not only on the trained images but also on transfer images, indicating generalization of learning. In Experiment 2, to control for the possibility that the increase in expertise is due to mere exposure, we trained subjects via highlighting of fixation sequences from novices, not experts, and observed no transition toward expertise. In Experiment 3, to determine the specificity of the training effect, we trained subjects with expert fixation sequences from images other than the one being viewed, which preserves coarse-scale statistics of expert gaze but provides no information about fine-grain features. Observing at least a partial transition toward expertise, we obtain only weak evidence that the highlighting procedure facilitates the learning of critical local features. We discuss possible improvements to the highlighting procedure.

  2. The committee of scientific expertise coordination; Le comite de coordination d'expertise scientifique

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2003-07-01

    Placed under the MIES control, the Committee of scientific expertise coordination defines the needs, the contain and the planing of expertises realized in function of Climate national and international decisions and negotiations calendars. The Committee verifies the different expertises and offers the administrations, scientific tools and techniques useful for the negotiations. It can also define long-dated research needs which require the scientific community mobilization. This paper provides some document of the Committee: objectives, operating and priorities of the Committee, scenarios ''Factor 4'' and ''crack technology'', perceptions and practices, developing countries (China, India...), Euromed. (A.L.B.)

  3. The committee of scientific expertise coordination; Le comite de coordination d'expertise scientifique

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2003-07-01

    Placed under the MIES control, the Committee of scientific expertise coordination defines the needs, the contain and the planing of expertises realized in function of Climate national and international decisions and negotiations calendars. The Committee verifies the different expertises and offers the administrations, scientific tools and techniques useful for the negotiations. It can also define long-dated research needs which require the scientific community mobilization. This paper provides some document of the Committee: objectives, operating and priorities of the Committee, scenarios ''Factor 4'' and ''crack technology'', perceptions and practices, developing countries (China, India...), Euromed. (A.L.B.)

  4. Reporting of Positive Results in Randomized Controlled Trials of Mindfulness-Based Mental Health Interventions.

    Directory of Open Access Journals (Sweden)

    Stephanie Coronado-Montoya

    Full Text Available A large proportion of mindfulness-based therapy trials report statistically significant results, even in the context of very low statistical power. The objective of the present study was to characterize the reporting of "positive" results in randomized controlled trials of mindfulness-based therapy. We also assessed mindfulness-based therapy trial registrations for indications of possible reporting bias and reviewed recent systematic reviews and meta-analyses to determine whether reporting biases were identified.CINAHL, Cochrane CENTRAL, EMBASE, ISI, MEDLINE, PsycInfo, and SCOPUS databases were searched for randomized controlled trials of mindfulness-based therapy. The number of positive trials was described and compared to the number that might be expected if mindfulness-based therapy were similarly effective compared to individual therapy for depression. Trial registries were searched for mindfulness-based therapy registrations. CINAHL, Cochrane CENTRAL, EMBASE, ISI, MEDLINE, PsycInfo, and SCOPUS were also searched for mindfulness-based therapy systematic reviews and meta-analyses.108 (87% of 124 published trials reported ≥1 positive outcome in the abstract, and 109 (88% concluded that mindfulness-based therapy was effective, 1.6 times greater than the expected number of positive trials based on effect size d = 0.55 (expected number positive trials = 65.7. Of 21 trial registrations, 13 (62% remained unpublished 30 months post-trial completion. No trial registrations adequately specified a single primary outcome measure with time of assessment. None of 36 systematic reviews and meta-analyses concluded that effect estimates were overestimated due to reporting biases.The proportion of mindfulness-based therapy trials with statistically significant results may overstate what would occur in practice.

  5. 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.

  6. Clinical Ethics Consultants are not “Ethics” Experts—But They do Have Expertise 1

    Science.gov (United States)

    Rasmussen, Lisa M.

    2016-01-01

    The attempt to critique the profession of clinical ethics consultation by establishing the impossibility of ethics expertise has been a red herring. Decisions made in clinical ethics cases are almost never based purely on moral judgments. Instead, they are all-things-considered judgments that involve determining how to balance other values as well. A standard of justified decision-making in this context would enable us to identify experts who could achieve these standards more often than others, and thus provide a basis for expertise in clinical ethics consultation. This expertise relies in part on what Richard Zaner calls the “expert knowledge of ethical phenomena” (1988, 8). PMID:27302970

  7. Reflections on clinical expertise and silent know-how in voice therapy

    DEFF Research Database (Denmark)

    Iwarsson, Jenny

    2014-01-01

    The concept of ‘clinical expertise’ is described as a part of evidence-based practice (EBP) together with ‘external scientific evidence’ and ‘patient values and perspectives’. However, clinical expertise in the management of voice disorders has not been described or discussed in much detail....... The expertise seems to consist partly of silent know-how that, from the outside, may seem improperly related to the personality of the speech-language pathologist or exclusively dependent on the number of years in the field. In this paper, it is suggested that clinical expertise in voice therapy consists...

  8. Expertise and processing distorted structure in chess.

    Science.gov (United States)

    Bartlett, James C; Boggan, Amy L; Krawczyk, Daniel C

    2013-01-01

    A classic finding in research on human expertise and knowledge is that of enhanced memory for stimuli in a domain of expertise as compared to either stimuli outside that domain, or within-domain stimuli that have been degraded or distorted in some way. However, we do not understand how experts process degradation or distortion of stimuli within the expert domain (e.g., a face with the eyes, nose, and mouth in the wrong positions, or a chessboard with pieces placed randomly). Focusing on the domain of chess, we present new fMRI evidence that when experts view such distorted/within-domain stimuli, they engage an active search for structure-a kind of exploratory chunking-that involves a component of a prefrontal-parietal network linked to consciousness, attention and working memory.

  9. Intuitive expertise in ICT graduate supervision

    Directory of Open Access Journals (Sweden)

    Jill Jameson

    2002-12-01

    Full Text Available Intuitive expertise in the application of advanced interdisciplinary facilitation is the subject of this personal reflection on the graduate supervisory style of Professor David Squires in computers in education. This single-case reflective study examines the characteristics of effective supervision observed during masters and doctoral supervision at King's College in the years 1990-9. Interdisciplinarity in ICT graduate studies particularly requires a fluency of supervisory expertise in enabling supervisees to combine multiple complex perspectives from a number of fields of knowledge. Intuitive combinatory aspects of supervision are highlighted in this reflection on the role carried out by an academic expert in facilitating student success. This is examined from a perspective incorporating affective as well as intellectual elements, informed by characteristics identified in professional sports and performing arts coaching/mentoring. Key characteristics comprising a model of intuitive expertise in ICT graduate supervision were outlined. The resultant portrait aims to complement existing literature on graduate supervision, with reference to the field of ICTI computers in education relating to student hypermedia composition.

  10. Competencies of Thai expertise teacher and PCK

    Science.gov (United States)

    Chantaranima, Tarntip; Yuenyong, Chokchai

    2018-01-01

    Pedagogical Content Knowledge (PCK) was accepted by worldwide Educators that it is a ubiquitous word in the preparation of teachers in the past decade. This study uses Pedagogical Content Knowledge (PCK) framework as a lens for classifying the guidelines and expectations for categorizing expertise teachers. Therefore, the paper tries to clarify the relationship between competencies of Thai expertise teacher and PCK elements. To promote skillful Thai teachers by offering them academic titles, the Office of the Teacher Civil Service and Education Personal Commission were developed to provide guidelines and expectations for categorizing expertise teachers (OTEPC, 2009). This article focuses on the guideline criteria which are three areas of consideration. The first area of consideration is teacher's disciplines including virtues and professional conducts. The second area of consideration is teacher's knowledge and teaching ability. The last area of consider is teacher's performance. It seemed that the OTEPC guideline pay too much attention on the first area. However, there are some issues of PCK appearing on the OTEPC teacher competency. The paper will discuss some suggestions of fill up PCK in the OTEPC guideline. The paper may have implication for Thailand teacher education.

  11. Efficacy of gamification-based smartphone application for weight loss in overweight and obese adolescents: study protocol for a phase II randomized controlled trial.

    Science.gov (United States)

    Timpel, Patrick; Cesena, Fernando Henpin Yue; da Silva Costa, Christiane; Soldatelli, Matheus Dorigatti; Gois, Emanuel; Castrillon, Eduardo; Díaz, Lina Johana Jaime; Repetto, Gabriela M; Hagos, Fanah; Castillo Yermenos, Raul E; Pacheco-Barrios, Kevin; Musallam, Wafaa; Braid, Zilda; Khidir, Nesreen; Romo Guardado, Marcela; Roepke, Roberta Muriel Longo

    2018-06-01

    Overweight and obesity are significant public health concerns that are prevalent in younger age cohorts. Preventive or therapeutic interventions are difficult to implement and maintain over time. On the other hand, the majority of adolescents in the United States have a smartphone, representing a huge potential for innovative digitized interventions, such as weight loss programs delivered via smartphone applications. Although the number of available smartphone applications is increasing, evidence for their effectiveness in weight loss is insufficient. Therefore, the proposed study aims to assess the efficacy of a gamification-based smartphone application for weight loss in overweight and obese adolescents. The trial is designed to be a phase II, single-centre, two-arm, triple-blinded, randomized controlled trial (RCT) with a duration of 6 months. The intervention consists of a smartphone application that provides both tracking and gamification elements, while the control arm consists of an identically designed application solely with tracking features of health information. The proposed trial will be conducted in an urban primary care clinic of an academic centre in the United States of America, with expertise in the management of overweight and obese adolescents. Eligible adolescents will be followed for 6 months. Changes in body mass index z score from baseline to 6 months will be the primary outcome. Secondary objectives will explore the effects of the gamification-based application on adherence, as well as anthropometric, metabolic and behavioural changes. A required sample size of 108 participants (54 participants per group) was calculated. The benefits of the proposed study include mid-term effects in weight reduction for overweight and obese adolescents. The current proposal will contribute to fill a gap in the literature on the mid-term effects of gamification-based interventions to control weight in adolescents. This trial is a well-designed RCT that is in

  12. Monitoring additive manufacturing based products in clinical trials

    NARCIS (Netherlands)

    Marinakis, Yorgos; Harms, Rainer; Walsh, Steven Thomas

    2017-01-01

    Under U.S. federal regulation 31 CFR §312, medical interventions must report on a series of clinical trials phases before being submitted for approval for release to the U.S. market. Clinical trials are now being performed on medical interventions that were constructed through additive

  13. Problems of university-based scientists associated with clinical trials.

    Science.gov (United States)

    Remington, R D

    1979-05-01

    University faculty members who participate in clinical trials face a number of difficulties in connection with this association. Publication opportunities are often limited, and individual scholarship is difficult to express and evaluate within the context of a cooperative trial. Merit increases, promotion, and the award of tenure will usually require evidence of scholarly achievement outside the trial setting. For this reason, it seems inadvisable to recommend that a young investigator devote a major portion of his scholarly and research time to such an activity. A possible exception may be a full-time appointment for 1 to 2 years. Nonetheless, cooperative clinical trials are an important investigative tool and they should continue to be associated with academic centers. If appropriate administrative arrangements can be made, it should be possible to solve the academic problems of the young investigator associated with such trials.

  14. Integration of technology-based outcome measures in clinical trials of Parkinson and other neurodegenerative diseases.

    Science.gov (United States)

    Artusi, Carlo Alberto; Mishra, Murli; Latimer, Patricia; Vizcarra, Joaquin A; Lopiano, Leonardo; Maetzler, Walter; Merola, Aristide; Espay, Alberto J

    2018-01-01

    We sought to review the landscape of past, present, and future use of technology-based outcome measures (TOMs) in clinical trials of neurodegenerative disorders. We systematically reviewed PubMed and ClinicalTrials.gov for published and ongoing clinical trials in neurodegenerative disorders employing TOMs. In addition, medical directors of selected pharmaceutical companies were surveyed on their companies' ongoing efforts and future plans to integrate TOMs in clinical trials as primary, secondary, or exploratory endpoints. We identified 164 published clinical trials indexed in PubMed that used TOMs as outcome measures in Parkinson disease (n = 132) or other neurodegenerative disorders (n = 32). The ClinicalTrials.gov search yielded 42 clinical trials using TOMs, representing 2.7% of ongoing trials. Sensor-based technology accounted for over 75% of TOMs applied. Gait and physical activity were the most common targeted domains. Within the next 5 years, 83% of surveyed pharmaceutical companies engaged in neurodegenerative disorders plan to deploy TOMs in clinical trials. Although promising, TOMs are underutilized in clinical trials of neurodegenerative disorders. Validating relevant endpoints, standardizing measures and procedures, establishing a single platform for integration of data and algorithms from different devices, and facilitating regulatory approvals should advance TOMs integration into clinical trials. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Conflict Resolution and Public Participation Center of Expertise

    Data.gov (United States)

    Federal Laboratory Consortium — On October 17, 2008, the Conflict Resolution and Public Participation Center (CPCX) was named a Corps Center of Expertise (CX) and Directory of Expertise (DX). The...

  16. Prospective iterative trial of proteasome inhibitor-based desensitization.

    Science.gov (United States)

    Woodle, E S; Shields, A R; Ejaz, N S; Sadaka, B; Girnita, A; Walsh, R C; Alloway, R R; Brailey, P; Cardi, M A; Abu Jawdeh, B G; Roy-Chaudhury, P; Govil, A; Mogilishetty, G

    2015-01-01

    A prospective iterative trial of proteasome inhibitor (PI)-based therapy for reducing HLA antibody (Ab) levels was conducted in five phases differing in bortezomib dosing density and plasmapheresis timing. Phases included 1 or 2 bortezomib cycles (1.3 mg/m(2) × 6-8 doses), one rituximab dose and plasmapheresis. HLA Abs were measured by solid phase and flow cytometry (FCM) assays. Immunodominant Ab (iAb) was defined as highest HLA Ab level. Forty-four patients received 52 desensitization courses (7 patients enrolled in multiple phases): Phase 1 (n = 20), Phase 2 (n = 12), Phase 3 (n = 10), Phase 4 (n = 5), Phase 5 (n = 5). iAb reductions were observed in 38 of 44 (86%) patients and persisted up to 10 months. In Phase 1, a 51.5% iAb reduction was observed at 28 days with bortezomib alone. iAb reductions increased with higher bortezomib dosing densities and included class I, II, and public antigens (HLA DRβ3, HLA DRβ4 and HLA DRβ5). FCM median channel shifts decreased in 11/11 (100%) patients by a mean of 103 ± 54 mean channel shifts (log scale). Nineteen out of 44 patients (43.2%) were transplanted with low acute rejection rates (18.8%) and de novo DSA formation (12.5%). In conclusion, PI-based desensitization consistently and durably reduces HLA Ab levels providing an alternative to intravenous immune globulin-based desensitization. © Copyright 2014 The American Society of Transplantation and the American Society of Transplant Surgeons.

  17. Latest expertise investigations in nuclear dismantling and industrial applications

    International Nuclear Information System (INIS)

    Gallozzi Ulmann, Adrien; Chazalet, Julien; Couturier, Pierre; Touzain, Etienne; Amgarou, Khalil; Menaa, Nabil

    2013-06-01

    During the last decades, CANBERRA has developed know-how, expertise and intervention strategies based on its feedback experiences in many countries. This document covers a wide range of applications involving nuclear characterization, for which CANBERRA is able to provide measurement set-up and results, activity characterization and radioactive source localization, as well as to guarantee safety or process thresholds corresponding to the customer's needs. To improve processes best-in-class methodology, know-how and tools have been used in complex examples described in this paper. CANBERRA has demonstrated its ability to better and efficiently prepare for and execute decontamination and dismantling activities. (authors)

  18. The Politics of Financial Regulation Expertise

    DEFF Research Database (Denmark)

    Ban, Cornel; Seabrooke, Leonard; Freitas, Sarah

    Who controls global policy debates on shadow banking regulation? By looking at the policy recommendations of the Bank of International Settlements, the International Monetary Fund and the Financial Stability Board, we show how experts tied to these institutions secured control over how shadow...... banking is treated. In so doing, these technocrats reinforced each other’s expertise and excluded some potential competitors (legal scholars), coopted others (select Fed and elite academic economists). The findings have important implications for studying the relationship between IOs technocrats...

  19. Healthy Beyond Pregnancy, a Web-Based Intervention to Improve Adherence to Postpartum Care: Randomized Controlled Feasibility Trial.

    Science.gov (United States)

    Himes, Katherine Park; Donovan, Heidi; Wang, Stephanie; Weaver, Carrie; Grove, Jillian Rae; Facco, Francesca Lucia

    2017-10-10

    During the postpartum visit, health care providers address issues with short- and long-term implications for maternal and child health. Women with Medicaid insurance are less likely to return for a postpartum visit compared with women with private insurance. Behavioral economics acknowledges that people do not make exclusively rational choices, rather immediate gratification, cognitive and psychological biases, and social norms influence decision making. Drawing on insights from decision science, behavioral economists have examined how these biases can be modulated through carefully designed interventions. We have developed a Web-based tool, Healthy Beyond Pregnancy, that incorporates empirically derived concepts of behavioral economics to improve adherence rates to the postpartum visit. The primary objectives of this pilot study were to (1) refine and assess the usability of Healthy Beyond Pregnancy and (2) assess the feasibility of a randomized controlled trial (RCT) of the intervention. We used a multistep process and multidisciplinary team of maternal-fetal medicine physicians, a behavioral economist, and researchers with expertise in behavioral interventions to design Healthy Beyond Pregnancy. We assessed the usability of the program with the Post-Study System Usability Questionnaire (PSSUQ), a validated 7-point scale, and semistructured interviews with postpartum women. We then conducted a feasibility trial to determine the proportion of eligible women who were willing to participate in an RCT of Healthy Beyond Pregnancy and the proportion of women willing to complete the Web-based program. Exploratory outcomes of the pilot trial included attendance at the postpartum visit, uptake of long-acting reversible contraception, and uptake of any contraception. The median PSSUQ score for Healthy Beyond Pregnancy was 6.5 (interquartile range: 6.1-7) demonstrating high usability. Semistructured interviews (n=10) provided in-depth comments about users' experience and

  20. [Consistency and Reliability of MDK Expertise Examining the Encoding in the German DRG System].

    Science.gov (United States)

    Gaertner, T; Lehr, F; Blum, B; van Essen, J

    2015-09-01

    Hospital inpatient stays are reimbursed on the basis of German diagnosis-related groups (G-DRG). The G-DRG classification system is based on complex coding guidelines. The Medical Review Board of the Statutory Health Insurance Funds (MDK) examines the encoding by hospitals and delivers individual expertises on behalf of the German statutory health insurance companies in cases in which irregularities are suspected. A study was conducted on the inter-rater reliability of the MDK expertises regarding the scope of the assessment. A representative sample of 212 MDK expertises was taken from a selected pool of 1 392 MDK expertises in May 2013. This representative sample underwent a double-examination by 2 independent MDK experts using a special software based on the 3MTM G-DRG Grouper 2013 of 3M Medica, Germany. The following items encoded by the hospitals were examined: DRG, principal diagnosis, secondary diagnoses, procedures and additional payments. It was analysed whether the results of MDK expertises were consistent, reliable and correct. 202 expertises were eligible for evaluation, containing a total of 254 questions regarding one or more of the 5 items encoded by hospitals. The double-examination by 2 independent MDK experts showed matching results in 187 questions (73.6%) meaning they had been examined consistently and correctly. 59 questions (23.2%) did not show matching results, nevertheless they had been examined correctly regarding the scope of the assessment. None of the principal diagnoses was significantly affected by inconsistent or wrong judgment. A representative sample of MDK expertises examining the DRG encoding by hospitals showed a very high percentage of correct examination by the MDK experts. Identical MDK expertises cannot be achieved in all cases due to the scope of the assessment. Further improvement and simplification of codes and coding guidelines are required to reduce the scope of assessment with regard to correct DRG encoding and its

  1. Special features of health services and register based trials – experiences from a randomized trial of childbirth classes

    Directory of Open Access Journals (Sweden)

    Sevón Tiina

    2008-06-01

    Full Text Available Abstract Background Evaluating complex interventions in health services faces various difficulties, such as making practice changes and costs. Ways to increase research capacity and decrease costs include making research an integral part of health services and using routine data to judge outcomes. The purpose of this article is to report the feasibility of a pilot trial relying solely on routinely collected register data and being based on ordinary health services. Methods The example intervention was education to public health nurses (PHN (childbirth classes to reduce caesarean section rates via pre-delivery considerations of pregnant women. 20 maternity health centers (MHC were paired and of each 10 pairs, one MHC was randomly allocated to an intervention group and the other to a control; 8 pairs with successful intervention were used in the analyses (1601 mothers. The women visiting to the study maternity centers were identified from the Customer Register of Helsinki City. A list of the study women was made using the mother's personal identification number, visit date, the maternity center code, birth date and gestation length. The mode of delivery and health outcomes were retrieved from the Finnish Medical Birth Register (MBR. Process data of the intervention are based on observations, written feedback and questionnaires from PHNs, and project correspondence. Results It took almost two years to establish how to obtain permissions and to actually obtain it for the trial. Obtaining permissions for the customer and outcome data and register linkages was unproblematic and the cluster randomization provided comparable groups. The intervention did not succeed well. Had the main aim of the trial been to cause a change in PHNs behavior, we would have very likely intensified the intervention during the trial. Conclusion Our experiences encourage the use of trials that obtain their outcomes from registers. Changing the behavior of ordinary health

  2. How to attain expertise in clinical communication?

    Science.gov (United States)

    Wouda, Jan C; van de Wiel, Harry B M

    2013-12-01

    Several factors complicate the attainment of expertise in clinical communication. Medical curricula and postgraduate training insufficiently provide the required learning conditions of deliberate practice to overcome these obstacles. In this paper we provide recommendations for learning objectives and teaching methods for the attainment of professional expertise in patient education. Firstly, we propose to use functional learning objectives derived from the goals and strategies of clinical communication. Secondly, we recommend using teaching and assessment methods which: (1) contain stimulating learning tasks with opportunities for immediate feedback, reflection and corrections, and (2) give ample opportunity for repetition, gradual refinements and practice in challenging situations. Video-on-the-job fits these requirements and can be used to improve the competency in patient education of residents and medical staff in clinical practice. However, video-on-the-job can only be successful if the working environment supports the teaching and learning of communication and if medical staff which supervises the residents, is motivated to improve their own communication and didactic skills. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Musical expertise and foreign speech perception.

    Science.gov (United States)

    Martínez-Montes, Eduardo; Hernández-Pérez, Heivet; Chobert, Julie; Morgado-Rodríguez, Lisbet; Suárez-Murias, Carlos; Valdés-Sosa, Pedro A; Besson, Mireille

    2013-01-01

    The aim of this experiment was to investigate the influence of musical expertise on the automatic perception of foreign syllables and harmonic sounds. Participants were Cuban students with high level of expertise in music or in visual arts and with the same level of general education and socio-economic background. We used a multi-feature Mismatch Negativity (MMN) design with sequences of either syllables in Mandarin Chinese or harmonic sounds, both comprising deviants in pitch contour, duration and Voice Onset Time (VOT) or equivalent that were either far from (Large deviants) or close to (Small deviants) the standard. For both Mandarin syllables and harmonic sounds, results were clear-cut in showing larger MMNs to pitch contour deviants in musicians than in visual artists. Results were less clear for duration and VOT deviants, possibly because of the specific characteristics of the stimuli. Results are interpreted as reflecting similar processing of pitch contour in speech and non-speech sounds. The implications of these results for understanding the influence of intense musical training from childhood to adulthood and of genetic predispositions for music on foreign language perception are discussed.

  4. Musical expertise and foreign speech perception

    Directory of Open Access Journals (Sweden)

    Eduardo eMartínez-Montes

    2013-11-01

    Full Text Available The aim of this experiment was to investigate the influence of musical expertise on the automatic perception of foreign syllables and harmonic sounds. Participants were Cuban students with high level of expertise in music or in visual arts and with the same level of general education and socio-economic background. We used a multi-feature Mismatch Negativity (MMN design with sequences of either syllables in Mandarin Chinese or harmonic sounds, both comprising deviants in pitch contour, duration and Voice Onset Time (VOT or equivalent that were either far from (Large deviants or close to (Small deviants the standard. For both Mandarin syllables and harmonic sounds, results were clear-cut in showing larger MMNs to pitch contour deviants in musicians than in visual artists. Results were less clear for duration and VOT deviants, possibly because of the specific characteristics of the stimuli. Results are interpreted as reflecting similar processing of pitch contour in speech and non-speech sounds. The implications of these results for understanding the influence of intense musical training from childhood to adulthood and of genetic predispositions for music on foreign language perception is discussed.

  5. Potential of adaptive clinical trial designs in pharmacogenetic research, A simulation based on the IPASS trial

    NARCIS (Netherlands)

    Van Der Baan, Frederieke H.; Knol, Mirjam J.|info:eu-repo/dai/nl/304820350; Klungel, Olaf H.|info:eu-repo/dai/nl/181447649; Egberts, Toine C.G.|info:eu-repo/dai/nl/162850050; Grobbee, Diederick E.; Roes, Kit C.B.

    2011-01-01

    Background: An adaptive clinical trial design that allows population enrichment after interim analysis can be advantageous in pharmacogenetic research if previous evidence is not strong enough to exclude part of the patient population beforehand.With this design, underpowered studies or unnecessary

  6. Radiofrequency and health. Expertise update. Opinion of the ANSES. Collective expertise report

    International Nuclear Information System (INIS)

    Cardis, Elisabeth; Dore, Jean-Francois; Marc-Vergnes, Jean-Pierre; Agnani, Jean-Benoit; Bruguiere, Pierre; Crouzier, David; Debaz, Josquin; Debuire, Brigitte; Deltour, Isabelle; LE Drean, Yves; Ledoigt, Gerard; Letertre, Thierry; Marchand, Dorothee; Massardier-Pilonchery, Amelie; Nadi, Mustapha; Pereira De Vasconcelos, Anne; Hours, Martine; Fite, Johanna; Merckel, Olivier; Roth, Olivia; Vergriette, Benoit; Saddoki, Sophia

    2013-10-01

    In a context of development of new technologies of wireless communications, and therefore of radio-electric signals used to transmit information, this voluminous document reports a detailed study on the effects of radiofrequency on health. It is notably based on a large literature survey and on an assessment of the level of proof of these effects by experts (proved, possible, probable, insufficiently proved, or no effect on mankind). These effects can be either biological or on health. The report presents the context, scope and modalities of the expertise study, presents the main artificial and natural sources of radiofrequency radiation, gives a detailed presentation of new exposure sources (new signals, new radio-electric networks and their applications like mobile phones, pads, mobile television, local wireless networks, RFID, so on). It describes metrology and dose measurement techniques for electromagnetic fields (exposure characterization in laboratory, characterization of the electromagnetic environment, individual exposure measurement devices, digital dosimetry). It addresses the efficiency of anti-wave devices. The next part presents the literature survey (method, analysis, results). The authors then report an assessment of the risk level related to radio-frequencies for the central nervous system (neurotoxicity mechanisms, cognitive functions, memory and behaviour, sleep and circadian rhythms, hearing functions, neurological and neuro-degenerative diseases), and an assessment of the risk level of radio-frequencies for other non-carcinogenic effects (possible mechanisms, reproduction, immunology, endocrine system, and so on). They discuss the researches on potential carcinogenic mechanisms. They give an overview of the evolutions of regulations and management measures in France, and propose a set of recommendations

  7. A web-based clinical trial management system for a sham-controlled multicenter clinical trial in depression.

    Science.gov (United States)

    Durkalski, Valerie; Wenle Zhao; Dillon, Catherine; Kim, Jaemyung

    2010-04-01

    Clinical trial investigators and sponsors invest vast amounts of resources and energy into conducting trials and often face daily challenges with data management, project management, and data quality control. Rather than waiting months for study progress reports, investigators need the ability to use real-time data for the coordination and management of study activities across all study team members including site investigators, oversight committees, data and safety monitoring boards, and medical safety monitors. Web-based data management systems are beginning to meet this need but what distinguishes one system from the other are user needs/requirements and cost. To illustrate the development and implementation of a web-based data and project management system for a multicenter clinical trial designed to test the superiority of repeated transcranial magnetic stimulation versus sham for the treatment of patients with major depression. The authors discuss the reasons for not using a commercially available system for this study and describe the approach to developing their own web-based system for the OPT-TMS study. Timelines, effort, system architecture, and lessons learned are shared with the hope that this information will direct clinical trial researchers and software developers towards more efficient, user-friendly systems. The developers use a combination of generic and custom application code to allow for the flexibility to adapt the system to the needs of the study. Features of the system include: central participant registration and randomization; secure data entry at the site; participant progress/study calendar; safety data reporting; device accounting; monitor verification; and user-configurable generic reports and built-in customized reports. Hard coding was more time-efficient to address project-specific issues compared with the effort of creating a generic code application. As a consequence of this strategy, the required maintenance of the system is

  8. Fusion of expertise among accounting accounting faculty. Towards an expertise model for academia in accounting.

    NARCIS (Netherlands)

    Njoku, Jonathan C.; van der Heijden, Beatrice; Inanga, Eno L.

    2010-01-01

    This paper aims to portray an accounting faculty expert. It is argued that neither the academic nor the professional orientation alone appears adequate in developing accounting faculty expertise. The accounting faculty expert is supposed to develop into a so-called ‘flexpert’ (Van der Heijden, 2003)

  9. The influence of expertise on continuous categories: A whole report study of colour expertise

    DEFF Research Database (Denmark)

    Dall, Jonas Olsen; Sørensen, Thomas Alrik

    2018-01-01

    Recently research has shifted from examining discrete categories (e.g. letters) to continuous categories (e.g. colours). While studies have shown that stimuli specific expertise influence discrete categories, there are little research into how it influences continuous categories. The current study...

  10. Forensic entomology: implementing quality assurance for expertise work.

    Science.gov (United States)

    Gaudry, Emmanuel; Dourel, Laurent

    2013-09-01

    The Department of Forensic Entomology (Institut de Recherche Criminelle de la Gendarmerie Nationale, France) was accredited by the French Committee of Accreditation (Cofrac's Healthcare section) in October 2007 on the basis of NF EN ISO/CEI 17025 standard. It was the first accreditation in this specific field of forensic sciences in France and in Europe. The present paper introduces the accreditation process in forensic entomology (FE) through the experience of the Department of Forensic Entomology. Based upon the identification of necrophagous insects and the study of their biology, FE must, as any other expertise work in forensic sciences, demonstrate integrity and good working practice to satisfy both the courts and the scientific community. FE does not, strictly speaking, follow an analytical method. This could explain why, to make up for a lack of appropriate quality reference, a specific documentation was drafted and written by the staff of the Department of Forensic Entomology in order to define working methods complying with quality standards (testing methods). A quality assurance system is laborious to set up and maintain and can be perceived as complex, time-consuming and never-ending. However, a survey performed in 2011 revealed that the accreditation process in the frame of expertise work has led to new well-defined working habits, based on an effort at transparency. It also requires constant questioning and a proactive approach, both profitable for customers (magistrates, investigators) and analysts (forensic entomologists).

  11. The nature of expertise and human resource functions supporting expertise in nuclear industry organizations

    International Nuclear Information System (INIS)

    Rintala, N.; Katri, S.; Eila, J.; Pahkin, K.; Anneli, L.

    2007-01-01

    Full text: The nuclear industry worldwide faces the challenge of preserving the existing expertise, competence and knowledge despite of the ageing workforce and upcoming retirements. Challenges are also imposed by the reducing amount of new recruits and students entering the nuclear industry, which amounts to fewer young professionals that have the potential to become nuclear experts in the future. Although many other industries share similar challenges, the preservation of expertise in the nuclear industry is even more important due to the safety-critical nature of the nuclear operations and the special characteristics that high-reliability organizations such as nuclear power plants have. As a response to the risk of knowledge loss, nuclear organizations have engaged in knowledge capturing efforts. New information systems and organizational practices have been implemented to safeguard nuclear expertise. Recently, IAEA has proposed nuclear organizations to design and adopt people-centered programs that encompass themes such as workforce planning, recruitment, training, succession planning, leadership development and knowledge management. Thus, in order to address the current risks to nuclear expertise, attention should be focused on these different areas and corresponding human resources (HR) functions within the nuclear organizations. Our paper presents results from a project which examines the nature of expert work and human resources (HR) functions that support the development and preservation of expertise. The study adopts a qualitative cross-sectional case study design. Two organizational units from different nuclear industry organizations have been selected as cases. The research data will be gathered in April-May 2007 and preliminary results will be presented in the International Conference of Knowledge Management in Nuclear Facilities, in June 2007. The main data will comprise of thematic interviews to experts, their managers and HR representatives

  12. Valuing Trial Designs from a Pharmaceutical Perspective Using Value-Based Pricing.

    Science.gov (United States)

    Breeze, Penny; Brennan, Alan

    2015-11-01

    Our aim was to adapt the traditional framework for expected net benefit of sampling (ENBS) to be more compatible with drug development trials from the pharmaceutical perspective. We modify the traditional framework for conducting ENBS and assume that the price of the drug is conditional on the trial outcomes. We use a value-based pricing (VBP) criterion to determine price conditional on trial data using Bayesian updating of cost-effectiveness (CE) model parameters. We assume that there is a threshold price below which the company would not market the new intervention. We present a case study in which a phase III trial sample size and trial duration are varied. For each trial design, we sampled 10,000 trial outcomes and estimated VBP using a CE model. The expected commercial net benefit is calculated as the expected profits minus the trial costs. A clinical trial with shorter follow-up, and larger sample size, generated the greatest expected commercial net benefit. Increasing the duration of follow-up had a modest impact on profit forecasts. Expected net benefit of sampling can be adapted to value clinical trials in the pharmaceutical industry to optimise the expected commercial net benefit. However, the analyses can be very time consuming for complex CE models. © 2014 The Authors. Health Economics published by John Wiley & Sons Ltd.

  13. Guided Web-Based Cognitive Behavior Therapy for Perfectionism: Results From Two Different Randomized Controlled Trials.

    Science.gov (United States)

    Rozental, Alexander; Shafran, Roz; Wade, Tracey D; Kothari, Radha; Egan, Sarah J; Ekberg, Linda; Wiss, Maria; Carlbring, Per; Andersson, Gerhard

    2018-04-26

    Perfectionism can become a debilitating condition that may negatively affect functioning in multiple areas, including mental health. Prior research has indicated that internet-based cognitive behavioral therapy can be beneficial, but few studies have included follow-up data. The objective of this study was to explore the outcomes at follow-up of internet-based cognitive behavioral therapy with guided self-help, delivered as 2 separate randomized controlled trials conducted in Sweden and the United Kingdom. In total, 120 participants randomly assigned to internet-based cognitive behavioral therapy were included in both intention-to-treat and completer analyses: 78 in the Swedish trial and 62 in the UK trial. The primary outcome measure was the Frost Multidimensional Perfectionism Scale, Concern over Mistakes subscale (FMPS CM). Secondary outcome measures varied between the trials and consisted of the Clinical Perfectionism Questionnaire (CPQ; both trials), the 9-item Patient Health Questionnaire (PHQ-9; Swedish trial), the 7-item Generalized Anxiety Disorder scale (GAD-7; Swedish trial), and the 21-item Depression Anxiety Stress Scale (DASS-21; UK trial). Follow-up occurred after 6 months for the UK trial and after 12 months for the Swedish trial. Analysis of covariance revealed a significant difference between pretreatment and follow-up in both studies. Intention-to-treat within-group Cohen d effect sizes were 1.21 (Swedish trial; 95% CI 0.86-1.54) and 1.24 (UK trial; 95% CI 0.85-1.62) for the FMPS CM. Furthermore, 29 (59%; Swedish trial) and 15 (43%; UK trial) of the participants met the criteria for recovery on the FMPS CM. Improvements were also significant for the CPQ, with effect sizes of 1.32 (Swedish trial; 95% CI 0.97-1.66) and 1.49 (UK trial; 95% CI 1.09-1.88); the PHQ-9, effect size 0.60 (95% CI 0.28-0.92); the GAD-7, effect size 0.67 (95% CI 0.34-0.99); and the DASS-21, effect size 0.50 (95% CI 0.13-0.85). The results are promising for the use of

  14. A simple method for calculating power based on a prior trial.

    NARCIS (Netherlands)

    Borm, G.F.; Bloem, B.R.; Munneke, M.; Teerenstra, S.

    2010-01-01

    OBJECTIVE: When an investigator wants to base the power of a planned clinical trial on the outcome of another trial, the latter study may not have been reported in sufficient detail to allow this. For example, when the outcome is a change from baseline, the power calculation requires the standard

  15. Expertise in Everyday Nurse–Patient Conversations

    Directory of Open Access Journals (Sweden)

    Lindsay M. Macdonald

    2016-04-01

    Full Text Available A great deal of nursing activity is embedded in what is considered to be everyday conversation. These conversations are important to health professionals because communication can affect health outcomes, and they are important to patients who want to know they are being heard and cared for. How do nurses talk with patients and what are the features of effective communication in practice? In this exploratory study, two expert nurses recorded conversations with patients during domiciliary visits. Linguistic discourse analysis, informed by contextual knowledge of domiciliary nursing shows the nurses skillfully used small talk to support their clinical work. In their conversations, nurses elicit specific information, normalize unpleasant procedures, manage the flow of the interaction, and strengthen the therapeutic relationship. Small talk can be big talk in achieving nursing goals. Critically reflecting on recorded clinical interactions can be a useful method of professional development and a way of demonstrating nursing expertise.

  16. Losing nuclear expertise - A safety concern

    International Nuclear Information System (INIS)

    Ziakova, M.

    2002-01-01

    Full text: Since the mid of eighties several important changes in human beings behaviour, which influence nuclear field, can be observed - the loss of interest in studying technical disciplines (namely nuclear), strong pressure of environmental movements, stagnation of electricity consumption and deregulation of electric markets. All these factors create conditions which are leading to the decrease of job positions related to the nuclear field connected particularly with research, design and engineering. Loss of interest in studying nuclear disciplines together with the decrease of number of job positions has led to the declining of university enrolments, closing of university departments and research reactors. In this manner just a very small number of appropriately educated new experts are brought In the same moment the additional internal factor - the relative ageing of the human workforce on both sites operators of nuclear facilities and research and engineering organisations can be observed. All these factors, if not addressed properly, could lead to the loss of nuclear expertise and the loss of nuclear expertise represents the direct thread to the nuclear safety. The latest studies have shown that at present NPPs cannot be replaced by other kinds of electric sources and in no case by renewable ones in an efficient manner. Therefore it is necessary to carefully manage knowledge gathered in the nuclear field during the years and to keep on the nuclear safety research, education and training to ensure and upgrade safe and reliable operation of existing and future nuclear facilities. This is responsibility of both the governments of the states using nuclear applications and owners of nuclear facilities. (author)

  17. An Issues-Based Research Project: National Goals on Trial.

    Science.gov (United States)

    DeVille, Priscilla; And Others

    This paper summarizes the results of a research project completed by three doctoral students enrolled in an advanced curriculum development course at the University of Southern Mississippi (Hattiesburg). The students used a mock trial format to consider reasons to support establishment of a national curriculum (concerning the American public's…

  18. Trials

    Directory of Open Access Journals (Sweden)

    Michele Fornaro

    2010-01-01

    Full Text Available Mental Retardation (MR is a developmental disability characterized by impairments in adaptive daily life skills and difficulties in social and interpersonal functioning. Since multiple causes may contribute to MR, associated clinical pictures may vary accordingly. Nevertheless, when psychiatric disorders as Treatment Resistant Depression (TRD and/or alcohol abuse co-exist, their proper detection and management is often troublesome, essentially due to a limited vocabulary MR people could use to describe their symptoms, feelings and concerns, and the lack of reliable screening tools. Furthermore, MR people are among the most medicated subjects, with (over prescription of antidepressants and/or typical antipsychotics being the rule rather than exception. Thus, treatment resistance or even worsening of depression, constitute frequent occurrences. This report describes the case of a person with MR who failed to respond to repetitive trials of antidepressant monotherapies, finally recovering using aripiprazole to fluvoxamine augmentation upon consideration of a putative bipolar diathesis for “agitated” TRD. Although further controlled investigations are needed to assess a putative bipolar diathesis in some cases of MR associated to TRD, prudence is advised in the long-term prescription of antidepressant monotherapies in such conditions.

  19. The relaxation exercise and social support trial-resst: study protocol for a randomized community based trial

    Directory of Open Access Journals (Sweden)

    Nakkash Rima

    2011-08-01

    Full Text Available Abstract Background Studies suggests a possible link between vaginal discharge and common mental distress, as well as highlight the implications of the subjective burden of disease and its link with mental health. Methods/Design This is a community-based intervention trial that aims to evaluate the impact of a psycho-social intervention on medically unexplained vaginal discharge (MUVD in a group of married, low-income Lebanese women, aged 18-49, and suffering from low to moderate levels of anxiety and/or depression. The intervention consisted of 12 sessions of structured social support, problem solving techniques, group discussions and trainer-supervised relaxation exercises (twice per week over six weeks. Women were recruited from Hey el Selloum, a southern disadvantaged suburb of Beirut, Lebanon, during an open recruitment campaign. The primary outcome was self-reported MUVD, upon ruling out reproductive tract infections (RTIs, through lab analysis. Anxiety and/or depression symptoms were the secondary outcomes for this trial. These were assessed using an Arabic validated version of the Hopkins Symptoms Checklist-25 (HSCL-25. Assessments were done at baseline and six months using face-to face interviews, pelvic examinations and laboratory tests. Women were randomized into either intervention or control group. Intent to treat analysis will be used. Discussion The results will indicate whether the proposed psychosocial intervention was effective in reducing MUVD (possibly mediated by common mental distress. Trial Registration The trial is registered at the Wellcome Trust Registry, ISRCTN assigned: ISRCTN: ISRCTN98441241

  20. Qualitative Understanding of Magnetism at Three Levels of Expertise

    Science.gov (United States)

    Stefani, Francesco; Marshall, Jill

    2010-03-01

    This work set out to investigate the state of qualitative understanding of magnetism at various stages of expertise, and what approaches to problem-solving are used across the spectrum of expertise. We studied three groups: 10 novices, 10 experts-in-training, and 11 experts. Data collection involved structured interviews during which participants solved a series of non-standard problems designed to test for conceptual understanding of magnetism. The interviews were analyzed using a grounded theory approach. None of the novices and only a few of the experts in training showed a strong understanding of inductance, magnetic energy, and magnetic pressure; and for the most part they tended not to approach problems visually. Novices frequently described gist memories of demonstrations, text book problems, and rules (heuristics). However, these fragmentary mental models were not complete enough to allow them to reason productively. Experts-in-training were able to solve problems that the novices were not able to solve, many times simply because they had greater recall of the material, and therefore more confidence in their facts. Much of their thinking was concrete, based on mentally manipulating objects. The experts solved most of the problems in ways that were both effective and efficient. Part of the efficiency derived from their ability to visualize and thus reason in terms of field lines.

  1. Treatment Algorithms Based on Tumor Molecular Profiling: The Essence of Precision Medicine Trials.

    Science.gov (United States)

    Le Tourneau, Christophe; Kamal, Maud; Tsimberidou, Apostolia-Maria; Bedard, Philippe; Pierron, Gaëlle; Callens, Céline; Rouleau, Etienne; Vincent-Salomon, Anne; Servant, Nicolas; Alt, Marie; Rouzier, Roman; Paoletti, Xavier; Delattre, Olivier; Bièche, Ivan

    2016-04-01

    With the advent of high-throughput molecular technologies, several precision medicine (PM) studies are currently ongoing that include molecular screening programs and PM clinical trials. Molecular profiling programs establish the molecular profile of patients' tumors with the aim to guide therapy based on identified molecular alterations. The aim of prospective PM clinical trials is to assess the clinical utility of tumor molecular profiling and to determine whether treatment selection based on molecular alterations produces superior outcomes compared with unselected treatment. These trials use treatment algorithms to assign patients to specific targeted therapies based on tumor molecular alterations. These algorithms should be governed by fixed rules to ensure standardization and reproducibility. Here, we summarize key molecular, biological, and technical criteria that, in our view, should be addressed when establishing treatment algorithms based on tumor molecular profiling for PM trials. © The Author 2015. Published by Oxford University Press.

  2. Expertise and age-related changes in components of intelligence.

    Science.gov (United States)

    Masunaga, H; Horn, J

    2001-06-01

    In a sample of 263 male GO players at 48 levels of expertise and ranging from 18 to 78 years of age, it was found that factors of expertise deductive reasoning (EDR) and expertise working memory (EWM) were independent of factors of fluid reasoning (Gf) and short-term working memory (STWM) that, along with cognitive speed (Gs), have been found to characterize decline of intelligence in adulthood. The main effects of analyses of cross-sectional age differences indicated age-related decline in EDR and EWM as well as in Gf, STWM, and Gs. However, interaction and partialing analyses indicated that decline in EDR and EWM decreased to no decline with increase in level of expertise. The results thus suggest that with increase in factors known to raise the level of expertise--particularly, intensive, well-designed practice--there may be no age-related decline in the intelligence that is measured in the abilities of expertise.

  3. Guidance for Researchers Developing and Conducting Clinical Trials in Practice-based Research Networks (PBRNs)

    Science.gov (United States)

    Dolor, Rowena J.; Schmit, Kristine M.; Graham, Deborah G.; Fox, Chester H.; Baldwin, Laura Mae

    2015-01-01

    Background There is increased interest nationally in multicenter clinical trials to answer questions about clinical effectiveness, comparative effectiveness, and safety in real-world community settings. Primary care practice-based research networks (PBRNs), comprising community- and/or academically affiliated practices committed to improving medical care for a range of health problems, offer ideal settings for these trials, especially pragmatic clinical trials. However, many researchers are not familiar with working with PBRNs. Methods Experts in practice-based research identified solutions to challenges that researchers and PBRN personnel experience when collaborating on clinical trials in PBRNs. These were organized as frequently asked questions in a draft document presented at a 2013 Agency for Health care Research and Quality PBRN conference workshop, revised based on participant feedback, then shared with additional experts from the DARTNet Institute, Clinical Translational Science Award PBRN, and North American Primary Care Research Group PBRN workgroups for further input and modification. Results The “Toolkit for Developing and Conducting Multi-site Clinical Trials in Practice-Based Research Networks” offers guidance in the areas of recruiting and engaging practices, budgeting, project management, and communication, as well as templates and examples of tools important in developing and conducting clinical trials. Conclusion Ensuring the successful development and conduct of clinical trials in PBRNs requires a highly collaborative approach between academic research and PBRN teams. PMID:25381071

  4. The Healthy Steps Study: A randomized controlled trial of a pedometer-based Green Prescription for older adults. Trial protocol

    Directory of Open Access Journals (Sweden)

    Schluter Philip J

    2009-11-01

    Full Text Available Abstract Background Graded health benefits of physical activity have been demonstrated for the reduction of coronary heart disease, some cancers, and type-2 diabetes, and for injury reduction and improvements in mental health. Older adults are particularly at risk of physical inactivity, and would greatly benefit from successful targeted physical activity interventions. Methods/Design The Healthy Steps study is a 12-month randomized controlled trial comparing the efficacy of a pedometer-based Green Prescription with the conventional time-based Green Prescription in increasing and maintaining physical activity levels in low-active adults over 65 years of age. The Green Prescription interventions involve a primary care physical activity prescription with 3 follow-up telephone counselling sessions delivered by trained physical activity counsellors over 3 months. Those in the pedometer group received a pedometer and counselling based around increasing steps that can be monitored on the pedometer, while those in the standard Green Prescription group received counselling using time-based goals. Baseline, 3 month (end of intervention, and 12 month measures were assessed in face-to-face home visits with outcomes measures being physical activity (Auckland Heart Study Physical Activity Questionnaire, quality of life (SF-36 and EQ-5D, depressive symptoms (Geriatric Depression Scale, blood pressure, weight status, functional status (gait speed, chair stands, and tandem balance test and falls and adverse events (self-report. Utilisation of health services was assessed for the economic evaluation carried out alongside this trial. As well, a process evaluation of the interventions and an examination of barriers and motives for physical activity in the sample were conducted. The perceptions of primary care physicians in relation to delivering physical activity counselling were also assessed. Discussion The findings from the Healthy Steps trial are due in late

  5. Reactor pressure vessel and reactor coolant circuit cast duplex stainless steel components contribution of the expertise for life management studies

    International Nuclear Information System (INIS)

    Bezdikian, Georges

    2006-09-01

    The life management of French Nuclear Power Plants is a major stake from an economic and a technical point of view considering the aging management assessment of the key components of the plant. The actual life evaluation is the result of prediction of life assessment from important program of expertise for the 3-loop PWR and 4-loop PWR plants in operation. To optimize the strategic policy in order to achieve the best possible performance and to prepare the technical and economical choice and decision, the paper presents the association of life management strategy and the program of expertise considering: - the identification of degradation for different components and prediction criteria proposed; - the large database from cast reactor coolant and component removed from nuclear power plants and expertise studies to confirm the prediction; - the life evaluation of RPV with radiation surveillance program based on the expertise of irradiation capsules, it is particularly shown how the expertise is in the center of the strategic choice. The French utility has organized the life management of nuclear plant as a function of several programs of expertise of knowledge on the long term experience feedback and the maintenance program for life. This paper shows updated on RPV and reactor coolant equipment activities engaged by utility on: - periodic maintenance and volume of expertise; - Alternative maintenance actions; - Large volume of expertise and how are managed these results to predict the aging management. (author)

  6. Instructional Design for Accelerated Macrocognitive Expertise in the Baseball Workplace

    OpenAIRE

    Fadde, Peter J.

    2016-01-01

    The goal of accelerating expertise can leave researchers and trainers in human factors, naturalistic decision making, sport science, and expertise studies concerned about seemingly insufficient application of expert performance theories, findings and methods for training macrocognitive aspects of human performance. Video-occlusion methods perfected by sports expertise researchers have great instructional utility, in some cases offering an effective and inexpensive alternative to high-fidelity...

  7. Expertise synthesis on the CSPE; Synthese d'expertise sur la CSPE

    Energy Technology Data Exchange (ETDEWEB)

    Blonde, G.; Poizat, F

    2008-01-15

    This document presents a synthesis of the results of an expertise realized on the CSPE, the compensation tax of the electric public service. This tax concerns the management of the electricity production additional costs in isolated areas, the solidarity, a policy to favor the energy efficiency and the renewable energies. The document explains the historical aspects of the tax elaboration, its financial importance, the consequences and the impacts on the competition. (A.L.B.)

  8. The Automation-by-Expertise-by-Training Interaction.

    Science.gov (United States)

    Strauch, Barry

    2017-03-01

    I introduce the automation-by-expertise-by-training interaction in automated systems and discuss its influence on operator performance. Transportation accidents that, across a 30-year interval demonstrated identical automation-related operator errors, suggest a need to reexamine traditional views of automation. I review accident investigation reports, regulator studies, and literature on human computer interaction, expertise, and training and discuss how failing to attend to the interaction of automation, expertise level, and training has enabled operators to commit identical automation-related errors. Automated systems continue to provide capabilities exceeding operators' need for effective system operation and provide interfaces that can hinder, rather than enhance, operator automation-related situation awareness. Because of limitations in time and resources, training programs do not provide operators the expertise needed to effectively operate these automated systems, requiring them to obtain the expertise ad hoc during system operations. As a result, many do not acquire necessary automation-related system expertise. Integrating automation with expected operator expertise levels, and within training programs that provide operators the necessary automation expertise, can reduce opportunities for automation-related operator errors. Research to address the automation-by-expertise-by-training interaction is needed. However, such research must meet challenges inherent to examining realistic sociotechnical system automation features with representative samples of operators, perhaps by using observational and ethnographic research. Research in this domain should improve the integration of design and training and, it is hoped, enhance operator performance.

  9. Sustainable network of independent technical expertise for radioactive waste disposal

    International Nuclear Information System (INIS)

    Serres, Christophe; Rocher, Muriel; Lemy, Frank; Havlova, Vaclava; Mrskova, Adela; Heriard Dubreuil, Gilles

    2014-01-01

    been developed. For each of these issues, the needs of national safety authorities and of TSO for dialogue and/or guidance development and harmonisation were identified. A set of R and D activities was structured into main key safety issues related to the safety functions and components of the deep geological disposal. This will constitute the basis for the development and future implementation of a scientific research agenda (SRA) proper to expertise bodies and technical safety organisations. In parallel, an assessment of available technical means and scientific skills amongst SITEX partners is under consideration in order to identify areas for possible co-operation, exchange of staff and needs for improvement. This will contribute to assess how in practice this SRA could be implemented amongst organisation in close co-operation. Another objective of the elaboration of such SRA is to engage in scientific dialogue with IGD-TP, keeping in mind the context of the new EC H2020 programme and the identification of possible research projects of common interest for IGD-TP and SITEX. A tentative framework for deriving a harmonised safety review method is proposed mainly based on development of existing material produced by the former European Pilot Study and the IAEA GEOSAF project. As an integrated part of the technical and scientific review process, SITEX engaged with the identification of practical ways to interact with civil society in the expertise function on a durable process. For this purpose, a dedicated meeting was organised with actors of the civil society in Senec (Slovakia) in September 2013. Finally, a framework document describing the characterisation of the national expertise function and elaborating a reflection on what could be the missions and the role of the future European SITEX network will be issued on the basis on the above elements with the objective to establish the future terms of reference of the network. (authors)

  10. A Semantic Web-based System for Mining Genetic Mutations in Cancer Clinical Trials.

    Science.gov (United States)

    Priya, Sambhawa; Jiang, Guoqian; Dasari, Surendra; Zimmermann, Michael T; Wang, Chen; Heflin, Jeff; Chute, Christopher G

    2015-01-01

    Textual eligibility criteria in clinical trial protocols contain important information about potential clinically relevant pharmacogenomic events. Manual curation for harvesting this evidence is intractable as it is error prone and time consuming. In this paper, we develop and evaluate a Semantic Web-based system that captures and manages mutation evidences and related contextual information from cancer clinical trials. The system has 2 main components: an NLP-based annotator and a Semantic Web ontology-based annotation manager. We evaluated the performance of the annotator in terms of precision and recall. We demonstrated the usefulness of the system by conducting case studies in retrieving relevant clinical trials using a collection of mutations identified from TCGA Leukemia patients and Atlas of Genetics and Cytogenetics in Oncology and Haematology. In conclusion, our system using Semantic Web technologies provides an effective framework for extraction, annotation, standardization and management of genetic mutations in cancer clinical trials.

  11. Using Cognitive Load Theory to Tailor Instruction to Levels of Accounting Students' Expertise

    Science.gov (United States)

    Blayney, Paul; Kalyuga, Slava; Sweller, John

    2015-01-01

    Tailoring of instructional methods to learner levels of expertise may reduce extraneous cognitive load and improve learning. Contemporary technology-based learning environments have the potential to substantially enable learner-adapted instruction. This paper investigates the effects of adaptive instruction based on using the isolated-interactive…

  12. Expertise and governance of climate change

    International Nuclear Information System (INIS)

    Encinas de Munagorri, R.; Colson, R.; Denis, B.; Leclerc, O.; Rousseau, S.; Torre-Schaub, M.

    2009-01-01

    Global warming has become in few years a prominent problem which requires the implementation of a world governance to be solved. However, the share of human activities in the global warming phenomenon and the actions susceptible to mitigate the greenhouse gases emission generate scientifical, political and legal conflicts at the same time. Assessing the taking into account of climate change by international institutions raises several questions. By what process a true fact can become established at the world scale? Are experts free or constrain by procedure rules? How to regulate the worldwide carbon trade? Is the governance requirement foreseen in international systems respected by decision making practices? How to explain experts' omnipresence in the observance mechanisms of climate change treaties? Is their influence determining, at the international and internal scale, in the elaboration of a climate law? These questions, analyzed by researchers in law and political science, are indissociable of method stakes with an inter-disciplinary horizon. This book, result of a collective work, is not limited to a description of standards and actors' practices in force. Its ambition is to apprehend law, science and politics in their interactions. Climate change is an appropriate topic to think about the links between the different scientific disciplines. The book concludes with a prospective about the contribution of laws analysis to expertise which involves the dogmatic, realistic and epistemologic aspects. (J.S.)

  13. Sherlock Holmes: an expert's view of expertise.

    Science.gov (United States)

    André, Didierjean; Fernand, Gobet

    2008-02-01

    In recent years, there has been an intense research effort to understand the cognitive processes and structures underlying expert behaviour. Work in different fields, including scientific domains, sports, games and mnemonics, has shown that there are vast differences in perceptual abilities between experts and novices, and that these differences may underpin other cognitive differences in learning, memory and problem solving. In this article, we evaluate the progress made in the last years through the eyes of an outstanding, albeit fictional, expert: Sherlock Holmes. We first use the Sherlock Holmes character to illustrate expert processes as described by current research and theories. In particular, the role of perception, as well as the nature and influence of expert knowledge, are all present in the description of Conan Doyle's hero. In the second part of the article, we discuss a number of issues that current research on expertise has barely addressed. These gaps include, for example, several forms of reasoning, the influence of emotions on cognition, and the effect of age on experts' knowledge and cognitive processes. Thus, although nearly 120-year-old, Conan Doyle's books show remarkable illustrations of expert behaviour, including the coverage of themes that have mostly been overlooked by current research.

  14. Example-based learning: Effects of model expertise in relation to student expertise

    NARCIS (Netherlands)

    T. Boekhout (Teun); T.A.J.M. van Gog (Tamara); M.W.J. van de Wiel (Margje); D. Gerards-Last (Dorien); F. Geraets (Frank)

    2010-01-01

    textabstractBackground. Worked examples are very effective for novice learners. They typically present a written-out ideal (didactical) solution for learners to study. nAims. This study used worked examples of patient history taking in physiotherapy that presented a non-didactical solution (i.e.,

  15. Using professional expertise in partnership with families: A new model of capacity building.

    Science.gov (United States)

    Clerke, Teena; Hopwood, Nick; Chavasse, Fran; Fowler, Cathrine; Lee, Sally; Rogers, Julie

    2017-03-01

    The first five years of parenting are critical to children's development. Parents are known to respond best to interventions with a partnership-based approach, yet child and family health nurses (CFHNs) report some tension between employing their expertise and maintaining a partnership relationship. This article identifies ways in which CFHNs skilfully use their professional expertise, underpinned by helping qualities and interpersonal skills, to assist families build confidence and capacity, and thus buffer against threats to parent and child well-being. It reports on an Australian ethnographic study of services for families with young children. Fifty-two interactions were observed between CFHNs and families in day-stay and home visiting services in Sydney. A new model is presented, based on four partnership activities and the fluid movement between them, to show how CFHNs use their expertise to identify strengths and foster resilience in families in the longer term, without undermining the principles of partnership.

  16. Classification of Recommender Expertise in the Wikipedia Recommender System

    DEFF Research Database (Denmark)

    Jensen, Christian D.; Pilkauskas, Povilas; Lefévre, Thomas

    2011-01-01

    to the quality of articles. The Wikipedia Recommender System (WRS) was developed to help users determine the credibility of articles based on feedback from other Wikipedia users. The WRS implements a collaborative filtering system with trust metrics, i.e., it provides a rating of articles which emphasizes...... an evaluation of four existing knowledge classification schemes with respect to these requirements. This evaluation helped us identify a classification scheme, which we have implemented in the current version of the Wikipedia Recommender System....... feedback from recommenders that the user has agreed with in the past. This exposes the problem that most recommenders are not equally competent in all subject areas. The first WRS prototype did not include an evaluation of the areas of expertise of recommenders, so the trust metric used in the article...

  17. Classification of Recommender Expertise in the Wikipedia Recommender System

    DEFF Research Database (Denmark)

    Jensen, Christian D.; Pilkauskas, Povilas; Lefevre, Thomas

    2011-01-01

    to the quality of articles. The Wikipedia Recommender System (WRS) was developed to help users determine the credibility of articles based on feedback from other Wikipedia users. The WRS implements a collaborative filtering system with trust metrics, i.e., it provides a rating of articles "which emphasizes...... an evaluation of four existing knowledge classification schemes with respect to these requirements. This evaluation helped us identify a classification scheme, which we have implemented in the current version of the Wikipedia Recommender System....... feedback from recommenders that the user has agreed with in the past. This exposes the problem that most recommenders are not equally competent in all subject areas. The first WRS prototype did not include an evaluation of the areas of expertise of recommenders, so the trust metric used in the article...

  18. Expertise of using striking techniques for power stroke in badminton.

    Science.gov (United States)

    Zhu, Qin

    2013-10-01

    Two striking techniques (fast swing and angled striking) were examined to see if they allowed effective use of string tension for the power stroke in badminton. 12 participants (4 novices, 4 recreational, and 4 expert badminton players) were recorded by a fast-speed camera while striking a shuttlecock with racquets of 8 different string tensions. The peak speed of the shuttlecock, the racquet angle and the shuttlecock angle were analyzed. The results showed that expert players succeeded in using both striking techniques to overcome the constraint of string tension and produce a consistently superior stroke. Failure to use either striking technique resulted in inferior performance that was constrained by string tension. Expertise in badminton allows the necessary motor adjustments based on the affordance perception of the string tension.

  19. Driven by Expertise and Insulation? The Autonomy of European Regulatory Agencies

    Directory of Open Access Journals (Sweden)

    Christoph Ossege

    2015-03-01

    Full Text Available Expertise and autonomy are cornerstones to the effective operation and legitimacy of European Regulatory Agencies (ERAs. Yet, we know little about ERAs’ actual autonomy, nor about factors shaping it. This article studies ERAs’ actual autonomy from public and private actors, emphasising two crucial explanatory factors: expertise and rulemaking competences. The lack of insights on expertise is particularly striking, as expertise—the “raison d’être” and main resource of expert bodies—provides ERAs with a potentially powerful means to increase autonomy. Relying on a rational institutionalist framework within which ERAs enjoy substantive discretion to pursue their goals, the study empirically compares three powerful ERAs—the European Medicines Agency, the European Chemicals Agency, and the European Food Safety Authority. Based on the analysis of 39 semi-structured expert interviews, findings show that expertise is a crucial explanation for ERAs’ substantive autonomy from the Commission. Towards research intensive private stakeholders, the role of expertise becomes less pronounced. Instead, ERAs are more successful in protecting their autonomy by engaging in the risk-averse interpretation of the regulatory framework and by adapting rules over time to adapt their needs: they engage in “procedural insulation”. Political salience provides a scope condition for ERAs to use expert knowledge and rulemaking competences more strategically—potentially undermining scientific quality.

  20. [Evaluation of Web-based software applications for administrating and organising an ophthalmological clinical trial site].

    Science.gov (United States)

    Kortüm, K; Reznicek, L; Leicht, S; Ulbig, M; Wolf, A

    2013-07-01

    The importance and complexity of clinical trials is continuously increasing, especially in innovative specialties like ophthalmology. Therefore an efficient clinical trial site organisational structure is essential. In modern internet times, this can be accomplished by web-based applications. In total, 3 software applications (Vibe on Prem, Sharepoint and open source software) were evaluated in a clinical trial site in ophthalmology. Assessment criteria were set; they were: reliability, easiness of administration, usability, scheduling, task list, knowledge management, operating costs and worldwide availability. Vibe on Prem customised by the local university met the assessment criteria best. Other applications were not as strong. By introducing a web-based application for administrating and organising an ophthalmological trial site, studies can be conducted in a more efficient and reliable manner. Georg Thieme Verlag KG Stuttgart · New York.

  1. A Multimodal Neural Network Recruited by Expertise with Musical Notation

    Science.gov (United States)

    Wong, Yetta Kwailing; Gauthier, Isabel

    2010-01-01

    Prior neuroimaging work on visual perceptual expertise has focused on changes in the visual system, ignoring possible effects of acquiring expert visual skills in nonvisual areas. We investigated expertise for reading musical notation, a skill likely to be associated with multimodal abilities. We compared brain activity in music-reading experts…

  2. Invasive Species Working Group: Research Summary and Expertise Directory

    Science.gov (United States)

    Jack Butler; Dean Pearson; Mee-Sook Kim

    2009-01-01

    Rocky Mountain Research Station (RMRS) personnel have scientific expertise in widely ranging disciplines and conduct multidisciplinary research on invasive species issues with emphasis in terrestrial and aquatic habitats throughout the Interior West, Great Plains, and related areas (fig. 1; Expertise Directory; appendix). RMRS invasive species research covers an array...

  3. Toward a multifactorial model of expertise: beyond born versus made.

    Science.gov (United States)

    Hambrick, David Z; Burgoyne, Alexander P; Macnamara, Brooke N; Ullén, Fredrik

    2018-02-15

    The debate over the origins of individual differences in expertise has raged for over a century in psychology. The "nature" view holds that expertise reflects "innate talent"-that is, genetically determined abilities. The "nurture" view counters that, if talent even exists, its effects on ultimate performance are negligible. While no scientist takes seriously a strict nature-only view of expertise, the nurture view has gained tremendous popularity over the past several decades. This environmentalist view holds that individual differences in expertise reflect training history, with no important contribution to ultimate performance by innate ability ("talent"). Here, we argue that, despite its popularity, this view is inadequate to account for the evidence concerning the origins of expertise that has accumulated since the view was first proposed. More generally, we argue that the nature versus nurture debate in research on expertise is over-or certainly should be, as it has been in other areas of psychological research for decades. We describe a multifactorial model for research on the nature and nurture of expertise, which we believe will provide a progressive direction for future research on expertise. © 2018 New York Academy of Sciences.

  4. A Data Management System Integrating Web-based Training and Randomized Trials: Requirements, Experiences and Recommendations.

    Science.gov (United States)

    Muroff, Jordana; Amodeo, Maryann; Larson, Mary Jo; Carey, Margaret; Loftin, Ralph D

    2011-01-01

    This article describes a data management system (DMS) developed to support a large-scale randomized study of an innovative web-course that was designed to improve substance abuse counselors' knowledge and skills in applying a substance abuse treatment method (i.e., cognitive behavioral therapy; CBT). The randomized trial compared the performance of web-course-trained participants (intervention group) and printed-manual-trained participants (comparison group) to determine the effectiveness of the web-course in teaching CBT skills. A single DMS was needed to support all aspects of the study: web-course delivery and management, as well as randomized trial management. The authors briefly reviewed several other systems that were described as built either to handle randomized trials or to deliver and evaluate web-based training. However it was clear that these systems fell short of meeting our needs for simultaneous, coordinated management of the web-course and the randomized trial. New England Research Institute's (NERI) proprietary Advanced Data Entry and Protocol Tracking (ADEPT) system was coupled with the web-programmed course and customized for our purposes. This article highlights the requirements for a DMS that operates at the intersection of web-based course management systems and randomized clinical trial systems, and the extent to which the coupled, customized ADEPT satisfied those requirements. Recommendations are included for institutions and individuals considering conducting randomized trials and web-based training programs, and seeking a DMS that can meet similar requirements.

  5. [The genesis, system, functions, and tendencies in the development of forensic expertise].

    Science.gov (United States)

    Rossinskaya, E R

    The author considers the main landmarks in the formation and development of the science of forensic expertise and related activities. Special attention is given to the necessity of increasing knowledge and skills in judicial proceedings, further elaboration and perfection of the theory and practice of forensic expertise to meet the requirements put forward by the XXIth century. It is emphasized that this work is needed to lay the foundation for the creation of the self-consistent science - forensic expertology, based on the interdisciplinary general theory of forensic expertise. The author builds up the definition of the subject of forensic expertology taking into consideration the basic issues studied by this science. The scientific paradigm, its functions, tendencies and prospects for its further development are substantiated.

  6. The Politics of Neutrality and the Changing Role of Expertise in Public Administration

    DEFF Research Database (Denmark)

    Triantafillou, Peter

    2015-01-01

    This article explores and discusses the ongoing attempt to reinstate an ethos of neutrality in public administration. It focuses on the political benefits and costs of contemporary strategies in public administration for using expertise based on an ethos of neutrality. On the one hand, expertise...... may serve to allow a particular form of value neutrality that curbs abuse of political office, questions received wisdom on the efficacy of policy interventions, and thereby holds the potential to minimize the waste of public resources employed to meet political goals. On the other hand, the use...

  7. Knowledge management: Preserving skills and expertise for nuclear industry

    International Nuclear Information System (INIS)

    Urjan, Daniel; Havris, Alexandru

    2003-01-01

    All healthy organizations generate and use knowledge. As organizations interact with their environments, they absorb information, turn it into knowledge and take action based on it in combination with their experiences, values and internal rules. Without knowledge, an organization could not organize itself; it would be unable to maintain itself as a functioning enterprise. Like any highly technical endeavor, the use of nuclear technology relies heavily on a vast accumulation of knowledge - volumes of scientific research, engineering analysis, operational data, regulatory reviews and many other types of technical information - combined with a complex assortment of people with the requisite educational background, expertise and acquired insight to apply that body of knowledge safely and effectively. Methods must be found to better capture this enormous body of nuclear experience. Today's nuclear workforce needs to document knowledge and then mentor the new nuclear scientists to build upon it, rather than having to re-create it. The latest studies have shown that at present NPPs cannot be replaced by other kinds of electric sources and in no case by renewable ones in an efficient manner. Therefore it is necessary to carefully manage knowledge gathered in the nuclear field during the years and to keep on the nuclear safety research, education and training to ensure and upgrade safe and reliable operation of existing and future nuclear facilities. Having in mind the complexity of this issue of global concern, this presentation tries to provide a brief overview of what knowledge management is and how it can help organizations to preserve knowledge, skills and expertise, particularly for the nuclear environment. What are the challenges of nuclear knowledge management and who should lead knowledge management efforts are also some of the issues covered in the presentation. (authors)

  8. Maintaining nuclear competence and expertise in Japan

    International Nuclear Information System (INIS)

    Fujii, Y.

    2004-01-01

    The fundamental law of atomic energy, which strictly restricts the application of atomic energy to the peaceful use, was established in 1955 in Japan. Since then, during the past five decades, great efforts were made to develop atomic energy. So far 52 units of light water reactors, 29 BWRs and 23 PWRs, have been built and in operation, 5 units are under construction and 6 units are planed to be built. Total capacity of presently operated NPPs amounts to 45.7 Gwe and the nuclear energy shares 30 % of the total electricity generation in Japan. During the past 10 years, several accidents occur in the nuclear facilities of electric power companies, and JNC ( previously PNC ). In spite of these accidents, including the accident of Kansai Electric Power Co. this year, the important role of nuclear energy to sustain the lives of people in Japan is intact. In the nuclear energy projection, the construction of NPPs continues till 2010. Thereafter reconstructions of NPPs are foreseen in the decade 2030's for the replacement of present NPPs in operation after 60 years services. Attention has been directed to the technology preservation: how competence and expertise of nuclear engineering can be maintained till the next period of replacement construction, in particular, the period between years 2010 and 2030. The present paper reviews the status of nuclear engineering programs in universities in Japan. The nuclear education programs started in graduate schools in 1957 and expanded to undergraduate schools of major national universities. Presently nine universities are providing systematic nuclear education programs in their graduate schools, although the corresponding department have been changed their names from 'nuclear' to more broaden terms of 'quantum', 'energy' and 'system' in several universities. Under the conditions of shrinking nuclear industries, how to maintain the present education system is seriously concerned matter in the universities. The present paper

  9. TheME: an environment for building formal KADS II models of expertise

    NARCIS (Netherlands)

    Balder, John; Akkermans, J.M.; Akkermans, Hans

    1992-01-01

    COMMONKADS is a well-known methodology for the development of knowledge-based systems. In this methodology one constructs so-called models of expertise as a basis for the development. A new feature with respect to older versions of the KADS methodology is a formal version of these models, whereby

  10. Rapid Dynamic Assessment of Expertise to Improve the Efficiency of Adaptive Elearning

    Science.gov (United States)

    Kalyuga, Slava; Sweller, John

    2005-01-01

    In this article we suggest a method of evaluating learner expertise based on assessment of the content of working memory and the extent to which cognitive load has been reduced by knowledge retrieved from long-term memory. The method was tested in an experiment with an elementary algebra tutor using a yoked control design. In the learner-adapted…

  11. How do ICT firms in Turkey manage innovation? : diversity in expertise versus diversity in markets

    NARCIS (Netherlands)

    Akçomak, S.; Akdeve, E.; Fındık, D.

    2013-01-01

    This paper provides a novel taxonomy of firms based on specialization versus diversification in production and markets. Firms may choose to specialize on few production activities or alternatively may build expertise in many activities. There is an accompanying decision when firms sell their

  12. Evidence-Based Literacy Support: The "Literacy Octopus" Trial. Evaluation Report and Executive Summary

    Science.gov (United States)

    Lord, Pippa; Rabiasz, Adam; Roy, Palak; Harland, Jennie; Styles, Ben; Fowler, Katherine

    2017-01-01

    The Evidence-based Literacy Support-"Literacy Octopus" Trial tested a range of dissemination interventions and resources, all of which aimed to engage schools in using evidence-based materials to improve teaching and learning in Key Stage 2 literacy. Four delivery partners provided interventions. These included light-touch,…

  13. OARSI Clinical Trials Recommendations

    DEFF Research Database (Denmark)

    Emery, C. A.; Roos, Ewa M.; Verhagen, E.

    2015-01-01

    The risk of post-traumatic osteoarthritis (PTOA) substantially increases following joint injury. Research efforts should focus on investigating the efficacy of preventative strategies in high quality randomized controlled trials (RCT). The objective of these OARSI RCT recommendations is to inform...... the design, conduct and analytical approaches to RCTs evaluating the preventative effect of joint injury prevention strategies. Recommendations regarding the design, conduct, and reporting of RCTs evaluating injury prevention interventions were established based on the consensus of nine researchers...... internationally with expertise in epidemiology, injury prevention and/or osteoarthritis (OA). Input and resultant consensus was established through teleconference, face to face and email correspondence over a 1 year period. Recommendations for injury prevention RCTs include context specific considerations...

  14. Effects of psychological therapies in randomized trials and practice-based studies.

    Science.gov (United States)

    Barkham, Michael; Stiles, William B; Connell, Janice; Twigg, Elspeth; Leach, Chris; Lucock, Mike; Mellor-Clark, John; Bower, Peter; King, Michael; Shapiro, David A; Hardy, Gillian E; Greenberg, Leslie; Angus, Lynne

    2008-11-01

    Randomized trials of the effects of psychological therapies seek internal validity via homogeneous samples and standardized treatment protocols. In contrast, practice-based studies aim for clinical realism and external validity via heterogeneous samples of clients treated under routine practice conditions. We compared indices of treatment effects in these two types of studies. Using published transformation formulas, the Beck Depression Inventory (BDI) scores from five randomized trials of depression (N = 477 clients) were transformed into Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) scores and compared with CORE-OM data collected in four practice-based studies (N = 4,196 clients). Conversely, the practice-based studies' CORE-OM scores were transformed into BDI scores and compared with randomized trial data. Randomized trials showed a modest advantage over practice-based studies in amount of pre-post improvement. This difference was compressed or exaggerated depending on the direction of the transformation but averaged about 12%. There was a similarly sized advantage to randomized trials in rates of reliable and clinically significant improvement (RCSI). The largest difference was yielded by comparisons of effect sizes which suggested an advantage more than twice as large, reflecting narrower pre-treatment distributions in the randomized trials. Outcomes of completed treatments for depression in randomized trials appeared to be modestly greater than those in routine care settings. The size of the difference may be distorted depending on the method for calculating degree of change. Transforming BDI scores into CORE-OM scores and vice versa may be a preferable alternative to effect sizes for comparisons of studies using these measures.

  15. Whether Audit Committee Financial Expertise Is the Only Relevant Expertise: A Review of Audit Committee Expertise and Timeliness of Financial Reporting

    Directory of Open Access Journals (Sweden)

    Saeed Rabea Baatwah

    2013-06-01

    Full Text Available This study reviews the literature on audit committee expertise and financial reporting timeliness. Financial reporting timeliness and audit committee expertise are two areas of research gaining the attention of a large number of stakeholders because they contribute to the reliability and the  relevancy of financial reporting. Indeed, the focus of this review is primarily on the recent developments in the pertinent literature in order to show the limitations of such research and encourage future research to overcome these limitations. By also looking at the development of the audit committee expertise literature, this study concludes that (1 like most audit committee literature, financial reporting timeliness literature continues to assume the absence of the contribution of expertise other than financial expertise, and ignore the role of audit committee chair; (2 most of this literature fails to find a significant effect because it ignores the interaction among corporate governance mechanisms. Accordingly, this study posits that ignoring the issues raised in such research by future research would lead to major mistakes in reforms relating to how the quality of financial reporting can be enhanced.

  16. Comparison of Bobath based and movement science based treatment for stroke: a randomised controlled trial.

    Science.gov (United States)

    van Vliet, P M; Lincoln, N B; Foxall, A

    2005-04-01

    Bobath based (BB) and movement science based (MSB) physiotherapy interventions are widely used for patients after stroke. There is little evidence to suggest which is most effective. This single-blind randomised controlled trial evaluated the effect of these treatments on movement abilities and functional independence. A total of 120 patients admitted to a stroke rehabilitation ward were randomised into two treatment groups to receive either BB or MSB treatment. Primary outcome measures were the Rivermead Motor Assessment and the Motor Assessment Scale. Secondary measures assessed functional independence, walking speed, arm function, muscle tone, and sensation. Measures were performed by a blinded assessor at baseline, and then at 1, 3, and 6 months after baseline. Analysis of serial measurements was performed to compare outcomes between the groups by calculating the area under the curve (AUC) and inserting AUC values into Mann-Whitney U tests. Comparison between groups showed no significant difference for any outcome measures. Significance values for the Rivermead Motor Assessment ranged from p = 0.23 to p = 0.97 and for the Motor Assessment Scale from p = 0.29 to p = 0.87. There were no significant differences in movement abilities or functional independence between patients receiving a BB or an MSB intervention. Therefore the study did not show that one approach was more effective than the other in the treatment of stroke patients.

  17. A computational approach to measuring the correlation between expertise and social media influence for celebrities on microblogs

    OpenAIRE

    Zhao, Wayne Xin; Liu, Jing; He, Yulan; Lin, Chin Yew; Wen, Ji-Rong

    2016-01-01

    Social media influence analysis, sometimes also called authority detection, aims to rank users based on their influence scores in social media. Existing approaches of social influence analysis usually focus on how to develop effective algorithms to quantize users’ influence scores. They rarely consider a person’s expertise levels which are arguably important to influence measures. In this paper, we propose a computational approach to measuring the correlation between expertise and social medi...

  18. Standardized terminology for clinical trial protocols based on top-level ontological categories.

    Science.gov (United States)

    Heller, B; Herre, H; Lippoldt, K; Loeffler, M

    2004-01-01

    This paper describes a new method for the ontologically based standardization of concepts with regard to the quality assurance of clinical trial protocols. We developed a data dictionary for medical and trial-specific terms in which concepts and relations are defined context-dependently. The data dictionary is provided to different medical research networks by means of the software tool Onto-Builder via the internet. The data dictionary is based on domain-specific ontologies and the top-level ontology of GOL. The concepts and relations described in the data dictionary are represented in natural language, semi-formally or formally according to their use.

  19. European Marketing Authorizations Granted Based on a Single Pivotal Clinical Trial: The Rule or the Exception?

    Science.gov (United States)

    Morant, Anne Vinther; Vestergaard, Henrik Tang

    2018-07-01

    A minimum of two positive, adequate, and well-controlled clinical trials has historically been the gold standard for providing substantial evidence to support regulatory approval of a new medicine. Nevertheless, the present analysis of European Marketing Authorizations granted between 2012 and 2016 showed that 45% of new active substances were approved based on a single pivotal clinical trial. For therapeutic areas such as oncology and cardiovascular diseases, approvals based on a single pivotal trial are the rule rather than the exception, whereas new medicines within the nervous system area were generally supported by two or more pivotal trials. While overall similar trends have been observed in the US, the recent US Food and Drug Administration approvals of nervous system medicines based on a single pivotal trial suggest that a case-by-case scientific evaluation of the totality of evidence is increasingly applied to facilitate faster access of new medicines to patients suffering from serious diseases. © 2017 American Society for Clinical Pharmacology and Therapeutics.

  20. The FAITH Trial: Baseline Characteristics of a Church-based Trial to Improve Blood Pressure Control in Blacks.

    Science.gov (United States)

    Schoenthaler, Antoinette; Lancaster, Kristie; Midberry, Sara; Nulty, Matthew; Ige, Elizabeth; Palfrey, Amy; Kumar, Niketa; Ogedegbe, Gbenga

    2015-08-07

    To describe the baseline characteristics of participants in the Faith-based Approaches in the Treatment of Hypertension (FAITH) Trial. FAITH evaluates the effectiveness of a faith-based lifestyle intervention vs health education control on blood pressure (BP) reduction among hypertensive Black adults. Participants included 373 members of 32 Black churches in New York City. Baseline data collected included participant demographic characteristics, clinical measures (eg, blood pressure), behaviors (eg, diet, physical activity), and psychosocial factors (eg, self-efficacy, depressive symptoms). Participants had a mean age of 63.4 ± 11.9 years and 76% were female. About half completed at least some college (53%), 66% had an income ≥$20,000, and 42.2% were retired or on disability. Participants had a mean systolic and diastolic BP of 152.1 ± 16.8 mm Hg and 86.2 ± 12.2 mm Hg, respectively, and a mean BMI of 32 kg/m2. Hypertension (HTN) medications were taken by 95% of participants, but most (79.1%) reported non-adherence to their regimen. Participants reported consuming 3.4 ± 2.6 servings of fruits and vegetables and received 30.9% of their energy from fat. About one-third (35.9%) reported a low activity level. Participants in the FAITH trial exhibited several adverse clinical and behavioral characteristics at baseline. Future analyses will evaluate the effectiveness of the faith-based lifestyle intervention on changes in BP and lifestyle behaviors among hypertensive Black adults.

  1. Can Team-Based Care Improve Patient Satisfaction? A Systematic Review of Randomized Controlled Trials

    Science.gov (United States)

    Wen, Jin; Schulman, Kevin A.

    2014-01-01

    Background Team-based approaches to patient care are a relatively recent innovation in health care delivery. The effectiveness of these approaches on patient outcomes has not been well documented. This paper reports a systematic review of the relationship between team-based care and patient satisfaction. Methods We searched MEDLINE, EMBASE, Cochrane Library, CINAHL, and PSYCHOINFO for eligible studies dating from inception to October 8, 2012. Eligible studies reported (1) a randomized controlled trial, (2) interventions including both team-based care and non-team-based care (or usual care), and (3) outcomes including an assessment of patient satisfaction. Articles with different settings between intervention and control were excluded, as were trial protocols. The reference lists of retrieved papers were also evaluated for inclusion. Results The literature search yielded 319 citations, of which 77 were screened for further full-text evaluation. Of these, 27 articles were included in the systematic review. The 26 trials with a total of 15,526 participants were included in this systematic review. The pooling result of dichotomous data (number of studies: 10) showed that team-based care had a positive effect on patient satisfaction compared with usual care (odds ratio, 2.09; 95% confidence interval, 1.54 to 2.84); however, combined continuous data (number of studies: 7) demonstrated that there was no significant difference in patient satisfaction between team-based care and usual care (standardized mean difference, −0.02; 95% confidence interval, −0.40 to 0.36). Conclusions Some evidence showed that team-based care is better than usual care in improving patient satisfaction. However, considering the pooling result of continuous data, along with the suboptimal quality of included trials, further large-scale and high-quality randomized controlled trials comparing team-based care and usual care are needed. PMID:25014674

  2. Attrition and Adherence in a Web-Based Distress Management Program for Implantable Cardioverter Defibrillator Patients (WEBCARE): Randomized Controlled Trial

    DEFF Research Database (Denmark)

    Habibovic, M.; Cuijpers, P.; Alings, M.

    2014-01-01

    Background: WEB-Based Distress Management Program for Implantable CARdioverter defibrillator Patients (WEBCARE) is a Web-based randomized controlled trial, designed to improve psychological well-being in patients with an implantable cardioverter defibrillator (ICD). As in other Web-based trials, ...

  3. Professional Expertise in Magic – Reflecting on professional expertise in magic:An interview study

    Directory of Open Access Journals (Sweden)

    Olli eRissanen

    2014-12-01

    Full Text Available The purpose of the present investigation was to analyse interviews of highly regarded Finnish magicians. Social network analysis (N=120 was used to identify Finland’s most highly regarded magicians (N=16. The selected participants’ careers in professional magic and various aspects of their professional conduct were examined by relying on semi-structured interviews. The results revealed that cultivation of professional level competence in magic usually requires an extensive period of time compared with other domains of expertise. Magic is a unique performing art and it differs from other professions focusing on deceiving the audience. A distinctive feature of magical expertise is that the process takes place entirely through informal training supported by communities of magical practitioners. Three interrelated aspects of magical activity were distinguished: magic tricks, performance, and audience. Although magic tricks constitute a central aspect of magic activity, the participants did not talk about their tricks extensively; this is in accordance with the secretive nature of magic culture.The interviews revealed that a core aspect of the magicians’ activity is performance in front of an audience that repeatedly validates competence cultivated through years of practice. The interviewees reported investing a great deal of effort in planning, orchestrating, and reflecting on their performances. Close interaction with the audience plays an important role in most interviewees’ activity. Many participants put a great deal of effort in developing novel magic tricks. It is common to borrow magic effects from fellow magicians and develop novel methods of implementation. Because magic tricks or programs are not copyrighted, many interviewees considered stealing an unacceptable and unethical aspect of magical activity. The interviewees highlighted the importance of personality and charisma in the successful pursuit of magic activity.

  4. How student models of expertise and innovation impact the development of adaptive expertise in medicine.

    Science.gov (United States)

    Mylopoulos, Maria; Regehr, Glenn

    2009-02-01

    The ability to innovate new solutions in response to daily workplace challenges is an important component of adaptive expertise. Exploring how to optimally develop this skill is therefore of paramount importance to education researchers. This is certainly no less true in health care, where optimal patient care is contingent on the continuous efforts of doctors and other health care workers to provide the best care to their patients through the development and incorporation of new knowledge. Medical education programmes must therefore foster the skills and attitudes necessary to engage future doctors in the systematic development of innovative problem solving. The aim of this paper is to describe the perceptions and experiences of medical students in their third and fourth years of training, and to explore their understanding of their development as adaptive experts. A sample of 25 medical students participated in individual 45-60-minute semi-structured interviews. Interviews were audiotaped, transcribed and entered into NVivo qualitative data analysis software to facilitate a thematic analysis. The analysis was both inductive, in that themes were generated from the data, and deductive, in that our data were meaningful when interpreted in the context of theories of adaptive expertise. Participants expressed a general belief that, as learners in the health care system, exerting any effort to be innovative was beyond the scope of their responsibilities. Generally, students suggested that innovative practice was the prerogative of experts and an outcome of expert development centred on the acquisition of knowledge and experience. Students' perceptions of themselves as having no responsibility to be innovative in their learning process have implications for their learning trajectories as adaptive experts.

  5. The Virtual Anemia Trial: An Assessment of Model‐Based In Silico Clinical Trials of Anemia Treatment Algorithms in Patients With Hemodialysis

    Science.gov (United States)

    Topping, Alice; Kappel, Franz; Thijssen, Stephan; Kotanko, Peter

    2018-01-01

    In silico approaches have been proposed as a novel strategy to increase the repertoire of clinical trial designs. Realistic simulations of clinical trials can provide valuable information regarding safety and limitations of treatment protocols and have been shown to assist in the cost‐effective planning of clinical studies. In this report, we present a blueprint for the stepwise integration of internal, external, and ecological validity considerations in virtual clinical trials (VCTs). We exemplify this approach in the context of a model‐based in silico clinical trial aimed at anemia treatment in patients undergoing hemodialysis (HD). Hemoglobin levels and subsequent anemia treatment were simulated on a per patient level over the course of a year and compared to real‐life clinical data of 79,426 patients undergoing HD. The novel strategies presented here, aimed to improve external and ecological validity of a VCT, significantly increased the predictive power of the discussed in silico trial. PMID:29368434

  6. Expertise as evidence in criminal proceedings from the Communist period until nowadays

    Directory of Open Access Journals (Sweden)

    Saimir Fekolli

    2015-07-01

    Full Text Available During their procedural activity, investigative and judicial bodies have the pressing need to make use of special knowledge in different scientific fields of technique and science in order to resolve outstanding issues related to the subject of verification, which the law has defined as subject of expertise in criminal trial. Experts’ opinion is conceived and implemented as a particular means of verification; experts help in discovering the facts that are important to finding out the truth in criminal proceedings. In addition, they ascertain the facts and give an opinion on them, as a result of specific skills they have in the field of technique, science or culture. Experts and the process conducted by them were given importance in the legislation of the Communist era particularly with the drafting of the Code of Criminal Procedure of 1979 which provides in considerable detail both the functions and the importance of expertise to resolve a criminal case. Furthermore, nowadays expertise as evidence in criminal proceedings is becoming increasingly important and is emerging, especially in view of developments in the field of Technique and Science since many criminals are very good at using innovations as a priority means for escaping detection and punishment. But on the other hand, scientific developments are increasingly cooperating with law and justice institutions to resolve the events and to provide assistance for achieving quality results in a shorter time, something that probably was unthinkable before.

  7. Neural basis of nonanalytical reasoning expertise during clinical evaluation

    NARCIS (Netherlands)

    Durning, S.J.; Costanzo, M.E.; Artino, A.R.; Graner, J.; Vleuten, C.P.M. van der; Beckman, T.J.; Wittich, C.M.; Roy, M.J.H.M. van; Holmboe, E.S.; Schuwirth, L.

    2015-01-01

    INTRODUCTION: Understanding clinical reasoning is essential for patient care and medical education. Dual-processing theory suggests that nonanalytic reasoning is an essential aspect of expertise; however, assessing nonanalytic reasoning is challenging because it is believed to occur on the

  8. Best Practice for Developmental Stuttering: Balancing Evidence and Expertise

    Science.gov (United States)

    Byrd, Courtney T.; Donaher, Joseph

    2018-01-01

    Purpose: Best practice for developmental stuttering remains a topic of debate. In the clinical forum following the introduction, four fluency experts balance the evidence and expertise to describe their approach to assessment and treatment.

  9. Expertise development in the professions; Implications for teaching and assessment

    NARCIS (Netherlands)

    Boshuizen, Els

    2011-01-01

    Boshuizen, H. P. A. (2011, 30 August - 3 September). Expertise development in the professions; Implications for teaching and assessment. Paper presented at the bi-annual EARLI conferences, Exeter, UK.

  10. Negotiating knowledges and expertise in refugee resettlement organizations

    Directory of Open Access Journals (Sweden)

    Sarah Steimel

    2016-12-01

    Full Text Available Interviews with both refugees and organizational staff in two nonprofit refugee resettlement organizations in the United States reveal the ways in which knowledge(s and expertise are crafted, threatened, and understood in refugee organizations. Refugee-participants described the need for knowledgeable communication, barriers to the communication of knowledge, and processes of negotiating whose expertise is involved. Organizational staff participants described the duty of communicating expert knowledge, the limits of knowledge as expertise, and alternative communications of expertise. These tensions surrounding “knowing” in refugee resettlement organizations highlights the need for a more complex theoretical understanding of the processes of knowing present in refugee resettlement. These tensions also suggest areas in which refugee resettlement agencies and other nonprofit staff can make on-the-ground changes to better facilitate refugee resettlement processes.

  11. Redesigning Radiotherapy Quality Assurance: Opportunities to Develop an Efficient, Evidence-Based System to Support Clinical Trials

    Science.gov (United States)

    Bekelman, Justin E.; Deye, James A.; Vikram, Bhadrasain; Bentzen, Soren M.; Bruner, Deborah; Curran, Walter J.; Dignam, James; Efstathiou, Jason A.; FitzGerald, T. J.; Hurkmans, Coen; Ibbott, Geoffrey S.; Lee, J. Jack; Merchant, Timothy E.; Michalski, Jeff; Palta, Jatinder R.; Simon, Richard; Ten Haken, Randal K.; Timmerman, Robert; Tunis, Sean; Coleman, C. Norman; Purdy, James

    2012-01-01

    Background In the context of national calls for reorganizing cancer clinical trials, the National Cancer Institute (NCI) sponsored a two day workshop to examine the challenges and opportunities for optimizing radiotherapy quality assurance (QA) in clinical trial design. Methods Participants reviewed the current processes of clinical trial QA and noted the QA challenges presented by advanced technologies. Lessons learned from the radiotherapy QA programs of recent trials were discussed in detail. Four potential opportunities for optimizing radiotherapy QA were explored, including the use of normal tissue toxicity and tumor control metrics, biomarkers of radiation toxicity, new radiotherapy modalities like proton beam therapy, and the international harmonization of clinical trial QA. Results Four recommendations were made: 1) Develop a tiered (and more efficient) system for radiotherapy QA and tailor intensity of QA to clinical trial objectives. Tiers include (i) general credentialing, (ii) trial specific credentialing, and (iii) individual case review; 2) Establish a case QA repository; 3) Develop an evidence base for clinical trial QA and introduce innovative prospective trial designs to evaluate radiotherapy QA in clinical trials; and 4) Explore the feasibility of consolidating clinical trial QA in the United States. Conclusion Radiotherapy QA may impact clinical trial accrual, cost, outcomes and generalizability. To achieve maximum benefit, QA programs must become more efficient and evidence-based. PMID:22425219

  12. Expertise, motivation and teaching in learning companion systems

    OpenAIRE

    Uresti, Jorge Adolfo Ramirez; du Boulay, Benedict

    2004-01-01

    This paper describes work carried out to explore the role of a learning companion as a teachable student of the human student. A LCS for Binary Boolean Algebra has been developed to explore the hypothesis that a learning companion with less expertise than the human student would be beneficial if the student taught it. The system implemented two companions with different expertise and two types of motivational conditions. An empirical evaluation was conducted. Although significant differential...

  13. The scripts and expertise of firesetters: A preliminary conceptualization

    OpenAIRE

    Butler, Helen; Gannon, Theresa A.

    2015-01-01

    The importance of cognition in the facilitation and reinforcement of criminal behavior has been highlighted and recognized in numerous offender populations. Coupled with this is an emerging body of literature suggesting offenders may, in fact, display a certain level of expertise in their offending. In this paper, the notion of offending expertise along with cognition—specifically the concept of offence scripts—will be explored in relation to firesetting behavior for the first time. Using res...

  14. Cell-based interventions for neurologic conditions: ethical challenges for early human trials.

    Science.gov (United States)

    Mathews, D J H; Sugarman, J; Bok, H; Blass, D M; Coyle, J T; Duggan, P; Finkel, J; Greely, H T; Hillis, A; Hoke, A; Johnson, R; Johnston, M; Kahn, J; Kerr, D; Kurtzberg, J; Liao, S M; McDonald, J W; McKhann, G; Nelson, K B; Rao, M; Regenberg, A; Siegel, A W; Smith, K; Solter, D; Song, H; Vescovi, A; Young, W; Gearhart, J D; Faden, R

    2008-07-22

    Attempts to translate basic stem cell research into treatments for neurologic diseases and injury are well under way. With a clinical trial for one such treatment approved and in progress in the United States, and additional proposals under review, we must begin to address the ethical issues raised by such early forays into human clinical trials for cell-based interventions for neurologic conditions. An interdisciplinary working group composed of experts in neuroscience, cell biology, bioethics, law, and transplantation, along with leading disease researchers, was convened twice over 2 years to identify and deliberate on the scientific and ethical issues raised by the transition from preclinical to clinical research of cell-based interventions for neurologic conditions. While the relevant ethical issues are in many respects standard challenges of human subjects research, they are heightened in complexity by the novelty of the science, the focus on the CNS, and the political climate in which the science is proceeding. Distinctive challenges confronting US scientists, administrators, institutional review boards, stem cell research oversight committees, and others who will need to make decisions about work involving stem cells and their derivatives and evaluate the ethics of early human trials include evaluating the risks, safety, and benefits of these trials, determining and evaluating cell line provenance, and determining inclusion criteria, informed consent, and the ethics of conducting early human trials in the public spotlight. Further study and deliberation by stakeholders is required to move toward professional and institutional policies and practices governing this research.

  15. Trial watch: Naked and vectored DNA-based anticancer vaccines.

    Science.gov (United States)

    Bloy, Norma; Buqué, Aitziber; Aranda, Fernando; Castoldi, Francesca; Eggermont, Alexander; Cremer, Isabelle; Sautès-Fridman, Catherine; Fucikova, Jitka; Galon, Jérôme; Spisek, Radek; Tartour, Eric; Zitvogel, Laurence; Kroemer, Guido; Galluzzi, Lorenzo

    2015-05-01

    One type of anticancer vaccine relies on the administration of DNA constructs encoding one or multiple tumor-associated antigens (TAAs). The ultimate objective of these preparations, which can be naked or vectored by non-pathogenic viruses, bacteria or yeast cells, is to drive the synthesis of TAAs in the context of an immunostimulatory milieu, resulting in the (re-)elicitation of a tumor-targeting immune response. In spite of encouraging preclinical results, the clinical efficacy of DNA-based vaccines employed as standalone immunotherapeutic interventions in cancer patients appears to be limited. Thus, efforts are currently being devoted to the development of combinatorial regimens that allow DNA-based anticancer vaccines to elicit clinically relevant immune responses. Here, we discuss recent advances in the preclinical and clinical development of this therapeutic paradigm.

  16. Sources of transportation expertise by selected technical areas

    International Nuclear Information System (INIS)

    1987-01-01

    The US Department of Energy (DOE), Office of Civilian Radioactive Waste Management (OCRWM) has assigned components of its Waste Transportation Program to three of the DOE Operations offices. The DOE Oak Ridge Operations Office (ORO) is responsible for the transportation operations design, development, acquisition, testing, implementation, and program management, including the equipment, facilities, and services of the transportation system. Within ORO, the OCRWM transportation component is assigned to the Transportation Operations Project Office (TOPO). The specific activities involved in the ORO/TOPO include procurement, operational testing, inspection, logistics, interfaces, maintenance, management and improvements, and system operation. Oak Ridge Associated Universities (ORAU) has developed (and will maintain and enhance) a data base of sources of transportation expertise in selected technical areas for ORO. The data base includes individuals and organizations who have indicated that they have capabilities and interest in assisting ORO in the design, development, implementation, and management of the OCRWM transportation system. This assistance might be in the form of consulting or subcontract work and/or participation in peer review panels, technical evaluation committees, workshops, advisory groups, etc. This initial project was completed in the four month period of January 30, 1987 through May 31, 1987

  17. Crowdsourcing medical expertise in near real time.

    Science.gov (United States)

    Sims, Max H; Bigham, Jeffrey; Kautz, Henry; Halterman, Marc W

    2014-07-01

    Given the pace of discovery in medicine, accessing the literature to make informed decisions at the point of care has become increasingly difficult. Although the Internet creates unprecedented access to information, gaps in the medical literature and inefficient searches often leave healthcare providers' questions unanswered. Advances in social computation and human computer interactions offer a potential solution to this problem. We developed and piloted the mobile application DocCHIRP, which uses a system of point-to-multipoint push notifications designed to help providers problem solve by crowdsourcing from their peers. Over the 244-day pilot period, 85 registered users logged 1544 page views and sent 45 consult questions. The median initial first response from the crowd occurred within 19 minutes. Review of the transcripts revealed several dominant themes, including complex medical decision making and inquiries related to prescription medication use. Feedback from the post-trial survey identified potential hurdles related to medical crowdsourcing, including a reluctance to expose personal knowledge gaps and the potential risk for "distracted doctoring." Users also suggested program modifications that could support future adoption, including changes to the mobile interface and mechanisms that could expand the crowd of participating healthcare providers. © 2014 Society of Hospital Medicine.

  18. Systematic data ingratiation of clinical trial recruitment locations for geographic-based query and visualization.

    Science.gov (United States)

    Luo, Jake; Chen, Weiheng; Wu, Min; Weng, Chunhua

    2017-12-01

    Prior studies of clinical trial planning indicate that it is crucial to search and screen recruitment sites before starting to enroll participants. However, currently there is no systematic method developed to support clinical investigators to search candidate recruitment sites according to their interested clinical trial factors. In this study, we aim at developing a new approach to integrating the location data of over one million heterogeneous recruitment sites that are stored in clinical trial documents. The integrated recruitment location data can be searched and visualized using a map-based information retrieval method. The method enables systematic search and analysis of recruitment sites across a large amount of clinical trials. The location data of more than 1.4 million recruitment sites of over 183,000 clinical trials was normalized and integrated using a geocoding method. The integrated data can be used to support geographic information retrieval of recruitment sites. Additionally, the information of over 6000 clinical trial target disease conditions and close to 4000 interventions was also integrated into the system and linked to the recruitment locations. Such data integration enabled the construction of a novel map-based query system. The system will allow clinical investigators to search and visualize candidate recruitment sites for clinical trials based on target conditions and interventions. The evaluation results showed that the coverage of the geographic location mapping for the 1.4 million recruitment sites was 99.8%. The evaluation of 200 randomly retrieved recruitment sites showed that the correctness of geographic information mapping was 96.5%. The recruitment intensities of the top 30 countries were also retrieved and analyzed. The data analysis results indicated that the recruitment intensity varied significantly across different countries and geographic areas. This study contributed a new data processing framework to extract and integrate

  19. Systematic data ingratiation of clinical trial recruitment locations for geographic-based query and visualization

    Science.gov (United States)

    Luo, Jake; Chen, Weiheng; Wu, Min; Weng, Chunhua

    2018-01-01

    Background Prior studies of clinical trial planning indicate that it is crucial to search and screen recruitment sites before starting to enroll participants. However, currently there is no systematic method developed to support clinical investigators to search candidate recruitment sites according to their interested clinical trial factors. Objective In this study, we aim at developing a new approach to integrating the location data of over one million heterogeneous recruitment sites that are stored in clinical trial documents. The integrated recruitment location data can be searched and visualized using a map-based information retrieval method. The method enables systematic search and analysis of recruitment sites across a large amount of clinical trials. Methods The location data of more than 1.4 million recruitment sites of over 183,000 clinical trials was normalized and integrated using a geocoding method. The integrated data can be used to support geographic information retrieval of recruitment sites. Additionally, the information of over 6000 clinical trial target disease conditions and close to 4000 interventions was also integrated into the system and linked to the recruitment locations. Such data integration enabled the construction of a novel map-based query system. The system will allow clinical investigators to search and visualize candidate recruitment sites for clinical trials based on target conditions and interventions. Results The evaluation results showed that the coverage of the geographic location mapping for the 1.4 million recruitment sites was 99.8%. The evaluation of 200 randomly retrieved recruitment sites showed that the correctness of geographic information mapping was 96.5%. The recruitment intensities of the top 30 countries were also retrieved and analyzed. The data analysis results indicated that the recruitment intensity varied significantly across different countries and geographic areas. Conclusion This study contributed a new

  20. Effectiveness in practice-based research: Looking for alternatives to the randomized controlled trial (RCT)

    NARCIS (Netherlands)

    Tavecchio, L.

    2015-01-01

    Over the last decade, the status of the randomized controlled trial (RCT), hallmark of evidence-based medicine (research), has been growing strongly in general practice, social work and public health. But this type of research is only practicable under strictly controlled and well-defined settings

  1. Mindfulness-based stress reduction for residents: A randomized controlled trial

    NARCIS (Netherlands)

    Verweij, H.; Ravesteijn, H.J. van; Hooff, M.L.M. van; Lagro-Janssen, A.L.M.; Speckens, A.E.M.

    2018-01-01

    Background: Burnout is highly prevalent in residents. No randomized controlled trials have been conducted measuring the effects of Mindfulness-Based Stress Reduction (MBSR) on burnout in residents. Objective: To determine the effectiveness of MBSR in reducing burnout in residents. Design: A

  2. Training Head Start Teachers to Conduct Trial-Based Functional Analysis of Challenging Behavior

    Science.gov (United States)

    Rispoli, Mandy; Burke, Mack D.; Hatton, Heather; Ninci, Jennifer; Zaini, Samar; Sanchez, Lisa

    2015-01-01

    Trial-based functional analysis (TBFA) is a procedure for experimentally identifying the function of challenging behavior within applied settings. The purpose of this study was to examine the effects of a TBFA teacher-training package in the context of two Head Start centers implementing programwide positive behavior support (PWPBS). Four Head…

  3. Trial-Based Functional Analysis and Functional Communication Training in an Early Childhood Setting

    Science.gov (United States)

    Lambert, Joseph M.; Bloom, Sarah E.; Irvin, Jennifer

    2012-01-01

    Problem behavior is common in early childhood special education classrooms. Functional communication training (FCT; Carr & Durand, 1985) may reduce problem behavior but requires identification of its function. The trial-based functional analysis (FA) is a method that can be used to identify problem behavior function in schools. We conducted…

  4. Community based physiotherapeutic exercise in COPD self-management: a randomised controlled trial.

    NARCIS (Netherlands)

    Effing, T.; Zielhuis, G.A.; Kerstjens, H.; Valk, P. van der; Palen, J.A.M. van der

    2011-01-01

    Little is known about effects of community-based physiotherapeutic exercise programmes incorporated in COPD self-management programmes. In a randomised trial, the effect of such a programme (COPE-active) on exercise capacity and various secondary outcomes including daily activity as a marker of

  5. Community based psysiotherapeutic exercise in COPD self-management: A randomised controlled trial

    NARCIS (Netherlands)

    Effing, T.W.; Zielhuis, Gerhard; Kerstjens, Huib; van der Valk, Paul; van der Palen, Jacobus Adrianus Maria

    2011-01-01

    Little is known about effects of community-based physiotherapeutic exercise programmes incorporated in COPD self-management programmes. In a randomised trial, the effect of such a programme (COPE-active) on exercise capacity and various secondary outcomes including daily activity as a marker of

  6. Musical Expertise Increases Top–Down Modulation Over Hippocampal Activation during Familiarity Decisions

    Directory of Open Access Journals (Sweden)

    Pierre Gagnepain

    2017-09-01

    Full Text Available The hippocampus has classically been associated with episodic memory, but is sometimes also recruited during semantic memory tasks, especially for the skilled exploration of familiar information. Cognitive control mechanisms guiding semantic memory search may benefit from the set of cognitive processes at stake during musical training. Here, we examined using functional magnetic resonance imaging, whether musical expertise would promote the top–down control of the left inferior frontal gyrus (LIFG over the generation of hippocampally based goal-directed thoughts mediating the familiarity judgment of proverbs and musical items. Analyses of behavioral data confirmed that musical experts more efficiently access familiar melodies than non-musicians although such increased ability did not transfer to verbal semantic memory. At the brain level, musical expertise specifically enhanced the recruitment of the hippocampus during semantic access to melodies, but not proverbs. Additionally, hippocampal activation contributed to speed of access to familiar melodies, but only in musicians. Critically, causal modeling of neural dynamics between LIFG and the hippocampus further showed that top–down excitatory regulation over the hippocampus during familiarity decision specifically increases with musical expertise – an effect that generalized across melodies and proverbs. At the local level, our data show that musical expertise modulates the online recruitment of hippocampal response to serve semantic memory retrieval of familiar melodies. The reconfiguration of memory network dynamics following musical training could constitute a promising framework to understand its ability to preserve brain functions.

  7. DEVELOPING A MODEL OF COMPETENCY AND EXPERTISE CERTIFICATION TESTS FOR VOCATIONAL HIGH SCHOOL STUDENTS

    Directory of Open Access Journals (Sweden)

    Pardjono Pardjono

    2015-12-01

    Full Text Available This study aims to: (1 develop, produce, and investigate the appropriateness model of competency and expertise certification tests for vocational high school (VHS students of the Mechanical Engineering expertise competency.To attain the objectives, the researcher conducted a research and development study consisting of 10 steps. The research product was validated by experts, VHS teachers, and lecturers at Mechanical Engineering Education through Focus Group Discussion (FGD, and the field tryout conducted at SMK Warga Surakarta and SMK Bhineka Karya Simo, Boyolali, Central Java. The results of the study are. (1 The study produces a model of Competency and Expertise Certification Tests Based on the School Production Unit (CECT_SPU for VHS Students of the Mechanical Engineering Expertise Competency; (2 The CECT_SPU model satisfies the criteria for a good modelby a mean score of 3.557; (3 The mean score of the model implementation in the tryouts were 3.670 in the individual tryout and 3.730 in the small-group tryout;  (4 The CECT_SPU model satisfies the criteria for an effective modelby a mean score of 3.730; (5 The CECT_SPU model satisfies the criteria for an efficient modelby a mean score of 3.780; (6 The CECT_SPU model satisfies the criteria for a practical model; by a mean score of 3.700.

  8. Missing data in trial-based cost-effectiveness analysis: An incomplete journey.

    Science.gov (United States)

    Leurent, Baptiste; Gomes, Manuel; Carpenter, James R

    2018-06-01

    Cost-effectiveness analyses (CEA) conducted alongside randomised trials provide key evidence for informing healthcare decision making, but missing data pose substantive challenges. Recently, there have been a number of developments in methods and guidelines addressing missing data in trials. However, it is unclear whether these developments have permeated CEA practice. This paper critically reviews the extent of and methods used to address missing data in recently published trial-based CEA. Issues of the Health Technology Assessment journal from 2013 to 2015 were searched. Fifty-two eligible studies were identified. Missing data were very common; the median proportion of trial participants with complete cost-effectiveness data was 63% (interquartile range: 47%-81%). The most common approach for the primary analysis was to restrict analysis to those with complete data (43%), followed by multiple imputation (30%). Half of the studies conducted some sort of sensitivity analyses, but only 2 (4%) considered possible departures from the missing-at-random assumption. Further improvements are needed to address missing data in cost-effectiveness analyses conducted alongside randomised trials. These should focus on limiting the extent of missing data, choosing an appropriate method for the primary analysis that is valid under contextually plausible assumptions, and conducting sensitivity analyses to departures from the missing-at-random assumption. © 2018 The Authors Health Economics published by John Wiley & Sons Ltd.

  9. Web-Based and Mobile Stress Management Intervention for Employees: A Randomized Controlled Trial

    OpenAIRE

    Heber, Elena; Lehr, Dirk; Ebert, David Daniel; Berking, Matthias; Riper, Heleen

    2016-01-01

    Background: Work-related stress is highly prevalent among employees and is associated with adverse mental health consequences. Web-based interventions offer the opportunity to deliver effective solutions on a large scale; however, the evidence is limited and the results conflicting. Objective: This randomized controlled trial evaluated the efficacy of guided Web-and mobile-based stress management training for employees. Methods: A total of 264 employees with elevated symptoms of stress (Perce...

  10. Critical Pedagogy as Collective Social Expertise in Higher Education

    Directory of Open Access Journals (Sweden)

    Juha Suoranta

    2006-10-01

    Full Text Available In this article, dedicated to the revolutionary educational work of Peter McLaren, we will deal with the question of practical teaching methods in higher education from the point of view of critical pedagogy. We argue that nowadays teaching and learning in educational and social sciences are too often meaningless from the point of view of critical collective learning. Thus the central task in critical pedagogy, and in reform of higher education, is to understand the oppressive aspects of present college life and overall society in order to generate pedagogical, individual and societal transformation while developing pedagogical strategies and study methods that work toward the elimination of various forms of subordination based on class, gender, race and sexual orientation, and strengthen students’ possibilities for genuine collective learning while empowering them to fight against inequalities in the world. Our reflections stem from our academic life and teaching experiences both in Finland and the U.S. We suggest that in order to teach critically, educators need to use more collaborative and collective teaching and learning methods. Thus the idea of collective social expertise becomes a core aim of teaching in the context of critical pedagogy.

  11. Stock investment funds in Brazil: performance and management expertise

    Directory of Open Access Journals (Sweden)

    Paulo Rogério Faustino Matos

    2012-01-01

    Full Text Available This article analyzes the stock investment fund market in Brazil and proposes dynamic rankings constructed from different risk-return metrics, during the period from 1998 to 2009. We find an uncommon level of persistence, mainly among the best performing funds, due to the expertise of the managers. The quadrimestral rebalancing of the portfolios based on these rankings permits inferring that in scenarios characterized as economic booms or recovery of financial markets, the strategies with equal participation in winner funds provides significantly higher average monthly gains, reduction of risk associated with diversification and consequently enhanced performance in relation to market or sector benchmarks. This evidence is robust to the use of different performance metrics for fund selection, indicating that active investors in winning funds demand good performance not only in terms of the Sharpe ratio, but also with respect to other metrics, such as the Treynor, Calmar and Sortino ratios. In these optimistic scenarios, only the industrial sector index (INDX provided returns compatible with those of these fund’s portfolios. However, during periods of crisis, no strategy involving the funds managed to provide hedge levels characteristic of the electric energy sector index (IEE, so it can be said that the majority of investing strategies are dominated in gain-risk criteria by sector or market indexes, with the exception of value-weighted portfolios composed of losing funds, a signal that the usual passive investors in large funds indexed to the Ibovespa can be presenting a greater level of inertia.

  12. Measurements of the Russian identity: Sociological assessments and humanitarian expertise

    Directory of Open Access Journals (Sweden)

    A A Onosov

    2016-12-01

    Full Text Available Within the framework of the existing scientific approaches, the authors consider the process of ethnization of the Russians’ mass consciousness under the expanding internal and external labor migration in Russia. The article presents the results of the situational analysis and humanitarian expertise of the set of key challenges determined by the migration. Based on the statistics, opinion polls data and expert assessments the article describes the empirical model of the identity of ethnic Russian population of Moscow and the Moscow region as the major centers of attraction for international migrants. The comprehensive analysis of the issues and controversies of the labor migration in the region and relationships of ethnic groups living in the region is preceded by the description of the identity of native inhabitants of the region as perceived by the ethnic Russian population. To measure the identity for the axiological ranking the authors use a number of relatively independent variables besides ethnic (national identity: religious involvement, civilizational orientation, cultural, professional, territorial and other important features. Thus, the authors present a multi-dimensional space of identity, in which each dimension has its specific meaning for personal self-identification and its own scale for assessing particular attributes.

  13. Alternative approaches to providing engineering expertise on shift

    International Nuclear Information System (INIS)

    Olson, J.; Schreiber, R.E.; Melber, B.D.

    1984-05-01

    This report represents the conclusions of a project studying the role of engineering expertise on shift in nuclear power plants. Using the present shift technical advisor (STA) position as the base case, several alternatives are analyzed. On-shift alternatives included the STA, the SS (shift supervisor), and the SE (shift engineer). The SE is degreed, experienced, trained, and licensed as a Senior Reactor Operator. Some non-shift alternatives were also studied. These included a cadre of on-call engineers and specialists within continual contact and easy reach of the plant; a technical system of phone and data lines linking the plant with a facility similar to an on-site technical support center; and finally, an SPDS (safety parameter display system) to agument technical upgrading of operator aids presently available. Potential problems considered in the analysis of implementation of these alternatives included job content constraints, problems of crew acceptance, and problems of labor supply and retention. Of the considered alternatives, the SE and SS options appear superior to the current STA approach. The SE approach appears the easiest to implement and the most effective under varied plant conditions. The SE may also serve as liaison to off-site support facilities

  14. A study of expertise effects for products with contradictory semantics

    Directory of Open Access Journals (Sweden)

    Wang Ching-Yi

    2017-01-01

    Full Text Available In the design studies, researchers often use the semantic differential method with bipolar adjectives, such as “modern vs. classical” or “simple vs. complex” when investigating the semantics projected by product forms. However, in design practice, some design examples clearly exhibit the simultaneous use of contradictory meanings in product semantics. For example, retro car evokes nostalgia by borrowing characteristics from classical cars. At the same time it exhibits a modern style. However, most studies measure the product semantics mostly by using subjective measurement. There is lack objective measurement for that. In this research, we examined the results of applying the semantic differential method to measure contradiction in product semantics. The results showed that the distributions of semantic differential ratings for the stimuli with contradictory meanings have higher standard deviations. The sensitivity of semantic recognition may depend on participant expertise. The design experts are trained to be good at visual thinking that could easily identify the contradiction semantics between products. In general, successful embedding of contradictory meanings into product forms are based on simple, typical, and rational forms that can display complex, novel, and perceptual images by adding supplementary elements.

  15. Interval breast cancers in the 'screening with tomosynthesis or standard mammography' (STORM) population-based trial.

    Science.gov (United States)

    Houssami, Nehmat; Bernardi, Daniela; Caumo, Francesca; Brunelli, Silvia; Fantò, Carmine; Valentini, Marvi; Romanucci, Giovanna; Gentilini, Maria A; Zorzi, Manuel; Macaskill, Petra

    2018-04-01

    The prospective 'screening with tomosynthesis or standard mammography' (STORM) trial recruited women participating in biennial breast screening in Italy (2011-2012), and compared sequential screen-readings based on 2D-mammography alone or based on tomosynthesis (integrated 2D/3D-mammography). The STORM trial showed that tomosynthesis screen-reading significantly increased breast cancer detection compared to 2D-mammography alone. The present study completes reporting of the trial by examining interval breast cancers ascertained at two year follow-up. 9 interval breast cancers were identified; the estimated interval cancer rate was 1.23/1000 screens [9/7292] (95%CI 0.56 to 2.34) or 1.24/1000 negative screens [9/7235] (95%CI 0.57 to 2.36). In concurrently screened women who attended the same screening services and received 2D-mammography, interval cancer rate was 1.60/1000 screens [40/25,058] (95% CI 1.14 to 2.17) or 1.61/1000 negative screens [40/24,922] (95% CI 1.15 to 2.18). Estimated screening sensitivity for the STORM trial was 85.5% [59/69] (95%CI 75.0%-92.8%), and that for 2D-mammography screening was 77.3% [136/176] (95%CI 70.4%-83.2%). Interval breast cancer rate amongst screening participants in the STORM trial was marginally lower (and screening sensitivity higher) than estimates amongst 2D-screened women; these findings should be interpreted with caution given the small number of interval cases and the sample size of the trial. Much larger screening studies, or pooled analyses, are required to examine interval cancer rates arising after breast tomosynthesis screening versus digital mammography screening. Copyright © 2018 Elsevier Ltd. All rights reserved.

  16. What is an expert? A systems perspective on expertise

    Science.gov (United States)

    Caley, Michael Julian; O'Leary, Rebecca A; Fisher, Rebecca; Low-Choy, Samantha; Johnson, Sandra; Mengersen, Kerrie

    2014-01-01

    Expert knowledge is a valuable source of information with a wide range of research applications. Despite the recent advances in defining expert knowledge, little attention has been given to how to view expertise as a system of interacting contributory factors for quantifying an individual's expertise. We present a systems approach to expertise that accounts for many contributing factors and their inter-relationships and allows quantification of an individual's expertise. A Bayesian network (BN) was chosen for this purpose. For illustration, we focused on taxonomic expertise. The model structure was developed in consultation with taxonomists. The relative importance of the factors within the network was determined by a second set of taxonomists (supra-experts) who also provided validation of the model structure. Model performance was assessed by applying the model to hypothetical career states of taxonomists designed to incorporate known differences in career states for model testing. The resulting BN model consisted of 18 primary nodes feeding through one to three higher-order nodes before converging on the target node (Taxonomic Expert). There was strong consistency among node weights provided by the supra-experts for some nodes, but not others. The higher-order nodes, “Quality of work” and “Total productivity”, had the greatest weights. Sensitivity analysis indicated that although some factors had stronger influence in the outer nodes of the network, there was relatively equal influence of the factors leading directly into the target node. Despite the differences in the node weights provided by our supra-experts, there was good agreement among assessments of our hypothetical experts that accurately reflected differences we had specified. This systems approach provides a way of assessing the overall level of expertise of individuals, accounting for multiple contributory factors, and their interactions. Our approach is adaptable to other situations where it

  17. Talent in the taxi: a model system for exploring expertise.

    Science.gov (United States)

    Woollett, Katherine; Spiers, Hugo J; Maguire, Eleanor A

    2009-05-27

    While there is widespread interest in and admiration of individuals with exceptional talents, surprisingly little is known about the cognitive and neural mechanisms underpinning talent, and indeed how talent relates to expertise. Because many talents are first identified and nurtured in childhood, it can be difficult to determine whether talent is innate, can be acquired through extensive practice or can only be acquired in the presence of the developing brain. We sought to address some of these issues by studying healthy adults who acquired expertise in adulthood. We focused on the domain of memory and used licensed London taxi drivers as a model system. Taxi drivers have to learn the layout of 25,000 streets in London and the locations of thousands of places of interest, and pass stringent examinations in order to obtain an operating licence. Using neuropsychological assessment and structural and functional magnetic resonance imaging, we addressed a range of key questions: in the context of a fully developed brain and an average IQ, can people acquire expertise to an exceptional level; what are the neural signatures, both structural and functional, associated with the use of expertise; does expertise change the brain compared with unskilled control participants; does it confer any cognitive advantages, and similarly, does it come at a cost to other functions? By studying retired taxi drivers, we also consider what happens to their brains and behaviour when experts stop using their skill. Finally, we discuss how the expertise of taxi drivers might relate to the issue of talent and innate abilities. We suggest that exploring talent and expertise in this manner could have implications for education, rehabilitation of patients with cognitive impairments, understanding individual differences and possibly conditions such as autism where exceptional abilities can be a feature.

  18. General practice-based clinical trials in Germany - a problem analysis

    Directory of Open Access Journals (Sweden)

    Hummers-Pradier Eva

    2012-11-01

    Full Text Available Abstract Background In Germany, clinical trials and comparative effectiveness studies in primary care are still very rare, while their usefulness has been recognised in many other countries. A network of researchers from German academic general practice has explored the reasons for this discrepancy. Methods Based on a comprehensive literature review and expert group discussions, problem analyses as well as structural and procedural prerequisites for a better implementation of clinical trials in German primary care are presented. Results In Germany, basic biomedical science and technology is more reputed than clinical or health services research. Clinical trials are funded by industry or a single national programme, which is highly competitive, specialist-dominated, exclusive of pilot studies, and usually favours innovation rather than comparative effectiveness studies. Academic general practice is still not fully implemented, and existing departments are small. Most general practitioners (GPs work in a market-based, competitive setting of small private practices, with a high case load. They have no protected time or funding for research, and mostly no research training or experience. Good Clinical Practice (GCP training is compulsory for participation in clinical trials. The group defined three work packages to be addressed regarding clinical trials in German general practice: (1 problem analysis, and definition of (2 structural prerequisites and (3 procedural prerequisites. Structural prerequisites comprise specific support facilities for general practice-based research networks that could provide practices with a point of contact. Procedural prerequisites consist, for example, of a summary of specific relevant key measures, for example on a web platform. The platform should contain standard operating procedures (SOPs, templates, checklists and other supporting materials for researchers. Conclusion All in all, our problem analyses revealed that

  19. Developing civil society expertise to promote democratic ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    It will also build civil society partnership networks and capacity for effective engagement with principal stakeholders in defence affairs, helping to transform attitudes and ... IDRC is supporting research that studies the most effective ways to empower women, prevent gender-based violence, and make digital platforms work for ...

  20. Who participates in a randomized trial of mindfulness-based stress reduction (MBSR) after breast cancer?

    DEFF Research Database (Denmark)

    Würtzen, Hanne; Oksbjerg Dalton, Susanne; Kaae Andersen, Klaus

    2013-01-01

    Danish population-based registries and clinical databases to determine differences in demographics, breast cancer and co-morbidity among 1208 women eligible for a randomized controlled trial (www.clinicaltrials.gov identifier: NCT00990977) of mindfulness-based stress reduction MBSR. RESULTS: Participants......BACKGROUND: Discussion regarding the necessity to identify patients with both the need and motivation for psychosocial intervention is ongoing. Evidence for an effect of mindfulness-based interventions among cancer patients is based on few studies with no systematic enrollment. METHODS: We used...

  1. Developing evidence-based dentistry skills: how to interpret randomized clinical trials and systematic reviews.

    Science.gov (United States)

    Kiriakou, Juliana; Pandis, Nikolaos; Madianos, Phoebus; Polychronopoulou, Argy

    2014-10-30

    Decision-making based on reliable evidence is more likely to lead to effective and efficient treatments. Evidence-based dentistry was developed, similarly to evidence-based medicine, to help clinicians apply current and valid research findings into their own clinical practice. Interpreting and appraising the literature is fundamental and involves the development of evidence-based dentistry (EBD) skills. Systematic reviews (SRs) of randomized controlled trials (RCTs) are considered to be evidence of the highest level in evaluating the effectiveness of interventions. Furthermore, the assessment of the report of a RCT, as well as a SR, can lead to an estimation of how the study was designed and conducted.

  2. Simulation-based camera navigation training in laparoscopy-a randomized trial

    DEFF Research Database (Denmark)

    Nilsson, Cecilia; Sørensen, Jette Led; Konge, Lars

    2017-01-01

    patient safety. The objectives of this trial were to examine how to train laparoscopic camera navigation and to explore the transfer of skills to the operating room. MATERIALS AND METHODS: A randomized, single-center superiority trial with three groups: The first group practiced simulation-based camera...... navigation tasks (camera group), the second group practiced performing a simulation-based cholecystectomy (procedure group), and the third group received no training (control group). Participants were surgical novices without prior laparoscopic experience. The primary outcome was assessment of camera.......033), had a higher score. CONCLUSIONS: Simulation-based training improves the technical skills required for camera navigation, regardless of practicing camera navigation or the procedure itself. Transfer to the clinical setting could, however, not be demonstrated. The control group demonstrated higher...

  3. Automatic Selection of Clinical Trials Based on A Semantic Web Approach.

    Science.gov (United States)

    Cuggia, Marc; Campillo-Gimenez, Boris; Bouzille, Guillaume; Besana, Paolo; Jouini, Wassim; Dufour, Jean-Charles; Zekri, Oussama; Gibaud, Isabelle; Garde, Cyril; Duvauferier, Regis

    2015-01-01

    Recruitment of patients in clinical trials is nowadays preoccupying, as the inclusion rate is particularly low. The main identified factors are the multiplicity of open clinical trials, the high number and complexity of eligibility criteria, and the additional workload that a systematic search of the clinical trials a patient could be enrolled in for a physician. The principal objective of the ASTEC project is to automate the prescreening phase during multidisciplinary meetings (MDM). This paper presents the evaluation of a computerized recruitment support systems (CRSS) based on semantic web approach. The evaluation of the system was based on data collected retrospectively from a 6 month period of MDM in Urology and on 4 clinical trials of prostate cancer. The classification performance of the ASTEC system had a precision of 21%, recall of 93%, and an error rate equal to 37%. Missing data was the main issue encountered. The system was designed to be both scalable to other clinical domains and usable during MDM process.

  4. Likelihood-based methods for evaluating principal surrogacy in augmented vaccine trials.

    Science.gov (United States)

    Liu, Wei; Zhang, Bo; Zhang, Hui; Zhang, Zhiwei

    2017-04-01

    There is growing interest in assessing immune biomarkers, which are quick to measure and potentially predictive of long-term efficacy, as surrogate endpoints in randomized, placebo-controlled vaccine trials. This can be done under a principal stratification approach, with principal strata defined using a subject's potential immune responses to vaccine and placebo (the latter may be assumed to be zero). In this context, principal surrogacy refers to the extent to which vaccine efficacy varies across principal strata. Because a placebo recipient's potential immune response to vaccine is unobserved in a standard vaccine trial, augmented vaccine trials have been proposed to produce the information needed to evaluate principal surrogacy. This article reviews existing methods based on an estimated likelihood and a pseudo-score (PS) and proposes two new methods based on a semiparametric likelihood (SL) and a pseudo-likelihood (PL), for analyzing augmented vaccine trials. Unlike the PS method, the SL method does not require a model for missingness, which can be advantageous when immune response data are missing by happenstance. The SL method is shown to be asymptotically efficient, and it performs similarly to the PS and PL methods in simulation experiments. The PL method appears to have a computational advantage over the PS and SL methods.

  5. Challenges of a community based pragmatic, randomised controlled trial of weight loss maintenance.

    Science.gov (United States)

    Randell, Elizabeth; McNamara, Rachel; Shaw, Christine; Espinasse, Aude; Simpson, Sharon Anne

    2015-12-18

    Randomised controlled trials (RCTs) have a reputation for being inherently difficult to deliver as planned and often face unforeseen challenges and delays, particularly in relation to organisational and governance difficulties, participant interest, constraints due to allocation of costs, local investigator interest and lengthy bureaucracy. Recruitment is often difficult and the challenges faced often impact on the cost and delivery of a successful trial within the funded period. This paper reflects upon the challenges faced in delivering a pragmatic RCT of weight loss maintenance in a community setting and suggests some potential solutions. The weight loss maintenance in adults trial aimed to evaluate the impact of a 12 month, individually tailored weight maintenance intervention on BMI 3 years from randomisation. Participants were recruited primarily from participant identification centres (PICs)-GP surgeries, exercise on referral schemes and slimming world. The intervention was delivered in community settings. A recruitment strategy implementation plan was drafted to address and monitor poor recruitment. Delays in opening and recruitment were experienced early on. Some were beyond the control of the study team such as; disagreement over allocation of national health service costs and PIC classification as well as difficulties in securing support from research networks. That the intervention was delivered in community settings was often at the root of these issues. Key items to address at the design stage of future trials include feasibility of eligibility criteria. The most effective element of the recruitment implementation plan was to refocus sources of recruitment and target only those who could fulfil the eligibility criteria immediately. Learnings from this trial should be kept in mind by those designing similar studies in the future. Considering potential governance, cost and research network support implications at the design stage of pragmatic trials of

  6. Meeting the challenges of recruitment to multicentre, community-based, lifestyle-change trials: a case study of the BeWEL trial.

    Science.gov (United States)

    Treweek, Shaun; Wilkie, Erna; Craigie, Angela M; Caswell, Stephen; Thompson, Joyce; Steele, Robert J C; Stead, Martine; Anderson, Annie S

    2013-12-18

    Recruiting participants to multicentre, community-based trials is a challenge. This case study describes how this challenge was met for the BeWEL trial, which evaluated the impact of a diet and physical activity intervention on body weight in people who had had pre-cancerous bowel polyps. The BeWEL trial was a community-based trial, involving centres linked to the Scottish National Health Service (NHS) colorectal cancer screening programme. BeWEL had a recruitment target of 316 and its primary recruitment route was the colonoscopy clinics of the Scottish Bowel Screening Programme. BeWEL exceeded its recruitment target but needed a 6-month no-cost extension from the funder to achieve this. The major causes of delay were lower consent rates (49% as opposed to 70% estimated from earlier work), the time taken for NHS research and development department approvals and the inclusion of two additional sites to increase recruitment, for which there were substantial bureaucratic delays. A range of specific interventions to increase recruitment, for example, telephone reminders and a shorter participant information leaflet, helped to increase the proportion of eligible individuals consenting and being randomized. Recruitment to multicentre trials is a challenge but can be successfully achieved with a committed team. In a UK context, NHS research and development approval can be a substantial source of delay. Investigators should be cautious when estimating consent rates. If consent rates are less than expected, qualitative analysis might be beneficial, to try and identify the reason. Finally, investigators should select trial sites on the basis of a formal assessment of a site's past performance and the likelihood of success in the trial being planned. Current Controlled Trials ISRCTN53033856.

  7. Telegerontology as a Novel Approach to Address Health and Safety by Supporting Community-Based Rural Dementia Care Triads: Randomized Controlled Trial Protocol.

    Science.gov (United States)

    Wallack, Elizabeth M; Harris, Chelsea; Ploughman, Michelle; Butler, Roger

    2018-02-22

    Telegerontology is an approach using videoconferencing to connect an interdisciplinary team in a regional specialty center to patients in rural communities, which is becoming increasingly practical for addressing current limitations in rural community-based dementia care. Using the remotely-delivered expertise of the Telegerontology dementia care team, we aim to enhance the caregiver/patient/physician triad and thereby provide the necessary support for the person with dementia to "age in place." This is a cluster randomized feasibility trial with four rural regions in the province of Newfoundland and Labrador, Canada (2 regions randomly assigned to "intervention" and 2 to "control"). The study population includes 22 "dementia triads" that consist of a community-dwelling older Canadian with moderate to late dementia, their family caregivers, and their Primary Care Physician (PCP). Over the 6-month active study period, all participants will be provided an iPad. The intervention is intended as an adjunct to existing PCP care, consisting of weekly Skype-based videoconferencing calls with the Telegerontology physician, and other team members as needed (occupational therapist, physical therapist etc). Control participants receive usual community-based dementia care with their PCP. A baseline (pre-) assessment will be performed during a home visit with the study team. Post intervention, 6- and 12-month follow-up assessments will be collected remotely using specialized dementia monitoring applications and Skype calls. Primary outcomes include admission to long-term care, falls, emergency room visits, hospital stays, and caregiver burden. Results will be available in March of 2018. Results from this study will demonstrate a novel approach to dementia care that has the potential to impact both rural PCPs, family caregivers, and people with dementia, as well as provide evidence for the utility of Telegerontology in models of eHealth-based care. ©Elizabeth M. Wallack, Chelsea

  8. An Expertise Engine: MAST in the 2020s

    Science.gov (United States)

    Goldston Peek, Joshua Eli; Smith, Arfon M.; Momcheva, Ivelina G.

    2018-06-01

    The original Hubble Space Telescope archive showed how encapsulating expertise in science-ready data products could accelerate the pace of scientific advancement, and enable extremely productive archival research. In the 2000s, MAST and the Hubble Legacy Archive showed how taking these products to the next level further democratized astronomy, with archival science overtaking PI science as the dominant output of MAST missions. We argue that these data products fundamentally act as a vector for expertise, allowing novice users access to the detailed and advanced techniques of experts. In the 2020s we will see an explosion of data volume, data precision, and data complexity which will demand an even more powerful and sophisticated expertise engine. We’ll discuss how MAST plans to rise to meet that challenge.

  9. Musical expertise induces neuroplasticity of the planum temporale.

    Science.gov (United States)

    Meyer, Martin; Elmer, Stefan; Jäncke, Lutz

    2012-04-01

    The present manuscript summarizes and discusses the implications of recent neuroimaging studies, which have investigated the relationship between musical expertise and structural, as well as functional, changes in an auditory-related association cortex, namely, the planum temporale (PT). Since the bilateral PT is known to serve as a spectrotemporal processor that supports perception of acoustic modulations in both speech and music, it comes as no surprise that musical expertise corresponds to functional sensitivity and neuroanatomical changes in cortical architecture. In this context, we focus on the following question: To what extent does musical expertise affect the functioning of the left and right plana temporalia? We discuss the relationship between behavioral, hemodynamic, and neuroanatomical data obtained from musicians in light of maturational and developmental issues. In particular, we introduce two studies of our group that show to what extent brains of musicians are more proficient in phonetic task performance. © 2012 New York Academy of Sciences.

  10. Current expertise location by exploiting the dynamics of knowledge

    Directory of Open Access Journals (Sweden)

    Josef Nozicka

    2012-10-01

    Full Text Available Systems for expertise location are either very expensive in terms of the costs of maintenance or they tend to become obsolete or incomplete during the time. This article presents a new approach to knowledge mapping/expertise location allowing reducing the costs of knowledge mapping by maintaining the accuracy of the knowledge map. The efficiency of the knowledge map is achieved by introducing the knowledge estimation measures analysing the dynamics of knowledge of company employees and their textual results of work. Finding an expert with most up-to date knowledge is supported by focusing publishing history analysis. The efficiency of proposed measures within various timeframes of publishing history is evaluated by evaluation method introduced within the article. The evaluation took place in the environment of a middle-sized software company allowing seeing directly a practical usability of the expertise location technique. The results form various implications deployment of knowledge map within the company.

  11. Profitability expertise of rural methanization projects

    International Nuclear Information System (INIS)

    2010-02-01

    The main objectives of this study were to analyze the profitability of projects of methanization, and to identify factors which curb or favour their profitability. It is based on a detailed analysis of the investment and of the profitability of 50 sites of different sizes and at different stages of progress (from the feasibility study to few months of operation), and also of experiences in three neighbour countries (Germany, Switzerland and Belgium). First, the study highlights the importance of investment costs in the biogas production global cost, notably with respect to current German prices. Then, it comments the impact of subsidies on facility profitability. It proposes ways to improve public support to the different energetic vectors produced from biogas: electricity, biomethane, and heat

  12. Accurate diagnosis of CHD by Paediatricians with Expertise in Cardiology.

    Science.gov (United States)

    Jacob, Hannah C; Massey, Hannah; Yates, Robert W M; Kelsall, A Wilfred

    2017-08-01

    Introduction Paediatricians with Expertise in Cardiology assess children with a full history, examination, and often perform an echocardiogram. A minority are then referred to an outreach clinic run jointly with a visiting paediatric cardiologist. The accuracy of the echocardiography diagnosis made by the Paediatrician with Expertise in Cardiology is unknown. Materials and methods We conducted a retrospective review of clinic letters for children seen in the outreach clinic for the first time between March, 2004 and March, 2011. Children with CHD diagnosed antenatally or elsewhere were excluded. We recorded the echocardiography diagnosis made by the paediatric cardiologist and previously by the Paediatrician with Expertise in Cardiology. The Paediatrician with Expertise in Cardiology referred 317/3145 (10%) children seen in the local cardiac clinics to the outreach clinic over this period, and among them 296 were eligible for inclusion. Their median age was 1.5 years (range 1 month-15.1 years). For 244 (82%) children, there was complete diagnostic agreement between the Paediatrician with Expertise in Cardiology and the paediatric cardiologist. For 29 (10%) children, the main diagnosis was identical with additional findings made by the paediatric cardiologist. The abnormality had resolved in 17 (6%) cases by the time of clinic attendance. In six (2%) patients, the paediatric cardiologist made a different diagnosis. In total, 138 (47%) patients underwent a surgical or catheter intervention. Discussion Paediatricians with Expertise in Cardiology can make accurate diagnoses of CHD in children referred to their clinics. This can allow effective triage of children attending the outreach clinic, making best use of limited specialist resources.

  13. A novel experience-based internet intervention for smoking cessation: feasibility randomised controlled trial

    Directory of Open Access Journals (Sweden)

    John Powell

    2016-11-01

    Full Text Available Abstract Background The internet is frequently used to share experiences of health and illness, but this phenomenon has not been harnessed as an intervention to achieve health behaviour change. The aim of this study was to determine the feasibility of a randomised trial assessing the effects of a novel, experience-based website as a smoking cessation intervention. The secondary aim was to measure the potential impact on smoking behaviour of both the intervention and a comparator website. Methods A feasibility randomised controlled single-blind trial assessed a novel, experience-based website containing personal accounts of quitting smoking as a cessation intervention, and a comparator website providing factual information. Feasibility measures including recruitment, and usage of the interventions were recorded, and the following participant-reported outcomes were also measured: Smoking Abstinence Self-Efficacy Questionnaire, the single-item Motivation to Stop Scale, self-reported abstinence, quit attempts and health status outcomes. Eligible smokers from two English regions were entered into the trial and given access to their allocated website for two weeks. Results Eighty-seven smokers were randomised, 65 completed follow-up (75 %. Median usage was 15 min for the intervention, and 5 min for the comparator (range 0.5–213 min. Median logins for both sites was 2 (range 1–20. All participant-reported outcomes were similar between groups. Conclusions It was technically feasible to deliver a novel intervention harnessing the online sharing of personal experiences as a tool for smoking cessation, but recruitment was slow and actual use was relatively low, with attrition from the trial. Future work needs to maximize engagement and to understand how best to assess the value of such interventions in everyday use, rather than as an isolated ‘dose of information’. Trial registration ISRCTN29549695 DOI 10.1186/ISRCTN29549695 . Registered 17/05/2013.

  14. Randomized controlled trials of simulation-based interventions in Emergency Medicine: a methodological review.

    Science.gov (United States)

    Chauvin, Anthony; Truchot, Jennifer; Bafeta, Aida; Pateron, Dominique; Plaisance, Patrick; Yordanov, Youri

    2018-04-01

    The number of trials assessing Simulation-Based Medical Education (SBME) interventions has rapidly expanded. Many studies show that potential flaws in design, conduct and reporting of randomized controlled trials (RCTs) can bias their results. We conducted a methodological review of RCTs assessing a SBME in Emergency Medicine (EM) and examined their methodological characteristics. We searched MEDLINE via PubMed for RCT that assessed a simulation intervention in EM, published in 6 general and internal medicine and in the top 10 EM journals. The Cochrane Collaboration risk of Bias tool was used to assess risk of bias, intervention reporting was evaluated based on the "template for intervention description and replication" checklist, and methodological quality was evaluated by the Medical Education Research Study Quality Instrument. Reports selection and data extraction was done by 2 independents researchers. From 1394 RCTs screened, 68 trials assessed a SBME intervention. They represent one quarter of our sample. Cardiopulmonary resuscitation (CPR) is the most frequent topic (81%). Random sequence generation and allocation concealment were performed correctly in 66 and 49% of trials. Blinding of participants and assessors was performed correctly in 19 and 68%. Risk of attrition bias was low in three-quarters of the studies (n = 51). Risk of selective reporting bias was unclear in nearly all studies. The mean MERQSI score was of 13.4/18.4% of the reports provided a description allowing the intervention replication. Trials assessing simulation represent one quarter of RCTs in EM. Their quality remains unclear, and reproducing the interventions appears challenging due to reporting issues.

  15. Trial-based economic evaluations in occupational health: principles, methods, and recommendations.

    Science.gov (United States)

    van Dongen, Johanna M; van Wier, Marieke F; Tompa, Emile; Bongers, Paulien M; van der Beek, Allard J; van Tulder, Maurits W; Bosmans, Judith E

    2014-06-01

    To allocate available resources as efficiently as possible, decision makers need information on the relative economic merits of occupational health and safety (OHS) interventions. Economic evaluations can provide this information by comparing the costs and consequences of alternatives. Nevertheless, only a few of the studies that consider the effectiveness of OHS interventions take the extra step of considering their resource implications. Moreover, the methodological quality of those that do is generally poor. Therefore, this study aims to help occupational health researchers conduct high-quality trial-based economic evaluations by discussing the theory and methodology that underlie them, and by providing recommendations for good practice regarding their design, analysis, and reporting. This study also helps consumers of this literature with understanding and critically appraising trial-based economic evaluations of OHS interventions.

  16. The magic grasp: motor expertise in deception.

    Directory of Open Access Journals (Sweden)

    Cristiana Cavina-Pratesi

    2011-02-01

    Full Text Available Most of us are poor at faking actions. Kinematic studies have shown that when pretending to pick up imagined objects (pantomimed actions, we move and shape our hands quite differently from when grasping real ones. These differences between real and pantomimed actions have been linked to separate brain pathways specialized for different kinds of visuomotor guidance. Yet professional magicians regularly use pantomimed actions to deceive audiences.In this study, we tested whether, despite their skill, magicians might still show kinematic differences between grasping actions made toward real versus imagined objects. We found that their pantomimed actions in fact closely resembled real grasps when the object was visible (but displaced (Experiment 1, but failed to do so when the object was absent (Experiment 2.We suggest that although the occipito-parietal visuomotor system in the dorsal stream is designed to guide goal-directed actions, prolonged practice may enable it to calibrate actions based on visual inputs displaced from the action.

  17. Trial-based psychotherapy and the efficacy of trial-based thought record in changing unhelpful core beliefs and reducing self-criticism.

    Science.gov (United States)

    de Oliveira, Irismar Reis; Hemmany, Curt; Powell, Vania B; Bonfim, Thaís D; Duran, Erica P; Novais, Nilma; Velasquez, Michella; Di Sarno, Elaine; Alves, Gledson L; Cesnik, Joici A

    2012-03-01

    The best prevention against relapse results when patients are taught to restructure negative core beliefs (CBs). Efficacy of the trial-based thought record (TBTR) in decreasing the credit given by patients to negative CBs and corresponding emotions was evaluated. Patients (n = 166) were submitted to a simulation of a legal trial to assess their adherence to negative CBs and corresponding emotions after each cognitive therapy technique incorporated by TBTR. Significant reductions existed in percent values after the first and second defense attorney pleas, as well as after jury's verdict and initial preparation for the appeal (p < 0.001), relative to the investigation phase. Significant differences also emerged between the defense attorney's first and second pleas and between the defense attorney's second plea and jury's verdict, as well as preparation for the appeal (p < 0.001). There was no significant difference between percentages presented by patients submitted to TBTR used in the empty chair format relative to the conventional format. Similarly, there was no difference between outcomes, regardless of therapists' level of exposure to TBTR. TBTR may help patients reduce attachment to negative CBs and corresponding emotions. Outcomes were significantly favorable regardless of the format use and therapists' level of exposure to TBTR.

  18. Unbiased tensor-based morphometry: improved robustness and sample size estimates for Alzheimer's disease clinical trials.

    Science.gov (United States)

    Hua, Xue; Hibar, Derrek P; Ching, Christopher R K; Boyle, Christina P; Rajagopalan, Priya; Gutman, Boris A; Leow, Alex D; Toga, Arthur W; Jack, Clifford R; Harvey, Danielle; Weiner, Michael W; Thompson, Paul M

    2013-02-01

    Various neuroimaging measures are being evaluated for tracking Alzheimer's disease (AD) progression in therapeutic trials, including measures of structural brain change based on repeated scanning of patients with magnetic resonance imaging (MRI). Methods to compute brain change must be robust to scan quality. Biases may arise if any scans are thrown out, as this can lead to the true changes being overestimated or underestimated. Here we analyzed the full MRI dataset from the first phase of Alzheimer's Disease Neuroimaging Initiative (ADNI-1) from the first phase of Alzheimer's Disease Neuroimaging Initiative (ADNI-1) and assessed several sources of bias that can arise when tracking brain changes with structural brain imaging methods, as part of a pipeline for tensor-based morphometry (TBM). In all healthy subjects who completed MRI scanning at screening, 6, 12, and 24months, brain atrophy was essentially linear with no detectable bias in longitudinal measures. In power analyses for clinical trials based on these change measures, only 39AD patients and 95 mild cognitive impairment (MCI) subjects were needed for a 24-month trial to detect a 25% reduction in the average rate of change using a two-sided test (α=0.05, power=80%). Further sample size reductions were achieved by stratifying the data into Apolipoprotein E (ApoE) ε4 carriers versus non-carriers. We show how selective data exclusion affects sample size estimates, motivating an objective comparison of different analysis techniques based on statistical power and robustness. TBM is an unbiased, robust, high-throughput imaging surrogate marker for large, multi-site neuroimaging studies and clinical trials of AD and MCI. Copyright © 2012 Elsevier Inc. All rights reserved.

  19. Computer-Based Cognitive Training for Mild Cognitive Impairment: Results from a Pilot Randomized, Controlled Trial

    OpenAIRE

    Barnes, Deborah E.; Yaffe, Kristine; Belfor, Nataliya; Jagust, William J.; DeCarli, Charles; Reed, Bruce R.; Kramer, Joel H.

    2009-01-01

    We performed a pilot randomized, controlled trial of intensive, computer-based cognitive training in 47 subjects with mild cognitive impairment (MCI). The intervention group performed exercises specifically designed to improve auditory processing speed and accuracy for 100 minutes/day, 5 days/week for 6 weeks; the control group performed more passive computer activities (reading, listening, visuospatial game) for similar amounts of time. Subjects had a mean age of 74 years and 60% were men; 7...

  20. A cluster-based randomized controlled trial promoting community participation in arsenic mitigation efforts in Bangladesh

    OpenAIRE

    George, Christine Marie; van Geen, Alexander; Slavkovich, Vesna; Singha, Ashit; Levy, Diane; Islam, Tariqul; Ahmed, Kazi Matin; Moon-Howard, Joyce; Tarozzi, Alessandro; Liu, Xinhua; Factor-Litvak, Pam; Graziano, Joseph

    2012-01-01

    Abstract Objective To reduce arsenic (As) exposure, we evaluated the effectiveness of training community members to perform water arsenic (WAs) testing and provide As education compared to sending representatives from outside communities to conduct these tasks. Methods We conducted a cluster based randomized controlled trial of 20 villages in Singair, Bangladesh. Fifty eligible respondents were randomly selected in each village. In 10 villages, a community member provided As education and WAs...

  1. Mindfulness-Based Cognitive Therapy as a Treatment for Chronic Tinnitus: A Randomized Controlled Trial

    OpenAIRE

    McKenna, L.; Marks, E. M.; Hallsworth, C. A.; Schaette, R.

    2017-01-01

    BACKGROUND: Tinnitus is experienced by up to 15% of the population and can lead to significant disability and distress. There is rarely a medical or surgical target and psychological therapies are recommended. We investigated whether mindfulness-based cognitive therapy (MBCT) could offer an effective new therapy for tinnitus. METHODS: This single-site randomized controlled trial compared MBCT to intensive relaxation training (RT) for chronic, distressing tinnitus in adults. Both treatments in...

  2. Transfer of Rule-Based Expertise through a Tutorial Dialogue

    Science.gov (United States)

    1979-09-01

    be causing the infection (.2) [RULE633]. {The student asks, "Does the patient have a fever ?") " FEBRILE MYCIN never needed to inquire about whether...remaining clauses, some we classified most as restrictions, and the one or two that remained constituted the key factor(s) of the rule. The " petechial ...Infection is bacterial, KEY-FACTORt 4) Petechial is one of the types of rash which the patient has, RESTRICTIONS 5) Purpuric is not one of the types

  3. Evaluation of web-based annotation of ophthalmic images for multicentric clinical trials.

    Science.gov (United States)

    Chalam, K V; Jain, P; Shah, V A; Shah, Gaurav Y

    2006-06-01

    An Internet browser-based annotation system can be used to identify and describe features in digitalized retinal images, in multicentric clinical trials, in real time. In this web-based annotation system, the user employs a mouse to draw and create annotations on a transparent layer, that encapsulates the observations and interpretations of a specific image. Multiple annotation layers may be overlaid on a single image. These layers may correspond to annotations by different users on the same image or annotations of a temporal sequence of images of a disease process, over a period of time. In addition, geometrical properties of annotated figures may be computed and measured. The annotations are stored in a central repository database on a server, which can be retrieved by multiple users in real time. This system facilitates objective evaluation of digital images and comparison of double-blind readings of digital photographs, with an identifiable audit trail. Annotation of ophthalmic images allowed clinically feasible and useful interpretation to track properties of an area of fundus pathology. This provided an objective method to monitor properties of pathologies over time, an essential component of multicentric clinical trials. The annotation system also allowed users to view stereoscopic images that are stereo pairs. This web-based annotation system is useful and valuable in monitoring patient care, in multicentric clinical trials, telemedicine, teaching and routine clinical settings.

  4. From Meaning Well to Doing Well: Ethical Expertise in the GIS Domain

    Science.gov (United States)

    Huff, Chuck

    2014-01-01

    There is evidence to support the idea that moral action can be thought of in terms of expertise in a domain. This paper reviews work on the development of moral expertise across five levels, from novice to expertise. It addresses the role of habit in expertise and self-regulation strategies that signal when habitual action is not working and that…

  5. A Preliminary Trial of a Prototype Internet Dissonance-Based Eating Disorder Prevention Program for Young Women with Body Image Concerns

    Science.gov (United States)

    Stice, Eric; Rohde, Paul; Durant, Shelley; Shaw, Heather

    2012-01-01

    Objective: A group dissonance-based eating disorder prevention program, in which young women critique the thin ideal, reduces eating disorder risk factors and symptoms, but it can be difficult to identify school clinicians with the time and expertise to deliver the intervention. Thus, we developed a prototype Internet version of this program and…

  6. France bundles knowledge and expertise in intelligent energy networks; Frankrijk bundelt kennis en expertise in intelligente energienetwerken

    Energy Technology Data Exchange (ETDEWEB)

    Van Kooij, E.

    2012-03-15

    The networks that provides cities, office buildings, houses, cars and mobile phones with energy, is expected in the coming years to be digitized. The French innovation cluster Systematic has recently taken the initiative to set up a knowledge partnership which should connect knowledge and expertise with regard to future smart grids [Dutch] Het netwerk dat onze steden, kantoren, huizen, auto's en mobieltjes van energie voorziet, zal naar verwachting in de komende jaren een digitalisering ondergaan. Het Franse innovatiecluster Systematic heeft onlangs het initiatief genomen een samenwerkingsverband op te richten die kennis en expertise op het gebied van toekomstige intelligente energienetwerken bij elkaar brengt.

  7. Detangling Value: A study into the benefits of using in-house CSR expertise compared with the benefits of using CSR consultancy expertise

    OpenAIRE

    MacCarthy, Jennifer

    2007-01-01

    Abstract The topic of Corporate Social Responsibility (CSR) is an area with an increasing breadth of literature. However, literature regarding how CSR expertise is sourced for developing CSR projects and programmes within companies is distinctly weak. This study takes, arguably, the two most predominant forms of CSR expertise, in-house CSR expertise and CSR consultancies, and investigates what value these different types of expertise offer in sourcing for CSR activities. Bey...

  8. A Structural Equation Model of Expertise in College Physics

    Science.gov (United States)

    Taasoobshirazi, Gita; Carr, Martha

    2009-01-01

    A model of expertise in physics was tested on a sample of 374 college students in 2 different level physics courses. Structural equation modeling was used to test hypothesized relationships among variables linked to expert performance in physics including strategy use, pictorial representation, categorization skills, and motivation, and these…

  9. Mapping the institutional consolidation of EU human health expertise

    NARCIS (Netherlands)

    de Ruijter, A.

    The EU’s role in the field of human health is solidifying in terms of law and policy, but also with respect to the institutional organisation of human health expertise. In light of the emerging health-care union and questions regarding the nature and scope of a European health law, the institutional

  10. Mapping the institutional consolidation of EU human health expertise

    NARCIS (Netherlands)

    de Ruijter, Anniek

    2016-01-01

    The EU’s role in the field of human health is solidifying in terms of law and policy, but also with respect to the institutional organisation of human health expertise. In light of the emerging health-care union and questions regarding the nature and scope of a European health law, the institutional

  11. Expertise, Task Complexity, and Artificial Intelligence: A Conceptual Framework.

    Science.gov (United States)

    Buckland, Michael K.; Florian, Doris

    1991-01-01

    Examines the relationship between users' expertise, task complexity of information system use, and artificial intelligence to provide the basis for a conceptual framework for considering the role that artificial intelligence might play in information systems. Cognitive and conceptual models are discussed, and cost effectiveness is considered. (27…

  12. The Development of Information Search Expertise of Research Students

    Science.gov (United States)

    Kai-Wah Chu, Samuel; Law, Nancy

    2008-01-01

    This study identifies the development of information search expertise of 12 beginning research students (six in education and six in engineering) who were provided with a set of systematic search training sessions over a period of one year. The study adopts a longitudinal approach in investigating whether there were different stages in the…

  13. Expertise in the Age of Post-Factual politics

    DEFF Research Database (Denmark)

    Berling, Trine Villumsen; Bueger, Christian

    2017-01-01

    What has become known as post-factual politics poses particular challenges to the role of expertise, calling for a new type of reflexivity able to inform scholarly strategies towards policy. Taking recent literature on the ‘practice turn’ as our point of departure, we argue for introducing a sens...

  14. A Step Forward: Investigating Expertise in Materials Evaluation

    Science.gov (United States)

    Johnson, Keith; Kim, Mija; Ya-Fang, Liu; Nava, Andrea; Perkins, Dawn; Smith, Anne Margaret; Soler-Canela, Oscar; Lu, Wang

    2008-01-01

    This article reports on a study investigating the textbook evaluation techniques of novice and experienced teachers, which was conducted by the Language Teaching Expertise Research Group (or LATEX) within Lancaster University's Department of Linguistics and English Language. Three ELT teachers were chosen to evaluate the student and teacher…

  15. Social networks and expertise development for Australian breast radiologists.

    Science.gov (United States)

    Taba, Seyedamir Tavakoli; Hossain, Liaquat; Willis, Karen; Lewis, Sarah

    2017-02-11

    In this study, we explore the nexus between social networks and expertise development of Australian breast radiologists. Background literature has shown that a lack of appropriate social networks and interaction among certain professional group(s) may be an obstacle for knowledge acquisition, information flow and expertise sharing. To date there have not been any systematic studies investigating how social networks and expertise development are interconnected and whether this leads to improved performance for breast radiologists. This study explores the value of social networks in building expertise alongside with other constructs of performance for the Australian radiology workforce using semi-structured in-depth interviews with 17 breast radiologists. The findings from this study emphasise the influences of knowledge transfer and learning through social networks and interactions as well as knowledge acquisition and development through experience and feedback. The results also show that accessibility to learning resources and a variety of timely feedback on performance through the information and communication technologies (ICT) is likely to facilitate improved performance and build social support. We argue that radiologists' and, in particular, breast radiologists' work performance, needs to be explored not only through individual numerical characteristics but also by analysing the social context and peer support networks in which they operate and we identify multidisciplinary care as a core entity of social learning.

  16. Towards identifying programming expertise with the use of physiological measures

    DEFF Research Database (Denmark)

    Kontogiorgos, Dimosthenis; Manikas, Konstantinos

    2015-01-01

    In this position paper we propose means of measuring programming expertise on novice and expert programmers. Our approach is to measure the cognitive load of programmers while they assess Java/Python code in accordance with their experience in programming. Our hypothesis is that expert programmers...

  17. Flight nursing expertise: towards a middle-range theory

    Science.gov (United States)

    Reimer, Andrew P.; Moore, Shirley M.

    2010-01-01

    Aim This paper presents a middle-range Theory of Flight Nursing Expertise. Background Rotary-wing (helicopter) medical transport has grown rapidly in the USA since its introduction, particularly during the past 5 years. Patients once considered too sick to transport are now being transported more frequently and over longer distances. Many limitations are imposed by the air medical transport environment and these require nurses to alter their practice. Data sources A literature search was conducted using Pubmed, Medline, CINAHL, secondary referencing and an Internet search from 1960 to 2008 for studies related to the focal concepts in flight nursing. Discussion The middle-range Theory of Flight Nursing Expertise is composed of nine concepts (experience, training, transport environment of care, psychomotor skills, flight nursing knowledge, cue recognition, pattern recognition, decision-making and action) and their relationships. Five propositions describe the relationships between those concepts and how they apply to flight nursing expertise. Implications for nursing After empirical testing, this theory may be a useful tool to assist novice flight nurses to attain the skills necessary to provide safe and competent care more efficiently, and may aid in designing curricula and programmes of research. Conclusion Research is needed to determine the usefulness of this theory in both rotary and fixed-wing medical transport settings, and to examine the similarities and differences related to expertise needed for different flight nurse team compositions. Curriculum and training innovations can result from increased understanding of the concepts and relationships proposed in this theory. PMID:20337803

  18. Expertise: Myth or Reality of a Cross-National Definition?

    Science.gov (United States)

    Germain, Marie-Line; Ruiz, Carlos Enrique

    2009-01-01

    Purpose: The purpose of this paper is to offer a comparison of how human expertise is perceived by human resource development (HRD) scholars across several Western European countries and in the USA. Design/methodology/approach: A qualitative, exploratory approach using electronic mail was used for this study. In total, 36 leading HRD scholars from…

  19. Political Expertise and Affect: Effects on News Processing.

    Science.gov (United States)

    Hsu, Mei-Ling; Price, Vincent

    1993-01-01

    Investigates interactions between political expertise and affect in shaping cognitive strategies people employ in forming reactions to newspaper stories. Finds that, in processing the news articles, political experts produced a greater number of thoughts and a larger share of arguments than did novices. Observes no predicted main effects of…

  20. Conditions for Intuitive Expertise: A Failure to Disagree

    Science.gov (United States)

    Kahneman, Daniel; Klein, Gary

    2009-01-01

    This article reports on an effort to explore the differences between two approaches to intuition and expertise that are often viewed as conflicting: heuristics and biases (HB) and naturalistic decision making (NDM). Starting from the obvious fact that professional intuition is sometimes marvelous and sometimes flawed, the authors attempt to map…

  1. True Teaching Expertise: The Weaving Together of Theory and Practice

    Science.gov (United States)

    Mascio, Bryan

    2016-01-01

    How do we strengthen the teaching profession? This question weighs on many educators, researchers, politicians, and parents. The public discourse around teaching often feels very negative; it does not clearly define teaching expertise, but it does reflect a very clear belief that many teachers just do not have it. In this article, a former…

  2. Organizational change and human expertise in nuclear power plants: some implications for training and error prevention

    International Nuclear Information System (INIS)

    Masson, M.; Malaise, N.; Housiaux, A.; Keyser, V. de

    1993-01-01

    Reliability and safety are two very important goals, which depend on technical and organizational factors, but also on human expertise. How to ensure a safe functioning of a nuclear power plant in a changing context, and what might be the role and aspects of training and transfer of knowledge? These are the questions we shall deal with in this paper, on the basis of two field studies. The two field studies stress the needs for setting up case based training, which best ensure the acquisition of know-how. Furthermore, as shown by the second one, gaining expertise involves developing large repertoires of highly skilled, semi-routinized activities. Supporting expert operators not only should tackle problem solving activities but should thus also include the prevention of routine errors, which go along with skill acquisition. (orig.)

  3. Incretin-based therapies for type 2 diabetes mellitus in Asian patients: Analysis of clinical trials

    Directory of Open Access Journals (Sweden)

    Melva Louisa

    2010-08-01

    Full Text Available Aim To review the effi cacy and safety data on incretin-based therapies currently available (exenatide, liraglutide, sitagliptin, vildagliptin for the treatment of type 2 diabetes mellitus in Asian population.Methods We conducted Medline search of all relevant randomized clinical trials of incretin-based therapies for type 2 diabetes mellitus in Asian populations. Data pertinent to the efficacy and safety of GLP-1 mimetics and DPP-4 inhibitors were extracted and used.Results We found 14 randomized controlled trials of incretin based-therapy which included 3567 type 2 diabetes mellitus in Asian population (Japanese, Chinese, Korean, Indian. It was shown that incretin-based therapies improved HbA1c at higher extent (up to -1.42% in exenatide 10 mcg bid, -1.85% for liraglutide 0.9 mg qd, -1.4% for sitagliptin 100 mg and -1.4% for vildagliptin 50 mg bid compared to the effects observed in studies with Caucasian population, with comparable safety profile.Conclusion The efficacy of incretin-based therapies in Asian patients improved glycemic parameters in a higher magnitude on some glycemic parameters compared with those in Caucasian population. These results indicate that incretin-based therapies may be more effective in Asian population than in Caucasian. (Med J Indones 2010; 19: 205-12Key words: exenatide, incretin, liraglutide, sitagliptin, type-2 diabetes, vildagliptin

  4. Therapist guided internet based cognitive behavioural therapy for body dysmorphic disorder: single blind randomised controlled trial.

    Science.gov (United States)

    Enander, Jesper; Andersson, Erik; Mataix-Cols, David; Lichtenstein, Linn; Alström, Katarina; Andersson, Gerhard; Ljótsson, Brjánn; Rück, Christian

    2016-02-02

    To evaluate the efficacy of therapist guided internet based cognitive behavioural therapy (CBT) programme for body dysmorphic disorder (BDD-NET) compared with online supportive therapy. A 12 week single blind parallel group randomised controlled trial. Academic medical centre. 94 self referred adult outpatients with a diagnosis of body dysmorphic disorder and a modified Yale-Brown obsessive compulsive scale (BDD-YBOCS) score of ≥ 20. Concurrent psychotropic drug treatment was permitted if the dose had been stable for at least two months before enrolment and remained unchanged during the trial. Participants received either BDD-NET (n=47) or supportive therapy (n=47) delivered via the internet for 12 weeks. The primary outcome was the BDD-YBOCS score after treatment and follow-up (three and six months from baseline) as evaluated by a masked assessor. Responder status was defined as a ≥ 30% reduction in symptoms on the scale. Secondary outcomes were measures of depression (MADRS-S), global functioning (GAF), clinical global improvement (CGI-I), and quality of life (EQ5D). The six month follow-up time and all outcomes other than BDD-YBOCS and MADRS-S at 3 months were not pre-specified in the registration at clinicaltrials.gov because of an administrative error but were included in the original trial protocol approved by the regional ethics committee before the start of the trial. BDD-NET was superior to supportive therapy and was associated with significant improvements in severity of symptoms of body dysmorphic disorder (BDD-YBOCS group difference -7.1 points, 95% confidence interval -9.8 to -4.4), depression (MADRS-S group difference -4.5 points, -7.5 to -1.4), and other secondary measures. At follow-up, 56% of those receiving BDD-NET were classed as responders, compared with 13% receiving supportive therapy. The number needed to treat was 2.34 (1.71 to 4.35). Self reported satisfaction was high. CBT can be delivered safely via the internet to patients with body

  5. Initial Field Trial of a Coach-Supported Web-Based Depression Treatment.

    Science.gov (United States)

    Schueller, Stephen M; Mohr, David C

    2015-08-01

    Early web-based depression treatments were often self-guided and included few interactive elements, instead focusing mostly on delivering informational content online. Newer programs include many more types of features. As such, trials should analyze the ways in which people use these sites in order to inform the design of subsequent sites and models of support. The current study describes of a field trial consisting of 9 patients with major depressive disorder who completed a 12-week program including weekly coach calls. Patients usage varied widely, however, patients who formed regular patterns tended to persist with the program for the longest. Future sites might be able to facilitate user engagement by designing features to support regular use and to use coaches to help establish patterns to increase long-term use and benefit.

  6. A predictive approach to selecting the size of a clinical trial, based on subjective clinical opinion.

    Science.gov (United States)

    Spiegelhalter, D J; Freedman, L S

    1986-01-01

    The 'textbook' approach to determining sample size in a clinical trial has some fundamental weaknesses which we discuss. We describe a new predictive method which takes account of prior clinical opinion about the treatment difference. The method adopts the point of clinical equivalence (determined by interviewing the clinical participants) as the null hypothesis. Decision rules at the end of the study are based on whether the interval estimate of the treatment difference (classical or Bayesian) includes the null hypothesis. The prior distribution is used to predict the probabilities of making the decisions to use one or other treatment or to reserve final judgement. It is recommended that sample size be chosen to control the predicted probability of the last of these decisions. An example is given from a multi-centre trial of superficial bladder cancer.

  7. OPTIMIZATION OF SCIENTIFIC AND TECHNICAL EXPERTISE OF THE APPLICATIONS FOR STATE SUBSIDIES

    Directory of Open Access Journals (Sweden)

    S. Yu. Tuzova

    2016-01-01

    Full Text Available The main aspects of the evaluation of projects for the grant of Federal Target Program «Researches and developments in priority directions of scientific and technological complex of Russia for 2014-2020» is discussed. This subject is very relevant, because the efficiency of scientific and technical expertise is a guarantee of the eff ectiveness of innovative projects management. This is particularly important for the projects, which have significant practical orientation and being competitive in the international scientific and technical level.The purpose of this article is a justification of importance of improvement of technologies of information support of experts. These technologies allow to draw the attention of the expert to a number of discrepancies in the documentation, to quickly process the large volume of information at various scientometric databases, to reduce the manhours of the expert per project and to increase efficiency of scientific and technical expertise.Advantages and disadvantages of the use of machine analysis of keyword and semantic analysis of documents during the scientific and technical expertise have been described. The criteria for peer review as a quality research project; qualifications, work experience, academic achievements of the project implementing team and instrument base; the potential Bidder; financial support of the project. Various criteria for analysis of the project (quality of the research project, qualifications, work experience, academic achievements of the project implementing team and their instrument base, the potential and the project financial support are considered.Conclusions. First, use of modern information technology in scientific and technical expertise allows to expand the information field and an expert to carry out a deeper analysis of projects. Secondly, the stocktaking of the advantages and disadvantages of using machine analysis for keywords and semantic analysis of the documents

  8. A novel experience-based internet intervention for smoking cessation: feasibility randomised controlled trial.

    Science.gov (United States)

    Powell, John; Newhouse, Nikki; Martin, Angela; Jawad, Sena; Yu, Ly-Mee; Davoudianfar, Mina; Locock, Louise; Ziebland, Sue

    2016-11-11

    The internet is frequently used to share experiences of health and illness, but this phenomenon has not been harnessed as an intervention to achieve health behaviour change. The aim of this study was to determine the feasibility of a randomised trial assessing the effects of a novel, experience-based website as a smoking cessation intervention. The secondary aim was to measure the potential impact on smoking behaviour of both the intervention and a comparator website. A feasibility randomised controlled single-blind trial assessed a novel, experience-based website containing personal accounts of quitting smoking as a cessation intervention, and a comparator website providing factual information. Feasibility measures including recruitment, and usage of the interventions were recorded, and the following participant-reported outcomes were also measured: Smoking Abstinence Self-Efficacy Questionnaire, the single-item Motivation to Stop Scale, self-reported abstinence, quit attempts and health status outcomes. Eligible smokers from two English regions were entered into the trial and given access to their allocated website for two weeks. Eighty-seven smokers were randomised, 65 completed follow-up (75 %). Median usage was 15 min for the intervention, and 5 min for the comparator (range 0.5-213 min). Median logins for both sites was 2 (range 1-20). All participant-reported outcomes were similar between groups. It was technically feasible to deliver a novel intervention harnessing the online sharing of personal experiences as a tool for smoking cessation, but recruitment was slow and actual use was relatively low, with attrition from the trial. Future work needs to maximize engagement and to understand how best to assess the value of such interventions in everyday use, rather than as an isolated 'dose of information'. ISRCTN29549695 DOI 10.1186/ISRCTN29549695 . Registered 17/05/2013.

  9. Internet-Based, Randomized Controlled Trial of Omega-3 Fatty Acids for Hyperactivity in Autism

    Science.gov (United States)

    Bent, Stephen; Hendren, Robert L.; Zandi, Tara; Law, Kiely; Choi, Jae-Eun; Widjaja, Felicia; Kalb, Luther; Nestle, Jay; Law, Paul

    2014-01-01

    Objective Preliminary evidence suggests that omega-3 fatty acids may reduce hyperactivity in children with autism spectrum disorder (ASD). We sought to examine the feasibility of a novel, internet-based clinical trial design to evaluate the efficacy of this supplement. Method E-mail invitations were sent to parents of children aged 5-8 enrolled in the Interactive Autism Network. All study procedures, including screening, informed consent, and collection of outcome measures took place over the internet. The primary outcome measures were parent- and teacher-rated changes in hyperactivity on the Aberrant Behavior Checklist. Results During the 6-week recruitment period, 57 children from 28 states satisfied all eligibility criteria and were randomly assigned to 1.3 grams of omega-3 fatty acids or an identical placebo daily for 6 weeks. Outcome assessments were obtained from all 57 participants and 57 teachers, and the study was completed in 3 months. Children in the omega-3 fatty acid group had a greater reduction in hyperactivity (-5.3 points) compared to the placebo group (-2.6 points), but the difference was not statistically significant (1.9 point greater improvement in the omega-3 group, 95% CI -2.2 to 5.2). Side effects were rare and not associated with omega-3 fatty acids. Participant feedback was positive. Conclusion Internet-based randomized controlled trials of therapies in children with ASD are feasible and may lead to marked reductions in the time and cost of completing trials. A larger sample size is required to definitively determine the efficacy of omega-3 fatty acids. Clinical trial registration information—Omega-3 Fatty Acids for Hyperactivity Treatment in Autism Spectrum Disorder; http://clinicaltrials.gov; NCT01694667. PMID:24839884

  10. Implementation of clinical research trials using web-based and mobile devices: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Roy Eagleson

    2017-03-01

    Full Text Available Abstract Background With the increasing implementation of web-based, mobile health interventions in clinical trials, it is crucial for researchers to address the security and privacy concerns of patient information according to high ethical standards. The full process of meeting these standards is often made more complicated due to the use of internet-based technology and smartphones for treatment, telecommunication, and data collection; however, this process is not well-documented in the literature. Results The Smart Heart Trial is a single-arm feasibility study that is currently assessing the effects of a web-based, mobile lifestyle intervention for overweight and obese children and youth with congenital heart disease in Southwestern Ontario. Participants receive telephone counseling regarding nutrition and fitness; and complete goal-setting activities on a web-based application. This paper provides a detailed overview of the challenges the study faced in meeting the high standards of our Research Ethics Board, specifically regarding patient privacy. Conclusion We outline our solutions, successes, limitations, and lessons learned to inform future similar studies; and model much needed transparency in ensuring high quality security and protection of patient privacy when using web-based and mobile devices for telecommunication and data collection in clinical research.

  11. The Effect of Domain and Technical Expertise on the Training Outcomes for Case Management Systems in High Domain Expertise Fields

    Science.gov (United States)

    Epstein, Steven L.

    2017-01-01

    The successful implementation of an enterprise system requires training and end users in the new systems and procedures. There has been no research reporting a relationship between Domain Expertise (DE) and the successful implementation of an enterprise system. This study sought to begin filling this knowledge gap by exploring the relationship…

  12. The Virtual Anemia Trial: An Assessment of Model-Based In Silico Clinical Trials of Anemia Treatment Algorithms in Patients With Hemodialysis.

    Science.gov (United States)

    Fuertinger, Doris H; Topping, Alice; Kappel, Franz; Thijssen, Stephan; Kotanko, Peter

    2018-04-01

    In silico approaches have been proposed as a novel strategy to increase the repertoire of clinical trial designs. Realistic simulations of clinical trials can provide valuable information regarding safety and limitations of treatment protocols and have been shown to assist in the cost-effective planning of clinical studies. In this report, we present a blueprint for the stepwise integration of internal, external, and ecological validity considerations in virtual clinical trials (VCTs). We exemplify this approach in the context of a model-based in silico clinical trial aimed at anemia treatment in patients undergoing hemodialysis (HD). Hemoglobin levels and subsequent anemia treatment were simulated on a per patient level over the course of a year and compared to real-life clinical data of 79,426 patients undergoing HD. The novel strategies presented here, aimed to improve external and ecological validity of a VCT, significantly increased the predictive power of the discussed in silico trial. © 2018 The Authors CPT: Pharmacometrics & Systems Pharmacology published by Wiley Periodicals, Inc. on behalf of American Society for Clinical Pharmacology and Therapeutics.

  13. Nurse-Moderated Internet-Based Support for New Mothers: Non-Inferiority, Randomized Controlled Trial.

    Science.gov (United States)

    Sawyer, Michael G; Reece, Christy E; Bowering, Kerrie; Jeffs, Debra; Sawyer, Alyssa C P; Mittinty, Murthy; Lynch, John W

    2017-07-24

    Internet-based interventions moderated by community nurses have the potential to improve support offered to new mothers, many of whom now make extensive use of the Internet to obtain information about infant care. However, evidence from population-based randomized controlled trials is lacking. The aim of this study was to test the non-inferiority of outcomes for mothers and infants who received a clinic-based postnatal health check plus nurse-moderated, Internet-based group support when infants were aged 1-7 months as compared with outcomes for those who received standard care consisting of postnatal home-based support provided by a community nurse. The design of the study was a pragmatic, preference, non-inferiority randomized control trial. Participants were recruited from mothers contacted for their postnatal health check, which is offered to all mothers in South Australia. Mothers were assigned either (1) on the basis of their preference to clinic+Internet or home-based support groups (n=328), or (2) randomly assigned to clinic+Internet or home-based groups if they declared no strong preference (n=491). The overall response rate was 44.8% (819/1827). The primary outcome was parenting self-competence, as measured by the Parenting Stress Index (PSI) Competence subscale, and the Karitane Parenting Confidence Scale scores. Secondary outcome measures included PSI Isolation, Interpersonal Support Evaluation List-Short Form, Maternal Support Scale, Ages and Stages Questionnaire-Social-Emotional and MacArthur Communicative Development Inventory (MCDI) scores. Assessments were completed offline via self-assessment questionnaires at enrolment (mean child age=4.1 weeks, SD 1.3) and again when infants were aged 9, 15, and 21 months. Generalized estimating equations adjusting for post-randomization baseline imbalances showed that differences in outcomes between mothers in the clinic+Internet and home-based support groups did not exceed the pre-specified margin of

  14. Motivational interviewing in a Web-based physical activity intervention with an avatar: randomized controlled trial.

    Science.gov (United States)

    Friederichs, Stijn; Bolman, Catherine; Oenema, Anke; Guyaux, Janneke; Lechner, Lilian

    2014-02-13

    Developing Web-based physical activity (PA) interventions based on motivational interviewing (MI) could increase the availability and reach of MI techniques for PA promotion. Integrating an avatar in such an intervention could lead to more positive appreciation and higher efficacy of the intervention, compared to an intervention that is purely text-based. The present study aims to determine whether a Web-based PA intervention based on MI with an avatar results in more positive appreciation and higher effectiveness of the intervention, when compared to an intervention that is purely text-based. A three-arm randomized controlled trial was conducted, containing the following research conditions: (1) a Web-based PA intervention based on MI with an avatar, (2) a content-identical intervention without an avatar, and (3) a control condition that received no intervention. Measurements included PA behavior and process variables, measured at baseline, directly following the intervention and 1 month post intervention. Both interventions significantly increased self-reported PA at 1 month, compared to the control condition (beta(AVATARvsCONTROL)=.39, P=.011; beta(TEXTvsCONTROL)=.44, P=.006). No distinctions were found regarding intervention effect on PA between both interventions. Similarly, the results of the process evaluation did not indicate any significant differences between both interventions. Due to the limited relational skills of the avatar in this study, it probably did not succeed in forming a stronger relationship with the user, over and above text alone. The findings suggest that avatars that do not strengthen the social relationship with the user do not enhance the intervention impact. Future research should determine whether Web-based PA interventions based on MI could benefit from inclusion of a virtual coach capable of more complex relational skills than used in the current study, such as responding in gesture to the user's state and input. Dutch Trial

  15. An open trial of Acceptance-based Separated Family Treatment (ASFT) for adolescents with anorexia nervosa.

    Science.gov (United States)

    Timko, C Alix; Zucker, Nancy L; Herbert, James D; Rodriguez, Daniel; Merwin, Rhonda M

    2015-06-01

    Family based-treatments have the most empirical support in the treatment of adolescent anorexia nervosa; yet, a significant percentage of adolescents and their families do not respond to manualized family based treatment (FBT). The aim of this open trial was to conduct a preliminary evaluation of an innovative family-based approach to the treatment of anorexia: Acceptance-based Separated Family Treatment (ASFT). Treatment was grounded in Acceptance and Commitment Therapy (ACT), delivered in a separated format, and included an ACT-informed skills program. Adolescents (ages 12-18) with anorexia or sub-threshold anorexia and their families received 20 treatment sessions over 24 weeks. Outcome indices included eating disorder symptomatology reported by the parent and adolescent, percentage of expected body weight achieved, and changes in psychological acceptance/avoidance. Half of the adolescents (48.0%) met criteria for full remission at the end of treatment, 29.8% met criteria for partial remission, and 21.3% did not improve. Overall, adolescents had a significant reduction in eating disorder symptoms and reached expected body weight. Treatment resulted in changes in psychological acceptance in the expected direction for both parents and adolescents. This open trial provides preliminary evidence for the feasibility, acceptability, and efficacy of ASFT for adolescents with anorexia. Directions for future research are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Internet based patient education improves informed consent for elective orthopaedic surgery: a randomized controlled trial.

    Science.gov (United States)

    Fraval, Andrew; Chandrananth, Janan; Chong, Yew M; Coventry, Lillian S; Tran, Phong

    2015-02-07

    Obtaining informed consent is an essential step in the surgical pathway. Providing adequate patient education to enable informed decision making is a continued challenge of contemporary surgical practice. This study investigates whether the use of a patient information website, to augment patient education and informed consent for elective orthopaedic procedures is an effective measure. A randomised controlled trial was conducted comparing the quality of informed consent provided by a standard discussion with the treating surgeon compared to augmentation of this discussion with an online education resource (www.orthoanswer.org). Participants were recruited from orthopaedic outpatient clinics. Patients undergoing five common orthopaedic procedures were eligible to participate in the trial. The primary outcome measure was knowledge about their operation. Satisfaction with their informed consent and anxiety relating to their operation were the secondary outcome measures. There was a statistically significant increase in patient knowledge for the intervention arm as compared to the control arm (p education website as an augment to informed consent improves patient knowledge about their planned operation as well as satisfaction with the consent process whilst not increasing their anxiety levels. We recommend that all patients be directed to web based education tools to augment their consent. Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12614001058662 .

  17. [Bibliometrics study on indications of acupuncture therapy based on foreign acupuncture clinical trials].

    Science.gov (United States)

    He, Wei; Tong, Yuan-Yuan; Zhao, Ying-Kai; Rong, Pei-Jing; Wang, Hong-Cai

    2012-10-01

    In the present paper, the authors make a bibliometrics study on clinical indications of acupuncture therapy based on the published foreign articles about acupuncture clinical trials collected from PubMed database and Excerpta Medica database (EMbase). In 1996, 64 acupuncture indications were declared by WHO in Milan conference. But in recent 15 years, clinical trials have been conducted extensively in the foreign countries. Till now, 77 new indications for acupuncture therapy have been found in the foreign journals. The authors recommended that 29 indications (knee osteoarthritis, critique age problems, muscular fasciae ache, anxiety, etc.) should be added to the first class, 4 indications (irritable bowel syndrome, malposition, backache, simple obesity) should be upgraded from the second class to the first class, and the other 3 indications (childbirth pain, male and female barren) should be upgraded from the third class to the first class due to their application frequency in clinical trials. Increase of clinical indications reflects extensive application of acupuncture therapy and may help providing a better service for people's health.

  18. Working memory, reasoning, and expertise in medicine-insights into their relationship using functional neuroimaging.

    Science.gov (United States)

    Hruska, Pam; Krigolson, Olav; Coderre, Sylvain; McLaughlin, Kevin; Cortese, Filomeno; Doig, Christopher; Beran, Tanya; Wright, Bruce; Hecker, Kent G

    2016-12-01

    Clinical reasoning is dependent upon working memory (WM). More precisely, during the clinical reasoning process stored information within long-term memory is brought into WM to facilitate the internal deliberation that affords a clinician the ability to reason through a case. In the present study, we examined the relationship between clinical reasoning and WM while participants read clinical cases with functional magnetic resonance imaging (fMRI). More specifically, we examined the impact of clinical case difficulty (easy, hard) and clinician level of expertise (2nd year medical students, senior gastroenterologists) on neural activity within regions of cortex associated with WM (i.e., the prefrontal cortex) during the reasoning process. fMRI was used to scan ten second-year medical students and ten practicing gastroenterologists while they reasoned through sixteen clinical cases [eight straight forward (easy) and eight complex (hard)] during a single 1-h scanning session. Within-group analyses contrasted the easy and hard cases which were then subsequently utilized for a between-group analysis to examine effects of expertise (novice > expert, expert > novice). Reading clinical cases evoked multiple neural activations in occipital, prefrontal, parietal, and temporal cortical regions in both groups. Importantly, increased activation in the prefrontal cortex in novices for both easy and hard clinical cases suggests novices utilize WM more so than experts during clinical reasoning. We found that clinician level of expertise elicited differential activation of regions of the human prefrontal cortex associated with WM during clinical reasoning. This suggests there is an important relationship between clinical reasoning and human WM. As such, we suggest future models of clinical reasoning take into account that the use of WM is not consistent throughout all clinical reasoning tasks, and that memory structure may be utilized differently based on level of expertise.

  19. Study protocol: home-based telehealth stroke care: a randomized trial for veterans

    Directory of Open Access Journals (Sweden)

    McGee-Hernandez Nancy

    2010-06-01

    Full Text Available Abstract Background Stroke is one of the most disabling and costly impairments of adulthood in the United States. Stroke patients clearly benefit from intensive inpatient care, but due to the high cost, there is considerable interest in implementing interventions to reduce hospital lengths of stay. Early discharge rehabilitation programs require coordinated, well-organized home-based rehabilitation, yet lack of sufficient information about the home setting impedes successful rehabilitation. This trial examines a multifaceted telerehabilitation (TR intervention that uses telehealth technology to simultaneously evaluate the home environment, assess the patient's mobility skills, initiate rehabilitative treatment, prescribe exercises tailored for stroke patients and provide periodic goal oriented reassessment, feedback and encouragement. Methods We describe an ongoing Phase II, 2-arm, 3-site randomized controlled trial (RCT that determines primarily the effect of TR on physical function and secondarily the effect on disability, falls-related self-efficacy, and patient satisfaction. Fifty participants with a diagnosis of ischemic or hemorrhagic stroke will be randomly assigned to one of two groups: (a TR; or (b Usual Care. The TR intervention uses a combination of three videotaped visits and five telephone calls, an in-home messaging device, and additional telephonic contact as needed over a 3-month study period, to provide a progressive rehabilitative intervention with a treatment goal of safe functional mobility of the individual within an accessible home environment. Dependent variables will be measured at baseline, 3-, and 6-months and analyzed with a linear mixed-effects model across all time points. Discussion For patients recovering from stroke, the use of TR to provide home assessments and follow-up training in prescribed equipment has the potential to effectively supplement existing home health services, assist transition to home and

  20. ASCOT: a text mining-based web-service for efficient search and assisted creation of clinical trials

    Science.gov (United States)

    2012-01-01

    Clinical trials are mandatory protocols describing medical research on humans and among the most valuable sources of medical practice evidence. Searching for trials relevant to some query is laborious due to the immense number of existing protocols. Apart from search, writing new trials includes composing detailed eligibility criteria, which might be time-consuming, especially for new researchers. In this paper we present ASCOT, an efficient search application customised for clinical trials. ASCOT uses text mining and data mining methods to enrich clinical trials with metadata, that in turn serve as effective tools to narrow down search. In addition, ASCOT integrates a component for recommending eligibility criteria based on a set of selected protocols. PMID:22595088

  1. Institutionalized Ignorance as a Precondition for Rational Risk Expertise

    DEFF Research Database (Denmark)

    Merkelsen, Henrik

    2011-01-01

    the lowest organizational level, where concrete risks occur, to the highest organizational level, where the body of professional risk expertise is situated. The article emphasizes the role of knowledge, responsibility, loyalty, and trust as risk-attenuation factors and concludes by suggesting......The present case study seeks to explain the conditions for experts’ rational risk perception by analyzing the institutional contexts that constitute a field of food safety expertise in Denmark. The study highlights the role of risk reporting and how contextual factors affect risk reporting from...... that the preconditions for the expert's rationality may rather be a lack of risk-specific knowledge due to poor risk reporting than a superior level of risk knowledge....

  2. Social dimensions of expertise in World of Warcraft players

    Directory of Open Access Journals (Sweden)

    Mark Chen

    2009-03-01

    Full Text Available Expertise development in the massively multiplayer online game World of Warcraft (Blizzard Entertainment, 2004 depends greatly on a player's use of social skills to gain access to expert player groups and accrue social and cultural capital. Drawn from ethnographic research, this paper maps out various forms of expert practice and highlights the social aspects of game play that often eclipse the importance of game-mechanics knowledge. At the time of this research, playing World of Warcraft and developing expertise in the game happened roughly within a two-stage process: (1 leveling up, or advancing one's character or avatar while learning the mechanics of the game, and (2 drawing on social capital gained during the first stage to join a group of up to 40 players to partake in high-end or endgame content.

  3. Integrating LCA and EHS expertise in the assessment of nanoparticles

    DEFF Research Database (Denmark)

    Olsen, Stig Irving; Hankin, Steve; Chaudry, Qasim

    DTU with their expertise in LCA have joined forces with IOM in two nanotechnology-related projects, one of which additionally involves and is lead by FERA. The first project, Nancore, includes the evaluation of health risks and environmental impacts over the life cycle concurrently with the devel......DTU with their expertise in LCA have joined forces with IOM in two nanotechnology-related projects, one of which additionally involves and is lead by FERA. The first project, Nancore, includes the evaluation of health risks and environmental impacts over the life cycle concurrently...... the overall environmental impacts of the technology. Through the concurrent assessments, the strengths of the two tools are combined to provide a more qualified assessment of both the health and safety aspects and the life cycle impacts. The overall aim of the second project, sponsored by Defra...

  4. The Neural Circuitry of Expertise: Perceptual Learning and Social Cognition

    Directory of Open Access Journals (Sweden)

    Michael eHarre

    2013-12-01

    Full Text Available Amongst the most significant questions we are confronted with today include the integration of the brain's micro-circuitry, our ability to build the complex social networks that underpin society and how our society impacts on our ecological environment. In trying to unravel these issues one place to begin is at the level of the individual: to consider how we accumulate information about our environment, how this information leads to decisions and how our individual decisions in turn create our social environment. While this is an enormous task, we may already have at hand many of the tools we need. This article is intended to review some of the recent results in neuro-cognitive research and show how they can be extended to two very specific types of expertise: perceptual expertise and social cognition. These two cognitive skills span a vast range of our genetic heritage. Perceptual expertise developed very early in our evolutionary history and is likely a highly developed part of all mammals' cognitive ability. On the other hand social cognition is most highly developed in humans in that we are able to maintain larger and more stable long term social connections with more behaviourally diverse individuals than any other species. To illustrate these ideas I will discuss board games as a toy model of social interactions as they include many of the relevant concepts: perceptual learning, decision-making, long term planning and understanding the mental states of other people. Using techniques that have been developed in mathematical psychology, I show that we can represent some of the key features of expertise using stochastic differential equations. Such models demonstrate how an expert's long exposure to a particular context influences the information they accumulate in order to make a decision.These processes are not confined to board games, we are all experts in our daily lives through long exposure to the many regularities of daily tasks and

  5. Fulfilling the needs for statistical expertise at Aalborg Hospital

    DEFF Research Database (Denmark)

    Dethlefsen, Claus

    In 2005, the first statistician was employed at Aalborg Hospital due to expanding research activities as part of Aarhus University Hospital. Since then, there has been an increased demand for statistical expertise at all levels. In the talk, I will give an overview of the current staff...... of statisticians and the organisation. I will give examples from our statistical consultancy and illustrate some of the challenges that have led to research projects with heavy statistical involvement....

  6. Context-specific effects of musical expertise on audiovisual integration

    Science.gov (United States)

    Bishop, Laura; Goebl, Werner

    2014-01-01

    Ensemble musicians exchange auditory and visual signals that can facilitate interpersonal synchronization. Musical expertise improves how precisely auditory and visual signals are perceptually integrated and increases sensitivity to asynchrony between them. Whether expertise improves sensitivity to audiovisual asynchrony in all instrumental contexts or only in those using sound-producing gestures that are within an observer's own motor repertoire is unclear. This study tested the hypothesis that musicians are more sensitive to audiovisual asynchrony in performances featuring their own instrument than in performances featuring other instruments. Short clips were extracted from audio-video recordings of clarinet, piano, and violin performances and presented to highly-skilled clarinetists, pianists, and violinists. Clips either maintained the audiovisual synchrony present in the original recording or were modified so that the video led or lagged behind the audio. Participants indicated whether the audio and video channels in each clip were synchronized. The range of asynchronies most often endorsed as synchronized was assessed as a measure of participants' sensitivities to audiovisual asynchrony. A positive relationship was observed between musical training and sensitivity, with data pooled across stimuli. While participants across expertise groups detected asynchronies most readily in piano stimuli and least readily in violin stimuli, pianists showed significantly better performance for piano stimuli than for either clarinet or violin. These findings suggest that, to an extent, the effects of expertise on audiovisual integration can be instrument-specific; however, the nature of the sound-producing gestures that are observed has a substantial effect on how readily asynchrony is detected as well. PMID:25324819

  7. A sociological analysis of ethical expertise: The case of bioethics

    Directory of Open Access Journals (Sweden)

    Nathan Emmerich

    2016-12-01

    Full Text Available This paper examines the question of ethical expertise and does so in the context of bioethics or, more accurately, applied ethics and the ethical governance of the life sciences. This analysis builds on a perspective set out in a previous paper and develops it further such that it relates to democratic processes. I argue that the academic practice of applied ethics exhibits a particular logic, way of thinking or eidos. Drawing on work in the history of science I present the logic of this practice as underpinned by a particular set of values or ethos. This can be contrasted with what Bernstein calls the democratic ethos as well as that of everyday moral agents. Using the framework of expertise developed by Collins and Evan’s—which differentiates between ubiquitous, contributory, and interactional expertise—I suggest that (bioethicists should modulate their expertise depending on the particular nature of the fora—academic, public, and policy-making—they are speaking in.

  8. Anticipatory Governance: Bioethical Expertise for Human/Animal Chimeras

    Science.gov (United States)

    Harvey, Alison; Salter, Brian

    2012-01-01

    The governance demands generated by the use of human/animal chimeras in scientific research offer both a challenge and an opportunity for the development of new forms of anticipatory governance through the novel application of bioethical expertise. Anticipatory governance can be seen to have three stages of development whereby bioethical experts move from a reactive to a proactive stance at the edge of what is scientifically possible. In the process, the ethicists move upstream in their engagement with the science of human-to-animal chimeras. To what extent is the anticipatory coestablishment of the principles and operational rules of governance at this early stage in the development of the human-to-animal research field likely to result in a framework for bioethical decision making that is in support of science? The process of anticipatory governance is characterised by the entwining of the scientific and the philosophical so that judgements against science are also found to be philosophically unfounded, and conversely, those activities that are permissible are deemed so on both scientific and ethical grounds. Through what is presented as an organic process, the emerging bioethical framework for human-to-animal chimera research becomes a legitimating framework within which ‘good’ science can safely progress. Science gives bioethical expertise access to new governance territory; bioethical expertise gives science access to political acceptability. PMID:23576848

  9. Musical expertise and the ability to imagine loudness.

    Directory of Open Access Journals (Sweden)

    Laura Bishop

    Full Text Available Most perceived parameters of sound (e.g. pitch, duration, timbre can also be imagined in the absence of sound. These parameters are imagined more veridically by expert musicians than non-experts. Evidence for whether loudness is imagined, however, is conflicting. In music, the question of whether loudness is imagined is particularly relevant due to its role as a principal parameter of performance expression. This study addressed the hypothesis that the veridicality of imagined loudness improves with increasing musical expertise. Experts, novices and non-musicians imagined short passages of well-known classical music under two counterbalanced conditions: 1 while adjusting a slider to indicate imagined loudness of the music and 2 while tapping out the rhythm to indicate imagined timing. Subtests assessed music listening abilities and working memory span to determine whether these factors, also hypothesised to improve with increasing musical expertise, could account for imagery task performance. Similarity between each participant's imagined and listening loudness profiles and reference recording intensity profiles was assessed using time series analysis and dynamic time warping. The results suggest a widespread ability to imagine the loudness of familiar music. The veridicality of imagined loudness tended to be greatest for the expert musicians, supporting the predicted relationship between musical expertise and musical imagery ability.

  10. Musical expertise and the ability to imagine loudness.

    Science.gov (United States)

    Bishop, Laura; Bailes, Freya; Dean, Roger T

    2013-01-01

    Most perceived parameters of sound (e.g. pitch, duration, timbre) can also be imagined in the absence of sound. These parameters are imagined more veridically by expert musicians than non-experts. Evidence for whether loudness is imagined, however, is conflicting. In music, the question of whether loudness is imagined is particularly relevant due to its role as a principal parameter of performance expression. This study addressed the hypothesis that the veridicality of imagined loudness improves with increasing musical expertise. Experts, novices and non-musicians imagined short passages of well-known classical music under two counterbalanced conditions: 1) while adjusting a slider to indicate imagined loudness of the music and 2) while tapping out the rhythm to indicate imagined timing. Subtests assessed music listening abilities and working memory span to determine whether these factors, also hypothesised to improve with increasing musical expertise, could account for imagery task performance. Similarity between each participant's imagined and listening loudness profiles and reference recording intensity profiles was assessed using time series analysis and dynamic time warping. The results suggest a widespread ability to imagine the loudness of familiar music. The veridicality of imagined loudness tended to be greatest for the expert musicians, supporting the predicted relationship between musical expertise and musical imagery ability.

  11. Dedicated OO expertise applied to Run II software projects

    International Nuclear Information System (INIS)

    Amidei, D.

    2000-01-01

    The change in software language and methodology by CDF and D0 to object-oriented from procedural Fortran is significant. Both experiments requested dedicated expertise that could be applied to software design, coding, advice and review. The Fermilab Run II offline computing outside review panel agreed strongly with the request and recommended that the Fermilab Computing Division hire dedicated OO expertise for the CDF/D0/Computing Division joint project effort. This was done and the two experts have been an invaluable addition to the CDF and D0 upgrade software projects and to the Computing Division in general. These experts have encouraged common approaches and increased the overall quality of the upgrade software. Advice on OO techniques and specific advice on C++ coding has been used. Recently a set of software reviews has been accomplished. This has been a very successful instance of a targeted application of computing expertise, and constitutes a very interesting study of how to move toward modern computing methodologies in HEP

  12. The changing role of veterinary expertise in the food chain.

    Science.gov (United States)

    Enticott, Gareth; Donaldson, Andrew; Lowe, Philip; Power, Megan; Proctor, Amy; Wilkinson, Katy

    2011-07-12

    This paper analyses how the changing governance of animal health has impacted upon veterinary expertise and its role in providing public health benefits. It argues that the social sciences can play an important role in understanding the nature of these changes, but also that their ideas and methods are, in part, responsible for them. The paper begins by examining how veterinary expertise came to be crucial to the regulation of the food chain in the twentieth century. The relationship between the veterinary profession and the state proved mutually beneficial, allowing the state to address the problems of animal health, and the veterinary profession to become identified as central to public health and food supply. However, this relationship has been gradually eroded by the application of neoliberal management techniques to the governance of animal health. This paper traces the impact of these techniques that have caused widespread unease within and beyond the veterinary profession about the consequences for its role in maintaining the public good of animal health. In conclusion, this paper suggests that the development of the social sciences in relation to animal health could contribute more helpfully to further changes in veterinary expertise.

  13. Reducing discards without reducing profit: Free gear choice in a Danish result-based management trial

    DEFF Research Database (Denmark)

    Mortensen, Lars O.; Ulrich, Clara; Qvist Eliasen, Søren

    2017-01-01

    The 2013 Common Fisheries Policy introduced a landing obligation on a range of species. This is changing the fundamental principles on which EU fisheries management is based, with more focus on the full accountability of all catches (a move towards catch quota management) and less accountability...... on the means used to obtain these catches (a move towards results-based management). To investigate the potentials and challenges that these paradigm shifts give rise to, a 6-months ‘unrestricted gear’ trial was performed in Denmark in 2015,. Twelve trawlers of different size, rigging, fishing area and target......, where unwanted catches could be reduced to some extent without negative effects on economic viability. Some practical implementation challenges were nevertheless encountered, which are discussed in the perspective of implementing results-based management at full scale....

  14. Teacher Professional Knowledge and Classroom Management: On the Relation of General Pedagogical Knowledge (GPK) and Classroom Management Expertise (CME)

    Science.gov (United States)

    König, Johannes; Kramer, Charlotte

    2016-01-01

    Due to the need for measurement instruments that allow an investigation of teachers' situational cognition and thus go beyond the limited scope of classical paper-and-pencil-tests, we ask how a specific video-based measurement of teachers' classroom management expertise can provide additional information when compared with an established…

  15. Deliberate Practice in Medicine: The Motivation to Engage in Work-Related Learning and Its Contribution to Expertise

    Science.gov (United States)

    van de Wiel, Margje W. J.; Van den Bossche, Piet

    2013-01-01

    This study examined physicians' motivation to engage in work-related learning and its contribution to expertise development beyond work experience. Based on deliberate practice theory, semi-structured interviews were conducted with 17 residents and 28 experienced physicians in internal medicine, focusing on the activities they engaged in during…

  16. Everyday Expertise in Self-Management of Diabetes in the Dominican Republic: Implications for Learning and Performance Support Systems Design

    Science.gov (United States)

    Reyes Paulino, Lisette G.

    2012-01-01

    An epidemic such as diabetes is an extremely complex public health, economic and social problem that is difficult to solve through medical expertise alone. Evidence-based models for improving healthcare delivery systems advocate educating patients to become more active participants in their own care. This shift demands preparing chronically ill…

  17. Are all types of expertise created equal? Car experts use different spatial frequency scales for subordinate categorization of cars and faces.

    Science.gov (United States)

    Harel, Assaf; Bentin, Shlomo

    2013-01-01

    A much-debated question in object recognition is whether expertise for faces and expertise for non-face objects utilize common perceptual information. We investigated this issue by assessing the diagnostic information required for different types of expertise. Specifically, we asked whether face categorization and expert car categorization at the subordinate level relies on the same spatial frequency (SF) scales. Fifteen car experts and fifteen novices performed a category verification task with spatially filtered images of faces, cars, and airplanes. Images were categorized based on their basic (e.g. "car") and subordinate level (e.g. "Japanese car") identity. The effect of expertise was not evident when objects were categorized at the basic level. However, when the car experts categorized faces and cars at the subordinate level, the two types of expertise required different kinds of SF information. Subordinate categorization of faces relied on low SFs more than on high SFs, whereas subordinate expert car categorization relied on high SFs more than on low SFs. These findings suggest that expertise in the recognition of objects and faces do not utilize the same type of information. Rather, different types of expertise require different types of diagnostic visual information.

  18. A study on mobile PC display design in NPP maintenance considering the level of expertise

    International Nuclear Information System (INIS)

    Kim, In

    2010-02-01

    Recently, the importance of effective maintenance in nuclear power plants (NPPs) has been emphasized and research into effective maintenance by adopting mobile maintenance aids (MMAs) have been attempted. MMAs are currently used during operation and maintenance in NPPs, but no method that considers the limitations of mobile devices has been proposed. For improved and effective use, an MMA display design method based on abstraction hierarchy (AH) is proposed and its design considerations are discussed in this study. Six levels of abstraction hierarchy are proposed in this paper to classify the maintenance information. By classifying and organizing maintenance information using AH, maintenance information can be used effectively by users either high or low levels of expertise. When information classification has been finished, the information requirements and relationships for MMA design is extracted from the analysis of the AH result. Representative human-machine interface (HMI) guidelines issued by the US NRC, which are generally used in NPPs, are applied. With the considerations of MMA design analysis and practical guidelines, AH-based MMA is designed for maintenance tasks. An experiment is conducted using the AH-based MMA in order to estimate the effectiveness of the proposed method for maintenance tasks and to identify design considerations to enhance the proposed MMAs. The result indicated that an AH-based manual was more effective than a conventional manual in terms of task completion time and number of errors. The workload for the AH-based manual was estimated to be less than the conventional manual for low levels of expertise. However, a conventional manual was more comprehensive than the proposed manual and the steps contained in the maintenance manual were easier to remember. As the level of expertise increases, subjects tended to follow more abstract information while the number of navigations decreased. It is believed that when mobile devices become

  19. Development and evaluation of a web-based assent for adolescents considering an HIV vaccine trial.

    Science.gov (United States)

    Blake, Diane R; Lemay, Celeste A; Maranda, Louise S; Fortenberry, J Dennis; Kearney, Margaret H; Mazor, Kathleen M

    2015-01-01

    HIV vaccine trials with minors will likely require parental permission and informed assent from adolescents. For this to be a valid process, the information needs to be presented in a manner that promotes adolescent comprehension. Previous studies suggest that adolescent comprehension of assent is often insufficient. We developed an interactive web-based assent that included interspersed quiz questions for a hypothetical HIV vaccine trial. Efficacy of the web-based assent was compared to a standard paper assent with and without interspersed questions. One hundred twenty teen participants, ages 15-17 years, from five community organizations were randomized to self-administered web-based assent (n=60) or investigator-administered paper assent with (n=29) or without (n=31) interspersed quiz questions. After reviewing the assent, participants completed a 27-item comprehension test. Comprehension scores were compared between groups. The mean number of correctly answered questions were 21.2 for the full paper group and 21.1 for the web-based group (t118=-0.08, p=0.94). Scores were 20.2 for the paper without interspersed questions sub-group and 22.1 for the paper with interspersed questions sub-group (t58=1.96, p=0.055). Participants in the web-based group performed as well on the comprehension test as those in the paper group, and those in the paper with questions sub-group performed better than those in the paper without questions sub-group, suggesting that interspersed quiz questions may improve understanding of a traditional paper assent. The minimal investigator time and standardized administration of the web-based assent as well as ability to tailor the assent discussion to topics identified by incorrect comprehension test responses are advantages worthy of further investigation.

  20. Community based yoga classes for type 2 diabetes: an exploratory randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Drincevic Desanka

    2009-02-01

    Full Text Available Abstract Background Yoga is a popular therapy for diabetes but its efficacy is contested. The aim of this study was to explore the feasibility of researching community based yoga classes in Type 2 diabetes with a view to informing the design of a definitive, multi-centre trial Methods The study design was an exploratory randomised controlled trial with in-depth process evaluation. The setting was two multi-ethnic boroughs in London, UK; one with average and one with low mean socio-economic deprivation score. Classes were held at a sports centre or GP surgery. Participants were 59 people with Type 2 diabetes not taking insulin, recruited from general practice lists or opportunistically by general practice staff. The intervention group were offered 12 weeks of a twice-weekly 90-minute yoga class; the control group was a waiting list for the yoga classes. Both groups received advice and leaflets on healthy lifestyle and were encouraged to exercise. Primary outcome measure was HbA1c. Secondary outcome measures included attendance, weight, waist circumference, lipid levels, blood pressure, UKPDS cardiovascular risk score, diabetes-related quality of life (ADDQoL, and self-efficacy. Process measures were attendance at yoga sessions, self-reported frequency of practice between taught sessions, and qualitative data (interviews with patients and therapists, ethnographic observation of the yoga classes, and analysis of documents including minutes of meetings, correspondence, and exercise plans. Results Despite broad inclusion criteria, around two-thirds of the patients on GP diabetic registers proved ineligible, and 90% of the remainder declined to participate. Mean age of participants was 60 +/- 10 years. Attendance at yoga classes was around 50%. Nobody did the exercises regularly at home. Yoga teachers felt that most participants were unsuitable for 'standard' yoga exercises because of limited flexibility, lack of basic fitness, co-morbidity, and lack

  1. Redesigning a large school-based clinical trial in response to changes in community practice

    Science.gov (United States)

    Gerald, Lynn B; Gerald, Joe K; McClure, Leslie A; Harrington, Kathy; Erwin, Sue; Bailey, William C

    2011-01-01

    Background Asthma exacerbations are seasonal with the greatest risk in elementary-age students occurring shortly after returning to school following summer break. Recent research suggests that this seasonality in children is primarily related to viral respiratory tract infections. Regular hand washing is the most effective method to prevent the spread of viral respiratory infections; unfortunately, achieving hand washing recommendations in schools is difficult. Therefore, we designed a study to evaluate the effect of hand sanitizer use in elementary schools on exacerbations among children with asthma. Purpose To describe the process of redesigning the trial in response to changes in the safety profile of the hand sanitizer as well as changes in hand hygiene practice in the schools. Methods The original trial was a randomized, longitudinal, subject-blinded, placebo-controlled, community-based crossover trial. The primary aim was to evaluate the incremental effectiveness of hand sanitizer use in addition to usual hand hygiene practices to decrease asthma exacerbations in elementary-age children. Three events occurred that required major modifications to the original study protocol: (1) safety concerns arose regarding the hand sanitizer’s active ingredient; (2) no substitute placebo hand sanitizer was available; and (3) community preferences changed regarding hand hygiene practices in the schools. Results The revised protocol is a randomized, longitudinal, community-based crossover trial. The primary aim is to evaluate the incremental effectiveness of a two-step hand hygiene process (hand hygiene education plus institutionally provided alcohol-based hand sanitizer) versus usual care to decrease asthma exacerbations. Enrollment was completed in May 2009 with 527 students from 30 schools. The intervention began in August 2009 and will continue through May 2011. Study results should be available at the end of 2011. Limitations The changed design does not allow us to

  2. Redesigning a large school-based clinical trial in response to changes in community practice.

    Science.gov (United States)

    Gerald, Lynn B; Gerald, Joe K; McClure, Leslie A; Harrington, Kathy; Erwin, Sue; Bailey, William C

    2011-06-01

    Asthma exacerbations are seasonal with the greatest risk in elementary-age students occurring shortly after returning to school following summer break. Recent research suggests that this seasonality in children is primarily related to viral respiratory tract infections. Regular hand washing is the most effective method to prevent the spread of viral respiratory infections; unfortunately, achieving hand washing recommendations in schools is difficult. Therefore, we designed a study to evaluate the effect of hand sanitizer use in elementary schools on exacerbations among children with asthma. To describe the process of redesigning the trial in response to changes in the safety profile of the hand sanitizer as well as changes in hand hygiene practice in the schools. The original trial was a randomized, longitudinal, subject-blinded, placebo-controlled, community-based crossover trial. The primary aim was to evaluate the incremental effectiveness of hand sanitizer use in addition to usual hand hygiene practices to decrease asthma exacerbations in elementary-age children. Three events occurred that required major modifications to the original study protocol: (1) safety concerns arose regarding the hand sanitizer's active ingredient; (2) no substitute placebo hand sanitizer was available; and (3) community preferences changed regarding hand hygiene practices in the schools. The revised protocol is a randomized, longitudinal, community-based crossover trial. The primary aim is to evaluate the incremental effectiveness of a two-step hand hygiene process (hand hygiene education plus institutionally provided alcohol-based hand sanitizer) versus usual care to decrease asthma exacerbations. Enrollment was completed in May 2009 with 527 students from 30 schools. The intervention began in August 2009 and will continue through May 2011. Study results should be available at the end of 2011. The changed design does not allow us to directly measure the effectiveness of hand

  3. Effect of a primary health-care-based controlled trial for cardiorespiratory fitness in refugee women

    Directory of Open Access Journals (Sweden)

    Johansson Sven-Erik

    2010-08-01

    Full Text Available Abstract Background Refugee women have a high risk of coronary heart disease with low physical activity as one possible mediator. Furthermore, cultural and environmental barriers to increasing physical activity have been demonstrated. The aim of the study was to evaluate the combined effect of an approximate 6-month primary health care- and community-based exercise intervention versus an individual written prescription for exercise on objectively assessed cardiorespiratory fitness in low-active refugee women. Methods A controlled clinical trial, named "Support for Increased Physical Activity", was executed among 243 refugee women recruited between November 2006 and April 2008 from two deprived geographic areas in southern Stockholm, Sweden. One geographic area provided the intervention group and the other area the control group. The control group was on a higher activity level at both baseline and follow-up, which was taken into consideration in the analysis by applying statistical models that accounted for this. Relative aerobic capacity and fitness level were assessed as the two main outcome measures. Results The intervention group increased their relative aerobic capacity and the percentage with an acceptable fitness level (relative aerobic capacity > 23 O2ml·kg·min-1 to a greater extent than the control group between baseline and the 6-month follow-up, after adjusting for possible confounders (P = 0.020. Conclusions A combined primary health-care and community-based exercise programme (involving non-profit organizations can be an effective strategy to increase cardiorespiratory fitness among low-active refugee women. Trial Registration ClinicalTrials.gov ID: NCT00747942

  4. Instructional Design for Accelerated Macrocognitive Expertise in the Baseball Workplace

    Directory of Open Access Journals (Sweden)

    Peter J. Fadde

    2016-03-01

    Full Text Available The goal of accelerating expertise can leave researchers and trainers in human factors, naturalistic decision making, sport science, and expertise studies concerned about seemingly insufficient application of expert performance theories, findings and methods for training macrocognitive aspects of human performance. Video-occlusion methods perfected by sports expertise researchers have great instructional utility, in some cases offering an effective and inexpensive alternative to high-fidelity simulation. A key problem for instructional designers seems to be that expertise research done in laboratory and field settings doesn’t get adequately translated into workplace training. Therefore, this article presents a framework for better linkage of expertise research/training across laboratory, field, and workplace settings. It also uses a case study to trace the development and implementation of a macrocognitive training program in the very challenging workplace of the baseball batters’ box. This training, which was embedded for a full season in a college baseball team, targeted the perceptual-cognitive skill of pitch recognition that allows expert batters to circumvent limitations of human reaction time in order to hit a 90 mile-per-hour slider. While baseball batting has few analogous skills outside of sports, the instructional design principles of the training program developed to improve batting have wider applicability and implications. Its core operational principle, supported by information processing models but challenged by ecological models, decouples the perception-action link for targeted part-task training of the perception component, in much the same way that motor components routinely are isolated to leverage instructional efficiencies. After targeted perceptual training, perception and action were recoupled via transfer-appropriate tasks inspired by in situ research tasks. Using NCAA published statistics as performance measures

  5. Instructional Design for Accelerated Macrocognitive Expertise in the Baseball Workplace.

    Science.gov (United States)

    Fadde, Peter J

    2016-01-01

    The goal of accelerating expertise can leave researchers and trainers in human factors, naturalistic decision making, sport science, and expertise studies concerned about seemingly insufficient application of expert performance theories, findings and methods for training macrocognitive aspects of human performance. Video-occlusion methods perfected by sports expertise researchers have great instructional utility, in some cases offering an effective and inexpensive alternative to high-fidelity simulation. A key problem for instructional designers seems to be that expertise research done in laboratory and field settings doesn't get adequately translated into workplace training. Therefore, this article presents a framework for better linkage of expertise research/training across laboratory, field, and workplace settings. It also uses a case study to trace the development and implementation of a macrocognitive training program in the very challenging workplace of the baseball batters' box. This training, which was embedded for a full season in a college baseball team, targeted the perceptual-cognitive skill of pitch recognition that allows expert batters to circumvent limitations of human reaction time in order to hit a 90 mile-per-hour slider. While baseball batting has few analogous skills outside of sports, the instructional design principles of the training program developed to improve batting have wider applicability and implications. Its core operational principle, supported by information processing models but challenged by ecological models, decouples the perception-action link for targeted part-task training of the perception component, in much the same way that motor components routinely are isolated to leverage instructional efficiencies. After targeted perceptual training, perception and action were recoupled via transfer-appropriate tasks inspired by in situ research tasks. Using NCAA published statistics as performance measures, the cooperating team

  6. Immune Monitoring in Cancer Vaccine Clinical Trials: Critical Issues of Functional Flow Cytometry-Based Assays

    Directory of Open Access Journals (Sweden)

    Iole Macchia

    2013-01-01

    Full Text Available The development of immune monitoring assays is essential to determine the immune responses against tumor-specific antigens (TSAs and tumor-associated antigens (TAAs and their possible correlation with clinical outcome in cancer patients receiving immunotherapies. Despite the wide range of techniques used, to date these assays have not shown consistent results among clinical trials and failed to define surrogate markers of clinical efficacy to antitumor vaccines. Multiparameter flow cytometry- (FCM- based assays combining different phenotypic and functional markers have been developed in the past decade for informative and longitudinal analysis of polyfunctional T-cells. These technologies were designed to address the complexity and functional heterogeneity of cancer biology and cellular immunity and to define biomarkers predicting clinical response to anticancer treatment. So far, there is still a lack of standardization of some of these immunological tests. The aim of this review is to overview the latest technologies for immune monitoring and to highlight critical steps involved in some of the FCM-based cellular immune assays. In particular, our laboratory is focused on melanoma vaccine research and thus our main goal was the validation of a functional multiparameter test (FMT combining different functional and lineage markers to be applied in clinical trials involving patients with melanoma.

  7. Web-Based Intervention for Nutritional Management in Cystic Fibrosis: Development, Usability, and Pilot Trial.

    Science.gov (United States)

    Stark, Lori J; Opipari-Arrigan, Lisa; Filigno, Stephanie S; Simon, Stacey L; Leonard, Amanda; Mogayzel, Peter J; Rausch, Joseph; Zion, Cynthia; Powers, Scott W

    2016-06-01

    Usability and pilot testing of a web intervention (BeInCharge.org [BIC]) of behavior plus nutrition intervention for children with cystic fibrosis (CF) ages 4-9 years. Think Aloud methodology was used with five mothers to assess usability and refine the intervention. A pilot trial was then conducted with 10 mothers of children with CF ages 4-9 years randomized to the web-based BIC or a Standard Care Control (STC). Change in weight gain for each group was compared in a pre-to-post design. Mothers rated the usability and clarity of BIC highly. The pilot trial showed children of mothers who received BIC had a significant change in weight pre-to-post-treatment (0.67 kg, p = .04). Change for the STC was not significant (0.41 kg, p = .10). A web-based behavior plus nutrition intervention appears promising in increasing weight gain in children with CF. © The Author 2015. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. Controlling Chronic Diseases Through Evidence-Based Decision Making: A Group-Randomized Trial.

    Science.gov (United States)

    Brownson, Ross C; Allen, Peg; Jacob, Rebekah R; deRuyter, Anna; Lakshman, Meenakshi; Reis, Rodrigo S; Yan, Yan

    2017-11-30

    Although practitioners in state health departments are ideally positioned to implement evidence-based interventions, few studies have examined how to build their capacity to do so. The objective of this study was to explore how to increase the use of evidence-based decision-making processes at both the individual and organization levels. We conducted a 2-arm, group-randomized trial with baseline data collection and follow-up at 18 to 24 months. Twelve state health departments were paired and randomly assigned to intervention or control condition. In the 6 intervention states, a multiday training on evidence-based decision making was conducted from March 2014 through March 2015 along with a set of supplemental capacity-building activities. Individual-level outcomes were evidence-based decision making skills of public health practitioners; organization-level outcomes were access to research evidence and participatory decision making. Mixed analysis of covariance models was used to evaluate the intervention effect by accounting for the cluster randomized trial design. Analysis was performed from March through May 2017. Participation 18 to 24 months after initial training was 73.5%. In mixed models adjusted for participant and state characteristics, the intervention group improved significantly in the overall skill gap (P = .01) and in 6 skill areas. Among the 4 organizational variables, only access to evidence and skilled staff showed an intervention effect (P = .04). Tailored and active strategies are needed to build capacity at the individual and organization levels for evidence-based decision making. Our study suggests several dissemination interventions for consideration by leaders seeking to improve public health practice.

  9. Evaluating the Accuracy of Results for Teacher Implemented Trial-Based Functional Analyses.

    Science.gov (United States)

    Rispoli, Mandy; Ninci, Jennifer; Burke, Mack D; Zaini, Samar; Hatton, Heather; Sanchez, Lisa

    2015-09-01

    Trial-based functional analysis (TBFA) allows for the systematic and experimental assessment of challenging behavior in applied settings. The purposes of this study were to evaluate a professional development package focused on training three Head Start teachers to conduct TBFAs with fidelity during ongoing classroom routines. To assess the accuracy of the TBFA results, the effects of a function-based intervention derived from the TBFA were compared with the effects of a non-function-based intervention. Data were collected on child challenging behavior and appropriate communication. An A-B-A-C-D design was utilized in which A represented baseline, and B and C consisted of either function-based or non-function-based interventions counterbalanced across participants, and D represented teacher implementation of the most effective intervention. Results showed that the function-based intervention produced greater decreases in challenging behavior and greater increases in appropriate communication than the non-function-based intervention for all three children. © The Author(s) 2015.

  10. Adapting Animal-Assisted Therapy Trials to Prison-Based Animal Programs.

    Science.gov (United States)

    Allison, Molly; Ramaswamy, Megha

    2016-09-01

    Prison-based animal programs have shown promise when it comes to increased sociability, responsibility, and levels of patience for inmates who participate in these programs. Yet there remains a dearth of scientific research that demonstrates the impact of prison-based animal programs on inmates' physical and mental health. Trials of animal-assisted therapy interventions, a form of human-animal interaction therapy most often used with populations affected by depression/anxiety, mental illness, and trauma, may provide models of how prison-based animal program research can have widespread implementation in jail and prison settings, whose populations have high rates of mental health problems. This paper reviews the components of prison-based animal programs most commonly practiced in prisons today, presents five animal-assisted therapy case studies, evaluates them based on their adaptability to prison-based animal programs, and discusses the institutional constraints that act as barriers for rigorous prison-based animal program research implementation. This paper can serve to inform the development of a research approach to animal-assisted therapy that nurses and other public health researchers can use in working with correctional populations. © 2016 Wiley Periodicals, Inc.

  11. Trial Promoter: A Web-Based Tool for Boosting the Promotion of Clinical Research Through Social Media.

    Science.gov (United States)

    Reuter, Katja; Ukpolo, Francis; Ward, Edward; Wilson, Melissa L; Angyan, Praveen

    2016-06-29

    Scarce information about clinical research, in particular clinical trials, is among the top reasons why potential participants do not take part in clinical studies. Without volunteers, on the other hand, clinical research and the development of novel approaches to preventing, diagnosing, and treating disease are impossible. Promising digital options such as social media have the potential to work alongside traditional methods to boost the promotion of clinical research. However, investigators and research institutions are challenged to leverage these innovations while saving time and resources. To develop and test the efficiency of a Web-based tool that automates the generation and distribution of user-friendly social media messages about clinical trials. Trial Promoter is developed in Ruby on Rails, HTML, cascading style sheet (CSS), and JavaScript. In order to test the tool and the correctness of the generated messages, clinical trials (n=46) were randomized into social media messages and distributed via the microblogging social media platform Twitter and the social network Facebook. The percent correct was calculated to determine the probability with which Trial Promoter generates accurate messages. During a 10-week testing phase, Trial Promoter automatically generated and published 525 user-friendly social media messages on Twitter and Facebook. On average, Trial Promoter correctly used the message templates and substituted the message parameters (text, URLs, and disease hashtags) 97.7% of the time (1563/1600). Trial Promoter may serve as a promising tool to render clinical trial promotion more efficient while requiring limited resources. It supports the distribution of any research or other types of content. The Trial Promoter code and installation instructions are freely available online.

  12. Internet-based treatment for adults with depressive symptoms: the protocol of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Cuijpers Pim

    2007-12-01

    Full Text Available Abstract Background Depression is a highly prevalent condition, affecting more than 15% of the adult population at least once in their lives. Guided self-help is effective in the treatment of depression. The purpose of this study is to investigate the effectiveness of two Internet-based guided self-help treatments with adults reporting elevated depressive symptoms. Other research questions concern the identification of potential mediators and the search for subgroups who respond differently to the interventions. Methods This study is a randomized controlled trial with three conditions: two treatment conditions and one waiting list control group. The two treatment conditions are Internet-based cognitive behavior therapy and Internet-based problem-solving therapy. They consist of 8 and 5 weekly lessons respectively. Both interventions are combined with support by e-mail. Participants in the waiting list control group receive the intervention three months later. The study population consists of adults from the general population. They are recruited through advertisements in local and national newspapers and through banners on the Internet. Subjects with symptoms of depression (≥ 16 on the Center for Epidemiological Studies Depression scale are included. Other inclusion criteria are having sufficient knowledge of the Dutch language, access to the Internet and an e-mail address. Primary outcome is depressive symptoms. Secondary outcomes are anxiety, quality of life, dysfunctional cognitions, worrying, problem solving skills, mastery, absence at work and use of healthcare. We will examine the following variables as potential mediators: dysfunctional cognitions, problem solving skills, worrying, anxiety and mastery. Potential moderating variables are: socio-demographic characteristics and symptom severity. Data are collected at baseline and at 5 weeks, 8 weeks, 12 weeks and 9 months after baseline. Analyses will be conducted on the intention

  13. Study protocol for the evaluation of an Infant Simulator based program delivered in schools: a pragmatic cluster randomised controlled trial

    OpenAIRE

    Brinkman, Sally A; Johnson, Sarah E; Lawrence, David; Codde, James P; Hart, Michael B; Straton, Judith AY; Silburn, Sven

    2010-01-01

    Abstract Background This paper presents the study protocol for a pragmatic randomised controlled trial to evaluate the impact of a school based program developed to prevent teenage pregnancy. The program includes students taking care of an Infant Simulator; despite growing popularity and an increasing global presence of such programs, there is no published evidence of their long-term impact. The aim of this trial is to evaluate the Virtual Infant Parenting (VIP) program by investigating pre-c...

  14. Population-based versus practice-based recall for childhood immunizations: a randomized controlled comparative effectiveness trial.

    Science.gov (United States)

    Kempe, Allison; Saville, Alison; Dickinson, L Miriam; Eisert, Sheri; Reynolds, Joni; Herrero, Diana; Beaty, Brenda; Albright, Karen; Dibert, Eva; Koehler, Vicky; Lockhart, Steven; Calonge, Ned

    2013-06-01

    We compared the effectiveness and cost-effectiveness of population-based recall (Pop-recall) versus practice-based recall (PCP-recall) at increasing immunizations among preschool children. This cluster-randomized trial involved children aged 19 to 35 months needing immunizations in 8 rural and 6 urban Colorado counties. In Pop-recall counties, recall was conducted centrally using the Colorado Immunization Information System (CIIS). In PCP-recall counties, practices were invited to attend webinar training using CIIS and offered financial support for mailings. The percentage of up-to-date (UTD) and vaccine documentation were compared 6 months after recall. A mixed-effects model assessed the association between intervention and whether a child became UTD. Ten of 195 practices (5%) implemented recall in PCP-recall counties. Among children needing immunizations, 18.7% became UTD in Pop-recall versus 12.8% in PCP-recall counties (P immunization rates in preschool children.

  15. Computer-based teaching is as good as face to face lecture-based teaching of evidence based medicine: a randomised controlled trial

    Science.gov (United States)

    2007-01-01

    Background At postgraduate level evidence based medicine (EBM) is currently taught through tutor based lectures. Computer based sessions fit around doctors' workloads, and standardise the quality of educational provision. There have been no randomized controlled trials comparing computer based sessions with traditional lectures at postgraduate level within medicine. Methods This was a randomised controlled trial involving six postgraduate education centres in the West Midlands, U.K. Fifty five newly qualified foundation year one doctors (U.S internship equivalent) were randomised to either computer based sessions or an equivalent lecture in EBM and systematic reviews. The change from pre to post-intervention score was measured using a validated questionnaire assessing knowledge (primary outcome) and attitudes (secondary outcome). Results Both groups were similar at baseline. Participants' improvement in knowledge in the computer based group was equivalent to the lecture based group (gain in score: 2.1 [S.D = 2.0] versus 1.9 [S.D = 2.4]; ANCOVA p = 0.078). Attitudinal gains were similar in both groups. Conclusion On the basis of our findings we feel computer based teaching and learning is as effective as typical lecture based teaching sessions for educating postgraduates in EBM and systematic reviews. PMID:17659076

  16. A pilot randomized trial teaching mindfulness-based stress reduction to traumatized youth in foster care.

    Science.gov (United States)

    Jee, Sandra H; Couderc, Jean-Philippe; Swanson, Dena; Gallegos, Autumn; Hilliard, Cammie; Blumkin, Aaron; Cunningham, Kendall; Heinert, Sara

    2015-08-01

    This article presents a pilot project implementing a mindfulness-based stress reduction program among traumatized youth in foster and kinship care over 10 weeks. Forty-two youth participated in this randomized controlled trial that used a mixed-methods (quantitative, qualitative, and physiologic) evaluation. Youth self-report measuring mental health problems, mindfulness, and stress were lower than anticipated, and the relatively short time-frame to teach these skills to traumatized youth may not have been sufficient to capture significant changes in stress as measured by electrocardiograms. Main themes from qualitative data included expressed competence in managing ongoing stress, enhanced self-awareness, and new strategies to manage stress. We share our experiences and recommendations for future research and practice, including focusing efforts on younger youth, and using community-based participatory research principles to promote engagement and co-learning. CLINICALTRIALS.GOV: Protocol Registration System ID NCT01708291. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Community-based intervention for blood pressure reduction in Nepal (COBIN trial)

    DEFF Research Database (Denmark)

    Neupane, Dinesh; McLachlan, Craig S; Christensen, Bo

    2016-01-01

    . The study will provide detailed information on the burden of blood pressure and also whether treatment targets are being met. Moreover, evidence will be provided on the future role of female community health volunteers for hypertension management in Nepal. The lessons learned from this study may also...... study is to determine the effect of family-based home health education and blood pressure monitoring by trained female community health volunteers. The primary outcome is change in mean systolic blood pressure. A community-based, open-masked, two-armed, cluster-randomized trial will be conducted...... proportion size, 929 individuals for the intervention group and 709 individuals for the control group will participate in the study. Due to the nature of the study, study participants are not compensated or insured. As part of the blood pressure intervention, trained female community health volunteers...

  18. Randomized trial of a population-based, home-delivered intervention for preschool language delay.

    Science.gov (United States)

    Wake, Melissa; Tobin, Sherryn; Levickis, Penny; Gold, Lisa; Ukoumunne, Obioha C; Zens, Naomi; Goldfeld, Sharon; Le, Ha; Law, James; Reilly, Sheena

    2013-10-01

    Population approaches to lessen the adverse impacts of preschool language delay remain elusive. We aimed to determine whether systematic ascertainment of language delay at age 4 years, followed by a 10-month, 1-on-1 intervention, improves language and related outcomes at age 5 years. A randomized trial nested within a cross-sectional ascertainment of language delay. Children with expressive and/or receptive language scores more than 1.25 SD below the mean at age 4 years entered the trial. Children randomly allocated to the intervention received 18 1-hour home-based therapy sessions. The primary outcomes were receptive and expressive language (Clinical Evaluation of Language Fundamentals - Preschool, 2(nd) Edition) and secondary outcomes were child phonological skills, letter awareness, pragmatic skills, behavior, and quality of life. A total of 1464 children were assessed for language delay at age 4 years. Of 266 eligible children, 200 (13.6%) entered the trial, with 91 intervention (92% of 99) and 88 control (87% of 101) children retained at age 5 years. At age 5 years, there was weak evidence of benefit to expressive (adjusted mean difference, intervention - control, 2.0; 95% confidence interval [CI] -0.5 to 4.4; P = .12) but not receptive (0.6; 95% CI -2.5 to 3.8; P = .69) language. The intervention improved phonological awareness skills (5.0; 95% CI 2.2 to 7.8; P language intervention was successfully delivered by non-specialist staff, found to be acceptable and feasible, and has the potential to improve long-term consequences of early language delay within a public health framework.

  19. Comparison of treatment effect sizes from pivotal and postapproval trials of novel therapeutics approved by the FDA based on surrogate markers of disease: a meta-epidemiological study.

    Science.gov (United States)

    Wallach, Joshua D; Ciani, Oriana; Pease, Alison M; Gonsalves, Gregg S; Krumholz, Harlan M; Taylor, Rod S; Ross, Joseph S

    2018-03-21

    The U.S. Food and Drug Administration (FDA) often approves new drugs based on trials that use surrogate markers for endpoints, which involve certain trade-offs and may risk making erroneous inferences about the medical product's actual clinical effect. This study aims to compare the treatment effects among pivotal trials supporting FDA approval of novel therapeutics based on surrogate markers of disease with those observed among postapproval trials for the same indication. We searched Drugs@FDA and PubMed to identify published randomized superiority design pivotal trials for all novel drugs initially approved by the FDA between 2005 and 2012 based on surrogate markers as primary endpoints and published postapproval trials using the same surrogate markers or patient-relevant outcomes as endpoints. Summary ratio of odds ratios (RORs) and difference between standardized mean differences (dSMDs) were used to quantify the average difference in treatment effects between pivotal and matched postapproval trials. Between 2005 and 2012, the FDA approved 88 novel drugs for 90 indications based on one or multiple pivotal trials using surrogate markers of disease. Of these, 27 novel drugs for 27 indications were approved based on pivotal trials using surrogate markers as primary endpoints that could be matched to at least one postapproval trial, for a total of 43 matches. For nine (75.0%) of the 12 matches using the same non-continuous surrogate markers as trial endpoints, pivotal trials had larger treatment effects than postapproval trials. On average, treatment effects were 50% higher (more beneficial) in the pivotal than the postapproval trials (ROR 1.5; 95% confidence interval CI 1.01-2.23). For 17 (54.8%) of the 31 matches using the same continuous surrogate markers as trial endpoints, pivotal trials had larger treatment effects than the postapproval trials. On average, there was no difference in treatment effects between pivotal and postapproval trials (dSMDs 0.01; 95

  20. A Community-Based Randomized Trial of Hepatitis B Screening Among High-Risk Vietnamese Americans.

    Science.gov (United States)

    Ma, Grace X; Fang, Carolyn Y; Seals, Brenda; Feng, Ziding; Tan, Yin; Siu, Philip; Yeh, Ming Chin; Golub, Sarit A; Nguyen, Minhhuyen T; Tran, Tam; Wang, Minqi

    2017-03-01

    To evaluate the effectiveness of a community-based liver cancer prevention program on hepatitis B virus (HBV) screening among low-income, underserved Vietnamese Americans at high risk. We conducted a cluster randomized trial involving 36 Vietnamese community-based organizations and 2337 participants in Pennsylvania, New Jersey, and New York City between 2009 and 2014. We randomly assigned 18 community-based organizations to a community-based multilevel HBV screening intervention (n = 1131). We randomly assigned the remaining 18 community-based organizations to a general cancer education program (n = 1206), which included information about HBV-related liver cancer prevention. We assessed HBV screening rates at 6-month follow-up. Intervention participants were significantly more likely to have undergone HBV screening (88.1%) than were control group participants (4.6%). In a Cochran-Mantel-Haenszel analysis, the intervention effect on screening outcomes remained statistically significant after adjustment for demographic and health care access variables, including income, having health insurance, having a regular health provider, and English proficiency. A community-based, culturally appropriate, multilevel HBV screening intervention effectively increases screening rates in a high-risk, hard-to-reach Vietnamese American population.

  1. An internet-based intervention for adjustment disorder (TAO): study protocol for a randomized controlled trial.

    Science.gov (United States)

    Rachyla, Iryna; Pérez-Ara, Marian; Molés, Mar; Campos, Daniel; Mira, Adriana; Botella, Cristina; Quero, Soledad

    2018-05-31

    Adjustment Disorder (AjD) is a common and disabling mental health problem. The lack of research on this disorder has led to the absence of evidence-based interventions for its treatment. Moreover, because the available data indicate that a high percentage of people with mental illness are not treated, it is necessary to develop new ways to provide psychological assistance. The present study describes a Randomized Controlled Trial (RCT) aimed at assessing the effectiveness and acceptance of a linear internet-delivered cognitive-behavioral therapy (ICBT) intervention for AjD. A two-armed RCT was designed to compare an intervention group to a waiting list control group. Participants from the intervention group will receive TAO, an internet-based program for AjD composed of seven modules. TAO combines CBT and Positive Psychology strategies in order to provide patients with complete support, reducing their clinical symptoms and enhancing their capacity to overcome everyday adversity. Participants will also receive short weekly telephone support. Participants in the control group will be assessed before and after a seven-week waiting period, and then they will be offered the same intervention. Participants will be randomly assigned to one of the 2 groups. Measurements will be taken at five different moments: baseline, post-intervention, and three follow-up periods (3-, 6- and 12-month). BDI-II and BAI will be used as primary outcome measures. Secondary outcomes will be symptoms of AjD, posttraumatic growth, positive and negative affect, and quality of life. The development of ICBT programs like TAO responds to a need for evidence-based interventions that can reach most of the people who need them, reducing the burden and cost of mental disorders. More specifically, TAO targets AjD and will entail a step forward in the treatment of this prevalent but under-researched disorder. Finally, it should be noted that this is the first RCT focusing on an internet-based

  2. Evaluating the design and reporting of pragmatic trials in osteoarthritis research.

    Science.gov (United States)

    Ali, Shabana Amanda; Kloseck, Marita; Lee, Karen; Walsh, Kathleen Ellen; MacDermid, Joy C; Fitzsimmons, Deborah

    2018-01-01

    Among the challenges in health research is translating interventions from controlled experimental settings to clinical and community settings where chronic disease is managed daily. Pragmatic trials offer a method for testing interventions in real-world settings but are seldom used in OA research. The aim of this study was to evaluate the literature on pragmatic trials in OA research up to August 2016 in order to identify strengths and weaknesses in the design and reporting of these trials. We used established guidelines to assess the degree to which 61 OA studies complied with pragmatic trial design and reporting. We assessed design according to the pragmatic-explanatory continuum indicator summary and reporting according to the pragmatic trials extension of the CONsolidated Standards of Reporting Trials guidelines. None of the pragmatic trials met all 11 criteria evaluated and most of the trials met between 5 and 8 of the criteria. Criteria most often unmet pertained to practitioner expertise (by requiring specialists) and criteria most often met pertained to primary outcome analysis (by using intention-to-treat analysis). Our results suggest a lack of highly pragmatic trials in OA research. We identify this as a point of opportunity to improve research translation, since optimizing the design and reporting of pragmatic trials can facilitate implementation of evidence-based interventions for OA care. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  3. Driven by expertise and insulation?: the autonomy of European regulatory agencies

    OpenAIRE

    Ossege, Christoph

    2015-01-01

    Expertise and autonomy are cornerstones to the effective operation and legitimacy of European Regulatory Agencies (ERAs). Yet, we know little about ERAs' actual autonomy, nor about factors shaping it. This article studies ERAs' actual autonomy from public and private actors, emphasising two crucial explanatory factors: expertise and rulemaking competences. The lack of insights on expertise is particularly striking, as expertise -the "raison d'être" and main resource of expert bodies- provides...

  4. SieveSifter: a web-based tool for visualizing the sieve analyses of HIV-1 vaccine efficacy trials.

    Science.gov (United States)

    Fiore-Gartland, Andrew; Kullman, Nicholas; deCamp, Allan C; Clenaghan, Graham; Yang, Wayne; Magaret, Craig A; Edlefsen, Paul T; Gilbert, Peter B

    2017-08-01

    Analysis of HIV-1 virions from participants infected in a randomized controlled preventive HIV-1 vaccine efficacy trial can help elucidate mechanisms of partial protection. By comparing the genetic sequence of viruses from vaccine and placebo recipients to the sequence of the vaccine itself, a technique called 'sieve analysis', one can identify functional specificities of vaccine-induced immune responses. We have created an interactive web-based visualization and data access tool for exploring the results of sieve analyses performed on four major preventive HIV-1 vaccine efficacy trials: (i) the HIV Vaccine Trial Network (HVTN) 502/Step trial, (ii) the RV144/Thai trial, (iii) the HVTN 503/Phambili trial and (iv) the HVTN 505 trial. The tool acts simultaneously as a platform for rapid reinterpretation of sieve effects and as a portal for organizing and sharing the viral sequence data. Access to these valuable datasets also enables the development of novel methodology for future sieve analyses. Visualization: http://sieve.fredhutch.org/viz . Source code: https://github.com/nkullman/SIEVE . Data API: http://sieve.fredhutch.org/data . agartlan@fredhutch.org. © The Author(s) 2017. Published by Oxford University Press.

  5. Placebo cohorts in phase-3 MS treatment trials - predictors for on-trial disease activity 1990-2010 based on a meta-analysis and individual case data.

    Directory of Open Access Journals (Sweden)

    Jan-Patrick Stellmann

    Full Text Available BACKGROUND: Annualized relapse rates (ARR in the placebo cohorts of phase-3 randomized controlled trials (RCT of new treatments for relapsing remitting multiple sclerosis (RRMS have decreased substantially during the last two decades. The causes of these changes are not clear. We consider a better understanding of this phenomenon essential for valuing the effects of new drugs and by designing new trials. OBJECTIVES: To identify predictive factors of on-study ARR in early and recent MS trials. METHODS: ARR, rate of relapse-free patients, trial start dates, baseline demographics, relapse definitions and the use of McDonald criteria were retrieved by literature research of the placebo cohorts from RRMS phase-3 trials. Predictors were estimated by univariate and multivariate regression analyses and random-effects meta-regression. In addition, regression models were calculated by the Sylvia Lawry Centre's (SLC, including individual case data from clinical trials performed until 2000. The most reliable meta-analytic results can be gained from pooled individual case data. In lack of this, random-effects meta-analyses are recommended. RESULTS: Data from 12 published and one unpublished trial show a decrease of ARR from 1988 to 2012 (adjR(2 = 0.807, p<0.0001. Regression models identified McDonald criteria followed by baseline mean age and the pre-study relapse rate as predictors of the ARR. The pooled individual case data (n = 505 confirmed a decrease of ARR over time. The pre-study relapse rate was the best predictor for on-study relapses. Lacking individual case data after implementation of the McDonald criteria excludes a direct comparison concerning McDonald criteria. CONCLUSION: Pre-study relapse rate was the best predictor for on-study relapse rate but failed to explain the decrease of the ARR over time alone. Higher age at baseline and the implementation of McDonald criteria were associated as well with a lowered relapse rate in the random

  6. GENDER LINGUSTICS AND DIAGNOSTICS OF THE SEX AS A PROBLEM OF AUTHORSHIP’S EXPERTISE

    OpenAIRE

    Вязигина, Н. В.

    2017-01-01

    In article the problem of authorship’s expertise connected with diagnostics of a sex of the author of the document is described. The solution of the problem with the help of the knowledge base, methods and means of gender linguistics is proposed. The essence of a modern gender linguistics and the main directions of its development is considered: research of language as systems and research of speech behavior of men and women. The analytical review of available scientific works in the sphere o...

  7. Web-Based Cognitive Behavioral Therapy for Female Patients With Eating Disorders: Randomized Controlled Trial.

    Science.gov (United States)

    ter Huurne, Elke D; de Haan, Hein A; Postel, Marloes G; van der Palen, Job; VanDerNagel, Joanne E L; DeJong, Cornelis A J

    2015-06-18

    Many patients with eating disorders do not receive help for their symptoms, even though these disorders have severe morbidity. The Internet may offer alternative low-threshold treatment interventions. This study evaluated the effects of a Web-based cognitive behavioral therapy (CBT) intervention using intensive asynchronous therapeutic support to improve eating disorder psychopathology, and to reduce body dissatisfaction and related health problems among patients with eating disorders. A two-arm open randomized controlled trial comparing a Web-based CBT intervention to a waiting list control condition (WL) was carried out among female patients with bulimia nervosa (BN), binge eating disorder (BED), and eating disorders not otherwise specified (EDNOS). The eating disorder diagnosis was in accordance with the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, and was established based on participants' self-report. Participants were recruited from an open-access website, and the intervention consisted of a structured two-part program within a secure Web-based application. The aim of the first part was to analyze participant's eating attitudes and behaviors, while the second part focused on behavioral change. Participants had asynchronous contact with a personal therapist twice a week, solely via the Internet. Self-report measures of eating disorder psychopathology (primary outcome), body dissatisfaction, physical health, mental health, self-esteem, quality of life, and social functioning were completed at baseline and posttest. A total of 214 participants were randomized to either the Web-based CBT group (n=108) or to the WL group (n=106) stratified by type of eating disorder (BN: n=44; BED: n=85; EDNOS: n=85). Study attrition was low with 94% of the participants completing the posttest assignment. Overall, Web-based CBT showed a significant improvement over time for eating disorder psychopathology (F97=63.07, PWeb-based CBT participants in all three

  8. A randomized controlled trial of internet-based therapy in depression.

    Science.gov (United States)

    Moritz, Steffen; Schilling, Lisa; Hauschildt, Marit; Schröder, Johanna; Treszl, András

    2012-08-01

    Depression is among the most prevalent disorders worldwide. In view of numerous treatment barriers, internet-based interventions are increasingly adopted to "treat the untreated". The present trial (registered as NCT01401296) was conducted over the internet and aimed to assess the efficacy of an online self-help program for depression (Deprexis). In random order, participants with elevated depression symptoms received program access or were allocated to a wait-list control condition. After eight weeks, participants were invited to take part in an online re-assessment. To compensate for common problems of online studies, such as low completion rates and unclear diagnostic status, reminders and incentives were used, and clinical diagnoses were externally confirmed in a subgroup of 29% of participants. Relative to the wait-list group, program users experienced significant symptom decline on the Beck Depression Inventory (BDI; primary outcome), the Dysfunctional Attitudes Scale (DAS), the Quality of Life scale (WHOQOL-BREF) and the Rosenberg Self-Esteem Scale (RSE). Compared to wait-list participants, symptom decline was especially pronounced among those with moderate symptoms at baseline as well as those not currently consulting a therapist. Completion (82%) and re-test reliability of the instruments (r = .72-.87) were good. The results of this trial suggest that online treatment can be beneficial for people with depression, particularly for those with moderate symptoms. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Randomized controlled trial of a computer-based module to improve contraceptive method choice.

    Science.gov (United States)

    Garbers, Samantha; Meserve, Allison; Kottke, Melissa; Hatcher, Robert; Ventura, Alicia; Chiasson, Mary Ann

    2012-10-01

    Unintended pregnancy is common in the United States, and interventions are needed to improve contraceptive use among women at higher risk of unintended pregnancy, including Latinas and women with low educational attainment. A three-arm randomized controlled trial was conducted at two family planning sites serving low-income, predominantly Latina populations. The trial tested the efficacy of a computer-based contraceptive assessment module in increasing the proportion of patients choosing an effective method of contraception (women per year, typical use). Participants were randomized to complete the module and receive tailored health materials, to complete the module and receive generic health materials, or to a control condition. In intent-to-treat analyses adjusted for recruitment site (n=2231), family planning patients who used the module were significantly more likely to choose an effective contraceptive method: 75% among those who received tailored materials [odds ratio (OR)=1.56; 95% confidence interval (CI): 1.23-1.98] and 78% among those who received generic materials (OR=1.74; 95% CI: 1.35-2.25), compared to 65% among control arm participants. The findings support prior research suggesting that patient-centered interventions can positively influence contraceptive method choice. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Dosimetric intercomparison for multicenter clinical trials using a patient-based anatomic pelvic phantom

    International Nuclear Information System (INIS)

    Ebert, M. A.; Harrison, K. M.; Howlett, S. J.; Cornes, D.; Bulsara, M.; Hamilton, C. S.; Kron, T.; Joseph, D. J.; Denham, J. W.

    2011-01-01

    Purpose: To assess dose delivery accuracy to clinically significant points in a realistic patient geometry for two separate pelvic radiotherapy scenarios. Methods: An inhomogeneous pelvic phantom was transported to 36 radiotherapy centers in Australia and New Zealand. The phantom was treated according to Phase III rectal and prostate trial protocols. Point dose measurements were made with thermoluminescent dosimeters (TLDs) and an ionisation chamber. Comprehensive site-demographic, treatment planning, and physical data were collected for correlation with measurement outcomes. Results: Dose delivery to the prescription point for the rectal treatment was consistent with planned dose (mean difference between planned and measured dose - 0.1 ± 0.3% std err). Dose delivery in the region of the sacral hollow was consistently higher than planned (+1.2 ± 0.2%). For the prostate treatment, dose delivery to the prostate volume was consistent with planned doses (-0.49 ± 0.2%) and planned dose uniformity, though with a tendency to underdose the PTV at the prostate-rectal border. Measured out-of-field doses were significantly higher than planned. Conclusions: A phantom based on realistic anatomy and heterogeneity can be used to comprehensively assess the influence of multiple aspects of the radiotherapy treatment process on dose delivery. The ability to verify dose delivery for two trials with a single phantom was advantageous.

  11. Effect of simulated dawn on quality of sleep – a community-based trial

    Directory of Open Access Journals (Sweden)

    Haukka Jari

    2003-10-01

    Full Text Available Abstract Background Morning light exposure administered as simulated dawn looks a promising method to treat Seasonal Affective Disorder, but it may moreover help with resetting the inaccurate organisation of body clock functions relative to sleep occurring in winter among people in general. Disturbances in sleep patterns are common and may compromise wellbeing even in the short term. Our hypothesis was that simulated dawn could improve the subjective quality of sleep during winter. Methods A community-based trial with 100 volunteer subjects provided with dawn simulators. Study period lasted for eight weeks, and subjects used the dawn simulators for two weeks at a time, each subject acting as his own control (ABAB-design. Main outcome measure was subjective quality of sleep recorded each morning with Groningen Sleep Quality Scale. Results 77 subjects completed the trial. Quality of sleep improved while subjects were using dawn simulator-devices (p = 0.001. The treatment became beneficial after six days' use of dawn simulator, but the effect did not last after the use was ceased. Conclusion Dawn simulation may help to improve the subjective quality of sleep, but the benefits are modest. Further research is needed to verify these findings and to elucidate the mechanism by which dawn simulation acts on the sleep-wake pattern.

  12. How Well Do Computer-Generated Faces Tap Face Expertise?

    Directory of Open Access Journals (Sweden)

    Kate Crookes

    Full Text Available The use of computer-generated (CG stimuli in face processing research is proliferating due to the ease with which faces can be generated, standardised and manipulated. However there has been surprisingly little research into whether CG faces are processed in the same way as photographs of real faces. The present study assessed how well CG faces tap face identity expertise by investigating whether two indicators of face expertise are reduced for CG faces when compared to face photographs. These indicators were accuracy for identification of own-race faces and the other-race effect (ORE-the well-established finding that own-race faces are recognised more accurately than other-race faces. In Experiment 1 Caucasian and Asian participants completed a recognition memory task for own- and other-race real and CG faces. Overall accuracy for own-race faces was dramatically reduced for CG compared to real faces and the ORE was significantly and substantially attenuated for CG faces. Experiment 2 investigated perceptual discrimination for own- and other-race real and CG faces with Caucasian and Asian participants. Here again, accuracy for own-race faces was significantly reduced for CG compared to real faces. However the ORE was not affected by format. Together these results signal that CG faces of the type tested here do not fully tap face expertise. Technological advancement may, in the future, produce CG faces that are equivalent to real photographs. Until then caution is advised when interpreting results obtained using CG faces.

  13. Public scientific expertise and judicial risks: the case of radon

    International Nuclear Information System (INIS)

    Massuelle, M.H.

    2000-01-01

    In France, radon has emerged as a public health issue mainly at the initiative of scientists. Even if public authorities have set up an embryo of regulations, for a long time scientists faced the radon issue alone, in producing knowledge, informing about their results, providing advice to public authorities, various bodies and individuals, and in participating in the process of technical standardisation. These functions are identified in the paper in order to sketch out a typology of different situations, formal and informal, in which researchers transformed into experts are called to collaborate. During their missions, experts are exposed to 'judicial risks', particularly in terms of civil liability or 'professional' responsibility and even criminal responsibility. They face legal difficulties because of the lack of a legal framework for public scientific expertise. The situation is confused: there is a growing will to involve scientific experts in decision-making in the field of public health, especially when the precautionary principle is at stake, and in parallel, no real materialisation of this expertise in terms of regulations, which puts on experts' shoulders some new responsibilities. Moreover we can observe a generalised increase in the attribution of blame and penal responsibility in French society which make the position of all actors involved more uncomfortable. We know that radon, as a domestic risk, is particular in many ways. Nevertheless, it can be used in an analysis of scientists' roles/actions and of the legal difficulties they face, to illustrate appropriately the problems that arise as expertise is developed about new risks. (author)

  14. Drawing on a Sculpted Space of Actions : Educating for Expertise while Avoiding a Cognitive Monster

    NARCIS (Netherlands)

    Keestra, M.

    Although expertise is usually considered as a positive outcome of education and practice in domains as varied as sports, science, music and politics, there are also concerns about negative effects of expertise. Since expertise is facilitated largely by implicit, automatic cognitive and brain

  15. School-based cognitive behavioral interventions for anxious youth: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Haugland, Bente Storm Mowatt; Raknes, Solfrid; Haaland, Aashild Tellefsen; Wergeland, Gro Janne; Bjaastad, Jon Fauskanger; Baste, Valborg; Himle, Joe; Rapee, Ron; Hoffart, Asle

    2017-03-04

    Anxiety disorders are prevalent among adolescents and may have long-lasting negative consequences for the individual, the family and society. Cognitive behavioral therapy (CBT) is an effective treatment. However, many anxious youth do not seek treatment. Low-intensity CBT in schools may improve access to evidence-based services. We aim to investigate the efficacy of two CBT youth anxiety programs with different intensities (i.e., number and length of sessions), both group-based and administered as early interventions in a school setting. The objectives of the study are to examine the effects of school-based interventions for youth anxiety and to determine whether a less intensive intervention is non-inferior to a more intensive intervention. The present study is a randomized controlled trial comparing two CBT interventions to a waitlist control group. A total of 18 schools participate and we aim to recruit 323 adolescents (12-16 years). Youth who score above a cutoff on an anxiety symptom scale will be included in the study. School nurses recruit participants and deliver the interventions, with mental health workers as co-therapists and/or supervisors. Primary outcomes are level of anxiety symptoms and anxiety-related functional impairments. Secondary outcomes are level of depressive symptoms, quality of life and general psychosocial functioning. Non-inferiority between the two active interventions will be declared if a difference of 1.4 or less is found on the anxiety symptom measure post-intervention and a difference of 0.8 on the interference scale. Effects will be analyzed by mixed effect models, applying an intention to treat procedure. The present study extends previous research by comparing two programs with different intensity. A brief intervention, if effective, could more easily be subject to large-scale implementation in school health services. ClinicalTrials.gov, NCT02279251 . Registered on 15 October 2014. Retrospectively registered.

  16. A phenomenological investigation of science center exhibition developers' expertise development

    Science.gov (United States)

    Young, Denise L.

    The purpose of this study was to examine the exhibition developer role in the context of United States (U.S.) science centers, and more specifically, to investigate the way science center exhibition developers build their professional expertise. This research investigated how successfully practicing exhibition developers described their current practices, how they learned to be exhibition developers, and what factors were the most important to the developers in building their professional expertise. Qualitative data was gathered from 10 currently practicing exhibition developers from three science centers: the Exploratorium, San Francisco, California; the Field Museum, Chicago, Illinois; and the Science Museum of Minnesota, St. Paul, Minnesota. In-depth, semistructured interviews were used to collect the data. The study embraced aspects of the phenomenological tradition and sought to derive a holistic understanding of the position and how expertise was built for it. The data were methodically coded and organized into themes prior to analysis. The data analysis found that the position consisted of numerous and varied activities, but the developers' primary roles were advocating for the visitor, storytelling, and mediating information and ideas. They conducted these activities in the context of a team and relied on an established exhibition planning process to guide their work. Developers described a process of learning exhibition development that was experiential in nature. Learning through daily practice was key, though they also consulted with mentors and relied on visitor studies to gauge the effectiveness of their work. They were adept at integrating prior knowledge gained from many aspects of their lives into their practice. The developers described several internal factors that contributed to their expertise development including the desire to help others, a natural curiosity about the world, a commitment to learning, and the ability to accept critique. They

  17. Art expertise and attribution of museum porcelain and faience

    Directory of Open Access Journals (Sweden)

    Revenok N.N.

    2017-06-01

    Full Text Available the article considers problems of research of museum art porcelain and faience of the XIX – the beginning of the XX century in the process of carrying out fine art expertise and also reveals the main criteria of Museum attribution. An important part of the examination methodology of thin-ceramic products is the development of special methods for their study in the conditions of modern laboratories on the latest-generation devices. The results presented in the article can contribute to the practical application of the proposed methods in conducting art criticism of art porcelain and faience in the museum research and restoration work.

  18. Using Trial-Based Functional Analysis to Design Effective Interventions for Students Diagnosed with Autism Spectrum Disorder

    Science.gov (United States)

    Larkin, Wallace; Hawkins, Renee O.; Collins, Tai

    2016-01-01

    Functional behavior assessments and function-based interventions are effective methods for addressing the challenging behaviors of children; however, traditional functional analysis has limitations that impact usability in applied settings. Trial-based functional analysis addresses concerns relating to the length of time, level of expertise…

  19. Using focused ethnography in paediatric settings to explore professionals' and parents' attitudes towards expertise in managing chronic kidney disease stage 3-5.

    Science.gov (United States)

    Nightingale, Ruth; Sinha, Manish D; Swallow, Veronica

    2014-09-18

    Interactions between parents and healthcare professionals are essential when parents of children with chronic conditions are learning to share expertise about clinical care, but limited evidence exists on how they actually interact. This paper discusses the use of focused ethnography in paediatric settings as an effective means of exploring attitudes towards expertise. The paper draws on repeated observations, interviews and field-notes involving the parents of six children with chronic kidney disease, and 28 healthcare professionals at two, tertiary, children's hospital-based units. Data were analysed using the Framework approach and the concepts of expertise and self-management. Our study highlighted rewards and challenges associated with focused ethnography in this context. Rewards included the ability to gain a richer understanding of the complex phenomena of mutual acknowledgement of expertise that occurs during parent/ healthcare professional interactions. Challenges related to gaining informed consent and ensuring potential participants had an adequate understanding of the purpose of the study. Two dimensions of parental expertise around their child (personal and clinical) were evident in our data. Parents' and professionals' expertise about the child and their condition was acknowledged and exchanged as parents learnt to share clinical-care with the multi-disciplinary team. Healthcare professionals acknowledged parents' need to understand aspects of each of the eight disciplinary knowledge bases relating to their child's management and recognised parents' expert knowledge of their child, found ways to mobilise this knowledge, and wove parents' expertise into the management plan. Parents spoke of the degree to which their own expert knowledge of their child complemented healthcare professionals' clinical knowledge. However, ambivalence around expertise was evident as both parents and healthcare professionals questioned what the expertise was, and who the

  20. Experts, meta-expertise and mediators. Ethical oversight of research in multidisciplinary scenarios

    Directory of Open Access Journals (Sweden)

    Wilfredo Betancourt Mosquera

    2016-07-01

    Full Text Available Based on a case study drawn from the written records of a Colombian Research Ethics Committee (rec, this article discusses the impact that its multidisciplinary nature has on its decision-making processes. recs are analyzed as “boundary organizations” in which experts from different disciplines can meet. Additionally, recs are viewed as contemporary socio-epistemic arenas in which research ethics are produced. It was found that multiple expertise is often seen by some of its members as an «anomaly» which impedes ordinary work and ideally should be avoided. During the assessment of research projects the rec sought to manage this task through homogenizing decision-making processes in accordance with the expertise of some of its members, avoiding the convergence of «communities of practice.» Furthermore, the members of the rec frequently base their decisions either on their own ethical judgments, or by mirroring those of more qualified reviewers. This dynamic is largely a consequence of «meta-expertise,» that is to say, rec members’ ability or legitimacy to judge expert knowledge which they do not possess. It is concluded that researchers have wide possibilities to interpret and define the ethical dimension of their work. Within local practices of ethical reviews, researchers act as «interactional» actors able to assess and communicate recs about their own ethics. Paradoxically, despite their character as a public setting for multidisciplinary dialogue, recs end up being spaces in which the professional esotericism of disciplinary communities is reaffirmed and the socio-epistemic authority of experts reinforced.

  1. Internet-based photoaging within Australian pharmacies to promote smoking cessation: randomized controlled trial.

    Science.gov (United States)

    Burford, Oksana; Jiwa, Moyez; Carter, Owen; Parsons, Richard; Hendrie, Delia

    2013-03-26

    Tobacco smoking leads to death or disability and a drain on national resources. The literature suggests that cigarette smoking continues to be a major modifiable risk factor for a variety of diseases and that smokers aged 18-30 years are relatively resistant to antismoking messages due to their widely held belief that they will not be lifelong smokers. To conduct a randomized controlled trial (RCT) of a computer-generated photoaging intervention to promote smoking cessation among young adult smokers within a community pharmacy setting. A trial was designed with 80% power based on the effect size observed in a published pilot study; 160 subjects were recruited (80 allocated to the control group and 80 to the intervention group) from 8 metropolitan community pharmacies located around Perth city center in Western Australia. All participants received standardized smoking cessation advice. The intervention group participants were also digitally photoaged by using the Internet-based APRIL Face Aging software so they could preview images of themselves as a lifelong smoker and as a nonsmoker. Due to the nature of the intervention, the participants and researcher could not be blinded to the study. The main outcome measure was quit attempts at 6-month follow-up, both self-reported and biochemically validated through testing for carbon monoxide (CO), and nicotine dependence assessed via the Fagerström scale. At 6-month follow-up, 5 of 80 control group participants (6.3%) suggested they had quit smoking, but only 1 of 80 control group participants (1.3%) consented to, and was confirmed by, CO validation. In the intervention group, 22 of 80 participants (27.5%) reported quitting, with 11 of 80 participants (13.8%) confirmed by CO testing. This difference in biochemically confirmed quit attempts was statistically significant (χ(2) 1=9.0, P=.003). A repeated measures analysis suggested the average intervention group smoking dependence score had also significantly dropped

  2. Internet-Based Cognitive Behavior Therapy for Procrastination: Study Protocol for a Randomized Controlled Trial

    Science.gov (United States)

    Rozental, Alexander

    2013-01-01

    period, albeit without therapist contact. Results The current study is believed to result in three important findings. First, a CBT intervention is assumed to be beneficial for people suffering from problems caused by procrastination. Second, the degree of therapist contact will have a positive effect on treatment outcome as procrastination can be partially explained as a self-regulatory failure. Third, an Internet based CBT intervention is presumed to be an effective way to administer treatment for procrastination, which is considered highly important, as the availability of adequate care is limited. The current study is therefore believed to render significant knowledge on the treatment of procrastination, as well as providing support for the use of Internet based CBT for difficulties due to delayed tasks and commitments. Conclusions To our knowledge, the current study is the first clinical trial to examine the effects of CBT for procrastination, and is assumed to render significant knowledge on the treatment of procrastination, as well as investigating whether it can be delivered via the Internet. Trial Registration ClinicalTrials.gov: NCT01842945; http://clinicaltrials.gov/show/NCT01842945 (Archived by WebCite at http://www.webcitation.org/6KSmaXewC). PMID:24220277

  3. Central endoscopy reads in inflammatory bowel disease clinical trials: The role of the imaging core lab.

    Science.gov (United States)

    Ahmad, Harris; Berzin, Tyler M; Yu, Hui Jing; Huang, Christopher S; Mishkin, Daniel S

    2014-08-01

    Clinical trials in inflammatory bowel disease (IBD) are evolving at a rapid pace by employing central reading for endoscopic mucosal assessment in a field that was, historically, largely based on assessments by local physicians. This transition from local to central reading carries with it numerous technical, operational, and scientific challenges, many of which can be resolved by imaging core laboratories (ICLs), a concept that has a longer history in clinical trials in a number of diseases outside the realm of gastroenterology. For IBD trials, ICLs have the dual goals of providing objective, consistent assessments of endoscopic findings using central-reading paradigms whilst providing important expertise with regard to operational issues and regulatory expectations. This review focuses on current approaches to using ICLs for central endoscopic reading in IBD trials. © The Author(s) 2014. Published by Oxford University Press and the Digestive Science Publishing Co. Limited.

  4. Exposure-Based Cognitive Behavior Therapy for Children with Abdominal Pain: A Pilot Trial.

    Directory of Open Access Journals (Sweden)

    Maria Lalouni

    Full Text Available Children with pain-related functional gastrointestinal disorders (P-FGIDs have an increased risk for school absenteeism, depression, anxiety and low quality of life. Exposure-based cognitive behavior therapy (CBT has shown large treatment effects in adults with irritable bowel syndrome, but has not been tested for children 8-12 years with P-FGIDs.The aim of this trial was to test the feasibility, acceptability and potential efficacy of a newly developed exposure-based CBT for children with P-FGIDs.The children (n = 20 with a P-FGID, were referred by their treating physicians. The participants received 10 weekly sessions of exposure-based CBT and were assessed at pre-treatment, post-treatment and 6-month follow-up.Children improved significantly on the primary outcome measure pain intensity at post (Cohen's d = 0.40, p = 0.049 and at 6-month follow-up (Cohen's d = 0.85, p = 0.004. Improvements were also seen in pain frequency, gastrointestinal symptoms, quality of life, depression, anxiety, school absenteeism and somatic symptoms. Improvements were maintained or further increased at 6-month follow-up. The children engaged in the exposures and were satisfied with the treatment.Exposure-based CBT for children with P-FGIDs is feasible, acceptable and potentially efficacious.

  5. Effectiveness of a web-based intervention for injured claimants: a randomized controlled trial.

    Science.gov (United States)

    Elbers, Nieke A; Akkermans, Arno J; Cuijpers, Pim; Bruinvels, David J

    2013-07-20

    There is considerable evidence showing that injured people who are involved in a compensation process show poorer physical and mental recovery than those with similar injuries who are not involved in a compensation process. One explanation for this reduced recovery is that the legal process and the associated retraumatization are very stressful for the claimant. The aim of this study was to empower injured claimants in order to facilitate recovery. Participants were recruited by three Dutch claims settlement offices. The participants had all been injured in a traffic crash and were involved in a compensation process. The study design was a randomized controlled trial. An intervention website was developed with (1) information about the compensation process, and (2) an evidence-based, therapist-assisted problem-solving course. The control website contained a few links to already existing websites. Outcome measures were empowerment, self-efficacy, health status (including depression, anxiety, and somatic symptoms), perceived fairness, ability to work, claims knowledge and extent of burden. The outcomes were self-reported through online questionnaires and were measured four times: at baseline, and at 3, 6, and 12 months. In total, 176 participants completed the baseline questionnaire after which they were randomized into either the intervention group (n=88) or the control group (n=88). During the study, 35 participants (20%) dropped out. The intervention website was used by 55 participants (63%). The health outcomes of the intervention group were no different to those of the control group. However, the intervention group considered the received compensation to be fairer (Pwebsite was evaluated positively. Although the web-based intervention was not used enough to improve the health of injured claimants in compensation processes, it increased the perceived fairness of the compensation amount. Netherlands Trial Register NTR2360.

  6. Internet-based cognitive behavior therapy for major depressive disorder: A randomized controlled trial.

    Science.gov (United States)

    Rosso, Isabelle M; Killgore, William D S; Olson, Elizabeth A; Webb, Christian A; Fukunaga, Rena; Auerbach, Randy P; Gogel, Hannah; Buchholz, Jennifer L; Rauch, Scott L

    2017-03-01

    Prior research has shown that the Sadness Program, a technician-assisted Internet-based cognitive behavioral therapy (iCBT) intervention developed in Australia, is effective for treating major depressive disorder (MDD). The current study aimed to expand this work by adapting the protocol for an American population and testing the Sadness Program with an attention control group. In this parallel-group, randomized controlled trial, adult MDD participants (18-45 years) were randomized to a 10-week period of iCBT (n = 37) or monitored attention control (MAC; n = 40). Participants in the iCBT group completed six online therapy lessons, which included access to content summaries and homework assignments. During the 10-week trial, iCBT and MAC participants logged into the web-based system six times to complete self-report symptom scales, and a nonclinician technician contacted participants weekly to provide encouragement and support. The primary outcome was the Hamilton Rating Scale for Depression (HRSD), and the secondary outcomes were the Patient Health Questionnaire-9 and Kessler-10. Intent-to-treat analyses revealed significantly greater reductions in depressive symptoms in iCBT compared with MAC participants, using both the self-report measures and the clinician-rated HRSD (d = -0.80). Importantly, iCBT participants also showed significantly higher rates of clinical response and remission. Exploratory analyses did not support illness severity as a moderator of treatment outcome. The Sadness Program led to significant reductions in depression and distress symptoms. With its potential to be delivered in a scalable, cost-efficient manner, iCBT is a promising strategy to enhance access to effective care. © 2016 Wiley Periodicals, Inc.

  7. The effect of navigational expertise on wayfinding in new environments.

    Science.gov (United States)

    Woollett, Katherine; Maguire, Eleanor A

    2010-12-01

    Becoming proficient at navigation in urban environments is something that we all aspire to. Here we asked whether being an expert at wayfinding in one environment has any effect on learning new spatial layouts. Licensed London taxi drivers are among the most proficient urban navigators, training for many years to find their way around a complex and irregularly-laid out city. We first tested how well they could learn the layout of an unfamiliar town compared with a group of non-taxi drivers. Second, we investigated how effectively taxi drivers could integrate a new district into their existing spatial representation of London. We found that taxi drivers were significantly better than control participants at executing routes through the new town, and representing it at a map-like survey level. However, the benefits of navigational expertise were not universal. Compared with their performance in the new town, taxi drivers were significantly poorer at learning the layout of a new area that had to be integrated with their existing knowledge of London. We consider reasons for this picture of facilitation and limitation, in particular drawing parallels with how knowledge acquisition occurs in the context of expertise in general.

  8. The nature of chess expertise: knowledge or search?

    Directory of Open Access Journals (Sweden)

    Ekaterina E. Vasyukova

    2012-01-01

    Full Text Available In this article, we briefl y survey studies of the nature of expertise, and we presentthe results of research directed at evidence of the complicated nature of expertise,which is most eff ectively seen in experts’ use of a transfer mechanism. Thephenomenon of the transfer of verbalized operational senses (VOS is analyzedand is investigated on the basis of the sense theory of thinking, as proposed byTikhomirov (1969, 1984.It is shown that VOS transfer manifests itself in diverse forms. It seems to be dependenton the factors of chess position and the age and skill level of the player.Diverse forms of transferring are associated with a change in separate indices ofVOS volume, structure, depth, and degree of consciousness in a connected position.VOS transfer is found more in skilled than in unskilled chess players; skilledplayers demonstrate selectivity of search in a connected position. VOS transfer isassociated not simply with the repetition and copying of some forecasts, whichgive the direction of search, but also with using and transforming the results ofprevious verbal searches.

  9. Social and psychological risks expertise in crisis communities

    International Nuclear Information System (INIS)

    Shvalb, Y.

    1998-01-01

    Emerging and development of crises in the communities leads to considerable increase of individual's risks' quality and quantity. Irrespectively of risk scale - partial or total influence on a community - a number of tendencies of risks increase could be identified. On social level risks result from the tendency of social protection decrease and restriction in free choice of activities' forms and kinds. On group level confrontation and clashes emerge, increase intolerance and decrease tolerance are identified. On interpersonal (micro group) level aggression and abuse intensify. On individual level a complex of negative psychological statuses develops, which is diverse both as for its content and forms. Reasons of crisis development and its dynamics determine the content and concrete forms of risks on all levels. Systematic description of risks and development of psychological support programmes for population in risk presupposes organization and delivering of comprehensive social and psychological expertise of situation. Such an expertise makes it possible to unite in a comprehensive model of the multi-professional descriptions of crisis situations on the above mentioned levels, the subjective concepts of the population (or its separate groups) together with evaluation of various projects and programmes on crisis coping and risks decrease options. (author)

  10. Experiencing art: the influence of expertise and painting abstraction level

    Directory of Open Access Journals (Sweden)

    Elina ePihko

    2011-09-01

    Full Text Available How does expertise influence the perception of representational and abstract paintings? We asked 20 experts on art history and 20 laypersons to explore and evaluate a series of paintings ranging in style from representational to abstract in five categories. We compared subjective aesthetic judgments and emotional evaluations, gaze patterns, and electrodermal reactivity between the two groups of participants. The level of abstraction affected aesthetic judgments and emotional valence ratings of the laypersons but had no effect on the opinions of the experts: the laypersons’ aesthetic and emotional ratings were highest for representational paintings and lowest for abstract paintings, whereas the opinions of the experts were independent of the abstraction level. The gaze patterns of both groups changed as the level of abstraction increased: the number of fixations and the length of the scanpaths increased while the duration of the fixations decreased. The viewing strategies—reflected in the target, location and path of the fixations—however indicated that experts and laypersons paid attention to different aspects of the paintings. The electrodermal reactivity did not vary according to the level of abstraction in either group but expertise was reflected in weaker responses, compared with laypersons, to information received about the paintings.

  11. Teacher knowledge, instructional expertise, and the development of reading proficiency.

    Science.gov (United States)

    Reid Lyon, G; Weiser, Beverly

    2009-01-01

    Teacher knowledge and instructional expertise have been found in correlational and pre- and posttest studies to be related to student reading achievement. This article summarizes data presented in this special issue and additional research to address four questions: (a) What do expert reading teachers know? (b) Why do teachers need to acquire this knowledge? (c) Do teachers believe they have this knowledge? and (d) Are teachers being adequately prepared to teach reading? Well-designed studies relevant to this topic have been sparse with a noticeable lack of attention given to identifying specific causal links between teacher knowledge, teaching expertise, and student reading achievement. Until the appropriate research designs and methodologies are applied to address the question of causal effects, conclusions about the specific content that teachers must know and the instructional practices that are most beneficial in presenting this content are preliminary at best. Future studies of the effect of essential reading content knowledge must be extended beyond word-level skills to vocabulary, reading comprehension, and writing.

  12. Multimedia-based training on Internet platforms improves surgical performance: a randomized controlled trial.

    Science.gov (United States)

    Pape-Koehler, Carolina; Immenroth, Marc; Sauerland, Stefan; Lefering, Rolf; Lindlohr, Cornelia; Toaspern, Jens; Heiss, Markus

    2013-05-01

    Surgical procedures are complex motion sequences that require a high level of preparation, training, and concentration. In recent years, Internet platforms providing surgical content have been established. Used as a surgical training method, the effect of multimedia-based training on practical surgical skills has not yet been evaluated. This study aimed to evaluate the effect of multimedia-based training on surgical performance. A 2 × 2 factorial, randomized controlled trial with a pre- and posttest design was used to test the effect of multimedia-based training in addition to or without practical training on 70 participants in four groups defined by the intervention used: multimedia-based training, practical training, and combination training (multimedia-based training + practical training) or no training (control group). The pre- and posttest consisted of a laparoscopic cholecystectomy in a Pelvi-Trainer and was video recorded, encoded, and saved on DVDs. These were evaluated by blinded raters using a modified objective structured assessment of technical skills (OSATS). The main evaluation criterion was the difference in OSATS score between the pre- and posttest (ΔOSATS) results in terms of a task-specific checklist (procedural steps scored as correct or incorrect). The groups were homogeneous in terms of demographic parameters, surgical experience, and pretest OSATS scores. The ΔOSATS results were highest in the multimedia-based training group (4.7 ± 3.3; p Multimedia-based training improved surgical performance significantly and thus could be considered a reasonable tool for inclusion in surgical curricula.

  13. The Relaxation Exercise and Social Support Trial (RESST: a community-based randomized controlled trial to alleviate medically unexplained vaginal discharge symptoms

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    Kobeissi Loulou

    2012-11-01

    Full Text Available Abstract Background Symptoms such as medically unexplained vaginal discharge (MUVD are common and bothersome, leading to potentially unnecessary use of resources. Methods A community-based individually randomized controlled trial to assess the effectiveness of a relatively simple, culturally appropriate multi-component intervention on reducing reported MUVD, among women suffering from low-moderate levels of common mental distress. The setting was a socio-economically deprived, informal settlement in the southern suburbs of Beirut, Lebanon. The intervention comprised up to 12 group sessions implemented over a six-week period, each divided into a psychosocial and a relaxation exercise component. The primary outcome was self-reported MUVD, which was defined as a complaint of vaginal discharge upon ruling out reproductive tract infections (RTIs, through lab analysis. Anxiety and/or depression symptoms were the secondary outcomes for this trial. These were assessed using an Arabic validated version of the Hopkins Symptoms Checklist-25 (HSCL-25. Assessments were done at baseline and six months using face-to face interviews, pelvic examinations and laboratory tests. Women were randomized into either intervention or control group. Blinding on the intervention status was not possible for both logistic and ethical reasons, especially as knowledge of involvement in the intervention was integral to its delivery. Intent to treat analysis was used. Results Of 75 women randomized to the intervention, 48% reported MUVD at 6 months compared with 63% of 73 in the control group (difference of -15%, 95% confidence interval (CI -31%, 0%, p=0.067. Adjustments for baseline imbalances and any factors relating to consent had no appreciable effect on these results. The risk of MUVD was reduced in absolute terms by 2.4% for each intervention session attended (95% CI -4.9%, 0.0%, p=0.049. While there was also marginal evidence of a beneficial effect on anxiety, there was

  14. Basic-level categorization of intermediate complexity fragments reveals top-down effects of expertise in visual perception.

    Science.gov (United States)

    Harel, Assaf; Ullman, Shimon; Harari, Danny; Bentin, Shlomo

    2011-07-28

    Visual expertise is usually defined as the superior ability to distinguish between exemplars of a homogeneous category. Here, we ask how real-world expertise manifests at basic-level categorization and assess the contribution of stimulus-driven and top-down knowledge-based factors to this manifestation. Car experts and novices categorized computer-selected image fragments of cars, airplanes, and faces. Within each category, the fragments varied in their mutual information (MI), an objective quantifiable measure of feature diagnosticity. Categorization of face and airplane fragments was similar within and between groups, showing better performance with increasing MI levels. Novices categorized car fragments more slowly than face and airplane fragments, while experts categorized car fragments as fast as face and airplane fragments. The experts' advantage with car fragments was similar across MI levels, with similar functions relating RT with MI level for both groups. Accuracy was equal between groups for cars as well as faces and airplanes, but experts' response criteria were biased toward cars. These findings suggest that expertise does not entail only specific perceptual strategies. Rather, at the basic level, expertise manifests as a general processing advantage arguably involving application of top-down mechanisms, such as knowledge and attention, which helps experts to distinguish between object categories. © ARVO

  15. Collaborative community based care for people and their families living with schizophrenia in India: protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Dabholkar Hamid

    2011-01-01

    Full Text Available Abstract Background There is a large treatment gap with few community services for people with schizophrenia in low income countries largely due to the shortage of specialist mental healthcare human resources. Community based rehabilitation (CBR, involving lay health workers, has been shown to be feasible, acceptable and more effective than routine care for people with schizophrenia in observational studies. The aim of this study is to evaluate whether a lay health worker led, Collaborative Community Based Care (CCBC intervention, combined with usual Facility Based Care (FBC, is superior to FBC alone in improving outcomes for people with schizophrenia and their caregivers in India. Methods/Design This trial is a multi-site, parallel group randomised controlled trial design in India. The trial will be conducted concurrently at three sites in India where persons with schizophrenia will be screened for eligibility and recruited after providing informed consent. Trial participants will be randomly allocated in a 2:1 ratio to the CCBC+FBC and FBC arms respectively using an allocation sequence pre-prepared through the use of permuted blocks, stratified within site. The structured CCBC intervention will be delivered by trained lay community health workers (CHWs working together with the treating Psychiatrist. We aim to recruit 282 persons with schizophrenia. The primary outcomes are reduction in severity of symptoms of schizophrenia and disability at 12 months. The study will be conducted according to good ethical practice, data analysis and reporting guidelines. Discussion If the additional CCBC intervention delivered by front line CHWs is demonstrated to be effective and cost-effective in comparison to usually available care, this intervention can be scaled up to expand coverage and improve outcomes for persons with schizophrenia and their caregivers in low income countries. Trial registration The trial is registered with the International Society

  16. Visual strategies underpinning the development of visual-motor expertise when hitting a ball.

    Science.gov (United States)

    Sarpeshkar, Vishnu; Abernethy, Bruce; Mann, David L

    2017-10-01

    It is well known that skilled batters in fast-ball sports do not align their gaze with the ball throughout ball-flight, but instead adopt a unique sequence of eye and head movements that contribute toward their skill. However, much of what we know about visual-motor behavior in hitting is based on studies that have employed case study designs, and/or used simplified tasks that fall short of replicating the spatiotemporal demands experienced in the natural environment. The aim of this study was to provide a comprehensive examination of the eye and head movement strategies that underpin the development of visual-motor expertise when intercepting a fast-moving target. Eye and head movements were examined in situ for 4 groups of cricket batters, who were crossed for playing level (elite or club) and age (U19 or adult), when hitting balls that followed either straight or curving ('swinging') trajectories. The results provide support for some widely cited markers of expertise in batting, while questioning the legitimacy of others. Swinging trajectories alter the visual-motor behavior of all batters, though in large part because of the uncertainty generated by the possibility of a variation in trajectory rather than any actual change in trajectory per se. Moreover, curving trajectories influence visual-motor behavior in a nonlinear fashion, with targets that curve away from the observer influencing behavior more than those that curve inward. The findings provide a more comprehensive understanding of the development of visual-motor expertise in interception. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  17. Imaging-based enrichment criteria using deep learning algorithms for efficient clinical trials in mild cognitive impairment.

    Science.gov (United States)

    Ithapu, Vamsi K; Singh, Vikas; Okonkwo, Ozioma C; Chappell, Richard J; Dowling, N Maritza; Johnson, Sterling C

    2015-12-01

    The mild cognitive impairment (MCI) stage of Alzheimer's disease (AD) may be optimal for clinical trials to test potential treatments for preventing or delaying decline to dementia. However, MCI is heterogeneous in that not all cases progress to dementia within the time frame of a trial and some may not have underlying AD pathology. Identifying those MCIs who are most likely to decline during a trial and thus most likely to benefit from treatment will improve trial efficiency and power to detect treatment effects. To this end, using multimodal, imaging-derived, inclusion criteria may be especially beneficial. Here, we present a novel multimodal imaging marker that predicts future cognitive and neural decline from [F-18]fluorodeoxyglucose positron emission tomography (PET), amyloid florbetapir PET, and structural magnetic resonance imaging, based on a new deep learning algorithm (randomized denoising autoencoder marker, rDAm). Using ADNI2 MCI data, we show that using rDAm as a trial enrichment criterion reduces the required sample estimates by at least five times compared with the no-enrichment regime and leads to smaller trials with high statistical power, compared with existing methods. Copyright © 2015 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

  18. Developing a Deeper Understanding of "Mathematics Teaching Expertise": An Examination of Three Chinese Mathematics Teachers' Resource Systems as Windows into Their Work and Expertise

    Science.gov (United States)

    Pepin, Birgit; Xu, Binyan; Trouche, Luc; Wang, Chongyang

    2017-01-01

    In order to develop a deeper understanding of mathematics teaching expertise, in this study we use the Documentational Approach to Didactics to explore the resource systems of three Chinese mathematics "expert" teachers. Exploiting the Western and Eastern literature we examine the notion of "mathematics teaching expertise", as…

  19. A randomized controlled trial of smartphone-based mindfulness training for smoking cessation: a study protocol.

    Science.gov (United States)

    Garrison, Kathleen A; Pal, Prasanta; Rojiani, Rahil; Dallery, Jesse; O'Malley, Stephanie S; Brewer, Judson A

    2015-04-14

    Tobacco use is responsible for the death of about 1 in 10 individuals worldwide. Mindfulness training has shown preliminary efficacy as a behavioral treatment for smoking cessation. Recent advances in mobile health suggest advantages to smartphone-based smoking cessation treatment including smartphone-based mindfulness training. This study evaluates the efficacy of a smartphone app-based mindfulness training program for improving smoking cessation rates at 6-months follow-up. A two-group parallel-randomized clinical trial with allocation concealment will be conducted. Group assignment will be concealed from study researchers through to follow-up. The study will be conducted by smartphone and online. Daily smokers who are interested in quitting smoking and own a smartphone (n = 140) will be recruited through study advertisements posted online. After completion of a baseline survey, participants will be allocated randomly to the control or intervention group. Participants in both groups will receive a 22-day smartphone-based treatment program for smoking. Participants in the intervention group will receive mobile mindfulness training plus experience sampling. Participants in the control group will receive experience sampling-only. The primary outcome measure will be one-week point prevalence abstinence from smoking (at 6-months follow-up) assessed using carbon monoxide breath monitoring, which will be validated through smartphone-based video chat. This is the first intervention study to evaluate smartphone-based delivery of mindfulness training for smoking cessation. Such an intervention may provide treatment in-hand, in real-world contexts, to help individuals quit smoking. Clinicaltrials.gov NCT02134509 . Registered 7 May 2014.

  20. Single-Trial Decoding of Bistable Perception Based on Sparse Nonnegative Tensor Decomposition

    Science.gov (United States)

    Wang, Zhisong; Maier, Alexander; Logothetis, Nikos K.; Liang, Hualou

    2008-01-01

    The study of the neuronal correlates of the spontaneous alternation in perception elicited by bistable visual stimuli is promising for understanding the mechanism of neural information processing and the neural basis of visual perception and perceptual decision-making. In this paper, we develop a sparse nonnegative tensor factorization-(NTF)-based method to extract features from the local field potential (LFP), collected from the middle temporal (MT) visual cortex in a macaque monkey, for decoding its bistable structure-from-motion (SFM) perception. We apply the feature extraction approach to the multichannel time-frequency representation of the intracortical LFP data. The advantages of the sparse NTF-based feature extraction approach lies in its capability to yield components common across the space, time, and frequency domains yet discriminative across different conditions without prior knowledge of the discriminating frequency bands and temporal windows for a specific subject. We employ the support vector machines (SVMs) classifier based on the features of the NTF components for single-trial decoding the reported perception. Our results suggest that although other bands also have certain discriminability, the gamma band feature carries the most discriminative information for bistable perception, and that imposing the sparseness constraints on the nonnegative tensor factorization improves extraction of this feature. PMID:18528515

  1. Multimedia based health information to parents in a pediatric acute ward: a randomized controlled trial.

    Science.gov (United States)

    Botngård, Anja; Skranes, Lars P; Skranes, Jon; Døllner, Henrik

    2013-12-01

    To determine whether multimedia based health information presented to parents of children with breathing difficulties in a pediatric acute ward, is more effective than verbal information, to reduce parental anxiety and increase satisfaction. This randomized controlled trial was conducted in a pediatric acute ward in Norway, from January to March 2011. Parents were randomly assigned to a multimedia intervention (n=53), or verbal health information (n=48). Primary outcome measure was parental anxiety, and secondary outcome measures were parental satisfaction with nursing care and health information. Parental anxiety decreased from arrival to discharge within both groups. At discharge the anxiety levels in the intervention group were no lower than in the control group. There was no difference in satisfaction with nursing care between the groups, but parents in the intervention group reported higher satisfaction with the health information given in the acute ward (p=.005). Multimedia based health information did not reduce anxiety more than verbal information, among parents to children with breathing difficulties. However, after discharge the parents were more satisfied with the multimedia approach. More research is needed to recommend the use of multimedia based information as a routine to parents in pediatric emergency care. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  2. Most children with cancer are not enrolled on a clinical trial in Canada: a population-based study.

    Science.gov (United States)

    Pole, Jason D; Barber, Randy; Bergeron, Rose-Émilie; Carret, Anne Sophie; Dix, David; Kulkarni, Ketan; Martineau, Emilie; Randall, Alicia; Stammers, David; Strahlendorf, Caron; Strother, Douglas R; Truong, Tony H; Sung, Lillian

    2017-06-05

    Primary objective was to describe the proportion of children newly diagnosed with cancer enrolled on a therapeutic clinical trial. Secondary objectives were to describe reasons for non-enrollment and factors associated with enrollment on trials. In this retrospective cohort study, we included children newly diagnosed with cancer between 0 and 14 years of age and diagnosed from 2001 to 2012. We used data from the Cancer in Young People in Canada (CYP-C) national pediatric cancer population-based database. CYP-C captures all cases of pediatric cancer (0-14 years) diagnosed and treated at one of the 17 tertiary pediatric oncology centers in Canada. Non-enrollment was evaluated using univariate and multiple logistic regression analysis. There were 9204 children with cancer included, of whom 2533 (27.5%) were enrolled on a clinical trial. The most common reasons cited for non-enrollment were lack of an available trial (52.2%) and physician choice (11.2%). In multiple regression, Asian and Arab/west Asian race were associated with lower enrollment (P = 0.006 and P = 0.032 respectively). All cancer diagnoses were more likely to be enrolled compared to astrocytoma and children with acute lymphoblastic leukemia had an almost 18-fold increased odds of enrollment compared to astrocytoma (P Canada, 27.5% of children with cancer are enrolled onto therapeutic clinical trials and lack of an available trial is the most common reason contributing to non-enrollment. Future research should better understand reasons for lack of trial availability and physician preferences to not offer trials.

  3. A cross-validation trial of an Internet-based prevention program for alcohol and cannabis: Preliminary results from a cluster randomised controlled trial.

    Science.gov (United States)

    Champion, Katrina E; Newton, Nicola C; Stapinski, Lexine; Slade, Tim; Barrett, Emma L; Teesson, Maree

    2016-01-01

    Replication is an important step in evaluating evidence-based preventive interventions and is crucial for establishing the generalizability and wider impact of a program. Despite this, few replications have occurred in the prevention science field. This study aims to fill this gap by conducting a cross-validation trial of the Climate Schools: Alcohol and Cannabis course, an Internet-based prevention program, among a new cohort of Australian students. A cluster randomized controlled trial was conducted among 1103 students (Mage: 13.25 years) from 13 schools in Australia in 2012. Six schools received the Climate Schools course and 7 schools were randomized to a control group (health education as usual). All students completed a self-report survey at baseline and immediately post-intervention. Mixed-effects regressions were conducted for all outcome variables. Outcomes assessed included alcohol and cannabis use, knowledge and intentions to use these substances. Compared to the control group, immediately post-intervention the intervention group reported significantly greater alcohol (d = 0.67) and cannabis knowledge (d = 0.72), were less likely to have consumed any alcohol (even a sip or taste) in the past 6 months (odds ratio = 0.69) and were less likely to intend on using alcohol in the future (odds ratio = 0.62). However, there were no effects for binge drinking, cannabis use or intentions to use cannabis. These preliminary results provide some support for the Internet-based Climate Schools: Alcohol and Cannabis course as a feasible way of delivering alcohol and cannabis prevention. Intervention effects for alcohol and cannabis knowledge were consistent with results from the original trial; however, analyses of longer-term follow-up data are needed to provide a clearer indication of the efficacy of the intervention, particularly in relation to behavioral changes. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  4. Efficacy of a biomechanically-based yoga exercise program in knee osteoarthritis: A randomized controlled trial.

    Science.gov (United States)

    Kuntz, Alexander B; Chopp-Hurley, Jaclyn N; Brenneman, Elora C; Karampatos, Sarah; Wiebenga, Emily G; Adachi, Jonathan D; Noseworthy, Michael D; Maly, Monica R

    2018-01-01

    Certain exercises could overload the osteoarthritic knee. We developed an exercise program from yoga postures with a minimal knee adduction moment for knee osteoarthritis. The purpose was to compare the effectiveness of this biomechanically-based yoga exercise (YE), with traditional exercise (TE), and a no-exercise attention-equivalent control (NE) for improving pain, self-reported physical function and mobility performance in women with knee osteoarthritis. Single-blind, three-arm randomized controlled trial. Community in Southwestern Ontario, Canada. A convenience sample of 31 women with symptomatic knee osteoarthritis was recruited through rheumatology, orthopaedic and physiotherapy clinics, newspapers and word-of-mouth. Participants were stratified by disease severity and randomly allocated to one of three 12-week, supervised interventions. YE included biomechanically-based yoga exercises; TE included traditional leg strengthening on machines; and NE included meditation with no exercise. Participants were asked to attend three 1-hour group classes/sessions each week. Primary outcomes were pain, self-reported physical function and mobility performance. Secondary outcomes were knee strength, depression, and health-related quality of life. All were assessed by a blinded assessor at baseline and immediately following the intervention. The YE group demonstrated greater improvements in KOOS pain (mean difference of 22.9 [95% CI, 6.9 to 38.8; p = 0.003]), intermittent pain (mean difference of -19.6 [95% CI, -34.8 to -4.4; p = 0.009]) and self-reported physical function (mean difference of 17.2 [95% CI, 5.2 to 29.2; p = 0.003]) compared to NE. Improvements in these outcomes were similar between YE and TE. However, TE demonstrated a greater improvement in knee flexor strength compared to YE (mean difference of 0.1 [95% CI, 0.1 to 0.2]. Improvements from baseline to follow-up were present in quality of life score for YE and knee flexor strength for TE, while both also

  5. Increasing Cervical Cancer Screening Coverage: A Randomised, Community-Based Clinical Trial.

    Directory of Open Access Journals (Sweden)

    Amelia Acera

    Full Text Available Opportunistic cervical cancer screening can lead to suboptimal screening coverage. Coverage could be increased after a personalised invitation to the target population. We present a community randomized intervention study with three strategies aiming to increase screening coverage.The CRICERVA study is a community-based clinical trial to improve coverage of population-based screening in the Cerdanyola SAP area in Barcelona.A total of 32,858 women residing in the study area, aged 30 to 70 years were evaluated. A total of 15,965 women were identified as having no registration of a cervical cytology in the last 3.5 years within the Public Health data base system. Eligible women were assigned to one of four community randomized intervention groups (IGs: (1 (IG1 N = 4197 personalised invitation letter, (2 (IG2 N = 3601 personalised invitation letter + informative leaflet, (3 (IG3 N = 6088 personalised invitation letter + informative leaflet + personalised phone call and (4 (Control N = 2079 based on spontaneous demand of cervical cancer screening as officially recommended. To evaluate screening coverage, we used heterogeneity tests to compare impact of the interventions and mixed logistic regression models to assess the age effect. We refer a "rescue" visit as the screening visit resulting from the study invitation.Among the 13,886 women in the IGs, 2,862 were evaluated as having an adequate screening history after the initial contact; 4,263 were lost to follow-up and 5,341 were identified as having insufficient screening and thus being eligible for a rescue visit. All intervention strategies significantly increased participation to screening compared to the control group. Coverage after the intervention reached 84.1% while the control group reached 64.8%. The final impact of our study was an increase of 20% in the three IGs and of 9% in the control group (p<0.001. Within the intervention arms, age was an important determinant of rescue visits

  6. Web-Based Cognitive Remediation Improves Supported Employment Outcomes in Severe Mental Illness: Randomized Controlled Trial.

    Science.gov (United States)

    Harris, Anthony Wf; Kosic, Tanya; Xu, Jean; Walker, Chris; Gye, William; Redoblado Hodge, Antoinette

    2017-09-20

    Finding work is a top priority for most people; however, this goal remains out of reach for the majority of individuals with a severe mental illness (SMI) who remain on benefits or are unemployed. Supported employment (SE) programs aimed at returning people with a severe mental illness to work are successful; however, they still leave a significant number of people with severe mental illness unemployed. Cognitive deficits are commonly found in SMI and are a powerful predictor of poor outcome. Fortunately, these deficits are amenable to treatment with cognitive remediation therapy (CRT) that significantly improves cognition in SMI. CRT combined with SE significantly increases the likelihood of individuals with severe mental illness obtaining and staying in work. However, the availability of CRT is limited in many settings. The aim of this study was to examine whether Web-based CRT combined with a SE program can improve the rate return to work of people with severe mental illness. A total of 86 people with severe mental illness (mean age 39.6 years; male: n=55) who were unemployed and who had joined a SE program were randomized to either a Web-based CRT program (CogRem) or an Internet-based control condition (WebInfo). Primary outcome measured was hours worked over 6 months post treatment. At 6 months, those participants randomized to CogRem had worked significantly more hours (P=.01) and had earned significantly more money (P=.03) than those participants randomized to the WebInfo control condition. No change was observed in cognition. This study corroborates other work that has found a synergistic effect of combining CRT with a SE program and extends this to the use of Web-based CRT. The lack of any improvement in cognition obscures the mechanism by which an improved wage outcome for participants randomized to the active treatment was achieved. However, the study substantially lowers the barrier to the deployment of CRT with other psychosocial interventions for

  7. A theory-based video messaging mobile phone intervention for smoking cessation: randomized controlled trial.

    Science.gov (United States)

    Whittaker, Robyn; Dorey, Enid; Bramley, Dale; Bullen, Chris; Denny, Simon; Elley, C Raina; Maddison, Ralph; McRobbie, Hayden; Parag, Varsha; Rodgers, Anthony; Salmon, Penny

    2011-01-21

    Advances in technology allowed the development of a novel smoking cessation program delivered by video messages sent to mobile phones. This social cognitive theory-based intervention (called "STUB IT") used observational learning via short video diary messages from role models going through the quitting process to teach behavioral change techniques. The objective of our study was to assess the effectiveness of a multimedia mobile phone intervention for smoking cessation. A randomized controlled trial was conducted with 6-month follow-up. Participants had to be 16 years of age or over, be current daily smokers, be ready to quit, and have a video message-capable phone. Recruitment targeted younger adults predominantly through radio and online advertising. Registration and data collection were completed online, prompted by text messages. The intervention group received an automated package of video and text messages over 6 months that was tailored to self-selected quit date, role model, and timing of messages. Extra messages were available on demand to beat cravings and address lapses. The control group also set a quit date and received a general health video message sent to their phone every 2 weeks. The target sample size was not achieved due to difficulty recruiting young adult quitters. Of the 226 randomized participants, 47% (107/226) were female and 24% (54/226) were Maori (indigenous population of New Zealand). Their mean age was 27 years (SD 8.7), and there was a high level of nicotine addiction. Continuous abstinence at 6 months was 26.4% (29/110) in the intervention group and 27.6% (32/116) in the control group (P = .8). Feedback from participants indicated that the support provided by the video role models was important and appreciated. This study was not able to demonstrate a statistically significant effect of the complex video messaging mobile phone intervention compared with simple general health video messages via mobile phone. However, there was

  8. Internet-based cognitive behavior therapy for procrastination: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Rozental, Alexander; Carlbring, Per

    2013-11-12

    therapist contact. The current study is believed to result in three important findings. First, a CBT intervention is assumed to be beneficial for people suffering from problems caused by procrastination. Second, the degree of therapist contact will have a positive effect on treatment outcome as procrastination can be partially explained as a self-regulatory failure. Third, an Internet based CBT intervention is presumed to be an effective way to administer treatment for procrastination, which is considered highly important, as the availability of adequate care is limited. The current study is therefore believed to render significant knowledge on the treatment of procrastination, as well as providing support for the use of Internet based CBT for difficulties due to delayed tasks and commitments. To our knowledge, the current study is the first clinical trial to examine the effects of CBT for procrastination, and is assumed to render significant knowledge on the treatment of procrastination, as well as investigating whether it can be delivered via the Internet. ClinicalTrials.gov: NCT01842945; http://clinicaltrials.gov/show/NCT01842945 (Archived by WebCite at http://www.webcitation.org/6KSmaXewC).

  9. Web-based consultation between general practitioners and nephrologists: a cluster randomized controlled trial.

    Science.gov (United States)

    van Gelder, Vincent A; Scherpbier-de Haan, Nynke D; van Berkel, Saskia; Akkermans, Reinier P; de Grauw, Inge S; Adang, Eddy M; Assendelft, Pim J; de Grauw, Wim J C; Biermans, Marion C J; Wetzels, Jack F M

    2017-08-01

    Consultation of a nephrologist is important in aligning care for patients with chronic kidney disease (CKD) at the primary-secondary care interface. However, current consultation methods come with practical difficulties that can lead to postponed consultation or patient referral instead. This study aimed to investigate whether a web-based consultation platform, telenephrology, led to a lower referral rate of indicated patients. Furthermore, we assessed consultation rate, quality of care, costs and general practitioner (GPs') experiences with telenephrology. Cluster randomized controlled trial with 47 general practices in the Netherlands was randomized to access to telenephrology or to enhanced usual care. A total of 3004 CKD patients aged 18 years or older who were under primary care were included (intervention group n = 1277, control group n = 1727) and 2693 completed the trial. All practices participated in a CKD management course and were given an overview of their CKD patients. The referral rates amounted to 2.3% (n = 29) in the intervention group and 3.0% (n = 52) in the control group, which was a non-significant difference, OR 0.61; 95% CI 0.31 to 1.23. The intervention group's consultation rate was 6.3% (n = 81) against 5.0% (n = 87) (OR 2.00; 95% CI 0.75-5.33). We found no difference in quality of care or costs. The majority of GPs had a positive opinion about telenephrology. The data in our study do not allow for conclusions on the effect of telenephrology on the rate of patient referrals and provider-to-provider consultations, compared to conventional methods. It was positively evaluated by GPs and was non-inferior in terms of quality of care and costs. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  10. Clinical Trials

    Medline Plus

    Full Text Available ... the same scientific safeguards as clinical trials for adults. For more information, go to "How Do Clinical ... based on what is known to work in adults. To improve clinical care of children, more studies ...

  11. Study protocol for the evaluation of an Infant Simulator based program delivered in schools: a pragmatic cluster randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Hart Michael B

    2010-10-01

    Full Text Available Abstract Background This paper presents the study protocol for a pragmatic randomised controlled trial to evaluate the impact of a school based program developed to prevent teenage pregnancy. The program includes students taking care of an Infant Simulator; despite growing popularity and an increasing global presence of such programs, there is no published evidence of their long-term impact. The aim of this trial is to evaluate the Virtual Infant Parenting (VIP program by investigating pre-conceptual health and risk behaviours, teen pregnancy and the resultant birth outcomes, early child health and maternal health. Methods and Design Fifty-seven schools (86% of 66 eligible secondary schools in Perth, Australia were recruited to the clustered (by school randomised trial, with even randomisation to the intervention and control arms. Between 2003 and 2006, the VIP program was administered to 1,267 participants in the intervention schools, while 1,567 participants in the non-intervention schools received standard curriculum. Participants were all female and aged between 13-15 years upon recruitment. Pre and post-intervention questionnaires measured short-term impact and participants are now being followed through their teenage years via data linkage to hospital medical records, abortion clinics and education records. Participants who have a live birth are interviewed by face-to-face interview. Kaplan-Meier survival analysis and proportional hazards regression will test for differences in pregnancy, birth and abortion rates during the teenage years between the study arms. Discussion This protocol paper provides a detailed overview of the trial design as well as initial results in the form of participant flow. The authors describe the intervention and its delivery within the natural school setting and discuss the practical issues in the conduct of the trial, including recruitment. The trial is pragmatic and will directly inform those who provide

  12. Assessing the Effectiveness of Case-Based Collaborative Learning via Randomized Controlled Trial.

    Science.gov (United States)

    Krupat, Edward; Richards, Jeremy B; Sullivan, Amy M; Fleenor, Thomas J; Schwartzstein, Richard M

    2016-05-01

    Case-based collaborative learning (CBCL) is a novel small-group approach that borrows from team-based learning principles and incorporates elements of problem-based learning (PBL) and case-based learning. CBCL includes a preclass readiness assurance process and case-based in-class activities in which students respond to focused, open-ended questions individually, discuss their answers in groups of 4, and then reach consensus in larger groups of 16. This study introduces CBCL and assesses its effectiveness in one course at Harvard Medical School. In a 2013 randomized controlled trial, 64 medical and dental student volunteers were assigned randomly to one of four 8-person PBL tutorial groups (control; n = 32) or one of two 16-person CBCL tutorial groups (experimental condition; n = 32) as part of a required first-year physiology course. Outcomes for the PBL and CBCL groups were compared using final exam scores, student responses to a postcourse survey, and behavioral coding of portions of video-recorded class sessions. Overall, the course final exam scores for CBCL and PBL students were not significantly different. However, CBCL students whose mean exam performance in prior courses was below the participant median scored significantly higher than their PBL counterparts on the physiology course final exam. The most common adjectives students used to describe CBCL were "engaging," "fun," and "thought-provoking." Coding of observed behaviors indicated that individual affect was significantly higher in the CBCL groups than in the PBL groups. CBCL is a viable, engaging, active learning method. It may particularly benefit students with lower academic performance.

  13. Efficacy of handrubbing with alcohol based solution versus standard handwashing with antiseptic soap: randomised clinical trial

    Science.gov (United States)

    Girou, Emmanuelle; Loyeau, Sabrina; Legrand, Patrick; Oppein, Françoise; Brun-Buisson, Christian

    2002-01-01

    Objective To compare the efficacy of handrubbing with an alcohol based solution versus conventional handwashing with antiseptic soap in reducing hand contamination during routine patient care. Design Randomised controlled trial during daily nursing sessions of 2 to 3 hours. Setting Three intensive care units in a French university hospital. Participants 23 healthcare workers. Interventions Handrubbing with alcohol based solution (n=12) or handwashing with antiseptic soap (n=11) when hand hygiene was indicated before and after patient care. Imprints taken of fingertips and palm of dominant hand before and after hand hygiene procedure. Bacterial counts quantified blindly. Main outcome measures Bacterial reduction of hand contamination. Results With handrubbing the median percentage reduction in bacterial contamination was significantly higher than with handwashing (83% v 58%, P=0.012), with a median difference in the percentage reduction of 26% (95% confidence interval 8% to 44%). The median duration of hand hygiene was 30 seconds in each group. Conclusions During routine patient care handrubbing with an alcohol based solution is significantly more efficient in reducing hand contamination than handwashing with antiseptic soap. What is already known on this topicTo improve compliance with hand hygiene during patient care, handrubbing with an alcohol based solution has been proposed as a substitute for handwashing because of its rapid action and accessibilityExperimental studies show that handrubbing is at least as effective as medicated soap in reducing artificial contamination of handsMany healthcare workers still have reservations regarding its efficacy and are reluctant to use this techniqueWhat this study addsWhen used in routine practice, handrubbing with an alcohol based solution after contact with patients achieved a greater reduction in bacterial contamination of hands than conventional handwashing with medicated soap PMID:12183307

  14. [Evidence-based quality assessment of 10-year orthodontic clinical trials in 4 major dental journals].

    Science.gov (United States)

    Sun, Yan-nan; Lei, Fei-fei; Cao, Yan-li; Fu, Min-kui

    2010-02-01

    To assess the quality of orthodontic clinical trials published in 4 major dental journals in the past 10 years and establish the reference standard for orthodontic clinical trials and quality control of dental journals. All the clinical trials published in Chinese Journal of Stomatology, West China Journal of Stomatology, Journal of Practice Stomatology and Chinese Journal of Orthodontics from 1999 to 2008 were searched. The demographic information of the papers was extracted and the quality of the clinical trials according to the consolidated standards of reporting trials (CONSORT) was assessed. Four hundred and ninety-four clinical trials were retrieved, and 21.3% (105/494) of them were supported by grants. For the study design, only 26.1% (129/494) were prospective studies, and 3.8% (19/494) were randomized clinical trials. It was hard to evaluate precisely due to the lack of information about the details of the study designs. For the randomized clinical trials, the lack of details for randomization, allocation concealment, blinding and intention to treat compromised the quality. The general quality of clinical trials in orthodontics is poor. It needs to be improved both in the clinical study design and the paper writing.

  15. How does the World Trade Organization know? The mobilization and staging of scientific expertise in the GMO trade dispute.

    Science.gov (United States)

    Bonneuil, Christophe; Levidow, Les

    2012-02-01

    The World Trade Organization (WTO) dispute settlement procedure is a key arena for establishing global legal norms for what counts as relevant knowledge. As a high-profile case, the WTO trade dispute on GMOs mobilized scientific expertise in somewhat novel ways. Early on, the Panel put the dispute under the Sanitary and Phytosanitary (SPS) Agreement through a new legal ontology; it classified transgenes as potential pests and limited all environmental issues to the 'plant and animal health' category. The selection of scientific experts sought a multi-party consensus through a fast adversarial process, reflecting a specific legal epistemology. For the SPS framing, focusing on the defendant's regulatory procedures, the Panel staged scientific expertise in specific ways that set up how experts were questioned, the answers they would give, their specific role in the legal arena, and the way their statements would complement the Panel's findings. In these ways, the dispute settlement procedure co-produced legal and scientific expertise within the Panel's SPS framework. Moreover, the Panel operated a procedural turn in WTO jurisprudence by representing its findings as a purely legal-administrative judgement on whether the EC's regulatory procedures violated the SPS Agreement, while keeping implicit its own judgements on substantive risk issues. As this case illustrates, the WTO settlement procedure mobilizes scientific expertise for sophisticated, multiple aims: it recruits a source of credibility from the scientific arena, thus reinforcing the standard narrative of 'science-based trade discipline', while also constructing new scientific expertise for the main task--namely, challenging trade restrictions for being unduly cautious.

  16. Implementation of evidence-based antenatal care in Mozambique: a cluster randomized controlled trial: study protocol.

    Science.gov (United States)

    Chavane, Leonardo; Merialdi, Mario; Betrán, Ana Pilar; Requejo-Harris, Jennifer; Bergel, Eduardo; Aleman, Alicia; Colomar, Mercedes; Cafferata, Maria Luisa; Carbonell, Alicia; Crahay, Beatrice; Delvaux, Therese; Geelhoed, Diederike; Gülmezoglu, Metin; Malapende, Celsa Regina; Melo, Armando; Nguyen, My Huong; Osman, Nafissa Bique; Widmer, Mariana; Temmerman, Marleen; Althabe, Fernando

    2014-05-21

    Antenatal care (ANC) reduces maternal and perinatal morbidity and mortality directly through the detection and treatment of pregnancy-related illnesses, and indirectly through the detection of women at increased risk of delivery complications. The potential benefits of quality antenatal care services are most significant in low-resource countries where morbidity and mortality levels among women of reproductive age and neonates are higher.WHO developed an ANC model that recommended the delivery of services scientifically proven to improve maternal, perinatal and neonatal outcomes. The aim of this study is to determine the effect of an intervention designed to increase the use of the package of evidence-based services included in the WHO ANC model in Mozambique. The primary hypothesis is that the intervention will increase the use of evidence-based practices during ANC visits in comparison to the standard dissemination channels currently used in the country. This is a demonstration project to be developed through a facility-based cluster randomized controlled trial with a stepped wedge design. The intervention was tailored, based on formative research findings, to be readily applicable to local prenatal care services and acceptable to local pregnant women and health providers. The intervention includes four components: the provision of kits with all necessary medicines and laboratory supplies for ANC (medical and non-medical equipment), a storage system, a tracking system, and training sessions for health care providers. Ten clinics were selected and will start receiving the intervention in a random order. Outcomes will be computed at each time point when a new clinic starts the intervention. The primary outcomes are the delivery of selected health care practices to women attending the first ANC visit, and secondary outcomes are the delivery of selected health care practices to women attending second and higher ANC visits as well as the attitude of midwives in

  17. Systematic reviews of randomised clinical trials examining the effects of psychotherapeutic interventions versus "no intervention" for acute major depressive disorder and a randomised trial examining the effects of "third wave" cognitive therapy versus mentalization-based treatment for acute major

    DEFF Research Database (Denmark)

    Jakobsen, Janus Christian

    2014-01-01

    systematic reviews with meta-analyses and trial sequential analyses using The Cochrane Collaboration methodology examining the effects of cognitive therapy and psycho-dynamic therapy for major depressive disorder. We developed a thorough treatment protocol for a randomised trial with low risks of bias...... therapy versus mentalisation-based treatment for major depressive disorder. The first systematic review included five randomised trials examining the effects of psychodynamic therapy versus "no intervention' for major depressive disorder. Altogether the five trials randomised 365 participants who in each...... this result. The second systematic review included 12 randomised trials examining the effects of cognitive therapy versus "no intervention" for major depressive disorder. Altogether a total of 669 participants were randomised. All trials had high risk of bias. Meta-analysis showed that cognitive therapy...

  18. Web-Based Aftercare for Women With Bulimia Nervosa Following Inpatient Treatment: Randomized Controlled Efficacy Trial.

    Science.gov (United States)

    Jacobi, Corinna; Beintner, Ina; Fittig, Eike; Trockel, Mickey; Braks, Karsten; Schade-Brittinger, Carmen; Dempfle, Astrid

    2017-09-22

    Relapse rates in bulimia nervosa (BN) are high even after successful treatment, but patients often hesitate to take up further treatment. An easily accessible program might help maintain treatment gains. Encouraged by the effects of Web-based eating disorder prevention programs, we developed a manualized, Web-based aftercare program (IN@) for women with BN following inpatient treatment. The objective of this study was to determine the efficacy of the web-based guided, 9-month, cognitive-behavioral aftercare program IN@ for women with BN following inpatient treatment. We conducted a randomized controlled efficacy trial in 253 women with DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, fourth edition) BN and compared the results of IN@ with treatment as usual (TAU). Assessments were carried out at hospital admission (T0), hospital discharge/baseline (T1), postintervention (T2; 9 months after baseline), 9-month follow-up (T3; 18 months after baseline). The primary outcome, abstinence from binge eating and compensatory behaviors during the 2 months preceding T2, was analyzed by intention to treat, using logistic regression analyses. Frequencies of binge eating and vomiting episodes, and episodes of all compensatory behaviors were analyzed using mixed effects models. At T2, data from 167 women were available. There were no significant differences in abstinence rates between the TAU group (n=24, 18.9%) and the IN@ group (n=27, 21.4%; odds ratio, OR=1.29; P=.44). The frequency of vomiting episodes in the IN@ group was significantly (46%) lower than in the TAU group (P=.003). Moderator analyses revealed that both at T2 and T3, women of the intervention group who still reported binge eating and compensatory behaviors after inpatient treatment benefited from IN@, whereas women who were already abstinent after the inpatient treatment did not (P=.004; P=.002). Additional treatment utilization was high in both groups between baseline and follow-up. Overall, data

  19. Internet-based early intervention to prevent posttraumatic stress disorder in injury patients: randomized controlled trial.

    Science.gov (United States)

    Mouthaan, Joanne; Sijbrandij, Marit; de Vries, Giel-Jan; Reitsma, Johannes B; van de Schoot, Rens; Goslings, J Carel; Luitse, Jan S K; Bakker, Fred C; Gersons, Berthold P R; Olff, Miranda

    2013-08-13

    Posttraumatic stress disorder (PTSD) develops in 10-20% of injury patients. We developed a novel, self-guided Internet-based intervention (called Trauma TIPS) based on techniques from cognitive behavioral therapy (CBT) to prevent the onset of PTSD symptoms. To determine whether Trauma TIPS is effective in preventing the onset of PTSD symptoms in injury patients. Adult, level 1 trauma center patients were randomly assigned to receive the fully automated Trauma TIPS Internet intervention (n=151) or to receive no early intervention (n=149). Trauma TIPS consisted of psychoeducation, in vivo exposure, and stress management techniques. Both groups were free to use care as usual (nonprotocolized talks with hospital staff). PTSD symptom severity was assessed at 1, 3, 6, and 12 months post injury with a clinical interview (Clinician-Administered PTSD Scale) by blinded trained interviewers and self-report instrument (Impact of Event Scale-Revised). Secondary outcomes were acute anxiety and arousal (assessed online), self-reported depressive and anxiety symptoms (Hospital Anxiety and Depression Scale), and mental health care utilization. Intervention usage was documented. The mean number of intervention logins was 1.7, SD 2.5, median 1, interquartile range (IQR) 1-2. Thirty-four patients in the intervention group did not log in (22.5%), 63 (41.7%) logged in once, and 54 (35.8%) logged in multiple times (mean 3.6, SD 3.5, median 3, IQR 2-4). On clinician-assessed and self-reported PTSD symptoms, both the intervention and control group showed a significant decrease over time (PInternet-based early intervention in the prevention of PTSD symptoms for an unselected population of injury patients. Moreover, uptake was relatively low since one-fifth of individuals did not log in to the intervention. Future research should therefore focus on innovative strategies to increase intervention usage, for example, adding gameplay, embedding it in a blended care context, and targeting high

  20. Dissemination of evidence-based cancer control interventions among Catholic faith-based organizations: results from the CRUZA randomized trial.

    Science.gov (United States)

    Allen, Jennifer D; Torres, Maria Idalí; Tom, Laura S; Leyva, Bryan; Galeas, Ana V; Ospino, Hosffman

    2016-05-18

    The CRUZA randomized trial tested the efficacy of an organizational-level intervention to increase the capacity of Catholic faith-based organizations (FBOs) serving Latinos to implement evidence-based strategies (EBS) for cancer control. Thirty-one Catholic parishes were enrolled. Twenty were randomized to a "capacity enhancement" (CE) intervention and 11 to a "standard dissemination" (SD) condition. Each received a Program Implementation Manual and Toolkit of materials culturally adapted for FBOs with Latino audiences for five types of EBS recommended by the US Preventive Services Community Guide. CE parishes were offered a menu of capacity-building activities over a 3-month period, while SD parishes were provided a one-time consultation by an Intervention Specialist. Baseline and follow-up surveys compared the number and types of EBS offered. At baseline, only one parish had offered any cancer-related program in the prior year, yet a third (36 %) had offered some other type of health program or service. At post-intervention follow-up, all parishes offered a greater number of EBS. The only statistically significant difference between CE and SD groups was the number of parishes offering small media interventions (90 % in CE, 64 % in SD; p support to carry out programming. Further research is needed to examine the extent to which program offerings continued after the period of grant funding. Clinicaltrials.gov NCT01740219 .

  1. Recognition of Translator Expertise using Sequences of Fixations and Keystrokes

    DEFF Research Database (Denmark)

    Gómez, Pascual Martínez; Minocha, Akshay; Huang, Jin

    2014-01-01

    Professional human translation is necessary to meet high quality standards in industry and governmental agencies. Translators engage in multiple activities during their task, and there is a need to model their behavior, with the objective to understand and optimize the translation process....... In recent years, user interfaces enabled us to record user events such as eye-movements or keystrokes. Although there have been insightful descriptive analysis of the translation process, there are multiple advantages in enabling quantitative inference. We present methods to classify sequences of fixations...... and keystrokes into activities and model translation sessions with the objective to recognize translator expertise. We show significant error reductions in the task of recognizing certified translators and their years of experience, and analyze the characterizing patterns....

  2. Unitizing worker expertise and maximizing the brain reward centers

    Energy Technology Data Exchange (ETDEWEB)

    Martinez, Anthony Bert [Los Alamos National Laboratory

    2010-01-01

    People are experts when it comes to the work they do; unfortunately their expertise is not utilized as frequently as it could be. More opportunities need to be provided that allow people to participate in the design of their work including: accident investigations, job planning, and process improvements. Many employers use some form of job hazard analysis process to identify and document hazards and controls, but the front line worker is rarely involved. This presentation will show the core principles supporting employee involvement, provide examples where workers had brilliant ideas but no one listened, and provide examples where workers were given the opportunity to use their expertise to improve occupational safety. According to Abraham Maslow's Hierarch of Needs model, one essential human need is to be innovative and solve problems. Advances in brain science have proven, through functional magnetic resonance imaging (fMRI) studies, the brain reward pathway is activated when people are recognized for their intellectual contributions. As people contribute their expertise to improve occupational safety more frequently they will feel a sense of gratification. In addition, safety professionals will have more time to spend on strategic planning of emerging occupational safety issues. One effect of the current global recession is that SH&E professionals are asked to do more with less. Therefore, to be successful it is essential that SH&E professionals incorporate worker expertise in job planning. This will be illustrated in the presentation through an example where a worker had the answer to a difficult decision on appropriate personal protective equipment for a job but no one asked the worker for his idea during the job planning phase. Fortunately the worker was eventually consulted and his recommendation for the appropriate personal protective equipment for the job was implemented before work began. The goal of this presentation is to expand the awareness and

  3. SKODA Nuclear Machinery - tradition and expertise in nuclear power industry

    International Nuclear Information System (INIS)

    Svitak, F.

    1997-01-01

    The SKODA Nuclear Machinery company is a major manufacturer of nuclear reactor assemblies and supplier of WWER type primary coolant circuits. In the past, the company was nearly a monopolistic manufacturer of WWER reactor assemblies supplied to the Central and East European countries (except the USSR) grouped in the former Council of Mutual Economic Assistance. Over the 1980-1993 period, 21 units of the WWER-440 type and 3 units of the WWER-1000 type were manufactured. The company keeps abreast of technological progress and has been switching to new manufacturing areas, such as compact storage racks for spent fuel pools, hermetic cable bushings, spent fuel storage and transport casks, and cooperation in the manufacture of neutron flux measuring channels. Technological services provided to nuclear power plants constitute another important field of the company's business. The company's combined expertise in Soviet and Western designed PWRs is a considerable asset. (P.A.)

  4. An economic evaluation of highly purified HMG and recombinant FSH based on a large randomized trial.

    Science.gov (United States)

    Wechowski, Jaroslaw; Connolly, Mark; McEwan, Philip; Kennedy, Richard

    2007-11-01

    Public funding for IVF is increasingly being challenged by health authorities in an attempt to minimize health service costs. In light of treatment rationing, the need to consider costs in relation to outcomes is paramount. To assess the cost implications of gonadotrophin treatment options, an economic evaluation comparing highly purified human menopausal gonadotrophin (HP-HMG) and recombinant FSH (rFSH) has been conducted. The analysis is based on individual patient data from a large randomized controlled trial (n = 731) in a long agonist IVF protocol. The economic evaluation uses a discrete event simulation model to assess treatment costs in relation to live births for both treatments based on published UK costs. After one cycle the mean costs per IVF treatment for HP-HMG and rFSH were pound2396 (95% CI pound2383-2414) and pound2633 ( pound2615-2652), respectively. The average cost-saving of pound237 per IVF cycle using HP-HMG allows one additional cycle to be delivered for every 10 cycles. With maternal and neonatal costs applied, the median cost per IVF baby delivered with HP-HMG was pound8893 compared with pound11,741 for rFSH (P cost-saving potential of HP-HMG in IVF was still apparent after varying critical cost parameters in the probabilistic sensitivity analysis.

  5. Atlas-based liver segmentation and hepatic fat-fraction assessment for clinical trials.

    Science.gov (United States)

    Yan, Zhennan; Zhang, Shaoting; Tan, Chaowei; Qin, Hongxing; Belaroussi, Boubakeur; Yu, Hui Jing; Miller, Colin; Metaxas, Dimitris N

    2015-04-01

    Automated assessment of hepatic fat-fraction is clinically important. A robust and precise segmentation would enable accurate, objective and consistent measurement of hepatic fat-fraction for disease quantification, therapy monitoring and drug development. However, segmenting the liver in clinical trials is a challenging task due to the variability of liver anatomy as well as the diverse sources the images were acquired from. In this paper, we propose an automated and robust framework for liver segmentation and assessment. It uses single statistical atlas registration to initialize a robust deformable model to obtain fine segmentation. Fat-fraction map is computed by using chemical shift based method in the delineated region of liver. This proposed method is validated on 14 abdominal magnetic resonance (MR) volumetric scans. The qualitative and quantitative comparisons show that our proposed method can achieve better segmentation accuracy with less variance comparing with two other atlas-based methods. Experimental results demonstrate the promises of our assessment framework. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Can evidence change the rate of back surgery? A randomized trial of community-based education.

    Science.gov (United States)

    Goldberg, H I; Deyo, R A; Taylor, V M; Cheadle, A D; Conrad, D A; Loeser, J D; Heagerty, P J; Diehr, P

    2001-01-01

    Timely adoption of clinical practice guidelines is more likely to happen when the guidelines are used in combination with adjuvant educational strategies that address social as well as rational influences. To implement the conservative, evidence-based approach to low-back pain recommended in national guidelines, with the anticipated effect of reducing population-based rates of surgery. A randomized, controlled trial. Ten communities in western Washington State with annual rates of back surgery above the 1990 national average (158 operations per 100,000 adults). Spine surgeons, primary care physicians, patients who were surgical candidates, and hospital administrators. The five communities randomized to the intervention group received a package of six educational activities tailored to local needs by community planning groups. Surgeon study groups, primary care continuing medical education conferences, administrative consensus processes, videodisc-aided patient decision making, surgical outcomes management, and generalist academic detailing were serially implemented over a 30-month intervention period. Quarterly observations of surgical rates. After implementation of the intervention, surgery rates declined in the intervention communities but increased slightly in the control communities. The net effect of the intervention is estimated to be a decline of 20.9 operations per 100,000, a relative reduction of 8.9% (P = 0.01). We were able to use scientific evidence to engender voluntary change in back pain practice patterns across entire communities.

  7. Methods and issues in conducting a community-based environmental randomized trial

    International Nuclear Information System (INIS)

    Swartz, Lee J.; Callahan, Karen A.; Butz, Arlene M.; Rand, Cynthia S.; Kanchanaraksa, Sukon; Diette, Gregory B.; Krishnan, Jerry A.; Breysse, Patrick N.; Buckley, Timothy J.; Mosley, Adrian M.; Eggleston, Peyton A.

    2004-01-01

    The environment is suspected to play an important role in the prevalence and severity of asthma in inner-city children. This paper describes the implementation and baseline data of an inner-city community-based participatory research clinical trial designed to test the effectiveness of a pollutant and allergen control strategy on children's asthma morbidity. Participants were 100 elementary-school-aged children with asthma, graduates of a school-based asthma education program in East Baltimore. The intervention for half of the randomly assigned families consisted of environmental control education, allergen-proof encasements, pest extermination, and a HEPA air cleaner at the beginning of the study. Controls received the same at the end of the study. Participants visited a clinic for questionnaires, allergy skin testing, spirometry, and blood sample at baseline and 12 months. Home environments, NO 2 , O 3 , airborne particulates, and allergens were evaluated at baseline and at 6 and 12 months. Asthma morbidity and adherence was assessed quarterly. Collaboration with the community proved very beneficial in creating a study design and procedures acceptable to an inner-city community

  8. A practice-based trial of blood pressure control in African Americans (TLC-Clinic: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Schoenthaler Antoinette

    2011-12-01

    Full Text Available Abstract Background Poorly controlled hypertension (HTN remains one of the most significant public health problems in the United States, in terms of morbidity, mortality, and economic burden. Despite compelling evidence supporting the beneficial effects of therapeutic lifestyle changes (TLC for blood pressure (BP reduction, the effectiveness of these approaches in primary care practices remains untested, especially among African Americans, who share a disproportionately greater burden of HTN-related outcomes. Methods/Design This randomized controlled trial tests the effectiveness of a practice-based comprehensive therapeutic lifestyle intervention, delivered through group-based counseling and motivational interviewing (MINT-TLC versus Usual Care (UC in 200 low-income, African Americans with uncontrolled hypertension. MINT-TLC is designed to help patients make appropriate lifestyle changes and develop skills to maintain these changes long-term. Patients in the MINT-TLC group attend 10 weekly group classes focused on healthy lifestyle changes (intensive phase; followed by 3 monthly individual motivational interviewing (MINT sessions (maintenance phase. The intervention is delivered by trained research personnel with appropriate treatment fidelity procedures. Patients in the UC condition receive a single individual counseling session on healthy lifestyle changes and print versions of the intervention materials. The primary outcome is within-patient change in both systolic and diastolic BP from baseline to 6 months. In addition to BP control at 6 months, other secondary outcomes include changes in the following lifestyle behaviors from baseline to 6 months: a physical activity, b weight loss, c number of daily servings of fruits and vegetables and d 24-hour urinary sodium excretion. Discussion This vanguard trial will provide information on how to refine MINT-TLC and integrate it into a standard treatment protocol for hypertensive African Americans

  9. A randomized, controlled clinical trial: the effect of mindfulness-based cognitive therapy on generalized anxiety disorder among Chinese community patients: protocol for a randomized trial

    Directory of Open Access Journals (Sweden)

    Wong Samuel YS

    2011-11-01

    Full Text Available Abstract Background Research suggests that an eight-week Mindfulness-Based Cognitive Therapy (MBCT program may be effective in the treatment of generalized anxiety disorders. Our objective is to compare the clinical effectiveness of the MBCT program with a psycho-education programme and usual care in reducing anxiety symptoms in people suffering from generalized anxiety disorder. Methods A three armed randomized, controlled clinical trial including 9-month post-treatment follow-up is proposed. Participants screened positive using the Structure Clinical Interview for DSM-IV (SCID for general anxiety disorder will be recruited from community-based clinics. 228 participants will be randomly allocated to the MBCT program plus usual care, psycho-education program plus usual care or the usual care group. Validated Chinese version of instruments measuring anxiety and worry symptoms, depression, quality of life and health service utilization will be used. Our primary end point is the change of anxiety and worry score (Beck Anxiety Inventory and Penn State Worry Scale from baseline to the end of intervention. For primary analyses, treatment outcomes will be assessed by ANCOVA, with change in anxiety score as the baseline variable, while the baseline anxiety score and other baseline characteristics that significantly differ between groups will serve as covariates. Conclusions This is a first randomized controlled trial that compare the effectiveness of MBCT with an active control, findings will advance current knowledge in the management of GAD and the way that group intervention can be delivered and inform future research. Unique Trail Number (assigned by Centre for Clinical Trails, Clinical Trials registry, The Chinese University of Hong Kong: CUHK_CCT00267

  10. Comparison of deck- and trial-based approaches to advantageous decision making on the Iowa Gambling Task.

    Science.gov (United States)

    Visagan, Ravindran; Xiang, Ally; Lamar, Melissa

    2012-06-01

    We compared the original deck-based model of advantageous decision making assessed with the Iowa Gambling Task (IGT) with a trial-based approach across behavioral and physiological outcomes in 33 younger adults (15 men, 18 women; 22.2 ± 3.7 years of age). One administration of the IGT with simultaneous measurement of skin conductance responses (SCRs) was performed and the two methods applied: (a) the original approach of subtracting disadvantageous picks of Decks A and B from advantageous picks of Decks C and D and (b) a trial-based approach focused on the financial outcome for each deck leading up to the trial in question. When directly compared, the deck-based approach resulted in a more advantageous behavioral profile than did the trial-based approach. Analysis of SCR data revealed no significant differences between methods for physiological measurements of SCR fluctuations or anticipatory responses to disadvantageous picks. Post hoc investigation of the trial-based method revealed Deck B contributed to both advantageous and disadvantageous decision making for the majority of participants. When divided by blocks of 20, the number of advantageous to disadvantageous choices reversed as the task progressed despite the total number of picks from Deck B remaining high. SCR fluctuations for Deck B, although not significantly different from the other decks, did show a sharp decline after the first block of 20 and remained below levels for Decks C and D toward the end of the task, suggesting that participants may have gained knowledge of the frequency of loss for this deck. (c) 2012 APA, all rights reserved

  11. Guideline-based care of common mental disorders by occupational physicians (CO-OP study): a randomized controlled trial

    NARCIS (Netherlands)

    Rebergen, D. S.; Bruinvels, D. J.; Bezemer, P. D.; van der Beek, A. J.; van Mechelen, W.

    2009-01-01

    To evaluate the effectiveness of guideline-based care (GBC) of workers with mental health problems, which promotes counseling by the occupational physician (OP) facilitating return to work (RTW). In a randomized controlled trial with police workers on sick leave due to mental health problems (n =

  12. A Cluster Randomized Controlled Trial Testing the Effectiveness of Houvast: A Strengths-Based Intervention for Homeless Young Adults

    Science.gov (United States)

    Krabbenborg, Manon A. M.; Boersma, Sandra N.; van der Veld, William M.; van Hulst, Bente; Vollebergh, Wilma A. M.; Wolf, Judith R. L. M.

    2017-01-01

    Objective: To test the effectiveness of Houvast: a strengths-based intervention for homeless young adults. Method: A cluster randomized controlled trial was conducted with 10 Dutch shelter facilities randomly allocated to an intervention and a control group. Homeless young adults were interviewed when entering the facility and when care ended.…

  13. A web-based screening and accrual strategy for a cancer prevention clinical trial in healthy smokers.

    Science.gov (United States)

    Mohebati, Arash; Knutson, Allison; Zhou, Xi Kathy; Smith, Judith J; Brown, Powel H; Dannenberg, Andrew J; Szabo, Eva

    2012-09-01

    Screening and recruitment of qualified subjects for clinical trials is an essential component of translational research, and it can be quite challenging if the most efficient recruitment method is not utilized. In this report, we describe a successful web-based screening and accrual method used in a randomized prospective chemoprevention clinical trial with urinary biomarker endpoints. The targeted study population was a group of at-risk healthy current smokers with no evidence of lung disease. Craigslist was used as the sole recruitment modality for this study. All interested subjects were directed to a pre-screening website, in which subject questionnaire responses were linked to the study coordinator's secure e-mail account. Of the 429 initial inquiries, 189 individuals were initially eligible based on the questionnaire response. One hundred twenty-two people were telephone-screened, of whom 98 subjects were consented, 84 were randomized and 77 subjects completed the study successfully. Utilizing this single web-based advertising strategy, accrual for the trial was completed 7 months prior to the projected date. Craigslist is a cost effective and efficient web-based resource that can be utilized in accruing subjects to some chemoprevention trials. Published by Elsevier Inc.

  14. Can group-based reassuring information alter low back pain behavior? A cluster-randomized controlled trial

    DEFF Research Database (Denmark)

    Frederiksen, Pernille; Indahl, Aage; Andersen, Lars L

    2017-01-01

    -randomized controlled trial. METHODS: Publically employed workers (n = 505) from 11 Danish municipality centers were randomized at center-level (cluster) to either intervention (two 1-hour group-based talks at the workplace) or control. The talks provided reassuring information together with a simple non...

  15. Effectiveness of an internet- and app-based intervention for college students with elevated stress : Randomized controlled trial

    NARCIS (Netherlands)

    Harrer, Mathias; Adam, Sophia Helen; Fleischmann, Rebecca Jessica; Baumeister, Harald; Auerbach, Randy; Bruffaerts, Ronny; Cuijpers, Pim; Kessler, Ronald C.; Berking, Matthias; Lehr, Dirk; Ebert, David Daniel

    2018-01-01

    Background: Mental health problems are highly prevalent among college students. Most students with poor mental health, however, do not receive professional help. Internet-based self-help formats may increase the utilization of treatment. Objective: The aim of this randomized controlled trial was to

  16. A cluster randomized controlled trial testing the effectiveness of Houvast: A strengths-based intervention for homeless young adults

    NARCIS (Netherlands)

    Krabbenborg, M.A.M.; Boersma, S.N.; Veld, W.M. van der; Hulst, B. van; Vollebergh, W.A.M.; Wolf, J.R.L.M.

    2017-01-01

    Objective: To test the effectiveness of Houvast: a strengths-based intervention for homeless young adults. Method: A cluster randomized controlled trial was conducted with 10 Dutch shelter facilities randomly allocated to an intervention and a control group. Homeless young adults were interviewed

  17. Telephone-based nursing intervention improves the effectiveness of the informed consent process in cancer clinical trials

    NARCIS (Netherlands)

    Aaronson, N. K.; Visser-Pol, E.; Leenhouts, G. H.; Muller, M. J.; van der Schot, A. C.; van Dam, F. S.; Keus, R. B.; Koning, C. C.; ten Bokkel Huinink, W. W.; van Dongen, J. A.; Dubbelman, R.

    1996-01-01

    PURPOSE: Here we report the results of a randomized study undertaken to test the efficacy of a supplementary, telephone-based nursing intervention in increasing patients' awareness and understanding of the clinical trials in which they are asked to participate. METHODS: During a 12-month period, 180

  18. First Field Trial of Optical Label-Based Switching and Packet Drop on a 477km NTON/Sprint Link

    International Nuclear Information System (INIS)

    Hernandez, V J; Pan, Z; Cao, J; Tsui, V K; Bansal, Y; Fong, S K H; Zhang, Y; Jeon, M Y; Yoo, S J B; Bodtker, B; Bond, S; Lennon, W J; Higashi, H; Lyles, B; McDonald, R

    2001-01-01

    We demonstrate the first field trial of optical label-based wavelength switching and packet drop on 476.8km of the National Transparent Optical Network. Subcarrier multiplexed labels control a switch fabric that includes a tunable wavelength converter and arrayed waveguide grating router

  19. Internet-based self-management plus education compared with usual care in asthma: a randomized trial

    NARCIS (Netherlands)

    van der Meer, Victor; Bakker, Moira J.; van den Hout, Wilbert B.; Rabe, Klaus F.; Sterk, Peter J.; Kievit, Job; Assendelft, Willem J. J.; Sont, Jacob K.; Assendelft, W. J. J.; Thiadens, H. A.; Bakker, M. J.; van den Hout, W. B.; Kievit, J.; van der Meer, V.; Sont, J. K.; Kaptein, A. A.; Rikkers-Mutsaerts, E. R. V. M.; Rabe, K. F.; Bel, E. H. D.; Detmar, S. B.; Otten, W.; van Stel, H. F.; Roldaan, A. C.; de Jongste, J. C.; Toussaint, P. J.

    2009-01-01

    BACKGROUND: The Internet may support patient self-management of chronic conditions, such as asthma. OBJECTIVE: To evaluate the effectiveness of Internet-based asthma self-management. DESIGN: Randomized, controlled trial. SETTING: 37 general practices and 1 academic outpatient department in the

  20. A Randomized Controlled Trial of Acceptance-Based Behavior Therapy and Cognitive Therapy for Test Anxiety: A Pilot Study

    Science.gov (United States)

    Brown, Lily A.; Forman, Evan M.; Herbert, James D.; Hoffman, Kimberly L.; Yuen, Erica K.; Goetter, Elizabeth M.

    2011-01-01

    Many university students suffer from test anxiety that is severe enough to impair performance. Given mixed efficacy results of previous cognitive-behavior therapy (CBT) trials and a theoretically driven rationale, an acceptance-based behavior therapy (ABBT) approach was compared to traditional CBT (i.e., Beckian cognitive therapy; CT) for the…

  1. The Use of Trial-Based Functional Analysis in Public School Classrooms for Two Students with Developmental Disabilities

    Science.gov (United States)

    Rispoli, Mandy J.; Davis, Heather S.; Goodwyn, Fara D.; Camargo, Siglia

    2013-01-01

    Analogue functional analyses are a well-researched means of determining behavioral function in research and clinical contexts. However, conducting analogue functional analyses in school settings can be problematic and may lead to inconclusive results. The purpose of this study was to compare the results of a trial-based functional analysis with…

  2. Teacher Implementation of Trial-Based Functional Analysis and Differential Reinforcement of Alternative Behavior for Students with Challenging Behavior

    Science.gov (United States)

    Flynn, Susan D.; Lo, Ya-yu

    2016-01-01

    The purpose of this study was to examine the effects of a training package on three middle school special education teachers' accurate implementation of trial-based functional analysis (TBFA) and differential reinforcement of alternative behavior (DRA) with their students with autism spectrum disorders or emotional and behavioral disorders in the…

  3. Efficacy of an internet-based problem-solving training for teachers: results of a randomized controlled trial

    NARCIS (Netherlands)

    Ebert, D.D.; Lehr, D.; BoB, L.; Riper, H.; Cuijpers, P.; Andersson, G.; Thiart, H.; Heber, E.; Berking, M.

    2014-01-01

    Objective The primary purpose of this randomized controlled trial (RCT) was to evaluate the efficacy of internet-based problem-solving training (iPST) for employees in the educational sector (teachers) with depressive symptoms. The results of training were compared to those of a waitlist control

  4. Effectiveness of a Web-Based Intervention to Reduce Alcohol Consumption among French Hazardous Drinkers: A Randomized Controlled Trial

    Science.gov (United States)

    Guillemont, Juliette; Cogordan, Chloé; Nalpas, Bertrand; Nguyen-Thanh, Vi?t; Richard, Jean-Baptiste; Arwidson, Pierre

    2017-01-01

    This study aims to evaluate the effectiveness of a web-based intervention to reduce alcohol consumption among hazardous drinkers. A two-group parallel randomized controlled trial was conducted among adults identified as hazardous drinkers according to the Alcohol Use Disorders Identification Test. The intervention delivers personalized normative…

  5. Is the Generally Held View That Intravenous Dihydroergotamine Is Effective in Migraine Based on Wrong "General Consensus" of One Trial?

    DEFF Research Database (Denmark)

    Bekan, Goran; Tfelt-Hansen, Peer

    2016-01-01

    BACKGROUND: The claim that parenteral dihydroergotamine (DHE) is effective in migraine is based on one randomized, placebo-controlled, crossover trial from 1986. The aim of this review was to critically evaluate the original article. It was also found to be of interest to review quotes concerning...

  6. Community-based asthma care: trial of a "credit card" asthma self-management plan.

    Science.gov (United States)

    D'Souza, W; Crane, J; Burgess, C; Te Karu, H; Fox, C; Harper, M; Robson, B; Howden-Chapman, P; Crossland, L; Woodman, K

    1994-07-01

    Although asthma self-management plans are widely recommended as essential in the long-term treatment of adult asthma, there have been few studies examining their use. Our objective was to assess the effect of a "credit card" adult asthma self-management plan in a community experiencing major health problems from asthma, by means of a before and after intervention trial of the efficacy of the "credit card" plan, when introduced through community-based asthma clinics. The participants were 69 Maori people with asthma. The "credit card" plan consisted of written guidelines for the self-management of asthma, based on self-assessment of asthma severity, printed on a plastic card. On one side, management guidelines were based on the interpretation of peak expiratory flow rate (PEFR) recordings, whilst the reverse side was based on symptoms. The outcome measures used were before and after comparison of markers of asthma morbidity and requirement for acute medical treatment; and a structured questionnaire assessing the acceptability and use of the credit card plan. Following the introduction of the plan, the mean PEFR increased from 347 to 389 l.min-1, the percentage of nights woken fell from 30.4 to 16.9%, and the number of days "out of action" fell from 3.8 to 1.7%. The requirements for acute medical treatment also fell during the intervention period. Most participants commented favourably on the content and usefulness of the plan. In the situation of worsening asthma, 28% of subjects found the peak flow side of the card most helpful, 7% the symptoms side, and 48% found both sides equally helpful.(ABSTRACT TRUNCATED AT 250 WORDS)

  7. A Community-Based IoT Personalized Wireless Healthcare Solution Trial.

    Science.gov (United States)

    Catherwood, Philip A; Steele, David; Little, Mike; Mccomb, Stephen; Mclaughlin, James

    2018-01-01

    This paper presents an advanced Internet of Things point-of-care bio-fluid analyzer; a LoRa/Bluetooth-enabled electronic reader for biomedical strip-based diagnostics system for personalized monitoring. We undertake test simulations (technology trial without patient subjects) to demonstrate potential of long-range analysis, using a disposable test 'key' and companion Android app to form a diagnostic platform suitable for remote point-of-care screening for urinary tract infection (UTI). The 868 MHz LoRaWAN-enabled personalized monitor demonstrated sound potential with UTI test results being correctly diagnosed and transmitted to a remote secure cloud server in every case. Tests ranged over distances of 1.1-6.0 Km with radio path losses from 119-141 dB. All tests conducted were correctly and robustly received at the base station and relayed to the secure server for inspection. The UTI test strips were visually inspected for correct diagnosis based on color change and verified as 100% accurate. Results from testing across a number of regions indicate that such an Internet of Things medical solution is a robust and simple way to deliver next generation community-based smart diagnostics and disease management to best benefit patients and clinical staff alike. This significant step can be applied to any type of home or region, particularly those lacking suitable mobile signals, broadband connections, or even landlines. It brings subscription-free long-range bio-telemetry to healthcare providers and offers savings on regular clinician home visits or frequent clinic visits by the chronically ill. This paper highlights practical hurdles in establishing an Internet of Medical Things network, assisting informed deployment of similar future systems.

  8. Case-based learning and simulation: useful tools to enhance nurses' education? Nonrandomized controlled trial.

    Science.gov (United States)

    Raurell-Torredà, Marta; Olivet-Pujol, Josep; Romero-Collado, Àngel; Malagon-Aguilera, Maria Carmen; Patiño-Masó, Josefina; Baltasar-Bagué, Alícia

    2015-01-01

    To compare skills acquired by undergraduate nursing students enrolled in a medical-surgical course. To compare skills demonstrated by students with no previous clinical practice (undergraduates) and nurses with clinical experience enrolled in continuing professional education (CPE). In a nonrandomized clinical trial, 101 undergraduates enrolled in the "Adult Patients 1" course were assigned to the traditional lecture and discussion (n = 66) or lecture and discussion plus case-based learning (n = 35) arm of the study; 59 CPE nurses constituted a comparison group to assess the effects of previous clinical experience on learning outcomes. Scores on an objective structured clinical examination (OSCE), using a human patient simulator and cases validated by the National League for Nursing, were compared for the undergraduate control and intervention groups, and for CPE nurses (Student's t test). Controls scored lower than the intervention group on patient assessment (6.3 ± 2.3 vs 7.5 ± 1.4, p = .04, mean difference, -1.2 [95% confidence interval (CI) -2.4 to -0.03]) but the intervention group did not differ from CPE nurses (7.5 ± 1.4 vs 8.8 ± 1.5, p = .06, mean difference, -1.3 [95% CI -2.6 to 0.04]). The CPE nurses committed more "rules-based errors" than did undergraduates, specifically patient identifications (77.2% vs 55%, p = .7) and checking allergies before administering medication (68.2% vs 60%, p = .1). The intervention group developed better patient assessment skills than the control group. Case-based learning helps to standardize the process, which can contribute to quality and consistency in practice: It is essential to correctly identify a problem in order to treat it. Clinical experience of CPE nurses was not associated with better adherence to safety protocols. Case-based learning improves the patient assessment skills of undergraduate nursing students, thereby preparing them for clinical practice. © 2014 Sigma Theta Tau International.

  9. Effects of web-based interventions on cancer patients' symptoms: review of randomized trials.

    Science.gov (United States)

    Fridriksdottir, N; Gunnarsdottir, S; Zoëga, S; Ingadottir, B; Hafsteinsdottir, E J G

    2018-02-01

    Symptom management is of high priority in cancer care. Information and communication technology allows interventions to be provided through the internet to enhance the delivery of care. This study aimed to review the effects of web-based interventions on cancer patients' symptoms. MEDLINE, PSychINFO, PubMed, CINAHL, and Cochrane databases were systematically searched. Included were randomized controlled trials (RCTs), pilot RCTs, or quasi-experimental (QE) studies focusing on web-based interventions in adult cancer patients with at least one outcome primary or secondary, in terms of symptoms, treatment side effects, or distress. Data were analyzed study by study. Twenty studies were identified. All web interventions included information, 16 included self-management support, 14 included self-monitoring, 13 included feedback/tailored information, 12 used communication with health-care professionals, and eight used communication with other patients. Overall, 13 studies reported positive symptom outcomes. Psychological distress was reported in eight studies with positive intervention effects in three. Symptoms of anxiety/depression were reported in ten studies with positive intervention effects in five. Somatic symptom severity was reported in ten studies with intervention effects found in six, and symptom distress was reported in six studies with intervention effects found in all. This review shows the promising potential of web-based interventions for cancer symptom management, although it was limited by considerable heterogeneity in the interventions tested and targeted outcomes. The multidimensional nature of symptoms was partly addressed; only one study was guided by a comprehensive theoretical model of cancer symptom management. It can only be speculated which web elements are important for effective symptom outcomes. Further testing is needed for web-based cancer symptom management.

  10. Randomized clinical trial of Appendicitis Inflammatory Response score-based management of patients with suspected appendicitis.

    Science.gov (United States)

    Andersson, M; Kolodziej, B; Andersson, R E

    2017-10-01

    The role of imaging in the diagnosis of appendicitis is controversial. This prospective interventional study and nested randomized trial analysed the impact of implementing a risk stratification algorithm based on the Appendicitis Inflammatory Response (AIR) score, and compared routine imaging with selective imaging after clinical reassessment. Patients presenting with suspicion of appendicitis between September 2009 and January 2012 from age 10 years were included at 21 emergency surgical centres and from age 5 years at three university paediatric centres. Registration of clinical characteristics, treatments and outcomes started during the baseline period. The AIR score-based algorithm was implemented during the intervention period. Intermediate-risk patients were randomized to routine imaging or selective imaging after clinical reassessment. The baseline period included 1152 patients, and the intervention period 2639, of whom 1068 intermediate-risk patients were randomized. In low-risk patients, use of the AIR score-based algorithm resulted in less imaging (19·2 versus 34·5 per cent; P appendicitis (6·8 versus 9·7 per cent; P = 0·034). Intermediate-risk patients randomized to the imaging and observation groups had the same proportion of negative appendicectomies (6·4 versus 6·7 per cent respectively; P = 0·884), number of admissions, number of perforations and length of hospital stay, but routine imaging was associated with an increased proportion of patients treated for appendicitis (53·4 versus 46·3 per cent; P = 0·020). AIR score-based risk classification can safely reduce the use of diagnostic imaging and hospital admissions in patients with suspicion of appendicitis. Registration number: NCT00971438 ( http://www.clinicaltrials.gov). © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

  11. Explaining the effects of an intervention designed to promote evidence-based diabetes care: a theory-based process evaluation of a pragmatic cluster randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Kaner Eileen FS

    2008-11-01

    Full Text Available Abstract Background The results of randomised controlled trials can be usefully illuminated by studies of the processes by which they achieve their effects. The Theory of Planned Behaviour (TPB offers a framework for conducting such studies. This study used TPB to explore the observed effects in a pragmatic cluster randomised controlled trial of a structured recall and prompting intervention to increase evidence-based diabetes care that was conducted in three Primary Care Trusts in England. Methods All general practitioners and nurses in practices involved in the trial were sent a postal questionnaire at the end of the intervention period, based on the TPB (predictor variables: attitude; subjective norm; perceived behavioural control, or PBC. It focussed on three clinical behaviours recommended in diabetes care: measuring blood pressure; inspecting feet; and prescribing statins. Multivariate analyses of variance and multiple regression analyses were used to explore changes in cognitions and thereby better understand trial effects. Results Fifty-nine general medical practitioners and 53 practice nurses (intervention: n = 55, 41.98% of trial participants; control: n = 57, 38.26% of trial participants completed the questionnaire. There were no differences between groups in mean scores for attitudes, subjective norms, PBC or intentions. Control group clinicians had 'normatively-driven' intentions (i.e., related to subjective norm scores, whereas intervention group clinicians had 'attitudinally-driven' intentions (i.e., related to attitude scores for foot inspection and statin prescription. After controlling for effects of the three predictor variables, this group difference was significant for foot inspection behaviour (trial group × attitude interaction, beta = 0.72, p Conclusion Attitudinally-driven intentions are proposed to be more consistently translated into action than normatively-driven intentions. This proposition was supported by the

  12. Collaborative community based care for people and their families living with schizophrenia in India: protocol for a randomised controlled trial.

    Science.gov (United States)

    Chatterjee, Sudipto; Leese, Morven; Koschorke, Mirja; McCrone, Paul; Naik, Smita; John, Sujit; Dabholkar, Hamid; Goldsmith, Kimberley; Balaji, Madhumitha; Varghese, Mathew; Thara, Rangaswamy; Patel, Vikram; Thornicroft, Graham

    2011-01-13

    There is a large treatment gap with few community services for people with schizophrenia in low income countries largely due to the shortage of specialist mental healthcare human resources. Community based rehabilitation (CBR), involving lay health workers, has been shown to be feasible, acceptable and more effective than routine care for people with schizophrenia in observational studies. The aim of this study is to evaluate whether a lay health worker led, Collaborative Community Based Care (CCBC) intervention, combined with usual Facility Based Care (FBC), is superior to FBC alone in improving outcomes for people with schizophrenia and their caregivers in India. This trial is a multi-site, parallel group randomised controlled trial design in India.The trial will be conducted concurrently at three sites in India where persons with schizophrenia will be screened for eligibility and recruited after providing informed consent. Trial participants will be randomly allocated in a 2:1 ratio to the CCBC+FBC and FBC arms respectively using an allocation sequence pre-prepared through the use of permuted blocks, stratified within site. The structured CCBC intervention will be delivered by trained lay community health workers (CHWs) working together with the treating Psychiatrist. We aim to recruit 282 persons with schizophrenia. The primary outcomes are reduction in severity of symptoms of schizophrenia and disability at 12 months. The study will be conducted according to good ethical practice, data analysis and reporting guidelines. If the additional CCBC intervention delivered by front line CHWs is demonstrated to be effective and cost-effective in comparison to usually available care, this intervention can be scaled up to expand coverage and improve outcomes for persons with schizophrenia and their caregivers in low income countries. The trial is registered with the International Society for the Registration of Clinical Trials and the allocated unique ID number is ISRCTN

  13. School-based suicide prevention programmes: the SEYLE cluster-randomised, controlled trial.

    Science.gov (United States)

    Wasserman, Danuta; Hoven, Christina W; Wasserman, Camilla; Wall, Melanie; Eisenberg, Ruth; Hadlaczky, Gergö; Kelleher, Ian; Sarchiapone, Marco; Apter, Alan; Balazs, Judit; Bobes, Julio; Brunner, Romuald; Corcoran, Paul; Cosman, Doina; Guillemin, Francis; Haring, Christian; Iosue, Miriam; Kaess, Michael; Kahn, Jean-Pierre; Keeley, Helen; Musa, George J; Nemes, Bogdan; Postuvan, Vita; Saiz, Pilar; Reiter-Theil, Stella; Varnik, Airi; Varnik, Peeter; Carli, Vladimir

    2015-04-18

    Suicidal behaviours in adolescents are a major public health problem and evidence-based prevention programmes are greatly needed. We aimed to investigate the efficacy of school-based preventive interventions of suicidal behaviours. The Saving and Empowering Young Lives in Europe (SEYLE) study is a multicentre, cluster-randomised controlled trial. The SEYLE sample consisted of 11,110 adolescent pupils, median age 15 years (IQR 14-15), recruited from 168 schools in ten European Union countries. We randomly assigned the schools to one of three interventions or a control group. The interventions were: (1) Question, Persuade, and Refer (QPR), a gatekeeper training module targeting teachers and other school personnel, (2) the Youth Aware of Mental Health Programme (YAM) targeting pupils, and (3) screening by professionals (ProfScreen) with referral of at-risk pupils. Each school was randomly assigned by random number generator to participate in one intervention (or control) group only and was unaware of the interventions undertaken in the other three trial groups. The primary outcome measure was the number of suicide attempt(s) made by 3 month and 12 month follow-up. Analysis included all pupils with data available at each timepoint, excluding those who had ever attempted suicide or who had shown severe suicidal ideation during the 2 weeks before baseline. This study is registered with the German Clinical Trials Registry, number DRKS00000214. Between Nov 1, 2009, and Dec 14, 2010, 168 schools (11,110 pupils) were randomly assigned to interventions (40 schools [2692 pupils] to QPR, 45 [2721] YAM, 43 [2764] ProfScreen, and 40 [2933] control). No significant differences between intervention groups and the control group were recorded at the 3 month follow-up. At the 12 month follow-up, YAM was associated with a significant reduction of incident suicide attempts (odds ratios [OR] 0·45, 95% CI 0·24-0·85; p=0·014) and severe suicidal ideation (0·50, 0·27-0·92; p=0·025

  14. Global reach: Red Deer oilfield expertise, not least in taming disasters, lures international clientele

    Energy Technology Data Exchange (ETDEWEB)

    Lorenz, A.

    2002-10-07

    The rise to international prominence of two Red Deer, Alberta, firms --Safety Boss and Red Flame -- by performing heroic feats in Kuwait's flaming oil fields, are chronicled. These two firms, along with several others in Red Deer, provide expertise in fire fighting that is sought after by petroleum companies in the farthest corners of the world. Red Deer companies can be found training Kazakhs, Russians, Kuwaitis, Iranians, and Turkmen in fighting oil well fires. Red Flame, for example developed a method called 'hot-tapping' while fighting blazing oil well fires in Kuwait, which they have since extended by developing hot-tapping equipment that would work on the highest pressure wells in the world. Last summer Red Flame personnel trained a Schlumberger crew in Kazakhstan working on custom-designed equipment that could perform at pressures of 5,000 psi. Red Flame also designed 'extended reach' hot-tapping in response to a request from Petro-Canada. Meanwhile, Safety Boss, the oldest and best known oil well fire fighting company in Canada, boasts of having extinguished 180 wells in their 1991 stint in Kuwait, while their closest competitor, Texas-based Wild Well, doused only 117. With improved safety policies and procedures the number of oil well blow-outs diminished dramatically in recent years, but there are always opportunities for the Red Deer expertise somewhere around the world.

  15. Harnessing private sector expertise to improve complementary feeding within a regulatory framework: Where is the evidence?

    Science.gov (United States)

    van Liere, Marti J; Tarlton, Dessie; Menon, Ravi; Yellamanda, M; Reerink, Ietje

    2017-10-01

    Global recognition that the complex and multicausal problems of malnutrition require all players to collaborate and to invest towards the same objective has led to increased private sector engagement as exemplified through the Scaling Up Nutrition Business Network and mechanisms for blended financing and matched funding, such as the Global Nutrition for Growth Compact. The careful steps made over the past 5 to 10 years have however not taken away or reduced the hesitation and scepticism of the public sector actors towards commercial or even social businesses. Evidence of impact or even a positive contribution of a private sector approach to intermediate nutrition outcomes is still lacking. This commentary aims to discuss the multiple ways in which private sector can leverage its expertise to improve nutrition in general, and complementary feeding in particular. It draws on specific lessons learned in Bangladesh, Côte d'Ivoire, India, Indonesia, and Madagascar on how private sector expertise has contributed, within the boundaries of a regulatory framework, to improve availability, accessibility, affordability, and adequate use of nutritious foods. It concludes that a solid evidence base regarding the contribution of private sector to complementary feeding is still lacking and that the development of a systematic learning agenda is essential to make progress in the area of private sector engagement in nutrition. © 2017 John Wiley & Sons Ltd.

  16. Neurology expertise and postgraduate training programmes in the Arab world: a survey.

    Science.gov (United States)

    Benamer, Hani T S

    2010-01-01

    Neurological disorders are increasingly recognised as a major public health problem, especially in the developing world. Having adequate neurology expertise to tackle this issue is essential. A 17-item survey was conducted to gather information about the number, training and location of neurologists and supportive facilities available to them in the 16 middle- and high-income Arab countries. Data about the availability of postgraduate training programmes was collected. Surveys were returned from all targeted countries. The population per neurologist ranges from 35,000 to just over two million, and the most neurologists are based in large cities. Most of the practising neurologists had received extensive training in neurology and/or passed specialty exams. The majority had all or part of their training abroad. Neuro-radiological and neuro-physiological investigations are generally available in most surveyed countries but neuro-genetics and neuro-immunology services are lacking. Neurology training programmes are available in ten Arab countries with a total of 504-524 trainees. The availability of neurologists, supportive services and training programmes varies between Arab countries. Further development of neurology expertise and local training programmes are needed. Copyright 2010 S. Karger AG, Basel.

  17. Behavioral and subcortical signatures of musical expertise in Mandarin Chinese speakers.

    Directory of Open Access Journals (Sweden)

    Caitlin Dawson

    Full Text Available Both musical training and native language have been shown to have experience-based plastic effects on auditory processing. However, the combined effects within individuals are unclear. Recent research suggests that musical training and tone language speaking are not clearly additive in their effects on processing of auditory features and that there may be a disconnect between perceptual and neural signatures of auditory feature processing. The literature has only recently begun to investigate the effects of musical expertise on basic auditory processing for different linguistic groups. This work provides a profile of primary auditory feature discrimination for Mandarin speaking musicians and nonmusicians. The musicians showed enhanced perceptual discrimination for both frequency and duration as well as enhanced duration discrimination in a multifeature discrimination task, compared to nonmusicians. However, there were no differences between the groups in duration processing of nonspeech sounds at a subcortical level or in subcortical frequency representation of a nonnative tone contour, for fo or for the first or second formant region. The results indicate that musical expertise provides a cognitive, but not subcortical, advantage in a population of Mandarin speakers.

  18. Sources of expertise in transportation planning, management, and operations: Information received as of September 25, 1987

    International Nuclear Information System (INIS)

    1987-01-01

    The DOE Office of Storage and Transportation Systems is responsible for the development and management of a transportation system to provide all the necessary services for the transportation of the spent fuel and wastes from reactor sites to repositories. DOE/ORO has requested Oak Ridge Associated Universities (ORAU) to assist DOE in developing rosters of sources of transportation expertise in: (1) carrier operations; (2) transportation management, planning, and logistics; (3) transportation equipment; (4) transportation facilities design and operation; (5) vehicle safety; and (6) transportation operations quality assurance; as related to truck, rail, barge, and intermodal transportation. Persons or organizations with experience in shipping of non-hazardous materials, spent nuclear fuel, other radioactive materials, and/or other hazardous materials were included in the information system. A mailed inquiry was sent to over 2300 potential sources of transportation expertise. Responses were received from 207 persons and 254 organizations. Section 1 contains the identification numbers of the individuals and organizations that responded. Section 2 contains identification codes, names, addresses, and phone numbers of each of the individual and organization respondents. The reader can refer to Section 2 for the name and address of the respondents for the identification codes listed for each technical area/experience base in Section 1

  19. My Team of Care Study: A Pilot Randomized Controlled Trial of a Web-Based Communication Tool for Collaborative Care in Patients With Advanced Cancer.

    Science.gov (United States)

    Voruganti, Teja; Grunfeld, Eva; Jamieson, Trevor; Kurahashi, Allison M; Lokuge, Bhadra; Krzyzanowska, Monika K; Mamdani, Muhammad; Moineddin, Rahim; Husain, Amna

    2017-07-18

    The management of patients with complex care needs requires the expertise of health care providers from multiple settings and specialties. As such, there is a need for cross-setting, cross-disciplinary solutions that address deficits in communication and continuity of care. We have developed a Web-based tool for clinical collaboration, called Loop, which assembles the patient and care team in a virtual space for the purpose of facilitating communication around care management. The objectives of this pilot study were to evaluate the feasibility of integrating a tool like Loop into current care practices and to capture preliminary measures of the effect of Loop on continuity of care, quality of care, symptom distress, and health care utilization. We conducted an open-label pilot cluster randomized controlled trial allocating patients with advanced cancer (defined as stage III or IV disease) with ≥3 months prognosis, their participating health care team and caregivers to receive either the Loop intervention or usual care. Outcome data were collected from patients on a monthly basis for 3 months. Trial feasibility was measured with rate of uptake, as well as recruitment and system usage. The Picker Continuity of Care subscale, Palliative care Outcomes Scale, Edmonton Symptom Assessment Scale, and Ambulatory and Home Care Record were patient self-reported measures of continuity of care, quality of care, symptom distress, and health services utilization, respectively. We conducted a content analysis of messages posted on Loop to understand how the system was used. Nineteen physicians (oncologists or palliative care physicians) were randomized to the intervention or control arms. One hundred twenty-seven of their patients with advanced cancer were approached and 48 patients enrolled. Of 24 patients in the intervention arm, 20 (83.3%) registered onto Loop. In the intervention and control arms, 12 and 11 patients completed three months of follow-up, respectively. A mean

  20. Establishing Evidence-Based Indications for Proton Therapy: An Overview of Current Clinical Trials

    Energy Technology Data Exchange (ETDEWEB)

    Mishra, Mark V., E-mail: mmishra@umm.edu [Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland (United States); Aggarwal, Sameer [Department of Internal Medicine, University of Maryland School of Medicine, Baltimore, Maryland (United States); Bentzen, Soren M. [Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland (United States); Knight, Nancy [Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland (United States); Mehta, Minesh P. [Miami Cancer Institute at Baptist Health South Florida, Miami, Florida (United States); Regine, William F. [Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland (United States)

    2017-02-01

    Purpose: To review and assess ongoing proton beam therapy (PBT) clinical trials and to identify major gaps. Methods and Materials: Active PBT clinical trials were identified from (clinicaltrials.gov) and the World Health Organization International Clinical Trials Platform Registry. Data on clinical trial disease site, age group, projected patient enrollment, expected start and end dates, study type, and funding source were extracted. Results: A total of 122 active PBT clinical trials were identified, with target enrollment of >42,000 patients worldwide. Ninety-six trials (79%), with a median planned sample size of 68, were classified as interventional studies. Observational studies accounted for 21% of trials but 71% (n=29,852) of planned patient enrollment. The most common PBT clinical trials focus on gastrointestinal tract tumors (21%, n=26), tumors of the central nervous system (15%, n=18), and prostate cancer (12%, n=15). Five active studies (lung, esophagus, head and neck, prostate, breast) will randomize patients between protons and photons, and 3 will randomize patients between protons and carbon ion therapy. Conclusions: The PBT clinical trial portfolio is expanding rapidly. Although the majority of ongoing studies are interventional, the majority of patients will be accrued to observational studies. Future efforts should focus on strategies to encourage optimal patient enrollment and retention, with an emphasis on randomized, controlled trials, which will require support from third-party payers. Results of ongoing PBT studies should be evaluated in terms of comparative effectiveness, as well as incremental effectiveness and value offered by PBT in comparison with conventional radiation modalities.

  1. Early intervention of multiple home visits to prevent childhood obesity in a disadvantaged population: a home-based randomised controlled trial (Healthy Beginnings Trial

    Directory of Open Access Journals (Sweden)

    Alperstein Garth

    2007-05-01

    Full Text Available Abstract Background Studies have shown that a proportion of children as young as two years are already overweight. This indicates that obesity prevention programs that commence as early as possible and are family-focused are needed. This Healthy Beginnings Trial aims to determine the efficacy of a community-based randomized controlled trial (RCT of a home visiting intervention in preventing the early onset of childhood overweight and obesity. The intervention will be conducted over the first two years of life to increase healthy feeding behaviours and physical activity, decrease physical inactivity, enhance parent-child interaction, and hence reduce overweight and obesity among children at 2 and 5 years of age in the most socially and economically disadvantaged areas of Sydney, Australia. Methods/design This RCT will be conducted with a consecutive sample of 782 first time mothers with their newborn children. Pregnant women who are expecting their first child, and who are between weeks 24 and 34 of their pregnancy, will be invited to participate in the trial at the antenatal clinic. Informed consent will be obtained and participants will then be randomly allocated to the intervention or the control group. The allocation will be concealed by sequentially numbered, sealed opaque envelopes containing a computer generated random number. The intervention comprises eight home visits from a specially trained community nurse over two years and pro-active telephone support between the visits. Main outcomes include a duration of breastfeeding measured at 6 and 12 months, b introduction of solids measured at 4 and 6 months, c nutrition, physical activity and television viewing measured at 24 months, and d overweight/obesity status at age 2 and 5 years. Discussion The results of this trial will ascertain whether the home based early intervention is effective in preventing the early onset of childhood overweight and obesity. If proved to be effective, it

  2. A community-based cluster randomised trial of safe storage to reduce pesticide self-poisoning in rural Sri Lanka

    DEFF Research Database (Denmark)

    Pearson, Melissa; Konradsen, Flemming; Gunnell, David

    2011-01-01

    . One approach to reducing access to pesticides is for households to store pesticides in lockable "safe-storage" containers. However, before this approach can be promoted, evidence is required on its effectiveness and safety. Methods/Design A community-based cluster randomised controlled trial has been...... at the 5% significance level. Secondary outcomes will include the incidence of all pesticide poisoning and total self-harm. Discussion This paper describes a large effectiveness study of a community intervention to reduce the burden of intentional poisoning in rural Sri Lanka. The study builds on a strong...... partnership between provincial health services, local and international researchers, and local communities. We discuss issues in relation to randomisation and contamination, engaging control villages, the intervention, and strategies to improve adherence. Trial Registritation The trial is registered...

  3. Community-based peer-led diabetes self-management: a randomized trial.

    Science.gov (United States)

    Lorig, Kate; Ritter, Philip L; Villa, Frank J; Armas, Jean

    2009-01-01

    The purpose of this study is to determine the effectiveness of a community-based diabetes self-management program comparing treatment participants to a randomized usual-care control group at 6 months. A total of 345 adults with type 2 diabetes but no criteria for high A1C were randomized to a usual-care control group or 6-week community-based, peer-led diabetes self-management program (DSMP). Randomized participants were compared at 6 months. The DSMP intervention participants were followed for an additional 6 months (12 months total). A1C and body mass index were measured at baseline, 6 months, and 12 months. All other data were collected by self-administered questionnaires. At 6 months, DSMP participants did not demonstrate improvements in A1C as compared with controls. Baseline A1C was much lower than in similar trials. Participants did have significant improvements in depression, symptoms of hypoglycemia, communication with physicians, healthy eating, and reading food labels (P < .01). They also had significant improvements in patient activation and self-efficacy. At 12 months, DSMP intervention participants continued to demonstrate improvements in depression, communication with physicians, healthy eating, patient activation, and self-efficacy (P < .01). There were no significant changes in utilization measures. These findings suggest that people with diabetes without elevated A1C can benefit from a community-based, peer-led diabetes program. Given the large number of people with diabetes and lack of low-cost diabetes education, the DSMP deserves consideration for implementation.

  4. A school-based randomized controlled trial to improve physical activity among Iranian high school girls

    Directory of Open Access Journals (Sweden)

    Ghofranipour Fazloalha

    2008-04-01

    Full Text Available Abstract Background Physical activity (PA rates decline precipitously during the high school years and are consistently lower among adolescent girls than adolescent boys. Due to cultural barriers, this problem might be exacerbated in female Iranian adolescents. However, little intervention research has been conducted to try to increase PA participation rates with this population. Because PA interventions in schools have the potential to reach many children and adolescents, this study reports on PA intervention research conducted in all-female Iranian high schools. Methods A randomized controlled trial was conducted to examine the effects of two six-month tailored interventions on potential determinants of PA and PA behavior. Students (N = 161 were randomly allocated to one of three conditions: an intervention based on Pender's Health Promotion model (HP, an intervention based on an integration of the health promotion model and selected constructs from the Transtheoretical model (THP, and a control group (CON. Measures were administered prior to the intervention, at post-intervention and at a six-month follow-up. Results Repeated measure ANOVAs showed a significant interaction between group and time for perceived benefits, self efficacy, interpersonal norms, social support, behavioral processes, and PA behavior, indicating that both intervention groups significantly improved across the 24-week intervention, whereas the control group did not. Participants in the THP group showed greater use of counter conditioning and stimulus control at post-intervention and at follow-up. While there were no significant differences in PA between the HP and CON groups at follow-up, a significant difference was still found between the THP and the CON group. Conclusion This study provides the first evidence of the effectiveness of a PA intervention based on Pender's HP model combined with selected aspects of the TTM on potential determinants to increase PA among

  5. More explicit communication after classroom-based crew resource management training: results of a pragmatic trial.

    Science.gov (United States)

    Verbeek-van Noord, Inge; de Bruijne, Martine C; Twisk, Jos W R; van Dyck, Cathy; Wagner, Cordula

    2015-02-01

    Aviation-based crew resource management trainings to optimize non-technical skills among professionals are often suggested for health care as a way to increase patient safety. Our aim was to evaluate the effect of a 2-day classroom-based crew resource management (CRM) training at emergency departments (EDs) on explicit professional oral communication (EPOC; non-technical skills). A pragmatic controlled before-after trial was conducted. Four EDs of general teaching hospitals were recruited (two intervention and two control departments). ED nurses and ED doctors were observed on their non-technical skills by means of a validated observation tool (EPOC). Our main outcome measure was the amount of EPOC observed per interaction in 30 minutes direct observations. Three outcome measures from EPOC were analysed: human interaction, anticipation on environment and an overall EPOC score. Linear and logistic mixed model analyses were performed. Models were corrected for the outcome measurement at baseline, days between training and observation, patient safety culture and error management culture at baseline. A statistically significant increase after the training was found on human interaction (β=0.27, 95% CI 0.08-0.49) and the overall EPOC score (β=0.25, 95% CI 0.06-0.43), but not for anticipation on environment (OR=1.19, 95% CI .45-3.15). This means that approximately 25% more explicit communication was shown after CRM training. We found an increase in the use of CRM skills after classroom-based crew resource management training. This study adds to the body of evidence that CRM trainings have the potential to increase patient safety by reducing communication flaws, which play an important role in health care-related adverse events. © 2014 John Wiley & Sons, Ltd.

  6. Challenges in conducting a community-based influenza vaccine trial in a rural community in northern India.

    Science.gov (United States)

    Kumar, Rakesh; Amarchand, Ritvik; Narayan, Venkatesh Vinayak; Saha, Siddhartha; Lafond, Kathryn E; Kapoor, Suresh K; Dar, Lalit; Jain, Seema; Krishnan, Anand

    2018-04-04

    Evidence on influenza vaccine effectiveness from low and middle countries (LMICs) is limited due to limited institutional capacities; lack of adequate resources; and lack of interest by ministries of health for influenza vaccine introduction. There are concerns that the highest ethical standards will be compromised during trials in LMICs leading to mistrust of clinical trials. These factors pose regulatory and operational challenges to researchers in these countries. We conducted a community-based vaccine trial to assess the efficacy of live attenuated influenza vaccine and inactivated influenza vaccine in rural north India. Key regulatory challenges included obtaining regulatory approvals, reporting of adverse events, and compensating subjects for trial-related injuries; all of which were required to be completed in a timely fashion. Key operational challenges included obtaining audio-visual consent; maintaining a low attrition rate; and administering vaccines during a narrow time period before the influenza season, and under extreme heat. We overcame these challenges through advanced planning, and sustaining community engagement. We adapted the trial procedures to cope with field conditions by conducting mock vaccine camps; and planned for early morning vaccination to mitigate threats to the cold chain. These lessons may help investigators to confront similar challenges in other LMICs.

  7. Study protocol for the evaluation of an Infant Simulator based program delivered in schools: a pragmatic cluster randomised controlled trial.

    Science.gov (United States)

    Brinkman, Sally A; Johnson, Sarah E; Lawrence, David; Codde, James P; Hart, Michael B; Straton, Judith A Y; Silburn, Sven

    2010-10-21

    This paper presents the study protocol for a pragmatic randomised controlled trial to evaluate the impact of a school based program developed to prevent teenage pregnancy. The program includes students taking care of an Infant Simulator; despite growing popularity and an increasing global presence of such programs, there is no published evidence of their long-term impact. The aim of this trial is to evaluate the Virtual Infant Parenting (VIP) program by investigating pre-conceptual health and risk behaviours, teen pregnancy and the resultant birth outcomes, early child health and maternal health. Fifty-seven schools (86% of 66 eligible secondary schools) in Perth, Australia were recruited to the clustered (by school) randomised trial, with even randomisation to the intervention and control arms. Between 2003 and 2006, the VIP program was administered to 1,267 participants in the intervention schools, while 1,567 participants in the non-intervention schools received standard curriculum. Participants were all female and aged between 13-15 years upon recruitment. Pre and post-intervention questionnaires measured short-term impact and participants are now being followed through their teenage years via data linkage to hospital medical records, abortion clinics and education records. Participants who have a live birth are interviewed by face-to-face interview. Kaplan-Meier survival analysis and proportional hazards regression will test for differences in pregnancy, birth and abortion rates during the teenage years between the study arms. This protocol paper provides a detailed overview of the trial design as well as initial results in the form of participant flow. The authors describe the intervention and its delivery within the natural school setting and discuss the practical issues in the conduct of the trial, including recruitment. The trial is pragmatic and will directly inform those who provide Infant Simulator based programs in school settings. ISRCTN24952438.

  8. Effect of an Automated Training Presentation on Pre-Service Behavior Analysts' Implementation of Trial-Based Functional Analysis

    Science.gov (United States)

    Lambert, Joseph M.; Lloyd, Blair P.; Staubitz, Johanna L.; Weaver, Emily S.; Jennings, Chelsea M.

    2014-01-01

    The trial-based functional analysis (FA) is a useful alternative to the traditional FA in contexts in which it is challenging to establish environmental control for extended periods of time. Previous researchers have demonstrated that others can be trained to conduct trial-based FAs with high procedural fidelity by providing a didactic…

  9. The post-accident nuclear issue: the new crisis expertise challenges for the IRSN

    International Nuclear Information System (INIS)

    Champion, D.

    2010-01-01

    The author reports the work performed by two work groups conducted by the IRSN (the French Radioprotection and Nuclear Safety Institute), the first one on the issue of assessment of radiological and dosimetric consequences in a post-accident situation, and the second one on hypotheses to be used to perform predictive assessments of these consequences. First dealing with the end of the emergency phase, he describes how to anticipate actions of protection against immediate post-accident consequences: orientation of the expertise strategy based on the CODIRPA's doctrine, post-accident zoning based on predictive indicators, use of reasonably prudent hypotheses for the first predictive assessments, importance of initial radioactive deposits to perform predictive assessments. Then, the author presents an iterative method of assessment of post-accident consequences: organization of environment radioactivity measurement programmes, periodic update of mapping of initial deposit and of actual deposits at a given time

  10. In vitro clinical trials: the future of cell-based profiling

    Directory of Open Access Journals (Sweden)

    Nathan T Ross

    2014-05-01

    Full Text Available The drug discovery process classically revolves around a set of biochemical and cellular assays to drive potency optimization and structural-activity relationship (SAR models. Layered on top of these concepts is the inclusion of molecular features that affect final drug use, things like: bioavailability, toxicity, stability, solubility, formulation, route of administration, etc. Paradoxically, most drugs entering clinical trials are only tested in a handful of human genetic backgrounds before they are given to people. Here we review efforts and opine on the use of large scale in vitro cellular and in vivo models that attempt to model human disease and include diversity found in the human genetic population. Because hundreds to thousands of individual assays are needed to scratch the surface of human genetic diversity, sophisticated high throughput automation technologies or pooling & deconvolution strategies are required. Characterization of each model needs to be extensive to enable non-biased informatics based modeling. Such approaches will enable deep understanding of genetic to pharmacological response and result in new methods for patient stratification in the clinic. Oncology medicines and cancer genetics have been paving the way for these approaches and we expect to see continued expansion to other fields such as immunology and neuroscience.

  11. Expanding the Evidence Base: Comparing Randomized Controlled Trials and Observational Studies of Statins.

    Science.gov (United States)

    Atar, Dan; Ong, Seleen; Lansberg, Peter J

    2015-01-01

    It is widely accepted that randomized controlled trials (RCTs) are the gold standard for demonstrating the efficacy of a given therapy (results under ideal conditions). Observational studies, on the other hand, can complement this by demonstrating effectiveness (results under real-world conditions). To examine the role that observational studies can play in complementing data from RCTs, we reviewed published studies for statins, a class of drugs that have been widely used to reduce the risk of cardiovascular (CV) events by lowering low-density lipoprotein cholesterol levels. RCTs have consistently demonstrated the benefits of statin treatment in terms of CV risk reduction and have demonstrated that more intensive statin therapy has incremental benefits over less intensive treatment. Observational studies of statin use in 'real-world' populations have served to augment the evidence base generated from statin RCTs in preselected populations of patients who are often at high CV risk and have led to similar safety and efficacy findings. They have also raised questions about factors affecting medication adherence, under-treatment, switching between statins, and failure to reach low-density lipoprotein cholesterol target levels, questions for which the answers could lead to improved patient care.

  12. Task-Based Mirror Therapy Augmenting Motor Recovery in Poststroke Hemiparesis: A Randomized Controlled Trial.

    Science.gov (United States)

    Arya, Kamal Narayan; Pandian, Shanta; Kumar, Dharmendra; Puri, Vinod

    2015-08-01

    To establish the effect of the task-based mirror therapy (TBMT) on the upper limb recovery in stroke. A pilot, randomized, controlled, assessor-blinded trial was conducted in a rehabilitation institute. A convenience sample of 33 poststroke (mean duration, 12.5 months) hemiparetic subjects was randomized into 2 groups (experimental, 17; control, 16). The subjects were allocated to receive either TBMT or standard motor rehabilitation-40 sessions (5/week) for a period of 8 weeks. The TBMT group received movements using various goal-directed tasks and a mirror box. The movements were performed by the less-affected side superimposed on the affected side. The main outcome measures were Brunnstrom recovery stage (BRS) and Fugl-Meyer assessment (FMA)-FMA of upper extremity (FMA-UE), including upper arm (FMA-UA) and wrist-hand (FMA-WH). The TBMT group exhibited highly significant improvement on mean scores of FMA-WH (P hemiparesis. MT using tasks may be used as an adjunct in stroke rehabilitation. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  13. Promoting first relationships: randomized trial of a relationship-based intervention for toddlers in child welfare.

    Science.gov (United States)

    Spieker, Susan J; Oxford, Monica L; Kelly, Jean F; Nelson, Elizabeth M; Fleming, Charles B

    2012-11-01

    We conducted a community-based, randomized control trial with intent-to-treat analyses of Promoting First Relationships (PFR) to improve parenting and toddler outcomes for toddlers in state dependency. Toddlers (10-24 months; N = 210) with a recent placement disruption were randomized to 10-week PFR or a comparison condition. Community agency providers were trained to use PFR in the intervention for caregivers. From baseline to postintervention, observational ratings of caregiver sensitivity improved more in the PFR condition than in the comparison condition, with an effect size for the difference in adjusted means postintervention of d = .41. Caregiver understanding of toddlers' social emotional needs and caregiver reports of child competence also differed by intervention condition postintervention (d = .36 and d = .42) with caregivers in the PFR condition reporting more understanding of toddlers and child competence. Models of PFR effects on within-individual change were significant for caregiver sensitivity and understanding of toddlers. At the 6-month follow-up, only 61% of original sample dyads were still intact and there were no significant differences on caregiver or child outcomes.

  14. Mobile-Based Video Learning Outcomes in Clinical Nursing Skill Education: A Randomized Controlled Trial.

    Science.gov (United States)

    Lee, Nam-Ju; Chae, Sun-Mi; Kim, Haejin; Lee, Ji-Hye; Min, Hyojin Jennifer; Park, Da-Eun

    2016-01-01

    Mobile devices are a regular part of daily life among the younger generations. Thus, now is the time to apply mobile device use to nursing education. The purpose of this study was to identify the effects of a mobile-based video clip on learning motivation, competence, and class satisfaction in nursing students using a randomized controlled trial with a pretest and posttest design. A total of 71 nursing students participated in this study: 36 in the intervention group and 35 in the control group. A video clip of how to perform a urinary catheterization was developed, and the intervention group was able to download it to their own mobile devices for unlimited viewing throughout 1 week. All of the students participated in a practice laboratory to learn urinary catheterization and were blindly tested for their performance skills after participation in the laboratory. The intervention group showed significantly higher levels of learning motivation and class satisfaction than did the control. Of the fundamental nursing competencies, the intervention group was more confident in practicing catheterization than their counterparts. Our findings suggest that video clips using mobile devices are useful tools that educate student nurses on relevant clinical skills and improve learning outcomes.

  15. Pilot trial of a dissonance-based cognitive-behavioral group depression prevention with college students.

    Science.gov (United States)

    Rohde, Paul; Stice, Eric; Shaw, Heather; Gau, Jeff M

    2016-07-01

    Conduct a pilot trial testing whether a new cognitive-behavioral (CB) group prevention program that incorporated cognitive-dissonance change principles was feasible and appeared effective in reducing depressive symptoms and major depressive disorder onset relative to a brochure control condition in college students with elevated depressive symptoms. 59 college students (M age = 21.8, SD = 2.3; 68% female, 70% White) were randomized to the 6-session Change Ahead group or educational brochure control condition, completing assessments at pretest, posttest, and 3-month follow-up. Recruitment and screening methods were effective and intervention attendance was high (86% attended all 6 sessions). Change Ahead participants showed medium-large reductions in depressive symptoms at posttest (M d = 0.64), though the effect attenuated by 3-month follow-up. Incidence of major depression onset at 3-month follow-up was 4% for Change Ahead participants versus 13% (difference ns). Change Ahead appears highly feasible and showed positive indications of reduced acute phase depressive symptoms and MDD onset relative to a minimal intervention control in this initial pilot. Given the brevity of the intervention, its apparent feasibility, and the lack of evidence-based depression prevention programs for college students, continued evaluation of Change Ahead appears warranted. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Recombinant streptokinase vs phenylephrine-based suppositories in acute hemorrhoids, randomized, controlled trial (THERESA-3)

    Science.gov (United States)

    Hernández-Bernal, Francisco; Castellanos-Sierra, Georgina; Valenzuela-Silva, Carmen M; Catasús-Álvarez, Karem M; Valle-Cabrera, Roselin; Aguilera-Barreto, Ana; López-Saura, Pedro A

    2014-01-01

    AIM: To compare the efficacy and safety of recombinant streptokinase (rSK) and phenylephrine-based suppositories in acute hemorrhoidal disease. METHODS: A multicenter (14 sites), randomized (1:1), open, parallel groups, active controlled trial was done. After inclusion, subjects with acute symptoms of hemorrhoids, who gave their written, informed consent to participate, were centrally randomized to receive, as outpatients, rSK (200000 IU) or 0.25% phenylephrine suppositories, which had different organoleptic characteristics. Treatment was administered by the rectal route, one unit every 6 h during 48 h for rSK, and up to a maximum of 5 d (20 suppositories) for phenylephrine. Evaluations were performed at 3, 5 and 10 d post-inclusion. The main end-point was the 5th-day complete clinical response (disappearance of pain and edema, and ≥ 70% reduction of the lesion size). Time to response and need for thrombectomy were secondary efficacy variables. Adverse events were evaluated too. RESULTS: 5th day complete response rates were 83/110 (75.5%) and 36/110 (32.7%) with rSK and phenylephrine suppositories, respectively. This 42.7% difference (95%CI: 30.5-54.2) was highly significant (P hemorrhoidal illness, with an adequate safety profile. PMID:24587636

  17. Recombinant streptokinase vs phenylephrine-based suppositories in acute hemorrhoids, randomized, controlled trial (THERESA-3).

    Science.gov (United States)

    Hernández-Bernal, Francisco; Castellanos-Sierra, Georgina; Valenzuela-Silva, Carmen M; Catasús-Álvarez, Karem M; Valle-Cabrera, Roselin; Aguilera-Barreto, Ana; López-Saura, Pedro A

    2014-02-14

    To compare the efficacy and safety of recombinant streptokinase (rSK) and phenylephrine-based suppositories in acute hemorrhoidal disease. A multicenter (14 sites), randomized (1:1), open, parallel groups, active controlled trial was done. After inclusion, subjects with acute symptoms of hemorrhoids, who gave their written, informed consent to participate, were centrally randomized to receive, as outpatients, rSK (200000 IU) or 0.25% phenylephrine suppositories, which had different organoleptic characteristics. Treatment was administered by the rectal route, one unit every 6 h during 48 h for rSK, and up to a maximum of 5 d (20 suppositories) for phenylephrine. Evaluations were performed at 3, 5 and 10 d post-inclusion. The main end-point was the 5(th)-day complete clinical response (disappearance of pain and edema, and ≥ 70% reduction of the lesion size). Time to response and need for thrombectomy were secondary efficacy variables. Adverse events were evaluated too. 5(th) day complete response rates were 83/110 (75.5%) and 36/110 (32.7%) with rSK and phenylephrine suppositories, respectively. This 42.7% difference (95%CI: 30.5-54.2) was highly significant (P suppositories showed a significant advantage over a widely used over-the-counter phenylephrine preparation for the treatment of acute hemorrhoidal illness, with an adequate safety profile.

  18. Combining auctions and performance-based payments in a forest enrichment field trial in Western Kenya.

    Science.gov (United States)

    Khalumba, Mercelyne; Wünscher, Tobias; Wunder, Sven; Büdenbender, Mirjam; Holm-Müller, Karin

    2014-06-01

    Cost-effectiveness is an important aspect in the assessment of payments for environmental services (PES) initiatives. In participatory field trials with communities in Western Kenya, we combined procurement auctions for forest enrichment contracts with performance-based payments and compared the outcomes with a baseline scenario currently used by the Kenyan Forest Service. Procurement auctions were the most cost-effective. The competitive nature of the auction reduced contracting expenses (provision costs), and the result-oriented payments provided additional incentives to care for the planted seedlings, resulting in their improved survival rates (service quantity). These gains clearly exceeded increases in transaction costs associated with conducting an auction. The number of income-poor auction participants and winners was disproportionately high and local institutional buy-in was remarkably strong. Our participatory approach may, however, require adaptations when conducted at a larger scale. Although the number of contracts we monitored was limited and prohibited the use of statistical tests, our study is one of the first to reveal the benefits of using auctions for PES in developing countries. © 2014 Society for Conservation Biology.

  19. Results of a Community-Based Randomized Trial to Increase Colorectal Cancer Screening Among Filipino Americans

    Science.gov (United States)

    Bastani, Roshan; Danao, Leda L.; Antonio, Cynthia; Garcia, Gabriel M.; Crespi, Catherine M.

    2010-01-01

    Objectives. We conducted 1 of the first community-based trials to develop a multicomponent intervention that would increase colorectal cancer screening among an Asian American population. Methods. Filipino Americans (n = 548) nonadherent to colorectal cancer (CRC) screening guidelines were randomized into an intervention group that received an education session on CRC screening and free fecal occult blood test (FOBT) kits; a second intervention group that received an education session but no free FOBT kits; and a control group that received an education session on the health benefits of physical activity. Results. Self-reported CRC screening rates during the 6-month follow-up period were 30%, 25%, and 9% for participants assigned to intervention with FOBT kit, intervention without the kit, and control group, respectively. Participants in either of the 2 intervention groups were significantly more likely to report screening at follow-up than were participants in the control group. Conclusions. A multicomponent intervention that includes an educational group session in a community setting can significantly increase CRC screening among Filipino Americans, even when no free FOBT kits are distributed. PMID:20864724

  20. Brain Research to Ameliorate Impaired Neurodevelopment - Home-based Intervention Trial (BRAIN-HIT

    Directory of Open Access Journals (Sweden)

    Mahantshetti Niranjana S

    2010-04-01

    Full Text Available Abstract Background This randomized controlled trial aims to evaluate the effects of an early developmental intervention program on the development of young children in low- and low-middle-income countries who are at risk for neurodevelopmental disability because of birth asphyxia. A group of children without perinatal complications are evaluated in the same protocol to compare the effects of early developmental intervention in healthy infants in the same communities. Birth asphyxia is the leading specific cause of neonatal mortality in low- and low-middle-income countries and is also the main cause of neonatal and long-term morbidity including mental retardation, cerebral palsy, and other neurodevelopmental disorders. Mortality and morbidity from birth asphyxia disproportionately affect more infants in low- and low-middle-income countries, particularly those from the lowest socioeconomic groups. There is evidence that relatively inexpensive programs of early developmental intervention, delivered during home visit by parent trainers, are capable of improving neurodevelopment in infants following brain insult due to birth asphyxia. Methods/Design This trial is a block-randomized controlled trial that has enrolled 174 children with birth asphyxia and 257 without perinatal complications, comparing early developmental intervention plus health and safety counseling to the control intervention receiving health and safety counseling only, in sites in India, Pakistan, and Zambia. The interventions are delivered in home visits every two weeks by parent trainers from 2 weeks after birth until age 36 months. The primary outcome of the trial is cognitive development, and secondary outcomes include social-emotional and motor development. Child, parent, and family characteristics and number of home visits completed are evaluated as moderating factors. Discussion The trial is supervised by a trial steering committee, and an independent data monitoring

  1. The role of surgical expertise with regard to chronic postoperative inguinal pain (CPIP) after Lichtenstein correction of inguinal hernia: a systematic review.

    Science.gov (United States)

    Lange, J F M; Meyer, V M; Voropai, D A; Keus, E; Wijsmuller, A R; Ploeg, R J; Pierie, J P E N

    2016-06-01

    The aim of this study was to evaluate whether a relation exists between surgical expertise and incidence of chronic postoperative inguinal pain (CPIP) after inguinal hernia repair using the Lichtenstein procedure . CPIP after inguinal hernia repair remains a major clinical problem despite many efforts to address this problem. Recently, case volume and specialisation have been found correlated to significant improvement of outcomes in other fields of surgery; to date these important factors have not been reviewed extensively enough in the context of inguinal hernia surgery. A systematic literature review was performed to identify randomised controlled trials reporting on the incidence of CPIP after the Lichtenstein procedure and including the expertise of the surgeon. Surgical expertise was subdivided into expert and non-expert. In a total of 16 studies 3086 Lichtenstein procedures were included. In the expert group the incidence of CPIP varied between 6.9 and 11.7 % versus an incidence of 18.1 and 39.4 % in the non-expert group. Due to the heterogeneity between groups no statistical significance could be demonstrated. The results of this evaluation suggest that an association between surgical expertise and CPIP is highly likely warranting further analysis in a prospectively designed study.

  2. Fundamentals of clinical trials

    CERN Document Server

    Friedman, Lawrence M; DeMets, David L; Reboussin, David M; Granger, Christopher B

    2015-01-01

    This is the fifth edition of a very successful textbook on clinical trials methodology, written by recognized leaders who have long and extensive experience in all areas of clinical trials. The three authors of the first four editions have been joined by two others who add great expertise.  Most chapters have been revised considerably from the fourth edition.  A chapter on regulatory issues has been included and the chapter on data monitoring has been split into two and expanded.  Many contemporary clinical trial examples have been added.  There is much new material on adverse events, adherence, issues in analysis, electronic data, data sharing, and international trials.  This book is intended for the clinical researcher who is interested in designing a clinical trial and developing a protocol. It is also of value to researchers and practitioners who must critically evaluate the literature of published clinical trials and assess the merits of each trial and the implications for the care and treatment of ...

  3. Can improving working memory prevent academic difficulties? A school based randomised controlled trial.

    Science.gov (United States)

    Roberts, Gehan; Quach, Jon; Gold, Lisa; Anderson, Peter; Rickards, Field; Mensah, Fiona; Ainley, John; Gathercole, Susan; Wake, Melissa

    2011-06-20

    Low academic achievement is common and is associated with adverse outcomes such as grade repetition, behavioural disorders and unemployment. The ability to accurately identify these children and intervene before they experience academic failure would be a major advance over the current 'wait to fail' model. Recent research suggests that a possible modifiable factor for low academic achievement is working memory, the ability to temporarily store and manipulate information in a 'mental workspace'. Children with working memory difficulties are at high risk of academic failure. It has recently been demonstrated that working memory can be improved with adaptive training tasks that encourage improvements in working memory capacity. Our trial will determine whether the intervention is efficacious as a selective prevention strategy for young children at risk of academic difficulties and is cost-effective. This randomised controlled trial aims to recruit 440 children with low working memory after a school-based screening of 2880 children in Grade one. We will approach caregivers of all children from 48 participating primary schools in metropolitan Melbourne for consent. Children with low working memory will be randomised to usual care or the intervention. The intervention will consist of 25 computerised working memory training sessions, which take approximately 35 minutes each to complete. Follow-up of children will be conducted at 6, 12 and 24 months post-randomisation through child face-to-face assessment, parent and teacher surveys and data from government authorities. The primary outcome is academic achievement at 12 and 24 months, and other outcomes include child behaviour, attention, health-related quality of life, working memory, and health and educational service utilisation. A successful start to formal learning in school sets the stage for future academic, psychological and economic well-being. If this preventive intervention can be shown to be efficacious, then

  4. Teaching of evidence-based medicine to medical students in Mexico: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Sánchez-Mendiola Melchor

    2012-11-01

    Full Text Available Abstract Background Evidence-Based Medicine (EBM is an important competency for the healthcare professional. Experimental evidence of EBM educational interventions from rigorous research studies is limited. The main objective of this study was to assess EBM learning (knowledge, attitudes and self-reported skills in undergraduate medical students with a randomized controlled trial. Methods The educational intervention was a one-semester EBM course in the 5th year of a public medical school in Mexico. The study design was an experimental parallel group randomized controlled trial for the main outcome measures in the 5th year class (M5 EBM vs. M5 non-EBM groups, and quasi-experimental with static-groups comparisons for the 4th year (M4, not yet exposed and 6th year (M6, exposed 6 months to a year earlier groups. EBM attitudes, knowledge and self-reported skills were measured using Taylor’s questionnaire and a summative exam which comprised of a 100-item multiple-choice question (MCQ test. Results 289 Medical students were assessed: M5 EBM=48, M5 non-EBM=47, M4=87, and M6=107. There was a higher reported use of the Cochrane Library and secondary journals in the intervention group (M5 vs. M5 non-EBM. Critical appraisal skills and attitude scores were higher in the intervention group (M5 and in the group of students exposed to EBM instruction during the previous year (M6. The knowledge level was higher after the intervention in the M5 EBM group compared to the M5 non-EBM group (pd=0.88 with Taylor's instrument and 3.54 with the 100-item MCQ test. M6 Students that received the intervention in the previous year had a knowledge score higher than the M4 and M5 non-EBM groups, but lower than the M5 EBM group. Conclusions Formal medical student training in EBM produced higher scores in attitudes, knowledge and self-reported critical appraisal skills compared with a randomized control group. Data from the concurrent groups add validity evidence to the

  5. Can improving working memory prevent academic difficulties? a school based randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Anderson Peter

    2011-06-01

    Full Text Available Abstract Background Low academic achievement is common and is associated with adverse outcomes such as grade repetition, behavioural disorders and unemployment. The ability to accurately identify these children and intervene before they experience academic failure would be a major advance over the current 'wait to fail' model. Recent research suggests that a possible modifiable factor for low academic achievement is working memory, the ability to temporarily store and manipulate information in a 'mental workspace'. Children with working memory difficulties are at high risk of academic failure. It has recently been demonstrated that working memory can be improved with adaptive training tasks that encourage improvements in working memory capacity. Our trial will determine whether the intervention is efficacious as a selective prevention strategy for young children at risk of academic difficulties and is cost-effective. Methods/Design This randomised controlled trial aims to recruit 440 children with low working memory after a school-based screening of 2880 children in Grade one. We will approach caregivers of all children from 48 participating primary schools in metropolitan Melbourne for consent. Children with low working memory will be randomised to usual care or the intervention. The intervention will consist of 25 computerised working memory training sessions, which take approximately 35 minutes each to complete. Follow-up of children will be conducted at 6, 12 and 24 months post-randomisation through child face-to-face assessment, parent and teacher surveys and data from government authorities. The primary outcome is academic achievement at 12 and 24 months, and other outcomes include child behaviour, attention, health-related quality of life, working memory, and health and educational service utilisation. Discussion A successful start to formal learning in school sets the stage for future academic, psychological and economic well-being. If

  6. On the Dynamics of Building Systems of Scientific Expertise: The Case of Ionizing Radiation

    International Nuclear Information System (INIS)

    Boudia, Soraya

    2008-01-01

    An examination of historical work shows that several systems of scientific expertise were shaped by public controversies. Taking the case of the health and environmental hazards of radioactivity as an example, this articles seeks to account for a twofold dynamic at work in building and/or reconfiguring systems of scientific expertise: expertise either as a resource to manage public mobilisation or as vector whereby some of the criticisms are incorporated into existing institutional systems by reconfiguring them or setting up new organisations

  7. Recommendations for centres of expertise in rare anaemias. The ENERCA White Book

    OpenAIRE

    Joan-Lluis Vives Corrons; María del Mar Mañú Pereira; Carlos Romeo-Casabona; Pilar Nicolás; Béatrice Gulbis; Androulla Eleftheriou; Michael Angastiniotis; Patricia Aguilar Martínez; Paola Bianchi; Richard Van Wijk; Hermann Heimpel; Barbara De la Salle; Andrea Mosca

    2014-01-01

    The Community added value of Centres of Expertise (CoE) and European Reference Networks (ERN) is particularly high for rare diseases (RD) due to the rarity of these conditions, which implies both a small number of patients and scarcity of expertise within a single country. Gathering expertise at the European level is therefore, paramount in order to ensure equal access to accurate information, appropriate and timely diagnosis and high quality clinical care and follow up for patients with rare...

  8. Architecture design of a generic centralized adjudication module integrated in a web-based clinical trial management system.

    Science.gov (United States)

    Zhao, Wenle; Pauls, Keith

    2016-04-01

    Centralized outcome adjudication has been used widely in multicenter clinical trials in order to prevent potential biases and to reduce variations in important safety and efficacy outcome assessments. Adjudication procedures could vary significantly among different studies. In practice, the coordination of outcome adjudication procedures in many multicenter clinical trials remains as a manual process with low efficiency and high risk of delay. Motivated by the demands from two large clinical trial networks, a generic outcome adjudication module has been developed by the network's data management center within a homegrown clinical trial management system. In this article, the system design strategy and database structure are presented. A generic database model was created to transfer different adjudication procedures into a unified set of sequential adjudication steps. Each adjudication step was defined by one activate condition, one lock condition, one to five categorical data items to capture adjudication results, and one free text field for general comments. Based on this model, a generic outcome adjudication user interface and a generic data processing program were developed within a homegrown clinical trial management system to provide automated coordination of outcome adjudication. By the end of 2014, this generic outcome adjudication module had been implemented in 10 multicenter trials. A total of 29 adjudication procedures were defined with the number of adjudication steps varying from 1 to 7. The implementation of a new adjudication procedure in this generic module took an experienced programmer 1 or 2 days. A total of 7336 outcome events had been adjudicated and 16,235 adjudication step activities had been recorded. In a multicenter trial, 1144 safety outcome event submissions went through a three-step adjudication procedure and reported a median of 3.95 days from safety event case report form submission to adjudication completion. In another trial

  9. Preventing smoking relapse via Web-based computer-tailored feedback: a randomized controlled trial.

    Science.gov (United States)

    Elfeddali, Iman; Bolman, Catherine; Candel, Math J J M; Wiers, Reinout W; de Vries, Hein

    2012-08-20

    Web-based computer-tailored approaches have the potential to be successful in supporting smoking cessation. However, the potential effects of such approaches for relapse prevention and the value of incorporating action planning strategies to effectively prevent smoking relapse have not been fully explored. The Stay Quit for You (SQ4U) study compared two Web-based computer-tailored smoking relapse prevention programs with different types of planning strategies versus a control group. To assess the efficacy of two Web-based computer-tailored programs in preventing smoking relapse compared with a control group. The action planning (AP) program provided tailored feedback at baseline and invited respondents to do 6 preparatory and coping planning assignments (the first 3 assignments prior to quit date and the final 3 assignments after quit date). The action planning plus (AP+) program was an extended version of the AP program that also provided tailored feedback at 11 time points after the quit attempt. Respondents in the control group only filled out questionnaires. The study also assessed possible dose-response relationships between abstinence and adherence to the programs. The study was a randomized controlled trial with three conditions: the control group, the AP program, and the AP+ program. Respondents were daily smokers (N = 2031), aged 18 to 65 years, who were motivated and willing to quit smoking within 1 month. The primary outcome was self-reported continued abstinence 12 months after baseline. Logistic regression analyses were conducted using three samples: (1) all respondents as randomly assigned, (2) a modified sample that excluded respondents who did not make a quit attempt in conformance with the program protocol, and (3) a minimum dose sample that also excluded respondents who did not adhere to at least one of the intervention elements. Observed case analyses and conservative analyses were conducted. In the observed case analysis of the randomized sample

  10. Effectiveness of web-based tailored advice on parents' child safety behaviors: randomized controlled trial.

    Science.gov (United States)

    van Beelen, Mirjam Elisabeth Johanna; Beirens, Tinneke Monique Jozef; den Hertog, Paul; van Beeck, Eduard Ferdinand; Raat, Hein

    2014-01-24

    Injuries at home are a major cause of death, disability, and loss of quality of life among young children. Despite current safety education, required safety behavior of parents is often lacking. To prevent various childhood disorders, the application of Web-based tools has increased the effectiveness of health promotion efforts. Therefore, an intervention with Web-based, tailored, safety advice combined with personal counseling (E-Health4Uth home safety) was developed and applied. To evaluate the effect of E-Health4Uth home safety on parents' safety behaviors with regard to the prevention of falls, poisoning, drowning, and burns. A randomized controlled trial was conducted (2009-2011) among parents visiting well-baby clinics in the Netherlands. Parents were randomly assigned to the intervention group (E-Health4Uth home safety intervention) or to the control condition consisting of usual care. Parents in the intervention condition completed a Web-based safety behavior assessment questionnaire; the resulting tailored safety advice was discussed with their child health care professional at a well-baby visit (age approximately 11 months). Parents in the control condition received counseling using generic safety information leaflets at this well-baby visit. Parents' child safety behaviors were derived from self-report questionnaires at baseline (age 7 months) and at follow-up (age 17 months). Each specific safety behavior was classified as safe/unsafe and a total risk score was calculated. Logistic and linear regression analyses were used to reveal differences in safety behavior between the intervention and the control condition at follow-up. A total of 1292 parents (response rate 44.79%) were analyzed. At follow-up, parents in the intervention condition (n=643) showed significantly less unsafe behavior compared to parents in the control condition (n=649): top of staircase (23.91% vs. 32.19%; OR 0.65, 95% CI 0.50-0.85); bottom of staircase (63.53% vs. 71.94%; OR 0

  11. Internet-Based Cognitive Behavioral Therapy for Children and Adolescents With Dental Anxiety: Open Trial.

    Science.gov (United States)

    Shahnavaz, Shervin; Hedman-Lagerlöf, Erik; Hasselblad, Tove; Reuterskiöld, Lena; Kaldo, Viktor; Dahllöf, Göran

    2018-01-22

    Cognitive behavioral therapy (CBT) is an evidence-based method for treating specific phobias, but access to treatment is difficult, especially for children and adolescents with dental anxiety. Psychologist-guided Internet-based CBT (ICBT) may be an effective way of increasing accessibility while maintaining treatment effects. The aim of this study was to test the hypothesis that psychologist-guided ICBT improves school-aged children's and adolescents' ability to manage dental anxiety by (1) decreasing avoidance and affecting the phobia diagnosis and (2) decreasing the dental fear and increasing the target groups' self-efficacy. The study also aimed to examine the feasibility and acceptability of this novel treatment. This was an open, uncontrolled trial with assessments at baseline, posttreatment, and the 1-year follow-up. The study enrolled and treated 18 participants. The primary outcome was level of avoidance behaviors, as measured by the picture-guided behavioral avoidance test (PG-BAT). The secondary outcome was a diagnostic evaluation with the parents conducted by a psychologist. The specific phobia section of the structured interview Kiddie-Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime (K-SADS-PL) was used. Other outcome measures included level of dental anxiety and self-efficacy. The ICBT, which employed exposure therapy, comprised 12 modules of texts, animations, dentistry-related video clips, and an exercise package (including dental instruments). Participants accessed the treatment through an Internet-based treatment platform and received Web-based guidance from a psychologist. Treatment also included training at dental clinics. Feasibility and acceptability were assessed by measures of engagement, adherence, compliance, completed measures, patient and parent satisfaction scale, and staff acceptability. The level of avoidance (according to the primary outcome measure PG-BAT) and dental anxiety decreased

  12. Eye Movement Correlates of Expertise in Visual Arts.

    Science.gov (United States)

    Francuz, Piotr; Zaniewski, Iwo; Augustynowicz, Paweł; Kopiś, Natalia; Jankowski, Tomasz

    2018-01-01

    The aim of this study was to search for oculomotor correlates of expertise in visual arts, in particular with regard to paintings. Achieving this goal was possible by gathering data on eye movements of two groups of participants: experts and non-experts in visual arts who viewed and appreciated the aesthetics of paintings. In particular, we were interested in whether visual arts experts more accurately recognize a balanced composition in one of the two paintings being compared simultaneously, and whether people who correctly recognize harmonious paintings are characterized by a different visual scanning strategy than those who do not recognize them. For the purposes of this study, 25 paintings with an almost ideal balanced composition have been chosen. Some of these paintings are masterpieces of the world cultural heritage, and some of them are unknown. Using Photoshop, the artist developed three additional versions of each of these paintings, differing from the original in the degree of destruction of its harmonious composition: slight, moderate, or significant. The task of the participants was to look at all versions of the same painting in pairs (including the original) and decide which of them looked more pleasing. The study involved 23 experts in art, students of art history, art education or the Academy of Fine Arts, and 19 non-experts, students in the social sciences and the humanities. The experimental manipulation of comparing pairs of paintings, whose composition is at different levels of harmony, has proved to be an effective tool for differentiating people because of their ability to distinguish paintings with balanced composition from an unbalanced one. It turned out that this ability only partly coincides with expertise understood as the effect of education in the field of visual arts. We also found that the eye movements of people who more accurately appreciated paintings with balanced composition differ from those who more liked their altered

  13. 2004-2015 A decade of expertise on climate economics

    International Nuclear Information System (INIS)

    Ducret, Pierre; Leguet, Benoit

    2015-01-01

    I4CE - the Institute for Climate Economics is an initiative of the Caisse des Depots, which continues to support it, and the Agence Francaise de Developpement, which has joined this project, giving the Institute a strong international dimension. The two major French public financial institutions are thus joining forces to create a real think tank, open to other partnerships. From the outset, I4CE benefits from the expertise and reputation which CDC Climat Research has acquired over ten years through its publicly available research, its discussions with public and private decision makers, and its research partnerships with other teams in France, Europe and around the world. I4CE aims at strengthening this independent economic expertise and increasing its influence. The creation of I4CE in 2015 is a step towards creating an agenda of solutions for the climate. I4CE hopes that its work will feed into efforts by France and international negotiators to reach an agreement in Paris in December 2015. However, I4CE has long believed that the transition towards a 'de-carbonised' economy which is resilient to climate change does not depend solely upon work by governments. I4CE believes that three other categories of stakeholders are just as essential for ensuring that this change is successful: - the industrial sector, and the energy sector in particular, the speed of transformation of which will depend greatly upon the inclusion of a carbon price in its model; - the finance sector which now must incorporate the 2 deg. C objective into the way in which it allocates capital; - regional stakeholders which decide on the future of cities, agriculture and forestry. I4CE has developed and organised its research programme for the coming years around these three areas, with the aim of providing its partners with the keys to understanding and decision making, acting as a meeting point for the best academic work and the constraints of political and economic action. This

  14. [The profile of neonaticide mothers in legal expertise].

    Science.gov (United States)

    Vellut, N; Simmat-Durand, L; Tursz, A

    2013-10-01

    Neonaticide is the term used to refer to the killing of newborn infants within the first 24 hours of life. A recent study conducted by Inserm Unit 750 found a frequency of 2.1 cases of neonaticide for 100,000 births in France. The persistence of these crimes raises serious issues, and scientists have attempted to explain this by the profile of neonaticidal mothers: young, or even teenage, single, primiparous, and socially deprived. The present study sought to question this profile, and to suggest a new profile for neonaticidal mothers. This retrospective study over the years 1996-2000 comprised 32 cases of neonaticide perpetrated in three French regions. Seventeen solved cases of these 32 cases generated 54 documents by expert consultants, mainly psychiatric and psychological expertise, studied and analysed here using Modalisa software for quantitative analyses and Nvivo software for qualitative data. No single socio-demographic profile was observed. The mothers were in contrasting situations at the time of the event. There were few psychotic profiles. The other psychopathological disturbances detected were very often related to the event. The most surprising feature in the expert reports describing the neonaticidal mothers was the existence of what we have termed "descriptive absent-factors". These mothers had not experienced major trauma in childhood such as the death of persons close or foster care. They were not living in an environment of family violence. They did not exhibit addictive or self-harm behaviour. Their parents before them had similar profiles, except three cases of alcoholism. Their parentage, and that of the infants, was not an issue. The most widely described personality features were immaturity, dependency on others, withdrawal, inhibition, emptiness, lack of affectivity, non-expressiveness, and devaluation of self-image. The very impoverished relational environment of these mothers also appears in the expertise data. Their affective and

  15. Managing nuclear knowledge and expertise - An industry perspective

    International Nuclear Information System (INIS)

    Garderet, Ph.

    2002-01-01

    Full text: The industrial demand for expertise and qualified personnel in nuclear sciences and technologies will obviously continue to be strong during the next decades: in all cases, a high level of competence will necessarily continue to be required to maintain high performances in operating current nuclear facilities (up to decommissioning) ; moreover, additional skills are to be engaged to conceive new projects or to propose new services for new industrial customers. The industrial needs evidently show some quantitative or qualitative specificities according to the strategy each country has adopted in the past or is adopting now for the use of nuclear power or other nuclear technologies. But the general trends concerning the access to qualified knowledge in nuclear sciences and technologies are globally the same, so concrete actions have to be taken as soon as possible to anticipate difficult situations and overcome the problems. In the countries where nuclear industry has been strongly developed during the past decades (for example France) the problem chiefly concerns the relative ageing of the human workforce and the ability to maintain the accumulated knowledge and replace technical expertise at the very moment when all the technological companies show a significant decline in the number of entrants in all the domain of science and engineering. The problem is reinforced by the fact that (strictly for the same reasons) this phenomenon is observed concurrently within the research laboratories, among the staff of the safety authorities and, more generally, in all the offices engaged in the decision making process about nuclear affairs. Part of the solution to these serious problems stands in the human resources policy that the main nuclear industries have to achieve : internal training through enterprise universities, auto-formation, tutorage of young scientists by seniors, programs of knowledge preservation, international mobility when possible. But more

  16. Eye Movement Correlates of Expertise in Visual Arts

    Directory of Open Access Journals (Sweden)

    Piotr Francuz

    2018-03-01

    Full Text Available The aim of this study was to search for oculomotor correlates of expertise in visual arts, in particular with regard to paintings. Achieving this goal was possible by gathering data on eye movements of two groups of participants: experts and non-experts in visual arts who viewed and appreciated the aesthetics of paintings. In particular, we were interested in whether visual arts experts more accurately recognize a balanced composition in one of the two paintings being compared simultaneously, and whether people who correctly recognize harmonious paintings are characterized by a different visual scanning strategy than those who do not recognize them. For the purposes of this study, 25 paintings with an almost ideal balanced composition have been chosen. Some of these paintings are masterpieces of the world cultural heritage, and some of them are unknown. Using Photoshop, the artist developed three additional versions of each of these paintings, differing from the original in the degree of destruction of its harmonious composition: slight, moderate, or significant. The task of the participants was to look at all versions of the same painting in pairs (including the original and decide which of them looked more pleasing. The study involved 23 experts in art, students of art history, art education or the Academy of Fine Arts, and 19 non-experts, students in the social sciences and the humanities. The experimental manipulation of comparing pairs of paintings, whose composition is at different levels of harmony, has proved to be an effective tool for differentiating people because of their ability to distinguish paintings with balanced composition from an unbalanced one. It turned out that this ability only partly coincides with expertise understood as the effect of education in the field of visual arts. We also found that the eye movements of people who more accurately appreciated paintings with balanced composition differ from those who more liked

  17. Progress and problems for randomized clinical trials: from streptomycin to the era of megatrials.

    Science.gov (United States)

    Hilbrich, Lutz; Sleight, Peter

    2006-09-01

    Randomized clinical trials (RCTs) are the definitive contributors to evidence-based medicine. RCTs assessing serious outcomes in cardiovascular disease have grown, with 'megatrials' becoming more common with the realization that wrong conclusions resulted from random error in inadequately sized trials. Simple design and a heterogeneous patient population were early features, but multinational trials have increased in scientific, logistical, bureaucratic, regulatory, and legal complexity. These studies now exceed the financial means of academia or medical charities. Governments have left the bill with the pharmaceutical industry, encouraging a symbiosis with academics, who contribute medical and scientific expertise, and access to patients. Industry provides pharmacological, pharmaceutical, technical and regulatory know-how, good clinical practice expertise, and legal assistance during the trial. Study supervision is then in the hands of an independent steering committee and associated subcommittees, until appropriate dissemination of results. Prospectively defined interaction with the sponsor facilitates unbiased design and conduct, but arrangements need careful implementation to avoid conflicts of interest. The patient is protected by a strong data safety monitoring board that is wholly independent. Megatrials are under threat from over-regulation, increasing costs, and difficulties in execution. These issues merit urgent public and political education and debate.

  18. A Controlled Randomized Preliminary Trial of a Modified Dissonance-Based Eating Disorder Intervention Program.

    Science.gov (United States)

    Green, M A; Willis, M; Fernandez-Kong, K; Reyes, S; Linkhart, R; Johnson, M; Thorne, T; Lindberg, J; Kroska, E; Woodward, H

    2017-12-01

    We conducted a controlled randomized preliminary trial of a modified dissonance-based eating disorder program (n = 24) compared to an assessment-only control condition (n = 23) via a longitudinal design (baseline, postintervention, 2-month follow-up) in a community sample of women (N = 47) with clinical (n = 22) and subclinical (n = 25) eating disorder symptoms. The traditional content of the Body Project, a dissonance-based eating disorder prevention program, was modified to include verbal, written, and behavioral exercises designed to dissuade self-objectification and maladaptive social comparison. Women with clinical and subclinical symptoms were included in the target audience to investigate both the treatment and the indicated prevention utility of the modified dissonance program. Body dissatisfaction, self-esteem, self-objectification, thin-ideal internalization, maladaptive social comparison, trait anxiety, and eating disorder symptoms were evaluated in the control and the modified dissonance condition at baseline, postintervention, and 2-month follow-up. We predicted a statistically significant 2 (condition: control, modified dissonance) x 3 (time: baseline, postintervention, 2-month follow-up) interaction in the mixed factorial multivariate analyses of variance results. Results confirmed this hypothesis. Eating disorder risk factors and symptoms decreased significantly among participants in the modified dissonance condition at postintervention and 2-month follow-up compared to baseline; symptom improvement was greater among participants in the modified compared to the control condition. A secondary analysis indicated symptom improvement did not vary as a function of symptom status (clinical, subclinical), suggesting the program is efficacious in both indicated prevention and treatment applications. Results provide preliminary support for the modified dissonance program. © 2017 Wiley Periodicals, Inc.

  19. Effects of the X:IT smoking intervention: a school-based cluster randomized trial.

    Science.gov (United States)

    Andersen, Anette; Krølner, Rikker; Bast, Lotus Sofie; Thygesen, Lau Caspar; Due, Pernille

    2015-12-01

    Uptake of smoking in adolescence is still of major public health concern. Evaluations of school-based programmes for smoking prevention show mixed results. The aim of this study was to examine the effect of X:IT, a multi-component school-based programme to prevent adolescent smoking. Data from a Danish cluster randomized trial included 4041 year-7 students (mean age: 12.5) from 51 intervention and 43 control schools. Outcome measure 'current smoking' was dichotomized into smoking daily, weekly, monthly or more seldom vs do not smoke. Analyses were adjusted for baseline covariates: sex, family socioeconomic position (SEP), best friend's smoking and parental smoking. We performed multilevel, logistic regression analyses of available cases and intention-to-treat (ITT) analyses, replacing missing outcome values by multiple imputation. At baseline, 4.7% and 6.8% of the students at the intervention and the control schools smoked, respectively. After 1 year of the intervention, the prevalence was 7.9% and 10.7%, respectively. At follow-up, 553 students (13.7%) did not answer the question on smoking. Available case analyses: crude odds ratios (OR) for smoking at intervention schools compared with control schools: 0.65 (0.48-0.88) and adjusted: 0.70 (0.47-1.04). ITT analyses: crude OR for smoking at intervention schools compared with control schools: 0.67 (0.50-0.89) and adjusted: 0.61 (0.45-0.82). Students at intervention schools had a lower risk of smoking after a year of intervention in year 7. This multi-component intervention involving educational, parental and context-related intervention components seems to be efficient in lowering or postponing smoking uptake in Danish adolescents. © The Author 2015; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

  20. Phase 3 Trial of a Sabin Strain-Based Inactivated Poliovirus Vaccine.

    Science.gov (United States)

    Liao, Guoyang; Li, Rongcheng; Li, Changgui; Sun, Mingbo; Jiang, Shude; Li, Yanping; Mo, Zhaojun; Xia, Jielai; Xie, Zhongping; Che, Yanchun; Yang, Jingsi; Yin, Zhifang; Wang, Jianfeng; Chu, Jiayou; Cai, Wei; Zhou, Jian; Wang, Junzhi; Li, Qihan

    2016-12-01

     The development of a Sabin strain-based inactivated poliovirus vaccine (Sabin-IPV) is imperative to protecting against vaccine-associated paralytic poliomyelitis in developing countries.  In this double-blinded, parallel-group, noninferiority trial, eligible infants aged 60-90 days were randomly assigned in a ratio of 1:1 to receive either 3 doses of Sabin-IPV or Salk strain-based IPV (Salk-IPV) at 30-day intervals and a booster at the age of 18 months. Immunogenicity and safety were assessed on the basis of a protocol.  Of 1438 infants, 1200 eligible infants were recruited and received either Sabin-IPV or Salk-IPV. From the Sabin-IPV and Salk-IPV groups, 570 and 564 infants, respectively, completed the primary immunization and formed the per-protocol population. The seroconversion rates of the participants who received Sabin-IPV were 100%, 94.9%, and 99.0% (types I, II, and III, respectively), and those of the participants who received Salk-IPV were 94.7%, 91.3%, and 97.9% 1 month after the completion of primary immunization. An anamnestic response for poliovirus types I, II, and III was elicited by a booster in both groups. Except in the case of fever, other adverse events were similar between the 2 groups.  The immune response induced by Sabin-IPV was not inferior to that established with Salk-IPV. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.